Artificial Pancreas Someday

Wearing the iPro & the pump reminds me often of the possibility of an artificial pancreas. An artifical pancreas will sense the glucose like the iPro, send it to a computer algorithm, which then tells the pump much insulin to give or withhold. I've been reading tonight, and they have already done this on teenagers overnight! There are still issues, but the research is very exciting! I don't think Andrew would be excited, though. It's not fun to wear all the machinery. What is exciting is that doctors think they can get much better control than anything we can do right now. That is good news for his eyes, heart, kidneys, nerves, etc. Here is an interesting link to read: http://www.endocrinetoday.com/view.aspx?rid=43543

One doctor thought the first models will be available in five years. Insurance won't cover it for longer than that. They are just now starting to cover continous glucose monitoring, and even the best companies only cover 80%. I hear that the CGM supplies cost even more than the pump supplies.



In the meantime, Andrew continues to live an active life. Here he is with his trophy from tonight's end of year soccer party with Gene, who helped coach his team. Andrew starts basketball on Tuesday!

Bionic Boy!

Andrew is wearing his iPro on the left & his pump site on the right. We have nicknamed him bionic boy! The insertion hurt, & he fought tears for a few minutes. Still, he was brave! The people at Vanderbilt were great! The Child Life Specialist designed a scavenger hunt for all the patients who have come in the last few weeks. Andrew got to explore the clinic and meet lab techs, phone nurses, & even see the adult side. Each station gave him a small prize. At the last stop, he got to pick a blanket! It was really sweet and helped make a dreaded visit for him a special one! All my kids love the Child Life Specialist & love playing in her playroom. She helps them learn about diabetes & helps kids cope with living with a chronic disease.

The tape over the iPro is driving Andrew crazy! However, we want to keep it in until Monday night or Tuesday morning. Even though the sensor is recording all the readings on the chip, we don't see anything. They also want to compare the interstitial glucose with blood glucose, so we are actually testing more often! He pricks his finger before breakfast, 2 hours after breakfast, after P.E. (safety check, not iPro related), before lunch, 2 hours after lunch/before loading bus, before dinner, 2 hours after dinner, before we go to bed, and at 2 am. He had a couple extra today because of going low. Counting the site change, he will have been pricked with a needle eleven times today. All of the BG readings have to be done with Vanderbilt's meter, which we will actually mail back to them along with the iPro. That means the meter has to go with him to school & back each day. I was nervous about him remembering to bring it home, so I handed him the meter this morning & explained how important it was that he keep up with it. My phone rang at school first block. The meter was still at home. I spent another planning period running to Legacy. Andrew came to nurse (low) while I was there, so at least I got to see him.

Since this office visit was so much shorter than most, we stopped by the Nashville Zoo when we were finished! It was Andrew's first time at the zoo, & it was precious to spend that time with him! The temperature was comfortable & it wasn't at all crowded. I wished all the kids could have been there, but I also enjoyed spending one-on-one time with Andrew. He enjoyed all the animals, but his favorite one was Amber. He still wants to bring her home!

He also enjoyed the playground. He loved this slide, and I have to confess it was fun! Andrew is standing on the slide so that you see how big it is!
It was a great day, full of lots of blessings. God's creation is amazing, and His mercies are new every morning!

iPro

Andrew goes to Vanderbilt on Wednesday to get his first iPro! It is a new CGM (continuous glucose monitor) that will measure the glucose in his tissue every few minutes. He will only wear it for a week. We won't see the readings, but they will be recorded on a chip that will get returned to the doctor. Then we will return to Vanderbilt to get results and recommendations to fine tune his insulin regimen. I think it will be very helpful. Andrew is less excited. I mentioned the iPro a month ago & he immediately responded, "How big is the needle?" We told him this morning that he's going on Wednesday. He didn't say much, but I know he's scared. I think it will be a lot like getting a site. Some don't really bother him & others really hurt. I hope the iPro goes in easily for him!

Caught Up!

October 26, 2009. This blog is finally caught up with the present. I am surprised that anyone is still reading this, but it has been great fun to write. I plan to write about our adventure with the iPro since that starts on Wednesday.

Life is pretty routine now, although it still has its ups and downs. Today, Andrew's BG was 66 at 2 am. I gave him 15g juice & rechecked in 15 minutes. His BG was 59. I'm glad I was checking him! I have no idea why he dropped so low. Maybe he was more active at AWANA than I knew. I gave him more juice, waited 15 more minutes, retested, and gave him a small more complex snack. Andrew woke up with BG in the 200s. His BG was still high mid-morning, so the school nurse corrected. Sometime after 10 am, he felt low & asked to go to the nurse. On the way, his site pulled out of his leg. The nurse called me, & I left school to go change his site. By next year, he will be able to do it himself. The nurse watched, so she might be able to help him too. Since he was low, I walked him to the lunchroom before returning to school. When I got home, Andrew had gone to a new friend's house. My first thought was, "What about his diabetes?" Gene explained that he had taken his supplies & the mom seemed knowledgable. I was happy that Andrew might have another safe place to play. Then, after he got home, he had left his diabetic bag in their car. After driving to their house & not finding it, he remembered he had left it upstairs in our playroom. Where was it really? In the laundry room, which is actually where it is supposed to be so that it is handy from the kitchen or on the way out the door. Diabetes still makes me tired, and I'm not even the one who has it!

Back To School

Andrew returned to a new teacher & a new nurse. Both have been wonderful to Andrew. The only surprise was that the teacher gives candy EVERY day if the kids behave. She offered to give Andrew stickers instead, but that's just not right. We didn't want Andrew eating candy everyday, so we had him take the candy to the nurse to be used for lows. Then he wanted to argue about what to eat when he was low. Now, he takes his candy to the nurse at the end of the day. She keeps it and sends it home in a bag with a list every other Friday. We put it in his "low box" here at home. It is where all the candy that he gets at birthday parties & holidays goes. If he is low, he enjoys some candy. We have NEVER had to buy anything for the low box. We do buy lots of juice boxes because we use those if he is <60.

I go to school the first week of school and read Taking Diabetes To School to Andrew's class. It helps prevent problems of misconceptions by educating his friends. Most of the kids have been fantastic. Sometimes an overzealous friend will drive him crazy asking, "Are you low??? You look high, etc." Yes, we realize that in the next few years we need to quit asking our son if he is high.

Sweet Summer

Summer was a wonderful time of healing & rest. Andrew loved to sleep late & eat a late breakfast, so we had lots of opportunities to tweak his morning basal rates. It was a relaxing time for all of us. We had to relearn what the pool would do to his BG since he took his pump off to swim. The first time that he went swimming, he didn't want his site to show. Then he went to camp & most of the kids had sites showing. From then on, he didn't care if it showed at our neighborhood pool. He wore a swimshirt when he went to a birthday swim party. Some friends at church had a backyard Bible club at the end of the summer. I let the kids go without me & gave them a cell phone to call if they needed anything. The house wasn't far away & it was only 2 hours long. There was a snack that Andrew ate & they carb counted. They can read labels & had a book for other things. I think they called me on the homemade cookies. One day, he said that he ate cookies & a lollipop for snack. I wasn't thrilled, but he had carb counted it well & bolused for it. His BG was doing fine. Andrew will have to live with this disease until they find a cure. Learning to manage temptations & keep his BG in line is an important skill. Hopefully, he won't always think cookies & lollipops are a snack. In the meantime, Kaitlyn & Andrew loved being trusted & seemed honest when telling us what they had done when I picked them up. It was a good learning experience.

Baseball Tournament

Andrew made it back from camp in time for his tournament game. His BG had been fine since I picked him up & reconnected the pump. He was excited to play. His team, the White Sox, had lost one tournament game while he was at camp. Tonight's game would put them in the finals, playing the team they lost against. Andrew did fine playing, but he looked like he felt bad & his body language was horrible. One of the other parents commented that he might just be tired from camp. He was tired. But there was something else. He acted like he did last year when I was convinced that baseball was bad for his health. Back when he was on Lantus. I don't think he ever felt well on Lantus, especially if he was out in the heat. He acted like he felt so much better on the pump. He loved being able to eat snacks with his team, which he had not been able to do most of the year before.

The White Sox won their game that night. They played the Red Sox for the championship the next day. They beat them the first time, and then, because it was a double elimination game & we had lost to them before, they took a short break & beat them again! Congratulations, White Sox!!!

Camp Was Great!

Finally, I got to see Andrew! It was so good to see him! He had so much fun! He had enjoyed boating, fishing, archery, rifles, swimming, ropes courses, tubing, crafts, games, & more. Many of those things he had never done before. He walked with a new confidence too. He had learned that he was okay without us & he had felt completely normal for a week. Everyone had taken their BG, had highs or lows, counted carbs, and it was just a normal part of life. My prayer had been for him as he got site changes. God answered that prayer through his problems & frequent site changes! He learned to put in his own site & had learned by observing his new friends how to handle sites in new places. Prior to camp, we were rotating sites around his stomach & rear. His friends used their arms for sites too, so Andrew tried it & loves it! They taught him how to drop the tubing down in his clothes to make it work. His friends used their thighs too, so Andrew tried that when he got home. What would have been a battle to make him try at home came naturally when he saw other kids do what was normal for them. The bad BG numbers from camp are long gone, but the positive affects of being around other diabetic kids are still here. It was one more reminder that life is more than numbers. Camp was good for Andrew!

Problems At Camp

I was excited to pick Andrew up on Friday morning. I got there early to be one of the first in line to pick him up. That was partly from eagerness & partly because he had a baseball game in the evening. We had to meet with the doctors/nurses first & go over BG numbers before getting our children. The lady who pulled out Andrew's chart explained that the doctor had decided Andrew's pump might be broken & had put him back on shots (What???). The doctor next to her leaned over & said, "Is this Andrew's Mom?" (Over 100 diabetic kids here, and you're looking for me. GREAT!). Apparently, Andrew's numbers had run high much of the week. They had changed Andrew's site again & again with no luck. When he was "High, over 600" the previous evening around 9 p.m., they discontinued the pump & gave him 8u Lantus, the 24 hour insulin. The doctor explained that I could try the pump again at the 24 hour mark. I explained that Andrew had only been off of Lantus since January & needed 11.5u then. 8u wasn't going to work, as his morning BG proved. The doctor explained that they weren't sure what dose to give & needed to be cautious. (You could have called me! I could have told you what dose he had been on!!!) I didn't say anything in the parentheses of this post. I replied, "I understand, but I need some advice. Andrew has to play in a tournament ball game tonight, and I don't want him to feel horrible. 8u Lantus isn't going to be enough. What do you recommend that I do to get through the day?" When I finally got to see Andrew, we reconnected his pump & ran it at 50% because of the Lantus.

Andrew's pump wasn't broken. Once he got home, everything returned to normal. Andrew is very competitive & his BG goes up when he competes. Most kids were going low because of activity, so Andrew was unusual. He did have one low while he was there - the lowest low he has ever had. I think he said it was in the 20s. He was fine, but he said his counselor carried him back to the cabin because they didn't want him to exercise at all, not even to walk. Andrew liked that.

Checking In - Tuesday of Camp

I decided to call Tuesday & check on Andrew. The nurse who answered the phone said she hadn't seen him, and that was a good sign. She would have another nurse call back with how his numbers had been. The nurse who called back was very nice. She said that his numbers had been high Monday night, but they had corrected him & he was doing better that day. I got the sense from talking to her that she had probably never met Andrew. I understand. I can't imagine how they manage over 100 diabetic children! I decided not to bother calling again. I prayed for him & his site changes. That was his biggest fear about camp. He had never let anyone other than me do a site change. We had changed it right before he left in hopes that he would only have to change it once. When we checked in, they told him that it would be changed every other day at camp. He was not happy!

First Diabetes Camp

Several people told us that it was very important that Andrew go to diabetes camp. The first year, he was only seven, Ben had just been born, and it was VBS week. This year seemed to be a good time. We drove down to Camp ASCCA (Alabama Special Camp for Children And Adults) in Jackson's Gap on Sunday afternoon. The camp is beautiful & has lots to do. We stood in line to check in medications, check BG & temperature, lice check, vision check, nutritionist check, etc. Then Andrew got to go to his cabin, which was nice, but unairconditioned. We unpacked everything & then headed to the meeting for parents. They explained that we would not be able to call & talk to our child. We could call & talk to the nurse about how the diabetes was going, but we would not be able to call our kids & they would not be able to call us. I didn't think Andrew would suffer from homesickness too badly. Surely, a diabetes camp full of doctors & nurses could handle his diabetes. I figured that he would be fine, but I wasn't too happy about not seeing my baby again until Friday. Suddenly, I could sense how little time I left with my kids before I drop them off at college. Scary thought!

Memorial Day Weekend Fast & Feast

Throughout the Spring, Andrew had strange episodes of highs with ketones & yet still lows other times. I struggled with the frequent feeling that things weren't right. Vanderbilt tested for celiac & other reasons that he wasn't regulating better. Thankfully, those results all came back fine. Finally, I got to speak with Ann, who has always been the best nurse for Ann. She asked us to raise Andrew's basal & do a basal check & email her the results. So that Saturday morning, we raised Andrew's morning basal rate from .075u/hr to .375u/hr, which is a huge jump, but was closer to his other hourly rates. Andrew skipped breakfast that morning & let us check his BG every hour. His BG actually drifted up a little each hour showing he actually needed a little more insulin each hour.

As a reward for skipping breakfast & doing the basal check, we promised Andrew we would go to Shoney's and let him eat the breakfast buffet. We let him eat whatever he wanted, but he had to have sugar-free syrup & drinks. Please don't ask how many carbs he ate!!!

This was a wonderful experiment for us! It explained so many of Andrew's problems. The lack of sufficient basal insulin was why he had gotten so ill with strep. It was why he kept having ketones. We had lots of opportinities to test his basal during the summer, and we were able to finally get it right. I found some pictures of him around his diagnosis & he looked so frail to me. He got better, but it wasn't until this past summer that I noticed him putting muscle back on & looking more like himself!

Broken Pump

The day after the wrestling, Andrew commented that his screen wasn't as bright. I still figured it was a setting change from changing the battery. At 1 am, I checked his BG & it was a little high. I wanted to cancel the -20% basal we had set from playing baseball so I pulled the pump out of Andrew's pocket. I couldn't read it! I turned out the light & could barely see well enough to cancel the temp basal. I still wondered if it was the battery change, so I found the new battery cap & replaced it. No improvement. I pulled out the manual & reset the screen using keystrokes from the book since I couldn't see the screen. Finally, I woke Gene. He looked at & said, "It says pump not primed." You have to reprime it everytime you replace the battery & I couldn't see the reminder! If Gene hadn't been able to make it out, he wouldn't have had any insulin the rest of the night. Finally, we called Animas, the producer of our pump. I felt really silly calling the person on call because our screen was too dim! The lady who called back was very nice & assured us that is why they provide 24 hour support. She agreed the pump was broken & ordered us a new one. That was 2 am on May 12th. The new pump was delivered to my school May 13th at no charge!

Wrestling

One afternoon, we let the kids wrestle in the family room. I remember thinking that I should make Andrew take his pump off, but they seemed to be doing okay. Then the neighbors invited Andrew to play at their house. Andrew "fell off the bed" twice (No, Mom, we weren't wrestling!). Andrew mentioned it because his arm hurt. We didn't think much about it until his bedtime BG - 578 with small ketones. When I checked the site on his bottom, it had completely ripped out! "Oh, I forgot. I hit my site when I fell off the bed." It was fixed by a new site, but his BG read High before it all got cleared up. Then he was 48 in his sleep. That night when I changed his site, I also changed the insulin & the battery. I thought the backlight looked more green than usual, but then I decided that it was just my imagination. It wasn't!

Strep Throat

In mid April, Andrew woke up not feeling well with a sore throat. Kaitlyn had just had strep throat, so I took him to the pediatrician to be tested. The quick test was negative. I wasn't surprised the next morning when the phone rang. It was the nurse telling me that Andrew's culture was positive, and he did have strep. She called in some antibiotics. Before I could get out of the building, my cell phone rang. It was the school nurse. Andrew was in her office throwing up. Vomiting is not good for diabetes. It can trigger ketones, which trigger vomiting, which triggers dehydration, which triggers ketones, etc. I called the doctor back to say it was too late for oral medication. When I picked Andrew up, he was pitiful! He was getting sick every couple minutes. I ran by the house to get his supplies & give him Emetrol. Emetrol didn't help at all. We went to the doctor for a shot of antibiotic. FYI, a child who has taken 1,460 insulin shots a year can still be needlephobic! They also gave us a presciption of Zofran, which from the insert looks like it is used mostly for chemo patients. We went straight to the pharmacy which said that it would take nearly an hour to fill the prescription. I cannot explain what it was like to watch Andrew for those few hours. It took my breath away and still does. Andrew got sicker in a matter of hours than he was at diagnosis. I don't know what his ketone levels were while I was driving him around waiting on the Zofran. Thankfully, Zofran is a fantastic drug!!! I got him home, gave him Zofran, and the vomiting stopped. After he settled down, I remembered to check for ketones. His urine ketones were large! I checked blood ketones & they were still 1.8. On that scale, 2.o means head to the hospital. He was coming down fast enough that I'm sure he was over that at the peak. Andrew cleared his ketones around dinner time. Once he hit the 24 hour mark, he was no longer contagious & went back to regular activities. However, his little body was worn out. The next day, he had ketones every time he ate a meal! He played baseball on Saturday, but that was hard on him too. It took days before he seemed okay to me.

I remember when Andrew was newly diagnosed, a couple who are parents of two diabetic children offered us advice. "Someday, there will be an illness that you can't stay on top of. When you get the ER, just mention DKA (diabetic ketoacidocis) & they will get right to you." It scared me at the time, but it might just be good to know!

Lows, Lows, and More Lows

Once we switched to straight sites instead of the angled ones, our user error went way down. February went fairly well. Once March hit, it started to warm up, baseball started, and Andrew began to fight tons of lows. We kept turning down basal, adjusting meal ratios, and were calling Vanderbilt all the time. Again, thank you God for a student teacher! Finally, one Vanderbilt nurse told us to turn down the basal immediately whenever he had a low until we could get them to stop. The school nurse didn't program pumps, so that meant leaving school & turning down Andrew's basal at school, on the ballfield, etc. He went 2 solid weeks with multiple lows every day. Of particular concern were school mornings. His basal was turned down to literally almost nothing (.050u/hr) & he still had lows. His BG was still high at 2 hours post breakfast so it didn't seem wise to drop the breakfast ratio. Nothing made sense. Your body naturally fights low BG by releasing stores of glucagon, adrenaline, & other hormones. I worried that as his reserves got more and more depleted, we were headed closer to serious trouble. I called the school nurse in exasperation & suggested we just prevent the morning lows with a snack. It didn't treat the cause of the problem, but it kept him safe in the meantime.

First Bad Site 2/6/09

About a week after starting the pump, Andrew woke up with BG 498. Since it was so high, Gene bolused right away & included his breakfast carbs in the bolus. When he told me about it, I asked if Andrew had checked for ketones (it's a urine test). We'd never really seen ketones before, so Gene had forgotten our new rule that we must check for ketones before giving a bolus. Andrew checked and they were large (scale is negative, trace, small, moderate, large)!!! They had only been moderate when he was diagnosed. We called the doctor on call to find out what to do. The site was likely to be the cause, but there was no way to tell how much of the 10.6 units he had actually received. We had to wait another 2 hours to check & if it was still high, give a shot. The doctor said not to bother sending him to school until this was resolved. There was no time to get a sub, and I had a student teacher, so I took Andrew to school with me. At 8 a.m., I took his BG and the meter read, "High, over 600." His BG was too high to read! The doctor's recommendations made sense at 6 a.m., but now that it was time to give a shot, I didn't know whether to give the 4u maximum correction or replace the entire 10.6u dose he should have had at breakfast. I picked up the phone and called our friend, Andrew's school nurse. I told her I felt like I needed to give a shot now & asked her which dose she recommended. She said that you can always give more, but you can't take it out. I gave 4u. Then I went to change the site. I was very nervous & worried. I tried to follow the steps for preparing a site, but somehow messed it up. I had only brought one site to school, so then we had to leave school to come home. We had just changed the site when the phone rang. The school nurse was checking on Andrew & asked where his BG was. Still High, over 600. She recommended giving the rest of the breakfast dose via injection. At 10 a.m., his BG was down to 460, but his ketones were still large. It was scary to see him get so sick so quickly. By 11:00, he was down to 287, & at lunch 84. The crisis was over, but it took awhile for my nerves to calm down. There was no point in heading to school at this point, so he just stayed with me at school. At the end of the day, he went to the gym to shoot hoops with a friend's child. He put the pump in his pocket, but it fell out during play. You guessed it! The site ripped out! All I could do is laugh. I learned that day that a pumper should always carry multiple sites!!!

New Vocabulary - Sites, Basal, Bolus, & Ketones

A site is where Andrew gets insulin from his pump into his body. It's like getting an IV. It is inserted with a needle, but leaves a soft "straw" (cannula) once the needle is withdrawn. To prevent infection, it must be changed to another part of the body every 2-3 days. If it doesn't get inserted correctly, Andrew gets NO insulin and gets sick very quickly.

Andrew needs insulin to live, even if he doesn't eat anything. The pump gives small amounts of insulin every few minutes just like your pancreas does for you. This is his basal insulin & it takes care of his basic needs. The pump allows the amount of insulin given each hour to vary. On shots, long-acting insulin works the same for all 24 hours, even if you need more or less while you sleep.

If Andrew eats anything, he needs extra insulin to cover it. We still have to calculate the number of carbs he eats and give him insulin for it. A bolus is an extra dose of insulin given to cover food or high BG.

Ketones are created as fat is burned for energy. Blood glucose is energy for the cells in the body & insulin allows it to get into the cells. When a diabetic doesn't have enough insulin, the glucose stays in the blood & the cells starve. That's why newly diagnosed patients were usually losing weight. The ketones release an acid that can be very dangerous. DKA, diabetic ketoacidosis, can be fatal.

Pump Start

Andrew started his pump on January 29, 2009. The first weekend was perfect! His body seemed happy with the new regimen. Andrew was uncomfortable with having the pump attached all the time. At first, he wanted me to come hold it while he was in the bathroom. That wasn't going to work! He wanted to keep the pump in his pocket, but would take it out and hold it when he ran. There was lots to remember about all the site changes---cycle the cartridge twice, remember to prime, it takes .7u to fill cannula,.... It's all automatic now, but I took notes at the start up appointment!

One Year Anniversary

January 25, 2009 was Andrew's one year anniversary of diagnosis. I wanted to celebrate, not that he had diabetes, but all that we had learned. The family had come so far and learned so much. I didn't want it to be a sad day, but wasn't sure how to "celebrate" it either. Then we found out that a new local diabetes support group was having a social that day at an indoor YMCA pool. It was perfect! We spent the afternoon swimming in January - an activity we wouldn't have been invited to without Andrew's diagnosis. Thank you, God, for providing the perfect way to spend the day!

"Getting a Pump Is Like Being Newly Diagnosed"

Vanderbilt warned us that adjusting to the pump was like being newly diagnosed all over again. It is normal to wonder what have you done after the first few weeks, and they encouraged us to stick through the first few months. It was hard to imagine it being that bad, but I was glad for the warning. By two weeks, Andrew hated the pump & wanted to go back to shots. I told him if he still hated it in 6 months, he could quit, but we were giving it a chance. For me, I had forgotten how stressful it is to have to call in BGs daily, wait for the phone nurse to call back, talk about BGs, make changes, etc. - all while trying to work! The Lord blessed me with a student teacher during the transition, which helped tremendously! We all like the pump now, but the start was a bit rough.

Andrew Chooses A Pump

Once Andrew decided that he wanted a pump, he had to go to another carb counting class. learn about the different pumps, wear a site for 3 days, carb count for 2 weeks, and pick a pump. The nurse encouraged the kids to pick since they are the ones who have to wear it. I was happy that he wanted the Animas Ping. It uses the smallest units of insulin, allowing for great precision. It is the only one that comes with a meter that works as a remote control. It is fantastic! When he needs a bolus for high BG during the night, we can use the meter to give it rather than try to dig the pump out of his pocket. It's also great when we are still carb counting and he wants to play. When we're finished counting, we just "zap" him!

Please Talk About Other Stuff Too!

Andrew doesn't mind talking to people about diabetes, but wants people to still see him for who he is. Andrew is so much more than just a set of BG numbers! Although diabetes is a big part of his life, he doesn't let it define him. He is an intelligent, active young boy who plays soccer, basketball, and baseball. He loves to swim, ride his bike, play spades, and plays on the Wii.

Even the other kids complained especially at first that all we talk about now is diabetes. We do spend a fair amount of time discussing carb counts, BG readings, changes that need to be made to his insulin, and adjustments that should be made for activities. We can't stop those converstations, but we are trying to limit how much the kids have to hear them. Learning to work as a team is important for parents and not necessarily easy. Diabetes requires quick reactions with some room for judgement. Gene and I want to manage it consistently, so we have frequent "medical consults" after the kids go to bed.

Just Stories

Once Andrew was diagnosed, I started to hear horror stories about diabetes everywhere I went. They aren't mine to share, but several scared me. One day Andrew's school nurse was encouraging us to consider a family diabetes camp. She said, "As soon as people find out you have diabetes, they all have to tell their story, just like when you are pregnant... At camp, you are around other families finding solutions to the everyday issues." That's when I realized that I had been taking the diabetes stories way too seriously. After 5 pregnancies, I knew better than to worry about every pregnancy story I heard. Yet, I still worried about the diabetic stories. For us, it seems like nearly everyday has a story. We've had extreme highs & extreme lows & close calls. When the day is done, though, it is just another story. We start fresh each morning & try again. Thanks for the perspective!