Rookie Mistake (365:11)

So this past weekend we went up to Nicola Lake to camp for a few days. As we're packing up extra infusion sets, reservoirs, dex, and a couple of glucagon shots, Dylan says to me, as a joke, "Don't forget the insulin, Mom."

"No way," I reply, chuckling. After all, I had just picked up a fresh vial from the pharmacy the night before so that we'd have more than enough for the trip, and for the site change we'd need to do while away.

Two hours later, we're in the car, entering Chilliwack (about an hour from home), when Dyl's pump beeps low reservoir. And then it dawns on me. I packed all the d-supplies from the cupboard but left the fresh and the old vials of insulin in the butter compartment of the fridge. Holy crap!!

Option 1? We could go back, but it's at least an hour home, and we're smack in the middle of rush hour traffic. Then the four hour drive to the lake. That would mean we'd arrive at the campground around 10:00pm to assemble tents and make dinner in the dark. Not fun.

Option 2? Stop at the nearest pharmacy and beg them to give me a vial of insulin. There are two immediate problems with this option. First, I have no prescription on me, and while my local pharmacy (who knows me, and is very familiar with Dylan's prescriptions) would do it no questions asked, other pharmacies may not. Second, all drugs in BC, including insulin, are monitored and patients are only permitted to draw them at a pre-set frequency, depending on established use. Meaning that the government computer system knows Dylan's regular insulin use, so if we suddenly try to get twice as much as normal, red flags go up. I picked up a vial the night before, plus another vial a few weeks ago, plus whatever Dylan's father might have recently ordered for his place. Would we be at our cap? There was only one way to find out.

I dragged Dylan in with me so he could show them his pump if there were any problems with the lack of prescription. Luckily the pharmacist was super understanding and immediately gave us a new vial. Yes, we were over the insurance company's drug limit, so we had to pay for the vial, but within 15 minutes we had insulin in hand and were back on our way to the campground.

A rookie mistake that I'll definitely never be making again.

Skating Along

The ice surface has been so smooth and sheen, free of cracks or dents, that we didn't even notice the big open hole ahead. Blindly we skated forward, bearing down, picking up speed, hurtling towards the gaping pit of freezing cold water. Before we knew it, we were submerged; soaking wet, struggling to get out before falling below the surface forever.

No, we didn't really fall under the ice, but this metaphor seems perfect to describe our family life with diabetes lately. Diabetes here has been uneventful, routine, common even; each day predictable and manageable. No lows, no highs, just a whole lot of 6's and 7's.

We were enjoying the skate, getting comfortable, and even temporarily forgetting that ice couldn't be perfect forever. Inevitably D would rear it's ugly head and we would fall. And that we did last night when Dylan's pump ran out of insulin in the middle of the night.

My own fault really, I should have refilled the reservoir earlier. I should have understood that with the stomach bug Dyl's has had the past couple of days, his insulin needs would have been higher. I should have been on top of it. But I wasn't.

Around 3:30am his pump alarm went off, signifying the end of the insulin and in his half-asleep state he heard it, but ignored it. By the time he woke up this morning his bg was 22.4 mmol/l. A quick site change, refill, and bolus, and we waited for the new insulin to do its job. We waited, and waited, and waited some more. Half an hour later we tested to discover a bg of 24.1 mmol/l. Crap. Another bolus, another wait, another test, and finally it started to come down.

A sudden and effective reminder for us to never get too comfortable with D because it has always been, and always will be, anything BUT predictable.

The Mystery of Increased Insulin Use

Earlier this week I posed about how Dylan had gone through about 125 units of insulin in 48 hours - a first for him. His intake is usually pretty consistent, with daily insulin ranging between 35 and 40 units per day, so using over 120 units in 2 days is alarming. Was it a pump/tubing issue? Faulty insulin? Major growth spurt? None of the above actually.

The mystery was solved when we woke up Wednesday morning to find a sick little boy, complete with nausea, a stuffy nose, and nasty cough. He stayed home from school all day Wednesday and then tried to return Thursday, lasting all of 15 minutes (I dropped him off at 8:45am and he called from the school office at 9:00am saying he wasn't feeling well enough to stay). This morning he woke up feeling a whole lot better, though still not 100%.

In the meantime, insulin dosage seems to have to returned to normal. We've been monitoring closely, but BG levels have returned to "normal" at his regular pump settings. Thinking back, I can't recall having experienced this before, where insulin dosage increased by 50% in the couple of days leading up to an illness, but then returned to typical amounts during the illness. Anyone else noticed this before?

Wordless Wednesday ~ Life in a Bottle

Where were you when I needed you Tuesday night?

Near Emergency, but Avoided

A near catastrophe tonight...

As the kids were getting ready for bed, Dylan did a quick nighttime bg check and noticed that he had only 5 units of insulin left in his pump. Hmph. It had only been 48 hours since his last infusion set change and he NEVER runs out of insulin before the 72 hour set change time. In fact, he usually has lots leftover because I always fill the reservoir, just in case.

Oh well, I thought, we'll just change his infusion set a day early, no big deal. I reach into the fridge's butter compartment to grab a vial of NovoRapid insulin, only to discover that there is none in there. I reach into the produce drawer for the back-up penfills I keep for emergencies (I've always kept a stash of short and long acting insulin penfills just in case of a pump malfunction or brief return to syringes). There is NPH in there, and some Levemir, but no rapid. 

After a brief second of confusion, I look to my right, where the familiar white and orange box sits perched atop the microwave. The EMPTY box that I purposely placed there the day before to REMIND me to refill the prescription. Somehow in my insanely busy schedule lately I forgot to re-order it. F*^k and double f*^k. My mind starts racing as I realize we are actually OUT of insulin for the first time ever. Completely out; not a drop in the house and only 5 units in the pump. And to add to my panic, I look at my watch to discover it's 9:20 pm (damn the late summer sunsets, I thought it was earlier) and the pharmacy closed at 9:00 pm.

Option 1 at this point is to find a late night pharmacy, which there are, but without a prescription I have to pay for the insulin and I'd rather not, seeing as we have insurance that covers the full cost (with a prescription). Options 2: borrow insulin from someone. At times like this Dylan is fortunate to have divorced parents who share custody and live close together. 

15 minutes later, I am home, insulin in hand. Near emergency avoided. Just another day with diabetes...

Oddity

I don't know how many infusion sets I have changed over the years. A lot. Once every three days, for four and a half years (Dylan was on MDIs for his first two years with diabetes), would mean somewhere around three hundred and fifty site changes. It's basically always the same thing - disconnect tubing from Dyl, peel off old set, rewind pump, dispose of old reservoir, fill new reservoir, attach new tubing, insert in pump, prime, insert new cannula in Dylan, attach pump, fixed prime. Good for another three days, assuming nothing plugs, falls off, gets kinked, infected, or runs out batteries. It's become routine. So routine, in fact, that I rarely need to think about it; I move in an almost robotic state, much like when tying my shoes or brushing my teeth.

But today, for some bizarre reason, something was different. As I popped the new reservoir onto the top of the insulin vial and pulled back the plunger to fill the reservoir with insulin, I found myself struck by the oddity of it. I watched as the life saving serum slowly filled the tube-shaped reservoir, the liquid creeping up the marked plastic: 50 units, 100 units, 150 units. As it neared the 180 unit mark (Dylan will only use about 120 units over 3 days, but I always add a little extra), I released the plunger and removed the reservoir from the insulin vial.

I found myself overwhelmed in a way I cannot even explain. How can something so small be responsible for so much? This tiny amount of simple, watery-looking substance gives my son life for three days. Without it, he would die. I am well aware of this fact, and I am eternally grateful to Frederick Banting for his miraculous discovery over ninety years ago. I am in awe of the advances in the field of medicine, that enable my son to wear an insulin pump, essentially a mini-computer, that continually injects him with one of six different preset amounts of basal insulin, specific to his body weight, activity level, and the time of day.

And yet today, for the first time, I was genuinely struck with a feeling of surprise at how readily we accept and embrace this blend of nature and technology. Pumpers are not alone in their use of health technology; the addition of man-made materials to the human body is widely used, ranging from braces to pacemakers, to prosthetic limbs, to breast implants, to wheelchairs, among other things. Each device serves a purpose, and many are brilliant inventions that not only enhance lives, but save them, each and every day.

With the exception of insulin itself, an insulin pump is the greatest advancement in diabetes care to date. It has changed diabetes itself, enabling it to become an easily manageable disease with fewer side effects and a longer life expectancy than ever before. I love Dylan's insulin pump and I am so thrilled the technology is available. Yet it is still a machine, and for today I found that odd, that's all.

Insulin at School: Whose Responsibility Is It? Part 3

This is the third and final installment in my "Insulin at School" series of posts. In Part 1 I outlined the issue itself (whether schools should be responsible/trained for administering insulin to children with type 1 diabetes); in Part 2 I provided some background information into what has worked for my family, and in Part 3 I will address what I think needs to happen now.

First and foremost, in Part 2 I talked a bit about the care plan I have set up with Dylan's school. His care plan is a collaboration between me, the community health nurse, and the school, and was written when he was first diagnosed in 2005. Each September we tweak the plan a bit to reflect and recent changes, as well as goals for his blood sugar levels. This care plan is still in place now, and will stay with him until he graduates from high school. It ensures that there are always people in the school (his teacher, as well as SEAs and administration) who know how to help him if and when needed. It covers a variety of situations, and is specific to Dylan's needs, but not include the administering of glucagon or insulin. Every type 1 child needs to have a care plan in place to ensure their safety. If you don't have one, get one. And if your school is uncooperative for any reason, talk to the principal, the superintendent, the ministry, whoever you need to. In BC, an alternative to a "medical care plan" is an Individual Education Plan (or IEP), but for this you need to have your children designated as having a special need. This is a designation that stays with them through graduation and is reflected on their transcripts and university applications, etc, so it's not for everyone. For the record, we have both. Dylan is designated by the Ministry of Education as "gifted" so he requires as IEP to reflect additional learning goals. We can include diabetes goals in his IEP as well.

However, the issue at hand is not care plans. The issue is whether schools should be administering insulin to our children, either via syringe or insulin pump. I think the answer is obvious. Why wouldn't they? The only question then becomes, who does it? And while I said yesterday that I don't believe the onus should fall entirely on the teacher, the classroom teacher is the one person that sees your child more than anyone else, and for that reason, they should be trained on how to administer insulin, or, at the very least, on how to give a glucagon shot. Then there should be at least one alternate person as well, such as an SEA. Why? Your child travels throughout the school every day; their primary location is the classroom, but then there's outside time, library, gym, music, and computers, for which they may have alternate teachers. And what about field trips? The classroom teacher might be the only adult present on a field trip, so their understanding of how to use glucagon is critical. 

I mentioned in yesterday's post that Dylan does all of his own boluses, and I have no intention of changing that. I have always encouraged him to be as independent as possible with his diabetes care, in part because the idea of relying on others frightens me, and because as he gets older, he will have to care for himself more and more. But he's 11, he's had type 1 for over 6 years, and has worn a pump for over 4 years. Translation: he's not new to this. Neither am I, and neither is his school. In fact, when he was diagnosed, he was 1 of 4 children in his school of 230 kids who had type 1. He's now the only one, as the others have moved on to high school. What that means, though, is that almost every teacher in his school has had a type 1 child in their classroom at some point in the past few years, so the entire school community is familiar with the unique needs of a child with diabetes. We are very fortunate in that way.

For kids who are recently diagnosed, or who are on MDIs, or are young, or whose parents work far from the school, or can't leave work, or who, for any number of other reasons, are dependent on the school to inject their child with insulin, the school community needs to step up and ensure their child's safety. And glucagon injections, well that's a given. Someone has to be able to do it at the school.

So where do we go from here? I believe we need to ensure that members of every school are trained to administer glucagon to a child with type 1 diabetes, including the classroom teacher. As for insulin injections, they should be willing to learn, and from there the procedure needs to be decided between the parents and the school, as each child's needs are so individual.

Insulin at School: Whose Responsibility Is It? Part 2

First of all, I want to send a big thank you out to all of the people who posted comments or sent emails in response to yesterday's Part 1 post. I had some great feedback!

I mentioned in yesterday's post that the more I thought about whose responsibility it should be to administer a child's insulin at school, the more conflicted I became, and I'm not sure that I'm any less conflicted today. And the more I perused the idea yesterday, the more I realized I cannot speak for other parents, nor can I suggest what the best "solution" is. What I can do is speak from my experience, in terms of what has worked for us, and what hasn't.

As parents we all want the same basic things for our child at school: for him or her to be safe and to have an enjoyable, successful learning experience. And while every classroom is comprised of children with diverse learning needs and unique circumstances, type 1 adds a bit of a special challenge to the mix because it is not only life threatening, but is treated differently in every child. It is not like a severe allergy, for example, where the treatment is straightforward with a quick shot from an Epi pen. Too much insulin is deadly.

I strongly believe that the onus of responsibility in administering insulin to a type 1 child at school should not fall entirely on the teacher's shoulders. School administration is not a realistic option either because ideally it should be someone who is in the classroom with the child, at least most of the time, so that they can recognize symptoms of high and low blood sugar, which can vary from child to child. But the problem then becomes, if not the teacher, and not the administration, then who?

In BC we have specially trained personnel in the school called Special Education Assistants, or SEAs, whose job it is to work with children with unique learning challenges that prevent them from functioning normally in the classroom. The overwhelming majority of these unique circumstances are either physical or mental disabilities, such as autism, severe behavioral problems, cerebral palsy, down syndrome, and learning disabilities, for example and, depending on the need, require the help of an SEA on either a full or part time basis. For many children, they would simply be unable to integrate into the classroom community without the help of an SEA, and as a teacher, my gratitude for this additional help is limitless. But SEAs are in high demand and there is not enough money to employ as many of them as are needed. Therefore they are assigned to children with the greatest need. In a perfect world, there would be enough money for to ensure that every child had the ideal leaning support, but that is not the reality.

Does my child have a critical need for an SEA? I don't think so, and hence why he does not have one. As a teacher, I have seen the myriad of needs in a typical classroom, and I am too familiar with how many children need an SEA much more than my son does. I cannot justify taking an SEA away from a child who desperately needs the help, in order to help monitor Dylan's blood sugar and administer his insulin.

So how have I addressed Dylan's insulin needs at school? Dylan was diagnosed when he was in kindergarten, in November of 2005, so he was only 3 months in to the school year. He went to a half day kindergarten in a public school, and was taking insulin via syringe at that point. I would give him his morning shot at home, before school, and he required no additional insulin at school. At snack time, an SEA would pop into the classroom and supervise while he tested his blood sugar, and they would record the number in a file. If the reading was low, Dylan would drink a juice box and retest 15 minutes later, again with the supervision of the SEA. If he was high, the SEA would call me and we would reduce his morning snack and have him drink a cup of water. For the odd times he was particularly high, the SEA would make him go outside and run a few laps around the school. It always worked.

In grade 1 we started him on an insulin pump and when I went to the pump training, I made sure that Dylan was trained too, so that he could administer his own boluses. The same procedure continued at school, except that the SEA would pop in at both recess and lunch to watch Dylan test. I would always put a little post it note in his lunch listing the carb counts for his recess snacks and his lunch, and he used the built in bolus wizard in his pump to figure out the bolus. That meant all he had to do was test, input the blood sugar number into the pump, input the carbs, and hit "Act". When he was in grade 1 and 2, the SEA would watch this whole process, just to ensure that he input the correct numbers. We kept the same procedure for lows (juice and retest after 15 mins) and we stopped worrying about highs at school because the bolus wizard in the pump automatically factored in his carb ratio and insulin sensitivity factor to give him the right amount of insulin for his food and to reduce the high. As Dylan got older, and more mature and responsible with his diabetes care, the calls home became less and less frequent. By the end of grade three he was starting to get annoyed because he was always having to wait for the SEA to arrive at his classroom (she was assigned full-time to another child and only saw Dylan for bg testing), and he didn't like missing 10 minutes of his 20 minute recess waiting, so he started going ahead without her. By the end of third grade, he asked me if we could drop the SEA altogether and arrange it so that he could seek her out if and when he needed her, but otherwise do his testing and pumping on his own. That is the way it has been ever since, and he's now in grade 6.

His teacher and the office staff have all been trained to recognize signs of high and low blood sugar in Dylan and they all know that he needs juice when he's low and to give it to him if he's unable to get it himself. He has a glucagon shot at school, though no one in the school is allowed to use it. We keep it there so that, in the event of an emergency, the school can call 911 and me, and whoever arrives first can administer it (I only live a few blocks from the school). To date, we have never used it at school.

All of the above being said, we have learned over the years that the best "assistant caregivers" for Dylan are his friends. They are the ones who have been with him for over 6 years and they know what his symptoms of high or low blood sugar are. They know where his juice and dex are kept, and they know to make him take them. On numerous occasions, he has avoided severe low blood sugars because his friends have noticed a change in his behavior/appearance before he even felt low.

Would I want his care plan any different? I don't think so. The only people allowed to touch Dylan's pump are him, me, his endo, and the CDE that did his pump training. I don't trust anyone else touching it, not even family members, so I definitely wouldn't want someone at school touching it. I understand that what works for us may not work for everyone, but that is the problem with a government mandated care plan for children with type 1 diabetes. It varies so much by child that there is NEVER going to be a plan that works for everyone.

Finally, I've realized at the end of this ridiculously long post, that my thoughts on this issue are still not complete and I think the issue warrants a Part 3 tomorrow!

Insulin at School: Whose Responsibility Is It? Part 1

My original idea with this post was to present the issue and then provide my own opinion about it. However, the more I examined my own thoughts about it, both as a parent and as a teacher, the more conflicted I became, and the longer this post got. So, I've decided to break it into two parts: issue today and opinion tomorrow. That being said, I would really welcome the opinions of others, particularly those outside of BC, who could shed some light on how insulin is administered in schools where you live.

According to an advocacy group in British Columbia, school staff should be trained to administer insulin, and life-saving glucagon injections, to diabetic students. The group, entitled "Unsafe at School: Advocating for Children with Type 1 Diabetes" is made up of BC parents and a number of physicians. It was formed after a North Vancouver father filed a complaint with the BC Human Rights Tribunal earlier this year. They have started a petition calling on government for change and almost 400 people have signed it thus far.

Currently there is no mandated care plan for children with Type 1 Diabetes in BC. School staff are not responsible for checking blood glucose levels, injecting insulin, managing pump boluses, or administering glucagon in an emergency. Each child, and each school is unique, so the level of support varies considerably but essentially the onus of responsibility falls on the parents, who, in some cases, have to visit their child's school at least once per day to administer insulin via pump or syringe.

The advocacy group believes that until this changes, diabetic children are not being adequately cared for at school and are being discriminated against because of their diabetes. They add that when a child with diabetes experiences high or low blood sugar their learning is compromised, and therefore should be treated similarly to a learning disabled child in the classroom. The Education Ministry is currently reviewing the situation.

To find out more about the advocacy group, or to join their efforts and sign the petition, visit their "Advocating for T1 Kids" page on Facebook. And to read the Vancouver Sun article that ran December 9th, click here.

Breakthrough; Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle

Synopsis: It is 1919 and Elizabeth Hughes, the eleven-year-old daughter of America's most-distinguished jurist and politician, Charles Evans Hughes, has been diagnosed with juvenile diabetes. It is essentially a death sentence. The only accepted form of treatment – starvation – whittles her down to forty-five pounds skin and bones. Miles away, Canadian researchers Frederick Banting and Charles Best manage to identify and purify insulin from animal pancreases – a miracle soon marred by scientific jealousy, intense business competition and fistfights. In a race against time and a ravaging disease, Elizabeth becomes one of the first diabetics to receive insulin injections – all while its discoverers and a little known pharmaceutical company struggle to make it available to the rest of the world.

Relive the heartwarming true story of the discovery of insulin as it’s never been told before. Written with authentic detail and suspense, and featuring walk-ons by William Howard Taft, Woodrow Wilson, and Eli Lilly himself, among many others. 

I absolutely adored this book. As a mother of a child with type 1 diabetes, the discovery of insulin is very close to my heart, so I found it very emotional to read about one of the first insulin recipients. It essentially weaves together 3 separate, but related characters and their journeys towards the discovery of insulin. The writing itself is mediocre, but the story moves quickly, and the outcome, as we all know, is historic.

The first is, of course, Elizabeth Hughes herself, a young girl diagnosed with diabetes when the only "treatment," if you can even call it that, is a starvation diet. For a miraculous three and a half years, Elizabeth survives the diet, slowly wasting away to a mere forty-five pounds by the time she is almost fifteen years of age. Throughout it all, she is cheerful, reflective, and determined to survive.

The second plot line follows the story of her parents, Charles and Antoinette, as they struggle to comes to grips with their daughter's bleak diagnosis, while maintaining an acceptable front for Charles's political life. It is his political connections that, in the end, enable Elizabeth to meet with Frederick Banting and receive the drug she so desperately needs.

The third and final story outlines the ups and downs of Frederick Banting's historic discovery. From the original "aha" moment, to the failed dog trials, to the battles with administration, and eventual breakthrough, the reader gets a glimpse into the life of the infamous scientist.

The climax of the book is, of course, the moment in which Elizabeth and Banting first meet (see WDD: Open a Book), and she receives her very first injection of insulin. From there her recovery is nothing short of a miracle, and she goes on to live a long and healthy life as one of the world's first MDI patients. I would highly recommend this book to anyone who has ever been affected by diabetes, or who is simply curious about one of the greatest medical breakthroughs of all time. 

100 Hundred Reasons to Love Banting & Best

Anyone and everyone who has been affected by diabetes loves and appreciates the outstanding contributions of Frederick Banting and Charles Best. Insulin is not only one of the greatest medical inventions of all time, but for a type 1 diabetic, it is the magical serum that keeps him or her alive. 

Canada is currently in the process of changing all of its paper currency into a new polymer format, which essentially looks and feels like plastic. Each bill is different and the $100 bill is extra special. Why? To celebrate Banting and Best's discovery, the Canadian Mint has featured a bottle of insulin on the new $100 bills. I remember seeing a little promotional video months ago, which featured information about the new bill, but then I completely forgot about it. That is, until my husband came home with one last weekend and showed it to me. Check it out!

The new Canadian $100 bill - see the insulin bottle?

For the umteenth time this year alone, thank you Banting & Best, for your dedication, creativity, and genius in discovering the drug that keeps my son alive.

Say WHAT?

What's the most ridiculous thing you've heard about your health or your condition. Was there any context? What did you think at the time you heard it - and what do you think of it now?

As with any chronic health condition, there are always those who think there are magic pills, super foods, or quick fixes to "cure" their disease. From cinnamon cures, to positive affirmations, to the Reader's Digest fiasco this past April (see my response here), misinformation is abundant in the health care community, and diabetes is no exception.

I can't begin to count how many times uneducated or misinformed people have suggested to me that my son got diabetes because he ate too much sugar, or didn't get enough exercise, or because someone else in our family had it. There have been too many, "Oh, I thought diabetes was just an adult disease," and, "Only people who are overweight have diabetes." I used to get mad when people made such ignorant comments, but over the years I have become less inclined to retort with anger and now simply try to correct them in the simplest and quickest way possible.

Type 1 diabetes is not curable, reversible, or stoppable. It can affect anyone of any age, weight, sex, and ethnic background, and it not caused by lifestyle choices. 

Every person in the world relies on insulin to stay alive. Without it we are ALL dead. But for most of us, cells in our pancreas automatically control the amount of insulin we produce. We eat, we produce insulin. We fast, or exercise, our body reduces insulin production. This process happens over and over throughout the day automatically. We don't need to tell our pancreas to secrete insulin any more than we need to tell our heart to beat or our lungs to breathe. It just happens.

In a type 1 diabetic, however, the immune system attacks and kills the cells in the pancreas that produce insulin, and therefore the patient must obtain insulin from one of two sources, either by injection or by subcutaneously, via an insulin pump. This means they must know exactly how much insulin to take at any given time. Too much, and hypoglycemia occurs, in which case the person needs fast acting sugar immediately or coma, or even death, can occur. Too little insulin, and the result is hyperglycemia, which over time can cause a range of nasty side effects ranging from blindness, to kidney failure, to amputation, and even death. It is a very delicate balance of food intake, activity level, and insulin and a type 1 diabetic must attempt to manage this balance every minute of every day for the rest of their lives.

Let's face it: it sucks. But there are scientists working around the world to make diabetes management easier and more effective so that kids like my son can live a long healthy life. And until there is cure, we will do what we can to manage the disease as best we can: weigh and measure food, count carbs, monitor activity levels, illnesses, growth patterns, weather changes, stress levels, and even mood swings. And take insulin to stay alive.

Activist's Choice: 6 Years with Diabetes

Write about whatever you want today!

Two days ago (Nov 21st) marked Dylan's 6 year diaversary. An anniversary of the day on which we received news that would forever change our lives. 

6 years of living with diabetes! Sometimes I can't believe it has been that long already; other times I can't remember our lives before diabetes.

What does 6 years with diabetes entail? Let me give you an basic idea...

13,158 blood sugar tests

2,190 insulin injections by syringe (pre-pump days)

488 infusion set changes

52,632 units of insulin

1 faulty pancreas

And these numbers are conservative. These numbers represent the basic, essential diabetes care Dylan needed in the past 6 years in order to stay alive; the minimum 6 tests per day, and infusion set changes every 3 days. They don't include extra testing when ill, at night, or at non-eating times. Nor are they representative of  faulty infusion sets or ones that fall off early. And they don't reflect all of the curve balls that diabetes has thrown our way over the past 6 years. They are the basic. The minimum. The life or death requirements.

So as Dylan nears his 11th birthday tomorrow, and continues through year seven with type 1 diabetes, I am grateful for the medical advances that keep my son alive today, but I still hold on to the hope that someday there will be a cure for this all encompassing disease.

"Excuse Me, Where is the Banting & Best Museum?"

Until recently, this questions went unanswered, as there was no museum dedicated to Banting & Best, the Canadian researchers who discovered insulin and forever changed the lives of millions of people around the world.

This week, however, that finally changed. The exhibit, entitled "Insulin: Toronto's Gift to the World," opened yesterday at the MaRS center in Toronto, Canada. It not only shows how the scientists discovered insulin, back in the summer of 1921, but outlines the continuing legacy of their work both in Toronto and around the world.

Those visiting the permanent exhibit can see a video, plus items from Banting and Best's laboratory, including scientific equipment used by the pair, as well as a collection of photographs, letters, and documents. There is even a selection of vials of insulin dating back to the 1920's.

Insulin vials from the 1920's to now

Banting and Best's discovery is one of the most important medical advances in history, and remains today one of the "most spectacular therapies that medicine has in its arsenal." (Bliss, The Discovery of Insulin). \

Banting won the Nobel Prize in October of 1923 for his incredible contribution to medicine, but creators of the exhibit hope that it will inspire a new generation of diabetes investigators to help find the ultimate grail: a true physiological insulin replacement.

For complete article, visit http://www.healthzone.ca/health/article/1076505--exhibit-celebrates-insulin-toronto-s-gift-to-the-world.

"O is for Outrage" ~ 90 Years of Insulin and We Still Haven't Got it Quite Right

Today marks the 90th anniversary of the discovery of insulin, the drug that keeps my 10 year old son alive. He, along with thousands of others, simply would be here if it weren't for the incredible work of Dr. Banting and Dr. Best. And while I am, and always will be, eternally grateful for this miracle drug that provides life-sustaining therapy for my son, I find myself unable to comprehend how, after 90 years, there can still be people on this planet without access to insulin.

This is simply unacceptable. We MUST do better. 

On that note, the International Diabetes Federation has launched the "O is for Outrage" campaign. Their wish is for President Barack Obama show the world that he is committed to the prevention and control of non-communicable diseases (NCDs) by attending the UN Summit Sept 19-20, 2011. 

What can you do to help the IDF? Visit their website and create a postcard, or use one of the templates provided. Submit it directly via their site, or save it and email it yourself. For full information, postcards, and to read more about the International Diabetes Federation's "O is for Outrage" campaign, visit: http://www.idf.org/O_is_for_OUTRAGE

Spring Cleaning Diabetes Style

Have you ever gone to change an infusion set or give an injection only to discover you are completely out of insulin? And I don't mean that the current vial is empty, I mean totally out - every blood glucose kit, emergency bag, even the extra stash in the produce drawer in the fridge. All of it. Gone.

I usually pride myself on being very organized. It is one of my strengths, though at 8:30pm last night, when I went to change Dylan's infusion set, I suddenly realized that I didn't have even a drop of insulin anywhere in the house. "How much is left in your pump reservoir?" I asked him, thinking maybe we could buy ourselves another night with that, and I could pick up more insulin from the pharmacy in the morning. "3.1 units," he says. Crap, I think to myself, that will last all of what, a few hours? He currently takes about 30 units per day, so 3.1 units right before bed, is simply not an option.

An emergency late-night trip to the pharmacy and we're back in business. Sure it was a little past bedtime at this point, but the alternative is unthinkable.

"How did I let that happen?" I kept asking myself. But I already knew the answer. I've simply been too busy lately and I've let things slide, even something as simple and necessary as reordering prescriptions. So I decided then and there that I would do a complete overhaul on my "diabetes cupboard." You know what cupboard I mean, we all have one, the place in your house that you keep all the supplies - the extra glucose meters, the strips, the pump supplies, the fast-acting sugar. But I highly doubt that most are as disastrous as mine was today!

I started by taking everything out and laying it on the kitchen counter. Wow, it was like a medical supply store threw up in my kitchen; there was stuff everywhere, some of which I didn't even know I had, some of which I had been keeping for far too long. Slowly and surely I went through it all, throwing away 2 expired glucagon shots, 2 expired bottles of ketone strips, and 1 glucose meter that I don't remember ever seeing before, and that we have never had any strips for. There were cans of Glucerna (Dylan drinks them when he's sick) that expired in 2007 (wtf?) and lollipops from Halloweens of years gone by. All in to the trash.

Next I got down to the nitty gritty - the glucose meters, or "kits" as we call them in our house. "How many kits do you think we have in the house right now, Dyl?" I asked him. "I don't know, 6?" he responds." "Ten!" I tell him. Ten! Plus the one in his classroom at school, the one in my car, the one at Grandma's, and probably another half a dozen at his dad's house. How can there be many, and yet sometimes we are hard-pressed to find one? The answer lies not in the number of kits, but in the number of WORKING kits. I opened every one and made sure each had a pricker, extra lancets, and a full bottle of strips. They all did. Then I checked power; only two had battery life, the other eight had dead batteries. Wow.

Finally, I reorganized all the other diabetes related paraphernalia, made a list of all the items I need to reorder, admired my neat orderly cupboard, and wrote a reminder in my calendar to inventory the diabetes supplies on a regular basis, so running out of insulin NEVER happens again.