Last Friday was Dylan's quarterly diabetes checkup with the team of caregivers. I've often wondered how diabetes checkups are done with other endocrinologists; ours has kind of a different approach I think.
Every 3 months we see the endo at what our local hospital calls the "Diabetes Education Center," which is essentially a wing of the hospital comprised of a large classroom and a few smaller, private rooms. Our stay lasts anywhere from as little as 45 minutes to as long as two hours and in that time we meet with at least 3 different individuals. A dietician is available to weigh and measure Dylan, take his blood pressure and talk about any changes in diet and/or activity level; a diabetes nurse does Dylan's A1C test, uploads Dylan's pump data to a software program to evaluate the numbers, and answers general health questions or issues; and the endocrinologist evaluates the numbers, both from the pump and the A1C, talks to us about changes, both good and bad, and adjusts Dylan's basal rates, carb ratios, or insulin sensitivity factor, if needed.
After we see everyone, there is always an educational session led by one of the individuals from the medical team. Topics vary from advanced pumping, to traveling with diabetes, to what to do when sick, among other topics. And then there are always a few other people there too. Last week our medtronic rep was there, as well as a medical student from the local university.
Together this amazing medical team provides a well balanced approach to diabetes that covers all aspects. But I think everyone's favorite part of the quarterly visit is the chance to sit and talk with other parents of type 1's. The appointments are scheduled by sex and age, so when we go, any other type 1 patients who are boys between the ages of 9 and 12 are also there. This is such a great opportunity not only for me to talk to other parents, but for Dylan to talk to other kids his age who have diabetes, an opportunity he doesn't get too often.
For the record, his A1C was 7.8. A bit higher than I would like, but an improvement over his previous one of 8.2, and the best A1C he's had in almost 2 years. The endo was happy to see it moving in the right direction, and it long as it continues to go down over the next few visits, I'm happy with it too.
So how do diabetes checkups work where you live? Do you see the endo alone, or is this team approach the norm?
Prelude: I actually started this post last Friday, just before Dylan returned from diabetes camp, but encountered computer problems. After taking our home computer in for what we thought would be a simple repair, it turns out we have blown something on the motherboard and need either a new motherboard, or a new computer altogether. Seeing as everything else on the computer is quite new, we opted for a new motherboard. So while we wait for it to be shipped from who knows where, I will be blogging from my iPhone, hence the delay...
Original post, Friday, July 15th, 2011:
Day 5 of diabetes camp, the final day, Dylan is coming home. He is spending the weekend with his dad, so I won't actually see him until Monday, but I can't wait to hear all about his week!
Dylan is at Camp Kakahmela, a diabetes camp organized by the Canadian Diabetes Association, and located in Gibsons, British Columbia, Canada, about a 10 minute drive and 40 minute ferry ride from our house. This is year 3 for Dyl and he absolutely loves it. Type 1 kids, and type 1 counsellors, travel from all over the world to attend this camp, so we are very fortunate to have it in our backyard! A team of diabetic nurses is there, of course, as well as 1 pediatric endocrinologist, who this year happens to be Dylan's endo, who has overseen his diabetes care since diagnosis in 2005.
What does all this mean to me, as a d-parent? It means some peace of mind, which any type 1 parent will tell you, doesn't come often. Yes, he is away from home, and participating in activities that pose a potential risk, but that has nothing to do with D, that is typical of any camp.
I get peace of mind because I trust the staff. I trust Dylan's endo explicitly; she knows him well and knows his diabetes patterns and history. She knows that he needs to run on an 80% temp basal for the week to avoid nighttime lows. She knows he can count his own carbs and enter all of his own data. This year she'll be thrilled to learn that he can change his own infusion sets - entirely by himself (not just the insulin, priming and tubing change, but he can insert the new cannula too, and we don't use a quick set, so he actually sticks that big long needle into his own tummy without help)!
I know that they will stay on top of his testing, including twice at night, and I know that when he gets home and we upload his pump data the numbers will be more stable than when he's at home. How do I know this? Because it happened last year and the year before.
This week i get a little break from being a d-mom. I get to sleep through the night and show my other 2 children that the world doesn't always revolve around diabetes. Of course I'll miss him, and I'll worry, even though I know he's safe. But that is really the best thing about diabetes camp, and the thing that a d-parent, and every parent, prays for each and every day - to know that your child is safe.
For more information about Camp Kakhamela visit: http://www.diabetes.ca/get-involved/helping-you/camps/british-columbia/kakhamela/
