Saturday, June 26, 2010


It's a quiet day in mommyhood today, at long last. Travel - even a short road trip, like we had last weekend - can throw things off a bit. I love to travel - I did a lot of it when I was younger - but now, it comes at a much bigger cost. Potty training got set back for a week. My glucose levels were, thankfully, stable. Good thing, as I spent most of the past week running up and down the stairs so many times, to get the necessary new clothes, etc., that I'd get to the top or bottom of the stairs, and forget which way I was going. I briefly considered going back to diapers (for H, not me!) - but that's a big no-no, apparently. I'm sure H's pride would have suffered, too. She may seem like a happy-go-lucky kid, and she is, but she's also hyperaware of what's going on around, and to, her. That still-forming ego of hers is fragile. Going back to diapers would have made her feel like a "bad person," as she told me once this past week after having had three "accidents" in an afternoon. Ouch!

We seem to be back on track now, so I'm glad we stuck with it. Diapering 37 pounds of wiggling and giggling is too much work! Sometimes I wonder where I get the energy to be a parent. Mostly, it comes from watching H. I get to eat a lot of extra carbs, too, I think. I snack almost as often as she does. I only hope that my regular eating isn't making her eat too often; any time she sees me eating, she wants what I'm having. I try to keep it healthy and low-fat, and limit amounts. I also try to keep H's activity level higher than mine. We go to the playground a lot, so all I have to do of fret over whether she'll fall of the high structures while she runs around like a nut.

It was maybe even harder to deal with this setback because we'd finally made it out of the woods, so to speak. (As in, does a bear...?) We'd just started coming out of a bad rut we'd fallen into because of the potty training. Not only would H want a "special treat" after using the potty - every single time - we also couldn't stray far from said potty, so trips to the playground became rare. I could tell both she and I were on the wrong track, healthwise. The treat would be a cookie or sometimes even a cupcake - that was what I had on hand, left over from what someone else brought to our house, at the beginning of training, so that's what she started demanding. Now, you may say, so what, a not-yet-three-year-old girls "demands" shouldn't be hard to handle. But then, you don't know toddler girls, and you don't know my H in particular. Sure, I could ignore the demands, or try to persuade her in another direction (here, have an m-and-m instead of a cupcake), but a full-on fit would ensure - followed by a nice puddle on the floor. See, parenting is this funny thing where your ability to control situations is always being challenged, if not out-right threatened.

But all was not lost. I switched to giving her a treat only after at least a half day of good potty use. I also made her play more in the yard, and started heading to the playground as soon as she uses the potty after arriving home from daycare. This last part isn't always easy, because once home, H settles into a routine that often involves TV. It's hard to get kids to switch gears. But she's old enough that she can hold a reward idea in her head for a decent while - so waiting a couple of hours for a cookie is usually possible, and the idea of the playground manages to lure her outside eventually, if I keep reminding her of the reward that's coming.

I'm not even sure how we got into the routine of the "special treat." When potty training started, I didn't want to use sweet rewards; I tried just praising H, and also giving her stickers and, a couple of times, bigger, non-food presents. She really liked all of this. But at one point we had those cookies and cupcakes in the house, and I let H have one and said it was a reward. I guess that was a mistake. (Ya think?!) I was partly horrified (all that sugar!), partly pleased that she could actually eat the stuff without any apparent immediately bad effects (like I would have), and partly desperate to make potty training work. But oh, the back-tracking! And yes, maybe the lure of the treat was that much greater because we hadn't allowed it before - because I just don't eat that stuff, and don't have it in the house.

Still, as I started out saying, things seem to be settling in well, we're down to one cookie a day, and I am breathing a lot easier. Motherhood is a symbiotic relationship, in that your daily routines are intimately intertwined. Anything that affects one person in this relationship deeply affects the other - and diabetes makes that even more true, or maybe just makes it more noticeable.

Tuesday, June 15, 2010

Et tu, CGM?

I come to praise the CGM, not to bury it. With all apologies to William Shakespeare, I've been thinking this mangled version of his line from "The Tragedy of Julius Caesar." (The real line being "I come to bury Caesar, not to praise him.") The meaning is the same, though.

I'm three days into my restart of the CGM, after an aborted start several months ago because I suddenly had trouble finding sites for my insulin pump infusion. This time, I used my "hip" (what a great euphemism!), to preserve my abdominal sites for the pump. The introducer needle wasn't that painful going in - or so I thought, until I nearly passed out. Okay, so 5 minutes later, I was recovered enough to finish the setup. I guess I have more muscle in that site than I expected. I also seem to have a really strong inflammatory reaction, because, just like before, it took an extra couple of hours for the device to start taking readings (beyond the two hours they say to wait before "calibrating" by telling the device what my real blood sugar level is, as opposed to the interstitial-fluid sugar level that the CGM measures).

So, I got it going. The up side is, it really works; it gives really accurate readings (although with just enough of a time delay not to be a useful basis for insulin doses, at least when the BG is changing rapidly). But. That first night, a couple of hours into my precious sleep, it starting buzzing (like a car alarm, I swear), to tell me the sensor was out of range. My insulin pump, which receives the wireless signal from the sensor in my "hip," was under my pillow and on the opposite side of my body from the sensor. The device can't send signals through the body. So any time I roll over in my sleep, it'll go out of range, and if it stays that way for 40 minutes, the car alarm buzzer goes off. I grumbled and moved the pump to the correct side of my body and tried to stay that way the rest of the night. A couple of hours later, the thing beeped again to tell me the CGM battery was low (which it shouldn't have been). I grumbled, got up, pulled the transmitter away from the sensor and put it in the charger. Then stuffed it in a drawer, because the charger light blinked in the dark like a police car light. At least I could sleep the rest of the night.

The next night, I got another wakeup call because of an out-of-range sensor. Then H woke up a couple of hours later. Then, after a couple of hours of fitfully trying to get back to sleep, the CGM buzzed again - to let me know I would have to calibrate in another 45 minutes. And all I wanted was another half hour of sleep! I didn't even have the low or high BG alarms set.

My sleep is precious to me. I already don't get enough. I'm one of those folks who need at least 8 hours a night. I usually get about 7. With the CGM, it's down to 5, and it's like being a new mom again, with so many interruptions I don't get to dream enough, and daytime feels like one long dream. As a result, it's been nearly impossible to do my work, I've gotten to work late every day, my hunger level is way up (harming my blood sugar), and I've had to drink way too much coffee (further affecting my blood sugar). I'm sure it's affecting my driving, too.

I called the CGM manufacturer yesterday (Medtronic, the same as my pump manufacturer). Now, I should say that the Dexcom I used during pregnancy had the same problem, so I knew it was unlikely they'd tell me how to turn these alarms off. I just wanted to give them a piece of my mind. Predictably, the rep said those alarms can't be turned off, to be sure the device is working so it'll alert me if my BG goes low (never mind that I could, and did, turn off the actual low alert). I told him I don't need the device to alert me to lows, I just want the data. I've managed to live 25 years with this disease, without a device warning me about lows (I told him), and suddenly they think it's their responsibility to be sure I'm alerted to lows? How paternalistic (I didn't actually say that part; too bad!). The rep suggested I keep the pump right next to me, closer to the sensor. But with a husband and two cats in a queen-sized bed, that's not reasonable. We can't fit a bigger bed in our room (would insurance cover a house renovation?).

Really, am I the only one who thinks it's abusive to force us to endure sleepless nights, just to know what our blood sugar is during that traditionally "black-box" time? It's like transporting the hospital environment into my very own bedroom - like having doctors and nurses interrupting my biological clock to tell me what my body needs, any 3 am of the week! No, thank you.

So why am I still putting up with it? because I'm desperate to get that information. But I call tell you, I am not going to use this device more than very occasionally. It's such a shame; if the manufacturer would just get out of the way, I could make so much better use of this technology.

I know, the whole point of being online with this stuff is to help and get help from others in the same situation. I'm really hoping someone else out there has figured this one out. If you have, please let me know! If not, let's get them to fix these devices so they'll really work.

Wednesday, June 9, 2010

"Allowed" to have kids?

Okay, so maybe I wasn't thinking so clearly in my past post - wherein I mentioned I put my meter in a zippered bag in the bathroom to keep H from grabbing it. Well, duh, don't they all (or mostly all) come in zippered bags, these days? I do use a different bag from the one it came in - not sure where that one is now. I guess the point is, (a) I get tired by the end of the day, when I usually write my posts; (b) I use whatever is at hand to solve a problem, be it diabetes-related or kid-related; both require MacGyvering all the time. So, when she started grabbing the meter, I found the nearest thing at hand to solve the problem. Okay, that's two points - it's my blog, I'm allowed!

Speaking of what I'm "allowed," I was pretty peeved by a New York Times opinion piece a couple of days ago, by some sort of philosopher, about whether people should really have kids. Here's the beginning of it:

Have you ever thought about whether to have a child? If so, what factors entered into your decision? Was it whether having children would be good for you, your partner and others close to the possible child, such as children you may already have, or perhaps your parents? For most people contemplating reproduction, those are the dominant questions. Some may also think about the desirability of adding to the strain that the nearly seven billion people already here are putting on our planet’s environment. But very few ask whether coming into existence is a good thing for the child itself. Most of those who consider that question probably do so because they have some reason to fear that the child’s life would be especially difficult — for example, if they have a family history of a devastating illness, physical or mental, that cannot yet be detected prenatally. All this suggests that we think it is wrong to bring into the world a child whose prospects for a happy, healthy life are poor, but we don’t usually think the fact that a child is likely to have a happy, healthy life is a reason for bringing the child into existence.

Yes, before I got pregnant and during pregnancy, I did think a lot about H's prospects for a healthy life, given the potential for my own diabetes to affect her development, and also the risk that she might someday get it herself. I still think about that second possibility, and hope fervently that it doesn't come to her - or at least not at too young an age. (What's "too" young? I don't know. But you know what I mean - it's particularly hard when the kid has no idea why he or she has to take shots, etc.)

But, contrary to the author's statement, I did in fact think that my child's own potential for happiness was a reason to bring her into existence (I guess I'm one of those "few people"). And that gets at the crux of what bothered me in what he wrote: The implication that being "unhealthy" might be a reason a child should not have been born. It was stated so off-handedly, as if to say, "of course, we're assuming the kid will be healthy; if not, the prospects for happiness are just too grim to contemplate." I've had this conversation with "healthy" people before: Once, someone I know said she wouldn't want to live if she had to be in a wheel chair. Several others agreed. I just thought, well, don't judge it until you're in the situation - you might think differently. Even with all that I've been through - not only the diabetes, by 14 years of migraine hell - I am still very, very happy I'm alive. I think too many people on the other side of that fence discount the very value of just living - the notion that life is worth it, even when it's far from perfect. (Never mind that, from a biological perspective, "just" living is the point of it all!) I thought, if I can even approximate all the good experiences I've had, and give them to my child, then chances are good that she will be glad she's alive.

My endo during my pregnancy said she'd encountered numerous people who think someone with diabetes shouldn't have kids. She works hard to counter that notion (thank you!). I would say to such people, first, it's not that simple: The genes that make us prone to diabetes can also be helpful in certain situations, like famine, so they're not "bad" genes, per se, just not helpful when food is as plentiful as it is these days - and you never know when that might change. Okay, that argument works better for type 2 than for type 1, but the genes for type 1 are probably even more numerous than for type 2, so some of them are, by themselves, probably "good" genes - they just got combined in a harmful way (and they also needed a bit of environmental bad luck). Throw them together in a slightly different way - which is what happens every time a new person comes into being - and those same genes might create something wonderful (like my daughter!).

And two, I would say, hey, there are a lot worse things that people can pass along to their kids - like attitudes of hate and intolerance.

When I was pregnant, I did all I could to make sure my unborn daughter's prospects for a healthy life were the same as anyone else's. I felt I owed it to her - after all, she didn't ask to get born, let alone born to someone with diabetes. But I also knew that it wasn't entirely up to me whether she'd end up healthy (it still isn't). I can only do my best. And I know that less-than-perfectly-healthy isn't a reason to wish I hadn't gotten pregnant in the first place. I can only hope she always thinks so, too, but I suspect she will: Every night, when I put her to bed, I tell her, "I love you forever, sweetie." Some nights, she says, "I love you too, Mommy." And other nights - like this very night - she says, "Thank you, Mommy."

Thursday, June 3, 2010

Now, where did I put that meter?

We've entered new territory: Potty training proper. Okay, 'nough said for a blog on diabetes, right? Well, yes - and no. Because it takes an awful lot of time, energy, and patience to potty train your toddler - all the things that diabetes care needs, so they're in direct competition. At least I know the potty training has an end point, right?

Meanwhile, I've been thinking about baby proofing as it applies to diabetes supplies. When H was born, I was already putting my tub of used needles in a high cabinet, out of reach of - well, clearly a newborn, but also a kid the age she is now (two and a half). In fact, I moved all my diabetes supplies out of reach at that point. And it turns out it was good I did, because it would actually have been hard to find the time to stop and think about that at just the right point when it needed to happen - when she was around 10 months, and started pulling up on things and being able to open drawers. That cliche, about staying one step ahead, is the not-always-achievable goal, but I've found the more I can do it, the more I can keep some sense of sanity.

Lately, even my meter and test strips have been subject to grabbing by the pudgy little hands - along with my husband's razor, toothpaste, the usual bathroom items. I've taken to putting my bathroom meter, strips, and lancets in a zipped bag (not a Ziploc baggie, but a real zippered bag) at the far back of the counter. It's still within sight and my easy reach, so I remember to test! But she's not so curious about it and is less likely to be able to open the bag before I get to her. She can unzip things - but of course I can't leave her completely unsupervised forever, anyway.

Of course, I'm used to planning a lot because of having diabetes, which helps. It's not that far to go from keeping track of how much of all those supplies you have (the strips, lancets, pump reservoirs and infusions sets, blah, blah, blah...oh yeah, and the insulin) -- to thinking about where you put them. Likewise, it's not so hard to think about packing snacks for the kid, when you're already used to carrying snacks for yourself (but it sure makes for a lot to carry!).