Ah, yes, the seemingly ever elusive "in range" that all PWDs and MoCWDs (Moms of Children with Diabetes...but you already knew the CWD part, I'm sure! ) strive for each and every moment of each and every day.
You would think it would be kinda like keeping your car in your lane while driving. I mean, those dotted lines on the dexcom trend graphs look a lot like lane markers, don't they?
But, no matter how hard we try, those silly BGs just like to ebb and flow out of those parameters. And that can be extremely frustrating...for the one who has to deal with the actual BGs and for the one who feels it's all riding on their shoulders.
Bean is in third grade. She's eight and a half. She's a rockin' CWD who is able to do just about everything on her own, D-wise. However, she doesn't grasp the whole 'in range' thing...well, she's starting to...and that's OK with me.
There's no need for her to shoulder any more of the D load than she has to. That's what I'm here for; what Ubergeek's here for.
She's great about her lows. She knows what numbers are 'good'...and we are trying to eliminate 'good' and 'bad' from our vocab when it comes to BGs. She knows when numbers are high.
We are working on her correcting when she's not with us (i.e. at school) since she can already treat a low like a boss.
It's just that I want so much (for her, and kinda for me, too) for those BGs to be more 'in range' than ebbing and flowing. Yeah, yeah, I know....wake up and join the real world! That's not gonna happen most of the time. She has Diabetes and by the sheer nature of the beast, her BGs are going to be up and down more than they are going to be steady.
The hell of it is that now that she's back at school those ebbs and flows can (and do) affect her learning. That's the part that I think know the teachers just can't grasp...at least not until they've dealt with Bean in the classroom for a significant amount of time. And sometimes even then they don't really understand how truly altered her brain function is when her BGs all over the place!
It frustrates me to no end that Bean's morning learning is skewed because of the breakfast spike. Sure, we're getting it to not go as high, and it's coming down faster without crashing her, but come on! That up and down isn't conducive to optimal learning.
It drives me nuts that her afternoon learning is altered due to how her body reacts to lunch. And it's the same dang lunch every flipping day! (Why? Because I know she'll eat it, all of it, and that's kinda important!) Some days her lunch treats her well and she has a little bump and then settles in nicely for the rest of the afternoon. Some days her lunch treats her poorly and she sky rockets and just stays there for the rest of the afternoon. (We don't have her correct at school until 2 hours post meal, and she doesn't always realize she needs to correct...which is why we're working on that aspect of her D care). Some days her lunch is sneaky and sends her plummeting just an hour after she's eaten and trying to learn while you are low is pretty dang hard.
So, if Bean is to actually supposed to be able to learn while she's at school (and isn't that the whole point?!?) she's in a rather precarious catch 22. I know she's able to do a pretty dang good job whens she's slightly out of range, but there are times when her BGs aren't even close to that range and she'll still be expected to be learning.
Yes, she has a 504 Plan. Yes, it gives parameters for testing, but I can't really extend that to the entire school day. It's just not possible (well, it's possible, just highly improbable for a growing kiddo) to be in range for the entire school day.
And don't even get me started on homework! There's the after school snack and dinner to factor in...ugh!!
If only I could figure out how to squeeze all the learning into her brain during those hours minutes (at least that's how it feels!) she's in range, no matter what time of the day or night it is. Oh, and don't even mention homeschooling to me....yes, it works for a lot of families and I'm a huge supporter of those who choose to go that route, but you might as well send me off to the loony bin and Bean to anger management classes! ;)
Just the normal 'it's Monday and my brain already feels like it's about to explode' kind of thoughts running through my mind today. (shaking head back and forth, rolling eyes, and sighing deeply)
Maybe a nap would help...if I could only trust Bug to not burn the house down!! ;)
See, while we were at FFL in July, we had Bug tested with TrialNet to see if she has any of the indicators for developing T1D. I was tested, too, mostly to show Bug it wasn't a big deal.
We decided to open them, not burn them.
So, Bug is negative for the antibodies they test for, but isn't, of course, guaranteed that her body won't attack her islets, but her finger tips are safe from me for a year. (holy long sentence, batman!)
School actually started yesterday, but since she had been running a fever on Tuesday, she couldn't go on Wednesday. School District policy states that students must be fever-free for 24 hours. Thankfully it was just a random 36 hour fever without any other symptoms or problems!
She was super excited and had a really hard time getting to and staying asleep last night, but she got up without much fuss this morning, thankfully!
We went in with her, of course, because there's a LOT of stuff to take on the first day, even without all the D stuff.
We dropped off the classroom snack stashes, supplies for the nurse's office, and then proceeded to divvy up juice boxes between the Office, Art, Sport, and Music classrooms. (Can anyone say 'need stock in Juicy Juice?')
We made sure Bean was settled into her classroom and did a last minute carb count for lunch since I had forgotten to put it in her kit at home...the ONE THING I forgot, thank you very much! (and it's more for the teacher than for Bean because it's her 'normal' lunch and she knows the carb count for it without even having to think!)
I know she's going to be fine. I do. I know she knows what to do if she feels low. I know she knows she is supposed to test before recess. I know she knows how to test and dose for lunch. I know she knows how to do everything she needs to do all by herself. I know that.
She has two new teachers this year. Sure, one of them knows her from social situations, but, she hasn't had her in the classroom and that's a whole different thing!
The nurse isn't there today. Sure, the school was able to add to her hours this year, but she's still only going to be there two, maybe two and half days a week. And today isn't one of those days.
This is her FIRST DAY back! New schedule, new procedures, friends she hasn't seen all summer. Sure, she knows how to do all the D stuff, but it can very easily get lost in the shuffle if she's thinking about other things.
Yep, totally called the school to make sure she tested before recess. Secretary went to her class to double check and then texted me with her number...182. Not bad for setting her temp basal late for breakfast!
Then I got a text letting me know that Secretary went with her to recess to introduce her to the new noon duty (recess monitor). LOVE HER!
Ubergeek and I plan to chat a bit after school with Bean's teachers, just to go over a few things with Bean actually being there with all of her gadgets since they've only had training with the nurse.
I should be relishing in the fact that I only have one kiddo at home today. I should be getting things done around the house because I'm not having to play referee all day. I should only have fleeting thoughts of 'hope she's having a good day.'
But, I'm a D-Mom. I call, I text, I make sure she's safe and taken care of. I ignore the piles of laundry that need to be folded because I can't even seem to concentrate on a menial task like that because my mind is racing with all the information that I hope the teachers remember. I blog to get it out of my head. I send up prayers, knowing that He cares for her even more than I do. I cry, not because I'm sad, but because that's what I do when there's nothing else I can do.
I was spoiled last year, having the long term sub job at Bean's school for three quarters of the year. I was just a radio call away if she needed anything. I was two minutes (if I had to walk down the hill slowly because of snow) from the main building where she was if I needed to physically get to her. Now, having been passed up for not one, but two, jobs at her school this year, I sit at home, cell phone on or right next to me. Sure, I'm reachable. Sure, I can offer words of help. But, I'm not THERE. And not only does it hurt because of the whole job thing, it hurts because I know I can't get to her quicker than 10 minutes if I need to actually be there. And it sucks! Really, really sucks.
Three hours, 15 minutes down. Three and a half hours to go. Ugh!
It's that time of year....the get everything ready for school time.
Training the Teachers
Update Care Sheet
Get FNP to help update School District required Forms
Get new Glucagon Rx filled....and add to the growing pile of unused ones (knock on wood!) for training.
SWAG basal rate adjustments based on last school year and summer rates...fun!
My head is swimming with a million and one things that need to be completed and ready to go for Wednesday morning. My sleep is even more interrupted (as if that's even possible!) because my brain just won't shut off. The stress induced cold sore that is just about gone on my bottom lip is now joined by one on my top lip that popped up this morning! UGH!
But, BUT...totally awesome news at Bean's three month check up this morning....
Her A1c is down to 8.2!!! Woo-to-the-frickin-Hoo!!
That's the lowest she's been and that's an 'over the summer with travel and what-not' number! She had been down to 8.4, then up to 9.0 (thinking a run of not so fab insulin 'helped' with that because she was running high off and on for the two weeks prior).
Yeah, I know it's just a number and it's not my report card...blah, blah, blah!
THIS number, this 8.2, reflects some damn hard work and not letting those stubborn highs win. Sure, she's had her fair share of lows because I've been a bit aggressive with those highs, but it's a learning process and we're getting better at hitting that nice 'range' more often.
Who knows what the next A1c will bring with the new school year. I'm not remotely concerned with it right now.
Right now, I'm going to celebrate and pat myself on the back and continue to tell Bean she ROCKS!
Reyna, over at Beta Buddies, was the first to come up with this idea...at least I'm pretty sure it was her. I know it was where I saw it first...if it was someone else, please let me know and I'll be happy to give credit where credit is due!
Sometimes you just need a little BG boost.
Times when a glucose tab just doesn't strike your fancy...or is just down right REFUSED. (For the record, Bean is a refuser of gluc tabs....I'm talking run the other direction kind of refuser!)
Times when you need a 'sugar shot.'
What, pray tell, is a sugar shot? Well, it's a container of fast acting sugar that is easily consumed. The container of choice is usually a used (but washed) test strip container. I mean, who doesn't have a ton of them!
We, until recently were using them, too. However, Ubergeek was doing some surfing on the interwebz and found out that the plastic used for the test strip containers contain a desiccant to help keep moisture from degrading the test strips.
This is what we found when we broke apart the containers we have.
The plastic isn't solid, it has a grainy substance incorporated into the
plastic. Enough to make us a bit wary of using them for food.
Now, some desiccants are harmless...like the ones used in table salt to keep it from clumping. Some are not so harmless. Not knowing (and not being able to find out so far in all the of searches I've done) which kind of desiccant is used in our particular test strip containers, we've decided to find alternative containers for Bean's sugar shots. There is, and will never be, judgement on your personal choice to use or not use test strip containers. Just trying to pass along some information so you can make an informed decision for yourself.
We happened to have an empty Tic Tac container, but it (a) was kinda big, (b) could hold way more carbs than Bean needs, and (c) made A LOT of noise when the appropriate amount of carbs were in it.
So, I went on a quest for small containers to use. I ended up at Michaels, in the beading supplies aisle, perusing all the little bitty plastic containers they had to offer.
I found a set of 12 cylindrical containers in a carrying case that looked like the right size...silly me forgot to bring along a sample of contents for the sugar shot! Plus, it was on sale 40% off! Score! So for $4.97, I have 12 sugar shot containers.
Bean isn't a 'candy lover,' so her sugar shot contents of choice are mini M&Ms. I have been using Christmas ones that I got on clearance at Target, but with the lows of camp last week, our supply was just about gone. I scored some at Fred Meyer, on sale at $0.65.
So, all told, Bean now has 11 sugar shots (only had enough M&Ms for 11!) for a cost of $0.69 each. Not bad!
Here's what they look like...
here's the label, in case you're interested in exactly what container it is
For our sugar shots, I used 13g weight of M&Ms, which works out to be 9g carbs. The containers can actually hold 17g weight of them, but that's more carbs than Bean needs for her BG boost. But, if your needs require a bit more carbs, you have the room!
These sugar shots will be great for Bean's kit, my purse, the classroom, nurse's office, front office. Small, easy, and effective BG booster. Love it! :)
Bean attended a day camp last week. A 9am to 4pm day camp. A camp that Bug was supposed to be going to until 11:30am, but the class for the 'little ones' was cancelled due to lack of enrollment....not only a bummer for her, but it meant the loss of an 'excuse' for me to check in on Bean each day!
See, this camp isn't a D camp. It doesn't have folks who have much, if any, idea about the ins and outs of T1D. Sure, Bean went two years ago (they do it every-other year), two months after dx, on shots, and I went everyday for lunch to make sure she did what needed to be done. Sure, there's a mom that volunteers who is a school nurse, but she wasn't with Bean's group, nor did I expect her to be Bean's personal D-assistant. (Though, it would have been nice!!)
But, since Bean is pretty much in charge of her D care at school, I wasn't concerned about this week. Well, not too concerned. I made sure Bean was prepared with carb counts for her lunch, a 'double stocked for lows' kit, and we talked through the 'basics' of her doing her own bolusing (she likes to tell me her dose before she hits 'confirm' for it to be delivered). I also had an info sheet (thanks to Ubergeek for reminding me...and printing it out) to give to her group leaders to give them a bit of general information.
Yeah, I knew she'd be pretty active, but I wasn't expecting the four or so lows the first day. So, on Tuesday, I reduced her basal a bit, but she still had several lows. Wednesday she started high for breakfast (204) and stayed high all day....see, she ROCKS treating lows, but she's not really up to speed on treating highs. She just doesn't think to correct herself. So, Wednesday was hard on her. Thursday she started out in a great place (105) so we reduced her basal like we did Tuesday instead of the even bigger reduction on Wednesday because Bean said she would rather treat lows than be high all day. And, she did...more lows, but she felt way better! Friday we opted for the bigger reduction in basal, and although she did have a couple of lows, she was only under 70 once and it was because they stayed an hour later to practice for their performance so she was 30 minutes late having her afternoon snack.
I totally see the week as a huge success, D-wise. Sure, she had more lows than I would like her to have, BUT she was so on top of it. She tested often, especially before doing physical activity, and anytime she felt low. Her leader commented to me on Wednesday that she was amazed at how seamlessly the whole diabetes thing was going (oh, if she only knew!) and how impressed she was with Bean and how she took care of everything. Bean had a great time and felt confident in her ability to take care of D needs. Yep, totally a success!
(yeah, not the best quality, but that's what happens when the camera
battery dies after you take two pictures
and you have to resort to the cell phone!!
but, even out of focus, she's cute!)
This is what I found when we showed up Friday. Every other day she was packed up and ready to go, but since Friday was the potluck and performance, they didn't have the kids pack up. So, I got to see the 'low fodder' of the day: two juice boxes, one apple sauce, one 'sugar shot' (container filled with mini M&Ms, about 8g carb). She can treat a low, but can't seem to find the trash can!! ;)