9.15.2013

My poor neglected blog!

I know it's been neglected because my family tells me.  Katie is still waiting on a ruling from Humana on her pump.  We are not thinking that they will approve her but we aren't sure.  No more news other than Kev's scans came back clear.  So at least one thing is good.

JDRF walk is happening soon (October 6th) so please consider joining us and once my one class ends I will have more time to update.  Plus we see the endo in a week to see how she is doing.

8.16.2013

Appeal

Well we are being forced to appeal.  Our insurance declined Katie for the pump.  Which was fine....but she's been on the insulin injections now for almost two months and in that time she has not stabilized even a little.  Granted I don't mean stabilize like how most people think.  I expect there to be some highs and lows...but what I don't expect with her blood sugar is for Katie to go from the 200s and rising fast to then falling fast to the 100s and lower.  It's wreaking havoc on her system and making her too sick to want to do anything.  This is an active woman.  She's always on the go.  It makes me so sad to see her SO sick and not wanting to dress up, wear makeup, go out with friends or do anything.  And it's not depression- it's simply the damn numbers.  She's sick of the first thing her family asks - "What does the dexcom say" or "what are your numbers?"  And I don't blame her at all!

Needless to say- after seeing the endo in the last few weeks....they've changed her insulin again.  The lantus was doing the job but it was causing her bleeding and burns and they switched her to Levemir.  Some idea but not as flat or long lasting as Lantus.  Which works better (aka no burning or bleeding) BUT doesn't control the blood sugars as well.  In addition to this- her Humalog was changed from the kwik pen to cartridges.  This was to help her do smaller increments of insulin.  They adjusted her insulin to carb ratio too.  (More on calculating that in another post!).  All of this wordiness to say that I basically wrote with Tenney's help (Thanks Tenney!  You are a DOLL!).  I used a few sample letters I found online but entered in a bunch of information on my own.  Referenced the American Endocrinologist's Association and their recommendations.  Then if that wasn't enough I decided to look up some journals and directed them to actual tables and data that I read.  I am hoping all this plus the Dexcom data is enough to convince them that Multiple Daily Injections (MDI) therapy is not the answer for Katie and insulin therapy is.

I want a world where an artificial pancreas is available and there is a cure for Type 1 Diabetes.  An artificial pancreas is the insulin pump and CGM all rolled into one and it talks to your phone on an app.  In addition to this..it is able to calculate how much insulin automatically that your body needs based on the concentration of sugar in your blood.  That's a pretty awesome device.  It's in trials now and I hope it gets through quickly.  I really do!

Keep us in your thoughts.  I'll update here when I can.  I'm about to be in the field next week so won't be posting as much and classes start again for me in two weeks on Monday.

I'll post our appeal letter here after all is said and done for those that might want a template to use. Right now I don't want to do anything to hurt her process.  In six months we can get it and for free but to see your child so sick from highs and lows- you are willing to do anything for her.  Fingers crossed!  (Toes too!)

8.10.2013

Travel and Diabetes

We discovered that while Katie *can* take part in all the eating out - going out of town entails...she probably shouldn't.  She's been running high ALL weekend.  We had gone up to MI to see Kev and spend some quality time together as a family.  She wasn't working so was less active but the meals we did eat out- Quaker Steak and Lube (burgers and fries and pretzels) and El Barrio (awesome, awesome mexican food in Grand Rapids!) and then Pizza at Pepperino's in downtown Grand Rapids, caused her blood sugars to raise up to over 300.

She was SO high she had trace amounts of ketones in her urine.  Yes I had to test...glad I knew how after animal phys class (We did this in lab one time).  I had her drink lots of water as when we first started- the color was a dark yellow.  By about two hours later it was more clear and the ketones were almost gone.  But she was almost as fuzzy as she is when she's low.  Thank goodness for my friend Mary.  Her son has diabetes and she has been such a huge help.  I can't even explain y'all how much it means to know that I have someone I can text to get answers.  We ended up giving her 1 extra unit of insulin after her blood sugar kept rising at 370.  We gave it with protein and that finally got her to start coming down.  So scary when it was happening.  She couldn't even think clearly at all.  We were told that diabetics are frequently arrested for appearing drunk or high.  I believe it.  Her lows and highs are like this.  It's probably why her so-called friends in HS believed the worst about her rather than tell us she was sleeping through classes, weaving and looking crazy.  She might have been diagnosed sooner if people had.

Our endo uses mychart which is AWESOME- because we can email them anytime and they will get back to us.  Plus we can page the doctor.  I just hate doing it when it seems so easy to figure things out.  But we always tell them what we tried.

When you travel- take triple the amount of everything.  It's worse than a baby traveling.  My one suitcase travel packing was tossed out the window.  We had to bring:

-extra dexcom insertion needle (in case we needed to do a site change)
-waterproof tape
-extra needles, test strips, lancets, insulin- cooler and ice for the unopened insulin
-extra snacks.  Glucose tablets for low blood sugar, hard candies, icing (great for lows), ketone strips, sharps container, carb guide, instructions for ketone strips, doctor numbers glucagon.
-food for the room for snacks including protein, fruit and veggies
and so on.  It was like bringing an extra suitcase...traveling light is a thing of the past.

I sure hope she starts to level off soon.  Keep her in your thoughts and prayers.

8.08.2013

We are almost at $600!!!!


It's hard to believe but we are almost at $600 in our efforts to raise money for the JDRF.  We can't wait for the walk and are so excited that people are wanting to donate to our cause!  It's not too late to join in- either to walk and raise your own money or to donate to our walk!!!!!  Katie and I get to go to a captain's lunch in a week and I know she is excited to learn all she can.  We also get to hear about the latest research on Type 1 Diabetes.  Katie still has a goal of raising $5000 so please- if you haven't donated- every little bit helps.  We are going to be designing tee shirts for our team to wear...we have some more work to do on that.  And we can't wait for the walk.  It's going to be October 6th on the Lakefront here.  Should be beautiful out.  There are other ways to donate also.  You can host a party- we just did one for South Hill Designs and Thirty-One and my friend Sandy donated her commission and our rewards and we raised $210 from one little party.  If you would want to host any type of party (Pampered Chef, Tupperware, etc and so on) we can raise even more.  Thanks!!!



8.06.2013

Insulin Change

Katie has been having super bad swings.  This is *very* hard on her body...I would assume it would be hard on anyone....but I can only attest to what I've seen with Kate.  She's been working about 30-32 hours a week and I think she's been a bit annoyed that the numbers haven't leveled off.

I suspect that it will always be a bit like this....especially with any physiological changes (illness, monthly stuff, etc and so on).  Any little change can wreak swings in her blood sugars.  What's the hardest isn't being at 70 or 200 or even 300.  It's the swinging within an hour from one to the other.  Her cells aren't ever working at 100% and she's getting exhausted.

Luckily we have a great endo and office- we had an appointment to see Dr. Kassar anyway- and so we talked it over with him.  We made the switch from Humalog 75/25 to Humalog and Lantus.  More on them below:

Humalog 75/25 is a great starting point. Humalog 75/25 is a man-made insulin that combines both intermediate acting insulin with fast-acting insulin.  It's great for a few reasons- because it only requires you to stick yourself with a needle two times a day.  And because it could be good if your body responds well to it.

For my bio/geek friends:
(From RxList:)
Chemically, insulin lispro is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. Insulin lispro is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered to produce insulin lispro. Insulin lispro protamine suspension (NPL component) is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation.
Insulin lispro has the following primary structure:  Insulin lispro has the empirical formula C257H383N65O77S6 and a molecular weight of 5808, both identical to that of human insulin.
Humalog® Mix75/25™ [insulin lispro protamine] Structural Formula Illustration


Humalog:  This insulin is similar to the 75/25 but it's only a rapid-acting human insulin analog.  (Insulin Analog is simply an altered form of insulin that is different from what happens in nature but works like human insulin.  The amino acid sequence is genetically modified (engineered) to change its adsorption, distribution, metabolism and excretion characteristics.  This alone would not help Katie.  Which is why she now also takes Lantus.

Lantus:  It's a long-acting basal insulin analogue.  The insulin is inside microcrystals so the insulin is slow acting.  Katie takes this at night so she can have it work over a long period of time(18+ hours).  Unlike Humalog- this insulin does not peak.  It's the best long acting insulin on the market according to our doctor.  It's not cheap..but then none of the insulin out there is.

Dangers of High Blood Sugar:  Blindness, loss of limbs, kidney failure and nerve problems to name a few- these appear OVER time.  And might not appear until much later in life.

Dangers of Low Blood Sugar (under 70 mg/dl):  Seizures, unconsciousness, accidents (while driving, walking or falling) The danger of something happening to you because of the low blood sugars is low..but things that CAN happen while you are confused and lethargic and have low blood sugar are scary.  Repeated seizures can cause brain damage, you can get in a car accident while you have a low (we've already had a major accident that we suspect was a result of the undiagnosed diabetes - and it WAS scary- they could have been killed!)

It's important to control Katie's blood sugar and work on the lows first since these cause danger to her body now.  But that doesn't mean you ignore the highs.  You can't because eventually if you ignore your diabetes it will come back to bite you when you are much older.  So right now Katie is taking Humalog before every meal.  She has to calculate a correction factor and other data in order to get the right amount of insulin.  Then at night she injects the Lantus.  She has gone from two sticks a day to four.  And I suspect more will occur before we get this figured out.  We really, really hope that six months passes quickly so we can get that OmniPod insulin pump and that Humana doesn't give us anymore issues about it.  We are still researching fighting and having an external review of the pump for Katie.  But right now all of our time and energy is going into making sure her numbers get to be in a tighter range.  Especially before school starts!


7.27.2013

Dietician

We are doing our last meeting with the dietician today.  It's been *very* helpful for us to learn all the ins and outs of this disease.  We've learned about counting carbs and good meal choices but most importantly as a parent- it's enabled me to not have to be the HEAVY on everything.

Katie still eats sugar.  Please don't think she doesn't.  She gets cravings like any other kid out there. We just ask her to limit that sugar and to make choices about carbs by choosing good carbs.  She knows how she feels when she eats candy or has ice cream.  But I don't see her giving it up forever.  So now when she has a Blizzard from DQ it's a small one and only when her numbers are running lower.  She has to drink water to bring her sugars down.  Exercise also is excellent for it.

Which is excellent because I need to exercise anyway.  Fruits and veggies are better choices.  Fruits are a better choice for carbs than ice cream or sugar.  But she also needs to avoid the sugar-free options that are great for type 2 diabetics if that is their choice.  Katie has a mom and dad who are educated in science.  I have a BS in Biology and a minor in Chemistry.  I'm getting my masters in Environmental Biology.  Needless to say I have opinions on aspartame and other poisons out there.  But this is our personal choice.  Plus sugar-free foods we found out have a lot of fat and other additives in them added in to make them more palatable.

We try and live more on fresh foods and eat that way.  We aren't perfect- no one is.  But these classes have given us a way to learn about what we need to do to keep Katie's organs as healthy as possible.  And she's handling it like a pro.

She wants to be a doctor or a personal trainer and she's all about health.  I see her easily getting her degrees and then going on to help find a cure for Type 1 diabetes.  She's going to be passionate about it because she's living it.  Go get 'em honey- we are behind you 100% all the way!  So, so proud of our girl!

7.26.2013

How low can you go?


Katie's Accu-Chek Nano Glucometer
55.  Yes that's how low.  That's lower than the low the endo office says to be worried about hypoglycemia at.  And it's the low we experienced the other day.  We had left the endo office after learning how to use the Dexcom CGM.  The problem was that when Katie inserted it..it hurt like the dickens (as my gram used to say) and she sobbed and held her breath.  Colleen (most awesome nurse practitioner and lifesaver) told her to BREATHE.  And kind of shook her.  I was getting into place to grab her.  It would have been SO much easier had her 55 low hit there.  But oh no..we had the joy of experiencing this low when she was in the car.

I had let her sit in the front of the jetta.  Kev was driving.  She was saying we should get her lunch on the way home..although now that I think back, I think *I* had said that.  So she was testing her blood in anticipation for eating.  We were looking for fast food that wasn't surrounded by construction because she was already a little late for work at Starbucks.

I *should* have known she was low when she growled at me about calling SB to let them know she'd be late.  When she tested her blood..she gasped and I said..what were the numbers?  She couldn't even TALK guys.  She was literally shaking by this point and showed me the meter and then it fell out of her fingers.  I saw 55 in a blur and started yelling to Kev to pull over ANYwhere that had food.

He is a man.  My love, my soulmate but he cannot change directions on a dime.  He just can't.  Some of it could be the hydrocephalus too...so he's in a fog trying to figure out WHERE and I'm like..there is a Dunkin' Donuts up ahead- pull in there...he's saying where...I'm getting annoyed...katie has dropped her whole bag now...there went the damn glucagon (I can assure you there is NO training on what to do when the glucagon is under your semi-conscious kid's seat in a moving vehicle).

I tell him to turn and it was the WRONG turn..I almost jumped out of the car to run to the DD which was right next door but not accessible but didn't.  I get him to get in the right spot as Katie starts moaning..and we park and I jump out.  I look back and he's joining me trying to lock the car and is like..Katie get out of the car.  I run back and I don't think I was very polite as I suggest he stay with her and find the damn stuff she dropped.

I can tell you two things...a) he stayed and gathered it all and b) that lady at the DD thinks I have QUITE the addiction to caffeine.  I got her an iced mocha something....a muffin, some munchkins and I don't know what all else.  I think I spent $20 trying to get enough carbs in my hands.  Who has time to read the nutrition when their kid is so low she could slip into that coma?  It was almost comical when I returned and Kev got the puppy dog eyes and looked at me and asked what I got HIM.

There are days I am not sure I am going to survive Katie's Type 1 Diabetes and Kev's hydrocephalus and that G-d must have *quite* the sense of humor over this.  Her blood sugar literally did not raise enough for her to work or drive herself.  So I dropped Kev off..got her fast food (horrid but fast).  And had to drive her to work.  I stayed for her to calibrate the Dexcom (once you do an insertion- it takes I think 12 hours for it to start working so it wouldn't have beeped if she was 55- thank GOODNESS we were testing before her noon meal and it was low then!)  My whole day was devoted to her diabetes again.  I'm not getting much accomplished at home other than clean up, make her meals and then go to appointments.  I'm so glad we are getting her stabilized (as much as we can) now because fall will be brutal- I'm in classes three days a week and she's in school 3-4 days.

I know I have a ton of gray hair from that experience.  We had glucose tablets, icing, snacks, etc.  But when it's dropped under a seat you are in a super scary predicament.  Usually (the lowest she's ever been is 59) you have time to get her carbs into her (15 g) and get her blood sugars up.  When it's at 55...not so much.  At any point she can go into a seizure and not be able to swallow..if she can't swallow it's glucagon time.
Glucagon injection kit- with us always!

I want a Diabetes boot camp for parents.  They can put me through scenarios so I can be prepared.  Ha.

7.25.2013

Dexcom G4 Platinum has landed at our house!



Katie has a new tool which is going to be super helpful in managing her diabetes!  These little devices are NOT cheap.  Our insurance discounted it down to $1600 roughly and $300 a month for supplies.  After we meet our deductible it will be covered 100% though (that is what we are waiting for!)

A continuous glucose monitor (Or CGM) is what Katie is now wearing.  It inserts via a catheter-type needle and stays on her body for 7 days.  Before we got this CGM we were testing her blood via a traditional glucose monitor about 12 times a day or more.  I don't think people realize- but diabetics must test their blood before every meal and bedtime.  In addition to this, because Katie drives she has to test it before she gets in the car also.  Then she needs to test when her numbers seem low or high.  We go through strips (at a $1 a strip) like they are water.  A CGM will enable us to only have to calibrate it every 12 hours and then test the normal 4 times a day.  It's important to note that this will show us trends...but that the device is giving us blood sugar levels from her interstitial tissue- NOT her actual blood.  So it has about a 15-20 min delay.  But it can tell us when she's rapidly increasing, decreasing or hitting lows.  She can then test with a traditional meter and compare levels.

The important thing for Katie is that this device will beep at her incessantly when she's sleeping until she wakes up when she's low or high and deals with it.  This is key for someone who does not recognize her low blood sugar.  She's had a few episodes at work before this CGM where she didn't recognize she was getting low and thank goodness her fellow employees did and got her to sit down and get some carbs into her system.

This device allows her to live more normally.  It checks her blood levels for her every five minutes.
I will say that the set up is clunky.  I can only imagine it will be smaller and easier to insert with every new release.  She has to put this sensor on and it has a sticky pad that sticks to her stomach and then at first it's got this plastic tube on it.  That tube houses the needle.  She needs to push it into her stomach and the needle then stays in place.  The sensor is waterproof and she wears it for 7 days before she makes a change. The receiver itself is good for about a year before you have to replace it and is NOT waterproof but she can keep that nearby.  She currently wears it like a pager almost.  I hope future versions will eventually link it to a cell phone so you don't have to have that big pager thing with you.

When she gets a pump she will have two devices she will need to carry.  I'm so grateful that Humana approved this CGM.  I finally got a good night's sleep knowing that it would beep at us if she had a severe low.  We will post more information as we learn more.  Right now we are working on getting the software on my laptop and then the receiver will download data for us that we can see trends on.  She can enter carbs and insulin units also and the device will calculate what is going on and when.  So priceless..

This is a way for her to check her blood sugar and make corrections while on the go.  She can check when we exercise, she's out running errands, at work, etc.  Priceless!!!

7.24.2013

Fundraising for Katie's Warriors!

My good friend Sandy sells South Hill Designs and Thirty-One bags.  We were so honored that she offered to do a party for us for Katie's Warriors and donated her commission to our JDRF (Juvenile Diabetes Research Foundation) Walk to Cure Diabetes (this coming October!)  Please click on the link to find our page- we are Katie's Warriors and we are walking at the Chicago Lakefront on 10/6/13.

Anyway there is still time to order these awesome necklaces and tote bags.  I'll include the links here.  100% of the commission from this party will be donated. 

Shop South Hill Designs at www.southhilldesigns.com/sandyburns. Please email sandyburns3@yahoo.com that you ordered under this fundraiser. 

Shop Thirty-One Gifts at http://www.mythirtyone.com/shop/catalog.aspx?eventId=E3447424&from=DIRECTLINK

AnnaGrace's Locket
These lockets are so cute and I love that we can personalize them for what we love.  Mine has a blessed coin and then birthstones for my gang plus a camera (for my love of photography) and an owl (for my biology interests).  I am waiting on my blue ribbon (for diabetes awareness) and my rainbow (private joke between my husband and myself  :)  AnnaGrace chose a horse, paint palette and guitar with Dream.  Katie chose a starbucks coffee cup (Barista - holla!) and a blue diabetes awareness ribbon with another charm.  

The mini locket holds only 1-2 charms..the one I posted here is the medium one.  The locket includes a chain.

The other product- Thirty One- are so nice.  The website and catalog does not do the products justice.  I love the lunch bag because it's thermal and keeps my foods cold for long days at class.  And the patterns are just too cute.  My other favorite bag is their every-wear wallet..it's big and has a strap you can pull out when you want to just take your cards and go and not have your whole purse!

We are closing out the party in a few days (by Saturday) so please order soon if you are planning on it.  We've already raised $191 for Katie's Warriors doing this party and we thank our family and friends for supporting us in this journey!  Thanks!

7.19.2013

The Mom Card

On her way to the new job!
Sometimes you just have to play it.  You walk that fine line everyday to not butt in and to allow your child to make their mistakes.  It's like when they are learning to walk or ride a bike, right?  Well every now and then you have to step in.  This past week has seen really bad lows and really high highs.  I think it's the combination of the two jobs together.  Katie quit GameStop because of lack of hours.  She loved it there but 3 hours a week wasn't going to work.  So she got and loves her full time job at Starbucks.  BUT she insisted on doing the full two week notice and then they decided to schedule her 10 full hours each of her last two weeks at GS.  Which would have been fine if she was a normal 18 year old..but we all know she's extraordinary and not normal!  She had texted me earlier in the week that she was not feeling well and her blood sugar was in the 60's.  So I texted her to leave work.  She got a bit short with me and said she was fine.  I called her at work and she answered and was slurring her words.  So I texted a neighbor to drive me there and texted Katie that I would drive her home.

To say she was annoyed with me for showing up and standing outside her work was an understatement.  But she then thanked me because I said her sugar was way too low and she looked horrible.  We got her a burger and salad and went home.  She's spiking high and swinging low all week.  Then on Wednesday she texted me from the 2nd job- GameStop to say she *really* didn't feel well.  Her coworker convinced her to sit down and drink some soda..but she said she was really tired and just didn't feel good.  I didn't even hesitate.  Enough was enough.  It's stressful enough to be on the receiving end of these texts -can you imagine being her body going through it?  So I called the store and told them that she could NOT work her shift and this would be her last day.  I said I was sorry but she's endangering her health out of some misguided sense of obligation.
I was lucky in that my uncle (in from out of town) and my mom had decided to follow me back to my house.  (In another story- my 98 year old grandmother is staying here right now while her house is getting new windows and doors!)  Thank goodness they were in the area and could help me with the logistics.  By the time I got to the store she was weaving and looking super pale.  And was out of it.  In the 15 min it takes to get home, she actually started feeling a bit better.  My uncle took her, my mom took her car and I went to get her food and meds.

I'm telling you as a parent- sometimes you have to play this card.  Even with the older adults.  She does NOT recognize she's low at all.  Ever it seems.  Sometimes she will catch it but usually she has no idea.  She did this at Starbucks...who adore her and the staff recognized it before she did because she was holding her head.  They forced her to take a break and test her blood and lo and behold- low low low.  They told me that they would all carry my phone number and be trained on the glucagon so she's safe and she can take whatever breaks she needs.  They've been so supportive.  She literally was diagnosed on the day they hired her.

And that bike she learned to ride?  Didn't happen without training wheels until she was in middle school.  We tried to get her to ride without them.  Sometimes it just takes what it takes.

7.14.2013

Doctor, Lawyer, Indian Chief

Do you remember this childhood rhyme?
      Rich Man, Poor Man,

Beggar Man, Thief,
Doctor, Lawyer, 
Indian Chief.
For some reason it came to mind when I was trying to think of a subject for this post.  :)  
This is what I feel like now...lawyer- or at least crafty when dealing with the insurance.  Doctor, nurse and everything else.  I've been reading other blogs and I realize this is NORMAL.  But it's tiring.  I feel like I'm on a tightrope because Katie is 18 and an adult and she's obviously wanting to be treated like an adult.  But is it wrong of me to want to make sure she has everything she needs?  She was going to a friend's house tonight and I tried about 20x to get her to agree to have the friend here.  She KNEW why I was doing it and pushed back equally as hard.  I had to literally bite my tongue when I asked her final plans and she said that he was picking her up here and bringing here to hang out at his place.  Now I'm sitting here trying NOT to obsessively text her over and over.  I'm trying guys.  I'm human though.

Case in point. Yesterday she was getting ready for work and I let her figure out what she needed. I believe I even asked as she was flying out the door if she had everything she needed.  Then she texted me she had NO snack with her.  You have to understand - she and I live by her meals.  She has to - literally.  Especially when working and doing physical activity - her numbers drop too low.  But I just told her to go to Target next door and get a snack.  And honestly- she figured it out.  Her best friend Mel was heading up there and was able to get her a snack.  I wasn't trying to be unfeeling but she has to learn.  I won't always be there for her and that kills me.  It's why I wish unrealistically that she had gotten diagnosed when she was little.  I feel like it's SO much harder to have a new adult be diagnosed.  As if she doesn't have enough to be responsible for???

So..I let her go today...I have texted her a few times and she is understanding more that I need to hear from her.  Need a text with her bs numbers.  And once in awhile..her lows are low and she gets freaked and asks to sleep with me and I gladly make room in the bed for her.....gladly....

This disease scares the heck out of me.  I think because I want to be in control all the time and it feels like we are falling down the rabbit hole.

I know more about carb counting and insulin amounts and things I never signed up for.  For those who know me- I was a creative person.  Trained originally years ago to be an elementary school teacher.  Went on to own a scrapbook store but when that store failed in the economy I did something so drastic my close friends and family (but not Kevin..he always knew or believed in me) thought I had lost it.  I went back to get a degree in Science.  I don't know if Kevin was rubbing off on me or what, but when he asked me what I wanted to do - that is what I said- BIOLOGY.  I believe we are on this path due to fate or whatever and this obviously was something I started studying for a reason a few years ago.  Little did I know it would be to help my daughter stay healthy and live a long life!  

I'm so glad I paid so close attention in all my courses..I know more about our cells and how they work from even before this disease....time to close down for the night...think it's about time to text my oldest.  I'm sure she will forgive me.  I always was a mama bear when someone was poking my kids..it's amazing to me how much like the mom in Steel Magnolias I can be when pushed....I'll do anything to make sure my daughter is ok.  Even if it means incurring her wrath for texting her numerous times in a night.  One day when she has a child she will get it!  

7.13.2013

Carbs, carbs and more carbs

We have more numbers running through our head each day.  I don't know how Katie keeps it all straight.  I just don't.  But she has to count every single carb.  Every. Single. Carb.  She started with the Diabetes App ($7)

But then decided to change over to the MyFitnessPal because it tracks her exercise, water and everything and provides a more clear picture to what is going on with her body.  MyFitnessPal was free I want to say and it tracks all your food..plus you can scan the barcode to find out the exact carbs.  Still everyday is a process....you have to know how to estimate them..and when she is on a pump she will need to be able to do this correctly.

Why?  Well as far as I understand to date- the pump and even insulin shots- give a specific amount of insulin anticipating that you will be eating x amount of carbs at a meal.  This is difficult to estimate.  What happens if you inject a set amount (more difficult when you have an insulin pump) and then a) the food isn't delivered to your table quick enough or b) you've eaten only 1/2 the meal and calculated for more carbs?

I know a lot of people do the low carb diet, etc.  But your body truly needs 45g (55g if you are a male) at each meal.  Then another 15 g for snacks.  There are simple carbs and complex carbs. She can eat sugar..but her body can't process it without the insulin.

Diet or diabetic foods she needs to avoid since they put in more fat to make them palatable.  So she has to just eat less of the stuff she normally eats.  Save fast food and sweets for the once-in-awhile.  And as she does it- so do we.  The good part of keeping count and exercising is that I've lost 3 lbs!  LOL

She has to be as precise as possible.  Things we put in our mouths and don't think about will not work for her without counting carbs.  She can eat proteins and stuff without counting it but her numbers are not staying "stable".  I put that in quotes because stability as we know it is gone.  Illness, activity and a host of other things (sunburn, etc) can affect her blood sugars.  Chinese food sends her numbers through the roof (and not even fried food) and so did Pizza Hut pizza....My homemade pizza was fine.  So it will be a learning curve!

When it rains, It Pours....

So we get Kev's scan results back on Thurs..or maybe it was Wed...hard to remember now.  Just to update those not in the know- Kev is my husband of almost 19 years (together almost 20 years now).  He had a horrible accident in early May and the car hydroplaned and rolled off the highway in Michigan.  He had a horrible concussion and somehow managed to convince the paramedics to release him- or they just didn't offer to bring him to the ER.  When he came to in the car- they were there standing over him..strangely they didn't stabilize his neck or anything.  SO weird.  Anyway we picked him up at a Big Boy restaurant where the state trooper dropped him off (INJURED) and the poor waitress was beside herself keeping an eye on him and getting reamed out by her bosses for letting him stay.

Anyway- his CT scan was not clear....it took me arguing to convince him to see our doc and even more to get him to get a CT.  We were surprised when it came back that he had hydrocephalus - moderate to severe.  We were told we should see a neurosurgeon ASAP but we waited another month to re-do the CT scan.  After that scan it appears there has been no change so we go to see the neurosurgeon on the 29th of July.

Another binder will most likely be started to keep track of his bills, etc  :)

And we will keep you all posted.  Please keep us in your thoughts and prayers!


7.11.2013

Everything and the kitchen sink

Katie is carrying SO many items with her these days.  The education we went to was awesome..they gave her a customized (glorified I guess) lunchbox.  So at least her needles are not visible, etc She carries in this little lunchbox:

-glucose monitor
-strips
-lancets
-lancing device
-carb counting book
-sharps container
-insulin pen
-needles for that pen
-glucose tablets
-snack
-logbook
-glucagon (sort of big container with her shot and glucagon for if she goes hypoglycemic)

and probably some other stuff I am forgetting.  She carries this everywhere with her.  To bed, to the store, to the car.  She can't leave it in the car because the insulin can denature in extreme heat or cold (it's a protein folks...and yes she knows the word denature..from me and her AP Bio class).

The goal is to do away with some of this stuff...the strips will still be there..the glucose monitor I believe becomes integrated with her pump but that means all new test strips..at all new $$$ and arguing with the insurance company.

Actually reading over her list I'm laughing b/c really the ONLY item she won't be carrying will be the insulin - I think..but then again- when she needs to bolus- then what?

This is a lot of stuff to figure out!

7.10.2013

Hitting that wall

For my friends and family- seriously?  Did I not predict locusts soon?  So Katie had a car accident in October- with Mike in the car after the homecoming game.  Her fault but the car was totaled and they were lucky to get out alive.  Then after that in the spring our house flooded with the bad storms that flooded the Chicago area.  We pulled up all the carpet in the basement (after sucking up 2 inches of water), replaced the sump pump and carried on.  Then in May- Kev was driving back from MI and got in a major accident- car rolled, he's lucky to be alive.  Dishwasher dies next...and now the fridge is starting to go.  Plus we get word that Kev's CT scan was NOT clear like we had hoped.....so we have to go a neurologist now to see what is going on with his brain (I'm glad that the ct scan caught *it* - whatever it may be).  Katie got diabetes and I just keep saying- ok this is it right?  I mean how much more can we all deal with?

I'm calling 2012-2013- the year I'd like to forget.  Please.  :)  Every single event has corresponded to me being in the field doing my research for my thesis...can I just say that I am nervously looking at August field day?  I mean really.  I just don't want to hear the next worst thing.
October Crash- bye bye van!

Now we have it easy compared to others..I know this....and I am so grateful.  So for each of those things:

October- car totaled- but my kids survived...amazing!!!!!  Plus we got a replacement used car that was not that much money out of pocket.  (Ok 4 grand is a lot but it could have been worse right?)

Spring- it flooded but lots of people lost their whole homes.  I lost carpet and padding.  Yes the basement has some issues (We are pulling off baseboards this weekend to see if there is hidden mold- I'm deathly allergic) but otherwise we got off rather easy with it.  And a desktop computer might have bitten the dust since the tower sat on the carpet.  But overall- we have a house- it wasn't leveled with the tornado, etc and so on.
Flood of 2013

May- Kev is alive....and in an odd twist when I called the guy I got my red Jetta TDI from- he had just gotten one at auction that very day and it was the first Jetta he got his hands on since the last one- he sold us.  :)  So that's a good twist.  The insurance company covered all but a few hundred to replace that car (unlike the van that had collision only) and Kev is alive.  Major fluid on brain- but he is functional.
Oh and Kev's car?  Imagine the van times 20.  The whole top of the car was mangled as it rolled a few times...the car un-useable totally.
Dishwasher?  The new one is so quiet..we could have just done dishes by hand and I would have gladly- but am so grateful I don't have to!  I love, love, love the new dishwasher  :)

So maybe we are having a run of good luck to go along with our bad luck?  I have to keep on looking at the silver lining because if I don't I might not make it.  It's funny- a professor at my school suggested back when Katie got in the accident that I drop out of the program and yet I am still plugging away.  To heck with that.  We can make it through this.  I firmly believe G-d doesn't give us more than we can handle...and hoping that he opens that window soon if the door is closed..because beating my head against it seems counterproductive!

And so we wait

We got the official call that there is no way around their black and white policy.  They didn't care about the reasons why this is important now- we simply have to wait 6 months.  Which is fine.  She's upset but will survive..she's a fighter.  It's just hard to manage with how active she is, etc.  Now to wait and see about the Dexcom G4.  I'm hoping that they approve that.  Please..we can stand some good news.  So fingers and toes crossed..I'll post an update here as soon as we know.

Wonder what they can deny next?  The bright sunny lining on all this?  The pump will be free by then.  Late december is when the six months of starting shots it.  June 26, 2013...so I don't forget.  On December 26, 2013 we can put in a request for it again.  Here's hoping they don't decline a 2nd time.

By then though - Obamacare kicks in and we might be changing up our policies anyway.  She may choose to use Starbucks insurance...it's all a mystery right now....

Denial is a river in Egypt?

Yes we got the "dreaded" denial call. I don't get this.  We have an 8500 deductible.  So if you make us wait 6 mos (the reasoning was that she hasn't been on insulin shots long enough- but wouldn't her endo actually be the better one to make that call insurance company?) - we get the pump FREE...all supplies free, etc because by then we will most likely have maxed out our deductible (we already are 3300 into it!).  But if we get it now and they approve it....we pay $1666 out of pocket.  Well played insurance company- well played......

Is it a tragedy if she doesn't get it?  To Katie yes- so for that reason alone I want it.  But truly her numbers are all over still....we are worrying about that dreaded under 100 blood sugar.  She's now working full time and her numbers are just wildly swinging.  Today she was 70 at one point.  And she's not really thinking clearly then.  She's not wanting to take time to deal with it..because as she says she's FINE...well she's 18 and invincible- but yet she's fragile...super fragile.

Anyway- the next step after denial is a peer-to-peer- her doctor talks to the insurance doctor to explain why they want the pump and so fast.  I don't know what the recourse is after if she's still denied.  I don't  know if because the reasoning is it hasn't been 6 mos that they will just resubmit it again in 6 mos?

And then we found out that the Dexcom Continuous Glucose Monitor (CGM) wasn't approved for sure yet either....we thought that it was since we submitted a payment plan.  So now we wait for that also.  Fingers crossed this one goes through.  With her numbers so all over the place- this device will be crucial in seeing her trends and also for notifying her if she has high or low blood sugar- which means she will sleep better at night.

We are hoping to re-carpet the basement bedroom (where she sleeps- lost carpeting in basement in flood a few months back) to make her room better....but that won't be instantaneously.

I don't get why the insurance company is so obnoxious about things either- why deny us her test strips? I don't get it.  Esp when your discount means I pay $100 over $112 or something stupid.  Why does every step require four steps back?  What do they think we are doing with her test strips?  What do they think will be the problem with us getting a pump??

I'll keep you all posted on how things progress after the peer-to-peer.  Hoping our Dr. Kassar is as persuasive as he seems!


7.09.2013

Getting organized

All I can say is- use a binder.  It helped so much.  The Diabetes education netted us the same handouts in some cases at the endo.  The JDRF sent us a supply pack- if you are newly diagnosed- go to their site and order one.  It's adorable for the kids.  A backback with a teddy bear and supplies and coupons!

I sorted the binder by sections- handouts, appts, paperwork from doctor, insulin section and then one for the dietician and then the pump.  I just hole punch stuff right into the binder and grab it with us for appts.

I do have a separate one for medical bills and insurance statements to reconcile.  And also her prescriptions.


7.08.2013

The Real Deal

We were told that she could swing into low blood sugars.  They showed me the handout where the guy looks cranky.  I was told she could get belligerent.  I had no idea what the meant.  But we did have the episode and it's important for other parents wondering if it's normal.

First it's laughable that I could convince a fully grown woman-child to eat a snack.  HAHAHAHAHA...she's stronger than I am (I have the bruises to prove it) and I had no idea what would set her off.  It turns out it was me texting to see where she was after work.  For most other 18 year olds..the eye rolling is normal.  What is not is a 20 min meltdown of destruction and chair throwing, kicking, punching, etc.  Perhaps more frank language would have been helpful from the doctor's office.  Or maybe no one wants to talk about it?

I'm not posting this out there for all to embarrass myself or my daughter.  But it was scary as crap and I was so glad I was dead honest with my best friend.  Who told me it was ok.  She didn't judge because frankly- that was not Katie who I was dealing with.  I think it was a combination of the stress of the disease combined with low blood sugar that sent her over the edge.  She kept screaming she wasn't mad at the disease because that would be STUPID..she thought we were the idiots (juicier words inserted please) and she hated US.  Her solution was to stop her insulin and move out.  I didn't handle it well.  Kev didn't either.  We both were upset. 

She finally got herself a snack and was able to think clearly enough to realize that she overreacted.  This is the same type of outburst we were dealing with for over a year now..nice to know our sweetheart daughter didn't mean it all those times.  And if she really was mad at us...maybe we will just give her a pass  :)

The scary part is that for Katie- her low sugar right now is in the 100s.  Her body loves being in the 200s.  So as she adjusts to having insulin in her body again she will have a lower and lower threshold before she's experiencing hypoglycemia.

We are now waiting for the honeymoon period.  Some kids for reasons totally not known- experience a lack of symptoms and their diabetes seems to go away.  Some might not even need insulin.  It's like their bodies get enough insulin that any islet (eyelet) cells left kick into gear and try and do what they are supposed to.  But eventually they die off.  The longest period of time this could be is a year or so.

And is it wrong of me to hope this doesn't happen?  All the insulin has a shelf life of 30 days.  That would be money down the drain if she ends up NOT needing it.

Some kids don't Honeymoon at all.  And don't get me wrong..I say kids because I have a kid with it.  But you can be diagnosed with T1D as an adult too.  Rarer but not impossible!


Type 1 vs. Type 2 Diabetes and Mythbusters

One of the things I've found myself repeating over and over is that Type 1 and Type 2 diabetes are caused due to very different reasons.

Type 1 Diabetes- 
IDDM (Insulin-Dependent Diabetes Mellitus) or was known as Childhood or Juvenile diabetes

This is the diabetes you hear ALL the horror stories about- people dying in their sleep...not managing it well.  Insulin shots, etc.  In the "olden" days (think back to Steel Magnolias) it was not as well controlled as it is today.  There have been many strides made to help control this life-threatening disease.  The statistic of 1 in 20 kids will die from it before the age of 18, really makes you stop and think!

Type 1 Diabetics (aka Katie's type)- make little or no insulin.  Insulin is needed because it's the keys that open the lock that is the on the door to  your cells.  Once insulin comes along and opens this lock- glucose can be utilized by that cell.  Glucose (aka Sugar) is used or burned for energy.  When it sits in our blood vessels these nick the vessel walls and can cause damage to organs and other tissues.  So what makes insulin?  Your pancreas.  When the pancreas does NOT work properly- it cannot product insulin- which in turn regulates all the glucose (sugar) in your body.  So in Katie's case- her Islet (eyelet) cells cannot make insulin or do and are attack by her own body.  Type 1 diabetes is an autoimmune disorder.

Type 2 Diabetes-
NIDDM (Non-Insulin Dependent Mellitus)

Prevents your body from using the insulin.  Your body DOES make insulin but usually not enough.  Most people with diabetes (about 95%) have type 2!  This occurs in usually older, overweight people.  8 out of 10 people with type 2 diabetes are overweight.  So that's why this type is considered controllable with pills and diet/exercise.  

Katie cannot just change her diet/exercise and magically her pancreas will starting making insulin.  Katie also cannot just manage her diabetes by taking a pill.  (Yes I have gotten some messages from well meaning family/friends telling me she will be fine if she just changes her diet).  It's ok because two weeks earlier I may have been one of those types of people!  I had NO idea how serious type 1 Diabetes was - or I had blocked it out of my mind.  I've had plenty of experience with Type 2 diabetes. It's on both sides of my family and I've dealt with it with both parents.

Myth 1- Not cured with diet and exercise (for that matter neither is type 2- it can go into remission but usually will return later in life)

Myth 2- Type 2 diabetics can't become type 1.  This is simply not true..because a lot of times they WILL eventually need insulin to survive.  

Myth 3- Type 1 diabetics can just take a pill.  There is no effective way to give insulin in a pill.  The acidic nature of the stomach would break down the pill before it could be absorbed across the stomach wall.

Myth 4-  Diabetes is not contagious.  I feel bad for Katie because some of her friends didn't know how to handle it.  I explained that some friends just didn't know what to say to her when faced with their own mortality.  There were some people who acted like they could catch it.  

Symptoms of diabetes:
-Frequent urination
-Excessive hunger and thirst
-Weight loss
-Changes in behavior

Now all of this can be explained also by exercising, drinking more water, dieting, being 18 and moody, being a senior and so on and so on.  We caught it early.  We were lucky.  We just keep repeating that to  ourselves.  Over and over.

If you have any questions on Katie or Type 1 diabetes- we are more than willing to talk to others!