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!

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.

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.

Guilt

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.

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.

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.

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!