I received this question from an anonymous poster on my 'Ask Me Anything' discussion board.
From posts and talks, it seems you are the only caregiver of Arden's diabetes. Understanding you're a stay at home dad, probably works easier that way, but I was curious how your wife is involved.
This is a great question and I am very glad that it was asked!
It was clear almost from day one that Arden's diabetes was a full-time job and that the 24/7 nature of the disease required a full day view of the events that not only transpired today but for the days prior. Those truths make handing Arden's care back and forth problematic. With that knowledge Kelly and I decided that one of us should be the primary and because I am a stay-at-home dad I was the obvious choice. If we were making the decision based on who was prettier, smarter or more detail oriented, Kelly would have gotten the job!
Arden's Day is written from my perspective and I don't share my stories in other's voices so it may seem like Kelly isn't as involved as she is. This is an unfortunate side-effect of blogging and why I was so glad to receive this question. I can be wordy so in an effort to keep my post to a readable length I avoid writing a lot of dialogue. Whether or not my writing is in any way special is up to the person reading it but I think my strength is bringing a reader into how I feel and allowing them to leave the text with the emotions that I experienced. I find that when a post has too much, 'and then he said this and I said that' things have a tendency to get muddled. In an effort to stay as short and sweet as my gabby mouth allows, I simplify some situations and combine characters. If Kelly and I confer for example, I may just relate that conversation to you as an inner monologue.
All that behind the curtain stuff aside... here are the ways that we manage things at our house.
During an average day I handle type I autonomously. I wake up every morning before Arden and check her BG and make adjustments if necessary so that she can begin her day with an in-range number. I come back into her room about 30 minutes before she eats breakfast and we pre bolus for the meal. During the school year Arden and I converse via text and phone throughout the day and make decisions together about her insulin, food and other type I needs. I am here when she arrives home and we take care of meals, bedtime and the rest. I wake up or often stay awake throughout the night to help keep her BG from causing issues as she sleeps... then we do it again. I take care of OmniPod changes, DexCom insertions, I order and maintain the supplies and go to the doctor's appointments. We handle things this way to make the best use of the knowledge base that continual exposure to type I care brings to me, not because Kelly can't or doesn't know how to handle them on her own. Kelly has a rather high pressure, long hour type of profession that uses a great deal of her time. We like to keep the time that she has left available, as best that we can, for her to enjoy our family.
When all of this gets the best of me, and it frequently does, I reach for Kelly and she takes over until I can be ready again. Kelly will take an overnight for me a few times a month and there are days on the weekends when she manages Arden all day and night without my involvement to give me a break and keep her up-to-date with how Arden's type I management is morphing. It's difficult to pass care because there are so many little tricks that I use and adjustments that I make on the fly, these small but important decisions are bred from countless hours of managing diabetes and can't be easily passed on to another CareGiver. For example, I gave Arden more insulin this morning then I usually would have based on three factors; a BG that we got yesterday at the same time of day, the fact that she is on the first day of a new pod and a spike that I saw on her CGM overnight. You just can't teach that stuff and it takes a lot of time to absorb, if Kelly (or anyone else) were to have began the day caring for Arden they wouldn't have the benefit of those three experiences and would have no way to know that a change was required. In kind, I didn't know until I took the last steps of the morning and put it all together in my head. It really is true that diabetes management is more of an art then a science!
I know from speaking to some of you that the method I described is very similar to how many two parent homes handle type I management. I think that each parent needs to have a working understanding of the way type I is handled because everyone needs a break once and a while and care shouldn't have to suffer during the moments of respite. I feel extremely lucky to have Kelly waiting to take the meter from me when I pass out, it's an ugly baton pass that very frequently begins with me slumping over on the sofa.
I'm going to borrow a passage from my own book and share it here. The book is only in it's first revision so this bit may or may not make it past editing but it will tell you all you need to know about Kelly and what she means to me and our family. I wrote this passage in the chapter that tells the story of Arden's diagnosis and subsequent hospital stay...
On the nights that are the hardest I think about Kelly in that crappy vinyl chair, sitting with sand in her ass, legs asleep and having to pee for the last twelve hours and I keep going in honor of what a great mom she is to our kids. I try my hardest to respect the fact that if our roles were reversed and Kelly was the one staying at home that she would provide daily that same level of care, love and concern that she did that day. I do what I do because it keeps Arden healthy, I do it because I love her, but I do it the way that I do it with Kelly’s example as my guide.
