Fall happenings and pump update

Well, Alyssa has been using the pump for a little over a month now.  We've had some ups and down, highs and lows; and tears and laughs....I would be lieing if I didn't tell you there have been times I thought I had made a mistake by pushing for Alyssa to get on the pump....I'd be lieing if I said I had not thought about disconnecting it and going back to shots.  But I keep reminding myself why this will be best for her in the long run. 

The hardest part....the first several site changes were a nightmare.  Alyssa's anxiety about them got her so upset leading up to it that it took at least an hour to calm her down to put in the new site. Fortunately that has gotten better.  The problem now is that she'll only let me put the sites on her bottom....we are alternating cheeks.  We have done the stomach once but she hated it.  Alyssa is so petite, her bottom is the only place she has any extra meat. 

We have also had a few scary high and low bgs that seem to have come out of no where.  There were also a few night time lows, but I think we've worked out those kinks with basal rate changes.  In the beginning I was checking her bgs every 3 hours while she slept, now I'm only checking once in the middle of the night.

I do finally feel we are getting the hang of things.  There definitely are many pros of using the pump.  Alyssa has much more freedom with when and what she eats....if she wants something to eat at any time, we just bolus for the carbs.   Its so nice to enter her carbs and the pump figures the amout of insulin...all of this without another injection.  This made Halloween and Thanksgiving a lot less stressful!  One site change every 3-4 days versus 12-16 injections over 3-4 days.

 Also, besides a few spikes and lows, her average blood sugars have been really good.  During cheer and tumble, we disconnect and honestly have had fewer lows during exercise because she's no longer on the long lasting insulin, Lantus. Since she's given little amounts of fast acting insulin every hour through the pump she no longer needs the long lasting.

Overall, even though I've had some moments of doubt, I believe the pump will afford Alyssa more freedom and as she gets older, more independence.  As with any change, adjustments should be expected.

P-day

I don't know who was more excited this morning... Me or Alyssa? We've both been anxious for this day, especially since we received her pump over a week ago. The huge Animas Ping Box and the slew of pump supplies are hard to miss when they are taking up 1/2 my kitchen table.

Since we've received the pump, Alyssa and I have played with it. I read 'the book' and watched the video, and when we sat down with the pump trainer things ran smoothly. Alyssa demonstrated most of the functions. After we set up the pump, filled it with insulin and checked blood sugar, it was time to insert the infusion set. The infusion set is a spring loaded device that punctures the skin with a needled and as it withdraws leaves a cannula. The tubing from the cannula connects to the pump and this is how insulin is infused.

Because Alyssa was scared, I asked her if she wanted to put the infusion set on me first. Of course she did... I'm still wearing it :)

She was a little scared but was very brave. As a reward we went out for a chocolate sundae :). So great to bolus for 50g of carbs by remote!!

The next few days are going to require close observation and I'm expecting some changes. In the beginning we'll be checking bg's before meals, 2 hours after meals, before bed, at midnight and at 3 am. The goal here is to eventually improve Alyssa's life and I feel the pump will after we all get used to it.

Another cool thing, we never noticed our endo wore a pump or even that she had T1D... Alyssa saw hers today and its the same pump we use :)

Diabetes stinks....

This morning while I was straightening Alyssa’s hair (today is picture day at school), I asked her, “If someone asked you what it was like to have diabetes, what would you say?” She replied simply with, “Diabetes stinks.” Now, for those of you who know Alyssa, you know that she can be quite dramatic. For instance, if she’s has a headache, her head is “killing her to deathhhh” or when she’s told to clean her room, she‘s been known to lay out in the floor explaining she‘s way too exhausted to take on such a task. So, as you can imagine, I was expecting a much more elaborate answer….like “diabetes is horrible!”, or “diabetes is the worst thing ever invented!”

Now most would think that this reply was a good thing. That Alyssa has adjusted to having diabetes, and that although it’s not great, it really isn’t that bad. Instead, her answer saddened me at first. What child should have to endure this? What child should not be able to eat a piece of candy without thinking about it or be able to eat a piece of their friends birthday cake without looking to their mother to be sure it’s ok. (Side note: at a recent birthday party she told me that she wanted to give up eating pizza so that she could have a slice of cake.) What child should have to prick her finger so that it bleeds before each meal, before physical activity, after physical activity, before she goes to bed, in the middle of the night, and every time she doesn’t feel just right. That’s any where from at minimum 4 and up to 8 times a day. What child should have to have 2 SHOTS in her bottom after breakfast, a SHOT in one of her arms after lunch and a SHOT in her other arm after dinner and sometimes a SHOT before bed if her glucose levels are too high.  What child should have to face the risks of heart and kidney disease, blindness, amputations, and early death?  More simply, what child should not be able to go to a sleep over or anywhere without their mom?

I know there are many diseases out there, and each one of them sadden me….especially any disease that robs a kid of the childhood they are entitled to. Diabetes is a disease that can do just that….if its allowed to….. My husband and I refuse to let this happen. The day Alyssa was diagnosed, I prayed that God would let me take this from her. I think in a small way He has because she has no fear or anxiety about the future of her disease.  I think she sees how diligent we are in advocating for her and researching for new treatments as well as preparing her to be able to manage this on her own one day.  She notices all the people who love, support, and push for finding ways to improve her life.  She knows that without research insulin would never have been discovered and meters wouldn’t be improving each time a new one comes out. Without research insulin pumps would not have been invented (We are so excited that Alyssa’s first pump is on the way and how its going to make life a little bit easier. And instead of 4 SHOTS a day, it will be a new infusion site every 3 days!!) Through all of this she believes living with diabetes will get a little bit easier over time. Most importantly, she trusts my words when I say there will be a cure one day.

I’ve said this many times….Diabetes is the first thing I think about in the morning and the last thing I think about before I go to sleep, and I will gladly take that on for her.  In Alyssa’s eyes diabetes is just a small part of her life and I‘m happy in that.


*This year our team, Alyssa's Army, will be walking in JDRF's event, Walk to a Cure at Elon University in Burlington, NC.  If you would like to make a donation to our team, you can do so through the link below.

Alyssa's Army Walk Page 

 

 

It's walk season.... Fundraising ideas

We have so many fundraising events that will benefit this year's walk. Of course we have the online donating through JDRF's walk page. We had a fundraising yard sale a couple weeks ago that was successful. Currently, we have 2 catalog/online shows going with Pampered Chef and 31. Next weekend some friends of ours are hosting a pig pick in' fundraiser. We asked one of our company's suppliers and they agreed to sell JDRF sneakers and another hairstylist friend is donating a portion from each client for the month of September. Our church also has been extremely generous with love offerings and donations for our yard sale.

With a little less then two weeks to go, I do not see how we can not reach our team goal of $3500!!

First day of school

With the first day of school came a new diabetes schedule. Left behind were the late nights and sleep in mornings. We started the new schedule a few days before school started, but I still knew the lazy days of summer that fit her current diabetes protocol was sure to change with the active life of a new 4th grader. I knew she would be more active so the morning of the first day I reduced her fast acting insulin. Mid morning she had her provided snack, but at lunch time a bg of 70. 2nd day of school, reduced insulin even more, usual snack and a lunch bg of 63. On the plus side, bg's have been normal at dinner which means her dose is good at lunch as well as the carbs in her afternoon snack. Tomorrow I'll make another reduction to see if that helps with the low blood sugar at lunch.

Going back to school

School starts 1 week from today, so I broke out Alyssa's most recent diabetes plan and starting filling out the paperwork for my meeting with the school nurse on Thursday. I will also give a brief training to her teacher on what to look for with Alyssa. The teacher will be attending a diabetes class provided by the school that usually happens sometime during the first week of school as well. So, this little training session is just so she knows what to expect the first few days of school.

I purchased enough snacks to last a month for the teacher to keep in her room as well as several juice box packs to treat lows. I've started getting her diabetes bag ready that stays in the office that will contain her meter, strips, syringes, glucose tablets, alcohol swabs and insulin. Ideally I would have liked for Alyssa to be on the pump before school started, but at least we have the ball rolling.... hopefully final approval in the next couple of weeks!!

Beaching it....

Vacation to Key West was great and the trip through airport security on the way back was much better than on the way there. Blood sugars behaved for the most part. We did have a few lows at the beach, but we were well prepared since we expected it.

Airport Security

The start of this trip reminded me of the Griswalds..... We were an airport security train wreck. I was so concerned with letting security know about Alyssa's diabetes supplies that forgot to remind her to remove her laptop from her bag and to toss her bottled water. So that was a little hold up...

I packed all of Alyssa's supplies in a little bag cooler. Inside was also a 4-pack of juice boxes and the security officer told me they needed to be less than 3oz umm no...4oz is 15 grams of carbs. I cleared it all up, she swabbed the juice and after running everything back through the scanner, we were on our way.

Overall, not too bad for Alyssa's first time flying since diagnosis. I'll be better on the return flight!

Getting ready for vacation

We are nearly packed for vacation. This is Alyssa's first time flying since her diagnosis. I got a letter from her endocrinologist and packed double the supplies we will need for the week long trip. I'll let you all know how it goes on Wednesday :) This afternoon, we even had time to hit the nail shop... Key West here we come!

Treating Lows

When I ask Alyssa what it feels like when her blood sugar is low, she says that she feels like she's shaking and her heart feels like its going to beat out of it's chest.  What I notice when she's low is that her face pales and although she's cool to the touch, she breaks into a sweat.  Also, her pupils dilate and her speech is affected.....it appears as though she's drunk.  Last night, just before bed she came to me and said she was low.  She was already treating herself with a juice box, as she had checked her sugar and it was 34!!  I sat her down and retrieved the Smarties from our supply cabinet and gave her a few of those after she finished the juice box.  This is always a touchy time because there is always the chance she'll lose consciousness.  The 15 minutes before re-check seems to last forever.  Then just as quick as the low came on, the color starts to return to her cheeks, her words become clearer and she says she feels better.  Re-check 92.  I gave her 4 peanut butter crackers.  At about 2:30 a.m., I checked again.....bg of 187. 

She had an 1 1/2 hour cheer practice earlier that evening, but her bg's were good before and after.  And what was crazy, was that at this time she was just playing on the laptop, nothing physical. She had a normal bg before dinner and ate really well.  Ughh....unpredictable!!

The D-O-C

When your child is first diagnosed with diabetes your world is set into a spin, especially if you have no previous exposure to the disease.  In my case, my step dad was diagnosed when I was in my early teens and I had gestational diabetes when I was pregnant with one of my children.  So, I had a little understanding of the physiological aspect of type 1 diabetes.  However, when my daughter was diagnosed I still felt like a steam roller had flattened me.  My new job was going to be her artificial pancreas.  I was going to have to measure and calculate what she ate.  I was going to need to determine the amount of insulin she needed based on her blood sugar levels and consumption of food; all while being sure to account for her physical activity.  I wasn't sure if I was the best person for this job.  What if I messed up?  What if I made a mistake?  And then there was the fact that our entire lives were flipped upside down.  This disease affects the entire family.

We were and are very fortunate to have a supportive "village" that immediately jumped in to help us make sense of this situation.  But what we needed too were other families who lived with this disease, who had been where we were.  I began to search the Internet for more information about living with this disease and stumbled across a mother's blog, D-Mom, The Sweet Life with a Diabetic Child.  I read her current and older posts.  Her blog led me to another d-mom's blog, and so and and so on.  Their blogs also led me to Facebook groups and Twitter events.  This is the Diabetes Online Community (#DOC).

Connecting with the DOC helped me know what to expect when my daughter returned to school after her diagnosis, helped me figure out what a 504 plan was, and led me to volunteering and advocating...they led me to start this blog.  From the DOC I've gotten advice, support, and understanding from other parents who live similar lives.  From the DOC, Alyssa has built relationships with other children who are like her....who have to prick their fingers and take injections and who feel bad when there sugar levels aren't just right.  (And they've helped us choose what pump we will get)

If you or your child is newly diagnosed, my advice to you is to connect through blogs and social media with others who have been where you are.  I'm sure glad I did!

Dawn Phenomenon and Pump News

Alyssa has experienced high blood sugars in the morning for the last two weeks or so.  High for her morning level is anything over 150.  As I have mentioned before, Alyssa's blood sugar usually drops about 100 over night.  So my goal is to have her sugar somewhere around 200 at bedtime.  If her glucose level is below 200, she'll have a bedtime snack and if it is close to 200 she will not.  What was odd, I was seeing high blood sugars in the mornings and even after the nights she didn't have a bedtime snack.  Could this be the 'dawn phenomenon' I've been hearing about?

Dawn phenomenon is the term used to describe early morning (usually between 2a-8a) high blood sugars in diabetics.  It is thought that the body releases hormones over night, like the growth hormone and cortisol, that cause insulin resistance.  Alyssa takes Lantus in addition to Novolog, which is a slow release insulin that normally works for 24 hours.  I've heard though it can often be unpredictable with schedule changes.  Of course other reasons can be incorrect dosing of insulin or eating too many grams of carbs before bed.  In my opinion, I think it is tied to activity level as well. 

What this means?  I will again be waking at 2 in the morning checking blood sugars to see if there is a rise in the middle of the night for a few days and see if adjustments need to be made to her diabetes plan.

Pump news: We looked at 4 insulin pumps the other night.  It was really cool because Alyssa got to touch them and see how they worked.  After the pump class, I read all the information and narrowed down to either the Omnipod or the Ping.  We have chosen to go with the One Touch Ping.  I really thought Lu was going to push for the Omnipod because it is tubeless and stays on, but she liked the Ping best.  The cool thing is that it is 100% waterproof and Alyssa also liked their infusion sets the best, which are easily inserted and come in different colors :).  So yesterday, I faxed all my insurance info over the the rep and we have started the process.  Next step will be to see how much they will cover!

http://www.animas.com/

Carb Counting Basics

I know I have written several posts about carb counting, but because diet is probably the most important aspect of managing diabetes, I don't think it can be covered too much.  Understanding carbohydrates helps determine which foods affect blood sugar and how much insulin should be given for the food eaten.

The 3 main nutrients in food: proteins, fats, and carbohydrates all affect blood sugar levels; however carbohydrates is the main effector.  After carbs are eaten and digested, they become glucose and enter the bloodstream.  This causes blood sugars to rise and insulin is required to move the sugar into the cells for energy.  Some might think that carbs are bad; but in reality, they are the body's main source of fuel.

Foods that contain carbs are: starches (Breads, starchy veggies), fruits, milk products, and sweets.

Estimating carbohydrates can be done based on serving sizes (some call carb choices).  On average 1 serving size will have about 15 grams of carbohydrate.  This method is best used when there are not any food labels or when eating at a restaurant.  Examples of carb choices are: 1 slice of bread, 1/2 cup of corn, 4 ounces of juice, small apple, 8 ounces of milk.  Each of these would be considered 15 grams of carbohydrate.

Counting grams of carbohydrate is much more precise.  Reading food labels and meal planning books are the best way to count grams of carbs.  I recommend the book, Calorie King.  When using this method, food is measured and then the carbohydrates are calculated.  When reading food labels, its important to determine how many servings you are going to eat and then multiply that by the grams of carbs per serving. 

*Watch out for products that say they are "Sugar-Free" or "No Sugar Added".  Just because a product is sugar-free doesn't mean its carb-free.  So always check the grams of carbohydrate.

Pump Class

Looking forward to going to play with the different insulin pumps this afternoon with Alyssa. Look for a post about the experience as well as the next step, insurance :D

A Great Weekend

Riding 4 wheelers through trails and mud and puddles was not something I thought I would ever do. I wouldn't say I'm a girly girl, but I never really saw the need to play in the mud. Alyssa on the other hand is very versatile. She likes being a girl, playing with makeup, painting her nails; but she also likes playing with toy cars and out in the dirt.

So, yesterday, I agreed Lu and I would go with the boys to Busco Beach, an ATV park a couple hours from home. Alyssa love it and I have to say I had a lot of fun too! She rode a lot on her own and has gotten really good. My sons Phil and J are fearless and they got a kick out of mom's screams as we went over ramps and through the mud.

For the most part diabetes behaved. We had one low towards the end of the day and honestly four wheeling is a lot of work, so we checked periodically and stopped for extra snacks.

All in all, it was a great day with the family filled with some great memories!

Type 1 Diabetes...need more snack ideas

Choosing snacks for Alyssa is an ever evolving task. Being a child with type 1 diabetes, high energy, high metabolism, and one who could previously eat anything she wanted....means mom had to become very creative. Her snacks need to be around 15g of carbohydrates to keep her blood sugars level.  I always keep sugar free jello, sugar free popsicles and cheese sticks on hand, as they are low carb alternatives when Alyssa’s hungry between snacks or meals. She loves vanilla flavored yogurt and a serving of the light is 14g of carbs. All the little 100 calorie snack packs have somewhere between 14-17g of carbohydrates and there are tons of varieties and great when you're on the go. It also gives her a chance to have chocolate chip cookies in mini size :). Sugar free jello pudding, ritz bits peanut butter snack packs, gold fish snack packs and 4 to a pack of peanut butter or cheese crackers are all 15g of carbs or less too. If she experiences a low blood sugar, I usually give her a 4oz. juice box followed by a protein/carb snack of cheese and crackers or cheese and a few grapes or apple slices. She has 3 snacks a day and who would want the same thing over and over? Therefore, I am always on the lookout for new snack ideas.




(An updated version of a early post).

What is A1C??

I have had several readers ask, "What is A1C?"

Of course, prior to Alyssa's diagnosis, I didn't know either.

Basically, A1C is a blood test that reflects patients blood glucose levels for the past 2-3 months.  Specifically, the A1C test measures the percentage of hemoglobin (the protein in red blood cells that carries oxygen) that is covered with sugar.  The higher the level, the higher average of blood sugars and the higher the risk of complications.

A normal A1C is between 4.5-6%, which means an average of 80-135 mg/dl (blood sugar levels).  An A1C 6.5 or higher indicates diabetes.  There is also pre-diabetes which is an A1C of 5.7-6.4%.  For most adults with diabetes, the ideal target is an A1C of 7% or lower (average bg's 170 or lower).  With children, the target is 8 % or lower (average bg's 205 or lower).

Counting Carbs

Counting carbohydrates can be quite difficult when your type 1 child eats something that doesn't have a label.  This week, Alyssa has been going to vacation bible school and the first thing they do is eat dinner.  The first day was pizza, applesauce, Oreos, and a Capri Sun (I brought a Capri Sun Roarin' Water because it only has 8g of carbs compared to the 22 in regular Capri Sun).  I knew a regular applesauce cup has about 22g of carbs, at least the brand I buy does.  I knew a regular slice of pizza has about 45g of carbs.  The Oreos were 25 g of carbs for a 3 cookie serving, but she only ate 1 of them.  Adding it all up in my head....this was a total of about 83 grams of carbs which would normally mean a basal rate of 4.15 units of insulin.  However, I knew she was going to be running around like crazy for the next few hours and burn up a lot of those carbs, so I decided to give her 3 units of Novolog.

At the end of VBS, blood glucose check read 212 (honestly, I thought it would be lower, but not too bad).

Changes

The endocrinologist made a few changes to Lu's regimen because her hemoglobin A1C had gone up .2 since our last quarter visit.  Yesterday was the first day of the dose change and also her 3 hour cheer practice.  I was a little nervous to give her the higher doses with breakfast, but didn't want her to spike before the 10:30 practice time.  Her Lantus was increased from 9 units, to 10 units and her Novolog rate was increased from 1 unit for every 20 grams of carbohydrates, to 1 unit for every 15 grams of carbohydrates.  I gave her the updated dose with breakfast at 7:30 and on the way to practice, checked her blood glucose levels.  258 at 10:15.....we are back to those post breakfast spikes where the insulin is taking a little longer to kick in.  Practice immediately started with warm-up and practicing jumps.  After about 20 minutes of that, they started tumbling and that lasted about 30 minutes.  At 11:30, we did a recheck of her bg's and she was at 115.  She had a snack, apple slices, peanut butter crackers and low-calorie Gatorade.  They practiced their competition routine and around 1:00, she gave me 'the look', which I knew meant that she didn't feel good.  Re-check, bg's 62.  Quick juice and a snack and the timing was good because the team decided to take a break.  10 minutes later,she perked right back up and finished practice with energy left over.

Dum Dum

On my last visit to the pharmacy to pick up Alyssa's diabetes supplies, I decided to go through the drive thru. I told the lady behind the glass that I need to pick up my daughters prescriptions, gave her date of birth and confirmed our address. Alyssa was in the seat next to me and the pharmacy tech waved at her. We chatted for a few minutes about the heat (over 100 degrees that day) while she rang everything up. It takes a few trips through the pass through because of the boxes of syringes. On the last pass, I opened the door to the pass through and beside Alyssa's bag of insulin was a Dum Dum lolly pop. I just smiled. And yes, Alyssa ate the sucker later!

I thought I had it together.....ugh

So, today was our quarterly visit with the pediatric endocrinologist.  Interesting morning, to say the least.  To start things off, I didn't sleep well last night, so when the alarm rang this morning, I didn't want to get up.  Thinking maybe I shouldn't have....  We did Alyssa's normal morning regimen and she asked if she could have a little coffee this morning. So, since she was up earlier than she had been in a few weeks I thought a little 'children's coffee' might help her get going.  I measured the milk, sugar free creamer and mixed them with a little coffee.  I accounted for that with her Novolog dose and we hit the road to drop her brother off at his first day of driver's ed and then on the see the doctor.

When the nurse called us back, she wanted to check Alyssa's blood glucose levels and I thought for sure it was going to be within range.  At this time it had been 2 hours since she had eaten....but a reading of 405.  I was floored!  She hasn't had a reading like that is such a long time.  Re-check...305...better, but what the heck??  I felt terrible.... I mean, I carefully measured her food, counted the carbohydrates, and calculated the insulin dose.... all of a sudden I felt like the worst mom in the world.  I mean, I know realistically that things like this happen and diabetes is a very tricky disease.  Sometimes bg's fluctuate for reasons out of our control like stress or excitement.  I know Alyssa and I both were excited to discuss the insulin pump with the endo.  Another blow, her A1C was 8.2, up from the last visit.  Ideally, they would like to see it 8 or less.  Ugh!

Well, on a happier note we did discuss the pump.  We are scheduled for an insulin pump class on Tuesday evening.  After we pick out the pump we want, the next step will be to contact the insulin pump company to start the purchasing process and see what pump and how much our insurance company will pay for.  I'll go into more detail in another post about the process of getting Alyssa started on the pump and the steps we'll take in the near future.

Pump talk

As I've mentioned before, I've been hoping to talk Alyssa into getting the pump. I know it seems to be an easy decision because she would go from 4 injections of insulin a day to changing the pump site every couple of days. However, I also know the idea can be quite scary and she already has to deal with so much. That is why I've never really pushed it, I just hoped she would show me when she was ready. This morning we went out for breakfast and the topic of getting a pump came up again. She showed a little more interest in the pump this time and said she would try it :). Fortunately, tomorrow is our appointment with the endocrinologist; so, we'll see how it goes!! There are several steps before we can start using the pump, but I'm excited we are on the way!!

Summer Schedule

I remember when I was a kid, the thing I looked forward to most during summer vacation was staying up late and not having to get up early in the morning. But when you have diabetes, its important to stay on a schedule. I have to admit, over the past several weeks we have slept a little later each morning so that now we get up between 7:30-8 as apposed to the 6:00 am alarm when school was in. And Alyssa is going to bed around 10:30-11 pm, when her school year bed time is 8:30-9... well she usually falls asleep somewhere around that time and we put her in her bed :)

I knew last night Alyssa had stayed up later than usual watching a movie. I woke up at 7:40 this morning, pricked her finger (she slept through it) blood glucose level was 147. I made her breakfast (3 little pancakes, sugar free syrup & a cup of milk is exactly 60 grams of carbohydrates), walked her sleepily into the kitchen and she started eating as I made her injections. I gave her her Lantus and Novolog and then proceeded with making coffee and cleaning up the kitchen. When I turned around, I noticed that Alyssa wasn't at the breakfast bar, so I went looking for her and this is where I found her.......

Sneaky Sneaky

Having diabetes stinks and I think it does even more so for a kid.  For the most part Alyssa manages her diabetes very well, knowing that she needs to check if she can have something before she puts it in her mouth.  I try not to keep the joys of sweets from her, my theory is anything in moderation.  She knows that even if she can't have a sweet at the moment she asks, she can save it for later when she can.  This decision is based on her glucose level, how soon it is to a mealtime, her activity level, and the amount of time before she goes to bed.

Yesterday with dinner she asked if she could have a low-sugar Klondike ice cream bar.  The dessert has 25 grams of carbohydrates and so I said that she could have it for desert after she ate her dinner.  With the ice cream, her dinner total came to 75 grams of carbohydrates (Normally 60).  Before dinner her blood glucose level was 144 (good).  Her insulin ratio is 1 unit for every 20 grams of carbohydrates, and because her bg's were good, no correction was needed.  So I gave her 3 1/2 units of Novolog.  All was good. 

At her bedtime glucose check her level was 166 and if they are under 200, she has a night time snack that is 15 grams of carbohydrates to balance her blood sugar level through the night.  She normally handles this on her own, and I'll call out to her, "What's your sugar?" she usually tells me what it is and I tell her if she needs a snack or not.  Well, I told her to get herself a snack (she has her own cabinet full of snacks all that are 15 grams of carbs or less)  However, miss flossy decided that she wanted to have another ice cream bar.  So, I'm in my room on my laptop and I hear my husband ask Alyssa if mom said she could have this ice cream?  "Alyssa!!" She had taken one bite.  Anyway, I had her wrap it up, promising she could have it the next day.  Diabetes is tricky and nights can produce dangerous lows or highs depending on her level of activity and pattern of bg's for the day.  That is why I choose to give her 15 grams of complex carbohydrate snacks that include protein before bedtime instead of sugary treats that can cause spikes and morning highs.  

I know it's tough to not be able to eat what she wants anytime she wants, and trust me, she didn't forget what I told her as she had her ice cream bar with her lunch this afternoon.

What is insulin?

Insulin is a hormone produced by the beta cells of the pancreatic inlets of Langerhans.  Insulin is secreted into the blood in response to the elevation of blood sugar levels.  Insulin then causes an individuals cells to absorb glucose from the blood and store it in the liver and muscles of the body so that it can be used as energy.

More than diabetes....

Alyssa is a beautiful, active, silly, sassy 9 year old girl who just so happens to have type 1 diabetes. She is so much more than a diabetic....Alyssa loves to cheer, tumble, dance, swim, sing, read, give make-overs to her girlfriends, paint nails, and play with her cat, Cookie, and Chihuahua, Poppy. She would rather be outside than in... loves riding her bike and her brother's four-wheeler. If she must stay in, she loves watching music videos on YouTube and playing on Stardoll.com. Her favorite color is green and she loves all things that glitter.....

"Hey I'm a wildflower, growin' in the sunshine
Soakin' up the way of life I was raised in
Runnin' barefoot bloomin' in a summer shower
Ponytail dancin' I can't help it, I'm a wildflower"
(Jane Dear Girls)

 

Tumble

Just an update on Alyssa's bg's.... This was her first tumble practice in 12 days. Before practice, her bg was 200.... She had a 15g carb snack prior to practice and drank a low sugar Gatorade throughout. At the end of 30 minutes of tumbling, blood glucose level was 83. Good bye high sugars from last week!! Still on summer schedule for cheer practice, so she's resting up for 3 hrs tomorrow. Happy that competitive cheer is year round :)

Diabetes doesn't define who you are....

Today was our church's Memorial Day Service.  This is a service where family and friends honor those who have passed on during the last year and a special guest speaker talks to the congregation about life and death and how we, as Christians, should not take for granted the time we have before we go on to glory.  This year's  guest speaker's subject was "Who are you?"  He believes when most people are asked this question, their first response is their name and then their profession when describing who they are.  His hope was that the congregation would see they should define themselves as how they live their life through acts and service for others.....as a child of God.  A person is more than their name; more than what they do for a living; more than some one's spouse or some one's parent or child. 

This question got me to thinking about my daughter and how many may think her disease defines who she is.  My daughter has type 1 diabetes, but that is not who she is.  Diabetes is just one part of her life.  Although, the disease can be overwhelming and attribute to how she feels, it is important to remember that this does not decide who Alyssa is or who she is going to be..... if anything, diabetes will make her stronger.

Summer Vacation

Alyssa has been experiencing post breakfast highs every morning this week except for today. Also, normally her bg's drop nearly 100 during the night and this week she's only been dropping about 50. (ie. before bed bg's were 200 and this morning 150)

The difference in this week and the others since schools been out for summer is that her cheer gym has been closed this week for the 4th. She normally practices cheer 3 hours a week and also has separate tumble lessons. So I'm sure the decrease in physical activity is affecting her levels. Back to it come Monday though :)

Life with T1 is definitely a balancing act.....

Type 1 Diabetes Misconceptions....

When you have type 1 diabetes you're pancreas does not produce enough or any insulin that lowers blood sugar and in many cases, glucagon, which raises blood sugar when it's low. Ultimately, a t1's body doesn't regulate glucose. So, I think there is a huge misconception that if you are diabetic that you can NEVER eat sugar... not true.... Anything in moderation... and as long as I test Lu's blood sugar and adjust her insulin dose to cover the extra sugar, there are no spikes. Also, believe it or not... there have been times sugar has SAVED HER LIFE!! 

Another misconception is that type 1 and type 2 diabetes are the same.  Type 2 can be linked to obesity, but that is not always the case.....in some cases it's in our genes.... and type 1 has no known cause.  Also, another fallacy is that diabetes is cured by insulin.  Insulin injections help keep diabetics alive, but is NOT a cure.  

Finally, many people think that diabetics cannot participate in athletics.  Not true... exercise is good for everyone.  Exercise does affect glucose levels, but as long as they are checked and precautions are taken, exercise can be very beneficial to diabetics by helping keep bg's within range.

It's time to gear up for walking season!!

Yesterday I re-upped for JDRF's walk to a cure on Oct. 6th in Elon, NC.  This year our team name will be Alyssa's Army!  I'm so excited about all the response we have already gotten!!  Research is so important, not only for a cure, but to also make the lives of people living with diabetes a little bit easier.  Remember, without research there would not be life saving insulin or meters or pumps...the list goes on and on!  It's very likely that each of us has been touched in some way by this disease; so, each one of us has a reason to support the Juvenile Diabetes Research Foundation.....my #1 reason is Alyssa!

I just wanted to add that Advanced Auto, Ford Motor Co., Marshall's and Walgreen's are all huge supporters of JDRF.  (I am not recieving any compensation ;)  So the next time you have a choice of where to shop, support companies that support JDRF!! 

Below: Some pictures from last year's walk!!

Alyssa's Birthday!!

Alyssa celebrated her 9th birthday this past Friday on June 15th.  The first thing she said that morning was that she wished she didn't have to have diabetes on her birthday.  So, it became my goal to keep diabetes from the forefront.  We had a fun day hanging at the pool with friends.  I knew she would be swimming and running, so I let her eat anything she wanted.  (Of course I kept the meter close by :)).  But she had mini cupcakes, Doritos, chocolate pudding; and, crackers, ham, and cheese.  When we left the pool, bg was 112!  So we stopped at McDonalds for a happy meal where she had a burger and fries and an injection.  That evening she had a few friends sleep over so, we went out for pizza.  Bedtime bg was 200 even!  What a great day!

Now, her party was the following day and her bg's were a different story.  They started off well in the morning, but by the time of her party at 3 pm, she was around 80 ( a little low for her in the afternoon).  She had several friends over and I'm sure her low was because she was so active.  They played on the slip 'n slide and in the jacuzzi.  When it was time for cake, Alyssa went in to change out of her swim suite and it seemed to be taking her a long time.  I went in to check on her, and she was incoherent.  She was trying to put her dry clothes on top of her bathing suite and when I asked her if she was ok, she said she was very tired.  She was very pale and her eyes seemed to be in a daze.  After she answered me,  she immediately started crying.  I knew she was low.  I grabbed a juice box, a container of frosting, and her meter.  Luckily when I stuck the straw in her mouth she began to drink the juice and I checked her bg..... 30!!  That's the lowest I've seen it.  She quickly finished the juice and I started taking finger fulls of icing and putting in her mouth.  In just a few minutes I could see the color coming back into her face.  I helped her get dressed and held her....she continued to cry...she was scared and so was I.  Ten minutes later, bg's back up to 90!!  Relief!!


(We had 2 cakes, this one Alyssa and her friend decorated)

We went back out on the porch where our family and friends were waiting for us and I said, "take 2!"

Guest Blog Post from Drugwatch.com: Type 2 Diabetes and Children

My blog is about my daughter's journey with type 1 diabetes; however, type 2 diabetes is also a terrible disease and the amount of children developing the disease is on the rise.  So when Jeff from Drugwatch.com asked if their writers could do a guest post on my blog regarding type 2 diabetes and children, I had to agree.   I thought my readers could get a great deal of information from their post that covers details of the disease as well as the medications that are used to treat type 2.  Thank you for the great information Alanna Ritchies of Drugwatch.com! 

As many as 45 percent of new onset pediatric diabetes cases in the United States are type 2. This is partially due to the growing population of obese children and adolescents.

Type 2 diabetes affects more than 22 million adults in the United States. It used to be primarily diagnosed in people older than 40, but it now affects an alarming number of children.

Over the past 20 years, the prevalence of childhood and adolescent obesity has doubled, according to the American Academy of Pediatrics Committee, putting children at risk of developing type 2 diabetes. At diagnosis, 85 percent of these children are obese.

Obesity and a lack of physical activity, as well as exposure to diabetes in utero, are thought to be major contributors to the increase in type 2 diabetes during childhood and adolescence. Generally, the diagnosis applies to those between 10 and 19 years of age with insulin resistance and a strong family history of type 2 diabetes.

The age of development is connected to changes in puberty that affect hormone levels. Doctors often diagnose children exhibiting symptoms like obesity, glucose in the urine or excessive thirst.

The Centers for Disease Control and Prevention’s Division of Diabetes Translation has been conducting workshops to raise physician awareness about the disease, determine the magnitude of the problem and assess and improve the quality of care among children and adolescents with type 2 diabetes.

In about 10 percent of cases, lifestyle intervention for those diagnosed with diabetes early may be enough. Everyone else will need either insulin, medication or both to control their blood sugar.

The Food and Drug Administration (FDA) has approved certain insulin products for children and one oral medication, metformin. Metformin increases the body’s sensitivity to insulin and decreases the amount of glucose produced by the liver. It can also promote weight loss.

While many adults with type 2 diabetes may be taking a thiazolidinedione such as Actos, this class of drugs has not been studied for pediatric use.

Adults and children should be aware of the risks, however. Actos, which is the most popular diabetes drug worldwide, has been linked to vision problems, fractures and heart failure. The Food and Drug Administration (FDA) has placed a black-box warning on Actos, listing restrictions for people with heart conditions.

Actos has also been repeatedly linked to bladder cancer, including by a recent study that showed an 80 percent increase in the risk. Thousands of Actos lawsuits have been filed by patients who have suffered.

Before thiazolidinediones or other type 2 diabetes medications are prescribed to children, more studies are necessary.

A child’s ability to take on medical regimens, exercise plans and diet changes is contingent upon supportive parents and an understanding of the diagnosis.

The American Diabetes Association plans to develop educational strategies for teaching children about managing type 2 diabetes. Children may blame themselves if their condition worsens, but should know that the disease is progressive, meaning it will worsen with time. It is also important that they and their parents understand the risks associated with popular medications like
Actos side effects and with type 2 diabetes in general.

Alanna Ritchie is a writer for
Drugwatch.com. An English major, she is an accomplished technical and creative writer.

Packing for Grandma's

Since Alyssa's diagnosis, the only people she has been left with are her two older brothers and her grandmothers.  On Thursday, my hubby and I will be leaving for the Florida Keys to celebrate our 18th wedding anniversary.  Ahhhh.....4 sun-filled days in paradise!!

Before Lu's DX, all I had to pack were her clothes when she'd spend the night away from home.  Now, packing takes much more preparation.

Alyssa's Packing List

*Diabetes supplies (meter, strips, lancets, alcohol swabs, syringes, & insulin)
*Emergency Kit for lows (Glucagon, smartie candies, and juice boxes)
*4 Breakfasts, 4 lunches, 4 dinners, and 24 snacks
 (I pack snacks and meals that I prepare ahead of time that have the exact amount of carbs that she needs for each meal)
*sugar free drinks & water bottles to mix sugar free Kool Aid in
*Schedule
(I type up her schedule and instructions for what to do in the event of highs or lows and add the emergency endocrinologist's number)
*clothes
*favorite pillow & stuffed animal
*games
*movies
*toiletries

Our car will be loaded down on the way to the airport until we drop her off.  What's funny is that everything that I am taking can fit into 1 rolling carry on bag!

Cheer Camp

Alyssa is on a competitive cheer team and this weekend she took part in her first cheer skills camp. Alyssa’s diabetes is very sensitive to extra physical activity, so this requires careful planning and monitoring as well as timing meals and insulin. This is because muscles use up glucose at almost 20 times the normal rate during intense exercise and can result in low blood sugar levels.

During her normal practices in order to avoid drops in blood glucose levels, we check her bg’s before class starts and if she is below 200 she has a carb/protein snack and she has a low sugar Gatorade on hand that has about 15 g of carbs. This snack and drink will replace the glucose slowly as she burns the glucose she has on board and holds her over through the 1 ½ hour practice. In the case of cheer camp, I knew the activity would be more intense and last longer. We checked her sugar when we arrived on day 1 and it was 212, she had a snack and about an hour in her bg was 200. At the water break re-check, her level was at 147, so she had a few grapes and more low sugar Gatorade. By the end of day 1 practice, her level was at 150. Day 2 started at 12:30p, so she ate lunch at 11:30a. When we got to the gym her bg was 300, but she had just eaten and had a lower level of insulin about 30 minutes prior. At the water break, we checked and her level was down to 200. She ate a few grapes and 2 peanut butter crackers. At the end of camp, her bg was 116. I knew her bg’s would continue to drop after the exercise stopped because her team had worked so much harder on day 2, so I let her have a little of the high carb snacks that were offered like cheese puffs, chips, grapes, and even a donut! I chose not to give her insulin and rechecked her bgs about an hour later…99...perfect... her body was still burning that glucose.  If she hadn't had that snack, she would have went low.

Alyssa is such a trooper. She didn’t complain about having her finger pricked 4 times extra because she was having such a good time… We have a longer choreography camp in a couple of weeks and I'm feeling a little bit better about it.

Mother of the Year

I do not know what has been wrong with me this week.  Maybe my brain fog has been caused by the leftovers of my sinus infection last week or from my new diet I started this week??  Or maybe its because I've been scrambling around getting everything in before the deadline for my new school that I will be attending in the fall.  It's been an interesting week for sure.... I hit my oldest son's truck pulling out of my driveway, I got stung by a bee, I did something to my hand....and then the winner this morning....

My son Jamon rides to school with a friend, so I drop him off on the way to Lu's school.  As I pull out of their driveway, it hits me, Alyssa didn't get her insulin!  Really?  Like she hasn't been getting insulin every morning for the past year and a half? The injections were made, it just totally slipped my mind.... I whipped the car around and headed back towards the house....arguing with my self.  How could you forget?  Remember, you are human.  Alyssa gets two injections in the morning, Lantus (a slow release insulin) and her quick-acting insulin, Novolog.  Normally, she checks her BG and I go ahead and give her the injections before she eats.  This morning though, her bg was 86, and because the Novolog usually drops her sugar pretty quickly,  I decided I would wait until she had eaten her breakfast to give her the injections.  I'm apparently not good with a change in protocol.  Ahh the anxiety...  

Anyway, we rushed home and I quickly gave her injections and we were back on the road to school.  And, we made it on time!  Hopefully there are not too many more mornings like this...not good for my inner control freak!

Math skills needed....

After dinner last night, Alyssa went in her room to work on a puzzle.  About an hour later, I went into check on her because she was too quiet and she was fast asleep in her bed....7:30p and way early for her?  I pricked her finger (she doesn't wake anymore) and the meter read 434...wth!!  recheck....413!  I calculated the carbs, she had eaten something she had eaten many times before and had gotten her insulin.  I woke her up and had her get in the shower while I made another injection.  Here is where math skills come in handy....

Oddly, Alyssa usually drops about 100 pts during the night...I'm not sure what crazy girl does in her sleep....but normally I try to make sure her levels are between 180-200 when she goes to bed.  Alyssa's correction rate is .5 units for every 50 over 150, but since her bedtime goal is around 200 and I wanted her to drop about 200 pts., I gave her 2.0 units.  Another problem, sometimes the insulin brings her down too quickly and she feels the affects of a low even if she is not (and if she doesn't eat as well).  So, I also gave her a 15 g carb snack.  I estimated with the insulin and the snack that she would wake up with a bg of about 150.  This morning....the meter read 136... pretty darn close!!

I'm not sure where this spike came from (I searched for evidence of a secret snack, but didn't find any??) I think its instinct to want to find the culprit, although there may not be a tangible one.  I mean really, there is no known cause for this disease so it's understandable that there is no known cause for occasional spikes or lows.   I try not to stress too much when situations like this happen, but its hard not to when your a control freak like me :-/

Packing for the Pool

Packing for the Pool

Today we are celebrating my son’s 17^th birthday with a family pool party at my sister-in-law’s home and as I prepare for the afternoon, I realize how much goes into preparing for Alyssa. This has become second nature and has become part of our ’check off list’ before we leave the house. This prep is not only today, this is anytime we go anywhere. Another reminder that diabetes doesn’t take a break.

In addition to packing sunscreen and beach towels, we have to pack a bag full of diabetes supplies. In her backpack: bg meter, strips, lancets, alcohol swabs, insulin, syringes, juice boxes, glucagon emergency kit, snacks, water bottles, and candy.

Alyssa is a very active little girl and rarely takes a break; and because we are going to a party where there will be swimming and lots of play with cousins, the chances of low blood sugar are very likely. On the upside, she’ll probably be able to enjoy a piece of birthday cake without an extra injection!

3rd Annual Diabetes Blog Week: What its like to have Type 1 Diabetes

What it’s like to have Type 1 Diabetes

Managing type 1 diabetes is a balancing act. This daily stabilization of blood sugar levels depends on the four injections of insulin in which the amount is based on food consumed and physical activity through out the day and night. Blood sugar levels have to be checked 6-8 times a day and there is constant worry about highs and lows, which can both be dangerous. Type 1 does not go away, it doesn’t take a break. Type 1 is on your mind constantly and you can never forget about it. It’s a 24 hour a day, 365 days a year job.

A day in the life of Alyssa:

6:15a Wake up, prick finger to check blood sugar

6:30a 2 insulin injections

Eat breakfast

9:30a snack

11:50a prick finger to check blood sugar

1 insulin injection

3:00 p snack

4:30p prick finger to check blood sugar

Cheer/tumble from 4:30-6p

5:45p prick finger to check blood sugar ½ way through practice

If low (usually) treat with juice

6:30p prick finger to check blood sugar

1 insulin injection

Eat dinner

9:30p prick finger to check blood sugar

Eat bedtime snack to avoid lows during the night

*Depending on how her bg’s have been there may be a blood sugar check in the middle of the night. Also, if she is more active than usual, there may be other blood checks during the day.