Houston . . . We have a Problem!: June 2011

Friday, June 10, 2011

Ah Yeah, It Isn't Freakin' "Magical" --- by: Reyna @ Beta Buddies

5:00 AM

My lovely friend, Reyna from Beta Buddies is guest posting over here with one of her 'greatest hits'. I love this post so much and I truly hope all of my friends and family will read it to understand that Nate's OmniPod is NOT magical. It only works because of the hard work and dedication that we put into it.

Thank you, Reyna for honoring me today by sharing your wonderful post and helping educate my friends and family.

About the title...and yes, I am starting to notice a pattern... with my "about the title" nonsense. I will try to stop after this post. So, back to "about the title"... I sooooo wanted to use the "F" word, but thought of my poor mother and refrained. Love you Mom.

Over a morning cup of coffee with my Mother-In-Law over the Thanksgiving Holiday, camaraderie washed over me as she shared an observation of hers. She had noticed when discussing Joe's diabetes with friends and acquaintances that people somehow, someway, somewhere have gotten the idea that the pump is "magical".

"Magical"... the art of appearing to perform supernatural feats using sleight of hand or other methods... an illusion.

Ah... or...

"Magical"... the use of supernatural methods to manipulate natural forces, such as witchcraft ... paranormal.

So, I think, unfortunately a portion of the general public thinks the pump can perform supernatural feats and perhaps some sort of fucked-up witchcraft resulting in euglycemic bliss. Well, let me share with you this: Nothing could be further from the truth. period.

Hard Work Not "Magic"...

The insulin pump is connected to the user 24/7. It uses short acting insulin that is pumped into the user 24hrs a day at pre-set rates (this is your basal) and then you need to program the pump to deliver insulin (a bolus) every time you eat carbohydrates (which requires you to measure or weigh your food...every time you eat) and whenever the user's blood sugar is high (the correction factor). Because there is only short acting insulin being used several checks need to be done throughout the day to check that the dosages are adequate and that DKA is not looming in the mix.

A typical day looks like this:

(Keep in mind this is everyday...always...there are no breaks...EVER. There is no "magic" people. Managing diabetes takes an incredible amount of work)

7am - Blood Sugar check; weigh cereal, measure milk, add up carbs...and then program the numbers into the pump.

9am - Blood Sugar check; read nutrition label on a snack cracker pack for the carb count...and then program the numbers into the pump.

11am - Blood Sugar check; prepare lunch...bread , measure out jelly using a tablespoon, peanut butter and measure milk...add up carbs...and then program the numbers into the pump.

2pm - Blood Sugar check (if the number is over 200...program the pump to deliver more insulin).

5pm - Blood Sugar check; measure soup, measure milk, add up carbs...and then program numbers into the pump.

7pm - Blood Sugar check (if the number is over 200...program the pump to deliver more insulin).

9pm - Blood Sugar check

11pm - Blood Sugar check

3 am - Blood Sugar check
*and you wonder why we are fucking crazy...

This is a schedule assuming all is going as planned; it doesn't take into account activity, illness, growth, holidays, vacations, etc. Anything and everything can throw off the blood sugar numbers, especially when you are dealing with a young child with type 1.

The advantages of the pump, as I saw them and still perceive them to be, were/are:

1) The ability to work in tenths and hundredths of unit increments of insulin. On injections we were only able to work in 0.5 unit increments. When pumping you can work in minuscule amounts. Trust me when I say this function can compress Blood Sugars that would oscillate like the needle on Pinocchio's Polygraph Test to a more manageable variance.

2) Less piercing of your kids flesh with needles. Most pump sites can be changed out every 3rd day, although it has been found that every other day site changes may be needed for young children. We have been changing Joe's sites out every 36 hours due to a constant issue with site failures. We are in contact with the Animas Rep. and have tried various products. This is what has worked for us to date, but we are still trying to find a more feasible solution.

3) The pump does the math for you. I say this with caution. As the operator of the pump you must take into consideration the activity that has occurred, is about to occur, or is about not to occur. As the operator, you will learn how to handle different foods. I find high Glycemic Index foods require less insulin than the pump calls for. Additionally, I have found that pizza, mac and cheese, and such require a doctorate in nutrition and endocrinology and pumpology and astrology to obtain euglycemia or hell even a 200 point spread.

4) The ability to titrate the basal according to activity. When traveling via car or plane, I crank that baby (the basal) up by 50 to 80% starting an hour before the trip and ending about 30 minutes prior to Joe's feet hitting the pavement. For a PE day, I decrease the basal by 50% an hour before PE and for the duration of PE. For hockey practice or hockey games I decrease the basal by 50% an hour before the said event starts and extend that basal decrease for 4 hours to stave off the post-activity lows.

5) Pumping provides additional tools to utilize when dealing with "troublesome", "meddlesome", "chronic blood sugar busting" foods. As stated above, certain foods require additional measures to keep blood sugars "stabilized" (term being used very loosely here). The "combo" or "square wave" or "extended" bolus features of pumps enable pumpers to attempt to take on these difficult foods with an additional arsenal. I loved A Sweet Grace's post on this particular subject where Penny discussed the difficult to manage foods.

The increased work-load, as I see it:

1) Due to no long acting insulin on board, Diabetic Ketoacidosis onset can be more rapid. You must be diligent in checking ketones when persistent high blood sugars are present. Site changes should be done for unexplainable highs that don't respond to corrections.

2) More frequent blood sugar testing... for DKA... and for setting adjustments.

3) More adjustments and critical thinking skills are required.

4) Childcare and care provided at school becomes more "complicated" with the pump.

Some fears we encountered when taking the "pumping plunge"...

When making the decision to pump, I was worried about my exuberant in all that he encountered 3 year old boy being "hooked-up" to something 24/7/365. I didn't like the thought of it. I was worried that he would get his tubing caught on drawer knobs, door knobs, any sort of knob. I worried about the "visibility" of his condition to the general public by wearing the pump. I worried about DKA from an experience I had in my role as an ICU RN. I can honestly, frankly, and truthfully tell you that I have found all of the above fears unfounded. I think in the 4 years that Joe has been pumping he has only lost 1 site from catching the tubing on a knob. The other fears haven't even been realized. Not once.

Our pump of choice...

We chose the Animas Pump for Joe. I decided on it because of the incredibly small basal rate increments that it could be adjusted by (0.025). Joe was extremely sensitive to insulin at diagnosis and I felt that this was the "go-to Pump" for a little guy. In working with a few different pump brands, I feel the Animas pump is the most intuitive. Admittedly, I am biased. The L.E.D. screen is the bomb! Animas was the best choice for us. Joe has been pumping for four years now. Our "contract" is up with Animas. I plan on researching Medtronic and Omnipod over the next few months to keep my perspective "fresh". Although, I must say it would take a lot of flashy shit for me to switch at this point. Animas has had our back from the start... I am an Animas girl through and through.

Here are some posts that I plan on re-reading: If you have a post that should be included please comment with a link and I will add it. ThankS!

Animas Posts:

Tracy from The Superhero And The Princess about her "Favorite Things" discusses the Animas Ping.
Wendy from Candy Hearts posted an extremely comprehensive post about the Animas Pump here.
The Princess and the Pump's Hallie is also an Animas girl at heart, she posted here.

Medtronic Posts:

Our Diabetic Life's Meri posted on the Medtronic MiniMed Paradigm insulin pump here.

Omnipod Posts:

From Houston,We Have A Problem, a wonderful post about the "tube-less" Omnipod written by Laura. (Oh - Hey - That's Me!)
Lorraine at This is Caleb wrote a fantastic review of the OmniPod here.

If you are just starting the decision making process on whether or not to pump, Donna from The Sugar Kids posted about the decision making and the pump start-up transition here.

Other Links:
Pump Therapy for Children: Weighing the Risks and Benefits
Links to Insulin Pump Information

A day-in-the-life of dispelling the myths of "magical pumps" and making informed decisions.

Thank you again, Reyna!!

| 11 comments

Friday, June 3, 2011

The boy took a header and I grabbed a BG

2:35 PM

In my defense I really didn't know it was that deep. When Nate was a wee one he had a run in with a lamp --- more accurately he tried to pull himself up to a standing position using a lamp cord. It didn't really work out for him. I did however learn from that experience that head wounds bleed!! A lot!

And the boy is tough!

He cried for a few minutes but then stopped.

Similar to the time he face planted out of the Radio Flyer . . .

So, at 1st glance I didn't really think this time was going to be anything more than just a lot of blood so you know I grabbed the meter. Save a finger grab it while you can seemed like a good motto at the time.

Ehhh - - - well turns out it this one was a little deeper than I thought.

Apparently, he was chasing Pancake, tripped on the living room rug, and fell head 1st into the leg of a chair.

Off to the ER ----

Serenity now.

And . . . Yes, he is playing Cut The Rope on my mom's iPhone --- he kicks ass!

| 15 comments

Thursday, June 2, 2011

Blogger Basal - May Edition

4:30 AM

The month of May has been crazy busy for the Houston family and I am guessing we are not alone. I know I for one am WAY behind on blog reading so hopefully, the BB will get us all caught up so that we can start fresh for June. You know June --- the month our children get out of school and are suddenly back in our care 24/7 --- AWESOME! Good Hell - I am so not prepared!

Please forgive my lack of originality but if you read last weeks post about 'losing it all' you know how my D world was rocked and I am still trying to play catch up.

Here we go . . .

May was Celiac Awareness Month --- Want to know more about Celiac? Would you like some help planning meals with Celiac? Well, check out these awesome posts ---

Wendy at Candy Hearts wrote: Our Gluten Free Life - The Stuff We Eat

and

Kris at My Sugar Bugs wrote: May is Celiac Awareness Month

I cannot even begin to tell you how helpful these 2 posts are --- Check. Them. Out. Now.

The month of May brought us D Blog Week. Once again put together by the amazing, Karen @ Bitter~Sweet.

Here are a few of the posts that DBW brought us ---

Jen at I am Your Pancreas wrote A Letter to Dexie --- Dex better step up his game or Jen just might throw him out the window. Wouldn't that be a sight to see?

Misty @ Life is Like a Box of Chocolates wrote her Sweet Ally a letter titled 'I will Fight your Fight' inspired by the Rascal Flatts song 'I Won't Let Go'. It's a beautiful letter written by a loving D Mama to her sweet daughter that I believe all D-Rents can understand.

Sweet, Sweet Haley at Naturally Sweet wrote a letter to all of the Children with Diabetes (CWD). If you have a child with diabetes --- you must read this letter, print it out and share it with your child. Thank you, Haley for being such a wonderful inspiration to the younger children living with type 1. The D-rents thank you for honestly, openness and willingness to share your ups and downs with diabetes with us.

Oh Reyna - Reyna - Reyna @ Beta Buddies . . . my lovely, lovely Reyna wrote an interesting letter to an earthworm. I promise you will never look or think about an earthworm the same way. I saw one today and totally wanted to check the bg on that little guy. Thanks, Reyna!

Nicole @ We Cara Lot wrote a letter about BALANCE. Looking for some balance? Look elsewhere my friends, with diabetes balance is tough to find. I love the example of the picture that shows food, insulin and exercise. Yes, if only diabetes were that easy. Right?

I won't lie - Meri submitted a post for blogger basal but I lost it and she's in the happiest place on earth so I chose this one for her. (Please don't be mad, Meri!) I got to catch up on a lot of blog reading while drafting the May edition of BB and this post from Meri @ Our Diabetic Life really spoke to me. Nighttime. It's a must read. Just to tease you a little bit - here is one part that spoke the loudest to me --- She knows that there are others. Mothers and fathers quietly…tenderly… walking the halls of their homes. They are the guardian angels of their children. It is nice in a way to know that we are not alone.

During this 2nd annual D-Blog Week a lot of us Super Christian, Regis & Kelly watching, Bon-Bon eating (ok I added the last one but it seemed to fit) D-Mamas found PWD blogger, Mike Lawson. He is a crack up for sure but more importantly his honesty and openness about living with type 1 is greatly appreciated by the D-Mama community. His post This is the one with 10 things I hate about Diabetes is so worth the mouse click to get over to his blog.

Lora @ My Diabetic Child -- keeps it real -- ALWAYS. This post on Day 7 of D-Blog week was short, sweet and to the point. Lora and I see eye to eye on the glittery unicorns and how it is ok if we don't see them sparkle everyday.

Denise @ My Sweetest Boy left the choice up to me to select her post for blogger basal. It was too hard to choose just one so I am using 2 of her D-blog Week entries. 1) Dear . . . is a touching post about possibly writing a letter to Bryce (her T1 son) or maybe to her 2 other boys, Jaden and Drew but she decided to write a letter to Diabetes instead. See what she had to say --- I couldn't agree with her words any more that I do!
2) Diabetes Through My Lens - - - I was really drawn to some of the pictures she posted so in case you missed them -- head over and check them out!

Beyond D-Blog week there were some other wonderful posts that I would like to share with you now . . .

Tracy at The Superhero and the Princess posted about Sweet Princess and a program called All About us Kids. The DOC is such a wonderful place to get help, love and support from others living with diabetes. I know that Tracy will agree with me when I say that not only is the DOC so wonderful when it comes to T1D but the support that we get for our Non-D children is nothing short of amazing too.

The next two posts are about how incredibly scary type 1 diabetes can be -- although, we all try to wake up each day with a great, big, glittery smile there are days that diabetes just sucks the life out of you and on those days it's ok to kick the fricking rainbow colored unicorn to the curb, sit down and blog it out. That's what the DOC is all about . . . supporting through the good times and the bad, happiness and sad!

Heidi from D-Tales writes about educating about D and how some when people ask "How Are You?" it's just easier to say 'fine'. Do people really want to know about the 39 that just popped on the meter and do we really need to share with them in front of our kids?

Hallie, Hallie Oh My Goodness grab your tissues for this post from Hallie @ The Princess and the Pump writes about SweetPea and The Scariest Night of Their Lives. There is nothing I can say about this post except that this is it . . . this is what we work so hard to prevent. This is why we check at night. This is why we attach our children to these medical devices. This is why we are here -- because no matter how hard we try and no matter how much we check sometimes things go wrong and when they do the DOC is hear to gently lift you up and support you. Always.

Wa-wa-Wait --- don't put your tissues down. You are going to need them for Chasiti's post at Forget the Chicken Nuggets - You can't play on the Playground until you eat your Fries (Holy Long Blog Name but funny as hell)--- Two Years Ago. It is a beautiful tribute to her baby girl's life being saved 2-years ago.

Heather from Sweet to the Soul writes a post titled Bitter Sweet Days. Sweet Heather talks truthfully about her feelings on having a 2nd T1 diagnosis in the family and finding the right pump for her little Princess. Praying for you and your beautiful family, Heather.

Alexis at Justice's Misbehaving Pancreas allows Justice to tell his story about his diagnosis day. The Day I Got Hurt --- by: Justice

Amy at DiaPeePees posted about another Terrific Tool of the Trade. And aren't we all looking for things to make D just a wee wee (haha - - rhymes with pee pee) bit easier.

Wheeewww . . . if you've made it this far then it is time to get down and have some fun with Denise (aka mom of Bean) from My Sweet Bean and Her Pod. The post is titled -- I'll Spare You the Cupcakes and it quickly became the anthem for D Mamas EVERYWHERE. Thank you, Denise and Ubergeek for rocking the DOC!!

and last but certainly not least . . . Stephanie from My Life as a Pancreas gives some linky love to some awesome peeps in the DOC as well as featuring a very interesting 'Snuggly Pancreas'. Missing your pancreas - - - head on over and check this one out. :)

Thank you again, Denise and Ubergeek (I just really like calling someone Ubergeek) for rockin' the DOC with the official D-Mama anthem . . .

| 13 comments