Flu Season Tips

updated 2/25/20

Flu season has arrived and the sad fact is that no matter how hard you try, sometimes you just can't avoid getting the flu. Dr. Adam Naddelman, MD, FAAP, President, Princeton Nassau Pediatrics, P.A. has a few tips on how to elude the flu, spot the virus in it's early stages, and what to do when you think that you've been bitten by the bug.

Preventative measures (from flu.gov)

Avoid close contact with people who are sick. When you are sick, keep your distance from others.

Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.

Cover your mouth and nose with a tissue when coughing or sneezing. Flu and other serious respiratory illnesses, like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS), are spread by cough, sneezing, or unclean hands.

Clean your hands. Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.

Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.

Practice other good health habits.Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Early flu signs

• Fever, usually 102º - 104º

• Cough

• Body aches that can be severe

Once symptoms begin
People who are high risk (chronic illness like diabetes and asthma, elderly or kids under 2) should seek medical care quickly. If the flu is diagnosed within the first 48 hours, antiviral drugs can be prescribed in hopes of shortening and/or lessening the effects of the flu. A full list of who is considered to be high risk can be found at Flu.gov.

For those considered low risk, Dr. Naddelman believes the best treatment is supportive care, including plenty of fluids, antipyretics to reduce fever and body aches, and lots of rest. 

Considering emergency medical assistance? Listen to episode 307 of the Juicebox Podcast

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Dr. Adam Naddelman, MD, FAAP

Dr. Naddelman stresses the importance of being on the look out for secondary infections with the flu, particularly pneumonia. Signs of influenza leading to a secondary bacterial infection like pneumonia include a high spiking fever several days into the illness, increasing cough and lethargy, and decreased appetite and oral intake. These signs require immediate medical attention.  

Once you've kicked the flu waiting twenty-four hours to reintroduce yourself to the public after your symptoms and fever have resolved is considered best practice.

Dr. Naddelman practices pediatrics, but his advice is transferrable to patients of all ages.

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I've gathered some links from the Children's Hospital of Philadelphia (CHOP) that you may find helpful if your child with type 1 diabetes falls prey to the flu.

Ketone/Sick Day Rules - Insulin Pump - pdf

Ketone/Sick Day Rules - NPH - pdf

Sick Day Log Sheet - pdf 

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This is a very good time for me to remind you that I am not a doctor and that nothing I write on Arden's Day or anywhere else should be taken as medical advice. My disclaimer says it all but you should really contact your own physician whenever you have questions about your or a loved ones health. Especially when the flu is involved. 

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Corona Shelter In Place: Update One

Before I began podcasting I did a fair amount of blogging, please bear with me while I remember how to write.

It’s March 19, 2020 and my family has been voluntarily sheltering in place for six days. Overall the time has been pleasant but I want to share a few things that I’ve noticed as the days pass.

Arden seems to like distance learning better than going to school, this was not surprising as she has been able to adjust her busy hours to meet her natural sleep pattern.

Kelly is working more hours which is allowing her to conquer tasks that would normally take more time. Saving commuting time is helping tremendously. I do worry that she isn’t taking enough breaks.

Cole has been sent home from college and the NCAA has cancelled the spring sports season. He is figuring out how to channel the massive amount of energy that he usually directs into playing baseball. Yesterday he got outside for the first time and the activity was good for him.

The house has never looked better, cleaning has become a pastime for a few of us. Arden spent a day cleaning the kid’s bathroom and it is sparkling.

Everything still feels pretty normal with the exception of how often we visit stores but the specter of what may still be coming is difficult to ignore. I find myself worrying most about food, security and diabetes supplies.

I’m going to spend this time working on the Juicebox Podcast by recording, editing and prepping future episodes. I’d like to add some home exercise to my day - I need to do that.

I’m hoping that you will use your time for something that you haven’t previously had the bandwidth for. Refocus on diabetes management, try that planking challenge - whatever. Just as long as you can look back on these days and feel like they weren’t wasted. I’ve been re-listenning to my Pro Tip series with Jenny Smith to brush up on my T1D management skills. I’ve picked a few books to read and I think that I may have an idea for bolstering the community around this blog and podcast.

Last two things: Those of you who aren’t able to stay home, please be safe and for anyone who feels uncertain about the coronavirus and what you should and shouldn’t be doing, I just recorded a very easy to follow conversation with Adam Naddelman, M.D. on the subject. Adam will be back on the show as events unfold.

Talk soon.

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I Can: A Diabetes Blog Week Day 1 Post by Nicky Gil

Nicky Gil is thirteen year old Ainsleigh's mom...  Nicky wanted to write for blog week and tell the story of the fear that she felt as she contemplated meal preparation during the first days of her daughter's diagnosis with type 1 diabetes. Her words really get to the heart of how a type 1 diagnosis can make a person feel.

I can make eggs 10 different ways...

I can make eggs 10 different ways. Just ask my daughter. That’s all she ate in the first few days after diagnosis when my refrigerator became this vast, cold box of completely forbidden and potentially deadly foods; but eggs, the “incredible, edible” were warm, filling and safe.  We’d had nutrition training the first week of diagnosis.  We’d met with the dietitian, the endocrinologist, multiple nurses – all sources of solid, reliable dietary guidance; this was not the issue – fear was.  I would stand in my kitchen at mealtime, paralyzed that my wrong choice would cost her a leg, a kidney, her eyesight, her life.  I wasn’t ready risk it for the sake of a piece of toast.  Eggs!  Eggs were safe.

hypoglycemia, hyperglycemia, bolus, basal, diabetic ketoacidosis,“carb to insulin” ratio

The eggs weren’t the only scrambled things those first few days.  New vocabulary bounced around my brain in no particular order - hypoglycemia, hyperglycemia, bolus, basal, diabetic ketoacidosis,“carb to insulin” ratio - flashcards wouldn’t have been a bad idea.   Meal creation was too daunting a task, I thought, given my limited knowledge of what was “safe.”  Thankfully, our diagnosis occurred in the summer, when I had access to a carton of eggs and a stove all day long and mercifully didn’t have to contemplate meals beyond the house just yet.  Perhaps, this would have nudged me to conquer my fear a couple days sooner and saved my family my unfortunate foray into poaching – perhaps.

My daughter took her reduced option menu in stride as, I’m sure, my confusion was nothing compared to hers.  Overnight, her world had completely transformed.  The pantry during the summers her first eight years was an open door – stocked (somewhat) nutritionally as the hours between a prepared breakfast and a prepared dinner were much more free flowing than during the school year.  Our pantry might as well have had an armed guard standing next to it the first week of diagnosis; it was right up there with the refrigerator in terms of its standing as a weapon of mass destruction.  In addition to her now (severely limited) food choices, we kept coming at her with small needles a few times a day and sticking them into her fingers and slighter bigger needles at mealtimes and sticking those into her stomach.  And we were full of (misguided) directions those first few days – no soccer, no ice cream, no sleepovers, drink this, eat your eggs.

Nicky Gil

It took three days for my daughter to decide she’d had enough.  As I approached with the needle, my shaking hand not very reassuring despite her telling me in exasperation multiple times, “It doesn’t hurt,” she took the insulin pen, looked me in the eye and said, “I’ll do it!”  Three days.  She’d had enough.  She’d was growing weary of fear – mine and hers.  I followed her lead, albeit a little more slowly.  She seized control of her situation in three days.  I branched out to toast with the eggs a few days after.  She learned to prick her own finger and I began to mentally unlock the pantry and the refrigerator.  As she learned to cope, I learned to manage my anxiety.

Four and half years in and I’ve just picked up a package of double stuffed Oreos at her request.  Funny, this isn’t something I would have given her pre diagnosis but, now, I fund the rebellious cookies.  She’ll carb count, she’ll program her pump, I’ll advise against more than one.  Our meals now include a variety of foods, most healthy, some not so healthy.  She ice skates daily, she goes to sleepovers (and texts me her numbers religiously if she wants to be allowed to go to the next one), she packs her lunch bag.  We worked our way slowly out of our first protein packed, miserable days.  We fought fear in our own way that first week, now we fight diabetes together, daily.  

Ainsleigh still eats eggs...

Nicky Gil - Mom of Ainsleigh Gil, age 13
Richmond, VA

Remember, anyone that wants to write for blog week and doesn't have an outlet for their words only needs to email me - I am happy to give your writing a home. - Scott

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Keep it to yourself: A Diabetes Blog Week Day 2 Post by Kelly Griffin

I put out the word on episode 15 of my podcast... If anyone in the diabetes online community didn't have their own blog and wanted to participate in Diabetes Blog Week, I'd host their blog post here on Arden's Day. Almost immediately, Kelly Griffin emailed me to say that she wanted to contribute a post. Initially Kelly considered writing anonymously but late yesterday she decided to not just attribute her name, but also her face to her writing. Kelly may not have been completely "out of the shadows" when she wrote this blog post... but she certainly is now! Please help me welcome Kelly into the light... - Scott

Keep it to yourself...

Thank you, Scott Benner and Karen Graffeo, for giving me the opportunity to write about a topic that seems to define my life with type 1 diabetes. To give a brief history, I was diagnosed with type 1 diabetes about 13 years ago. It was a puzzle to my doctor at the time, who assumed because I was in my  mid 20's, I must have type 2. It was actually the CDE (Certified Diabetes Educator) who determined that I was mostly likely a type 1 in a “honeymoon” phase. She turned out to be correct, and I quickly found an endocrinologist who helped me move to MDI. 

That was a time of significant transition in my life. I had been a professional student since undergrad, and was about to move to New York City to pursue a performance based career. When I shared my diagnosis with some people in the industry, I was quickly told to keep it to myself. They cared about me, and worried I might be looked at differently, or miss opportunities because I would be perceived as ill or somehow incapable. I didn't question it. Be it right or wrong, that was the way it was, and I adhered to that. I worked very hard to make sure that no one knew about my type 1.

I spent my whole life studying and preparing for this career, and I couldn't let my diagnosis become an issue now. 

Since diagnosis, I have been in pretty tight control of my diabetes, but at one visit I expressed frustration to my doctor about the amount of injections that I was giving each day, and that it was becoming harder to explain my trips to the restroom before every meal. For years, my endocrinologists have wanted me to be on a pump, but I refused because I couldn't image how in the world that would work in a quick costume change backstage. I could have several people helping me in and out of complicated clothing. Where would the pump go? How could I do this so that they wouldn't know? 

Now that I think back on it, that was my first glimpse into the DOC (Diabetes Online Community). I found forums of people talking about this “tubeless” pump. I started looking into it, and thought that might just work. I could easily hide it under a camisole while in a stage production, and no one would ever know. So, I started pumping with the OmniPod about 8 years ago, and have been using it ever since. 

Secrecy has its burdens.

Kelly Griffin

The longer I live with T1D, the more I feel the need to talk about it with someone. I need community. When you are diagnosed as an adult, you never have the experience of anyone else taking care of you. I know this is naïve, but I sometimes envy hearing about people diagnosed as children. I wish that my family knew what I deal with on a daily basis, and how hard it can be to stay in control. I have been the only one in my world who knows what I am going through. 

It was 13 years before I met another person with type 1.  I actually saw an article about this woman in a local publication, and semi-stalked her on Facebook until we were able to meet for coffee. It was the most amazing experience to sit down with someone who pulled out a pump that was “alarming” during our meeting. I am not the only one? So, I'm not the only one who sits with one arm digging into my abdomen for 3 hours in a live theater performance trying to muffle the sound of my pod beeping away? I'm not the only one who tries to discreetly light up my Dexcom screen in a movie theater to check my numbers? I'm not the only one who sits in fear of my Dexcom vibrating during church every Sunday? 

That meeting was so incredibly freeing, and it left me wanting more connection. I quickly delved into the DOC at that point. I found Scott Benner, Diabetic Danica, Kerri Sparling, and Cherise Shockley, to name just a few. Most of these people have no idea who I am, but I feel like I have community through their efforts, and I cannot express my gratitude enough. I am amazed at the strength I see in the DOC. The women, men, and children, who proudly display their pumps with or without tubing, check their blood sugars in public places, and post online without reservation or worry about what their professional colleagues might think. Those of you living boldly and out loud, inspire me.

I am choosing to walk out of the secrecy a little bit at a time. I'm not completely out of the shadows yet, but I'm working my way there. I see that I have to be bold if we're ever going to find a cure. I have to find a way of being comfortable speaking up. This is my first step, and I thank you for the opportunity. 

-Kelly Griffin

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What a wonderfully honest and brave post from Kelly - bravo!

Remember, anyone that wants to write for blog week and doesn't have an outlet for their words only needs to email me - I am happy to give your writing a home. - Scott

Sometimes Your Blog Makes Me Feel Like a Failure

A long time ago on a blog far far away lived the father of a little girl who has type 1 diabetes... 

Many years ago during a conversation with a fellow diabetes parent named Michelle I learned something about my blog that I was painfully unaware of... "Sometimes", Michelle told me, "Sometimes your blog makes me feel like a failure". This was of course, not my goal.

I was crushed because it wasn't Michelle who failed, it was me

Michelle and Mason

Michelle went on to share with me that while she enjoyed Arden's Day and found it to be refreshing and honest, it felt like my writing focused more on what went right with diabetes and in fact that the lack of relatable 'diabetes fail' conversations left her feeling as if everyone was 'succeeding' but her and that she was failing her son Mason.

I took her words to heart

I spent the next few days rereading my own blog and I could see what Michelle was talking about. I wasn't purposely just talking about the 'good stuff' but my attempt to be positive for the community was definitely coming off slanted in that direction. So I changed how I share online with Michelle's brave words as my guide. The adjustment was difficult in many ways but also incredibly rewarding. Anyway, that was a long time ago and today I pride myself on how honest and completely transparent this blog is - Not only is Arden's Day now a complete reflection of my life with type 1 diabetes but I've seen the power of sharing the good and the bad and how it has helped to buoy other families in their times of trouble. 

I owe all of that, to Michelle Golladay and she is this weeks guest on the Juicebox podcast.

As you listen to Michelle and I talk about parenting and diabetes she'll spend a few moments telling me about a Parent Advisor Program that she has helped to set up at the Akron Children's Hospital - bringing the DOC IRL! I've included links here and in the show notes of the podcast, local Ohio residents and those interested in learning more should check them out.

You can listen to our conversation right here with the embedded player, on iTunes, Stitcher or your favorite podcast application. 

About Akron Children's Parent Advisor Program

Michelle's Parent Mentor Page

Mentor Program Main Page

Contact Michelle 

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