I Can’t Even…

I don’t even know what to say here.  I just know that I haven’t posted anything in three weeks and I feel like I need to write something here, even if I can’t write about the real reason I haven’t posted anything in 3 weeks.

I’m going to say that the sh*t hit the fan recently and we are all still trying to recover and mop up the insane mess that our life has become.  Diabetes isn’t the biggest monster under the bed.  And that’s all that I can really say.

I hope everyone is well and enjoying summer break (if it’s started yet).

Take A Deep Breath and Count to 10

Back in December one of my favorite D-moms posted an article about diabetes and depression in children.  It is an anonymous D-mom’s story about her 11-year-old son suffering from depression and ultimately ending up in a psychiatric hospital for stabilization.  The story touched me in many ways, at first because I have a child who is 11.  Second, because I’ve personally had the experience of spending some time in a psychiatric hospital for severe depression.   The story made me feel very deeply for this family because it was hard to imagine watching my own child go through this same sort of downward spiral and not fully realizing exactly how deep that spiral had gone.  And then having the added fear of not only hearing your child say they want to end their own life, but then also trying to make arrangements for them to be safe, when everyone you talk to at the facility they are going to doesn’t understand or know how to manage their diabetes.  And because your child is depressed and suicidal they can’t manage their own care because, in case you didn’t realize it, too much insulin can be a deadly.  Lack of insulin can be deadly. Having suicidal thoughts and not getting proper treatment can be deadly.  I don’t want to even think about how helpless that mom must have felt having to make those arrangements.

A few weeks before this article I had been growing increasingly concerned about Angelina’s mental health.  Her therapist had also expressed some concern about her moods and was concerned about depression.  She had become more withdrawn in her therapy sessions and about every third session she wouldn’t speak at all, but sit and sulk.  At the beginning of January we met with her psychiatrist (who prescribed medications for her ADHD) and I had briefly mentioned we were concerned about depression and requested that she reach out to the therapist. I signed a release form and hoped that the therapist would be able to explain better than I was what was going on.  The psychiatrist seemed unaffected and said that mood swings were common at this stage.  We discussed how her current ADHD medication didn’t seem to be working well for her anymore and she prescribed a new one to try.  She suggested that we keep an eye on things and follow-up next month.

Things continued this way at therapy for the month of January.  The first week of February we met with the psychiatrist again and again I expressed concern about depression, as well as the therapist’s concern about depression.  She seemed to take things a little more seriously this time, but we still mainly focused on how things were going with the new ADHD medication and general talking points “How’s school?” Fine. “How are your grades?” I don’t know. “Are you hanging out with any friends?” No, I don’t really have any friends.   Those were about the only words muttered by Angelina in our 25 minute visit before she sort of curled up on the end of the sofa and started at the floor.  Any further attempts to engage her were met with stony silence.  At 20 minutes into the appointment, after nearly 3 minutes of no one saying anything the therapist says “We’ll follow-up in a month.  If she’s having more bad days than good we can possibly discuss medication.”  and we scheduled our next appointment and left.

That brings us to the past month. There are still more good days than bad, but there are more of those days where one minute things are fine and the next minute her entire attitude, mood and disposition change and she is sullen and completely withdrawn and refuses to speak or interact. About 3 weeks ago Angelina’s therapist asked me back to talk alone for a few minutes, and I ended up talking to her the entire session time while Angelina sat in the waiting room.  We discussed the possibility of antidepressants and her response was “I’m a therapist.  I don’t automatically jump to medication to try to help people.  But I’ve been seeing Angelina for a year and a half and in the past few months she talks to me less and less and I’m at the point that I don’t know what to do or how to reach her.  I can’t help her if she doesn’t talk to me. It’s obviously your decision, but at this point I think medication might be a good idea.”  About a week after our last visit with the psychiatrist I mentioned to my husband that we had discussed medication for depression.  I was a bit surprised when his response was “No. She’s already on enough medications. I don’t think that’s necessary.  A lot of kids this age deal with depression.  She doesn’t need to be medicated.”  And for the past few weeks we’ve dug up this discussion a few times, always meeting at a stalemate.  We were finally able to reach an agreement yesterday.

Today Angelina saw her psychiatrist and tomorrow she sees her therapist and will start taking an antidepressant.

Correct and Move On. (or what happens when it feels like you can’t)

Ugh. It’s me again. Venting. Again. I’m so tired (literally and figuratively) of crazy blood sugars! Last week Angelina started experiencing incredibly stubborn blood sugars between 11p-3a ish. I thought I knew the culprit so I just treated the lows and tried reduced temp basal rates. Then Monday she got sick and was running higher levels all day long. The outside culprit that I had blamed for the nighttime lows was no longer present so I was confused after a day spent battling numbers in the 300’s, that at night she was still dipping down drastically between 11p-3a and needing low treatment and reduced temp basals. But, come 3a the illness/stress hormones seemed to kick back in and if I didn’t start her back on increased temp basal for that she would wake up very high in the morning. So, needless to say I haven’t been sleeping very well lately. We did have 1 night where I didn’t have to reduce her basal and she ended up perfectly in range and I thought “Yay! The lows are over!” Then last night it happened again and BAD. Reduced basal drastically, especially considering how much extra basal she’s still getting during the day, plus gave multiple low treatments which seemed to move her barely at all.

So, tonight when she was low at bedtime (earlier than usual) I went ahead and reduced her basal rates for a few hours hoping that it would prevent those lows we’ve been seeing a little later on. She also had a single juice box at 10pm for a 63 bg. The juice only brought her up about 25 pts after 30 minutes, which is not as much as I’d like, but I figured I would wait and see what reduced basal would do. Well… here I am, 1:40am and her BG is 218!!! I stopped reduced temp basal around midnight when she hit 165 thinking that the “normal” downward spiral we see about that time would level her off or possible drop her slightly. Nope. Still going up. I have no idea what is happening. I am tired of this. I HATE DIABETES RIGHT NOW!

And saying that, if it’s not clear, you can envision the scene in the Jim Carrey version of The Grinch where he is going through the phone book saying “Hate, hate, hate, LOATHEEE ENTIRELY…” that is me right now, and diabetes is every entry in the phone book! I am normally a pretty positive person when it comes to diabetes care and a wise D-Mom told me early on “Correct and move on” and I try to live by that as much as I can. Because if you don’t just correct what’s happening right then, and move on, diabetes will take over your life in a bad way. But maybe it’s because it’s late and I’m tired, but know that I still have work to do before I can rest, and even then I will still probably be up in 2 hours doing more diabetes work. Maybe I am just feeling sorry for myself right now. Whatever the reason, I know these feelings will pass. I know that soon, maybe not tomorrow, or the next day, but soon, things will go back to “normal” and diabetes will return to being the passenger in the back seat, rather than the driver of our lives, but tonight is not that night. And tonight I am angry and sad and feeling burnt out. For myself and for Angelina.  I’m angry for the times like this past week, where diabetes has seemingly taken over everything.  I’m beyond tired. I’m exhausted, mentally and physically.  I didn’t really realize it until just now.

I just wish, more than anything, that this monster would leave my child’s body and we could be free of it, even for a day.  Even an hour.  Because even on her best days, it’s still there, lurking in the shadows, waiting for one small misstep.  An incorrectly counted meal or snack.  An incorrectly calculated dose of insulin.  A spontaneous stop at the park for half an hour.  All of it, any of it, can cause our carefully balanced house of cards to come tumbling down.  We must always plan for the unplanned.  Expect the unexpected.  Constantly be on our toes and monitoring blood sugar levels.  Making sure that I’m never without a quick source of glucose at any given time, for any given activity, even a quick trip to the grocery store.  Especially for a quick trip to the grocery store.

Constantly trying to remember what day it is today and what day it was when we last changed her infusion set or her sensor.  Or at least trying to remember to set the reminder that will remind me when it’s time to change these things.  This afternoon she asked for a glass of milk.  As she was bolusing she said “Oh, I have a low reservoir”.  There were 0.75 units of insulin left in her pump. And I sat there thinking hard, trying to remember what day it was and when we last changed her site.  Fortunately it was Monday, she just went through her insulin faster than usual because of being sick and needing extra insulin all around.

Two hours now since I increased her basal insulin.  Blood sugar has not gone down, but continues to steadily climb upward.   235 currently.  I guess that means that the lows aren’t coming tonight.  Time to correct and move on. To sleep.

Q&A: Ask a D-Mama

We are just over one month away from National Diabetes Awareness Month in November.  As someone who has made being educated about all things diabetes a priority, I’d like to start a Q&A series about diabetes on my blog.  No question is off limits if it is related to diabetes.  The point of this will be to educate and to hopefully dispel some common myths about Type 1 Diabetes.  I don’t care how much or how little you know about Type 1, please feel free to ask questions.  If I don’t know a definitive answer off-hand I will research it and answer to the best of my ability.  My hope is to encourage people to ask questions, and to avoid making assumptions if they do not deal with diabetes first-hand.  In addition to answering questions I will be giving away a mystery prize pack to one lucky winner (Est. value $20).  Entries will be tracked using Rafflecopter and will run through Nov 30, 2014.  Click on the link below to make sure your entries count!  Options for entering include: Commenting on this blog post, emailing your questions to chasinglows@gmail.com, tweeting about this blog post and giveaway along with your question, liking “Chasing Lows” on Facebook.  If you would like your question to remain anonymous please use the email option and state in the email that you would like to remain anonymous.  All questions and answers will be posted over the next two months in separate blog posts.  Please share this post with friends and family members. All are welcome to enter the giveaway by asking their own Type 1 Diabetes related question!

Swing Life Away

On September 16, 2014 Angelina experienced her first ever concert.  On a school night, no less.  During one of the opening bands she and I decided to hang out in the lobby because I am getting old and the band was just NOISE.  The music was actually okay but the “singer” just screamed random things into the microphone that were unintelligible and ouch, my ears.  Angelina felt the same way, so maybe it isn’t just old(er) age, lol.

As we were sitting out in the lobby a couple came and sat near us and we struck up a conversation.  Apparently the woman was a kindergarten teacher and told Angelina that she had the most awesome mom ever for bringing her to a Rise Against concert on a Tuesday.  It didn’t feel so awesome when I had to try to get her up for school at 7:30 the next morning after we didn’t get home until almost 1am.  Fortunately *cough* her site decided that it wanted to pull out at about the time she finally rolled out of bed and we had to do a site change which gave an “excuse” for being late, aside from “we were out late and she didn’t want to wake up this morning”, which would not be an excused absence.  I only feel slightly guilty for finding some diabetes related thing to make an excuse for tardiness.  But, at least it gave an honest excuse, right?  I know, I’m  a terrible mother.  First I let my kid stay out till all hours at punk rock concert then let her be late for school the next morning because instead of just sticking a new site in, I actually did our normal EMLA cream routine that takes at least an extra 30-45 minutes, instead of telling her to suck it up because we don’t have time for EMLA cream.  Of course, it had more to do with the fact that she had to get dressed and all of that so she might as well have a painless site since she was going to need the extra time anyway.

 

Also, Rise Against was awesome.  This is what her diabetes thought of the concert:

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Last song- crashing!

Last song- crashing!

And, not diabetes related, but concert photos, cuz, yeah!

Ironically closed Hollywood Video in Hollywood, CA

Ironically closed Hollywood Video next to the venue in Hollywood, CA

 

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Vacation and the TSA

If you read my blog because we belong to some of the same T1 groups then you have probably seen me posting about flying for the first time since Ang’s T1 diagnosis last year.  Or, my paranoia about being strip searched by the TSA for putting juice boxes in our carry on bags.  I am here to tell you that it was all for naught!

I have been so stressed out about what to pack for our trip as far as diabetes supplies and worried about “Is this going to get us in trouble?”  “Is this going to have to be thrown away at the security checkpoint?”  I now have the answers to those questions!  NO!  Just no!

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The insides of the medical suitcase. Lots of pokey things and liquids, gels and aerosols, OH MY!

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Elmo tried to make me lose my s**t!

We left Los Angeles Monday evening after a quick curbside good-bye as my husband dropped Angelina and I off at the airport.  I was a little disappointed because apparently the terminal we were dropped at didn’t have a skycap so I had to attempt to maneuver our giant suitcase (which I miraculously managed to get to weigh just under the 50 lb limit.  It weighed in at 48.6) while also carrying a giant purse, a giant backpack full of electronics, a carry on suitcase full of medical supplies, and corral Angelina!  We waited in line at the airline desk for what seemed like forever, but finally we were on our way to security.

I made a point to tell every TSA worker that we came in contact with that my daughter had T1D and that I was carrying medical supplies.  Of course, I didn’t need to and I kept being told “Tell them at the front”.  We finally made it through the (very narrow and anxiety inducing) line up to the conveyor belt.  Fortunately we got cleared into the TSA pre-check line which means I didn’t need to take anything out of any of our bags and we both got to keep our shoes on!  I told the gentleman that my daughter was T1 and that this suitcase was filled with medical supplies, including liquids.  He talked to the person running the scanner and let him know then directed us to the line for the metal detector.  I will stop here for a minute.

This was a big source of my anxiety.  We fly out of LAX and I sort of figured that if any airport had the AIT (imaging) machines, that it would be there.  TSA rules say that if you refuse the AIT you have to get a patdown.  You can’t choose the metal detector if you are supposed to go through the AIT unless you are physically incapable of standing with your arms above your head for the 7 seconds it takes them to scan you.  So, I had given Angelina an early heads up that she might have to get a pat down.  LAX does have the AIT machines, but apparently they only do them for some people and most people still just go through the metal detectors.  Woo! Was I happy to see that we didn’t have to go through the AIT.  However, when we got up to the metal detector Angelina was in front of me and the guy stops her and says “What’s that under your shirt?”  So she lifts up her shirt and starts explaining about how she has diabetes and it’s a machine for her insulin, yada yada yada. Angelina tends to be long-winded (wonder where she gets it from? *wink*) so I was just like, it’s an insulin pump and braced myself.  The guy says, okay, go on through and then stand right here and points to a spot to the side after the metal detector.

She walks through, no beeps.  I walk through, no beeps.  We stand to the side for a minute and a lady comes with a little piece of padded cloth, swipes it over Ang’s hand and sticks it in the machine then says we can go.  We walk over to the conveyor belt, grab our stuff and we are on our way.  No questions, no bag inspection, nothing.   All of my worrying was for nothing.  The whole experience was actually LESS stressful and intrusive than the last 3 or 4 times that we have flown since I didn’t have to separate out my bag of liquids and take off my shoes, etc.

The hardest part of the whole experience for me was waiting in the chute.  I am a big girl, and I am also prone to claustrophobia, so to be stuck in a partitioned line that is just wide enough to accommodate our rolling carryon suitcase, while wearing a big backpack, a big purse and said suitcase and trying to keep Angelina from knocking into things/people with her backpack was very uncomfortable.  But, we made it!

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Mood lighting to encourage sleep. Unless you’re traveling with a spastic 10 y/o who’s watching Disney on maximum brightness and insists on talking to you.

The flight is a different story.  Overnight flight with a very excited 10 y/o makes for a very exhausted mom who got zero sleep in over 24 hours.  Add in a 3 hour time loss and I am just very glad that I know what to expect for our return flight.  It should be easier.  David will be with us to help and it’s a daytime flight where we gain time instead of lose it.

 

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Pit stop for breakfast on the way from the airport. Nevermind it was technically 4am for us.

 

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Where Angelina was 15 minutes after arriving at our destination.

 

 

 

 

 

Which Came First? The Meltdown or the Low?

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As you can see from this (rather large) photo… blood sugar levels were floating along nicely at a pretty steady 115ish for a few hours after her very low carb dinner because she decided she only wanted chicken and sauce and not the side of rice.  Okay, fine, whatever, no big deal.   Dinner was a little later than usual this evening because I didn’t got the slow cooker started until later than I should have and so what, it happens.

We were watching the 3rd episode of Sherlock season 3 on Netflix and OMG it’s 8:45pm and you didn’t do your homework yet and you still need to take a shower before bed.  Of course, like every time I tell her she needs to do homework or shower (or both) there’s lots of whining and complaining and “I’ll do it super quick 5 minutes before I’m supposed to be asleep.  Please let me play on the computer for the next 40 minutes until then.”  To which the answer was a very firm “Not on your life.  If you can really do all that in 5 minutes then do it now and then you can have until bedtime to play.”  Makes sense, right?

Well, she did do her homework and it really did take her about 5 minutes.  But then it was time for the shower and instead she’s picking at scabs on the back of her heels.  I may not have mentioned this before but she has pretty bad eczema and one of her “quirks” is that she scratches herself bloody on a fairly regular basis despite our best efforts to keep things under wraps.  Well, she had some scratches already and she apparently decided that picking at scabs and scratching was a better use of her time than, oh, getting in the shower so she could actually do what she really wanted to do (computer time) before bed.  Around 9:10 I finally coerced her to stop picking and get in the bathroom for her shower.  Five minutes pass, no sound of the shower.  Ten minutes pass, still no sound of the shower.  At this point I announce that it’s 9:20 and she better be getting in the shower because it’s 10 minutes until bedtime.  At which point she promptly starts crying and sniffling in the bathroom.  She doesn’t want to get in of course, because all that freshly raw skin is going to burn under the water stream.

We’ve recently started recording her various “meltdowns” at the direction of her behavioral therapist so when the crying hadn’t subsided in 10 minutes I decided to start recording and go in to see what could possibly be the matter.  Of course she won’t talk to me, won’t get in the shower, won’t look at me, etc.  Just crocodile tears and lots of sniffles.  Any suggestion on my part that she now, finally, get in the shower is met with a sound that is similar to a cat that’s been backed into a corner and isn’t quite hissing, but has that deep rumbling sound they make that says “I WILL scratch you!”

After about 10 minutes I manage to get her into the shower and get her hair washed, her crying and being generally uncooperative the whole time.  I finally leave the bathroom with 21 minutes of this weird crying, sniffling, growling audio recording.  At this point her pump has also been off for almost an hour.  I think maybe her blood sugar is going to be heading upwards since no basal insulin and am shocked to see that instead she is 72 with a sideways down arrow.  I manage to check her with the meter (she, at this point, is laying in the bathtub with the water off but not getting out) and it also says 72.

And then I realize… She started dropping at 9:15.  The same time that she finally headed into the bathroom to start this entire process.

So… which came first?  The chicken or the egg?  Was this drawn out emotional meltdown the result of a blood sugar drop?  Or was she really that distraught over the prospect of showering that her blood sugar ended up dropping low?

Just one of those stupid, stupid things that we deal with living with a child with Type 1 and other emotional/behavioral issues.  It’s often hard to tell what caused what…