Just where do all the Sharps containers go, anyway?

I was just checking in with Kerri at SUM and read her latest entry on diabetic waste and if I knew how to do a link thingy I so would as it is worth a read for the 'think' factor alone.

Speaking of thinking... you'll have to excuse me and any craziness I may write tonight. I'm fevered, suffering from a bout with the flu which has forced me to retreat to my bed; my heating pad working to stop my chattering teeth. I can't be held responsible for any insane, delirium-induced ramblings I may embark upon... should be interesting.

Most of us are environmentally aware these days. With our world's growing population and increasing hunger for disposability, we are facing a pretty 'holy shit' kind of crisis in what to do with all our crap... and all our crap's crap once it is no longer needed. And diabetes is a condition requiring copious amounts of CRAP. And all that CRAP has packaging. (Holy crap! Did I just use the word 'crap' seven times in a paragraph? I blame the fever.)

It's dizzying to ponder the magnitude of waste generated in just one day to manage the world's diabetic population. Now consider the world's medical waste in general! ...sharps containers in every hospital room, nurse's station, medical examination room, and every responsible person with diabetes utilizes some sort of sharps container to contain all the sharps required... and that's A LOT!

Before becoming a Mom I worked as a registered nurse, utilizing sharps containers every single day. When one filled up to it's 'Do not fill past this line' line, I popped the seal on it and arranged for pick up, knowing an empty one would replace it. I never questioned where these sharps containers go. Now, looking back, I wonder why I never asked that question. I, alone arranged to have countless full sharps containers swapped out for empty ones. I think of all the other nurses out there who can say the same. That's a staggering number of bio hazardous-filled, yellow, plastic containers.

Where do all these containers magically disappear to?

Now, I may be pathetically naive, but I assumed they were brought to a waste management and recycling facility where they were emptied of their dangerous contents in a safe manner, the contents was somehow rendered 'clean' by way of autoclave or incineration, and the now empty boxes were somehow sterilized and sent back to pharmacies where they are... well... recycled, for goodness sake!

When we initially set up our business of managing Jenna's diabetes after her diagnosis we were told about the pharmacy's sharps program where, when you purchase syringes you get a free cute little sharps box which you can exchange at the pharmacy once it is full. GREAT! However, when Jenna started on the pump, we were dismayed that her infusion sets wouldn't fit into the opening of these cute little sharps containers. (I'm embarrassed to say that it didn't become our practice to remove the insertion needle from the set with a pair of needle-nose pliers and recycle the plastic infusion set for a few weeks post pump start-up. This revelation would have spared us the following quandary. However, I think you'll agree that this experience, in itself brought about a new level of environmental awareness for us. So all was not lost.)

So, before we had our epiphany of removing the needle and placing only that into the sharps container then recycling the plastic inserter, we were on a quest to find a larger sharps container to accommodate our falsely perceived need. Our pharmacy stated they could special order one in for us but they couldn't accept it back once full as they cannot accommodate it's large size. "No problem" we thought. "We'll find a way. There must be some facility who will dispose of our full, over sized sharps box for us."

I called our Diabetes Nurse Educator for her assistance. I thought maybe the hospital would take it and arrange for disposal. But she told me they don't do that. She went on to say that as far as she knows, filled sharps containers are sealed then disposed of exactly the same way all garbage is; it's dumped in landfills. I'm certain that, without coming right out and saying it, she was encouraging me to just chuck the filled container in with my other trash and curb it. I was HORRIFIED. My mind immediately launched into a cascade of thoughts... the sheer immensity of medical waste! I thought of what we are doing to our beloved planet. It made me feel ill.

I still have that over-sized container. It contains a half dozen or so infusion sets; the ones that didn't make it into the recycle bin, you know, pre-epiphany. It goes without saying that now, every infusion set is stripped for parts and each component is placed in it's respective, environmentally responsible receptacles. We even go so far as to snip off the connector at the end of the tubing. Anything to prolong the use of our spacious sharps container.

I'm still dumb-founded that we can send people into outer space, send probes to Mars, Twitter every damn thought we have, engineer and build structures that astound and seem to defy the laws of physics, but we haven't discovered a better way to dispose of medical waste.

Wow. I fear for our future. Our poor, trash burdened future.

Laying The Groundwork

I run. Not everyday, or even every other day. But I do like to get out and run every now and then. It feels good to push my body past it's zone of comfort. And in return, my body thanks me. It holds my asthma at bay by forcing oxygen into the cob-webby corners of my compromised lungs, strengthens the large muscles of my legs, improves my quality of sleep and gives me an all around physical and mental sense of well-being. If there is one thing I'd like to impress upon my girls, it is the wonderful benefits of exercise and treating their bodies well with good nutrition, adequate sleep and avoidance of those things that cause harm.

As I ran today, lost in my thoughts, feeling my lungs tighten, listening to the sound of my running shoes softly impact the pavement in a comforting rhythm, I thought of Jenna; how if she takes up running or any endurance sport, she will have more to think about than the average, non-diabetic athlete. And as I thought of what she would have to consider and prepare for before engaging in these activities, I felt all the more motivation to push myself. I do have an example to set of discipline and hard work. Exercise is an important aspect to a healthy lifestyle for everyone. But it is especially crucial, for those of us with chronic conditions, to battle against the ravages of our disease, be it asthma, diabetes or whatever the challenge.

I want my girls to live long, healthy, full lives. The groundwork for that is being laid now and I want their foundations to be rock-solid. So I ran today not only with the goal of maintaining my own good health and prolonging my life but I ran with the added incentive of my girl's good health and longevity.

When I got home again, my girls welcomed me home with hugs and kisses then spent the next 20 minutes doing stretches with me, asking questions and showing a keen interest in their own little body mechanics. I was delighted.

The groundwork is coming along nicely.

Our Screwed Up Society

Every time I'm at the grocery store, waiting in line at the check-out counter to pay for the food that nourishes my family, I am offended by the images on the covers of those fashion magazines and Hollywood star publications. Especially the ones that urge you to buy the magazine to discover the star's secrets to achieving their pre-pregnancy weight in an incredibly short period of time. We're talking a few short weeks post-pardom. I haven't actually read what "secrets" these stars are giving up, revealing how they achieved the impossible. I'm quite certain it would include more than a modicum of offhand, cavalier explanations that only serve to make real women feel like worthless lazy slobs that we can't achieve the same results with as little effort. I would guess that, in actuality, a great deal of medical and/or surgical intervention is employed to achieve these unbelievable results, utilizing financial resources that very few of the magazine's readers have at their disposal.

My problem with these magazines is that they are a major contributing factor to the unrealistic standards our society sets for women to achieve the "perfect" body. Women are sent the message that body fat is not to be tolerated and if you have curves you are FAT! This is causing girls and young women to do dangerous and damaging things to their bodies in a desperate attempt to fit into this unrealistic, unhealthy mold. Anorexia and bulimia have been around for some time now. This is not a new problem. So why have we put up with this shit for so long?! Why aren't women everywhere raging against this horrible, unfair pressure?!

Not long after my daughter's diagnosis I stumbled upon a Facebook group for diabulimics. I had never heard of this disorder before. But when I read about what it is and the personal stories of these young, misguided women with diabetes, struggling with very distorted body images and knowingly causing irreversible damage to their bodies to achieve the "perfect" body, I wept. In fact I sobbed uncontrollably, fearing for my little two year old baby girl with type 1 diabetes and her future as a young woman in this society with it's twisted standards and unrealistic expectations.

I made up my mind quickly that I had a big responsibility to set a healthy example for my girls. I need to be conscious of the way I view my own body and how much emphasis I put on my weight. With my girl's healthy self image as my motivation, I expect this won't be too much of a challenge.

The bigger issue to tackle would be how to bring about change in our society. I thought of the way the whole anti-smoking campaign was handled a few years back and I think that a similar approach might be effective. Cigarettes were removed from view in stores and, of course, advertising for smoking has been banned everywhere, at least in Canada. Why not do the same with these magazines that are potentially just as damaging to women's health, both physically and mentally?

My proposal is that we all start petitioning to have these magazines relocated to another area in the grocery store- behind a counter where you have to ask a clerk to get a specific magazine for you. In addition to this, I feel these magazines should have a large warning on the front cover, much like a pack of smokes has, stating that the images within have been modified via surgery or computer enhancement. Images appear smaller and closer to perfection than they actually are. Viewing this magazine could be damaging to your self-image.

Taking these magazines out of view might stop young, impressionable girls from being bombarded with these unhealthy images. And the warning might help those who choose to purchase and read them view the images with a healthier perspective. In the meantime, I plan to keep an open dialogue with my girls, informing them of the ridiculous lengths these stars go to to look the way they do... as well as the role airbrushing and computer technology plays in making them look unbelievably flawless. I have an obligation to my girls to expose these publications and the doctored images they contain for the fraudulent fiction they are as well as to celebrate the natural beauty in our world in it's many wonderful shapes and sizes. Besides, the truest form of beauty emanates from within and never, ever fades.

I Give Up

That's it. I'm done with delivery pizza. Seems every time I decide to order pizza I am doomed to pay dearly for wanting a night off of cooking a wholesome, balanced, diabetes-friendly meal. I just can't perfect the whole combo bolus business where pizza is concerned and I'm beginning to suspect it's because IT CAN'T BE DONE!! It's diabetic public enemy #1!

Tomorrow I'm buying some Weight Watchers wraps, some low fat mozzarella, and some of my kids favourite pizza toppings and from now on, when I'm feeling the need to take a night off, I'm going to enlist the help of my very capable and ultra-adorable little girls and we're going to have a "make-it-yourself" pizza night. Yes, it means that technically I'm not really getting a night off. There is a bit of prep work involved in pulling off a pizza constructing station. But that's OK. Jaz and Jenna will think they've won the lottery. They are forever wanting to help in the kitchen. Heck. I'm sure they'll be so chuffed about making pizzas I could likely talk them into doing clean up duty too. (I'm starting to wonder why I didn't come up with this little scheme... uh, I mean... plan a long time ago!)

So it's decided. A grand farewell to pizzeria pizza. Good riddance, you nasty, unforgiving, albeit tasty and convenient food!

Now please excuse me while I go check my baby and likely bolus her for a stubborn pizza induced high.

This all just SUCKS sometimes.

I spent the better part of a morning on the phone trying to get a hold of Jenna's endocrinologist and diabetic nurse clinician nearly two weeks ago; a desperate attempt to get some answers regarding some crazy high numbers Jenna had been having for a couple of days prior. Jenna's Endo is a wonderful woman who never once has made me feel like I'm inconveniencing her or asking something silly. This is unbelievably important to a parent who is feeling lost, alone and on the brink of panic. I feel incredibly lucky to have her in my corner. When I told her about Jenna's seemingly unexplainable spike in blood sugars she stated she had seen a similar scenario play out with several other young T1 patients of hers lately. She said it lasts about a week, requiring a temporary basal adjustment, then things calm down.

I adjust the basals as per her advice and cross every appendage possible hoping for the return of normalcy, or rather what has become our "normal" since diabetes became part of our lives.

We do the dance... checking way more than usual which is to say 10-11 times a day as opposed to our usual 6-8... causing Jenna's index fingers to become not only more calloused, but bruised and overtly sore looking. My heart hurts a little with every click of that damn lancing device. It's a necessary evil though. With the 20% increase in basal rates across the board I can't possibly rest easy. Every thing is up in the air again, as if the carpet has been unceremoniously yanked out from under us. She could dip too low in the night when I'm not watching. Or she could stay high leaving us wondering what the hell is going on. The latter is what occurred.

We spent several nights setting alarms every two hours and checking Jenna's blood sugars, bolusing each time. One night I was at my wits end when a third check was still in the mid teens and I knew something else had to be done. I would have to do a site change right away and give Jenna her third correction by injection; something we haven't had to do since her pump start up last September when we celebrated no more needles with our two and a half year old little girl.

I woke James to assist in the procedure. With both of us suffering from a lack of sleep unlike anything we'd ever experienced when caring for our infant girls, not to mention the prospect of doing an infusion set change at three in the morning on our sleepy hyperglycemic toddler and capping the whole process off with an injection of insulin, we found ourselves... well, let's just say~ a tad punchy.

While we were in the kitchen bickering over what needs to be done, Jenna wandered out of her room and stopped just outside her door looking as adorable and innocent as ever, disarming us both with her beautiful sleepy face. Quickly regaining our perspective once more, we got on with the necessary task at hand. James gathered up little Jenna in his arms in preparation for the insertion of the new infusion set. I say nothing to Jenna about the injection she has to receive.

After the new infusion set was inserted, the pump reattached and the old set removed, I picked up the needle I had pre-drawn before Jenna arrived on the scene. It was at this point I told Jenna that she had to have a needle. My years working as a nurse are what saw me through the next few moments. I quickly swooped in with the needle amid Jenna's pleas for me not to and, before she was able to fall to pieces, it was done. But she still had a little cry afterward anyway. I can't blame her. It must all be so confusing for her almost three year old mind to try to comprehend the reasons for all of the trials she must endure at the hands of her loving parents.

My heart broken, I followed as James carried Jenna back to her room. He settled her into bed once more and kissed her goodnight. I then leaned in to offer my affection but Jenna was angry with me and turned away. It may have been a combination of the shortage of sleep, the horrible instability of Jenna's blood sugars as of late, as well as being forced to inflict more pain upon my precious, undeserving little girl. Whatever the cause, her rejection was merely the straw that broke the camel's back and I wept. Right there in front of Jenna the tears began to flow. Her face changed and she too began to weep only this time it was out of compassion for me. I knew she felt bad for giving me the cold shoulder and now I was feeling even worse for making her feel bad. She deserved to be angry! I didn't blame her one bit. And if I was to be the target of that anger, so be it. But I needed to comfort her too. I may have been the one to administer the injection but I am also her mom; the person who usually "makes it all better." I think she was aware of this on some level and she reached out for me and hugged me. TIGHT.

We both cried and hugged each other for longer than your standard goodnight hug. I said I was sorry and I loved her. She said she loved me too. I went to bed with a lump in my throat, tears in my eyes and hoping with every ounce of my being that the injection would work.

The next morning an 8 appeared on the screen of the glucometer. It was the most beautiful number 8 I've ever seen.

Heavy Read

ok. So I received my copy of "Cheating Destiny" today in the mail. I just snuggled in to bed with my glass of water and all my pillows and opened the book. I got as far as page two of the prologue and I was forced to put the book down for a few minutes... having trouble reading through my tears. This book is hitting very close to home already... many memories and emotions are rushing back to the surface at break-neck speed.

Just felt the need to touch base with my fellow type 1 parent friends out there. I'm going to read this book. I am. But I think I'd better go get some tissues... perhaps the whole box.

On Being Misunderstood

Something occurred recently that left me a little shocked, a tad hurt and moderately frustrated and I feel the need to talk about it.

You know how the general public doesn't really know about type 1 diabetes? I mean, they think they know but they don't really know. It's not news to those of us who live with it on a daily, around the clock basis. We've all witnessed the ignorance. Ridiculous comments about what a diabetic can and can't eat, preconceived notions about the health of diabetics and the challenges they face, not to mention the blatant judgements as to why our children became diabetic, usually placing the blame squarely on the parents. One of my favourites was when a friend of mine stated shortly after my two year old was diagnosed that diabetics struggle with their weight and so my daughter would have to be careful about what she ate. HUH?! I didn't really know how to respond to that one. So I just calmly informed her that type 1 diabetics don't struggle with their weight anymore than anyone else... then I did some deep breathing and found my happy place.

To get to my point, I expect that most people who don't have any first hand experience with type 1 diabetes will have those kinds of misconceptions and even though I'm still annoyed, if not offended by some of them, I accept that there is a great lack of information and an abundance of misinformation out there with regards to this disease. BUT... I was surprised to discover during a recent telephone conversation with someone very close to me that this ignorance isn't just exclusive to those outside the family realm of type 1 diabetes.

An over-simplified solution to a hypothetical scenario involving my husband and I being away from our type 1 diabetic, pump wearing toddler overnight made me realize this person didn't get it. I mistakenly thought, or perhaps wrongly assumed that this person grasped the complexities of this disease and it's implications on our daily, if not, hourly lives. Now, to be fair, this person doesn't have any first hand experience with type 1 diabetes. This person hasn't even seen my daughter since her diagnosis and has only spoken to me on the phone a handful of times where the topic of conversation has been about my daughter's diagnosis. Nevertheless, the obvious lack of understanding made my heart sink. I suddenly felt quite lonely. Someone close to me who I thought really understood, didn't.

I should also mention that this person is a wonderful, caring person. I love this person immensly. I want to make it clear that this is not to injure or attack this person. This blog serves one main purpose; to help me deal with my daughter's diagnosis and all the ramifications it has on my life/our lives. I am merely venting and looking for understanding from those people in the world who do understand because they have been dealt a similar hand. That is the best way I know how to cope. Because, as parents of children with type 1 diabetes know, the only way to get through it and cope with the heartache is to reach out for understanding and support.

I have found a great deal of comfort and support from perfect strangers who also live with type 1 diabetes. It almost defies logic that someone as close to me as this person is would not be able to offer as much acumen. And in spite of the fact that this person's lack of appreciation for our situation is understandable, it still left me feeling... well... misunderstood.