Monday, August 31, 2009

I'll Take the #504 with a Side of Glucagon Training, Thanks

Several years before C started school, I had heard about a "504 Plan." I put it out of mind, on the back burner. She was still so young and I would be going to preschool with her so I didn't think much about her legal rights and such.

Then came kindergarten. I had to really wean myself away from the classroom. I ran office errands for the teachers. Ran off papers. Collated homework packs. I'd spy into the room now and then. Meet C in the Health Office for finger checks. And then it hit me. She needs a 504 plan. I need the 504 plan. If I seriously want to be able to leave the campus and, oh, I don't know, go to work, then we needed a plan laid out in black and white to cover all the diabetes bases. Even though the school personnel was wonderful and loving, I needed to put a plan in place for C's protection under the law. I don't know why, but I felt weird about doing this. Maybe it kind of stated loudly, I DON'T TRUST YOU PEOPLE! I don't know.

The only other D mom I knew at the school just left that year! Her daughter moved up to middle school. So I called her. A 504? They had never done one! Wow, I couldn't believe it. She was definitely looking into it now that her daughter was at the middle school.

Hmmm? What to do? I went online and started my search...anything to help me with a plan. I found some to look at, but it definitely had to be tailored to C's situation. CHLA gave me some guidelines too. The site, childrenwithdiabetes.com had tons of examples. And, so, we met to go over the plan with the principal, nurse, teacher and, of course, C. I leaned upon the experience of the principal. After all, her own daughter, now grown, has type 1 diabetes! You would think that would be such a soothing support. And, it is, to a point. But she's the principal and has way more to think about than just my daughter. But, I went with a standard form that she presented. We filled in the blanks, signed it and that was that. I had a difficult time enforcing my wish for glucagon to be kept in the classroom as well as in the office. My initiative to "teach" some staff about C's illness and how to give a glucagon injection was dismissed.

Last year went along without too many diabetes glitches. There was a time when all the first grades were going to do a food celebration of some sort and I wasn't notified in advance. There was a field trip that, post-surgery, I could not go on...and it ruffled some district feathers. But things worked out and they actually hired a "medical" person to accompany C. Maybe a few other times of substitutes rewarding kids all day with candy...that sort of thing. But we got through it okay.

This year, I tweaked the plan just slightly. I worded it so that the entire 2nd grade team, health aide office workers and such, will need to be trained on glucagon injections. This is the one thing that creates so many hypothetical crazy scenarios reeling around in my brain. My biggest fear: a severe hypoglycemic episode and no one around who knows what to do. Although, we've only needed to use it one time on C back when she was just 2 1/2 years old, I know it poses a daily threat to her. The reasons she may experience such a severe low are numerous. So this is the big focus for me...this time round. We will be meeting soon, hopefully this week. I'll put my diabetes game face on. This is such a critical step for me to take. I need the comfort of knowing that several people on campus understand the importance of this facet of diabetes.

So, yes, my order this year..."I'll take the #504 with a side of glucagon training, please. Thanks."

Friday, August 28, 2009

Candy World!



Oddly, this could be a wonderful dream or a horrific nightmare for someone dealing with diabetes.

During our little vacation this summer, we kept running into (literally) these crazy, HUGE, brightly-lit candy stores! We couldn't help it. It was like a gigantic magnet pulled my kids in!

Now, some folks may be thinking, "Wait a minute, I thought your daughter has diabetes," usually spoken in hushed tones for some reason. Well, yes. Yes, she does. But this store just screamed FUN! So, how could we resist!

Call me crazy, but I let C eat certain treats. I don't allow any of the purely sugar candies. (Although, jelly bellies are beginning to be the fast-acting sugar of choice for treating lows lately!) But, then there's chocolate. Chocolate is just so perfect. It has fat in it...not just sugar. So it doesn't send her sky-rocketing, then crashing. It actually works out okay for us as long as we count the carbs correctly. On special occasions, yes, she eats candy. We don't do it every day. We count and bolus accordingly.

So, in Candy World, I was going to allow my kids some fun treats! The boys picked out the "way-over-priced-by-weight" candies and scooped them into little bags...jelly beans, gummie things and of course the gargantuan jawbreaker. I wandered around with C, in search of the perfect chocolate. The great thing was, she was more interested in all the toys and stuffed animals rather than the candies. She is fanatical about stuffed animals! I kept asking, "Are you sure you don't want anything?"

"Oh, all I really want is this cute little stuffed turtle, Mom! Look! It has a little tu-tu!"

How could I argue with that?! Here we were in Candy World. I was willing to buy my type 1 daughter candy! And all she wanted was a stuffed animal. I actually was in awe of her decision for the remainder of our day.

Candy, candy, everywhere...and C is holding a strange blue squishy thing!

Wednesday, August 26, 2009

The First Day of School

Monday was the first day of school. It went something like this:

6:30 am I woke up and showered.

6:45 am Woke up middle C and C and checked her bg...155...not horrible...corrected.

Dressed. Breakfasted. Made lunches. Woke up big C.

7:35 am Out the door. Busy, busy parking lot...parked way far away.

Grabbed bags o' diabetes stuff. "Got your bag, C?" "Yes, mom!"

7:45 am At the Health Office. "Where's your bag?" "In the car." Ug. Back to car.

Back to Office. Talked with Health Aide. Nurse won't be here today! Must come and do all bg checks. Huh? Shook hands with middle C's teacher. Squeezed middle C good-bye. Walked with C to her new room. : ) Smiled at teacher. (We met and talked diabetes last week.) Left extra kit in classroom.

8:05 am Chatted with a few moms I haven't seen all summer.

8:20 am Back at home with big C. Had COFFEE. 1 more cup.

8:30 am Out the door. Picked up big C's friend. Dropped off at crosswalk of middle school. "Bye, sweetheart. Have a good day. I love you!" "Yea."
8:45 am To the grocery store. Although I just went 2 days ago, we are running out of food!

Raced home and put away perishable food.

9:35 am Off to school to do recess bg check...206...high, but we dealt with it. "Love you bug...see you at lunch!" Chatted with Health Aide.

10:00 am Back home. Put away rest of groceries. Continued with the endless laundry. Answered some emails. Processed some orders. Twittered some, of course.

11:35 am Back to school for lunch bg check...133...not bad. Corrected for lunch.

12:00 noon Back home. More computer time. Thought about 1:00 pm check...never mentioned this to new teacher. Maybe she'll be fine? Unless they play outside...so hot...she'll go low.

12:15 pm Called school. Talked with Health Aide. Decided on "in class" bg check at 1:30 pm. She'll call me. Okay.

12:30 pm Lunch for me...yay!

12:50 pm Out the door to pick up big C...middle schoolers have minimum day for Back-to-School Night...tonight!

1:15 pm Back home. Talked with big C about the day. He was unusually talk-y...so I took advantage. I heard all about his schedule and what friends are where...and what teachers are nice, mean, cool, etc.. Good times!

1:30 pm Get a call from school. C's bg wass...117...wow! Breathe.

2:00 pm Out the door to pick up C. Gathered bag from office. Hugged my big 2nd grader. Talked with teacher. "Everything went great!" Head home.

2:15 pm I heard all about C's new classroom. Pet turtles. Classroom helpers. "I got a lollipop, mom!" *sigh* "Let's save it for a low." bg check...152...okay. Correct and snack time.

2:45 pm Out the door to pick up middle C. (Yes, 3 different pick ups.)

3:00 pm A great 1st day in 5th grade! I heard all about the new teacher. Reward systems. Field trip plans. Who's in what class. All exciting! Snack time and relax.

3:30 pm "Any homework?" "No," "No," "No." But I have 3 big piles of papers to fill out and sign.
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It was exciting...the first day of school. Exhausting, but exciting. I count it a real blessing that I can be the taxi service for my kids. (I will need to remind myself of this blessing throughout the year!) There's something kind of magical about this time of year. I don't know...Maybe it's getting back into a routine that is comforting. Maybe it's seeing friends again. But, what I love the most is that feeling of great anticipation for what this school year can hold. The possibilities of learning, of growing. It's a great feeling. I think back a year--and how much my kids have grown and learned since then. Oh, the possibilities!

Monday, August 24, 2009

The Boardwalk


Why does this ride scare the bejeebers out of me?

Before we jump into post after post on the "back-to-school diabetes blues," (and believe me, there will be plenty) thought I'd write a light one full of summertime fun...
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We stayed around home most of the summer until August 9th. Then we made it up to the Monterey, California area for a week's break before the routine of school began. Good thing we got out of town when we did. With all 5 of us around the house, day-in and day-out for 2 months, I was seriously thinking of having myself committed. (Just kidding, kind of.)

During one of our days, we knew we wanted to take the kids around the bay to the Santa Cruz Boardwalk. I hadn't been there for nearly 20 years! We decided to be real cheapskates and go on one of their 75 cent nights (Mondays and Tuesdays). Every ride was only 75 cents! (Normally, they can be as much as 4 or 5 dollars!) Also, any soda was only 75 cents too...and maybe I shouldn't mention it, but 75 cents for cotton candy too! This promised to be a great time!

We made a day of it and first went up into the Redwoods. It was something! The weather was perfectly mild and we had a great time walking through the forest and peering up at these giant, ancient fellas. We even went inside some! And though the elevation wasn't even 2,000 feet, we felt like we were worlds away. Lunch was eaten under some shady oaks, and then it was time...the Boardwalk!

None of my pictures do these giant trees justice.

We took a very scenic drive down to the coast on Highway 9. With Gameboys banned, I made sure the kids took note of God's beauty all around us. We made our way to the Boardwalk just before 5 (just before the 75 cents rate started!) My kids were about to pop! I don't know what it was. We've done Disney, Knott's and the like, but something about the Boardwalk was making them hyper. Maybe it's the beach that edges right up to it. Maybe it's the scary, ricket-y rides. Or maybe it was the 75 cents for everything. But there we went.

It was so fun! The best part (for me) was the fact that there was no admission fee. We could freely walk in and among the attractions without spending a dime. And although the hotdog dinner was not even worth the 75 cents, it was an awesome time being a kid with my kids. (I told my husband that the hotdogs did not, in any way, constitute a dinner out for me!)

And diabetes? It behaved itself. For the most part. Even after a double chocolate dipped ice cream cone! That's all the credit I'm giving the D.

***So, if you're in or around Santa Cruz in the near future, crack open your piggy bank and get ready to have a great time with your kids. Remember to go on their 75 cent nights! And, again, though I would have loved to have been paid for this review, sadly...I was not. : )

I skipped this ride for a couple reasons!

The giant swing ride!

One last go on the merry-go-round!
---special note---Unfortunately, the day after our Santa Cruz fun, the much publicized Lockheed fire broke out in the forests above the Boardwalk. This saddened us so much and we hope that all the wonderful state parks were spared.

Monday, August 3, 2009

Ch-ch-ch-Changes

Change. I resist it in nearly every aspect of my life, though I know it's inevitable. Perhaps the area I resist change most is diabetes.

I remember that first year and a half with MDI (multiple daily injections). It was awful. I've written about it before...about dropping out of the nursing program mainly because of...well, because of needles. But, there I was, having to inject my little two year old daughter several times a day. Sometimes deep in the night. Ironic, really.

Then came the switch to the insulin pump. I resisted it. Our endo doc encouraged us from the beginning, probably the second month on...to try it. He was a firm believer in it...that it would be easier on control and on our nerves. We did make the switch. It was hard because, though I hated the injections, I felt like I kind of had a grasp on them. The pump meant a whole new set of rules, many new do's and don't's. (And, 4 years later, I'm still learning something new almost daily!)
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So, C had her endo appointment last Tuesday. I held guarded optimism about her Alc number. I felt like I was waiting for the professor to hand me my term paper for a final grade. At the last meeting, it had dropped, if only .2. I thought certain it couldn't be higher this time. Wrong. It was right back up to 8.2. Bleh! It produced a large pit-like feeling in my stomach. So much rides on this number. I know this is a great indicator of how C's been doing the last 3 months. I so want it to get under 7.0...

The famed Tiger Elevator at Childrens Hospital.



Our doc, so sweet, said "I know you're working hard at it. Let's tweak some overnight basals and raise her dinnertime carb ratios. I think that will really help." And, then we talked about the Minimed recall. Some of those mysterious highs that just would not budge were probably due to that. Possibly. Who knows? As the D folk on Twitter say: "I blame diabetes!"

It took a few nights for the effects of the changes to appear. I don't like changing more than one setting. I guess I like the scientific method. Too much change...it's making me crazy. We've been up the last 2 nights, trying to figure this out. Things are looking good but sometimes lower than I'm comfortable with...especially at bedtime. Last night was actually full of good numbers...just not full of much sleep...for me. Around 11:30 pm, I checked C. She was only 73. But I know that she has consistently been rising over night. So, I hung tight. I laid down, staring at the clock. I did not even close my eyes...

At 12 midnight, she was 77. So, okay, I thought... she's not dropping. I set the alarm for 2:00 am. She tested at 115...yay! I went back to bed without the alarm set. At about 8:30 am, her number was 126. I couldn't have asked for better numbers, all night long! (Well, I could have asked for 100 or maybe 95 at 11:30!) Good numbers, but not much sleep. What can I say?

C is growing, changing--everyday. I know her insulin needs will change too. I need to accept these changes and not fight them so much. I know this. It makes sense. I just don't like it.