We just returned from church and had a rare moment to take a family photo before eating some dinner and trying to tuck the kids off to bed!
Merry Christmas!
Wednesday, December 24, 2008
Merry Christmas
We just returned from church and had a rare moment to take a family photo before eating some dinner and trying to tuck the kids off to bed!
Merry Christmas!
Ready for Christmas
I think we might almost be ready for Christmas. I think Mike is dipping the last of the Oreo balls. I have wrapped every present that is going to be wrapped (Santa doesn't wrap presents at our house). The tree is up and finally decorated (last night).
We are headed to church for Christmas Eve service tonight and then dinner will be hors d'oeuvres and hopefully getting the kids in bed around 9pm.
And despite the fact that they haven't been able to drag themselves out of bed before 7:30 in about a week, I can guarantee you they'll be up at 6am! Last year we put up baby gates to block their ability to go or look downstairs until we are ready. I think I got rid of all of those, so we'll need to figure something else out.
For the first time in a really long time, we'll be staying home for the entire Christmas Day. We won't head to Roanoke until Dec 26th and stay for a couple of days. Return home and turn around for Williamsport for a couple more days. Mike's parents offered to come down, but Christmas is the only time we guarantee we can get up there and see Mike's grandmother, who is really up in years now, so we'll head up to see her. We'll return on New Years Day for a couple of days of relaxation before school and sports and dance starts again!
We are headed to church for Christmas Eve service tonight and then dinner will be hors d'oeuvres and hopefully getting the kids in bed around 9pm.
And despite the fact that they haven't been able to drag themselves out of bed before 7:30 in about a week, I can guarantee you they'll be up at 6am! Last year we put up baby gates to block their ability to go or look downstairs until we are ready. I think I got rid of all of those, so we'll need to figure something else out.
For the first time in a really long time, we'll be staying home for the entire Christmas Day. We won't head to Roanoke until Dec 26th and stay for a couple of days. Return home and turn around for Williamsport for a couple more days. Mike's parents offered to come down, but Christmas is the only time we guarantee we can get up there and see Mike's grandmother, who is really up in years now, so we'll head up to see her. We'll return on New Years Day for a couple of days of relaxation before school and sports and dance starts again!
Monday, December 22, 2008
Busy Christmas Season
Its been a busy Christmas season. Perhaps because I didn't really get a chance to "start" preparing until about the 12th of December. Really cuts the time short.
We've also been busy with other activities. A few highlights.
On December 12th, Mike had his company Christmas party at the nearby Udvar-Hazy Air and Space Museum. It was pretty neat to have the party laid out around the airplanes and space shuttle.
On December 14, Emma's preschool put on its Christmas program. They sang three songs and did a little skit. It was very cute and Emma had a good time. She really likes to sing and do all the motions with the songs.
We found a great preschool for Emma. Its an "in-home" preschool run by the pastor's wife at our church. There are only 8 kids there and she has been very willing to take on Emma's diabetes care, doses her for snack and lunch and calls me for any high or low readings. The moms have also been supportive, collecting carb information for any food at parties so that I can dose her properly. Its really a great preschool and we're very fortunate to have found it.
On December 19th, we finally took the kids to see Santa Claus. We got up and moving early because I didn't want a line at the mall, and I inevitably pick a day with a line. Well, we arrived at 8:45 and there was no line. We walked right up and saw Santa. The kids all told him what they want for Christmas, and that they behaved and did everything they are supposed to do. I didn't hear the entire conversation but I think something involved Emma brushing her teeth! I always like to take the chance to take some photos of the kids with the decorations around Santa too, because the mall does such a good job with them.
And finally, on December 19th, Michael earned his Brown belt in Tae Kwon Do. He has really progressed this year and it was nice to cap off the year with a belt graduation. He only has 3 belt levels left to Black - Brown Stripe, Red, and then Black. I would expect that on this pace that maybe by the end of 2009, Michael will have earned his Black Belt.
We have dinner tonight with some old friends from AMS that we haven't seen in years - after a reconnection on Facebook. I'm pretty excited to see them again!
So, its been a busy few weeks leading up to Christmas. The wrapping has started but is nowhere near finished. Two gifts still yet to arrive - expected on Christmas Eve, no less. I'm excited for the gifts I got the kids this year that I WANT them to have, and I'm sure they're excited about the gifts that THEY want. I also know they are enjoying the reduced school schedule we've been running the past couple of weeks.
We've also been busy with other activities. A few highlights.
On December 12th, Mike had his company Christmas party at the nearby Udvar-Hazy Air and Space Museum. It was pretty neat to have the party laid out around the airplanes and space shuttle. On December 14, Emma's preschool put on its Christmas program. They sang three songs and did a little skit. It was very cute and Emma had a good time. She really likes to sing and do all the motions with the songs.We found a great preschool for Emma. Its an "in-home" preschool run by the pastor's wife at our church. There are only 8 kids there and she has been very willing to take on Emma's diabetes care, doses her for snack and lunch and calls me for any high or low readings. The moms have also been supportive, collecting carb information for any food at parties so that I can dose her properly. Its really a great preschool and we're very fortunate to have found it.
On December 19th, we finally took the kids to see Santa Claus. We got up and moving early because I didn't want a line at the mall, and I inevitably pick a day with a line. Well, we arrived at 8:45 and there was no line. We walked right up and saw Santa. The kids all told him what they want for Christmas, and that they behaved and did everything they are supposed to do. I didn't hear the entire conversation but I think something involved Emma brushing her teeth! I always like to take the chance to take some photos of the kids with the decorations around Santa too, because the mall does such a good job with them.
And finally, on December 19th, Michael earned his Brown belt in Tae Kwon Do. He has really progressed this year and it was nice to cap off the year with a belt graduation. He only has 3 belt levels left to Black - Brown Stripe, Red, and then Black. I would expect that on this pace that maybe by the end of 2009, Michael will have earned his Black Belt.We have dinner tonight with some old friends from AMS that we haven't seen in years - after a reconnection on Facebook. I'm pretty excited to see them again!
So, its been a busy few weeks leading up to Christmas. The wrapping has started but is nowhere near finished. Two gifts still yet to arrive - expected on Christmas Eve, no less. I'm excited for the gifts I got the kids this year that I WANT them to have, and I'm sure they're excited about the gifts that THEY want. I also know they are enjoying the reduced school schedule we've been running the past couple of weeks.
Monday, December 15, 2008
She is just TOO smart!
I'm sitting here laughing in amazement at Emma.
She has a bunch of paper off the paper roll from her easel. She's trying to roll it nicely but of course its trying to roll on its own. She was getting quite frustrated at the paper for rolling up from both ends while she was trying to roll it nicely.
So, she went and got a small box of books to put on one end of the paper to keep it from rolling up until she could roll from the other end herself.
I'm not sure the 11-year-old would have figured that out!
She has a bunch of paper off the paper roll from her easel. She's trying to roll it nicely but of course its trying to roll on its own. She was getting quite frustrated at the paper for rolling up from both ends while she was trying to roll it nicely.
So, she went and got a small box of books to put on one end of the paper to keep it from rolling up until she could roll from the other end herself.
I'm not sure the 11-year-old would have figured that out!
Thursday, December 11, 2008
Home and lots to post
I have been a bit under the weather since we got back from Disney, so I haven't updated.
We had a great trip. Always sad to leave and wanting to know when we will go back.
Emma said on the last day "I had fun being here". I think that sums it up.
Cheney stayed at the vet for this trip - we usually leave him at home and have someone come in but he usually goes on a hunger strike. I hoped by putting him in the vet that he would have more attention and eat. They called me 2 days in that he wasn't eating and they were going to have to force feed him.
When I went to pick him up, all of his food was gone and I was shocked. They said they actually let him roam around the front treatment area and he then started eating fine.
Did I forget to tell them that he thinks he's a dog in a cat suit. He does. He needs the attention like a dog. And that's nothing compared to now that we're home - he won't leave my side. If I'm on the couch, he's on the couch. If I'm in the bed, he's right beside me - literally. At least he's happy to see us!
More on our trip later. We did a couple of different things that we enjoyed on this trip - always trying something a little new and different.
We had a great trip. Always sad to leave and wanting to know when we will go back.
Emma said on the last day "I had fun being here". I think that sums it up.
Cheney stayed at the vet for this trip - we usually leave him at home and have someone come in but he usually goes on a hunger strike. I hoped by putting him in the vet that he would have more attention and eat. They called me 2 days in that he wasn't eating and they were going to have to force feed him.
When I went to pick him up, all of his food was gone and I was shocked. They said they actually let him roam around the front treatment area and he then started eating fine.
Did I forget to tell them that he thinks he's a dog in a cat suit. He does. He needs the attention like a dog. And that's nothing compared to now that we're home - he won't leave my side. If I'm on the couch, he's on the couch. If I'm in the bed, he's right beside me - literally. At least he's happy to see us!
More on our trip later. We did a couple of different things that we enjoyed on this trip - always trying something a little new and different.
Sunday, November 30, 2008
In less than 2 days, we will be at Disney
While its dreary and cold and wet here, I can imagine what it will be like in TWO days when we are at Disney World!
Here's the weather report for our trip. Not too bad with only one day with any real chance of rain (30%) and my birthday is looking good (Dec 7):
Mon, Dec 8:
Sunny
High of 77
Low of 55
0% chance of rain
Sun, Dec 7:
Mostly Sunny
High of 76
Low of 51
10% chance of rain
Sat, Dec 6:
Partly Cloudy
High of 71
Low of 51
10% chance of rain
Fri, Dec 5:
Few Showers
High of 71
Low of 50
30% chance of rain
Thursday, Dec 4:
Partly Cloudy
High of 75
Low of 52
10% chance of rain
Wednesday, Dec 3:
Mostly Sunny
High of 72
Low of 52
10% chance of rain.
Tuesday, Dec 2:
Mostly Sunny
High of 65
Low of 40
10% chance of rain
Mom, don't forget to mail Morgan's birthday card if you haven't!
Here's the weather report for our trip. Not too bad with only one day with any real chance of rain (30%) and my birthday is looking good (Dec 7):
Mon, Dec 8:
Sunny
High of 77
Low of 55
0% chance of rain
Sun, Dec 7:
Mostly Sunny
High of 76
Low of 51
10% chance of rain
Sat, Dec 6:
Partly Cloudy
High of 71
Low of 51
10% chance of rain
Fri, Dec 5:
Few Showers
High of 71
Low of 50
30% chance of rain
Thursday, Dec 4:
Partly Cloudy
High of 75
Low of 52
10% chance of rain
Wednesday, Dec 3:
Mostly Sunny
High of 72
Low of 52
10% chance of rain.
Tuesday, Dec 2:
Mostly Sunny
High of 65
Low of 40
10% chance of rain
Mom, don't forget to mail Morgan's birthday card if you haven't!
Friday, November 28, 2008
Weather report is looking better!
Well, all of the rain forecast on YESTERDAY's weather report is gone from today's. I think that's an indication of how volitile the weather can be. We've been when its freezing cold, and shorts weather, and lots of rain, and none. All of these weather reports within the same couple of weeks of the year.
So, here's where we are today:
Sun, Dec 7:
Mostly Sunny
High of 75
Low of 53
0% chance of rain
Sat, Dec 6:
Mostly Cloudy
High of 73
Low of 54
10% chance of rain
Fri, Dec 5:
Partly Cloudy
High of 77
Low of 54
0% chance of rain
Thursday, Dec 4:
Partly Cloudy
High of 75
Low of 55
10% chance of rain
Wednesday, Dec 3:
Sunny
High of 67
Low of 51
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy
High of 64
Low of 40
0% chance of rain
The trip seems to be starting off with a little cooler weather and then getting warmer during the week, which just means we need 2-3 seasons worth of clothes, as well as medium-weight jackets in addition to some shorts. Makes for some fun packing - NOT!
So, here's where we are today:
Sun, Dec 7:
Mostly Sunny
High of 75
Low of 53
0% chance of rain
Sat, Dec 6:
Mostly Cloudy
High of 73
Low of 54
10% chance of rain
Fri, Dec 5:
Partly Cloudy
High of 77
Low of 54
0% chance of rain
Thursday, Dec 4:
Partly Cloudy
High of 75
Low of 55
10% chance of rain
Wednesday, Dec 3:
Sunny
High of 67
Low of 51
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy
High of 64
Low of 40
0% chance of rain
The trip seems to be starting off with a little cooler weather and then getting warmer during the week, which just means we need 2-3 seasons worth of clothes, as well as medium-weight jackets in addition to some shorts. Makes for some fun packing - NOT!
Thursday, November 27, 2008
Happy Thanksgiving!
Happy Thanksgiving to everyone. I hope you are enjoying a safe and happy holiday.
Today's weather forecast has a little bit of rain during our trip. But since I've see so many changes, and we are still a week out, I have confidence that it will get better (and I have shipped the ponchos down, just to be safe)
Sat, Dec 6:
Showers
High of 73
Low of 55
40% chance of rain
Fri, Dec 5:
Partly Cloudy
High of 75
Low of 54
10% chance of rain
Thursday, Dec 4:
Showers
High of 75
Low of 54
60% chance of rain
Wednesday, Dec 3:
Sunny
High of 67
Low of 51
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy
High of 64
Low of 41
0% chance of rain
Today's weather forecast has a little bit of rain during our trip. But since I've see so many changes, and we are still a week out, I have confidence that it will get better (and I have shipped the ponchos down, just to be safe)
Sat, Dec 6:
Showers
High of 73
Low of 55
40% chance of rain
Fri, Dec 5:
Partly Cloudy
High of 75
Low of 54
10% chance of rain
Thursday, Dec 4:
Showers
High of 75
Low of 54
60% chance of rain
Wednesday, Dec 3:
Sunny
High of 67
Low of 51
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy
High of 64
Low of 41
0% chance of rain
Wednesday, November 26, 2008
Getting closer
Today, I'm getting ready for Thanksgiving and our house and shipping a box down to Disney World with items we don't want to have to pack in our suitcases (such as ponchos, juice boxes, etc)
Weather report for today:
Friday, Dec 5:
Mostly Sunny
High of 72
Low of 52
10% chance of rain.
Thursday, Dec 4:
Mostly Sunny
High of 74
Low of 52
10% chance of rain.
Wednesday, Dec 3:
Sunny
High of 71
Low of 53
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy
High of 67
Low of 49
0% chance of rain
Weather report for today:
Friday, Dec 5:
Mostly SunnyHigh of 72
Low of 52
10% chance of rain.
Thursday, Dec 4:
Mostly SunnyHigh of 74
Low of 52
10% chance of rain.
Wednesday, Dec 3:
SunnyHigh of 71
Low of 53
0% chance of rain.
Tuesday, Dec 2:
Partly Cloudy High of 67
Low of 49
0% chance of rain
Tuesday, November 25, 2008
Still looking like great weather
Weather is still looking great for our trip. Starting to have to think about getting packed - especially since I want to ship a box down in advance!
We leave one week from today!
Tuesday, Dec 2:
Partly Cloudy (yesterday it said Mostly Sunny - I STILL don't know the difference)
High of 72
Low of 52
0% chance of rain
Wednesday, Dec 3:
Sunny
High of 74
Low of 55
0% chance of rain.
Thursday, Dec 4:
Mostly Cloudy
High of 77
Low of 50
10% chance of rain.
We leave one week from today!
Tuesday, Dec 2:
Partly Cloudy (yesterday it said Mostly Sunny - I STILL don't know the difference)
High of 72
Low of 52
0% chance of rain
Wednesday, Dec 3:
Sunny
High of 74
Low of 55
0% chance of rain.
Thursday, Dec 4:
Mostly Cloudy
High of 77
Low of 50
10% chance of rain.
Monday, November 24, 2008
New Pump!
We got Emma's new insulin pump today. Its an upgrade to our original pump (Animas 2020) called the One Touch Ping! It is a meter and a pump integrated.
For us, we wanted the ability to control the pump remotely. This means we don't have to pull it out of her pouch in order to dose her, or see what her insulin status is - its all on the meter. This will be especially valuable overnight, when we sometimes have to turn her over and dig out the pump to dose her.
For Emma, she wanted pink!
(Sorry the picture is grainy, out of focus, and not very good of Emma but she isn't cooperating for photos these days)
Bet you didn't know you were reading the blog of an amateur meteorologist, huh?
Tuesday, Dec 2:
Mostly Sunny
High of 72
Low of 53
0% chance of rain
Wednesday, Dec 3:
Mostly Cloudy
High of 75
Low of 56
10% chance of rain.
Gosh, if it gets much hotter, mom is actually going to say its TOO HOT! :)
So far, weather for our trip to visit our favorite rodent in Florida is looking promising!
Mostly Sunny
High of 72
Low of 53
0% chance of rain
Wednesday, Dec 3:
Mostly Cloudy
High of 75
Low of 56
10% chance of rain.
Gosh, if it gets much hotter, mom is actually going to say its TOO HOT! :)
So far, weather for our trip to visit our favorite rodent in Florida is looking promising!
Sunday, November 23, 2008
Sunny, high of 73, low of 54, 0% chance of rain
That's the weather report for Dec 2 - the day that we arrive at Disney World. Sounds pretty good to me.
Only 10 days left. I've had trouble getting excited about the upcoming trip. I think its maybe because I'm afraid that its going to be crowded - due to the fact I couldn't get rooms at the resort I wanted nor a couple of meal reservations that I wanted. But I'm finally starting to get excited
We go when we do (beginning of December) because its supposed to be one of the least crowded times, the weather is still great, and we LOVE to see the Christmas decorations. I hope all of those still prove true this trip!
Only 10 days left. I've had trouble getting excited about the upcoming trip. I think its maybe because I'm afraid that its going to be crowded - due to the fact I couldn't get rooms at the resort I wanted nor a couple of meal reservations that I wanted. But I'm finally starting to get excited
We go when we do (beginning of December) because its supposed to be one of the least crowded times, the weather is still great, and we LOVE to see the Christmas decorations. I hope all of those still prove true this trip!
Saturday, November 22, 2008
I've done my part to stimulate the economy!
I went shopping for Christmas presents today.
I have to tell you, I'm surprised at how expensive and BIG everything is. You can't just get a "small set of Tinkertoys", it has to be the "Super Size themed with colors" Tinkertoys - and price tag to go along with it.
And the electronics are all just expensive. Since kids are "engaged" with electronics earlier in their lives, its more years of electronics we have to deal with.
I even did my part to help the credit markets - I got a new credit card. Approved on the spot. I got a ToysRUs credit card that got me 10% off my purchases today (which I can say was NOT insignificant) and 6 months, no interest to pay. Since we are well disciplined in paying bills and don't pay interest or penalties on any of our credit cards, this is a safe approach for us to take and it spreads out our Christmas payments until June!
Have you done your part?
I have to tell you, I'm surprised at how expensive and BIG everything is. You can't just get a "small set of Tinkertoys", it has to be the "Super Size themed with colors" Tinkertoys - and price tag to go along with it.
And the electronics are all just expensive. Since kids are "engaged" with electronics earlier in their lives, its more years of electronics we have to deal with.
I even did my part to help the credit markets - I got a new credit card. Approved on the spot. I got a ToysRUs credit card that got me 10% off my purchases today (which I can say was NOT insignificant) and 6 months, no interest to pay. Since we are well disciplined in paying bills and don't pay interest or penalties on any of our credit cards, this is a safe approach for us to take and it spreads out our Christmas payments until June!
Have you done your part?
Friday, November 21, 2008
Good diabetes news!
Emma had her quarterly checkup yesterday. For many people, this is the only contact they have with their endocrinologist practice. For me, that is not the case (not withstanding the fact that I saw our nurse and Dr. at the JDRF Gala on Saturday). I email the nurse pretty often when we have trends that I can't figure out and need another set of eyes. She's really good at not just telling me what we should change, but WHY so that I can try and understand and make the change myself in the future.
The good news is that all of our discipline pays off - our A1C is 7.0%. We are all pretty happy with that for a couple of reasons. In general, its a great number for a 3-year-old. It equates to an average 170 blood glucose reading over the past 3 months. We've been seeing some lows that I don't like but the doctor is convinced that we aren't missing them, or our A1C would be lower. The other reason we are happy is because its down a smidgen from our previous one (7.1%). Every little bit helps. We've been working on her rates a lot and I was worried it would be a lot higher, so we're happy.
Everything else looks great and I always like going to these appointments!!
And, because I hadn't shared before - here is a photo of Mike and me from the JDRF Gala in DC this past Saturday:
The good news is that all of our discipline pays off - our A1C is 7.0%. We are all pretty happy with that for a couple of reasons. In general, its a great number for a 3-year-old. It equates to an average 170 blood glucose reading over the past 3 months. We've been seeing some lows that I don't like but the doctor is convinced that we aren't missing them, or our A1C would be lower. The other reason we are happy is because its down a smidgen from our previous one (7.1%). Every little bit helps. We've been working on her rates a lot and I was worried it would be a lot higher, so we're happy.
Everything else looks great and I always like going to these appointments!!
And, because I hadn't shared before - here is a photo of Mike and me from the JDRF Gala in DC this past Saturday:
Sunday, November 16, 2008
JDRF Gala
A short post now. A longer one later.
Last night we attended the Gala for our JDRF Chapter. After a last minute change in location due to the G20 summit, the event landed at the Mellon Auditorium on Constitution Ave.
I bought a new formal and borrowed some great jewelry from a friend. It was a great cocktail hour and silent auction, followed by dinner and a live auction.
Our Endocrinologist (Dr. Cogan) and our Nurse (Celia Henderson) were both there, so it was nice to chat "outside of the office".
The MC of the event was Amy Robach from NBC. Much to Mike's chagrin, I went up and introduced myself. She used to be on the board of the chapter and has a family connection to Type 1 diabetes. When I mentioned that I lived in Loudoun County, she immediately connected it to the recent election as she was sent here to cover this "swing county" in the "Swing state" of Virginia.
Very tired today from being up late at the party and then late checking Emma.
Last night we attended the Gala for our JDRF Chapter. After a last minute change in location due to the G20 summit, the event landed at the Mellon Auditorium on Constitution Ave.
I bought a new formal and borrowed some great jewelry from a friend. It was a great cocktail hour and silent auction, followed by dinner and a live auction.
Our Endocrinologist (Dr. Cogan) and our Nurse (Celia Henderson) were both there, so it was nice to chat "outside of the office".
The MC of the event was Amy Robach from NBC. Much to Mike's chagrin, I went up and introduced myself. She used to be on the board of the chapter and has a family connection to Type 1 diabetes. When I mentioned that I lived in Loudoun County, she immediately connected it to the recent election as she was sent here to cover this "swing county" in the "Swing state" of Virginia.
Very tired today from being up late at the party and then late checking Emma.
Friday, November 14, 2008
A typical day
In honor of World Diabetes Day, I thought I'd post what a typical day for a Type 1 diabetic (or parent of a Type 1 diabetic) is like. Of course, the irony is that there isn't a typical day - there are so many variables and factors that go into a diabetic's blood sugar, that normal doesn't happen, but here we go:
Morning
7:00am - Emma gets up. We check her blood sugar first thing. Recently she has either been waking up in range (70-150) or low. If she's low, we have to give her juice before she eats
7:30am - Emma eats breakfast. Every meal she has needs to have a protein in addition to carbs. Protein slows down the absorption of carbs and paces it better with the action of the insulin. She is given insulin through her pump for her breakfast.
9:30am - Check Emma's blood sugar. Her morning numbers have been a little crazy so we have to do a 2-hour post-meal check. These days, she is in the low end of range at this time, which means more testing. If she's below 100, we give her 2 ounces of juice because the insulin is still working in her body and she'll go even lower if we don't.
11:00am - Check Emma's blood sugar. If she's below 80, we give her between 1 and 2 ounces of juice
Afternoon
12:00pm - Check Emma's blood sugar and feed her lunch. These days she has started arguing with me about what she wants to eat. So, I can't give her insulin before she eats, because there's no guarantee she will eat it. So, she eats (or doesn't eat) and then we give her insulin based on what she ate.
12:30pm - Emma goes to take a nap - sometimes she goes right to sleep and sometimes she's awake for a long time.
3:00pm - Check Emma's blood sugar. Whether she's awake or not, we need to check her reading. There is just no telling whether she's going to be low, high, or in between, so we need to check. The good news is that we only have 4-5 combinations of food that she eats for lunch, so we are pretty confident in the carb counts that we are using.
5:00pm - Check Emma's blood sugar. This is a crazy time of day for Emma. During sports seasons, we are often heading out to baseball or soccer so she's running around a lot, which makes her readings drop. If we are at home, she's a lot calmer, so her readings will go up. Obviously, its not steady so we need to check.
Evening and Overnight
6:30pm - Check Emma's blood sugar for dinner. Dinner time varies a lot based on what activities the kids have and what time Mike is getting home from work. Dinner also introduces the most variability in carb counts as we have more variety for dinner than any other meal. Its often a meal with a higher fat content too, which affects Emma's blood sugars.
8:00pm - Bedtime for Emma.
8:30 - 9:00pm - Check Emma's blood sugar. Based on what we ate, how confident we are in the carb counts that we did, and what Emma's reading was before dinner, we check her between 2 and 2 1/2 hours after dinner. She's often not been in her room for long, so she's often not asleep or just going to sleep. But we have to disturb her to check her and sometimes give her juice if she's low.
10:00pm, 11:00pm, midnight, 2am, 3am, 4am - any of those times overnight, we have to check Emma's blood sugar. Each night we have to make a decision based on what she ate, what her 8:30pm reading was, what else is going on, whether she went right to sleep, etc. There are many variables that factor into the decision each night.
Each time we check Emma and she is low (below 80), we have to give her juice. Usually that means a re-check in 30-60 minutes to make sure she really DID go back up. If she's high enough that we need to give her a correction with insulin, we have to check her in 2 hours to make sure she came down, and didn't come down too low.
The other variable is the unknown. Since Emma cannot tell when she's high or low, we have to try to read the symptoms. If she's fussy or cranky, we have to test to see if she's low or high. But, lets not forget that she's 3. She can be fussy or cranky because she's 3, or because she's low or high. We hate that we have to test because we don't know.
Every 3-4 days, we have to change the location of her pump site. After a period of time, the tissues of your body become saturated with insulin and you need a new site. We rotate from time to time between her rump and her belly. Over the past 2 1/2 months we have found that her insulin needs are a lot lower when her site is on her belly. Which means we've had to adjust all of her insulin doses to accommodate. Which means more testing. We have also found that after we change her site, her body is so excited to have fresh insulin in a fresh site that it goes nuts and she drops low - really low. So, we are often fighting low readings for 6-12 hours after a site change - luckily its only every 3-4 days.
So as you see, you tend to be "time driven" when you have Type 1 diabetes. Its always about when the next time is to test, when you ate last, how much insulin is still working in your body, whether the fat in your food is going to make you spike later, whether a new site is going to make you go low, whether the exercise you did in the afternoon will make you go low, or the adrenalin in your system will make you go high, whether you looked at your mother wrong, whether the moon is in a strange cycle, or Jupiter and Mars are visible at sundown.
There are just so many factors that the best you can do is have discipline and structure and test often - keep them from going too low or too high and have as normal a life as possible and you've succeeded.
Morning
7:00am - Emma gets up. We check her blood sugar first thing. Recently she has either been waking up in range (70-150) or low. If she's low, we have to give her juice before she eats
7:30am - Emma eats breakfast. Every meal she has needs to have a protein in addition to carbs. Protein slows down the absorption of carbs and paces it better with the action of the insulin. She is given insulin through her pump for her breakfast.
9:30am - Check Emma's blood sugar. Her morning numbers have been a little crazy so we have to do a 2-hour post-meal check. These days, she is in the low end of range at this time, which means more testing. If she's below 100, we give her 2 ounces of juice because the insulin is still working in her body and she'll go even lower if we don't.
11:00am - Check Emma's blood sugar. If she's below 80, we give her between 1 and 2 ounces of juice
Afternoon
12:00pm - Check Emma's blood sugar and feed her lunch. These days she has started arguing with me about what she wants to eat. So, I can't give her insulin before she eats, because there's no guarantee she will eat it. So, she eats (or doesn't eat) and then we give her insulin based on what she ate.
12:30pm - Emma goes to take a nap - sometimes she goes right to sleep and sometimes she's awake for a long time.
3:00pm - Check Emma's blood sugar. Whether she's awake or not, we need to check her reading. There is just no telling whether she's going to be low, high, or in between, so we need to check. The good news is that we only have 4-5 combinations of food that she eats for lunch, so we are pretty confident in the carb counts that we are using.
5:00pm - Check Emma's blood sugar. This is a crazy time of day for Emma. During sports seasons, we are often heading out to baseball or soccer so she's running around a lot, which makes her readings drop. If we are at home, she's a lot calmer, so her readings will go up. Obviously, its not steady so we need to check.
Evening and Overnight
6:30pm - Check Emma's blood sugar for dinner. Dinner time varies a lot based on what activities the kids have and what time Mike is getting home from work. Dinner also introduces the most variability in carb counts as we have more variety for dinner than any other meal. Its often a meal with a higher fat content too, which affects Emma's blood sugars.
8:00pm - Bedtime for Emma.
8:30 - 9:00pm - Check Emma's blood sugar. Based on what we ate, how confident we are in the carb counts that we did, and what Emma's reading was before dinner, we check her between 2 and 2 1/2 hours after dinner. She's often not been in her room for long, so she's often not asleep or just going to sleep. But we have to disturb her to check her and sometimes give her juice if she's low.
10:00pm, 11:00pm, midnight, 2am, 3am, 4am - any of those times overnight, we have to check Emma's blood sugar. Each night we have to make a decision based on what she ate, what her 8:30pm reading was, what else is going on, whether she went right to sleep, etc. There are many variables that factor into the decision each night.
Each time we check Emma and she is low (below 80), we have to give her juice. Usually that means a re-check in 30-60 minutes to make sure she really DID go back up. If she's high enough that we need to give her a correction with insulin, we have to check her in 2 hours to make sure she came down, and didn't come down too low.
The other variable is the unknown. Since Emma cannot tell when she's high or low, we have to try to read the symptoms. If she's fussy or cranky, we have to test to see if she's low or high. But, lets not forget that she's 3. She can be fussy or cranky because she's 3, or because she's low or high. We hate that we have to test because we don't know.
Every 3-4 days, we have to change the location of her pump site. After a period of time, the tissues of your body become saturated with insulin and you need a new site. We rotate from time to time between her rump and her belly. Over the past 2 1/2 months we have found that her insulin needs are a lot lower when her site is on her belly. Which means we've had to adjust all of her insulin doses to accommodate. Which means more testing. We have also found that after we change her site, her body is so excited to have fresh insulin in a fresh site that it goes nuts and she drops low - really low. So, we are often fighting low readings for 6-12 hours after a site change - luckily its only every 3-4 days.
So as you see, you tend to be "time driven" when you have Type 1 diabetes. Its always about when the next time is to test, when you ate last, how much insulin is still working in your body, whether the fat in your food is going to make you spike later, whether a new site is going to make you go low, whether the exercise you did in the afternoon will make you go low, or the adrenalin in your system will make you go high, whether you looked at your mother wrong, whether the moon is in a strange cycle, or Jupiter and Mars are visible at sundown.
There are just so many factors that the best you can do is have discipline and structure and test often - keep them from going too low or too high and have as normal a life as possible and you've succeeded.
Thursday, November 13, 2008
Diabetes symptoms come on gradually
Many ask how I knew that Emma was sick and I can talk about the symptoms that she was experiencing, but its easy to look back and see what you were missing. Emma was taken to the Urgent Care with an ear infection on New Years Eve 2006. That was the first time she had had any sort of illness - she had been surprisingly healthy. Within 2 1/2 months, she was diagnosed with Type 1 diabetes. And looking back at the photos of her during that 2 1/2 months, I'm surprised we didn't suspect anything sooner about her illness.
Here's some information from the Children With Diabetes site that talks about the gradual development of Type 1 Diabetes:
Here's some information from the Children With Diabetes site that talks about the gradual development of Type 1 Diabetes:
Diabetes Develops Gradually
The process of developing diabetes is gradual. Studies performed by the Joslin Clinic1 have shown changes as much as nine years before the actual presentation of diabetes symptoms. The development of Type 1 diabetes can be broken down into five stages:
- Genetic predisposition
- Environmental trigger
- Active autoimmunity
- Progressive beta-cell destruction
- Presentation of the symptoms of Type 1 diabetes
People with Type 1 diabetes have a genetic pre-disposition to the disease, but one or more environmental insults is required to trigger disease. This fact can be derived from studies of identical twins with Type 1 diabetes. When one twin has Type 1 diabetes, the other twin gets diabetes only half the time. If the cause of Type 1 diabetes were purely genetic, both identical twins would always have Type 1 diabetes.
One environmental trigger is thought to be the Coxsackie B virus. Researchers at UCLA found that a small segment of GAD is structurally similar to a segment of a Coxsackie B protein. GAD is found on the surface of insulin-producing beta cells. The implication is that the body's immune system, after warding off the Coxsackie B virus, continues to attack beta cells because of the similarity of GAD to the virus.2
The environmental trigger results in the production of autoantibodies. People with Type 1 diabetes have antibodies in their blood that indicate an "allergy to self," or an autoimmune condition. One autoantibody found in people with Type 1 diabetes is the islet cell antibody. This antibody is often present months or years before the diabetes presents. Other antibodies include the GAD (or 64-K) antibody and the ICA 512 antibody. The presence of these antibodies is a sign that the body is attacking its own beta cells.
Symptoms of Diabetes
Once over 90% of the beta cells are destroyed, the body is no longer able to regulate blood sugar levels and the patient develops some or all of the classic symptoms of diabetes:
- excessive thirst
- excessive urination
- excessive hunger
- weight loss
- fatigue
- blurred vision
- high blood sugar level
- sugar and ketones in the urine
- Kussmaul breathing (rapid, deep, and labored breathing of people who have ketoacidosis or who are in a diabetic coma)
While the symptoms appear abruptly, the development of the disease actually occurs over a much longer period of time.
So, despite the fact that we saw the obvious symptoms for about 2 1/2 weeks, it was clear that Emma was developing this disease over a period of time. And I'm just glad that we identified it when we did or she could have been much worse before she was diagnosed.
Wednesday, November 12, 2008
Bartering Supplies
Anyone who has a chronic illness, has had a major medical problem, or who has to deal with insurance companies on a regular basis will laugh at this post.
Insurance companies are weird in what they decide to pay for and not pay for.
They have argued over and over with us about how many blood GLUCOSE test strips we get a month. We test on average about 11 times a day, which is 330 strips a month. And that's when Emma's not sick. If she's sick, or if she's having a lot of lows, we test more. But they wanted to just pay for 200 strips a month, so I've had to fight and get pre-authorization, and REMIND them that they pre-authorized in order to get enough test strips.
It took me about 3 months to get them to approve the blood KETONE testing strips - something you need to test for when a diabetic is running high numbers. When we first got the prescription, it was denied at Target - they were told it was a "medical" expense and not a "pharmacy" expense. So, I submitted the prescription to the approved medical supply company. It was denied - they were told it was a pharmacy expense. It took lots of phone calls from me AND the nurse from the Doctor's office, and finally my demanding a conference call with the supervisor from the Pharmacy Dept AND the Medical Supply Department where I got them to agree which department would be paying for this prescription and who would be calling to tell the supplier.
So, now I get two boxes a month of the blood KETONE strips - 10 in a box. Only once have I used 10 in a month. Many months I only use 1 or 2 strips. So, I have about 15 unopened boxes.
Someone on the Children With Diabetes message board today indicated that she had drums for the lancet that we use and she need blood GLUCOSE strips. Well, I don't have extra ones of those (because of the story above about arguing between 200 and 350). BUT, I have a TON of the Blood KETONE strips. Many people have trouble getting insurance to cover these strips.
So, I'm sending several boxes of Blood KETONE strips to a member of the board. She is sending blood GLUCOSE strips to the person who has the drums for the lancet. And that person is sending me some of the drums for the lancet that we like to use.
This is a ridiculous game to be played - thanks to a screwed up insurance system. But, as long as insurance is going to be screwed up, we'll figure out how to work the system the way it needs to be worked. I'll get rid of some items that will expire before I have a chance to use them, and get something that I'd like to have extras of. And everyone is happy.
Insurance companies are weird in what they decide to pay for and not pay for.
They have argued over and over with us about how many blood GLUCOSE test strips we get a month. We test on average about 11 times a day, which is 330 strips a month. And that's when Emma's not sick. If she's sick, or if she's having a lot of lows, we test more. But they wanted to just pay for 200 strips a month, so I've had to fight and get pre-authorization, and REMIND them that they pre-authorized in order to get enough test strips.
It took me about 3 months to get them to approve the blood KETONE testing strips - something you need to test for when a diabetic is running high numbers. When we first got the prescription, it was denied at Target - they were told it was a "medical" expense and not a "pharmacy" expense. So, I submitted the prescription to the approved medical supply company. It was denied - they were told it was a pharmacy expense. It took lots of phone calls from me AND the nurse from the Doctor's office, and finally my demanding a conference call with the supervisor from the Pharmacy Dept AND the Medical Supply Department where I got them to agree which department would be paying for this prescription and who would be calling to tell the supplier.
So, now I get two boxes a month of the blood KETONE strips - 10 in a box. Only once have I used 10 in a month. Many months I only use 1 or 2 strips. So, I have about 15 unopened boxes.
Someone on the Children With Diabetes message board today indicated that she had drums for the lancet that we use and she need blood GLUCOSE strips. Well, I don't have extra ones of those (because of the story above about arguing between 200 and 350). BUT, I have a TON of the Blood KETONE strips. Many people have trouble getting insurance to cover these strips.
So, I'm sending several boxes of Blood KETONE strips to a member of the board. She is sending blood GLUCOSE strips to the person who has the drums for the lancet. And that person is sending me some of the drums for the lancet that we like to use.
This is a ridiculous game to be played - thanks to a screwed up insurance system. But, as long as insurance is going to be screwed up, we'll figure out how to work the system the way it needs to be worked. I'll get rid of some items that will expire before I have a chance to use them, and get something that I'd like to have extras of. And everyone is happy.
Tuesday, November 11, 2008
Thanks for your service!
At the 11th hour of the 11th day of the 11th month, the armistice treaty between the Allies and Germany was signed, ending World War I.Since then, this day has become the day to not only celebrate the end to a brutal and bloody war, but to celebrate and honor all of the veterans of this country. Military service in this country is not required, but is left to those who volunteer. It takes a person of great personal strength and commitment to take on such a serious commitment, even moreso during a time of war.
Remember today to honor and thank all former and current members of our Armed Services for everything that they do to keep this the Land of the Free and Home of the Brave.
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