Friday, December 31, 2010

Looking Ahead.

Another year is drawing to a close.  It is a time for reflecting.  But try as I might, I can’t stop looking to the future this New Year’s Eve.  Big changes are afoot and I am anxious to get on with it.  It’s hard to look back at the past when ahead lies such an exciting future (or when one’s every worldly possession is boxed in cardboard, taped up and awaiting a moving truck).

I mentioned in a previous post that there were diabetes-related reasons for this move.  One thing I have learned in life, thanks to diabetes (a little New Year’s optimism is never a bad thing), is that we all need people.  None of us can thrive on our own or get along without loving support and help from friends and family.  

Diabetes is a tricky one.  If you don’t reach out for help now and then and nurture a support network, burn-out and despair can ensue.

I’m burnt out.  And despair?  I’ve felt it.  

My husband and I have been sleep deprived and burning the candle at both ends for almost three years now.  Jenna was only just two when she was diagnosed - not too long after the midnight feeds and wee hour diaper changes were a thing of the past.  Given this scenario, you can imagine how many times we have had a night out, just the two of us. 

I have enjoyed living on Canada’s west coast these past fifteen years, and have truly fallen in love with the mountains, trees and ocean.  There isn’t a lot I can complain about living in this nature-lover’s paradise.  If you’ve only ever seen pictures, I can assure you, they don’t do it any justice at all.  This incredible land scape is a part of me now.  It always will be.  I have shed more than a few tears in recent days in anticipation of departing.  But as sad as I am to be leaving, I am even more excited to be moving closer to my sister and her family. I look forward to my children having their cousins close by to play with, bond with, grow up with.  And I am so very happy to be able to see my sister more than once every two years.  

As for Jenna’s diabetes management, my sister is eager to learn.  She wants to know the ins and outs of pumping insulin.  And I am ready to teach.  Jenna is at an age where she can verbalize how she is feeling.  She does her own checks often and is learning her numbers, as a result.  (Another “glass-half-full” mention about diabetes: I believe Jenna has added confidence concerning math and numbers from living the past three years immersed in calculations, ratios and solving for x).  Jenna is burgeoning on an age of being slightly more independent with her diabetes management.

I have seen the sun set on my nursing career - a consequence of choosing to be at home with my girls in light of Jenna’s diagnosis.  This isn’t necessarily a bad thing, as proud as I am of that accomplishment.  But I have other interests I wish to pursue.  Nursing was rewarding but it had it’s dark side.  It was an easy decision to make, really.  I couldn’t wrap my head around going to work as a nurse, caring for others, while a daycare worker cared for my two year old child with diabetes.  Quite frankly, it scared the shit out of me, the very thought of it.  Furthermore, who could be more qualified to care for Jenna but her mom who also happens be a registered nurse?  I know some people have no choice but to work and my heart goes out to you.  But, since we had that option open to us, we chose to take it.

Jenna is almost school-aged now.  She will be attending junior kindergarten in the new year (I’m likely going to need some advice on how to handle the whole school issue from all you experienced D-parents out there in the weeks ahead) and her big sister will be enrolled in grade two full time.  I will still need to be available for checks and boluses while she is in school, but in anticipation of the little bit of free time I might have, I’ve started to ponder some professional possibilities.  Nothing is certain, however, so I’m going to leave it at that.  But 2011 should be an exciting year, full of possibilities.   

And of course, a very big and important part of my support network is the diabetes online community.   The comfort I feel knowing help, advise or just an ear to vent is a few clicks away is immense.  I’m forever grateful for all of you.  Thank you.

A very Happy New Year to us all.  May 2011 be a year full of promise, tolerance, love, kindness and understanding ...and a monumental advancement or two in the search for a cure would be nice as well (nod to all you beautiful scientists out there).

...and now I’m going to ring in the New Year with some dear friends I likely won’t see again for some time.  Be well and safe, everyone.

Tuesday, December 28, 2010

Worries and What Ifs

I was watching The Sound Of Music yesterday.  It is a favourite of mine, having watched it almost every Christmas for as far back as I can remember.

Something occurred to me at the end of the movie when, after the concert, the Von Trapp family escaped from the Nazi’s who were waiting to take Captain Von Trapp to his new commission in the Navy of the Third Reich.  At this point in the movie the family is informed that the Austrian borders are closed and they decide at the last minute that they must travel on foot over the Alps to cross into Switzerland.

I felt compelled to ponder, what if type 1 diabetes were thrown into this scenario?

Suppose one of the Von Trapp children was a type 1 diabetic.  In those days, things pertaining to diabetes management would have been quite different.  I would venture to guess that it would have hindered, if not altogether dashed their plan of escaping a Nazi annexed Austria.  Captain Von Trapp may well have had to comply with the orders to accept his position in the Third Reich’s Navy.

In this day and age the idea of trekking over a mountain range, on foot, with seven children, one with type 1 diabetes, without weeks of careful planning and specific consideration paid to diabetes management would be a daunting task fraught with risks.  The lugging of supplies alone, not to mention how to keep the insulin chilled would be a sizeable undertaking.  Not that it would be impossible, just complicated, as so much with diabetes is.  It would be damn near impossible to make such a journey in the late 1930’s with a type 1 diabetic child in tow and have the child fare alright throughout the trip.

While doing a little poking around on line in preparation to write this post I learned that the real Von Trapp family story doesn’t include a foot journey over the Alps at all.  Apparently a more comfortable form of travel for the time - a trip by rail - was involved and they went to Italy, not Switzerland.  It wasn’t even an escape.  They left openly.  Nevertheless, human history is full of stories of survival that require people to flee homes and homelands at a moments notice and become refugees.

As the mother of a child with type 1 diabetes I am compelled to insert type 1 diabetes into these scenarios.  I can’t help myself.  Even though I live in friendly, peace-loving Canada, like any mother, I imagine countless scenarios that could endanger my children, no matter how remote the chance is of them materializing.  Besides, somewhere in this world that very scenario is likely playing out and has probably played out countless times in the past.  I don’t like thinking about the possible outcomes.  I hate imagining what the parents of these compromised children must face.

And it doesn’t have to be political upheaval.  Natural disasters occur without discriminating between nations.  I watched the documentary on the 2004 tsunami in Indonesia a few weeks ago.  The same thought process occurred as I watched in horror while people on vacation suddenly found themselves fighting for their lives.  There had to be type 1 diabetics there at the time.  If they survived the giant waves, how did they get the supplies they needed to manage their diabetes in the aftermath?  No doubt some diabetics found themselves without supplies or unable to get to them as unimaginable chaos unfolded around them.

It is this part of type 1 diabetes that preys on my mind most often - how vulnerable my child is and how reliant on pharmaceuticals she must be.   I don’t like thinking about it but how can I not?  We have to consider unthinkable scenarios with this disease.  We have to be prepared because, to not be prepared could easily spell disaster very quickly.

How do you prepare?  How much supplies do you keep on hand at any given time?  Have you got a plan?  What back up measures have you taken?

And finally, how do you keep from driving yourself insane with worry at times?  I am a rational person that doesn’t waste time worrying unnecessarily.  But given the seemingly increasing number of catastrophic events that have occurred in the world in recent years, and indeed over the course of our planet’s history, I would be naive to think we are untouchable here in North America (think Katrina).

And in all honesty, sometimes the worrying gets me down.

Sunday, December 26, 2010

Diabetes Christmas Conundrums

How is it that I can measure, weigh and cook a meal from scratch and calculate with Pythagorean  precision the carbs in Jenna’s portion and still have her blood sugar go rogue;  yet we can go out to a fine dining establishment, eat a fancy meal, totally guess at carb counts, administer multiple boluses for food eaten in increments, and somehow have pristine, single digit blood sugar readings all night long thereafter?  I’m talking, unbelievable numbers.  Devine intervention numbers!  Holy crap she’s cured numbers!

We went out for Christmas dinner for the first time ever.  It was magical to tour the Butchart Gardens before hand then eat a four course Christmas feast with all the trimmings.  I don’t know how I can explain the spot on blood sugars Jenna had afterward.  Perhaps it was a perfect combination of activity - walking (running) through the gardens - along with fantastic carb counting guess work.  Whatever it was, it worked.  Somehow it just  worked.

And while we are on the topic of diabetes conundrums, here’s another puzzler:  Why does Jenna’s pump battery decide to end its three month long shift in the wee hours on a Christmas morn, after a rare night of excellent blood sugars led me to the false assumption that my midnight check would be the last time I would have to get up until morning?  I was hoping for a 7am wake up time, but the diabetes gods had other plans and were conspiring against me and my constant quest for more sleep.

Butchart Gardens at Christmas time is pure magic.

The girls were nestled all snug in their beds by 8pm, Christmas Eve.  They had no trouble falling asleep after stories were read to them.  Last year, Jazmine was up sometime between 1 and 2am, jacked up on Christmas hype.  I had to talk her down and settle her back to bed explaining that it was still time for sleeping. This year was no different, except for the time.  She was kind enough to wait until 3:30am before she entered our room excitedly announcing that Santa had visited.  For the second year in a row,  I got up to settle her back to bed then crawled back into my own still warm covers.

About 20 minutes later, I heard Jenna’s bedroom door slowly crrreeeaaak open.  Now she was awake and curious to see if Santa had visited as well.

“Go back to bed.  It’s too early,” I stated firmly from my warm cocoon.  The sound of little feet retreating back to bed followed by silence prompted me to breath a sigh of relief.

A while later, perhaps a half hour or more, I had just drifted blissfully into that surreal state of semi-lucid limbo, the one where you still have auditory awareness but your subconscious is spinning its strange little yarn of weirdness...


In an instant I was yanked back into full consciousness.

“What was that?”

“Mmmfph---wzz wut?” groaned a groggy J who, having just been awakened from his long winter’s nap,  hadn’t yet managed to regain full control over his verbal abilities.

“I heard a beeping sound,” I replied as I glanced at my phone’s clock, making note of the time.  It was 4:30am.

J mumbled something about not hearing a thing as I whipped back the covers - again - to investigate.  Of course, my first stop was Jenna’s room, since the sound I heard eerily resembled the sound her pump makes after a bolus of insulin is administered.

As I entered her room, she raised her head off her pillow to look at me and I wondered if she was still awake from when she had gotten up not long before.

“Hi honey...I heard a beeping sound,” I began whispering my explanation as I approached her bed.

“Maybe Santa is here!  Maybe it was Rudolph’s nose blinking!” Jenna whispered back excitedly.

I giggled and gave her a kiss for being so darned adorable.  “No sweetheart.  Santa has already come and gone.  I think what I heard was your pump.”

I began searching amid the bedsheets and pajamas for her pump which resides at her waist .  When I finally retrieved it and pressed a button, the low battery warning text appeared on the display.

Lalaloopsie dolls were a big hit!
So a battery change was done, albeit clumsily, and a prime/rewind sequence performed.  Afterward,  I returned to Jenna’s bedside to reconnect her pump.  I found her sitting up in bed, all wide-eyed and  smiles.  I tried to explain that it was still too early to get up but I knew my efforts were in vain.  She agreed to stay in bed but her little clock radio that is always serenading her at low volume while she sleeps was softly cranking out familiar Christmas tunes.  She remained in bed but she didn’t sleep.  Instead she sang.

We were all up - the coffee was brewing, the tree lit and the camera poised, ready to capture the magic of Christmas morning - all before 5am.

But those stellar blood sugars?  They more than made up for the lack of sleep.

Friday, December 24, 2010

Tidings of Comfort and Joy

When I was a little girl, the wonder of Christmas wasn’t just about getting presents from a big, hairy fella in a red suit with a penchant for chimney crawling.  Oh sure that was pretty exciting, but it was also knowing that people all over the world were gathering with joy and good will in their hearts and enjoying their families, eating good food, and celebrating the idea of loving one another and caring for each other.  There is something about being a part of an event that so many people are sharing that I have always found to be a very powerful experience.

I think we humans forget about just how connected we are to one another.   We are all in this whole experience together.  We spend far too much time criticizing our differences and not enough time finding our common ground.  And our common ground is vast - far greater than our differences.

You don’t have to be a Christian, or religious to appreciate what this time of year represents.  As Clark Griswold states at the end of National Lampoon’s Christmas Vacation, “It means something different to everyone.”

To me, it’s about being thankful for our health and our blessings and being together with those we love, paying tribute to those we have lost while celebrating our children and the promise they hold of a brighter, more compassionate and enlightened future.

Happy Holidays and Merry Christmas to each and every one of you.  May you feel loved and comforted this holiday season.

Monday, December 20, 2010

Finding The Calm Amid The Chaos

There are five days until Christmas and, given this year’s circumstances, I am impossibly calm, cool and collected.  I keep wondering what is wrong with me that I am so damn relaxed!  But I am.  It’s strange.

Here’s the situation:

We are moving.  And I don’t just mean moving across town.  This is a trans-continental move.  This is an EPIC move!  And it’s happening NOW.  Well, not right now, but in three short weeks we’ll be packing our every possession on a semi, then driving across this beautiful, albeit frozen country of ours and going back to my home town.  (We won’t be driving the semi - we’ll leave that to the professionals. We’ll be driving our Tundra pick-up - a very capable vehicle for what Mother Nature might have in store for us.)

The reasons for this move are varied, but it has a lot to do with the desire to be closer to my sister and her family.  It also has to do with the D.  But that is a separate post that I plan on writing very soon.

Right now, the issue is Christmas.  And packing.  And driving for days on end with two young children across a nation that is, at present, in the icy clutches of Old Man Winter.  And all the planning and preparation that these two ginormous events entail.

And...okay, YES.  There is the D to consider during all of this.  How can we not consider it?  It is never something that can be glossed over, even during the simplest of times.  I have prepared the lists of things to pack. I’ve ordered the Frio packs to keep cool the three vials of insulin I plan on packing, as insulin likes to be.  I’ve taken stock of our supplies and have on order all we will need to top up our reserves.  I’ve got the glucagon, which has recently become a more versatile and vital tool in the D toolbox as so many other D families have discovered. (For more info on glucagon mini-dosing, see this awesome post by Lorraine.)

We’ve been discussing the road trip and the need to go low carb with regards to snacking on the road.  We won’t be getting much in the way of exercise for several days straight (save for the odd pool time at any hotels we stay at that happen to have such facilities.)  This means that the temporary basal function will be called upon often to stave off any spikes.  But I want to further minimize the chance of fighting frequent highs which will only serve to make Jenna feel miserable and exhausted.  The drive alone will be enough of a physical and mental test as it is, without adding the insult of high blood sugar to it.  Doughnuts and muffins, while convenient and readily available, are really not the best choice (and, I dare say, that pertains to all of us.)  But I suspect we will all get tired of carrot and celery sticks pretty quickly.  So if anyone can recommend any low carb, low fat, low mess, car-friendly snacking ideas kindly leave me a comment.

So you can imagine what our household looks like these days.  Among the boxes and packing paper, we have a tree up, although it is a fake one.  Next year we will go back to a real tree.  But this year, we had to keep it simple and pull out the ol’ faker.  The stockings are hung by the chimney with...uh...well...lets just leave it at “they’re hung.”   The word “care” doesn’t apply when they are being taken down, tried on, played with, stuffed with toys from Christmases past and put back up in varying order, multiple times a day!  If they survive Jenna’s constant mauling due to her inability to leave all that jingles and sparkles alone, I will be astonished.

We even managed to sneak in a cookie baking session the other day, just prior to packing up my cookie sheets and mixing bowls.

Speaking of packing, J and I are on top of it.  We have been picking away at the task for weeks now and our garage is steadily filling with an ever growing mountain of packed boxes.

And in light of the packing chaos this year, we have made reservations to eat Christmas dinner out.  This will be a first for us.  I’m usually at home stuffing, then wrestling a turkey into a roaster and making those fancy cross slits in the bottom of each brussels sprout, the purpose of which continues to elude me.  On any given Christmas day I can be found ironing the fancy table cloth and its matching napkins just prior to placing them on the table which is always just prior to dinner being served.  Somehow, I always forget this detail until the very last minute.  But this year someone else is going to take care of these details. I whole-heartedly welcome this break from tradition, in light of all that is going on.  Next year I’m going to do Christmas up right.  The tree will be real.  The cookie baking will involve more than just one recipe.  And the Christmas dinner will be second to none.  But the best part about Christmas next year will be sharing it with my Mom, sister, brother-in-law, nieces and nephew for the first time in too many years.  It’s something I’ve been dreaming about for so long.

The next three weeks should prove to be unbelievably busy with a lot to consider, not the least of which is Jenna’s diabetes.  But through it all I have somehow become even more aware of how lucky we are and I am incredibly thankful.  This seemingly ill-timed move has had a strange, paradoxically calming effect on me.  I have a heightened awareness of what is really important.  We have amazing, supportive and loving family and friends, both here, on Canada’s west coast and back east in my home town.

And the four of us have each other (and our stash of diabetes supplies.)   I don’t need or want for anything more, for I know that wherever we (and the diabetes supplies) are, as long as we are together (with our big box of D-supplies and chilled insulin), that is where home is.