Holy @#%&*$% A1C
Seven years in dog years is what, 49? Well in A1C years, it's 28. Arden has had twenty-eight A1c tests since she was diagnosed and most of them didn't go too well. As I've shared in the past, Arden's A1c began it's journey above nine and drifted lower over the years as I learned how to better manage diabetes. It wasn't until recently that we've made real strides in decreasing that elusive number.
From the American Diabetes Association's explantation of Estimated Average Glucose (eAG) - check it out!
August is rapidly approaching which can only mean two things around here. The seven year anniversary of Arden's diagnosis, and the sixth anniversary of this blog are both coming soon.
Seven years in dog years is what, 49? Well in A1C years, it's 28. Arden has had twenty-eight A1c tests since she was diagnosed and most of them didn't go too well. As I've shared in the past, Arden's A1c began it's journey above nine and drifted lower over the years as I learned how to better manage diabetes. It wasn't until recently that we've made real strides in decreasing that elusive number.
I spoke in the past about the things that I attribute to helping Arden's A1c to fall. Things like finding the correct insulin for Arden, and technology like her DexCom G4 and OmniPod insulin pump. I recently wrote about Arden's decision to stop eating Fruit Loops and I think that may have put us over the top in this battle against "the number".
One year ago Arden's A1c was 8.1. Nine months ago we made real progress, 7.5 and back in January it was 7.4. I loved that 7.4 because it showed that the reduction wasn't a fluke, we were on to something! Today when we went to her Endo appointment I was certain that we would see another incremental reduction, and I was secretly hoping for 7.1. As I watched the timer count down on the testing equipment, my heart sped up just a bit. The last 10 seconds ticked away slowly, as I hoped to see that 7.1.
I'm not sure how I kept the words in my head when I saw the number, but somehow I didn't say, "Holy F*ck" outloud when the machine displayed Arden's latest A1C.
It was 6.5.
Six point five.
Six and a half.
Arden's A1c had dropped .09 in five months. I must of read that wrong I thought, so I stood up and looked closer and there it was just as clear as day, 6.5. I turned to Arden and said, "We did it Arden!". Then, without missing a beat, Arden warned the nurse that I was going to cry - but I never did. I wanted to cry, I wanted to scream into the air but I just sat back down, smiled, and told the nurse how Arden decided all on her own after our last visit to stop eating cereal for breakfast. "This was all her", I told the phlebotomist, "Arden asked after her last A1C what she could do to help it to go lower and I told her... she did the rest".
Back in February when Arden's A1C was 7.5 I listed a few simple reason that I thought helped the most to decrease her average daily blood glucose. I'm going to post them again here and then add two new ones.
Support - Love and support from family, friends and teachers is huge.
Insulin Pump - Being able to give insulin quickly and unobtrusively for meals, snacks and high BGs.
CGM - Arden's DexCom is a window to the past, present and future of her BGs and I couldn't make the pinpoint adjustments that helped us get to this new level without it. It's sad to me each day that the FDA doesn't approve it's use for young people.
Over night monitoring - Arden is sleeping almost half of each day, if you can control the night then a few bumps during the day don't hit the A1c average so hard.
Apidra - Arden's BGs are move stable on Apidra then they ever were with the other insulin she was using in the past. Make sure you are using the insulin that works best for you... not just the one some sales person gave your doc.
D.O.C. - You all give me strength to do these things when I otherwise feel like I can't. It's knowing that one of you is awake, sad, crying, happy or running around out of your mind like me that makes me realize that I'm doing okay.
new
Aggressively dealing with BG spikes - You know the ones, after a site change or miscalculated meal. In the past I preferred smaller boluses in the attempt to avoid a low but now I lean on the CGM and smack a high number in the face, preferring to catch it with carbs if I've administered too much insulin. The other way always left me bolusing and rebolusing for hours on end. The only thing I was accomplishing was taking five hours to guide Arden's BG back into place. Now, insulin, watch, catch the fall - done.
The new way that we manage BGs during the school day - Arden has four more days of school left this year and she has NEVER been to the nurse for a diabetes related reason, never. Arden and I text and speak by cell phone to manage her moment to moment type I needs. This new plan is one of the keys to her A1C reduction. In the past, I would make insulin and carb decisions only when Arden was with the nurse. This schedule left large gaps of time when high BGs, miscalculated carbs and the other diabetes anomalies would be left unaddressed. Now, Arden can text me if her BG is slightly elevated after lunch and we make small adjustments as we would if she was home with me. Lows are handle in kind, no more big carb intakes because I won't be in contact with Arden for many hours. We bump borderline lows and readdress if that bump didn't do the trick. No longer is the school day an eight hour crap shoot, Arden's diabetes is being dealt with immediately when in acts up. I plan on speaking more about this at length in the coming months.
This seems like a good time to remind you that I am not a doctor and that there is a clear message at the bottom of this page that insists that you never take anything that I say as medical advice because I do not mean these words to be such. I would however suggest talking about these easy adjustments with your doctor...
Update
on 2013-06-11 19:02 by Scott Benner
I originally posted an image with this piece that had some bad information on it. Thank you to Sara (@saraknic on Twitter) for pointing it out and leading me to the new graphic from The American Diabetes Association. Please check out their page about Estimated Average Glucose (eAG) and howitrelatestoA1C. Very cool stuff!
What have you always wanted to say to your child's teacher
Is there something about type I diabetes that you always wanted to say to your child's teacher but just couldn't? A fact or maybe a personal story? Have you ever dreamt of telling the administrator (that looked at you cross when you asked for an addition to your child's 504 plan) that you haven't slept through the night in countless years? Have you even once considered telling someone to go $%#@ themselves but instead smiled and nodded?
Tomorrow I will be giving a workshop at the Hamilton, NJ Barnes & Noble to fifty teachers about 504 Plans from the families perspective. We'll be talking about why I think that forming good relationships is so vital for not just the child, but the family, the school and the educator.
If you have something that you'd like me to pass on into the world, something that you think would help an educator to better understand our lives - I'd love to carry your message to them.
I genuinely believe that if the school could just get a glimpse into the world that we live in, they would become better partners in our children's education... and not just for children with type I diabetes.
There are so many families that would benefit from that understanding. Tomorrow I'm hoping to send a message that will reverberate beyond the few districts that will be represented. I want to leave them with a story that they will be touched and informed by, one that they will want to retell.
More information about the event is here on Barnes & Noble's website.
Readi Pak from Sanofi (GiveAway)
Did you know that Sanofi recently launched a multi-purpose bag venture? I didn't either. The entire thing seemed a bit odd to me at first, so I reached out to them with a few questions.
Was Readi Pak a company that Sanofi took over/rebranded?
Sanofi US designed Readi Pak after recognizing a need for a convenient and discreet way for people living with diabetes to carry around their diabetes supplies.
What made Sanofi get into this business? What is the goal?Sanofi strives to help people manage the complex challenges of diabetes by going beyond the molecule to develop and deliver best-in-class innovative, integrated and personalized solutions that address real needs people have in managing their diabetes every day. We designed the Readi Pak after recognizing a need for a convenient and discreet way for people living with diabetes to carry around diabetes supplies. To make this a relevant solution, we wanted input on the design and usability of the bags from those newly diagnosed with diabetes and shared our early prototypes with a small local student group (many of whom have type 1) for their feedback and opinions. We are pleased to offer new products such as the Readi Pak in order to help people manage their diabetes every day.
Are there plans to expand with other products?
At this time, this is a pilot program and we do not have any plans to expand or other products under development. However, our vision is to serve as a valued partner to the diabetes community by listening and engaging in a dialogue directly with people living with diabetes, and these conversations help us identify new opportunities to provide diabetes solutions that are truly relevant.
Now it makes sense to me why the company that makes Arden's insulin got involved in the D-accessory business. I've seen and used a Readi Pak and it's a solid product, appears very well made and was designed with diabetes in mind. It comes with a removable kit for your more often touched supplies and has plenty of room for all of the rest. It even has a reusable ice pack.
Enough of all that, let's get to the fun part.
I have three Readi Paks, one Camouflage, one Blue and one Pink Swirl (that I used to evaluate the bag (it's clean/new don't worry) to give away. I don't have many giveaways so please don't expect an elaborate system to be put in place to choose the winners. What you can expect is this... I'll be putting names in a hat and then asking Arden to draw them out. I assume no liability and offer no warrantee for the bags. If that sounds good to you... read on.
Anyone living in the U.S. (and that's only because I'm paying shipping) that is interested in winning a Readi Pak should comment below "Please Enter Me". Be sure to leave your email address in the provided place so I can contact you for a mailing address if you win. The drawing will be, let's say, Saturday, December, 22, 2012. Entries arriving before 9 AM on that day will be included in the drawing. Please include your color choice in the comment and I'll do my best to get it to you. There is only one rule, please just one entry per physical mailing address.
To learn more about the Readi Pak and to see the other colors, go to https://www.readionthego.com
I was not compensated by Sanofi/Readi Pak for this post. I'm even giving away the bag that was offered to Arden.
You can quickly become a site member to stay informed of future GiveAways and announcements. I'll be giving some copies of my book away early next year.
This GiveAway ended in December of 2012.
Argo
We don't have many diabetes ready babysitting options, and so we don't go out very much by ourselves. I'm sure that sounds familiar to a lot of you. Earlier in the week I found myself wishing that Kelly and I could get away for a couple of hours and then it dawned on me...
We don't have many diabetes ready babysitting options, and so we don't go out very much by ourselves. I'm sure that sounds familiar to a lot of you. Earlier in the week I found myself wishing that Kelly and I could get away for a couple of hours and then it dawned on me... Arden and I are managing her blood glucose so well via text messages from school with no adult involvement, why couldn't we do the same with her at home and me in a remote location?!
I enlisted my mother to babysit and told her that there wouldn't be any diabetes related decisions to be made. So with the comfort of knowledge that our New School Plan has brought, Kelly and I made our way to the cineplex and saw a movie that didn't have one, not one, talking animal in it!
It was the opening night of 'Argo' and so the theater was packed. Since we couldn't find a seat without a direct neighbor, I felt like I owed the person sitting to my left an explanation for why I'd be texting during the movie. A few moments before the trailers were about to begin I excused myself and spoke to the woman sitting next to me.
"Hi, I'm sorry to bother you. Our daughter has type I diabetes and I'm going to be helping her manage her insulin by text message during the movie". I was prepared for about a thousand different responses, every possible reply except for the one that I got. "Us too, well, our daughter has type I too", she said. "She's older now... how old is your daughter, when was she diagnosed?". We chatted for a few moments about our girls and then she said not to worry, put her hand on mine and told me that she hoped we enjoyed the movie. I smiled and said, "you too". It was like twitter, but in real life.
I guess we can get out more often now... It's been so long, pretty excited!
Oh, and both Kelly and I thought that the movie was excellent, really, really well done. Suspenseful and tense, even though we knew the outcome.
Emojis for texting DexCom data: A New School Plan Update
We are three weeks into the 2012 school year and I am back to report some amazing news. I'm not even sure I believe this, but Arden has yet to visit the school nurse for anything diabetes related. Not once, nada, zero times!
Our New Plan is working even better then I imagined due in large part to how smooth technology has made the transition. Apple's latest upgrade to the iPhone software included the addition of an emoji keyboard and we are making good use of it in our conversations about type I.
We try to keep our interactions as short as possible to minimize the time Arden is distracted from her school work. I estimate that our plan saves Arden from missing between forty-five minutes and an hour each day of class time, but there is always room for improvement. So when I noticed that our texting conversations were taking more time then I thought they should, I wondered why. Arden and I spoke and it turned out that she was struggling to spell some of the words that we use to discuss her DexCom CGM data. Words like, diagonal and horizontal. Other issues were less to do about spelling and more about word count. For example, "189 diagonal up" or "143 straight across". That's when I thought, "if there is an emoji of a heart, dress, shoe and dog pooh there must be arrows".
and there was...
So now we are speaking to each other with even more economy of time and our texting conversations have been trimmed in half, which makes more time for learning.
Emoji can be activated on Apple devices running iOS 6 like so. Settings>General>Keyboard>Keyboards>Add New Keyboard>Emoji. If you talk to your child about their DexCom data via text message this is more then worth your time to set up.
Another nice feature to check out is 'Send Read Receipts'. This one is great not just for diabetes, but for every parent/child texting conversation. Send Read Receipts allows you to see when the person on the other end of your conversation has read your message. It looks like this...
This setting is accessible by taking these steps. Settings>Messages>Send Read Receipts. Changing the setting to on "Allows others to be notified when you have read their messages". No more wondering if the person you are texting with has seen your message. Turning this feature on is a no-brainer for parents, but if you are trying to avoid someone... that's a whole other consideration.
