Saturday, March 23, 2013

Three months since diagnosis

Today marks exactly 3 months since the day Lily was diagnosed with type 1 diabetes. Somehow it feels like much longer than that. It's amazing what a difference just a couple of months make and how you adjust so quickly.

Lily is doing amazing. This week she started giving herself shots in the stomach at school and today she gave herself the insulin for lunch. We are so proud of her! She rotates injection sites so she always does one arm for breakfast, stomach at lunch, the other arm or leg for for dinner and stomach again at night. She has to rotate injections sites to avoid damage to the tissue under the skin which could lead to problem with absorption of the insulin. We can also use the sides of her lower back but she doesn't like this location much.

On Wednesday she had her quarterly Endocrinologist appointment and it went very well! Her A1C went down to 7.3 which is great. A1C's in the 7's is a nice range for kids and her Dr said she's doing very well. The week before she had blood work done for a thyroid and the results came back in normal range. She will have her thyroid checked every 6 months for now since she does have thyroid anti-bodies in her system.
In 3 months she has grown 1 1/4 inch and gained 10 lbs (most of that is just gaining back the weight she lost in the weeks of being sick before dx), what a growth spurt!

Her Dr feels that we are now ready to have more control in regards to her dosing etc. We no longer need to email her blood sugar log every week for changes. We will be looking for trends ourselves and make adjustments when needed. We are more than ready for this and are excited to be in charge. We are now on carb ratios (have been for awhile) where we calculate her insulin need depending on the amount of carbohydrates in a meal. When we first came home from the hospital we were on a fixed dose and she had to eat 55-60g of carbs every meal. Now we have more flexibility. Her ratios are different at different times of the day with her highest dose being in the morning. We also have the freedom to dose her for larger snacks so she's not limited to just 15 g snacks twice a day. That means that if we want to go have ice cream one afternoon we can just give her insulin to cover it.

We just signed her up for a summer camp for children with diabetes. It's a one week day camp in June. The camp will include outdoor activities, games and crafts etc as well as some diabetes and self management education for the kids. Most importantly she will get to be around kids dealing with the same challenges she is and hopefully she'll make some lasting friendships.

Monday, March 18, 2013

Night checks

When Lily was first diagnosed with T1D we were told to do blood glucose checks at night under certain circumstances.

1, Whenever we have to give her a correction dose of fast acting insulin at night. When her blood glucose is within her target we only give her long acting insulin at night but if she's high we also have to give fast acting insulin in a second shot.
2, Any time we are changing her dosage.
3, When she's sick.
4, Any time there's been anything unusual in her day, her BG values, extra activity etc.

I thought that meant that most of the time we would not need to wake up at night for checks. Well, I was wrong. So far we check her more often than not at night. Sometimes she sleeps right through it and sometimes she wakes up and wants to do it herself.

Lately she's been running at the low end of her range. She really has had some nice values and that's all great but being in the low range she's also experiencing more lows, meaning BG values under 70mg/dl which needs to be treated. At night we actually need to treat her as low at 100 to make sure she doesn't have a true low while sleeping.

This was my night yesterday. Had I been able to fall asleep before midnight I would have had an alarm for 12am as well but I was awake and checked her before going to bed. At 12am her BG was 107. There's no way of knowing which way it's gonna go from there, some nights she goes lower and some nights she goes higher, so I set my alarm for 1:30am. At that point her BG was 108 so basically no change. I set the alarm for 3am, this time it was 122. At that point I decided she'd most likely be fine until the morning since we get up at 6:30am anyway for school. Had it not gone up like that though I probably would have checked her again at 5am. Diabetes never sleeps!

Because we are seeing lows more frequently, sometimes daily, we are now lowering her insulin to find a better balance. Hopefully she responds well without going too high and maybe we can get some more sleep too.

Friday, March 15, 2013

Blood glucose meters

It's been a little over 2.5 months since Lily was diagnosed with T1D and we already have a handful of blood glucose meters. The medical companies sell the meters really cheap and even give them away for free sometimes. They make most of their money on the test strips you will be buying for the meter.
We have four different kinds of meters right now. We started out with the pink one, the OneTouch ultra mini, which is very basic and easy to use. This was given to us at the hospital. We currently have 3 of those, 1 for school and 2 for home. It gives you the blood glucose reading and the time and it stores up to 500 readings so you can go back and check but that's it....very basic.

Then we got this one, the new Bayer Contour Next USB. I had a coupon for a free Bayer meter (not this one) that I requested online but instead of sending us that one they upgraded it to this. This meter was released in the US in March 2013 and we got ours March 1st! It's been around in Europe since last year some time. We love this meter! It can do so much more than the OneTouch. We can log her blood glucose readings as fasting, before meal, after meal or no mark. We can also log her carbohydrate count and the amount insulin she takes and it can store up to 2000 entries. It then plugs right into the computer and it has it's own computer program that will give you a chart, it shows her averages and her trends among other things. It can then create printable PDF's that we can take with us to her Dr's appointments. It also has the new multi pulse technology where each blood sample is tested  7 times in a matter of seconds to get the most accurate reading. We get a reading in 5 seconds (most meters read in 5 seconds). It also has a second chance sampling capability where if you don't get enough blood on the test strip you can add some more. Most other meters won't do this and you have to start over with a new strip. It also requires 40% less blood than the OneTouch. It's great!

The bigger, grey, meter in the first picture we bought as a back up to the USB meter for $5 because it's also Bayer and uses the same test strips. It's much more basic though. Since we transferred our prescription to Bayer strips our insurance won't cover the OneTouch strips anymore so as we run out of those we won't be using it anymore and if something happened to the USB meter we don't want to be left without one.

Then there's the blue one, the Novamax plus. I got this for free as well. It just arrived today so I haven't had a chance to learn about all the features. The main reason I ordered this one is that it's not only a glucose meter, it can also test for Ketones and I'm excited about that. Ketones are produced when your body starts burning fat for energy instead of glucose. This is a serious condition and can lead to Ketoacidosis (what Lily had when she was diagnosed). Unfortunately it isn't too uncommon for T1D's to develop Ketones, especially when ill or with high blood sugars. Most of the time it doesn't turn in to Ketoacidosis but it needs to be monitored and treated at home. Whenever Lily gets sick we are supposed to check her for Ketones every 2 hours. We do this with Ketone test strips that we dip in her urine. The problem though is that it's sometimes hard to read the results, you are looking for a color match. It also takes a little while for Ketones to show up in the urine and so if you test positive from the urine it's possible that the body has already cleared out the Ketones. It's great to have the possiblity to do a blood test to see the exact level of Ketones. Since it does mean another finger stick we will probably only use it after Ketones have been detected in the urine or if she happens to to not be able to give us a urine sample etc. This meter could potentially save us a trip to the Dr or ER.

Here's link to more information on Ketones and Ketoacidosis.

The other day we bought this new purse for Lily to carry her supplies in when she's out and about. It's the perfect size and she can fit her meter, test strips, the poker, alcohol wipes, some glucose tabs and her cell phone in there. Perfect! 

Tuesday, March 12, 2013

UIL spelling winner

Natalie made the UIL spelling team for the 2nd year in a row! She was one out of three 4th graders going to compete with 5 other schools in the district. Unfortunately she came down with the flu the week before the competition and she was still home recovering the day of. Despite not being a 100% she won 1st place! We are so proud of this girl! Last year she got in 2nd place.

House update

They finally started working on our house! They haven't gotten far, still working on preparing for the foundation but at least it's happening!

Our lot.

This is another house like ours in the neighborhood. Our's will look exactly like this but with a slight difference in brick and stone.

We had two appointments at the design center and are now done with our selections for the house. We've choosen flooring, cabinets, countertops, light fixtures, bathroom fixtures etc. Most of it wasn't too hard because we had a good idea of what we wanted. I'm so excited to see how it turns out. This week we also had a meeting with the electrician to decide on tv and phone/internet outlets among other things. We also have to meet with the builder in a couple of weeks and go over any final details. After that point we will have walk through meetings at different points during the building process. As of now, they are estimating the house to be ready for us to move in on June 30th.


The boys turned 5 on January 30th and three days later on February 2nd Maddie turned 12. I'm so far behind on blogging so I thought I'd try to catch up and at least post a few pictures.

Lucas and Jacob's birthday





Their birthday cake, bowling theme.

 They got new bikes for their birthday.
Here Jakie is riding his scooter he got for Christmas.

Lucas on his bike.

Maddie's Birthday

 Maddie's Birthday cake. Den deiliga.

To celebrate her Birthday she got to bring her two best friends to jump street followed by dinner at Cici's pizza buffet.

Maddie at Jumpstreet

Maddie and her two best friends.