Thursday, September 27, 2007

If I had a GPS indicator attached to me, you'd find me...

In the car - and everywhere.

A typical week will find me:
  • At the dance studio
  • At the Taekwondo studio
  • At art class
  • At the dance studio
  • At the soccer field
  • At PE class
  • At drama
  • At the dance studio

There is a lot of running back and forth in the car. The good news is that most all of the places we need to go are nearby so its a quick trip, easy to run back and forth in between, or not bad to stay and wait.

Thus is the typical story of soccer season in the Stopper household. Whoever said that homeschoolers are homebodies is nuts!

Wednesday, September 26, 2007

Quick Update

We started Emma on her pump last Tuesday. Its been going good. I think we've had all the predicted challenges - changing meal ratios, changing baseline insulin, bad sites, lots of readings, the entire nine yards.

But despite the significant (supposedly temporary) increase in blood sugar testing that we have to do, I still think this is so much better than injections. Yesterday the nurse called to make a few changes while we were at the soccer field. I just called Emma over, pushed a few buttons and we were good to go.

Each time I call her over to "push some buttons on her pump", she says "No more shots?" and we do a little cheer.

With the other kids, we are going full force with school right now. I'm finally getting some plans loaded into my software so I can print out lesson plans - Samantha prefers this. We are also knee-deep into soccer, dance, piano, PE, drama, art, and Tae Kwon Do

Michael earned his first Tae Kwon Do belt this past weekend - his white belt. He was quite proud. The lead instructor, when speaking to them about respect, said that the respect has to go home too. He told them that they had to bow (to show respect) to their family when they left or that belt would be coming right back off!! Michael bowed to Samantha the minute he walked out of the door.

That's a quick update for now - more to come soon!

Sunday, September 16, 2007

How did you know?

This is another question I get asked a lot about Emma's diabetes. How did you know that she had diabetes? I think this question comes a lot out of fear - well, if her 2 year old can have diabetes, how do I know for sure that my child doesn't.

There are some clear signs of diabetes - the problem is, they don't usually come until the person has "suffered" for a while.

One important fact to know to understand diabetes - carbs and sugars in foods you eat are absorbed into your body for use as energy. In order for that to happen, insulin has to process the glucose in the carbs and sugars for it to be absorbed into your system. When a person's body stops producing insulin, glucose from food builds up in the blood stream because the insulin isn't present to process the glucose for absorption.

When this build-up begins, you usually don't have any outward signs. But as it proceeds, you begin to have outward signs, which are the symptoms or indicators of diabetes. Because the glucose isn't absorbed into your system, your body tries to find a method to get it out of your system - through urination. So, because you have extra glucose in your system, you pee more trying to get it out. Because you pee more, you are thirstier (you are basically dehydrated). You keep drinking water to quench the thirst caused by the constant release of glucose through urine. So, drinking lots of water and peeing a lot are two very teltale signs of a potential diabetic.

Another problem when the glucose isn't processed into your system is that your cells don't get their energy - which they get from glucose. So, in order for your cells to get the energy they need to function, they find it from other sources - your fat cells. Your body begins to burn fat for energy as its only source of energy. This energy is not as effective as glucose, so you begin to suffer from a lack of energy which eventually turns into extreme lethargy.

A by product of burning fat for energy is the acidic by-product left in your blood stream. These acids are called "ketones". As your body continues to burn fat for energy, the ketones in your blood stream rise. The only way to get rid of the ketones in your system is, ironically, insulin. Because your body isn't producing insulin, they continue to build up. The only way to know that your body has ketones is through a urine or glucose test - there are no outward signs of ketones themselves. However, the burning of fat in your body for energy also results in a loss of weight from the loss of fat. So, an undiagnosed diabetic may be experiencing weight loss.

Left untreated, the buildup of ketones causes ketoacidosis in your system which can eventually result in a coma. Most diabetics, fortunately, are diagnosed before their system reaches this state and can be treated with insulin to reduce the ketones in their system and reduce their blood glucose levels.

So, all of this technical information results in the following simple explanation of how Emma was diagnosed:
- An extreme increase in consumption of water
- An extreme increase in urination (which is easy to tell when they are in diapers)
- Loss of weight (2 pounds in 1 month)
- Extreme lethargy

The lethargy is the factor that finally keyed us in. We had been suspicious for a few days before that and had been researching symptoms on the web. But after Emma got really lethargic (and for anyone who has met her you would understand why this would be unusual), we finally decided something was wrong. And after two finger sticks with my old meter from when I was pregnant confirmed that something was wrong.

Friday, September 14, 2007

Diabetes 101

In my conversations with folks, I realize that many of them don't know a lot about diabetes. I'm not sure I knew a lot before Emma was diagnosed. I did have a grandmother that always "had to have her candy handy" and my brother had a friend in college "who was always checking his sugar" but that's about it. I watched a boy for a short time each afternoon when Samantha was in 2nd grade who was diabetic. I didn't have to give him injections, but I did know that he had to be on a schedule for eating and I knew that "over 300 meant to call his mom"

Boy what a difference 6 months makes.

So, here's a few facts to make everyone a little more knowledgeable about diabetes:
  • Emma has Type 1 Diabetes. Type 1 diabetes is when your pancreas stops producing insulin. It can be a genetic disposition, it can be caused by a virus. They aren't exactly sure. What they do know that it isn't caused by obesity, lack of exercise, or too much sugar (those are contributing factors to Type 2 Diabetes)
  • For a normal person, their fasting blood sugar level is usually below 100 and their typical blood sugar 2 hours after eating is usually below 150. For Emma, we target to keep her blood sugar between 80 and 180 but we are often happy as long as it stays in the low 200s.
  • Until a cure is found, Emma will be dependent on insulin medication. Every day. All day. Without insulin, her body cannot process the sugar that it ingests. Without insulin, her blood sugar levels will increase and her body will basically start feeding on itself and she will go into a state called "Ketoacidosis" which is a very dangerous and coma-inducing state.
  • Because we give her "artificial" insulin instead of naturally produced insulin, her body doesn't regulate its production and absorption like it would if she had a pancreas. That means sometimes we can give her too much insulin for what's going on in her body and she'll go low. Lows are dangerous and cause unconsciousness and seizures. We treat lows with juice and sugar in an attempt to get her back into range as quickly as possible.
  • Emma currently cannot tell for herself whether her sugar is low or high, so we have to do an enormous number of finger sticks to check it. She typically gets about 8 finger sticks a day (7:30am, 11am, noon, 3pm, 6pm, 9:30pm, midnight, 2am) with additional ones in between if she is acting unusual or something just doesn't seem right. It is clearly an art form to try and know when to check and treat her blood sugar levels.
  • Emma currently gets her insulin through injections - 4-6 times a day. She is a trooper about these injections, and rarely makes a peep as she gets them. Due to medical advancements in the past 5 years, she is currently on a wonderful 24-hour injection that gives her a baseline of insulin (like her pancreas would if it functioned). Then we only need to give her an injection based on what she eats. She can eat what she wants when she wants as long as she gets an injection.
  • In just a few days, Emma's injections will be replaced by an insulin pump. This wonderful invention is the closest thing to an artificial pancreas right now. This pump carries a vial of insulin that is slowly injected into her body through an infusion set all day and all night. It has programmable doses for her baseline insulin and then settings and calculations that we can use to give her insulin based on what she eats. This pump is about the size of a cell phone that can easily be clipped on a belt or tucked in a pouch, with small tubing attached to her infusion set.
  • The long-term effects of untreated / unmanaged diabetes can be pretty bad, including blindness, loss of feeling in extremities, amputation, etc. Even managed, her risk of heart disease is higher than that of a normal human. And pregnancies will be more difficult and high risk for her (yes, I know she's only 2). But, things are so much better than they were even 10 years ago and her chances for a more normal life are better than ever.

This information isn't given to scare anyone or upset anyone, but just to educate readers on the facts about diabetes. What's hard is to look at your child and see the child, and not the disease. I still find myself looking at her and thinking "I wonder what her blood sugar is" instead of wondering if she's happy or what she wants to play. After your mind is inundated with this disease, its hard to get it off your mind. But while we expect this pump start to be difficult, the long run will make it easier for our entire family to manage this disease. Then maybe we can go back to just dealing with the typical "2 year old challenges": potty training, tantrums, business, etc.

Wednesday, September 12, 2007

Pump Start in 6 days!!

We are excited. Emma will be going on her insulin pump in 6 days. We are looking forward to this as we really believe this will make our lives so much easier. It will also give us some greater control with Emma as the pump can be so much more precise in her dosing than we ever can.

We had our training yesterday on the pump. While it seems intimidating, its really not that difficult to use. I have been wearing it now 24 hours and I have been given a steady "basal" dose of saline (for the test) and given myself doses for meals and to correct readings out of range. I have overriden the suggestion of the machine, taken it as is, and even cancelled a dose mid-stream. I even slept in it last night - it wasn't too bad.

I will wear it for a couple more days and then Mike will wear it - and yes, he will be putting in Emma's meals and dosing himself for her food as well (all with saline). Then Emma will be put on it with saline and we will practice dosing her with saline at the same time we are still giving her insulin shots. And then we go in next Tuesday and we start her insulin doses on the pump. Yay!!

A recent email from a friend made me realize that there is so much that people don't know about diabetes or diabetics. My next post will be geared to educate folks about diabetics, diabetes, and what Emma's life will be like as a diabetic (and what it could be like if we didn't have the advances we have today)

Tuesday, September 11, 2007

In Memory Of: Odessa Morris

Odessa V. Morris

Imagine a day of great joy turned into a day of great sorrow. That is the feeling that many use to explain what happened on September 11, 2001. And its the story of the Morris Family of Maryland. This post is in honor of Odessa Morris.

September 11, 2001 started like many other mornings for Odessa and her family - only it wasn't just any morning. It was Odessa's 25 wedding anniversary with her husband - Tony. She didn't intend to go to work for long - and her husband dropped her at a nearby Metro station for her trip to the Pentagon that morning.

Odessa was a Budget Analyst working for the Department of the Army on the fateful morning of 9/11. Her "short work day" on that morning was her last day - as the terrorists of 9/11 crashed a plane into the side of the Pentagon. The side where Odessa worked.

After hearing of the attack, it took her husband hours of calling and searching to learn that she was missing. I cannot imagine the feelings going through his mind at that moment - wondering if it was too much to hope for, but probably holding on to the only thing he had - hope.

Odessa loved animals, and she loved to cook, and she had a relationship with Jesus Christ - which means she is residing in Heaven now. Hopefully that brings some comfort to her family. She left behind her husband of 25 years and 3 children, now grown. But nothing, even the passing of time, can fill the void and the hole in each of their souls that was taken the day that Odessa was killed in the Pentagon.

There are so many tribute pages to the victims on 9/11 on the internet now. I have provided links to a few here. If you are so inclined, leave a tribute to Odessa on one of these.

As for me, I have thought about her a lot since deciding to blog a tribute to a victim on 9/11. Having walked the halls of the Pentagon myself, I know exactly where she was when the Pentagon was hit. I have been in many of the offices that were destroyed by that attack. While I knew no one personally who died on 9/11, I feel like I know Odessa V. Morris a little bit better now.

So 9/11 will always be a bittersweet day for the Morris family and when I think of 9/11 and everything our country experienced that day, I will say a prayer for her family to have peace during this trying time and remember her with smiles and laughter.

But never forget. Never forget what they did and those who died. Remember the victims with honor and the agressors with hatred. Hatred for what they took from us and what they did to us. Always remember.

Thursday, September 06, 2007

Gettin in a groove!

Well, finally, the neighborhood kids are back in school and I'm able to get into the groove with the kids. The schoolwork is going much smoother and we are moving along nicely.

I added in History this week. History is pretty time consuming but we've been good about doing it every day. I'm wrapping up a little bit of Sonlight Core 3 (1st 1/2 of Am History) over the next few days and then we'll jump into Sonlight Core 4 (2nd 1/2 of Am History). We're in the "middle" period of "post American Revolution but pre-Civil War" that doesn't have much for elementary-aged kids to study other than "people went west". We don't get into the politics of expansionism or Manifest Destiny at this level, so there isn't much to discuss until the Civil War.

I still need to add in Science. The kids have picked some experiements they want to do from our "Critical Thinking through Science" books for us to do but I'm not quite ready to do them yet. Each of our books has a unit on "observation" at the beginning and since we are just focusing on a bunch of experiments this year, I think it will be valuable to start with teaching them how to actually "observe" and then we'll get in. We'll do our first observation experiment on Monday.

Latin will also start on Monday. I didn't start it this week because Monday was a holiday and the book is structured in "5 part" lessons so I'd like to start on a Monday to try and get it into the "week" mode. Latin is really just for Samantha but Michael wants to watch the DVD too, so I'll have him listen in. The curriculum is 3rd or 4th grade to start, so its a little advanced for him, but not much.

The teacher got a new cart!! Each of the kids last year got a rolling ELFA cart for their books and papers. Its easier than keeping them in one room and using them in a variety - we just move them around. But my books kept moving back and forth from the kitchen table to a pile on the desk and back and forth. Now I have a rolling cart of my own with the books sorted by subject (teacher books, answer keys, test booklets, extra school supplies, etc) and I can already see the kitchen will be neater as a result.

Lesson planning is still happening pen to paper. I have a great program to do my lesson planning but I'm just not there yet. Some of the subjects will be easy - they just have 160 or so lessons numbered, you guessed it, 1 - 160. But there are a few that I'm doing a bit different, and others have 32 lessons, with 5 parts, and its just harder right now to put it in the computer than it is to write it on a piece of paper. We'll get there, just not yet - I'm focusing on getting them into the work right now, which is more important.

Tomorrow, Samantha has her first Drama rehearsal for the season and she's playing with a homeschool friend that we have hardly seen over the summer. She's pretty excited.