The Big Bang Theory: Big Disappointment

The Big Bang Theory is my favorite TV show... I've been looking forward to the season premiere for weeks now.  I was rather surprised and displeased, however, when Penny made an inappropriate, uneducated, and misleading statement regarding a person wearing an insulin pump.

The text, quoted from The Big Bang Theory forum's taping reports:

He asks how her previous job experience prepared her for this kind of work. She talks about when she was waitressing she was a very convincing salesperson because she got large customers who shouldn’t be eating cheesecake to eat cheesecake. One in particular even had an insulin pump. The interviewer says “I have an insulin pump.” And she responds with something like “You should stay away from cheesecake.”

I believe the term Penny actually used in the episode was "fatties", but I may be mistaken- I was a bit shocked at the whole conversation.

We know the all science on the show is real thanks to an on-set consultant. The algorithms and formulas the guys work with are all true to life.  Why, then, didn't anyone take two seconds to Google "insulin pump" and learn that wearing one is: 1.) nothing to joke about, and 2.) has nothing to do with being fat?

People wearing insulin pumps have enough trouble already explaining that it's not because they are fat, lazy, or not taking "proper" care of their diabetes.   My daughter certainly didn't ask to have her pancreas shut down at age five.   Insulin pumps are a wonderful, life-saving device... not a punch line.

Here's the message I sent to CBS:

I was very disappointed that my favorite show, The Big Bang Theory, treated an insulin pump as a punch line.  Being overweight has nothing to do with an insulin pump, which is typically worn by Type I Diabetics.  Type I means that the body does not produce any insulin, regardless of diet or exercise or the amount of cheesecake eaten.  If TBBT has a science consultant on set to assure the accuracy of the equations on Sheldon's white board, why couldn't someone have taken a few moments to Google insulin pumps and present something accurate?
Sincerely,
the mom of a Type I Diabetic child
who wears a life-saving insulin pump 

The Big Bang Theory could take this and make it a learning opportunity.  Maybe when Penny starts working at the pharmaceutical company she'll learn about insulin pumps and apologize for her earlier comments.... but I doubt if that will happen.

It was just one big disappointment.
 

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A Quick Update

Rosie is in the sixth grade now, and so far things have gone well with school this year.   Her teachers continue to let her test and treat in the classroom as needed, and she only goes to the clinic if a site comes out (she needs to call a parent for that) or she needs medicine for a headache (usually from being high and coming down quickly).

We stopped using the Enlite in late Spring.  The constant alarms and conflicting advice we got from the "help" line were just too frustrating.  Rosie was in tears several times about it.  We decided that it just wasn't worth it for us, so we've gone without a CGM for a couple of months now.  We're hoping to change back to a Dexcom system this Fall, if our insurance will allow it.

Otherwise, not much new in Rosie's d-world.  We're finding that the older she gets, the more diabetes is taking a back seat to her other activities-- and that's exactly how we want it.
 

Birthday Blood Sugars

Rosie turned eleven yesterday.  I can hardly believe that my tiny four pound preemie is now such a beautiful,  caring, happy young lady.

Her birthday blood sugars have been all over the place:

• 100-something at breakfast.  Yay!
• 399 when she got home from school and sheepishly admitted that she forgot to bolus her birthday cupcake.  
• By supper she had come crashing down to a lousy 39.  
• An hour later,  just before volleyball practice,  she was up to 128, but feeling shaky like she was dropping again.  We didn't bolus the 46 carbs she ate for supper and turned down her basal rate to 50%. ..a gamble,  but based on past experience,  it seemed like a good plan.
• She went down to 61 during practice.

After practice we'll head home to a hot shower (might bring her down), birthday ice cream (might shoot her up), and a site change (never know what that will do).  Diabetes apparently didn't get the memo that today should be all about the fun-- but we'll carry on, regardless!

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Two Weeks on Enlite: Frustrating

Right now, we're not so sure we should have switched.   To be fair, this has been an unusually tough two weeks for our family.  My sister-in-law passed away after being unexpectedly diagnosed just a month earlier with cancer.  There have been some other unusual things happening with family.  To say that these two weeks have been stressful is putting it mildly.

In the midst of everything else, though, we have been dealing with the Enlite.   And that's how we feel about it right now.... we're dealing with it.  Right now, our issues are:

• The majority of the time when Rosie enters a blood sugar reading, it then alarms and tells her there's a calibration error.  
• It's alarming so often that Rosie is now ignoring the alarms and sometimes shuts them off without even reading them.... which defeats the purpose of the alarms.  We're working on this with her, but she's 10, and the constant alarms are embarrassing to her. 
• I have never personally seen the reading be closer than 30-40 points off from a finger stick reading.   Rosie says it has been closer a few times at school.   (Our Dexcom was often exactly the same as the finger stick number we would enter.)
• At night, if Rosie has a heavy blanket on, I can't hear the alarms.  With her Dexcom we put it on her nightstand, and I could clearly hear the alarm a few doors down in my bedroom.  We're going to have to go back to using a baby monitor. 
• We went through four sensors in the first week.  The first few days seemed to be fine, but then Rosie had three come out within the next few days.  We've resorted to adding strips of IV3000 patches over top of the sensor just to keep it in.

So, we're frustrated.  This weekend one of my goals is to sit down with the manual and try to figure out how to make this thing work better for us.  If I can't figure it out, I'll call our trainer and hopefully she will be able to help us.  I know many people have been happy with this new system, so I'm hoping that we have just not had the time to work out the bugs yet and we will soon find a way to make this system work better for us.

P.S.  In the time it took for me to type this post it has alarmed twice.  Once to tell Rosie there was a calibration error (half an hour after she entered a finger stick number--??) and then a few minutes later to tell her to put in a new sensor.  That sensor was new four hours ago.   Arrrrghhhhhh!
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Upgraded to the Enlite

Long time, no blog... and I'm OK with that.  :)   I enjoy blogging, and still read many DOC blogs, but I've made a concentrated effort to spend more time offline.  That said, though, I had to post an update on Rosie.

On Saturday, we officially switched to the Medtronic Enlite system... meaning that she is no longer wearing a Dexcom CGM, but now has a CGM integrated into her pump.  (Please note that we loved our Dexcom, but switched on the recommendation of our endo, and also so that Rosie only has to carry/wear one device now.)

After three days on the system, here are my observations:

•  This thing alarms a LOT.  I'm sure there are ways to change/reduce the alarms even further than we have, but wow.... the first day I think it was alarming at least once an hour.  It thought she was high (she wasn't), it thought she was low (she wasn't), it wanted more blood sugars (done).  Yikes.  That reminds me... I need to email her teachers and warn them that we're still learning about this new device and it might disrupt class.
• We inserted Rosie's first site in the right side of her stomach, and she hasn't had any trouble with it at all.  This is a victory for us, as she has a history of reacting to various medical tapes and adhesives. I like that the adhesive includes a strip over top of the receiver, as we almost lost her last one one time  when the clips on the site broke while she was wearing it.
• So far, the numbers are not as accurate as I'd like.  We've been a good 30-40 points off, at minimum, every time she's poked her finger.  I'm hoping this will improve with use.  If we have to poke her finger 6-8 times per day just to keep this calibrated, I'm not sure it's worth it.   We only had to poke 3-4 times per day to keep her Dex in line.

So... we'll see.  I have very mixed feelings about the switch right now, and so does Rosie.  
 

Five Years

It was five years ago this week- 9/19/08-  that Rosie was diagnosed.

Every year, the date has kind of weighed on me.  I'd replay things in my mind and think about all the ways our lives have been changed due to this disease.  This year?  Other than a vague feeling that I was forgetting to do something all day, the day came and went without any fanfare.

Five years of finger pokes, carb counting, and sleepless nights.  That's a lot, yet just a drop in the bucket compared to the many years Rosie has ahead of her.  A cure can't come soon enough.
 

5th grade: So far, so good!

Rosie has been back in school for nine days now.  I have only received one call from the Clinic Aide, and that was about some missing paperwork that the endo's office hasn't faxed yet. I think it's a record-- usually by this time I've been in to "chat" with the Clinic Aide about some kind of problem at least once!

Rosie has a plastic shoe box with supplies in her homeroom.  She tests in the classroom as needed.  When she changes classrooms for various subjects, she carries glucose with her in her pump belt, and generally can rely on her Dexcom to see if she's going low.  If needed, she can leave the other classrooms and go to the clinic to test.  

She's run a little on the low side nearly every day, which tends to happen at the start of every school year with the changes in routine.  She's been able to treat/test herself and has done really well.  I'm so proud of her!
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Good Day + Bad Site = Bad Night

On Saturday I took four kids to the local splashpad, two of whom are Type 1.   My daughter Rosie, my son (non-d), and our two neighbors-- a girl Rosie's age, and a boy my son's age-- and who is also Type 1.  

It was nice, having another d-kid and sibling with us... not to mention that these kids are all good friends.   Nobody batted an eye when we pulled out two meters and did two finger pokes.  None of the four kids complained when they needed to sit after their snack for a few minutes and allow the d-kids to come up a little (from 84 and 83) before they ran off to play some more.  Any time we go places with non-d kids we have to explain and make a big deal out of testing and waiting... with these four, it was just a normal thing.   It was great!

Unfortunately, last night was not so nice.  I changed Rosie's site after supper, and apparently a wrinkle in the adhesive kept the catheter  from going all the way in.   Coincidentally, we also got ice cream last night, something we rarely do.   Around 11pm she spiked up to 537, complete with vomiting and headache.  A site change, a couple of hours on the couch,  and a 200% basal finally brought her down-- around 3am she was down to 194, and we finally went to bed.   Then, at her 6am check, she was low-- 49.  I don't know if that was from over-correcting the high, or if it was just normal, because the last two days she had also been low around that time.   At any rate, it was a long night that was very short on sleep!
 

Back to School Blues

My kids start back to school on Tuesday.  I know it's cliche, but where did the summer go?  Ugh.

This summer has been good in terms of diabetes-- Rosie's A1C is the lowest it's been in two years.   Rosie has taken charge of counting carbs and doing her own bolus at lunch (with supervision).  She hasn't had any sites ripped out or any pump issues for quite a while now.

School.  ::sigh::  We love the Catholic school that our kids attend, and the only issues we've ever had there involve extra care-- both with Rosie's diabetes and her brother's learning disability.  Both conditions require extra services (read: paperwork and meetings) that the school is required by law to provide, but getting them to provide those services isn't always easy.  My mama bear side tends to come out, and the clinic aide tends to look like a deer in headlights if I bump into her when she wasn't expecting to see me.  Oh well!

I feel like I'm gearing up to do battle again.   I know that going back to the school routine will throw her numbers off for a week or two- it always does.  I also know that every year we have issues with the clinic aide, and every year I can count on multiple phone calls before things are straightened out.  The first month of school is, basically, exhausting for all of us.

So, yeah...the thought of summer ending and sending Rosie back to school makes me kind of sad. Anyone else wishing for a few more weeks of summer?

 

D-eyes

I have always assumed that at some point my kids will need glasses.  I'm nearly blind, myself-- I can only see a few inches in front of my face without glasses or contacts.  Everyone on my side of the family wears contacts or glasses.  My husband has been blessed with much better vision, but even he sometimes needs to wear glasses at night.  So... I figured it was inevitable.

I took both kids to the ophthalmologist today.  Rosie's vision was "on the fence", with the Dr. stating that he won't be surprised if she starts complaining of vision problems within the next six months or so.  If not then, by the time we go back next year, he expects her to need glasses.

The Dr. reminded me how important it is for diabetics to see an ophthalmologist every year.  He compared it to a leaky hose-- he said that diabetes can keep poking tiny holes in a person's eye health  that aren't really noticable until all of the sudden you have a big flood of problems.  He encouraged us to keep up with our visits so that we can catch any issues in the "leak" phase, before they become big problems.

All in all, it was a good visit, and a good reminder: diabetes is always there, always working in the background, and we have to do our best to stay on top of it.

Just Call Me MacGyver

Last night we spent the night at my sister and brother-in-law's house.  We keep a small insulated bag stocked with d-supplies for trips like this-- we just have to add in the chilled insulin right before we leave the house and we're {usually} good to go.

I thought we were good until I went to change Rosie's site this morning and discovered that the bag was out of the blue plunger/ reservoir sets.  (OK, well, that's not their real name, but I can't think of it-- the blue thing we use to suck the insulin out of the bottle and put it into a new reservoir.  I'm a little more sleep deprived that usual...did I mention that I was up all night with my new baby niece and with Rosie being low? Seriously, it was pretty much once an hour either the baby was fussing or else Rosie's Dex was beeping!)

After checking the insulin left in her pump (nowhere near enough to make it back home) and weighing my options, I finally decided to try and use a syringe to refill her current reservoir as a temporary fix.  Slowly but surely, it worked-- I got enough insulin in it to last until we could get home and do a proper site change with a fresh reservoir.

I'm not recommending this by any means, but sometimes you've gotta do what you've gotta do!  ;)
 

Glucagon App

Ever worried that you might not remember how to use Glucagon in an emergency?  Do you tend to forget to fill your prescription and find expired Glucagons in your cabinet?  (Yeah, me too.)

There's a new app out from Lilly called, appropriately, Glucagon App.  It shows you how to use it in an emergency, allows you to virtually practice, reminds you to refill your prescrption, and more.

It looks like a great app to have, and I'd love to download it myself.  Unfortunately, it appears that it's only available for iPhones right now.  I'm hoping there's an Android version out soon.

I am in no way connected to this product and receive nothing for telling you about it... other than the satisfaction of passing along useful information.  
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Another Gray Ribbon

Not just a diabetes ribbon... it's also a brain cancer ribbon.  It turns out that they're both gray.  (I know, I know, diabetes also has a blue/gray one and the blue circle.)    

My sister was diagnosed last week with a large brain tumor/ cancer.  Surgery to remove the tumor went well, and the next step will be six months of chemo and radiation.  This was all very sudden and unexpected.

I usually keep this blog specifically about diabetes, but I had to take a moment to ask for your prayers for my sister.  My family has had a rough year-- my dad survived a heart attack, my mom survived kidney cancer, and now this... on top of our daily battle with Rosie's diabetes.   We appreciate any prayers you'd care to offer up--  thank you!
 

No Curveballs this Season

image source: The Principal's Posts

Has it really been a couple of months since I've posted?  Wow, time flies when you're counting carbs... or something like that.

We made it through another softball season with diabetes, and Rosie's team even won their league.  There were only a few games where Rosie had to sit out a bit and get some extra carbs.

It helps that Rosie has played on the same team for the past few years, so nobody pays much attention when she messes with her pump or sits down to gulp down a juice box.  Her coach is aware that if she wanders off the field to rummage in her bag, she's not just playing around, she needs carbs. We're comfortable enough there that she's even gone to a few practices without us sitting on the sidelines, and all was well.

I think we're finally feeling confident in the art balancing diabetes and softball season.  And yes, I realize that by putting that in writing, diabetes is sure to throw us some curveballs the next time Rosie sets foot on a field!

 

It finally happened: our ER visit

Ever since Rosie has been diagnosed (nearly five years ago now), I have lived in fear of the day that we would have to make a hospital visit for a simple virus.  I somehow felt like that would mean I hadn't done things right, or we had let things get out of control.   I know, I know... that's just that silly d-mom guilt thing.

Last weekend, Rosie's younger brother had a bad case of the flu.  He came home from school early on Friday vomiting, and pretty much spent the whole weekend being sick and laying on the couch.  Rosie and I were gone over night on a Girl Scout trip, so Little Brother was home with Dad.   I had hoped that Rosie might not catch it since we were gone.

Monday, Rosie was fine.  We even commented on how great her numbers had been all day that day-- a so-called "no hitter" on the Dex screen.   (In hindsight, I should have known better than to voice this out loud, right?)   

Well, you know how this goes.... yep, that night she was up through the night being sick.  By 6am she had a bg of 600 and large ketones.  DH tried giving her a Zofran, and she couldn't even keep that down.   I called the endo's office, expecting the standard issue instructions: sips of Gatorade, more Zofran, etc.   Nope.  The nurse immediately told us that we needed to bring Rosie to the ER.   Since Little Brother had also been sick that morning, he was staying home.  I packed up Rosie and DH stayed home with Little Brother.

The hospital-- which is also where our endo's office is-- is only about ten minutes from our house.  Poor Rosie got sick as soon as we got there-- she ran to the trash can in the parking lot.  A security guard saw us and kindly went inside to get a basin for Rosie.  They had a room ready and set to work on her IV, drawing blood, giving her Zofran in the IV, and hooking her up to various monitors.   By this time my normally happy girl was downright grumpy... she was getting mad about trivial things, like having a band-aid on her finger, and she was just not acting herself at all.

One thing surprised me: after we'd been there an hour or so, we were told to disconnect Rosie's pump.  They were not giving her any insulin at that time.  This worried me, so I stopped the ER doctor (stereotypical ER doc, who didn't want to slow down for questions-- grrr-- but actually was very nice) and asked about this.  He explained that the theory is that if there's something wrong with the pump, they won't know it, so to dose by pump might mean that she is not getting the correct amount of insulin.   They prefer to inject insulin.   That made sense to me, but there was still a good hour or so when she was sky-high and completely without insulin.   The whole process was hard for this mama bear to watch! 

After a couple of hours of waiting around and more bloodwork, Rosie was allowed to eat.  She ordered a cheese omelet (one of her favorite foods) and oatmeal.  Once she ate, she was like a whole new kid-- back to her normal personality and much more calm.  

An hour or so later, we were cleared to go home.  Her bg was down around 400, and evidently her ketones were down-- I don't recall them actually telling me what they were.   Rosie spent that evening and part of the next day sleeping, and by Thursday, she was back to normal, with blood sugars only spiking around 300 on occasion.

Whew.   All in all, it turned out that going to the hospital wasn't as bad as I'd feared.  It was kind of nice to be there and feel safe in knowing that there were plenty of people who could help her when she was so sick.  It's not something I'd want to repeat if we can avoid it, but if we have to go, I think I'll be much more comfortable with the idea next time.

 

Weather related lows?

Here's an interesting theory: very cold weather may cause low blood sugars.

 I have nothing scientific to back this up... just conversations with two local Type 1's, both of whom, like Rosie, experienced a lot of unexplained lows last week during Ohio's bitter cold weather.

It kind of makes sense to me.  After all, if Rosie is sky-high, we put her in a warm bath, and that helps bring her down.  So I suppose that it's not too far-fetched to think that cold might have the opposite affect.

I haven't researched this yet, I'm just thinking out loud.   Does anyone else experience a difference when there's a drastic change in temperature?

 

Low, low, low.

Last night was one of those nights.  Rosie went to bed low and stayed low all night.   We were both up a lot last night, and we're both tired and a little grumpy this morning.

We're out of juice, in both boxed and bottled form.  That never happens, but last night, it did.  So my treatment options were glucose tablets or fruit snacks.  I chose glucose.

When Rosie is really out of it, whether it's from the low or from being asleep, she fights.  She clamps her mouth shut and literally pushes me away when I try to get some sugar into her.  At one point she was keeping her arm held straight up in the air, for no apparent reason.  It strikes me as funny this morning, but in my sleep-deprived fog, it was just one more thing to contend with.  She was really out of it.   That hasn't happened for a couple of months now.

Temporary basals, several rounds of glucose, and lots of prayers got us through the night.

My new flavor of coffee (buttery caramel) is getting me through this morning.

I hope God understands why we didn't go to church this morning.   The idea of dragging us there to sit through mass just didn't seem feasible- Rosie and I are exhausted, and her little brother is always a challenge at mass anyway.   Resting quietly at home seemed like a better plan. 

Note to self:  buy juice on the way to work this evening.
 

Thankful for Zofran

The flu is bad enough.  The flu with Type I Diabetes is miserable.

Rosie didn't keep anything at all down for most of yesterday.  Not chicken broth, not Sprite, not water.  I finally called the endocrinologist's office to see if they had any suggestions.  I had run through my usual arsenol:  giving regular Sprite instead of Diet to get some carbs in her,  sips of broth, etc.    She was showing "trace" amounts of ketones and her numbers were good-- in the mid-100's all day-- but I was starting to worry about dehydration and increasing ketones.

Usually when I call, we get right through to the nurse or the nurses' voice mail, and they call back pretty quickly.  Yesterday, though, I was on hold for 15 minutes, and after speaking with the nurse, it took nearly an hour for her to speak with the endo and call me back.  She said that this area has really been hit hard with the flu bug and they were getting tons of calls for sick kids yesterday. 

At any rate, the endocrinologist prescribed some Zofran.  Zofran is one of the best drugs ever invented, in my humble opinion.   When I was pregnant with both kids I suffered from severe hyperemesis, and Zofran (plus Reglan in a pump that I wore 24/7) was the only thing that helped me.    So, anyways, I was thankful to hear that's what they wanted to try with Rosie. The plan was to try the Zofran and if she was still getting sick, to page the doctor last night and have Rosie admitted.

The Zofran is working.  Rosie sipped some broth, and later had a small bowl of chicken noodle soup last night.  This morning she's had some toast, and so far, so good.   Whew! 
 

Sick

Poor Rosie got up around 6am vomiting.  It was a rough night-- at bedtime she had one of those lows that just wouldn't go away.  50% temp basal + juice box + glucose tabs only got her up to 77.  Her Dex alarm was going off constantly.   Then she finally came up around 1am, and we both got a few hours of sleep before she starting feeling sick.  Ugh.

I never know how diabetes will affect a "normal" illness.  Generally, Rosie goes sky-high a day or two before she actually shows symptoms of an illness.  Last night, she was low- go figure.  This morning she's running high, but nothing scary- I think she hit 320 at the highest point so far.  (Not good, of course, but we tend to see at least one 400 when she's sick.) 

So, here we go again... just waiting to see what extra challenges diabetes will throw our way.

 

End of NHBPM

Whew!  It's over.  I set a goal at the beginning of November to try and blog daily in honor of Diabetes Awareness Month and WEGO Health's National Blog Post Month.  

I tried, really, but I still missed several days, because, well.... life happens.  Family and work and holiday stuff and school activities- you know how it is!   A few nights I'd be just drifting off to sleep when it would hit me that I hadn't posted that day, but I went ahead and chose sleep over getting back up and blogging.  You fellow d-parents will understand-- sleep is more important!

So I missed a few days, but I'm OK with that... after all, I blogged more this month than I have any other time since starting The Sugar Sharks.   I learn so much from other d-blogs and I appreciate this sense of community.   I'm proud to be a member of the DOC!
  I'm posting daily in November in honor of Diabetes Awareness Month and the WEGO Health's National Health Blog Post Month. #NHBPM