Friday, September 10, 2010

Ten is a Magic Number and When Girl's Brains Drain Like a Sieve

I've fallen off the blog for awhile, but I have a new mission and I welcome your help. My daughter just turned 10. She has been an amazingly compliant and helpful kids with diabetes. She knows more than most people about the disease and has always been very independent in her management.

On one of my previous posts, a reader told me to, "Let go. If you don't want Mutiny how about listening to your child instead of being a constant nag." Fair enough. My post was mostly sarcastic, but the fact is that every single day this week she forgot to take her insulin at one point each day, we ended up having lots of talks. I asked, "What would need to happen for your to remember to take your blood sugar and insulin?" She looked me in the eyes and said she honestly doesn't know.

I asked her what the benefits would be if she remembered and we talked about those. I also asked what the downside of not remembering is and we discussed all the ways that it sucks.

She is a SUPER kid. Bright, fun, loving, not rebelous at all, but she is just not remembering the task at hand. So I started asking friends about their girls, kids without diabetes, and it appears that 10 year old girls develop holes in their brains.

I did some more asking around, teachers of fith grade included, and they all agree that at this life stage, that self-centeredness abounds; that they really can't think the way they did even just a year ago, which explains a lot.

Another friend, who has a 10 year-old girl and a 12 year-old boy, told me he has been reading a book, Getting to Calm: Cool-headed Strategies for Parenting Tweens and Teens, which takes you into the emotional and mental world (brain) of our growing kids. I haven't read it yet and I tend not to enjoy books full of good advice (I read the first 30 pages of How to Tall, So Kids Will Listen. How to Listen, so Kids Will Talk about eight times). But here's what my friend, who has read a lot of it said.

He said that the girls at 10 are in a stage of "pruning and blooming." Their prefrontal cortext is said (simplified) to "orchestrate thought and action in accordance to internal goals." At this age, this is being "pruned," so to speak, meaning that developmentally, this part of the brain is somewhat out of order for a period of years often referred to by parents as teenage hell.

He said that beginning around age 10 for girls, they are very challenged at staying on track; starting one thing and moving to the next and then to the next. Diabetes is very much a series of steps that align with an internal goal of staying healthy and keeping mom out of her business.

So here is one scenario this week.

Snack time at school, 10:00 am
R: "Hi Mom, my blood sugar is 218.
Me: "OK, just please remember to put your blood sugar in your pump if it has gone off screen."
R: "Ok, Mom. I will. Love you. Gotta go!"

Lunch Time, 12:30 pm
R: Mom. Uh. Mmm. Uh, Mom? I don't know how this happened, but I'm 428.
Me: Ok. Did you take insulin for your snack?
R: Uh, I think so.
Me: Can you check your pump please?
R: Uh. Ok, hold on a sec. Mom? No.
Me: Ok. Didn't we talk at snack time? I believe you said you were 218. Don't you remember me telling you to be sure to put your BG in your pump?
R: Yes.

You know how the rest goes. Correction and everything is fine...until Wednesday. Same scenario, but she was at a friends house for dinner.

R: I'm 400.
Me: What did you eat?
R: Barely anything. A few crackers.
Me: Did you have milk?" She shakes her head, no. "Did you have any other carbs?
R: No...Oh! wait! I did have one of those, mmm, what do you call them? Mexican breads with the sugar on top?
Me: What kind of bread? Pan Dulce or the crispy ones rolled in sugar?
R: Uh. Those.
Me: Did you take Insulin?
R: I guess I forgot.

I am actually ok if she has a treat, but she knows full well, that that means she has to take care of that snack. She KNOWS this!

So, I need some strategies to help her remember, because it is obvious to me that everything has leaked out of her brain.

Today, I gave her a green rubber O-ring bracelet and told her that this is a physical reminder to take her blood sugar and take insulin. Her teacher is going to help remind her, but also give her something to tape to her desk which will remind her of these important tasks.

So, any advice you all have is welcome. I am totally willing to support her until her brain is whole again (18 or so they say), but finding ways that don't embarrass her, make her diabetes overt to anyone else and aren't hard for me to manage are the goal.

Wednesday, July 21, 2010

I'm hungry because I'm low, not because I'm hungry.

But here I sit eating a bowl of cereal. My blood sugar is 56. I feel low and I feel hungry. I drank a juice box, but no, I could not resist the call on Honey Bunches of Oats and milk. In fact, I think I'll have another bowl.

No, the juice hasn't quite hit yet...

Saturday, July 17, 2010

Kids get easier...right?

Seriously, today has been a long day. We had citywide swim championships today and now my girl is over at a slumber party where cake will be served at midnight. She is nine, almost 10 and she is an amazing kid. She forgets stuff, like taking your blood sugar or bolusing, but she tries. I just hate leaving her in the hands of other families.

It isn't that I think anything will happen per se, but I worry that nothing will happen. They won't remind her to check her sugar before cake and won't remind her to check before sleep, but most important, she won't remember to call me and tell me how its all going...blood sugar wise. Uggh.

Three minutes before cake-o-clock. She was low all evening. She was 58 when I was at their house. She was 63 at 9:30 at the pool (they checked her when I asked!!!!). Wonder how she is doing now. Really, I wonder.

One more minute before cake-o-clock.

Wonder if she'll call me? I feel like a lovesick teenager waiting for a boy to call. "Does he like me?" "Is he thinking of me?" The answer to both ruminations here is, "No! She is at a birthday party! She isn't thinking about you, or your worry!" But I do bet she is taking just fine care of herself. Mommy has some letting-go work to do, but it can wait until she is 25. Goodnight!

Wednesday, May 5, 2010

Minimed Revel: Jury still out, but underwhelmed

I hate to judge something without ample time to use it, but I am pretty underwhelmed with the Medtronic Minimed Revel and CGM package. I have been using the Medtronic Minilink CGM since it came out, ordering a new one after my other konked out after 18 months.

I had the 722 Minimed Paradigm pump and it has worked really well for me. But, back when I started this blog, I was testing the Freestyle Navigator. I loved it; for the most part.

I LOVED the predicative alarms. I actually stopped lows before I had them. What could be better. So when the Revel promised predictive alarms, I thought, "Hell ya!"

I have received predictive alarms, but many came when I was already low or moments from the threshold. I'm not 100 percent sure exactly what was happening with many of these, because I don't tend to take my BS when I wear the CGM (slap my wrist). It has been really accurate for me the majority of the time. Not perfect, but really good. So several alarms I got were maybe five minutes before the actual low alarm, but I don't know what my actual BS was.

So, I decided to check sugars when I got the alarm and the first time I did this I got the Predicted Low alarm and I was 55 mg/dl. This thing is supposed to warn me 30 minutes before a low and I was already 55. This happened several times with similar results.

Benefit of the doubt wants me to say, "I need to get used to it," "its a new machine, give it a break," but a big part of me is saying send it back.

It isn't any more helpful that the 722 at this point, it just has more alarms.

OH! Big issue, I can't hear the freakin' alarms at night.

I went for two hours with No Delivery and I didn't hear or feel a thing. The alarms were not great to begin with on the 722, but they were WAY too soft on the Revel. They have different low and high chimes, but they are not better and sound softer to me because they are so high pitched.

So, I haven't put a sensor on for two days because it makes me tired thinking about verifying the readings. Easier not to know, but I better figure this out soon, I'm running out of decision time.

Anyone using the Revel have some thoughts to share? I'd love input.

Thursday, February 18, 2010

Minimed Quickset Problem, Not Lot 8

I have had four "No Delivery" alarms out of one box of the new infusion sets Minimed has sent me. I reported it on the third time and just reported another.

It is with a box of 9mm, 23in. Quick-Set Paradigm with Lot Number: 9200558

It happens when I am bolusing only and within the three day window of normal infusion set function.

The Lot 8 issue was a fiasco and I wonder how long it took folks reporting their problems to get a adequate response. I bet if the problem had only been "No Delivery" vs. Spontaneous over delivery if it would have taken a lot longer for a recall? Any lack of delivery can be blamed on my scar tissue or improper insertion.

My experience has been that a No Delivery alarm is notice of a serious problem. I only twice or three times have gotten No Delivery alarms with an occlusion. I can be high for hours and never get an alarm, so when these alarms happen, I stop and pay attention.

Just curious if anyone else has had any problems.