Saturday, March 22, 2014

Independent doesn't mean alone...

I've heard of so many kids and teenagers who try to hide diabetes from their friends. They won't check or bolus in public, won't wear a pump, won't inject. My advice - give your friends the benefit of the doubt. They may surprise you.

Dealing with type 1 diabetes can be especially challenging for an active teenager. Sarah's currently in two shows right now, so has 2-3 hour rehearsals each evening, and 4-5 hours of show activities Friday through Sunday. Her insulin sensitivity is all over the map. Where she's perfect one day, the next is a real head-scratcher.

Last night I picked Sarah up from two and a half hours of rehearsing (in a dance heavy show) and we went straight to the adult community theater show she's in. On the way I'd picked up a sandwich so she could eat in the car. She checked, and was a little high, and bolused. I turned her basal down -70% for 6 hours to accommodate the show - our usual routine. I braided her hair, and left her to continue to prepare and be with her cast mates.

I went and sat at the back of the theater with my mom - both of us ushering for the show - and waited. A bit later, the actors began to trickle out for vocal warm-ups. My mom was anxious to see Sarah, and I pointed her out as soon as I saw her - accompanied by Andrew, her boyfriend/best friend. They had only begun to warm up, and by now everyone was on stage, when I saw them both hurriedly exit. Phone in hand, I stayed where I was. 

My 14 year old doesn't need her mom running back to check on her every five minutes. 

About 5 minutes later they emerged, still singing the warm-ups, and headed for the front of the stage. Catching my eye, Sarah holds up four fingers, and then nine fingers - 49. Then, she points at Andrew, points at herself, smiles and gives me a thumbs up. Message received "we got this mama".

I doubt there's a person in Sarah's cast who doesn't know she has diabetes - and it's not a big deal. They're a family and they take care of each other. If it wasn't Andrew, someone else would have watched her through her low - she has so many amazing friends. The trick? Sarah's been honest and open with her friends from the beginning. Some have been around long enough to remember when she was first diagnosed, and some haven't - but they're a family and they support each other.

Sarah (and Andrew) did an excellent job of managing her crazy blood sugar last night. She checked again before the show started and was 123. When the show was over she was 117. It doesn't get much better than that.

Thursday, January 16, 2014

What it is, and isn't...

So here’s the thing. Diabetes is one of the most confusing and conflicting diseases on the planet. And as my daughter grows older, it becomes ever more difficult to explain - but here’s the old college try.

Diabetes is a big deal! Diabetes is dangerous and missteps with insulin or an illness can result in a trip to the ER or even a stay in the ICU. We must be careful to dose insulin correctly, even though there’s no absolute formula that will work. We check blood sugar 10+ times every day and have a diabetes alert dog who lets her know any time her blood sugar gets out of whack.

But………... that doesn't mean my daughter can’t fully participate in activities. It doesn't means she’s “sick” or needs to be coddled. It doesn't mean she won’t live as long (or probably much longer) than average. It doesn't mean she’s less of a student, or that she isn't healthy. My daughter is NOT fragile and neither is her health. She’s vibrant, energetic, talented, smart, beautiful and overall completely amazing. She has more energy than the average teenager, more drive. She has an excellent understanding of nutrition and the importance of regular exercise. She’s more empathetic to the plight of others because she understands what it’s like to be different and have more responsibility than any teenager should have to bear.

She must not be doing well because she has to watch for those lows carefully; i.e. “I knew a guy and he never had lows”.

But………..In reality, she has more frequent lows for one reason - because we strive to keep her blood sugar as close to a non-diabetics blood sugar as is safely possible. Show me a type 1 diabetic who NEVER has lows, and I’ll show you someone who most likely has an average blood sugar much higher than my daughters. And note that we haven’t had what we’d consider a “serious” low in over two years, and in the nearly four years since Sarah has had diabetes she’s had only three lows that required outside intervention (i.e. someone else helping her to treat) and she has never been hospitalized since her diagnosis.

What can and can’t she do like everyone else?

She can:

Participate in school activities

Dance, Act, Sing

Get amazing grades

Eat like a normal person and not like a rabbit (unless she’s in the mood for carrots, which are yummy)

Take trips (Yep, we’re even planning one to Japan this summer!)

Go to friends houses to hang out or even (gasp!) spend the night

Go on dates

Go to college

Have a career

Get married

Have amazing, healthy children (someday, like a LONG time from now… )

Smile, laugh, hug… did I mention Smile? She’s good at that one.

Light up a room with her crazy enthusiasm and wonderful attitude

Pretty much anything else you can think of, except…

She can’t:

Produce her own insulin

Uh… that’s all I got

Now, you may (or may not) have some misconceptions about what type 1 diabetes is and isn’t. So allow me to reassure you:

  • She’s not “sick”, her pancreas simply isn’t producing insulin like it should.

  • She’s not contagious, and having type 1 diabetes does not mean her children will inherit a bum pancreas.

  • Type 1 diabetes is autoimmune, meaning her body did this to itself. She didn’t get diabetes from eating too much sugar, not exercising enough, taking vaccines, not taking vaccines, the flu shot, power lines, watching too much television, or drinking cows milk.

  • She can have children, someday, if she wants them. And she will be a terrific mom.

  • She monitors her blood sugar closely and often. She wears an insulin pump to deliver a constant flow of insulin and takes additional insulin for meals and snacks.

  • She can eat whatever you put on the table, though at times, if her blood sugar is high or she simply doesn’t want to deal with the challenge that comes with a large dessert or high carb food, she may elect to abstain.

What you might not know.

  • She has been carefully monitoring her nutrition since she was a child, so as an adult she will understand how to build healthful family meals.

  • She understands the importance of regular exercise and activity, and knows first hand how much better the body processes insulin with a healthy amount of exercise.

  • She listens to her body and knows when to ask for help.

  • She has great empathy for the struggles of others.

You may be thinking that diabetes causes:

  • Vision loss

  • Poor circulation

  • Limb amputations

  • Heart disease

  • High blood pressure

  • Kidney failure

You’re incorrect. These complications are not caused by diabetes, but by consistent high blood sugar (hyperglycemia) over a long period of time. My daughter works very hard to keep her blood sugar in a healthy range. This is the reason that she sometimes has low blood sugar (hypoglycemia) and has to drink a juice or eat something to bring her blood sugar up. As long as she continues to take good care of her body and manage her blood sugar, she will live a long and healthy life, just like a person without diabetes.

Type 1 diabetics know the value of hard work and perseverance.  Did you know that type 1 diabetics play professional football (Jay Cutler), are professional race car drivers (Charlie Kimball), are famous actors (Mary Tyler Moore, Jean Smart), and are Supreme Court Justices (Justice Sonia Sotomayor)?

So yes, I still might be a little overprotective. I do watch her carefully and stay involved in her diabetes, because she doesn't have the choice to just let it go, even for a day. I stay nearby, or in close contact with friends, teachers, or anywhere she has activities, just in case. Not because she can’t handle the occasional low on her own, but because if she goes lower than usual, she still likes to have mom there for comfort until she feels better. Someday, in the not so distant future, she’ll have to take the responsibility fully on her own, and she will be ready when that day comes.

Thanks for listening.