Inspired by Conversation
I enjoyed having Kristina and Greg on my podcast so much that I asked them if they'd be interested in contributing a blog post to Arden's Day. It suffices to say that the topic Greg chose to write about warmed my heart! After you read his piece you can listen to their episode with the link below on iTunes, Stitcher or via the player that I've placed at the end of the blog post. Enjoy! - Scott
Time to Get More Aggressive!
Last week, my wife, Kristina, and I had the great pleasure of being featured on the 9th episode of the Juicebox podcast. It was a lot of fun and we both loved listening to it!
For parents of a child with type one diabetes, it’s fairly common for one parent to assume the majority of the diabetes management responsibilities. In our case, we pretty much split the duties (although, in full transparency, my wife does way more than I do!). We thought this would make for an interesting and entertaining discussion. When Kristina pitched the idea of an interview to Scott Benner at the Juicebox Podcast, it went like this….
“We'd love to be a part of one of your upcoming podcasts! Not sure if you've had any D-mom/D-dads reach out as a team to chat with you but we thought it might be fun. We have VERY different styles of managing Isabella's diabetes but it works.”
But, I’ll be honest; the podcast was completely Kristina’s idea and I really didn’t have much of a choice in the matter. My wife is extremely outgoing (understatement?) and jumps at the chance to speak in public forums. I, on the other hand, have always been a bit more reserved and would prefer to avoid being the center of attention, if possible.
So, for me, the thought of being interviewed is somewhat anxiety-inducing from the start and more so when my wife informs me that the interview very well may include some “newlywed style” questions to see how well we know each other. While I think know my wife very well (for years she has been preparing me for the off chance that we might someday appear on a famous live TV game show….I can’t count the number of times I’ve heard ”honey, remember this for when we’re on the game show!”), needless to say I started to get slightly nervous.
Kristina went first while I sat in the other room pretending as if I was completely calm, cool and collected and not at all anxious about the interview. All I could hear was Kristina’s muffled voice followed by her seemingly uncontrollable laughter, most likely telling one of her favorite “Greg stories.” Oh boy. Here we go…
It was finally my turn to join in on the fun. Scott immediately made me feel at ease; my nerves started to melt away and I actually started to enjoy myself. We spent quite a bit of time talking about the team-based approach that Kristina and I use for managing diabetes, which works very well for us.
While Kristina and I do act as a team, we have quite different approaches in the way we prefer to manage Isabella’s diabetes. Kristina tends to have a heavier hand with insulin (often generously “rounding up” carb counts), which helps to avoid highs. I, however, prefer to take a more conservative approach with insulin to avoid very low lows, especially overnight. The thought of what could happen to Isabella as a result of too much insulin absolutely terrifies me.
Scott seemed to be intrigued by the fact that we work as a team but with very different approaches. As a veteran type one diabetes parent, Scott shared some stories about his approach to managing diabetes. He talked about how technology, especially Arden’s Dexcom CGM, has enabled him to get comfortable with taking a very aggressive approach to insulin. This approach has led to very tight control (I still can’t believe Arden’s last A1C!).
This part of our talk really hit home.
While I’ve known that getting a bit more aggressive with insulin is likely to lead to better outcomes, I am completely terrified that I might kill my daughter with too much insulin. Our conversation helped me realize that I need to get over this fear. We have amazing technology at our disposal (including Isabella’s brand new Dexcom Share2, which is an amazing game-changer in my book!) that I can more fully leverage to help me get comfortable with becoming more aggressive with insulin, which will ultimately result in lower A1Cs, better overall control and a healthier little girl.
After finishing the interview, I believe one of the first things I said to Kristina was, “I’m gonna get more aggressive!”
It’s time to get over my fear. Thanks, Scott, for pushing me over the edge.
Greg Dooley
InspiredByIsabella.com
Arden's 504 Plan for Download
504 Plan
Over the past few months I've received numerous requests for Arden's current 504 plan, I'm sorry that it has taken me so long to get it to you! This plan has been used at the fourth and fifth grade levels and I hope that it serves as a guide for you when you are crafting/creating/editing your child's 504.
Please remember that a good 504 plan is no replacement for a great relationship with your school and that sometimes those relationships take a lot of time to cultivate. I hope you can take a moment to read a past blog post about that subject.
Episode 65 of the Juicebox Podcast is all about 504 plans... you can listen here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Alexa- google play/android - iheart radio - or their favorite podcast app.
The Word file is available here. Arden's name and all personal information has been removed. Please feel free to use this document in anyway that will benefit your child. Please also remember that nothing that you read on Arden's Day is to be considered advice, my disclaimer says more. Decisions should always be made with he help of a physician.
Diabetes Hell Week
We've recently emerged from a diabetes hell week, it was a doozy! Unexplainable high blood sugars that last half of a day were followed by perfect BGs that would suddenly fluctuate in either or both directs. I didn't sleep very long most nights during this period and at times I thought perhaps someone had switched Arden's insulin with water.
Shit was bananas and I couldn't figure out how many carbs were in it...
Not wanting to be left out of the fun, our diabetes technology also acted flaky once or twice during hell week - during one such incident I found myself wondering, "How does it know to f%^* with me right now?".
As a rough afternoon with type 1 diabetes turned into a long day and that day into a week, I found myself making some of the same mistakes I've made in the past. I'm hoping that this post will serve as a reminder for me (and you) so I can avoid them next time.
The mistakes...
- I was willing to trade my health for better BGs when what I should have done is played a Get Out of Diabetes Free card and asked Kelly for help. Instead, I passed out on the sofa one night as I was trying and ultimately failing to stay awake for another long night of BG battling.
- I fell down the rabbit hole of wondering what Arden will do when she gets older during times like this.
- I was too tired the next day to cook and stopped eating well, this exasperated the situation by sapping my energy further.
I did manage to do a few things right...
- I injected when I thought an infusion site was to blame for a high BG - sometimes it was the site, sometimes in wasn't.
- I kept Arden hydrated.
- We didn't use diabetes as an excuse to stop doing our day-to-day stuff. It sucked but Arden took a hitting (softball) lesson with a BG over 280, she made it to school with shaky numbers and went to the mall with friends in the middle of a BG nightmare (New site, almost 400 BG and a Dexcom sensor that was so confused by the high it stopped working for 3 hours). We adjusted and kept moving. BG was around 100 when she arrived home.
What I took from hell week
A few things stuck with me after the craziness passed and normalcy returned.
- I already knew this first one but was reminded again, I can't be here for Arden if I'm not here. My health is important.
- Staying fluid is monumental and attitude goes a long way to effecting reality.
- I don't have to cry anymore when I begin to wonder what Arden will do when she moves out because diabetes technology has evolved so that we can be with her if/when she has the need. Now that continuous glucose monitoring technology is in the cloud, Arden can call from college or anywhere and say, "I'm not feeling well and I want to take a nap... can you watch my blood sugar?". I am so grateful for the Dexcom Share2 for this and for taking away my annual What is Arden going to do when she gets older cry-a-thon.
Miranda
Last night as Arden was attempting to stretch out her bedtime by doing her Miranda Sings impression, I mentioned to Kelly that Arden suddenly looks more mature. Her face looks different and her body seems stronger. It was one of those moments when you could swear that she grew since the morning. I thought to myself, "This must be why her blood sugars have been so crazy lately" then I smiled - maybe the smile was from Arden's rather spot on Miranda impression, maybe it was from knowing that hell week was for a good cause - maybe it was a bit of both.
What ever you do... do not go to YouTube and search Miranda Sings - you have been warned!
Take the Type 2 Diabetes Risk Test
from: American Diabetes Association
Diabetes is a serious disease that strikes nearly 30 million children and adults in the United States, and more than a quarter of them—eight million—do not even know they have it. An additional 86 million have prediabetes, which puts them at high risk for developing type 2 diabetes. Unfortunately, diagnosis often comes 7 to 10 years after the onset of the disease, after disabling and even deadly complications have had time to develop. Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of these complications such as heart disease, blindness, kidney disease, stroke, amputation and death.
Who should participate in Alert Day?
Everyone should be aware of the risk factors for type 2 diabetes. People who are overweight, under active (living a sedentary lifestyle) and over the age of 45 should consider themselves at risk for the disease. African Americans, Hispanics/Latinos, Native Americans, Asian Americans, Pacific Islanders and people who have a family history of the disease also are at an increased risk for developing type 2 diabetes. Studies have shown that type 2 diabetes can often be prevented or delayed by losing just 7 percent of body weight (such as 15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating. By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.
Click on the image to take the test
Language processing is impaired during moderate hypoglycemia
Effects of Acute Hypoglycemia on Working Memory and Language Processing...
New research sponsored by the ADA indicates that hypoglycemia causes significant deterioration in reading span and the accuracy of subject-verb agreement. Below is the research abstract from the study as well a link to the origin page. Click here to see the entire study in PDF form.
from: http://www.ncbi.nlm.nih.gov/pubmed/25758768
Effects of Acute Hypoglycemia on Working Memory and Language Processing in Adults With and Without Type 1 Diabetes.
Abstract
OBJECTIVE: To examine the effects of hypoglycemia on language processing in adults with and without type 1 diabetes.
RESEARCH DESIGN AND METHODS: Forty adults were studied (20 with type 1 diabetes and 20 healthy volunteers) using a hyperinsulinemic glucose clamp to lower blood glucose to 2.5 mmol/L (45 mg/dL) (hypoglycemia) for 60 min, or to maintain blood glucose at 4.5 mmol/L (81 mg/dL) (euglycemia), on separate occasions. Language tests were applied to assess the effects of hypoglycemia on the relationship between working memory and language (reading span), grammatical decoding (self-paced reading), and grammatical encoding (subject-verb agreement).
RESULTS: Hypoglycemia caused a significant deterioration in reading span (P < 0.001; η2 = 0.37; Cohen d = 0.65) and a fall in correct responses (P = 0.005; η2 = 0.19; Cohen d = 0.41). On the self-paced reading test, the reading time for the first sentence fragment increased during hypoglycemia (P = 0.039; η2 = 0.11; Cohen d = 0.25). For the reading of the next fragment, hypoglycemia affected the healthy volunteer group more than the adults with type 1 diabetes (P = 0.03; η2 = 0.12; Cohen d = 0.25). However, hypoglycemia did not significantly affect the number of errors in sentence comprehension or the time taken to answer questions. Hypoglycemia caused a deterioration of subject-verb agreement (correct responses: P = 0.011; η2 = 0.159; Cohen d = 0.31).
CONCLUSIONS: Hypoglycemia caused a significant deterioration in reading span and in the accuracy of subject-verb agreement, both of which are practical aspects of language involved in its everyday use. Language processing is therefore impaired during moderate hypoglycemia.
© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.