Wednesday, August 31, 2011

Diabetes Art Day tomorrow!


Hey everybody - tomorrow is Diabetes Art Day!
This is the brainchild of the uber-fabulous Lee Ann Thill.
She also writes at her blog The Butter Compartment - check that out too!







Stay tuned - we are creating for this year.....







Tuesday, August 30, 2011

1st day of school

Back to school! Yep, we started before Labor Day around here. And I sent the troops off. I have one in High School this year, one in Middle School and one in Elementary. Three different schools. If that won't drive me to drink by the end of the year, I don't know what will. I have schedules that rival NATO in their complexity.

The post wouldn't be complete without the requisite first day of school photo, would it?
OK, here you go -

We wear uniforms in our district.
Solid color polo shirt and solid shorts/bottoms.
And my house is a mess.

This year Grace wanted more responsibility when it came to her diabetes care. I am all for that and I usually take her lead when she says she wants more responsibility. Last year, in 3rd grade, she would drop off her care supplies in the nurse's office, report for a 10:30AM BG check, report for lunch check and to get dosed and report there before she left to walk home, to do one last BG check and  pick up her supply case. I have always left her PDM and her care kit in the nurse's office all day, it has not traveled with her.

I know, no one better even leave one comment about how AWFUL a mother I am for leaving her care kit in the nurse's office. OMG. Hey folks, she had complete other care kits in her classroom - extra meter, test strips, juices, snacks, etc. She also had random kits throughout the school. I was prepared, but I didn't do overkill, it's just not my style. Did I endanger her these past 3 years? Nah, don't think so. And if you think I did, don't even think of leaving a comment as such, cause you can just, well...

This year it looks different. Entering 4th grade and no one has morning snack at all in class. Grace also does not want to miss any class this year. So, plans change. I think they should evolve based on our kids.

Grace takes her care kit to her classroom every morning, not the nurse's office. It stays in class with her and Grace does her 10:30AM check on her own in the class. Now, the nurse still wants to know her BG at that time, so we asked Grace - would you like to text the nurse your BG number/dose, etc from your cell phone? Grace nixed that idea cause "CELL PHONES ARE NOT ALLOWED IN SCHOOL" - and she said it just like that to me, like, you big dummy Mommy. OK Grace, got it sister. So, we decided that Grace will, on a post-it, write her 10:30AM BG on a sheet, along with the dose - whether it be insulin or a juice/snack - and plop it on the teacher's desk. Guess what the teacher is gonna do with that? Glance at it, then there will be a classroom job each week - just like the other many jobs the students have, that rotates through the students, called 'runner' who's job it is is to run that paper to the nurse, one floor below them. Problem solved, everyone knows now and Grace doesn't have to leave class, or take the time to run it down.

At lunch, Grace takes her kit 3-4 minutes before the rest of the class and goes to the nurse's office to check and dose for lunch. She leaves her kit there throughout lunch and recess, which follows lunch. On the way back from recess, she picks it up and takes it back to class with her. (In class, she has a separate 'cubby' in the back of the room for her supplies) Before she leaves school for the day, she will do a BG check in the classroom to make sure she is OK to walk home. She's a walker, no busses here as we live a mile from school.


Grace's old stone school there, over 100 years old, isn't that cool?
She walks home from it each day, this is where I meet her.

Now, with all this checking in class, I know we need some ground rules. We need to know what to do with the number. So that everyone is on the same page, I crafted guidelines for numbers. Both the nurse and the teacher have them. Grace has one taped inside her kit, where she can see it as she tests. Hers states these guidelines as 'You' instead of referring to herself in the 3rd person, which would just be odd. Hers also says she is amazing and wonderful and that I love her at the end too. 

Here it is:

Grace’s BG testing in the classroom

250 and above Grace goes to the nurse with her diabetes kit
                            She is OK to walk there by herself.
                                             80 ---- 249       Grace doses herself through her PDM pump remote.
                                             61 ---- 79       Grace has a juice and rechecks her BG in 15 minutes.
                                            60 and below Grace has a juice immediately and sits down.
                                                         Nurse is called to come to the classroom.
                                                      She is NOT OK to walk to the nurse’s office.





So, now everyone knows what to do with the numbers. Grace's range is 80-150, with a target of 120. I let her dose herself up to 249 mark, because that is precisely what she would do in the nurse's office. Over 250, she will go down, get checked and see what's up.

I have given her leeway with her blood sugar numbers because she wants responsibility and I want to give it to her. This is how she is gonna be prepared for Middle School, where she will basically be on her own for her care. So, a little more responsibility now, a little more later in the year if Grace wants, a little more in 5th grade and we will get there.

Thursday, August 25, 2011

What Some Would Call Lies - Go Now!

The DOC. 
No one says it better than Mike Lawson of the wonderfully fantastic blog What Some Would Call Lies
He is everywhere. I mean it, the guy is everywhere. 
And he is one of the awesome parts of the DOC. 
He made a video about it and you should watch it now. 
Seriously. 




Go here and watch his video 

Monday, August 22, 2011

Overnight Basal Testing Joy

We started using Apidra in Grace's OmniPod last week. I know some changes needed to happen, we were 'striking the spike' mightily, not getting high after eating, but we were also having some lows from overcorrecting the highs. But, as with all things, diabetic and otherwise, first things first. So, before I start adjusting things willy-nilly, I needed to get some basal testing in.

Overnight basal test last night. Trying to figure out what happens and why BGs shoot up around midnight - 2 am with this new Apidra. Something needs to be adjusted in her basals. So, I thought I would show you what I do to figure it all out.

She ate dinner and had her last bolus about 5 pm. That gave the go ahead for the overnight basal test to begin about 8 pm, and then be checked every 2 hours. I abide by Gary's rules for basal testing - stay within the 80-250 range and once she either dips low, below 80, or goes above 250, stop the test and treat. He has some great information about basal testing here and here. (Lots of info on it in his book Think Like A Pancreas too, which is coming out in a 2nd revised and updated edition in December 2011!)

Here's how it all went down last night:

8 pm - 106
10 pm - 95
12 am - 144
2 am - 213
9 am - woke up - 141

Got my information! She rose the greatest from 12 am - 2 am, but also had a rise from 10 pm - 12 am.
I write it all down and start my math to make sense of it.

8 pm to 10 pm = decrease of -11 (slight decrease, but I am looking for a 30 point jump up or down)
Keep the rate at this time the same

10 pm to 12 am = rise of +49 points (over the 30 point rise that is the parameter)
Raise her basal rate from 9 pm to 11 pm by .5

12 am to 2 am = rise of +69 points (whoa! way over the 30 point rise parameter)
Raise her basal rate from 11 pm to 1 am by .5 to begin with, then 1.0 if needed

So, then I go back to what her basal rates were when we conducted this test:

12 am - 2 am  .50
2 am - 8 am    .40
8 am - 10 pm  .55
10 pm - 12 am  .60

And I adjust accordingly:

12 am - 2 am  increase to .55
2 am - 8 am   keep at .40 (while the rising BG of 141 is above my liking, school will be starting next wk)
8 am - 11 pm  keep at .55, but lengthen the time to 11 pm instead of 10 pm
11 pm - 12 am  increase to .65

This is what it looks like in my log book. Hey, no judgements.


So, the real test is to try and test drive these new overnight basals. Then I will switch to a morning basal test, then a late afternoon/dinner one. Once I get these done, I will then look at I:C ratios once more and correction factors.

Just thought I would fill you in on how I do it. As always, I'm not a doctor, I don't play one on TV, I do know some doctors, but you should always consult yours or your kiddo's before you change anything. 







Thursday, August 18, 2011

Gary Scheiner's 'Diabetes Bites' newsletter

Gary Scheiner is our CDE and he's just plain wonderful. His company, Integrated Diabetes Services, provides a whole host of services to people with diabetes, both Type 1 and Type 2. Gary himself has been a Type 1 diabetic for more than 25 years, he knows of what he speaks. He's also a pump guru, has worn every pump on the market (and some that never even got to the market or aren't yet on the market!) and speaks wisely about each one.

The greatest thing I have found about Gary is that he listens, problem solves and most of all, teaches. We all want, well, let me speak for myself here, I want a CDE who listens to where we are with diabetes - what we struggle with, what are the complications in our lives - and helps me solve it so that we can live better. And by better I mean healthier - physically and emotionally. Gary listens. He always asks great questions and by questioning he teaches. I always tell him, I want you to teach me, so that I, in turn, can teach Grace. That's where we are right now in our diabetes management. Our diabetes management will evolve over time, as Grace gets older.  I envision a future where Grace may see Gary all by herself and when that day comes, that will be wonderful too.

There isn't a time when I am not with Gary that I don't learn something. It may be how to tweak a basal, how to bolus for rice, a trick about backing out of OmniPod screens and putting in numbers a different way, a new way of looking at numbers, a way of correcting a high and why it's high in the first place. He pours over numbers from Grace's OmniPod with me and as he does, he jots down numbers, draws graphs, looks at percents of highs and lows and suddenly, though it may take me some time at first, the light bulb goes on and I get a clearer picture of what we are doing. I start to understand how to change the rates, how to look at patterns, and how to adjust. And he waits for the light to come on, like a true teacher.

So, this blog post isn't only to rave about Gary, it's to share his monthly newsletter with all of you. I asked him first if that was OK and he gave the resounding 'Yes!' He also wanted me to tell all of you that if you would like to subscribe to his monthly newsletter, entitled 'Diabetes Bites,' that all you have to do is email Debbie at Integrated Diabetes at debbie@integrateddiabetes.com your email address.

Now, his newsletter comes in PDF format, but apparently Blogger doesn't host PDFs, so I had to convert to a Google Doc. (Do I sound like I know what I'm doing, cause I don't) When I converted, some of the formatting did not come through, but honest, the original newsletter is formatted wonderfully!

Here is the link to open the Google Doc of 'Diabetes Bites,' Gary's August 2011 newsletter.

https://docs.google.com/document/d/1MfKgAHhclQM-zRFvZ0ArBggeIVrPVfGwSGs-p35s9mI/edit?hl=en_US

Email debbie@integrateddiabetes.com your email address if you would like to receive Gary's monthly newsletter!


Tuesday, August 16, 2011

Guest Post at Diabetesaliciousness!

It seems we are everywhere these days - gees!

I've guest posted today over at the uber-fabulous Kelly Kunik's Diabetesaliciousness blog
Kelly is one super woman with Type 1, an amazing friend and such an inspiration in the DOC 
(and in real life too!) 
She has become a great friend to both Grace and I.

Head on over to her blog today. I guest posted while she is away in Canada.
And Grace guest posted too, some honest words from my gal.




Monday, August 15, 2011

Grace's interview at Lauren's Hope Blog - Check her out!



Grace is over at Lauren's Hope and their blog today. 
She granted an interview to them about her diabetes. 
They did a fabulous job putting her words to paper.

So, head on over and check out the interview! Click on the title below.
Thanks Lauren's Hope!



Saturday, August 13, 2011

Home from Camp!




She's home. Picked her up on Friday and it was wonderful to see her sweet, punch-stained, grimy face along with her too-knotted-for-words hair. She looked tan and excited and well, like an improved Grace.

I have no words for how it changes her, diabetes camp. She sits among friends when I greet her. She falls back into place among them. And they are all like her, caring for, struggling with, living with diabetes.

It does a heart good to see your child among people who truly understand her.

We walked the same path as last year. I know why it gets to me, this walk up the path with 100+ other parents, when the camp director walks down to where the parents are gathered and announces "it's time to go hug your kids." All these parents, in the same damn boat as me, all feeling the same thing, all having taken a weeklong break from diabetes - but knowing their kids did not, of  walking and coming to retrieve them, to bring them home and start the 24/7 care again.

We all do it. We all walk the path to get our kids. And we don't talk as we do, it's almost reverent.
All the parents just walk up the path. I have tears in my eyes as I do it each year.




This year was different, she was waiting in the dining hall with all the other campers. There was going to be an assembly and singing, then check-out. It was wonderful. The campers were joyous, hugging, singing and being silly, and responded en masse to songs and requests. They knew the inside joke. All ages - from the little littles of 8 to the biggest bigs of 13, counselors, CITs, directors, doctors, nutritionists.



And ok, I cried when they sang the song 'Waltzing with Bears.' You would have too! They were all hugging and swaying together, even the boys. And the sense of camaraderie, the sense of belonging, the sense of surviving-the-whole-week at camp together and living to tell the tale... it was palpable in the air I tell you. It gave me goosebumps and tears. I taped a little for you, to give you the same.

video


Grace tells me about yoga, the zipline, creek stomping, swimming, arts and crafts, campfires and s'mores and sing-a-longs. She tells tales of her new friends and bunking together in the cabin. She happens to mention 'Oh yeah Mom, I did my whole Pod site change myself on Tuesday!' and we high-five as if this is just a blip on the screen of growing up with diabetes. She tells me she helped another girl with being homesick and had a low one night after swimming and oh yes, did she tell me about boating and fishing for teeny-tiny fish in the lake?

You see, the diabetes just rolls on in there. It's just a part of everything else. But it's not the only thing all week at camp. And for that, I thank my blessings, that the experience of camp is not lost in the diabetes. That she remembers what it is to be a kid at camp and have diabetes along with her. I am grateful beyond measure for it, this gift of knowing my gal has this, this sense of herself, that she is one among many, that when it comes down to it, she stands among people in her community who understand her, in a way her family just cannot.

It lightens her, this week.
Some of the burden of being 'the only one' turns into being 'one among many.'

Grace's cabin mates, all Type 1, even the counselors









Tuesday, August 9, 2011

Diabetes Camp - Year #2

Yes, it's that time of year again!
Drum roll please......

Diabetes Camp! 

This is year number two for Grace. You can read about year numero uno here, and the pick up from camp here and her interview about camp here.

And it is now what it must be like from now on when we drive her to camp,
meeting up with old friends,
seeing the same counselors,
hugging those who you missed all year long,
remembering where things were and are in the camp.

This feeling must be wonderful for her. To be remembered. To be part of something larger than yourself. To finally feel like you are in your second home.

I see it on her face even as we walk up the path to check-in. Her feet are lighter. She is smiling and joyous.


We meet up with her DBFF (that's 'Diabetes Best Friend Forever' in case you were wondering) Lily. Yes, famous Lily from our meet-ups and JDRF Walk where we surprised her. Finally, a whole week with each other. It's heaven to both of them.


We check in. We hand over all her diabetes supplies. I complete forms about her basal rates, her I:C ratios, I tell them about -30% for swimming, I tell them that yes, she can carb count with the best of them. 

I hand it all over.

And we get her settled into her bunk. And immediately she is at home.


The goodbyes this year are short and sweet. I tell her to have fun. I tell her to make new friends and remember to include all the new kids in your bunk, who may be here for the first time. I tell her to get the addresses and phone numbers of all the girls so she can write to them throughout the year.

And I kiss her and hug her and tell her, only once, how much I am going to miss her this week.



And I leave her to her second home.





Winner of a Lauren's Hope Bracelet is... Jessica!


We have a winner!!!!



Commenter #3 as determined by www.random.org


(and I cannot seem to load the image from random.org, it keeps saying 'server rejected' - argh!)



Congratulations to Jessica of the blog
'Spunky Mandu' for being the 3rd commenter 
and for winning a Lauren's Hope bracelet that you have chosen, 
along with engraving, sizing and shipping!


Jessica chose the April showers for her daughter!

Jessica, please email me at starrashton@yahoo.com with your email address ASAP.

Thanks to everyone who entered!!!
Denise from My Sweet Bean and her Pod was the original winner, but declined to win this, as she just won a bracelet over at Karen's Bitter-Sweet blog! I think Denise should head to Vegas baby!
Thanks Denise, for sharing the wealth!

Now go check out what Lauren's Hope has to offer - wonderfully stylish and durable medical ID jewelry!



Wednesday, August 3, 2011

Lauren's Hope Medical ID Bracelet GIVEAWAY!

It's a GIVEAWAY!
A spectacular Lauren's Hope bracelet giveaway!

Last day to enter is Monday - hurrry, hurry, hurry!!!!

My last post told you all about how wonderful I think Lauren's Hope medical ID jewelry is. And now, they were gracious enough to offer one of their medical ID bracelets for a giveaway to my readers!

And now,, here are some words from Lauren's Hope, about their medical ID jewelry:


When you or your child was diagnosed with diabetes, your life instantly changed forever. As your doctor explained medical procedures, medications, and other lifestyle adjustments, you may have been overwhelmed thinking about all the things that would have to change. One thing that your condition shouldn't affect, though, is your individualized sense of style! In the past, medical bracelets have been big, bulky, impersonal and unattractive - which meant a lot of people would opt not to wear them.


That’s why Lauren’s Hope was founded - to create medical alert jewelry that people would actually want to wear. This inspiration for the business came from a family friend of the company’s founders.  As a teenager with diabetes, Lauren refused to wear medical ID jewelry because it was “ugly” and could “draw attention” to her illness. Lauren’s mother asked for a fashionable medical ID to keep her daughter safe, and the rest is history.


Today, Lauren’s Hope is still dedicated to making beautiful medical ID jewelry for people of all ages, with any condition, and with any sense of style! Whether you have a style-savvy teenager with diabetes or you feel self-conscious wearing your own chunky diabetes ID to a dinner party, we can help you find a fashionable alternative that will keep you safe. People with diabetes, severe food, drug, and insect allergies, heart conditions, asthma, autism, a visual or hearing impairment, epilepsy, or any chronic illness need to wear medical alert jewelry with that information engraved, as well as people who are on certain medications or are gastric bypass, lap band or organ transplant patients.


In the event of an emergency, your medical ID will do more than just make you look good - it can also save your life.  Your medical ID bracelet should be custom engraved with a few important details so medical personnel will know how to treat you best. They will need to know your name, your medical condition(s), any allergies and important medications that you have, and emergency contact numbers.

The Rules:
1. Entries are one per person. Enter by leaving a comment on this post, with your first name and which bracelet you would like to win in your comment section. I know, I'm a simplistic kind of gal, but no extra entries for Tweeting, Facebooking or putting it up on your blog. That would be great to direct people over here to enter, but you, dear reader, are only getting one entry.
2. Enter until 12:00 AM EST on Monday, August 8th. That gives you all of Monday too!. Winners will be announced on Tuesday, August 9th, right here on this blog!
3. The winner will get their choice of ONE bracelet from Lauren's Hope. The bracelet includes the stainless steel tag, custom engraving and shipping! See, I told you they were nice at Lauren's Hope!



1. Item B90 - Mood Bead Medical ID Bracelet:



This is the Mood Bead medical ID bracelet.  Don't like to keep your emotions all bottled up? Set them free with this psychedelic, color-changing mood bracelet! Featuring color changing mood beads surrounded by Swarovski crystals and sterling silver Bali beads, this medical ID bracelet will take you all the way back to the 70s. Attach your custom engraved medical ID tag to complete the look and show the world what you're feeling.  The lobster clasps attach to your custom engraved medical ID tag.  Slap on your medical ID bracelet and see what kind of mood you are in today!


2. Item C232 -  Fiona Medical ID Bracelet:



This is the Fiona medical ID bracelet.  Everyone loves stylish simplicity - especially when it comes to medical ID jewelry. If you want a style that is elegant-yet-modest, you can't go wrong with this triple strand medical ID bracelet. This sophisticated design features black tubing and gray Swarovski crystals to create a look that is subtly stunning. Simply attach your custom engraved medical ID tag with our signature lobster clasps for instant, trouble-free elegance.


3. Item S140 - April Showers Medical ID Bracelet:

This is our S140 April Showers Medical ID bracelet. They say April showers bring May flowers.  Now you can have flowers anytime of the year.  This darling medical ID bracelet features 3 clay flower shaped beads (colors may vary), surrounded by delicate, colorful beads in pinks, greens and blues with stainless steel lobster clasps. This design will make it feel like springtime all year long!  Attach this sweet medical ID bracelet to your custom engraved medical ID tag and you'll be dancing in the rain!


4. Item A194 - Undercover Medical ID Bracelet:



This is the Undercover medical ID bracelet.  If you are confident and strong, with a bit of an edge, this stainless steel medical ID bracelet is perfect for you.  The unique crisscross pattern and durable stainless steel are things you might not want to keep under wraps! This stylish bracelet can hold up to 3 lines of your important medical information. Combine safety with style when you snap on this medical ID bracelet.


5. Item A148 - Into the Dark Medical ID Bracelet:



This is the Into the Dark medical ID bracelet.  Are you a fan of glow in the dark beads?  This unique medical ID bracelet features 2 lime green glowing beads.  The sides of the bracelet feature black tubing and you can attach this medical ID bracelet to your custom engraved medical ID tag with lobster clasps.



Good luck everyone!
Enter now by commenting. One entry per person.
State which bracelet you would like to win.
Tell your friends!
Giveaway ends midnight on Monday, August 8th.
Winner announced here on Tuesday, August 9th!