Saturday, January 26, 2013

Five Years!

Five years. 
Five years ago today, Andrew was diagnosed with type 1 diabetes.  I've thought about this milestone as we approached it, but the great thing is I didn't realize this was the day until thirty minutes ago!  Diabetes is no less important, but I love how it has become less consuming in my thoughts.  I don't know if anyone else thought of it today either.  Of course, thirty minutes ago when I wandered in to check on Andrew and saw his blood sugar was rising despite a correction, diabetes had my sudden attention.  I sent Andrew in to check ketones, and when he asked me to get him some water, I knew what the result would be.  Yes, ketones.  Either his site was bad or he is starting a tricky illness.  He doesn't feel good, but it is hard to tell if sickness is causing the ketones or ketones are causing him to feel sick.  We did a site change and a full correction.  I honestly believe he will be fine by morning, but I'm definitely checking on him in a couple of hours.
Five years.
We have come such a long way.  The first year, every day was new and difficult.  Every meal was hard to carb count  and dose and every new adventure at school or with friends had to be planned so that he could be safe and still act like a normal kid.  It was so exhausting.  I remember when he said he couldn't go to AWANA at a friend's church because he had diabetes.  I replied, "Of course, you can!" and thought to myself, "Now how am I going to make THAT work???"  But we did.  He was seven then, and he is twelve now.  He has grown so knowledgeable and responsible.  He can carb count his own meals and dose his own insulin through his pump.  He can go to a friend's house and carb count and take care of his diabetes all by himself.  He really is amazing.  Day to day life is less stressful because we have seen and dealt with so many situations already.
Five years.
I hate diabetes more now than in the beginning though.  I thought then that I would somehow figure out the patterns, everything would get better, and that his numbers would be great.  I'm disillusioned now.  I'm tired of calling in numbers and even the nurses not seeing a pattern.  Control is a myth and an ideal to strive for but lows and highs are going to happen.  Sites fail.  Like tonight.  I just wandered back in there and now Dex reads High and headed up slanted.  I read recently about three clinical stages of type 1:  not requiring insulin (Kaitlyn), needing insulin for control (Andrew five years ago), and needing insulin for survival (now).  If the site was bad, it was fine at lunch, so ketones developed in a matter of hours.  It's really scary how quickly he can get sick.  His lows seem a little scarier now too.  That's sad, but normal too.  I hate diabetes.
Five years.
I'm thankful for the new tools that we have to fight diabetes.  The pump is so much easier than pulling out shots all the time.  Dex, our continuous glucose monitor, has been a lifesaver, literally.  Andrew doesn't wake up in the night when he is low, so that low alarm is priceless.  If you're convinced he would wake up if he is low enough, go back and read the blog about the night he woke up low, but couldn't move or talk to get help.  We upgraded to the new Dexcom 4(http://www.dexcom.com/dexcom-g4-platinum) in December, and the alarms are so much easier to hear!  It looks cool, and the range is so much better.  The old Dex would say out of range when he rolled over in bed.  The new one picks up from the stands almost the entire time he is playing basketball!  This coming week, Andrew is getting trained on his new pump called the t-Slim (http://www.tandemdiabetes.com/Products/t-slim/Slim-and-Sleek/).  It has a touch screen and holds 100u more insulin per cartridge, which will be important as he approaches his teen years.  I'm hoping he likes it as much as he thinks he will since he is stuck with it for four years.  I am excited about the potential of the dexcom and pump working together to keep his blood sugar in control with an artificial pancreas in coming years.  Technology is great when it works.  I just checked on Andrew again.  Dex says he is High, but headed down slanted.  The new site is working, and Dex lets me know how he is doing without waking him and poking his finger.
Five years.
We have met amazing people and some great experiences because of diabetes.  We've grown and learned so much.  Andrew is healthy and happy.  It may not have been easy, but it has been a good five years. Camps, parties, friends, trips, talks, sports, etc.
Yes, five good years, even with diabetes.

Monday, November 5, 2012

Why I Recommend Trialnet

I've seen some questions lately, so I'd like to summarize our experience with Trialnet and explain why I would do it all over again.

The Trialnet Story

January 25, 2008, our lives changed forever with Andrew's type 1 diagnosis.  Our children were given the option of participating in Trialnet, but none of them were pressured to participate.  Kaitlyn immediately volunteered, and she was the only child tested at the next doctor visit.  She wanted to be a part of science and help doctors find out what caused diabetes.  She was so eager that I'm not sure we thought too long about how it would feel if the results came back positive.  Until they did.  I won't lie.  It felt like I'd been punched in the stomach...again.  They explained that it didn't mean she would get diabetes, because some people with antibodies never get diabetes.  They recommended a genetic study for a gene that they have found protects against diabetes and an oral glucose tolerance test.  Her genetic study revealed that she did not have the protective gene.  In 2008, she had four of five antibodies and was placed in the highest possible risk group with over a 50% chance of developing full type 1 diabetes within five years.  The boys all one by one volunteered and tested negative.  Kaitlyn began oral glucose tolerance tests every six months, and fell in love with the nurses who cared for her.  She loved being doted on, and, yes, she loved getting paid to participate. She went every six months until she failed two tests in a row and was officially diagnosed on March 5, 2012.  She is still doing great without insulin though.  Her highest ever A1c has been 5.1.

So, we've lived everyone's worst fear.  First antibodies and then diabetes.  She was diagnosed so early though, that we could still be blissfully unaware.  Do I hate diabetes?  YES!!!  Do I have any regrets about Trialnet?  NO!!! I have several reasons why I'm glad we participated.  But Kaitlyn is 13 now, and I thought you might like to hear first how she feels about it.  I asked her the following questions and typed her responses.

Q: Would you encourage someone to do Trialnet?


I encourage it because it gives you some warning. Sure, it’s sad when you find out, but at least you’ll be prepared for it when it does happen.

Q: Did it drive you crazy worrying about it?

I wasn’t worried. I just kind of enjoyed myself and got to know the really sweet ladies.

Q: Do you ever wish you didn’t know?

No. I don’t wish I didn’t know, because then I’d be more devastated and less prepared. It would seem so sudden.  At least now that I know I’m diabetic, I enjoy the short time that I have. I know I need to cherish things because it will be harder soon.

Obviously I've worried about her over the years.  I grieved a bit when I found out she had antibodies, when she didn't have the protective gene, when she had her first impaired glucose tolerance test, when she failed the first test, and when she was diagnosed.  But I have never regretted being a part of Trialnet. 
Here's why:

1. Trialnet protected Kaitlyn's health and will protect her from metabolic memory.


Sure, we all know the symptoms of diabetes. But, may I add, that we all know the symptoms when the body is already really struggling with diabetes! We don't know when the blood sugars first start to rise. I don't like to think about metabolic memory much because I can see in hindsight that Andrew had symptoms long before diagnosis. His initial A1c proved he had high blood sugars for a long time. However, Trialnet has given me the opportunity to protect Kaitlyn from this very real threat:

"The concept of a “metabolic memory,” that is of diabetic vascular stresses persisting after glucose normalization, has been supported both in the laboratory and in the clinic and in both type 1 and type 2 diabetes. " ( http://jcem.endojournals.org/content/94/2/410.abstract)

It's the idea that once stressed, the body still remembers some of that destructive behavior. I wasn't able to protect Andrew. But I know this - Kaitlyn won't be in DKA at diagnosis. She won't have poor metabolic memory. She will be healthy and get insulin support as soon as she needs it. Her pancreas won't be burnt out like Andrew's was. We will support it and hopefully have a long, wonderful honeymoon. We will do everything we can to keep her as healthy as we can. For me, waiting until she shows excessive thirst and urination is not good enough!

2.  We know much of what we know about the development of diabetes because of Trialnet.

An adult friend of mine was told that he got the flu, it attacked his pancreas, and he got diabetes that weekend.  Now, we know that isn't really true.  An illness may tip Kaitlyn over the edge where she needs insulin, but that trigger didn't cause it.  This process is well under way.  That is also the reason that we have prevention trials now.  There is hope that we may learn how to prevent this disease even before we can cure it.  That means none of my grandchildren will have this horrid disease.  Those trials wouldn't even be thought about if not for what we've learned through Trialnet and similar trials.

3.  Simple blood tests are giving clues to find a cure for our diabetic children.

They have found people who have antibodies but never get diabetes.  They have found a protective gene that most of these people have in common.  Within that is a clue.  What does that gene do to protect them?  Can we do the same thing for others to protect, treat, or cure???  They have learned to predict diabetes well with antibody testing.  Surely, the functions of those antibodies hold clues as well.

4.  Trialnet offers trials for prevention.

Trialnet has prevention trials for people who qualify.  For example, oral insulin was proven to not prevent diabetes, except that it did have a delay effect in a small subgroup with high levels of a certain antibody, the only one Kaitlyn didn't have.  The oral insulin has no side effects, at least that I know of, and may delay onset of symptoms by almost five years!  Ask any diabetic if they would have taken a pill every day to have five more years before diabetes!  There are a couple of new trials out now.  I started Kaitlyn on some supplements after her diagnosis that my other children are not on.  Her high bgs regulated and she has been doing great.  She wouldn't have that support if we didn't know. 

5.  Trialnet set a positive framework in place for Kaitlyn before she needs it.

She loved, loved, loved the people at Trialnet.  They were so positive and great models for her.  She has been curious about diabetes and willing to learn long before she needs it.  I'm not sure my other non-d kids can carb count, but she can because she wanted to learn.  She has had the opportunity for a gentler intro into diabetes.
I wish I could take diabetes away from Andrew and keep Kaitlyn from getting it altogether.  I have grieved in stages and will grieve again when Kaitlyn starts insulin.  I know it isn't over.  I can completely understand why some aren't willing to know.  To me, the protective benefit of knowing early is so worth it.  I don't check my other kids.  Until diagnosis, I wouldn't check Kaitlyn unless I saw symptoms.  Now, we check about two fastings a week and two after meals a week.  We will call if either of those numbers starts to creep up.  Hopefully, that will still be a long way away!!!

Thursday, September 13, 2012

Rising Numbers For Kaitlyn

Kaitlyn has a cold, and has lost her voice.  We watch her numbers more closely when she's sick.  Everything seemed fine until last night.  BG 158 after dinner.  Normal is under 140.  Her fasting this morning was fine, so we hoped it was a fluke.  We set the timer after dinner to get a good two hour reading.  153.  We tested again at 3 hours - 145.  These aren't horrible numbers.  They just aren't NORMAL ones.  Maybe they'll go back to normal when she gets well.  Or maybe the cold will be the straw that broke the camel's back for her struggling pancreas.  She goes to Vanderbilt next week.  Please pray for God's Hand to protect her!!!  Thank you!!!!

Saturday, August 11, 2012

A Poem Written Before Last Year's Walk

It's time to walk again to raise money to find a cure for type 1 diabetes, but I haven't sent out any emails yet  about the walk!  I found this poem that I scribbled down one night last year as I prepared to organize last year's walk team.  I'm definitely not a poet, but it still conveys much of what I feel:

Will you walk with me again?
I really hate to ask.
Would it hurt to skip a year?
Should last year be the last?

But then I think of when...
We first learned that life had changed
For precious little Andrew
...Not the life that we had planned.
How every day is fraught with peril
Highs and lows that come so soon
And I think of complications
   that always seem to loom...

I think of Kaitlyn and her carefree life
Despite her antibodies.
Despite the oral glucose test that
   proves her body's fighting.
I think of the sad look
   in the researcher's eyes
As he reminds the stats suggest
   it's just a matter of time.

She too will join the ranks of those
Who fight this mighty beast.
 She too will poke herself
   too many times a day.
Try to plan for each and every thing
   that might could come her way.
They count each carb, plan every bite,
   and inject for every morsel.
They wear contraptions just to live
   as close as they can to normal.

Will you walk with me again?
It really isn't in vain.
They've come so far since
   this race for a cure began.
We have good meters and better insulin.
Better pumps and even better
   continuous glucose meters.
We're running trials not in mice
   but in real, live human beings.
There's even one they hope to use
   for people such as Kaitlyn.
One that might stop this disease
Before enough damage is done.
It might not fixed the diagnosed,
But prevent it so there's none.

The artificial pancreas is an aid
   for those who wait.
Not a cure.  A treatment sure.
One that ends the swings
   from highs to lows and
The fear and embarassment they bring.
Less fear when playing, sleeping,
   pitching, testing.
No future lows when he is driving.
Less chance of complications coming.
Less change of Andrew dying.

Will you walk with me again?
Yes, research needs the money.
But, will you walk with me again
Just because we need YOU coming?
It's our 4th walk
So we're old pros.
But we don't want to be.
The fear set in that this is just
   how it's going to be.
No breaks in sight.  Not one night
When we know for sure
  he'll be alright.

It's not that we haven't learned
The tools and tricks to cope.
We count, measure, calculate
and know just how to dose.
He can go dangerously low
without much adrenalin from me.
Just another story and a dose of reality.

Andrew is amazing.
My little hero man.
He handles all of this as well
   as any young man can.
We're not pathetic.  We're okay.
I'm not telling a lie.
It's just tiring and lonely.
We're thankful for our friends.
Will you say a prayer for
   Kaitlyn and Andrew?
Will you walk with us again?
Thank you!

Tuesday, July 17, 2012

Surprise Ketones

Andrew had very large ketones tonight!!!  We completely didn't see it coming.  At lunch, his BG was 72 (great number), and he ate a slice of meat and some pears.  He rose steadily through the afternoon, so Gene had him do a correction about 30 minutes before dinner.  He was in the low 300's then, but he was coming down before we sat down to eat.  Andrew ate and got seconds, but then said that he didn't feel good.  He was a little nauseous.  So, I asked him to check his ketones.  He looked at it and said, "Time for a site change!!!"  It was black.  The site was two days old and looked fine, but we changed it anyway.  I was afraid to give an injection because he had a large dinner bolus on board.  Or did he?  We checked blood ketones, and they were the highest I've ever seen - 2.2.  I called the doctor just to be sure since I've never seen ketones that high.  She said we were doing everything right and that the ketones should clear.  Push 4 ounces of fluid per hour and give any corrections >300 with a syringe.  Andrew was happy that his last check was 298, so he could do the correction by pump. His last ketone check was also down to small.  Crisis averted.  I'm so glad he wasn't playing ball or exercising tonight.  Once we found the ketones, we put in his favorite movie, The Blind Side, and sat on the couch.  I'm also thankful for Dexcom, because I turned his basal rate of insulin way up until I could see his BG coming down.  His basal rate right now is still insanely high (+120%!), and Dex says 240 and steady.  I don't want to cancel the basal yet, but I can't sleep with that going either!

Saturday, June 30, 2012

General Update

Wow!  I haven't written in a long time!  I think about it often.  This blog has been theraupeutic for me, but I've been so busy that I haven't had time to write. Many of my imagined posts have involved  the Ping and the Pod (insulin pumps) that have been warring for our affection for the last few months.  Both have won battles, and there have been days that I have been ready to claim a victor.  Tonight, however, I'm still not sure of the winner.  So that story will have to wait for another night.  This one will be a ramble just to get past the block of the first post.

Kaitlyn blood sugars are doing great!  She hasn't had "high" blood glucose since diagnosis.  She was a little concerned about a 143 Tuesday night after getting hit in the head with a softball.  It left a scary dent in her forehead, so I took her to the ER.  Despite five kids, I've taken my kids to the ER three times.  1.  When the nurse at church told me too when Will fell out of a swing.  2.  When the doctor sent Andrew to the ER at diagnosis. 3. When Kaitlyn was hit Tuesday night.  She checked out okay, and they didn't even diagnose a concussion.  She looks and feels better.  I still feel a dent though....  As far as diabetes goes, I think she/we have worked through the grief stage.  I, at least, don't think I'm in denial of what will come, but, realistically, what she's dealing with isn't what we know as diabetes.  She checks her blood sugars, and they're always great.  I want it to stay that way a really long time!!!

What I didn't see coming was how seeing her normal BGs make me feel like a failure with Andrew.  I'm not only fine, I'm happy with a fasting BG of 120 for Andrew.  If it were Kaitlyn, that would be horrible!  I think I've stepped backwards emotionally in handling diabetes.  Don't get me wrong.  It's better than the beginning because I don't think about diabetes every minute.  In between, our life is peaceful and joyful.  There are days too that diabetes doesn't get any more attention than a neccessary inconvenience.  Then it a second, it takes your breath away again.  I hate diabetes more today that I hated it at the beginning.  I hate what it does to my boy.  I hate that I can't fix it.  I can't even regulate it well.  I'm tired of poking him.  I'm tired of seeing him high and low.  I'm tired of worrying about complications that may come if I don't do a good enough job helping him now.  Or complications that might come even if I do everything right.  I'm tired of the stories that I didn't write here.  The pod failures, the dex graphs, the bad baseball low, the forgotten diabetes bag, the swim party with friends....There are far worse things than diabetes, but I'm just tired and see no end in sight.  I think I have "diabetes burnout"!

One unwritten post would have told the story of Andrew participating in a research study to see if patients with type 1 for over three years still make any of their own insulin.  Andrew does not.  Those who do still make some of their own have fewer complications and usually lower A1c's.  Bummer, but not a surprise.  Andrew gets sick if his pump comes out in his sleep.  We didn't really think he was making that much of his own insulin! 

On a happier note, Andrew is actually doing great!!!  He finished elementary school with all A's all the way through!  He played travel baseball this Spring, and his team won the state tournament!!!  He is growing well in every way, and is headed to middle school this Fall!

Sunday, May 13, 2012

Happy Mother's Day!

Happy Mother's Day to all mothers!  Check out this amazing blog post by another D mom!  http://www.ourdiabeticlife.com/2012/05/we-are-d-mothers.html