Tuesday, December 30, 2008

A Year To Be Thankful For

Ahh... it's good to be back. I've been away too long and I've missed my little vent sessions. So much has happened this past year and with the New Year only 26 hours away, I'm feeling the need to stop and reflect; to take stock of what we've learned as a family and how we've grown. For me this has been a year of great gain. I am leaving 2008 a wiser, more grateful and more humble person than I was at it's beginning.

If I had one wish... well... you know what it would be. But Jenna's diagnosis has taught us a great deal. It has allowed us the opportunity to see just how strong we are as individuals and as a family. I'm in awe of Jenna's strength and courage and at such a young age! She isn't phased in the least by her blood sugar checks anymore. Oh sure, once in a while, to exert some control over the situation she'll dodge the lancet. But it isn't for fear of the poke anymore. And her infusion changes are being done without EMLA now, at her request. Seems the Tegaderm dressings we were using to cover the cream was rather uncomfortable when it was removed. She has opted to have infusion set changes done without any numbing and handles them like a pro!

We had an Endo appointment on December 18 and her HgA1c is a very sweet 7.5. Kate, our nurse, was anxious to look at the log book we use to record all of Jenna's blood sugars and boluses to ensure Jenna wasn't having too many low episodes in light of such a good number. Of course she wasn't. It has been our diligence and pump fluency that have gotten us such good results. The time we invested early on in the pump start up is paying off and Jenna is enjoying pretty good blood sugars as a result.

Kate was impressed with how well Jenna is coping with all the blood sugar checks and commented on the type 2 diabetics she works with. Many of them neglect to check their blood sugars because, "...it hurts." She said that she wishes she could introduce them to some of the children with type 1 she has in her practice like Jenna that have those checks performed multiple times a day, often by themselves and without complaining.

Which leads me to something else I've been witness to this year and that is the incredible resilience and strength of children. When it comes to adaptability and prevailing through adversity, they have much to teach adults. Children seem to be able to venture out of their comfort zone easier. And that really is the key to growth and learning. One has to be prepared to endure some discomfort to achieve things. Any athlete will attest to that. In fact, anyone who has accomplished anything extraordinary would probably agree. Maybe that's why children do so much growing and learning in such a small amount of time. They are constantly challenging themselves and taking risks. Adults aren't nearly as willing to take risks and be challenged. Perhaps that is why type 2 diabetes is on such a marked rise. Too many adults are clinging to their comfort zones in the form of comfortable chairs in front of the TV, comfort foods, and all other creature comforts that keep them sedentary and ultimately cause a decline in health. I feel grateful for being given an opportunity to witness and celebrate this strength in my children and be inspired by it.

I'm also grateful for the team my husband and I have become through this. I have read about how much the challenge of managing a child's diabetes is not always evenly shared by parents. Often it is the mother that shoulders most of the responsibility. But I am lucky to have a partner in parenting that takes as much of the responsibility as I do.

I am thankful to have been blessed with my oldest daughter, Jazmine, who's 5 year old heart and capacity for compassion rivals that of many adults. At times I am left stunned by her insightful, kind and gentle way. She is such a good big sister to Jenna and has even comforted me on occasion when she sensed I needed it.

I'm grateful for the network of people I have met, mostly on line, who also live with this disease. Whether they are parents of children with diabetes or adults that have lived with diabetes since they were children, we are all in it together. We all have many and varied experiences but we can relate to one another and feel compelled to celebrate each other's little victories and support one another through the setbacks. I truly am surprised at how much I found I needed to reach out to others who know what it means to be the parent of a type 1 diabetic. I usually like to handle my personal struggles as independently and privately as possible. I couldn't shoulder this one alone though.

I am thankful for the first white Christmas we here on Canada's west coast have had since the late 90's! It was so beautiful.

Finally, I find that in spite of still having moments of sadness that sweep over me like a powerful wave of water when I recall the day that Jenna was diagnosed, I am more thankful than ever for what I have and more optimistic about what the future holds for people living with type 1 diabetes. I'm making a conscious effort to take things one day at a time and not think too much about how my girls will handle all that life has to throw at them in the years to come. It's hard to do at times, but I'm trying.

Happy New Year and may 2009 be full of promise and goodness for all of us.

Thursday, December 25, 2008

Sunday, November 9, 2008

Sometimes you just have to laugh!

Jenna is a going concern for me every single day. And I'm not even talking about her diabetes management. Jenna is a very BUSY little girl. A constant source of exasperation as well as tremendous joy. Today we decided to take a long road trip to visit family. Jenna had packed her little puppy dog back pack with a few board books and some other little trinkets. About a half hour into our journey I became conscious of a ripping sound emanating from the back seat. I look back to find Jenna tearing sheets of paper from her book and chewing on them.

"What are you doing?!" I yell. It never ceases to amaze me what no good deeds I find her up to. I became enraged as this was one in a long list of impish acts Jenna had performed today. I reach back to confiscate the hopelessly marred book and remove the wad of saliva soaked paper from her mouth and begin my rant.

"Please don't rip up your books and for goodness sake don't eat them!! I don't have a carb count for book!" Next thing I knew Jenna broke into a fit of genuine laughter and the rest of the family quickly followed. Jenna got the diabetic humour I inadvertently spouted out in my fit of frustration. I was actually proud of her at that moment. Proud that she could see the humour in her disease. At such a young age she was able to see past the daily drudgery and laugh about things. It was a moment of levity that we all needed. Take THAT diabetes!

Monday, November 3, 2008

Something else to worry about...

OK. So ice cream cake is something to be avoided like the plague. Jenna's blood sugar went through the roof last night and once again I found myself setting my alarm to do wee hour checks. Needless to say I'm a tad punchy today due to sleep deprivation.

I hate these highs as they make me wonder what kind of lasting damage they are doing to my little girl.

A couple of days ago we were out running some errands. A fair bit of walking was involved but the girls seemed to be tolerating it well. Then, as we were walking back to the car after a short stint in the mall, suddenly Jenna began crying in pain with some degree of urgency. I picked her up as she was complaining about pain in her foot. I got her seated in her car seat and she promptly ripped off her shoe and sock all the while whimpering and crying in pain.

I examined the sole of her foot as she indicated that that was where the problem was. I saw nothing remarkable. I examined her sock but again found nothing. I felt around inside her shoe- nothing. All the while Jenna continued to be distressed by obvious discomfort on the sole of her foot. All I kept thinking is that she is developing diabetic neuropathy.

I know that it seems pretty unlikely as Jenna has only been diagnosed with diabetes for not quite six months now and we have had relatively good control in that time. But I just couldn't understand what this pain or discomfort could be and that seemed like the only possibility.

Luckily, I still keep her stroller in the back of the car, even though she seldom uses it anymore. We still had a couple of stops to make and she was agreeable to sitting in her stroller while we finished our errands. Jenna usually wants to walk and is at the stage of toddlerhood where she adamantly refuses to sit in a stroller "...like a baby." So I knew that what ever the problem was, it was causing her a considerable amount of discomfort.

By the time we completed our errands and were headed home, the problem seemed to have resolved. She hasn't complained of this same pain since. But I am still quite preoccupied with trying to decide on any other possible explanation besides diabetic neuropathy.

So if anyone has ever experienced this or has a child with diabetes who has had a similar experience and can share your experience and knowledge with me, I'd be very grateful. I'd love to believe it was completely unrelated... perhaps some kind of growing pains... anything non-diabetic related. But for the life of me, I can't seem to come up with another explanation.

At any rate, it will most definitely be brought up at our next pediatrician and endocrinologist appointment. I'm just terrified by what I might be told.

Sunday, November 2, 2008

I survived my first Halloween as the parent of a child with diabetes! ...t-shirt, please.

WOW!! What a weekend! I definitely feel that I've grown and learned a great deal this weekend. It's been stressful and I've had to work at remaining calm but I made it through our first Halloween. My girls had a great time trick or treating at a local mall. Jazmine went as a fairy and Jenna, a lady bug. We spent close to an hour there, hitting all the stores, then back to the car to do a quick blood sugar check and have one treat before going home for supper. Jenna was pretty low key during the last leg of the trick-or-treating and wanted to be carried out of the mall and through the parking lot to the car. It wasn't surprising, then, to find her blood sugar low at 3.3. Perfect timing!! We rummaged around her treat bag for some sweet-tarts and let her have at it. Then she ripped into a peanut butter cup for good measure.

We spent the rest of the evening in our jammies handing out treats to all the neighbourhood kids willing to brave the wind and rain. Then my girls approved the candy stash we were going to leave for The Great Pumpkin to come in the night and swap for toys (thank you Charlie Brown!) The whole candy swap was a huge hit with both my girls! They have spent most of the weekend playing with their new Barbies together and have watched the Tinkerbell movie left for them at least two times already. Eating treats hasn't really been an issue.

The weekend wrapped up today with a birthday party complete with a buffet table full of treats (mostly healthy) and an ice cream cake with a thick fudge centre, of which Jenna partook like all the other party goers, and enjoyed every last gooey drop!! Thankfully, this birthday party was held at a recreation centre and a huge gymnasium was rented for the little ones to rip it up in for a good hour. Jenna and Jazmine ran their little tushes off! It was a glorious sight to see our little toddler run and play with a seemingly endless supply of energy. I bolused for the cake but had to guess at a carb count. I must have been close because her levels have been pretty good, all things considered. I'm sure the activity helped quite a bit.

In spite of having to chase that high Saturday night due to my inaccurate carb counting, I feel really proud of myself for the way I handled things. I deliberately steered us into situations where I would have to allow Jenna freedom to indulge, all the while quietly monitoring her intake and bolusing as she ate. I don't want food to be an issue for Jenna. I don't want her to feel restricted and treated unfairly. I'm taking to heart all of the advice and wisdom of other people with type 1 in an effort to avoid as much as possible the repercussions and pit-falls of restricting Jenna and blaming it on her diabetes. I figure, if I can get incredibly good at handling situations with ease like guessing carb counts, knowing how to utilize activity to assist in keeping blood sugars in check and anticipating how certain foods will behave once Jenna's eaten them, I can pass on this knowledge to Jenna when she starts to take over her own diabetes management. My mastery of her diabetes will become hers one day. And hopefully Jenna will have a healthy relationship with food and have fond memories of a childhood filled with fun, laughter and a plethora of gastronomic experiences and diabetes will only have been a minor consideration instead of taking center stage. That is my goal.


Once again I find myself up in the night due to mandatory O.T. as issued by that hard assed Big 'D'! I wish I could blame Halloween candy for this but I fear it is my poor carb counting from last night's supper that is mainly to blame. We had homemade waffles, back bacon (lower fat!), and fruit salad.

The trouble arose, I believe, with the carb counts for the waffles. The mix states that, when making pancakes, 1/4 cup of the mix which translates to approximately 2 average sized pancakes is equal to 26 carbs. I thought that same count would carry over to 2 waffles. I fear this may have been a gross under estimation on my part.

Jenna was already 16 mmol/l at bedtime but when we tried to correct, her pump informed us that no bolus was necessary as she still had close to 2 units on board from her supper bolus. This gave me a false sense of security thinking everything was going in the right direction~ DOWN! Nothing was further from the truth.

At 10pm we do what we hoped to be our last check of the night and discover a jaw-dropping 23 blood sugar!! Jenna grabs her water bottle at the side of her bed while I fiddle with her pump and downs almost half it's contents! And the guilt hits me like a ton of bricks! A correction is given and I reluctantly crawl into bed with a sick feeling in the pit of my stomach and the alarm set for two hours later to do a follow-up check.

At a quarter to one in the morning, 45 minutes past the time my husband's alarm was SUPPOSED to go off, I awake with a start. Somehow his phone's alarm didn't sound. I leap out of bed, grab the glucometer and head for Jenna's room. Still high at 16.3 but at least we are now headed in the right direction. I give another correction of 0.35 units with 0.17 still on board and once again set an alarm for two hours later.

And now here I am. Sitting in front of my PC with my fuzzy pink bathrobe on, eyes dry and scratchy, and, ironically, having just stuffed three bite sized chocolates in my mouth. Yes, yes... Halloween candy left overs. I've had more chocolate today than my girls, for crying out loud!

The guilt is my real enemy here. It's what gnaws away and prevents me from getting adequate sleep. Not that I struggle with guilt that often, but when I do it's a real battle.

Well, I'm having trouble composing sentences and holding onto a thought. This could be a sign that I should conclude this entry and get my sorry hiney to bed. I'm feeling chilled here in the lower level of the house and my eyes really are stinging from a desperate need for sleep. Besides, experience has shown me that guilt only magnifies with sleep deprivation. I need sleep.

Saturday, October 25, 2008

Life's Little Pleasures/Lessons

I'm getting good at managing Jenna's diabetes with the pump~ REALLY good! Certain carb factors are now committed to memory so I'm not having to flip through pages of a book to look them up, pre-meal blood sugar checks are almost never forgotten these days and measuring all carbohydrate containing foods before they are placed on Jenna's plate is just becoming part of our daily routine.

I'm also finding that I have gotten to know Jenna's diabetes quite well. I know how certain foods are going to behave after she has eaten them and I can often predict what her blood sugar is going to be before we test her.

All of this sounds like good news, and it is! I'm enjoying feeling more confident about managing Jenna's diabetes. I find I have a bit more free time and my mind isn't constantly being taxed, racing around trying to keep three steps ahead of things.

I do, however, find myself plunging into episodes of sadness again, similar to when Jenna was just diagnosed. I think this is because I have become so fluent with the insulin pump and with the over all management of things, I have more time to think! And when I think, I still find myself in a state of disbelief that this has happened to my little baby girl! She's just brand new, for crying out loud! Shouldn't this kind of shit only happen to old people when the passage of time and a life-time of wear and tear, overindulgence and under-activity causes organs and systems to malfunction and fail?!

Being a registered nurse, I know a lot about this disease from a clinical perspective. I spent a great deal of time studying diabetes while I was in training and certainly had plenty of insulin dependent diabetic patients in my practice (most of them were geriatric patients and type 2.) But in this situation I am the Mom. The nurse in me must take a back seat because my heart is way too involved to be able to maintain the kind of perspective my nursing training might otherwise afford me. And like all Moms I want to know why. Why MY child? How did this happen?

Adding insult to injury is how guilty I feel when I do allow myself to get upset and angry at the cards my Jenna's been dealt. I know how lucky we are. There are mothers and fathers out there dealing with far more heart-breaking scenarios with their precious little ones. This is a manageable disease! Odds are Jenna is going to live a long, healthy, fulfilling life if she is diligent about her care and I'm determined to educate her to the very best of my ability on how to do just that.

But I keep thinking about life before the diagnosis; before the carb counting, food measuring, blood sugar monitoring and infusion site changes and I get so sad knowing that those days are gone for good.

I was out running some errands today and decided to stop and pick up a couple movies to enjoy with my family tonight. While I waited in line to pay, another mom was waiting behind me with her three year old daughter. From their conversation it was apparent they had a fun little night of movie watching planned just the two of them. The little girl picked up a giant bag of M&M's and looked at her mom with a hopeful, pleading expression on her face.

"Sure. We can share those while we watch the movie," was the response her mother gave her without even a moment's hesitation.

Admittedly, I felt feelings of envy at that moment with maybe just a hint of jealousy. I certainly can't sit down with my girls and a giant bag of M&M's while we mindlessly and repeatedly plunge our hands in and indulge. Not that I would have done that anyway. But I have been known, prior to the big "D", to sit down with my girls and a giant bowl of cherries while we all gorge ourselves silly. To diabetes, the source of the carb doesn't really matter a whole lot, be it candy or fruit or starch. A carb is a carb is a carb and each carb needs to be matched with the appropriate amount of insulin. It doesn't discriminate.

Gone are the days of eating with complete disregard to quantity. Everything must be measured and weighed. There can be no more eating from one big communal bowl like most families are inclined to do with things like chips or popcorn. This is a little family ritual that, I must admit, I took completely for granted before the arrival of diabetes made it necessary to closely monitor Jenna's carb consumption. We have to measure out quantities for Jenna and give her her own little portioned out bowl. And to prevent her from feeling like the "odd-man-out" we all get our own little portioned out bowl now as well.

I confess, I kind of miss all of us eating from the same popcorn bowl.

Maybe it was the sight of this Mom and her little girl planning a fun-filled evening with chocolate being part of the festivities or maybe it was my own craving for chocolate which I seldom allow myself to indulge and just couldn't ignore any longer. But later, at the grocery store I found myself looking in the candy section for some little extra indulgence I could bring home and share with my girls while we watched a movie together.

I discovered these neat little "thin" chocolate bars designed, I think, for weight-conscious chocolate lovers who don't want the massive carbohydrate hit of a standard sized chocolate bar. They are only 12 carbs each; perfect for an extra special treat for my family movie night. My girls were just giddy with delight when I presented them with these little goodies and I admit that the choc-aholic in me was pretty chuffed too.

The movies and the snacks were a big hit and as I sat with Jenna snuggled up on my lap and Jazmine nestled in my arms, the three of us enjoying a post chocolate buzz and watching a movie together, I felt so incredibly thankful for my blessings.

...and even though Jenna's sugars have done a delayed climb, as I anticipated they would, and just now, at 11:30pm, I had to do a correction bolus for a blood sugar of 17mmol/l, I have to say that it was worth it, just this once, to enjoy one of life's little pleasures with my girls. These moments won't come very often, but when they do I'll be damned if I'll allow them to be punctuated with guilt and regret~ life's too short.

...and maybe next time I'll employ a combo-bolus to take care of the chocolate carbs.

Thursday, October 23, 2008

More on the whole Halloween hoop-la...

So I've been reading some other blogs, namely SUM (Kerri rocks!) and I've been inspired by some of her readers to re-examine my approach to Halloween, just a little.

I think I'm on the right track with the "Candy Swap" idea, but I don't think I'm being very realistic or... well, let's face it... FUN expecting Jenna to do back flips at the chance to trade her Halloween candy stash for books. How lame is that?

So I'm going to learn from the wisdom of some of Kerri's readers and purchase a few fun little toys to swap. That's not to say I will omit the book idea entirely. I'll just limit it to one or two books. I do get tired of reading the same books to my girls at bedtime. I usually like to take advantage of any opportunity to broaden the selection of reading material.

It was also suggested to allow a treat to be enjoyed during the trick-or-treating; the idea being she would burn off the carbs of the treat while ripping around the neighbourhood. Makes total sense. Only problem is it breaks rule #1. And this is a rule that, as I discussed in yesterday's blog entry, I, myself had to observe in my trick-or-treating days. It was a safety measure since in my day the big urban, Halloween folk-lore was that some kid in some other obscure city somewhere had been poisoned by a treat that had been tampered with. That along with the "razor blade in the apple" horror story caused freaked out parents all over North America to forbid the consumption of candy before it had been thoroughly checked over at home, and to promptly toss all apples obtained during trick-or-treating into the trash. I actually think one would be hard pressed to find a single apple in the bag of any little ghost or goblin on Halloween night to this day. That kind of bad press tends to stick, even though I read not too long ago that it was just an urban myth and never did actually happen.

But I'm getting side-tracked.

My point is that, even though it makes good sense to let Jenna nibble on otherwise forbidden goodies while she gets a little cardio work-out, I think I'll refrain from doing that. It could snowball into a "one treat leads to two, then three..." situation. I also like the idea of looking over all the treats at home for safety sake. You can't be too careful when it comes to your kids.

I will also heed the advice to concentrate more on the costume than the treats. Maybe we will also limit trick-or-treating to just a quick trip around the block then come home to help hand out candy to the other kids. Jenna would love that!

OK. So it'll be alright. I just have to remember not to make that big a deal of it. Jenna shouldn't feel like we are centering her out just because of the big "D". I want her to feel no different than any other kid... at least as much as that is possible, given that she has diabetes and it's Halloween we're talking about here.

Wednesday, October 22, 2008

What's been going on lately...

It's been a busy couple of weeks with Thanksgiving and Halloween preparations, battling more bugs (I'm currently recovering from a little cold virus that, up to this point, I've managed to keep to myself~ fingers crossed), and other assorted tasks of managing the daily operations of our busy household. I've wanted to blog for several days now but the need for rest won out every time I had the urge.

However, today Jenna had a check-up with her endocrinologist and we were "graded" on how well we've been managing Jenna's diabetes so far. Her HgbA1C is... drum roll please... 8.1! Yes, we were quite the hit at the clinic today with that little beauty of a lab value! So with such good news to brag about, I was extra motivated to snuggle up in bed with the ol' lap top and get to typing.

And while I'm here, I may as well mention a couple of other items that have been praying on my mind and are relevant this time of year.

First, I had an experience a few nights back that had me quite puzzled and somewhat concerned. We usually check Jenna's blood sugar around 10pm before retiring for the night. From this reading we make our judgement call as to weather we need to check her again in the night or if we are safe to assume she'll be fine till morning. Usually this is done with little or no problem. More often than not Jenna cooperates and sometimes she sleeps right through it! This night, I'm not sure if we just woke her at the absolute wrong time or what, but she just came unhinged. Crying turned into full on screaming. No amount of consoling would comfort her. In fact, the more we (her Daddy and I) tried to comfort her, the more upset she became. Jenna would tolerate no physical contact from us and adamantly demanded that her Daddy leave the room. She wanted me to stay but to keep my distance. So I sat a few feet away on the floor feeling quite helpless while she screamed and cried and curled herself up into a ball in her pile of stuffies next to her bed.

If this had happened with Diabetes out of the equation, I would have chalked it up to waking a sleeping toddler up in the middle of some pretty intense dreaming. But with diabetes being part of the picture, I couldn't help but wonder if perhaps Jenna was feeling a little off at the time (her blood sugar was slightly high at about 12)and this, coupled with being awakened yet again for another finger stick, which has got to get somewhat annoying after a while, brought her to a breaking point.

Over all it took nearly an hour to finally get Jenna settled and back to sleep again.

The whole episode had me reliving moments of my childhood when I would be suffering with severe asthmatic episodes and had absolutely no patience for anyone trying to offer words of comfort. The intense physical discomfort and sheer terror of being unable to breath would make anyone trying to calm me down seem like they were patronizing me and trivializing my urgent need for medical intervention, adding to my anxiety. Although I know Jenna wasn't in that kind of crisis, I sensed a similar impatience from her with our attempts to calm her distressed state. This is why I can't help but wonder if she was experiencing some kind of physical distress. I don't know but I can certainly imagine that having a high blood sugar would make one feel pretty icky. Or perhaps it was just a strange sleeping state we were unfortunate enough to catch her in which caused her a similar amount of mental stress.

I guess I'll never know, because by morning it seemed all but forgotten by Jenna and any attempts to discuss it with her were more or less ignored. And I don't imagine she would have been able to express how she was feeling at the time anyway, given her age. So we just let it go. I did, however, mention to Jenna the next evening at bedtime that I would be in to check her in the night like always to make sure she is safe. Jenna agreed to cooperate and I think I detected a little bit of embarrassment from her for her actions the night before. The expression on her face was almost apologetic.

It hasn't been repeated (thank goodness) and I hope I'm not speaking too soon when I say that I think it was an isolated incident.

The next topic I want to mention is HALLOWEEN, that dreaded anti-diabetic holiday that has all us parents of type 1's trying to figure out new and creative ways to allow our pancreatically-challenged little ones to enjoy the festivities without sending them into DKA!

I know it should be as simple as allowing Jenna to do what all the other kids will be doing and just bolus her for treats consumed. But even before the big 'D' I was hard pressed to allow my kids to eat candy at all.

So last Halloween, before diabetes became a part of our lives, I started a little tradition I call the "Candy Swap". After trick-or-treating my girls return home with their candy at which time I reveal a stash of pre-wrapped, new books that they can swap their candy for, auction style. It was a hit last year, but Jenna wasn't even two yet. So she was oblivious to what was going on and just happy to be included, following her big sister's lead.

Having spent another year with Jenna getting to know her spicy little personality, I anticipate that it will be a chore just keeping her from sampling the candy before we even return home. I've already started creating rules to govern the evening:

Rule #1. No eating candy until we get home.
Rule #2. Any candy sampling before we return home will result in an immediate termination of the trick-or-treating portion of the program.

OK. So that's all the rules I have up to this point. And now that I look at them, I'm pretty sure these were the rules that governed my trick-or-treating and are likely the same rules that most kids have to follow each October 31st. It's probably sufficient since I don't really want to suck all the fun out of the evening. But I also don't want to spend the whole night doing blood sugar and ketone checks and bolusing the bu-jeezus out of Jenna in an effort to regain the upper hand.

Maybe I shouldn't stress too much about this crazy Halloween business after all. I'm sure my little candy swap scheme will take care of a good portion of the junk food and what ever is left I can confiscate and hide away to ration it out slowly until it is a dim memory, at which point I can pitch the remnants wiping the slate clean for that other occasion of over-indulgence~ CHRISTMAS!

Wednesday, October 8, 2008

Here's To Sisters!

The best sound in the world to me, the sound that makes my heart sing and my eyes well up, makes my mouth involuntarily broaden and turn up at the corners is the sound of my children's laughter. Any parent will tell you that this is a sound sweeter than any symphony or anything audible in nature.

I am so lucky to have been blessed with two wonderful little people to call my daughters. And what's the icing on the cake is that they seem to adore one another. They make each other laugh genuinely and heartily on a daily basis. Oh sure they have their sibling moments of arguing and competing. But overall, they are closer to one another than anyone else is to either of them as individuals. Not to minimize the relationship I share with them, but speaking as both their Mother and as someone who also is blessed with a sister (I love you, Shelly), nothing will ever compare to what they share between the two of them.

My oldest daughter, Jazmine is so protective of her little sister and has a high degree of empathy for her. If Jenna is upset or distressed Jazmine can't stand it and goes to great lengths to assist her. Jazmine has gotten quite cross and impatient with me in the past if she perceives that I'm not addressing Jenna's needs in a timely enough manner. I tend not to get too annoyed with this and, in fact respect it, as I relate to it very much in my experiences growing up with my older sister.

When Jenna first came home from hospital with her newly diagnosed diabetes, Jazmine was incredibly upset with all that Jenna had to endure; numerous blood sugar checks, three insulin injections per day, etc. I was quick to inform Jazmine that Jenna finds all this just as scary as she does but she doesn't have a choice in the matter. Jenna has to have her blood sugar checked and she needs her insulin to stay healthy. To watch my five year old "suck-it-up", for lack of a better term, and get brave for her little sister was just awe inspiring.

Jazmine went from crying and running away during these procedures to staying close by, observing and actually encouraging and cheering Jenna on! "It's OK, Jenna... you can do it... Hurray for Jenna!! You did it!!!"

I can't express in words how fortunate I feel to have been blessed with such delightful, kind, caring, fun-loving, fascinating, strong, smart, brave (I really could go on and on and on...) little girls. I am so very lucky to be a part of their lives.

Friday, October 3, 2008

Carboidrati Ossessione?

To update you on the battle of the bug, things didn't get too bad. Jenna did come down with cold symptoms but it occurred on Wednesday, two days earlier than my estimation.

Tonight I'm pleased to report both Jazmine and Jenna are well on the road to recovery; only an occasional sneeze and cough and the mucus factor has decreased significantly. Jenna's blood sugars have been pretty stellar too, considering the fact that she has been immune-compromised. Giant sigh of relief... ahhhhhhhhhhh.

Things have actually been the best ever with regards to Jenna's blood sugar readings. We have been slowly and methodically adjusting and fine-tuning all the variables on Jenna's pump... and there are many variables to adjust! It seems all our fine-tuning is paying off. We are seeing numbers that are well within our target ranges. I'm feeling rather accomplished as an insulin pump operator, actually!

I must add that accurate carb counting is partly to thank for this success. I began carb counting well before Jenna started on the pump in preparation for it. However, I wasn't as meticulous about it before the pump as I have had to be since. Likely because it is not the easiest or most convenient thing to do and since it wasn't crucial, I wasn't as motivated to put in the time or effort. Thankfully, with practice comes proficiency and I'm far better at carb counts now than I was only a few short weeks ago. I have numerous food count reference books aligned neatly on my kitchen counter, well within reach and my trusty food scale and calculator are always at the ready.

Occasionally, however, I'm faced with a challenge and tonight was one of those times. Supper was pretty easy; I had made ham, potatoes au gratin and broccoli. The potatoes were a minor challenge, but I just weighed Jenna`s portion and used a carb factor I use for mashed potato to calculate the carb count.

Dessert tonight was an unexpected challenge. I had bought a bag of imported Italian wafer cookies at a quaint little country market a few miles out of town earlier in the day. I figured a couple of these cookies would be a nice little way to cap off the meal without blowing Jenna's sugars out of the water and having to bolus the crud out of her afterward. Problem was the nutritional info was in Italian!

Now, I have a few years of French education under my belt so I can occasionally fake my way through some rough translation of certain words in Spanish and Italian. I had no trouble finding the "carboidrati" count, but problems arose when under the "per wafer" column two values were listed; 4.5 and 2.5. So which one was it? The second figure was labelled "di cui zuccheri". What the heck is that?

So my husband and I looked at each other with matching "...what the...?" faces and then, like a superhero being summoned to the scene of a crime, I dashed downstairs to the computer to do some rapid research. Super Mommy to the rescue! (Can you tell, I've been exposed to far too many viewings of The Incredibles lately?) I Googled Italian-English translation and found a site that helped me decode my bag of wafer cookies. The phrase translates as "...of which is sugar". Case solved. Back upstairs I sprinted feeling rather clever and dessert was served to a couple of very delighted little girls.

Tonight we can rest easy in the knowledge that the accuracy of our carb counting remains uncompromised and feeling relatively confident that Jenna has received just the right amount of insulin to see her through the night.

After proof-reading this entry, I'm left to ponder the possibility that this demon-driven desire to achieve an accurate carb count is becoming somewhat of an obsession with me. I mean, a couple of carbs shouldn't impact things that much. But, I must be doing something right, given Jenna's excellent blood sugar readings. Hey, she's my baby and I'm going to do whatever it takes to keep her as healthy as I can for as long as it's in my hands to do so. If I obsess, it is with very good reason... and without apology.

Monday, September 29, 2008

The Cursed Common Cold

Well, the adventure continues. A cold virus has entered our home and our lives. (Cue the ominous and foreboding music...)

Jazmine, my oldest daughter, came down with the symptoms late Saturday. By Sunday morning it was a full-blown cold in all it's mucus-y glory.

Now, my girls are still learning the concept of sharing. They are reluctant to share toys, food or even a spot on my lap at story time. However, as sure as I'm typing this they will no doubt share this amoeba.

As any parent of a child with type 1 will tell you, a cold or flu, normally innocuous in most healthy children, is somewhat of a nightmare for children with type 1 diabetes. Blood sugars soar and it is incredibly challenging to maintain the upper hand. I had to deal with a virus not too long after Jenna's initial diagnosis. At the time she was on multiple daily injections and I found it unbelievably stressful to manage the sudden increase in insulin needs. The fear of giving too much insulin is well-grounded and yet she constantly needed more and more as evidenced by her repeated high blood sugar readings.

Well, now Jenna is on the pump and I'm certain this is going to be at least a little easier to handle this time around. But it's another 'first' and I always stress with firsts.

The question now is when? It's a little like seeing the flash of lightening and waiting for the window-rattling clap of thunder that you know is imminent.

Best I can estimate, it took Jaz about 6 days to incubate this little bug, since I figure her exposure took place last Sunday when the neighbours visited with their little toddler who was in constant need of a tissue. If Jenna's exposure took place this Saturday, then she is due to become symptomatic by about Friday of this week.

Perhaps a better analogy would be awaiting the land-fall of a hurricane, in keeping with my weather theme. You know it is out there, gaining strength and momentum and moving ever closer toward shore. You have enough time to board up the windows, gather some emergency supplies then hunker down.

So I'm assigning myself some preparatory reading from my well worn, dog-eared copy of Pumping Insulin and I plan to replenish my stock of children's Tylenol. I may even place a preemptive call to my daughter's endocrinologist to obtain some council on how to change Jenna's basals in the event of a virus. Then we'll all hunker down and wait out the storm in hopes that it passes quickly.

Wednesday, September 24, 2008

Maintaining Perspective

Every morning before Jenna was diagnosed, I would wake up and if both my children were still sleeping, I would breath a sigh of relief, visit the bathroom in stealth mode in hopes of making it back to bed undetected by little ears and, if successful, steal a few more minutes of rest. All that has changed now.

Ever since Jenna's diagnosis, I wake up and if all is still quiet, I wonder and worry that maybe Jenna isn't just catching a few more much needed winks, but that something might be... well... wrong. I try to fight the urge as long as I can, but so far I can only make it 5 or 6 minutes before curiosity and all out fear get the better of me and I am compelled to get up, go into Jenna's room and get some sort of confirmation that she is indeed just sleeping. Usually that confirmation comes in the form of movement, a rustling of her bed sheets while she sleepily rolls over, a long, content sigh. Or she may even turn and look at me, having heard me enter, because she was awake too, enjoying the comfort of her bed for a few more minutes.

This is just a portion of the multitude of worries we parents of diabetic children go through every single day. It's bad enough having the standard worries of any parent. Pile on all the worries of managing your child's diabetes and you can pretty much kiss any rare worry-free moments goodbye... FOR GOOD! It's a 24 hour a day, 365 day a year wrap. And I recently read another mom of a diabetic child who is now grown say that she still worries. Every time the phone rings at odd times she is fearful for her child's well-being.

Now, as parents I know that this is what we signed up for. I didn't enter into this incredible journey naively. It starts with pregnancy and all the uncertainty it carries. Then there's the first year of your child's life; full of wonder and worry. Toddler-hood brings with it the need for parents to be ever vigilant, acting as your child's common sense in the absence of their, as yet, undeveloped good judgement. Heck, little one's at that age think they can fly if they flap their arms hard enough!!

But at a certain point you know you can look forward to a time when all those basic worries that are present almost every moment of every day subside because your child has reached a level of maturity and gained enough wisdom that you can relax a little. I'm guessing that's about when your child can say to you, "I'm going outside to play", and you can respond with, "Be back for supper", instead of having to drop what you are doing, don your outdoor gear and follow so that you can supervise. I have yet to reach that stage with either of my daughters.

Now add diabetes into the mix. It compounds and prolongs the worry factor. Sometimes I handle the stress and worry like a pro. Other times I am wracked with worries to the point that I fear I may buckle under the pressure. Constantly trying to stay one step ahead of things, studying blood sugar numbers, looking for trends in an effort to avert possible disaster, contemplating literally every ounce of food that Jenna injests, counting carbs, having to plan ahead and pack just to go out to the park for an hour, counting more carbs, trying to keep a running inventory of the incredible amount of diabetic supplies we have to keep on hand to avoid running out of something crucial, like test strips or carb tabs or INSULIN, for crying out loud, just to list a few! It is overwhelming at times!

I guess I can look forward to the time when Jenna can assist in the management of her diabetes, when she is able to feel she is low and say so. Or when she can go ahead and perform a blood sugar check on her own. Any help will be so welcome.

But for now the worry continues and the knots in my neck and back will stay firmly knotted. I will keep plenty of concealer on hand to cover up those dark circles under my eyes that tell the tale of a sleep deprived parent and I will try to keep my sense of humour~ keep enjoying life with my beautiful young children, and keep my fluid intake up in a vane attempt to counteract the aging effect this is having on me. I will count my blessings because they are abundant, and I will never make the mistake of thinking things can't get any better or worse... because, of course, they can.

Saturday, September 20, 2008

Misbehaving Pizza Carbs

The only thing worse than spending half the night chasing a rogue high is getting up in the wee hours to do a routine check and getting slugged in the gut by a 3.4 blood sugar! Such was the case a couple of nights ago. At 2:00am my hubby and I found ourselves having to shake off the sleepies, crack open a juice box and attempt to feed o.j. to our incredibly sleepy toddler.

Jenna doesn't often get juice these days, for obvious reasons. So when she has a low and requires juice or carb tabs (which she calls 'vitamins') it's a pretty exciting occasion for her. However, this night, the need for sleep was overriding her usual enthusiasm for these "treats". She was a very reluctant participant in our pre-dawn juice party, to say the least.

After much coaxing and pleading Jenna finally woke up enough to take a few sips of her orange juice. It doesn't take much for Jenna to boost her numbers back up to the good range so a third of the box's contents consumed, approximately 5 carbs, was sufficient to put my mind at ease again. Then it was a matter of reading Jenna a short story to help her resettle, making a trip down the hall to comfort and reassure my older daughter, Jaz, who by now was awake and upset by the goings on, set my alarm for half an hour to do the necessary recheck ensuring the juice did it's thing, and settle myself back into bed.

In addition to waging war on night time hypos, I've been working on cracking the pizza carb code. I just can't swear off pizza for ever. My family enjoys it too much and it's a great way to have a night off occasionally when I've forgotten to defrost something or I just need to spend an evening keeping the couch from floating up into the atmosphere. Tonight was one of those nights I feared the sofa may just slip into orbit so I ordered the pizza then promptly got to surfing the net, looking for nutritional information on pizza.

I found a great little website, calorielab.com, that lists over 500 restaurant's menus and 70 000 foods and our favourite pizza delivery joint just happened to be on here. I was able to get a more accurate carb count and judging from her bedtime reading, I think I finally cracked the code!! How exciting! I do tend to feel a little like Indiana Jones at times with the way diabetes has me running through a continuous series of obstacles, dodging traps, solving riddles and searching for clues in an effort to help my daughter obtain her "holy grail"; perfect blood sugar, or as close to perfect as we can get.

Diabetes has a way of keeping you on your toes, and just when you start to relax and settle back into your seat, it throws something new and unexpected at you to remind you NOT to get too comfy. You've got to keep your wits about you. Life with diabetes certainly isn't dull.

...and as if the fates have seen fit to help me demonstrate my point, just did a midnight check on Jenna and she's 18.1! A correction bolus is given and I must accept the obvious fact that the pizza carb "code" remains uncracked. Curses! Foiled again! What am I doing wrong?

Monday, September 15, 2008

A Diabetic Rite of Passage

It was inevitable. We were warned about this by our diabetes nurse in hospital when Jenna was just diagnosed. I wasn't the least bit phased by it at the time, but now that it has happened, my heart hurts for my little girl.

The tips of Jenna's two index fingers have developed little callouses from the constant pokes with the lancet to test her blood sugar. My two and a half year old, beautiful little girl now sports the trademark of a seasoned diabetic.

I know it isn't that big a deal, and I am without a doubt thankful for my blessings. It could be so much worse. But still I feel that familiar feeling of sadness that I felt so acutely upon her initial diagnosis every time I push that spring loaded trigger button and squeeze out her precious blood, drop by ever-loving drop.

When Jenna was first diagnosed, I remember friends and family saying that if she had to get diabetes, better now while she is so young. I remember at the time feeling both grateful for this small mercy and profoundly saddened by it at the same time. On the one hand, yes it is true that Jenna will be spared having to change habits that had been years in the making and will never mourn the loss of her far less complicated,pre-diagnosis days. But on the other hand, how tragic that she will never know what it's like to occasionally eat with reckless abandon, or to run out the door to play with only the clothes on her back and not have to worry about packing glucose tabs or her glucometer with her, not to mention her ever-present insulin pump strapped to her little waist.

The thought that really gave me pause was the one that popped into my head within the first 24 hours of her diagnosis; My daughter can't survive without the help of modern medicine. Jenna is sentenced to a lifetime of being a heavy consumer of pharmaceuticals for her very survival. She will never know any different.

Jenna is becoming more curious about her diabetes. She is asking questions and making statements, looking for confirmation and reinforcement, saying things like, "I have diabetes, right? I need my pump, don't I?" I know she is attempting to understand and deal with it all. I also know that this is just the tip of the ice burg. Over the years there will be many more of Jenna's questions to answer and emotions to feel and they aren't all going to be as positive and accepting as they seem to be now.

I guess in the grand scheme of things a couple of little callouses isn't the end of the world. But to me they represent all the pain, and trials Jenna has had to overcome and everything she has yet to endure throughout her life with diabetes. And because of that my heart breaks a little everytime I look upon those precious little two year old fingers.

...but the testament they are to her strenth and courage is what makes me fill to bursting with pride.

Thursday, September 11, 2008

Reflecting and Projecting

It's been nine days and three infusion set changes since Jenna's pump start up and I feel the need to review these past nine days and contemplate what I've learned about pumping insulin.

First, carb counting is definitely one of those things in life that takes practice. A few times this past week we have made some mistakes with our counting and Jenna's blood sugar has gone high as a result. I was using a small pad of paper and pen in the kitchen to document carbs as I prepared Jenna's meals, but I found this to be somewhat frustrating. The pad of paper was in the way and taking up valuable kitchen counter space, when it was present at all. Misplacing it and having to hunt for it often made the difference between a hot meal and a cold, unappetizing one. And all too often food counts were forgotten.

I came up with a solution and promptly made an emergency run to my local office supply store to purchase a little dry erase board that could be mounted to my refrigerator. Here I can jot down the carbs of each food item as I portion them out onto Jenna's plate. The list and the carb values can easily be edited with Jenna's requests for seconds or decisions to eat only a fraction of what I have given her. This has proven to be a far better system with less chance of miscalculation and I have those precious eight or nine square inches of counter space back.

The next thing I have learned is that pizza is no friend to diabetes. Or perhaps I just haven't found out how to handle those pesky pizza carbs just yet given my lack of experience. But one thing's for certain, I'm a little gun-shy of the stuff after a pizza supper resulted in my husband and I tag-teaming our way through a night of every two hour blood sugar checks, ketone checks and correction boluses while we chased a stubborn high. Not fun.

Something else I learned the hard way is never, EVER forget the pre-meal blood sugar check. During my older daughter's birthday party last Sunday, a good half hour after I brought out the lunch buffet for our little guests to enjoy, we realized we had forgetten the all too important check before our little food-loving toddler tucked in. Luckily, anticipating the party chaos and confusion, we had planned ahead and assigned one parent the task of watching and documenting everything Jenna ate so we had a relatively acurate carb count to work with. But still, how the hell do you bolus using the easy carb function when you don't have a blood sugar reading to enter?! We had to guess based on her mid-morning reading. But again we were doomed to chase a mild high for the remainder of the afternoon.

And finally, something I just want to throw out there as a minor dilemma rather than something learned; how can I convince my two year old insulin pumping daughter that she can sit in the tub and enjoy her baths just as she did before the pump? She is incredibly anxious about baths now where she wasn't before and I'm certain that is because of the presence of her cannula. In fact she LOVED her baths before she wore the infusion set. Now she is reluctant to get in the tub. If I can convince her to get in she absolutely refuses to sit down. Kinda makes me sad because bath time was such a fun time for Jenna and now she dreads it. It's minor, but I'd love to find a solution.

All things considered, I think we have survived the first week of pumping farely well. It has by no means been easy, and sleep was all too often a necessary sacrifice. But this truly has been worth the pain and exhaustion. Jenna is enjoying better blood sugar control, especially at night and her freedom from multiple injections has been a blessing. Jenna loves eating. She is one of those rare kids that will try anything and more often than not likes what she tries; a real pleasure to cook for for a Mom who enjoys cooking. She has been more free to occasionally enjoy her favourite foods in slightly greater quantities than she was before. It does my heart good to see her really enjoying meal times again.

Looking to the future I can't help pondering what lay ahead, technologically speaking. As advanced and incredible as this insulin pumping technology is, it is without question going to continue to advance and improve. Will there be a day when we reflect on this time in our lives and think how primitive this technology was in contrast to what we might be working with only a few short years from now? Or perhaps we will be cueing up for that cure that is talked about and promised so much. Hmmm... wouldn't that be nice? I love you, little pink pump, but I'd drop ya in a heartbeat to be rid of diabetes for good.

Friday, September 5, 2008

...you just do what you have to do.

I recently had the pleasure of visiting with some family members that we rarely get to see due to geography and the business of life. These family members include an eight year old daughter with a chronic metabolic disorder in the same ballpark as diabetes. We have a good deal in common.

I sat talking to Liz, this little girl's mother, comparing notes on what it's like to have a child with a chronic condition and what it means for the lives of family members on a day to day basis. I reflected on how my heart went out to them when I learned of their precious infant daughter's diagnosis who was, at that time, only one year old and I wasn't even a mom yet, let alone the mother of a child with diabetes.

I explained how, at the time, I didn't know where they were getting their strength to endure the heartache I could only imagine they were experiencing. I wondered how they got through it.

Liz looked at me with a mix of tender compassion for a fellow mom who now "knows", tempered with the no-nonsense, matter-of-fact attitude one develops after having to buck-the-hell-up for years and said, "Like any parent in our situation, you just do what you have to do. You find it in you somewhere to do whatever it is that you must."

I am finding that to be so true these days. I am far more sleep deprived now than I ever was taking care of newborns. And yet, somehow I only feel the effects of that occasionally and then it's just a fleeting moment of sheer exhaustion that seems to fade as quickly as it develops. It's as though I don't have time to be tired so I just ignore it.

I have noticed, especially in the last two days that I keep having to stifle an urge to just sit and weep. By no means is it coincidence that this has occurred at the same time as Jenna's pump start-up. I am once again on high alert due to this new and miraculous technology. We are still trying to learn all the intricacies of the pump and how to master it's use. Because with practice and eventual pump fluency, we are virtually assured of far better control and an easier go of things. But it's the 'getting there' that is causing the hastening of my own personal aging process.

Today was our first site change since her official start-up in hospital three days ago. I was stressed from the moment I opened my eyes early this morning anticipating this necessary task.

Insertion sites need to be changed every three days to prevent mal absorption of insulin due to a weary site and to maintain healthy skin integrity.

So Jenna was slated for a post breakfast site change and a juicy gob of EMLA was applied to the upper outer quadrant of her left little buttock and covered with a Tegaderm a good hour and a half prior to the procedure to numb the area and make the process much more kid friendly. Even still, Jenna has gone through too much these past three months to just concede to yet another procedure.

We get the job done, albeit through Jenna's tears and constant squirming, and everything seems ok. That is until an hour later, after a blood sugar check and a consequent bolus to correct a mild high, Jenna reacts to obvious pain at the insertion site when the insulin infuses.

OH GOD NO! More stress! The infusion shouldn't hurt and if it does, it could mean the cannula is situated next to a nerve and will likely need to be removed and reinserted.

I make a call to our diabetic nurse educator and leave a message explaining things. Impatiently, I call again and again over the course of the next hour. I start getting annoyed at the system and wonder why there isn't someone available around the clock; an actual PERSON who knows my daughter and all about her diabetes and can advise us of what to do in any given situation; someone who's sole purpose is to sit by the phone and await my calls for help!

This is one of those moments I want to sit and have a good cry.... but don't, of course. Instead I opt for engaging in petty bickering with my spouse and complete impatience for my older daughter and the constant stream of questions and requests that is the hallmark of any inquisitive five year old.

I pick up the phone a third time in frustration and dial her number. Her voicemail picks up immediately with only one ring and I surmise that she must have gotten my message and is trying to call me at that very moment. But my impatience is potentially going sabotage her efforts! I hang up with lightening speed and hold the phone in my hand, staring at it... daring it not to ring.

After a very pregnant pause... it rings. Relief.

After discussing the morning's events with her, we decide the best course of action is to wait until we bolus Jenna for her lunch and see if she continues to feel pain. If she does, we must do another site change.

So after lunch, I hold my breath as I bolus enough insulin to cover the carbs Jenna just ate. Not even so much as a flinch! She just keeps chattering away in her highchair examining the sticky jam on her fingers from her pb and j sandwich.

In disbelief I ask Jenna if it hurt. Completely oblivious to the emotional torment I have just endured and with the adorable coyness that only a two year old can get away with, she says "No mommy."

...and that was that.

Thursday, September 4, 2008

Lesson learned; Never let down my guard!

Just when I think I have a handle on this diabetes business, a curve ball is hurled at me with incredible force to snap me back into an uncomfortable, insecure state of humility and show me that I can never rest easy or get too confident. I must always expect the unexpected.

After enjoying a second day on the pump and good blood sugar levels with almost unprecedented consistency, suddenly all hell has broken loose. Jenna had a high reading before bed that we corrected with a bolus and mistakenly thought that would fix everything. She did come down slightly after two hours, but her midnight check is high again and now there is a small amount of ketones present in her blood. The plot thickens...

I am forced to ponder the cause of this unexpected and stubborn high; was it the stress of the dentist visit this afternoon causing a release of adrenalin and glucose? Jenna is not fond of the dentist to say the least! This in combination with a pizza supper~ notorious for wreaking havoc on blood sugars~ and an underestimation of the carbohydrates present in pizza crust, coupled with an inability to discern exactly how much of the greasy crust Jenna actually consumed due to her penchant for food play and an uncanny ability to mangle food items beyond recognition rendering them virtually immeasurable...

Or perhaps there is something wrong with the infusion itself and we have solved nothing yet but must wait another two hours to confirm this with another check. Meanwhile, her blood sugar will continue to climb, more ketones will form and her little body will endure more stress.

We bolus for the high blood sugar and give extra to clear the ketones and in two hours we will test again to ensure the bolus worked.

Fingers crossed that it has, because if it hasn't, we are looking at an insulin injection and a site change as there could be something wrong with the cannula; a kink or blockage of some sort. We would have to do it without the help of EMLA, a topical numbing agent that makes needles virtually painless for little ones, as it requires at least an hour to take effect. And doing it in the middle of the night, who knows how cooperative our sleepy little toddler will be with the whole ordeal!

If it does work... LOVE! And maybe I'll get a few hours sleep tonight after all. Fingers crossed, people... fingers crossed...

Tuesday, September 2, 2008

Proud Pumper Parent

Today marks the beginning of Jenna's diabetic journey with her new best friend strapped around her waist; the Animas insulin pump in pretty metalic pink.

It's been a long day of sleep and food deprivation for all family members, and much information and technical training has been crammed into this cob-webby, overburdened, 36 year old brain, so I'm afraid this pivotal entry must be brief. I have two night time blood sugar checks to do tonight and my bed beckons.

More on Jenna's pump start-up in the days and weeks to come, but suffice it to say Jenna is getting on quite well with the pump. She seems pretty proud of it, actually, and doesn't miss the MDI's one little bit.

It was so nice at supper tonight not to have to respond to Jenna's usual evening statement, "I don't need an insulin shot, Mommy", with "Sorry sweetie, but you do." Instead I was able to reply, "No you don't sweetie. You have a pump now!"


Sunday, August 31, 2008

Wee hour worries

If the number had been 11 or higher I would probably be sleeping peacefully right now. But the number was 9.2.

Jenna's 2:00 am blood sugar reading this morning is well within the "good" range, but due to several factors, I am left to toss and turn in bed, unable to return to dream land, wondering if she will dip too low before dawn.

I had awakened 20 minutes early for some unknown reason and decided to take a reading anyway and avoid the unpleasant sound of my alarm cutting into the lovely quiet. I had given Jenna her bedtime dose of intermediate acting insulin a good hour later than usual. As well, Jenna didn't eat quite as much as usual last evening. For these reasons, and admittedly probably because I am still a rookie at managing my daughter's diabetes, I am forced to wrestle with my worrying mommy mind and try to anticipate what her little body will do in the hours to come. I decided that a 4:00am recheck might be in order and this is where I believe I sealed my sleepless fate.

So instead of remaining in bed while I endure this torture I opted instead to tip-toe into the kitchen, grab a little wee hour snack- a single portion pack of Funbites Fruit Snacks I had purchased in a Costco sized box to treat Jenna's occasional lows (one would think I'm treating a hypoglycemic elephant considering the quantity I purchased)- and retreat to the office to munch and ramble.

So many thoughts flood my now completely conscious brain; menu planning for my oldest daughter Jazmine's fifth birthday party, the all too busy week ahead full of appointments, a pediatrician appointment for Jenna, dental appointments, an appointment with an accountant to discuss our new business, the start of the school year for Jazmine and the most daunting item on our schedule this week, starting Jenna on an insulin pump.

Jenna hasn't even had diabetes for three months and yet we have been able to set in motion the long series of events that will, in three days help us realize our long awaited and highly anticipated goal of Jenna's pump start-up. This is due largely to the fact that I feel incredibly strongly about Jenna getting tighter control over her blood sugars and have hastened the process along.

And yet now I am filled with apprehension and doubt about our ability to master use of the pump and of how my two year old will cope with being constantly connected to a little appliance.

Now, in the eleventh hour I am riddled with doubts and fears!

Could it be just my strange state of mind at this ungodly hour? Perhaps I'm just feeling overwhelmed on account of my far too full schedule of the week ahead. Or perhaps I know my daughter only too well and my fears will be confirmed when she won't leave the thing alone, wants to play with the buttons (thank goodness it has a lock-out feature), or just rips the infusion set right out... OUCH! This last senario would be just enough to sour her on the whole pump idea- not a good thing!

But hopefully this is just one of those things in life that is so intimidating because it is so worth doing. It's a huge step in the life of a person with diabetes to switch from MDI's (multiple daily injections) to pumping insulin! There is a pretty steep learning curve, and when you have spent everyday of your (or your child's) diabetic life trying to master MDI's and it's many peccadillo's, having to relearn another way of managing this cursed disorder, no matter how much better the outcome, is like looking up at Mt. Everest from the very bottom trying to muster the energy to climb it... YET AGAIN!

Well, worry and doubt aside, 4:00am is minutes away and I have a blood sugar check to do after which I will try to salvage a couple more hours sleep, provided Jenna's blood sugar is still in the normal range. Otherwise, I'll be trying to feed juice to a sleepy toddler and waiting 15 more minutes to do another check.

Such is the life of a parent of a child with diabetes.

Wednesday, August 6, 2008

Deep breath and... begin.

I'm not at all the type to compromise my anonymity by starting a blog. Or perhaps that should be past tense; I wasn't the type.

I suppose I can blame/ thank diabetes for this sudden change in character. Although, with the amount of anxiety I am feeling as I type this and prepare to post my first ever blog entry, I'm not so sure I've undergone a character change, but more experienced something so life changing and so fraught with uncertainty that I feel an overwhelming need to reach out and find others who understand what it means to be the parent of a child with type 1 diabetes. I also long to experience the catharsis that comes with writing one's emotions down.

So here I am... sharing... purging... worrying... losing sleep...

I am the proud mother of two beautiful girls, Jaz and Jenna. The youngest, Jenna, aged 2, was diagnosed with type1 diabetes just two months ago. Any parent who has gone through what we have gone through these past two months has my complete respect.

I should also explain my blog name. I'm sure it seems a bit odd and perhaps even humorous to some...

While my husband and I were in hospital with Jenna after her initial diagnosis, learning about how to manage her care at home, I was attempting to wrap my head around it all and put everything into some sort of perspective. One day while waiting for the elevator to go to the Diabetic teaching room I stated to my husband and our Diabetic Nurse Educator that it was like we still had our same precious little Jenna but that she now comes with a pet monkey, metaphorically speaking.

Like it or not, our little girl now comes complete with a pain-in-the-ass pet monkey that we have to feed, care for and supervise constantly. That's the deal. No debate, no discussion.

I am still attempting to cope with this new "family pet" and trying to take things one day at a time. Because when I look too far ahead there are just too many worries and what-ifs. Like when she's old enough to take over her own care will she be responsible and diligent? Or will she rebel and enter into a dangerous phase of denial?

But I will stop there as it is counter productive and each day brings plenty of things to worry about as it is, like will she have a low in the night tonight? Is she ever going to get over that cold she's had for, what seems like, a month now? Did I give her enough protein and carbs to see her through the night? Did she get more exercise today than I accounted for when I decided on her bed time insulin dose? Does my pediatrician really know what she is talking about when she assures me that Jenna will awaken with a nightmare if her blood sugar drops too low or will she , perish the thought, sleep right through it?

To conclude this pilot entry I wish to concentrate on the positive side of Jenna's diagnosis. For as devastating as it has been, it has also been rewarding. I have seen a side of my baby girl that I had yet to see prior to her diagnosis. She is incredibly brave and unbelievably tough. She truly is my little hero. In fact, both my beautiful, dear girls are inspirations to me to face life's challenges head-on and not let obstacles stop me from realizing my dreams and ambitions. I have witnessed positive change in every member of our family as a result of diabetes. Personal growth does indeed arise from life's trials and challenges.

So perhaps this "monkey" isn't such a curse after all. Could a diagnosis of type 1 diabetes be a blessing in a very good disguise?? I'd give anything for a cure right now so that my Jenna could go through life unconcerned with occasionally over indulging in sweets or balancing activity, exercise and stress with carb intake and insulin doses or possibly facing the devastating long term repercussions of poor blood sugar control.

But maybe type 1 Diabetes offers people an opportunity to gain wisdom beyond their years and learn a few valuable life lessons that most of us may only learn after a lifetime, if ever. And that just might almost make it worth the ride... almost. But I'd take a cure over extra wisdom any day.