Karma Ebbs, Karma Flows

As you read keep this thought in the back of your mind... "The story is about a juice box that saved the day"

This story begins weeks ago on a day that was one hundred and fifty percent unlike any day that I've ever experienced. I woke up early that morning to travel to New York City to be part of a panel of stay-at-home dads for an episode of the Katie Couric Show. A shiny black car arrived early that morning to transport me for a few hours to a world that I'd never before seen. Green rooms, backstage areas, even people styling my hair and applying makeup to my face - it was strange, fun and more than a bit exciting. When my time on television was over, I climbed back into the shiny chariot only to find an email from the National Basketball Association that featured a story about me. I read the article (written by the DOC's own Moira McCarthy) and then closed my eyes for a few minutes because I was already exhausted from the day. I needed to catch a bit of sleep on the ride home because this crazy day wasn't nearly over, I still had to sign books at a Barnes and Noble in Philadelphia that evening, like I said before... a day like no other.

So to recap the morning... Fancy black cars, Katie Couric, I met Steve Schirripa from the 'Sopranos' in the makeup room, joking in front a a live studio audience and a my name on an NBA email blast that landed in a half of a million inboxes across the country. And in a few hours I was going to get to sit in a book store and sign my book. All extraordinary stuff that no one imagines will ever happen to them, and it was happening to me all on the same day.

The book signing went great, one of the real highlights was when I met a gentleman who reads Arden's Day and his son. The best part of the night? Arden came with me to the signing. Perhaps this book writing thing will lead to more and maybe it won't, but for a few hours that night my little girl got to sit next to her dad as he signed his name in a book he wrote. You don't get too many opportunities in life to be a hero to your kids, this day was special. 

As Arden and I drove home that night through a teeming rain storm, we talked about the day. She asked me about what it was like to tape a TV show and we anxiously spoke about what the vacation that we were leaving for in two days would be like. It was as we were talking about our impending trip that I saw a small group of children standing on the side of the road. I instantly wondered why they were outside in the rain and it was so late at night. Then I got my answer out of the corner of my eye when I witnessed one of the kids reaching back as if they were going to throw something. I remember thinking, "Aw fu$k...". 

Bang, pop, thump, thump, bang, bang, crash...

The right side of my car was being pelted by hooligans, malcontents I tell ya... We were under attack. I stood on the side of the road staring through the rain hoping that I could see one of the little bastards, but they were gone. Arden was frightened, I was angry and the rain wasn't giving up, so I got back into the car and we went home. I stood in the rain washing my car and wondering what the light of the next day would reveal. When I woke the next day I was greeted by multiple and significant points of damage. I informed our insurance company and we left for our vacation.

Fast forward to yesterday...

This morning the insurance adjuster came to our house to assess the damage. A few minutes before the adjuster was finished, Arden wandered outside with that "just woke up" look on her face to find out what was happening. As she was fresh from her bedroom, Arden had her bag full of D-Tech with her. OmniPod PDM, DexCom receiver, MultiClix and a juice box all in a small leather purse. She set the bag down on a box in our garage and walked over to me to find out what was going on. Arden and I decided to pass the time as we waited for the gentleman's assessment by cleaning up the garage and taking the recycling down to the corner. 

Soon enough the adjuster finished and I asked Arden to move out of the way so I could put my car back into the garage, but she wanted to ride with me for the ten foot trip and so she climbed into the passenger side instead.

Moments before I was joking with the insurance guy about the day that my car was attacked. I told him that I must have used up all of my allotted good karma when I found myself on TV and at a book signing all on the same day. He laughed and as I sat down in my car to put it back into the garage, I quipped through the window, "I guess the universe was rebalancing itself when those kids pelted us". Then Arden and I drove forward...

POP!

I jammed on the brakes and my stomach dropped as I remembered leaving Arden's bag on the floor when we took the recycling to the street. I backed up slowly and Arden jumped out to see what made the loud pop but I already knew it was her bag. I felt sick when I realized that I drove over her PDM and DexCom receiver. I thought I was going to throw up... But it turns out that the pelting my car took all those weeks before must have been an overcorrection, and it seems that the universe owed my a credit. 

It was a juice box that exploded and acted as a warning signal to stop. Not only that but the juice was in a separate compartment so none of it got on the electronics. I was about to drive right over Arden's PDM, DexCom, MultiClix, and her bag but that little juice box happened to be on one end of the small bag while all of her gadgets were on the other. Thankfully, the juice was closer to the tire than the electronics and they remained untouched by my car's tire. 

Karma ebbs, Karma flows...

Arden pulled her gadgets from the bag and placed them onto the seat that she just vacated and said, "Well... this is the first time that I don't hate those juice boxes". ––– I thought to myself, "Me too".

(Almost) Up in the Air

How many OmniPods would you take on a ten day vacation?

If you were going to leave your home early one morning and drive over an hour to an airport to catch a four hour flight, one that would take you to a remote island location for ten days... how may OmniPods would you bring?

I brought eleven

I also brought two hundred test strips, an extra MultiClix, an entire package of lancet cartridges, one backup OmniPod PDM, a ketone meter with a 50 strips, two glucogon kits, four vials of Apidra, five DexCom sensors, a brick of juice boxes, candy, fast acting glucose tablets, five packages of needles, FlexiFix, AAA batteries, a DexCom charger and three copies of the travel letter that our endo wrote.

Other than the fact that everyone was a mix of exhausted (long year) and excited (we never go on vacations like this), our flight to the Caribbean was uneventful. The TSA experience in New York was fast, pleasant and so accommodating that the multiple juice boxes we brought through screening were treated like medication. Actually, for the first nine and a half days of this vacation all of my extra supply preparation was unnecessary. We never had one issue with our D technology, sensors stayed on, insulin resisted the heat and diabetes was a perfectly behaved travel partner.

It wasn't until we were literally walking out of the door to return home from our island getaway that things began to go the other way. I knew that the odds were stacked against us, I mean, how often do you get to go ten days without a significant diabetes issue that requires your inner MacGyver?

During travel, I keep enough supplies in my carry on bag to complete one site change. The bag also contains enough insulin and needles to manage for a full day without needing the backup supplies that are in my larger luggage. I lug that stuff with me when we fly with the hopes that I'll never need it.

Was it an omen, probably not... I don't believe in omens, but I did drop a vial of insulin as I was packaging the Apidra back into it's ice pack for the trip home. Fun Fact: I've never broken a vial of insulin until the one in my hand hit the stone floor of our rental home. No matter, I had three more. #prepared

We drove our rental jeep to the ferry, made the short trip from island to island and then jumped into a taxi destine for the airport. It was during that taxi ride that Arden's BG got a little squirrelly, I bolused. TSA was again a dream and before we knew it our bags were off to the belly of the plane. All that was left to do was to grab a pre-flight meal and wait to board. We ate, found our way to the correct gate and planted ourselves in some soft chairs. 

Ferry Departure

BEEP BEEP goes the DexCom

"I must have miscalculated the airport food", that's what I thought when Arden's CGM indicated that her BG was rising thirty minutes after our meal. I reassessed and added more insulin but the beeping continued, soon after the arrows changed from diagonal up to one arrow straight up. Before long, the arrow found a friend... two arrows up. Hmmm, WTF!? Turns out that Arden must have unknowingly banged her leg into something during our trip from paradise to the airport, I noticed a tear on the OmniPod adhesive and the canula looked withdrawn. Interestingly, on the same day that I dropped my first vial of insulin our first canula became dislodged. What a diabetes day we were having, I wonder what could make it even odder? How about my first airport pod change at gate 4. Honestly, it didn't bother me to change the pod there and Arden didn't care... she isn't shy about diabetes in public. So I balanced everything on my lap and set what didn't fit on my leg behind Kelly on the chair next to me. I filled the pod, primed, inserted and removed the old device in a few moments. We tested, increased Arden's basal rate and then busted out a good ole' fashioned needle to combat her wildly high BG of 425. 

I'll admit that I was a bit panicky for a moment, the notion of chasing this high number in the air dind't sit well but then I remembered that we had a full complement of juice and other items. I did experience a wave of dread as I used the only spare pod that I had in my carry on bag. I began to run through scenarios in my mind, how I could talk TSA into retrieving my luggage from the plane so I could get more? But then I calmed down, we boarded the island way (see pic at top) and a number of hours later we landed at JFK airport where Arden's BG was 113. Seems Ben Franklin was correct, An ounce of prevention is worth a pound of cure. Smart guy. I may not be Franklin but I know this for sure... Bring extra supplies when you travel, you never know what may happen.

Luckily, we can only afford to go on a trip like this once a decade, so I have time to rest and recover!

Finally, here are some obligatory vacation photos.

OmniPod, DexCom... you impress me

 

Tonight is the sixth night of our island vacation and I wanted to take a second to report in. So far during our trip Arden has been on an airplane, outside in the rain, lived in 90º heat and spent countless, often consecutive hours in the ocean. 

I am here to report that Arden's diabetes tech has not skipped a beat... I can't tell you just how invaluable these tools are in difficult situations like these. Between odd sleep times, varied and strangely timed meals and all of the activity, there is enough going on to mess with even the most Zen diabetes guru. I am not ashamed to tell you that I'd be just a little lost without our gear. 

I'll leave you with a picture of Arden in a mango tree.

I hope everyone is having a great week! 

Number Thirty Seven

Have you ever heard that if you ask a person to name a number between one and one-hundred, the most common answer that people give is thirty-seven?

I don't know if that's something that can be proven mathematically but I have noticed it a lot over the years, that number just pops up all of the time.

Arden's All-Star softball team competed in their All-Star tournament last week. They played their first game on Thursday night and lost. Friday was rained out so they were scheduled to play two games on Saturday but they couldn't lose again or they would be out of the tournament - you can only lose two.

Thursday's game required a large bolus to battle Arden's adrenaline and the same was needed for the first game on Saturday. They won that first game Saturday and after a thirty minute break to recharge, they played again. During that second game her BG held steady until about the fourth inning. Arden's DexCom CGM was hung on the fence of the dugout during the games and I would check it every inning or so depending on how her BGs were acting. Arden ran out on the field when the forth inning began, as she did I walked into the dugout and looked at her CGM. Her BG was 120 with two arrows pointed down, she was falling fast but I knew that a juice box would handle it. I was actually waiting for this fall. Arden ran in to the dugout, drank a juice box in about ten seconds and ran right back to third base. Her BG balanced out as I expected and the girls won the game about an hour later. When Saturday ended, the team was 1 and 2, and scheduled to play again the next day at 1pm.

Arden's BGs were on the low side overnight, as I expected they may be and I handled them with a little juice and some temp basals. Nothing out of the ordinary after a day of activity.

Sunday brought high temperatures and a clear sunny sky, it was very hot. The girls warmed up at twelve-thirty, the game began at one and the adrenaline hit her about 45 minutes later. I bolused when her BG began to climb but I was too late, Arden's BG was on the move. I tried desperately to get it to come back down without going to low. Arden has trouble running when her BG gets above about 200 - she is normally very fast but above 200, her speed and dexterity become average, so my goal is always to keep her under that number when she plays. They won the first game and the next game was going to start in a half an hour. Arden's BG wasn't moving but I still only gave her a slight bolus (.20) for all of the food that she ate after game one. I thought that the .20 was a conservative approach to her game break snack as I was still leary of a fall from the earlier adrenaline bolus. 

We were now into the second game and my plan was to check her CGM after the third inning. The last time I looked at it was before the second inning began, it read 192 with an arrow diagonal down. Before I could get up after Arden made the last out of the third inning, she ran through the gate toward me holding her hands over her head and gesturing for me to come to her...

"I feel really dizzy!"

I didn't bother to test before I handed her a juice. She sucked it down as I tested her free hand...she was 37.

I said to Kelly, "Give her another one" as I ran to get the CGM from the fence. Arden's BG was dropping so fast that the CGM hadn't caught up yet, it read 101 but now both of it's arrows were pointed down. Arden's BG was falling way too fast, she drank two juices, ate a fast acting tablet and was now chewing on a handful of Mike and Ike's. I tested again, BG was 49 and she was still very dizzy.

Arden and I went into the dugout to get out of the sun, she alternated between sipping cool water and fuetly holding her head to try and stop the dizziness - seeing her press her hands into the side of her head broke my heart. I hugged her as she laid into me, I quietly told her that it would stop soon. We tested again, 69 but the arrows on the CGM were still pointed straight down. I decided to follow what the meter was indicating, I believed that her BG was climbing and stoped considering more carbs. It was then that Arden's place in the lineup came up... it was her turn to hit. "They can skip you for one inning", I told her.

"I can hit", Arden stood up squeezed her head between her hands one last time and put her helmet on, we tested again and her BG was 131 but she was still feeling the low. What came next was Arden's only strikeout of the tournament. She fouled off two pitches, running them both out before swinging and missing the last pitch of her at bat. I sat in the dugout staring at her, I was sure that I shouldn't have let her hit but I just couldn't find the parental wisdom in telling her that diabetes was going to make her miss that at bat. Secretly, I was so happy that she didn't get on base because I didn't want her to run but you can't imagine how proud I was of her for trying. She sat out the next half inning, opting to lay on the bench with her head on my lap so she could try to get her bearings. She only said two things to me during that time... "It's getting better" and " I can't believe two balls went to my position". She was annoyed that she missed the opportunity to make two plays.

When her team made the last out, she sat up, looked at me and said, "I'm okay, go back with mom".

Arden and her team went on to win that game and then they won the next one too. They never lost after losing the first game on Thursday and they won three in a row on that hot Sunday afternoon. I'm still not positive that I should have let her hit but, well, check this out...

 

That's Arden holding her trophy. Her team won the 2013 eight year old All-Star tournament last weekend! She played all but three outs in the field and never missed an at bat. Arden beat all comers, including diabetes - I think that if I was any prouder of her... my heart would burst.