Life For A Child
The diabetes online community provides support for those who are a part of it.
We cheer each other up and on, lend advice, create friendships and so much more. We are people helping people live better with diabetes. I speak about the power of the DOC all of the time, it's staggering to witness it's reach and impact. It's helped me more times than I can count and I bet it's helped you too.
A few thoughtful folks in the DOC got together recently and began to wonder who else our community could help. How far can our love reach, can it extend beyond my twitter feed, past our FaceBook pages? Can the power of the DOC touch a child in a country that is an ocean away? I think it can. I'd bet on us any day of the week. So please take a moment, read on and find out where and how your love will be used to save a child with diabetes.
What is the International Diabetes Federation's Life of a Child Program
from the IDF website
Donations to the IDF Life for a Child Programme are carefully directed to key areas of diabetes care and management so that established paediatric diabetes centres and associations can provide the best possible care, given local circumstances, to all children and youth with diabetes in developing countries.
Just $1 a day provides a child with:
- regular insulin
- quality blood glucose monitoring equipment (meter, strips, lancets)
- essential clinical care
- up-to-date diabetes education materials
- specialised diabetes training for medical staff
“The scope of what needs to be done is vast. Diabetes management is complex. While the first step is getting access to insulin, it needs to be followed up with education on managing diabetes, extending sustained care and also improving the quality of care. This takes both time and ongoing resources, so donations such as yours are crucial to the success and longevity of the Life for a Child Programme. Thank you for your contribution.”
Dr Graham Ogle, LFAC General Manager.
Please consider making a one dollar donation to the IDF's Life For A Child program right now by clicking on this link and join the DOC in their Valentine's Day effort to Spare a Rose and Save a Child. Give the one you love eleven roses this year and then send the money you save to a child that desperately needs insulin.
Please share this page with the DOC and beyond. Then write about Life For A Child on your blog, Facebook wall or Twitter feed. Let's take this DOC thing out for a spin and really find out what it can do!
Opsite Flexifix
For the first time since Arden began wearing a CGM we are using a third party product to aid with adhesion. Back in December I realized that the adhesive on the new DexCom G4 sensors wasn't as resilient as it was on the prior version of the device. I tried for a few weeks to be sure that we weren't just having a bit of bad luck, but after a few attempts my suspicions were validated. As others started to experience the same lack of longevity the Internet became littered with folks saying that the new DexCom G4 adhiesive just doesn't stick like it did with the 7+.
I knew instantly that I wanted needed to add a third party product into the mix and I began to search online for options. All of my research led me to want to try Opsite Flexifix first so I ordered a roll on Amazon and waited for the UPS driver to arrive.
I later found a post on the D-Mom Blog that explains, step-by-step, how Leighann prepares her daughter's Flexifix to work in conjunction with a CGM sensor. I co-opted Leighann's plan for how she cuts the center hole and made one small change. Instead of a significant overlap, I cut the Flexifix just slightly larger than the DexCom's original adhesive (image below).
Tomorrow will the twenty first day since the sensor above was applied.
Opsite Flexifix, write it down.
Here it is Shelley.
I was Just Talking to Chris
I spoke with Christopher Snider, host of Just Talking Podcast last night for over an hour. We talked about movies, blogging, diabetes, being a type I CareGiver and my new book.
Chris is a fantastic host and his questions felt very organic, like I was chatting with a someone that I've known all my life. There were moments of real honesty, I cried a little bit when I was explaining why I blog about diabetes though I'm not sure if you'll be able to tell... I covered my mouth.
I'm so interested to listen to the episode because I've been having difficulty explaining my book, a difficulty that I find very frustrating. I spoke previously about experiencing awkwardness when I try to give a quick synopsis of Life Is Short. I'm finding that when I have time to speak at length about it I make out just fine, but when I'm asked to be brief, I can't seem to find the words. I struggle to find a way to condense how I feel into a sentence or two. I think that you'll hear that when you listen to Just Talking.
I continue to be unable to identify what my mental block is. Some days I feel like I don't want to short-change the book by saying something like, "it's stories from my life", because it's much more than that. I can't tell you how confusing it is to have written a book that I'm so proud of and not be able to say what it's about or understand why I'm blocked from being able to do so. Maybe the text is just so personal that I don't feel comfortable defining it. I'll figure it out, and if for some reason I can't, I'll be happy to let your reactions to the text speak for me.
I guess that I won't be too quick to make fun of an actor the next time I hear them say, in an interview, that they can't describe their movie because it's too personal. I think that I actually understand what they mean by that... Perhaps it's a universal feeling. Maybe when you create something and put it into the world for consumption it ceases being yours to define. Maybe now that I've finished writing Life Is Short it belongs to you?
My weird issues about writing aside, most of today's episode with Chris is centered on diabetes, blogging and being Arden's dad. I hope that you enjoy it. If you have time, please leave a comment and let me know your feelings on the interview. Obviously I have no idea how it went. :)
Episode 173 - 1:06:28
Stream online at http://justtalkingpodcast.com
Listen on iTunes
On Stitcher
Just Talking Archives
Basal Adjustments
I was asked on FaceBook to explain how I made the adjustment to Arden's overnight basal rates that resulted in the graph above. I'm sorry that it took me so long to write about my (less than technical) process. Here's how I did it...
Somewhere around the second week of overnight lows it became obvious to me that I was dealing with a trend and not an anomaly. Something had changed about her physiology and I was going to have to adjust - basal adjust.
I'm not going to lie, I didn't do any basal testing. I have the procedure around here somewhere, the page or so of directions from Arden's endo that explains how to do basal testing - but I tried a more, let's say, personal approach. Luckily CGM technology lends a distinct advantage and unless we are averting a low, Arden doesn't eat at this time of night so trend graphs are a perfect way to understand where we have too much basal insulin.
I broke out the stupid PC laptop that we had to buy, because the damn device manufacturers refuse to port their software over to OS X (Apple), then I downloaded Arden's DexCom data. It only took a moment to see what time of night that her blood glucose was drifting lower.
Arden's overnight basal rate was .30 per hour, all I did was dial it back to .20 starting one hour prior to when her BG was beginning to fall, not terribly scientific I know. The possibility that this adjustment would be too little or too much wasn't a huge concern, because let's face it, I'm awake anyway.
As you can see in the image above, the slow drift that was beginning around 4 am leveled off nicely. The picture you see here shows that there was room for a little more basal insulin. I waited two more nights to verify that this graph was accurate and then I moved the basal to .25 an hour. That adjustment caused a slight dip and so the next night I staggered the hourly rates .20, .25, .20, things have been golden since.
The reasons that I like handling basal adjustments myself are simple. Waiting until Arden's next endo appointment to discuss this doesn't feel like an option - too long. Continuing to live with lows would have not only taken the rest of the precious little energy that I have left, but also it would leave Arden in danger - not doing that. People living with diabetes will always need to make adjustments like this. Their bodies, like everyone else's, are constantly going through ebbs and flows. My pancreas doesn't secrete the exact same amount of insulin every hour and it makes sense that Arden's pump shouldn't either. Arden's body has needs, ever changing needs - I have to keep up with them.
We all have to be comfortable making decisions like this autonomously at some point. As parents we don't always have the time to call for an army of help and our children's bodies shouldn't have to wait days or weeks for balanced control. Don't get me wrong, I wouldn't make a grand change to Arden's care without our doctor and I don't chase every night that doesn't go perfectly, but basal adjustments when they obviously are needed... We can do that!
If you are going to make basal adjustments please don't forget to write down your old numbers in case you have to switch back. Actually, if you don't already have that information recorded somewhere, take a moment to do that. Write down basal rates, IC ratios, alarm thresholds and all of the other personally inputted data that your pump and glucose monitors retain, just to be safe.
Later this week I'll be talking about Pre-Bolusing, Arden's latest A1c and more... stop back, like Arden's Day on FaceBook or follow the RSS feed to stay in the loop.
Good luck getting those basal rates where they need to be and then enjoy the huge difference in your BGs!
Why does basketball make Arden's BG rise?
Arden brings the ball down the court, passes and looks for a rebound. (video)
Last week during Arden's quarterly Endo appointment I brought up an issue that I had identified but couldn't figure out. I explained to our nurse practitioner that when Arden exercises her BG falls. Riding a bike, running around, recess at school, really all of the her physical activities decrease her BG... except sports.
I, of course, am aware that activity can cause a decline in BG but our issue didn't seem to be following that "rule". It took me a while to be able to see past the expectation that physical exertion would decrease Arden's blood glucose level. Inexplicably, I was having trouble with her BGs actually going up during basketball games and practices this winter. When I finally thought back, I realized that I saw similar BG trends last summer during softball.
Our NP asked about Arden's level of competitiveness, as she spoke I began to understand what she was getting at...
Arden is a very competitive little girl, when it counts. That is to say that if she goes out back with her brother to shoot baskets her BG falls from the activity as you may expect but when she is in a game, when there is a score being kept and winners and losers are recorded - Arden's BGs go up.
I explained to our NP that Arden entered her last basketball game with a BG of 125 and that by the end of the game, just one hour later with no food or carbs in her system, her BG was 220 and climbing. I was bolusing during the game, which was nerve wracking when you consider that the expectation is that there will be a fall from the activity.
The NP described to me that this is a phenomenon that they generally see with boys, then she turned to Arden and said, "so, you like to win huh?". Apparently it's common for very competitive people to access their flight or flight response (also known as 'the stress response') during a sporting competition. Their desire to win is so strong that they feel the game on a different level. Adrenaline is released and their body prepare to battle as if they are fighting for their lives.
Next week when we arrived at the gym. I am going bolus as if Arden was about to consume a 15 carb juice box (the ones we use for low BGs). I'm confident that the insulin begins to act it will find a rising BG to tussle with, if I'm wrong... we'll just drink the juice. I'll report back and let you know what happens... Never a dull moment with type I diabetes.
