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Mommy’s Insulin Pen and a New Year’s Resolution

December 31, 2010 by sue campbell

At seventeen-years-old, my sister, Rachel, was attending college in our hometown.  She timed her entry to campus buildings with the movements of other students, as she was too weak to open doors herself. She had lost weight and slept all the time.  When she finally went to the doctor, she was diagnosed with Type I Diabetes. 

A non-diabetic person has blood sugar levels ranging from 80-130 mg/dl. At 180, you begin to experience the classic symptoms of diabetes: extreme thirst, frequent urination, fatigue, dry skin.  Rachel’s sugars were over 600 mg/dl.  She was admitted to the hospital for immediate treatment.

When you eat carbohydrates, your body turns them into glucose. Insulin is a hormone that allows glucose to be used by the cells of the body for energy. It’s frequently described as the key that unlocks the door to the cell to allow sugar in. Type I Diabetes occurs when, for unknown reasons, the immune system attacks and kills the cells of the pancreas that produce insulin.   Without insulin, sugar builds up in the blood stream and the body begins to burn fat for energy instead of sugar, producing an acidic substance called ketones.  The build up of ketones is known as ketoacidosis and, if left untreated, it is fatal. 

At nineteen, my sister developed her own strategy for dealing with diabetes.  She didn’t exactly like having to give herself shots all day, so she decided to take only a daily shot of long-acting insulin and forgo eating carbs of any kind.  Needless to say, this strategy didn’t work so well.  She kept losing weight and her hair began to fall out.  One day she found herself vomiting uncontrollably with what she thought was food poisoning but was really ketoacidosis.  She passed out in the bathroom and was taken to the hospital in a diabetic coma.  Happily, she recovered.

Before insulin therapy was discovered in the 1920s, Type I Diabetes was a death sentence.  Most patients lived less than a year after diagnosis and most of the victims were children (Type I is sometimes referred to as Juvenile Onset Diabetes).  Diabetes treatment has come a long way since then.  While the first blood glucose meters were as large as a backpack, modern meters fit in your pocket.   There are several choices for insulin delivery (insulin must be injected, as it doesn’t fair well against stomach acids): syringes, pens or even pumps.  Today, my sister wears an insulin pump, which delivers a steady dose of insulin through the day, and extra insulin at mealtimes.

As long time readers of this blog know, I also have diabetes.  I was diagnosed with Type II Diabetes in June 2009.  However, I don’t exactly fit the profile for Type II.  Type II is categorized by insulin resistance.  When a person eats too many carbohydrates, the body counters by over-producing insulin, and over time, cells become resistant to insulin, causing blood glucose levels to rise.  Most Type II Diabetics are over forty and overweight.  I was thirty-three when I was diagnosed, and not overweight.  After diagnosis, I saw a nutritionist and began to limit my carbohydrate intake and increase my exercise, I was able to bring my glucose levels down. 

However, recently, my sugars have been on the rise, despite my efforts. 

There is a test for blood glucose called the A1C.  It measures the amount of glucose that has attached itself to hemoglobin cells and provides an average glucose level of the last 2-3 months.  The A1C results is represented as a percentage, a non-diabetic person has an A1C of 5% or less.  Diabetes is diagnosed at a level of 6.5% and up.  Last spring, my A1C was 5.85% — a good number that made me feel smug about my stellar efforts at Diabetes management.  In November, it was up to 6.5%.  I began testing regularly and was alarmed that my sugars were much higher than I thought.

I asked my doctor to put me on an oral medication called Metformin.  It seemed to bring my sugars down, so after a week, I stopped my frequent testing and went back to my doctor’s recommendation of testing only a few times a week.  But something was still bothering me.  I had read an article about Latent Autoimmune Diabetes in Adults or LADA.  It’s basically Type I, but instead of getting it in childhood, it happens in adulthood.  People with LADA don’t fit the typical Type II profile, they are relatively young and active.  The chances of LADA are increased if the patient has a family history of Type I or other autoimmune diseases.

A few weeks ago, during an office visit for a sinus infection, I asked my doctor for a referral to an endocrinologist, a doctor who specializes in hormonal conditions such as diabetes.  My doctor assured me that the chances of my having LADA were slim, as the oral medicine I had been taking would not be working if I had LADA.  But he gladly wrote me the referral. 

I almost didn’t go.  I felt like maybe I was over-reacting, or being a hypochondriac.  But I went anyway, partly because I wanted to treat my diabetes as aggressively as possible to prevent kidney damage (as I only have one) and partly because my big brother told me to.

As the endocrinologist and I began our chat, I mentioned that I had been worried about LADA.

“I think that’s exactly what’s going on,” she said.  She was gentle but honest.  She told me it was just a matter of time — and not very much time — before I would need to begin taking insulin.  The beta cells of my pancreas were steadily being destroyed by my immune system and I wouldn’t be producing insulin for much longer.  She explained that in the early phases of the disease, glucose levels can be brought down by diet and exercise and oral medications because my body was still making some insulin, but the progression is inevitable.  She wanted me to get used to the idea of taking insulin and meet with a diabetes educator to practice giving myself injections.

She ordered another A1C test, even though I had just had the test just a month ago.  My number had jumped from 6.5% to 7.4% even with medication and increased diligence.  With that result, she told me I’d have to begin insulin immediately.  I would start with a shot of long acting insulin once a day and begin testing my glucose level four times a day.  She wanted me to send her my levels in a week and see me again the week after that.

That night, Ben went to the pharmacy to pick up my supplies.  He and Nora bought me two huge bouquets of flowers.  Before bed, I gave myself my first shot in the abdomen.  It didn’t hurt.  The next morning, my fasting glucose level, always too high for my liking, was actually in the normal range. 

I cried at least a little everyday for the first five days.  But really, I’m quite lucky.  Relative to many diabetics, my glucose levels have stayed low.  And we caught the LADA before my pancreas had shut down altogether.  If circumstances had been slightly different, diagnosis may have come only after a bout with ketoacidosis.

Over Christmas, I traveled to Minnesota where my sister lives and she showed me the ins and outs of her insulin pump and I showed her my phone, where I obssesively track my carbs, meds and blood sugar levels. (There’s an app for that!) 

“Is it true some people have diabetes that’s harder to control?” I asked.  I inherited a fear of the worst from my father.

She was encouraging, “You can handle the most bitch-ass diabetes ever.” 

Likewise, my endocrinologist told me, “You can do anything anyone else can do, it just takes more planning and more work.”

Good thing I’m a bitch-ass good planner and hard worker.

Which leads me to my New Year’s Resolution.  I’m not so worried about my ability to manage my diabetes.  What I want to work on is the stress associated with it.  Management and worry need not go hand in hand.  Rachel’s husband, my brother-in-law, put it best.  There will be times when I will feel down, out and frustrated by this chronic disease, at those times, the best way through it is to embrace it.  I have the tools to live a long and healthy life, I may as well relax and enjoy it.

Happy New Year, friends.  May the year to come bring you blessings that you fully realize.

Filed Under: Big Themes Tagged With: diabetes, glucose, insulin, ketoacidosis, LADA, pumps, resolutions

Guest Post: Campbell Christmas Letter

December 22, 2010 by sue campbell

Every year, my father-in-law, an avid (if not rabid) reader of this blog, writes a killer Christmas letter.  This is too good not to share.  I’m beginning to think he’s Garrison Keillor in disguise…

We are oatmeal people – rather bland, but certainly healthy and hearty. That pretty well sums up our year. And we like it that way.

 Debbie still hasn’t quite been able to grasp the concept of retirement. Yes, she did retire in June as Director of Early Childhood Programs with the Sauk Rapids School District.  But with two part time jobs  — teaching at St. Cloud State and working at the Initiative Foundation in Little Falls, along with some consulting / training work — it looks like real retirement will have to wait.

 Larry, on the other hand, has mastered the subtle nuances of retirement, taking much care to pace himself. His life is slow and relaxed, with bouts of biking, camping, birdhouse building, and live-trapping tribes of maraudering squirrels that persistently attack our gardens. This past summer he diligently captured 38 of those smarmy rodents, and stealthily returned them to freedom across the river. Squirrels have a strong homing instinct, but can’t swim, so it should all work out. Yes, the glass is indeed half full.

 We did a fair amount of biking this summer, including a chunk of the quite hilly Gitchi Gami Trail along Lake Superior. We also biked to Sauk Centre (into the wind), spent the night, and biked back the next day (also into the wind). We must have looked pretty bedraggled when we got to the hotel, because the desk clerk upgraded us to a jacuzzi suite. For once it paid off to be stinky and sweaty.

 Elizabeth is thriving in Minneapolis. She claims that she now loves winter, even after the 17 inches of snow that just fell. Of course, not owning a car in a world covered in ice and snow certainly helps. Lucille, her gracefully aging cat, has lost the last of her teeth, which along with having no claws, renders her to be pretty much useless as an animal of prey. But her role as an ornamental companion is quite secure. We would guess that a steaming bowl of oatmeal would suit them both just fine.

 Miss Nora, The Princess of Portland, is now 3½. She gathers eggs from their chickens daily, but has been dismayed recently because Colonel Sanders (yes, the Colonel is a hen), who lays blue eggs, is temporarily not laying. But when Nora can’t have blue eggs for breakfast, she enjoys a big bowl of oatmeal. That’s our girl! A few days ago Nora proclaimed that when she grows up she wants to marry Santa. Mrs. Santa might have a thing or two to say about that.

 Ben and Sue continue to live an oatmeal-worthy life of contentment in Portland. Ben has been taking some amazing photographs with the last rolls of Kodachrome color slide film that are available. He also just finished custom building a bicycle for cruising around America’s most bike-friendly city. Sue, with a sharp pencil and sharper wit, writes a blog called Mommy’s Pen. She also has had several magazine articles published on parenting and chicken care. On her blog, she describes herself as “a business systems analyst, freelance writer, mother, wife, gardener, knitter, spinner, and chicken keeper.” But never too busy for oatmeal.

 So all in all, our life is good. Our financial advisor urged us to celebrate our retirements by going on a cruise. Nope. That’s just not our style. We went to the Dairy Queen instead. Now if they only made Oatmeal Blizzards, then we could really celebrate.

 Have a Merry Christmas, and be sure to make time for a little oatmeal in your life.

The Campbells

Filed Under: Big Themes Tagged With: bike building, biking, chickens, christmas letters, Dairy Queen, gericatric cats, kodachrome, oatmeal, retirement, squirrel relocation

Kid’s Eye View

December 20, 2010 by sue campbell

If you take a three-year-old to a pumpkin patch, where she gets three slivers in her hand from a prickly stem, then a few days later ask her to draw a picture of a pumpkin, this is what you get:

A small pumpkin with huge red spikes protruding from the stem.

Filed Under: Development Tagged With: drawings, pumpkins, slivers, spikes

On Ice, Snow and Travel

December 16, 2010 by sue campbell

I grew up in Minnesota.  I remember winters where the middle of every street featured a wall of snow, dividing the lanes — there was no place else to put it.  Parking lots were used for snow storage.  You knew spring was imminent when the mountain of snow in the Kmart parking lot dwindled to a dirty hill. 

I don’t remember any buildings collapsing from snow, but years from now, I plan to tell my grandchildren that I was there when the Metrodome collapsed.  They won’t know if I simply set the event back twenty or so years — it will make for a great story.

We’ve lived in Portland for over ten years now.  Once or twice a year, a meteorologist spots a snowflake and the entire city shuts down.  Truly, an inch of accumlation causes people to abandon vehicles in the middle of the street.

But two years ago, there really was a blizzard in the Pacific Northwest.  In fact, it stormed a few times in as many days.  Many inches of snow.  Lots of ice.  Airport closures in three states.  Just a few days before we were to fly in Minnesota for Christmas. 

When I purchased the tickets a few months before, I thought myself clever for avoiding a layover in Denver.  Empirical data told me that Denver was far more likely to have a major winter storm than, say, Seattle.  And who wants to be stuck in an airport for the holidays?  With a toddler?  Nobody.  Nobody.

That Tuesday, all flights were cancelled out of Portland.  We were scheduled to fly out Wednesday morning around 5:00am or something crazy like that.  We packed, it felt ridiculous to pack, but we did it.  In the middle of the night, the power went out.  I knew this because I woke up to pee and the microwave clock was dark.  I woke up Ben and we took showers before we ran out of hot water. We set our flashlights in every room and hauled our suitcases out of the dark house and into the snowy driveway.

We made it to the airport in our all-wheel-drive car with chains on the tires.  So far, our flight was still on time. 

The airport was clogged with weary, smelly, pissed-off travelers, and we walked right by them and onto a small plane. 

We were in the air about twenty minutes when the pilot came on the loud speaker and told us we’d be returning to the Portland airport.  A warning light indicated a door was open.  My eyes closed while dread coursed through my nervous system.  Of course we would crash on the runway, it was punishment for actually getting on a flight. 

We didn’t crash.  We landed in back in Portland.  For the next half hour, the entire cabin listened nervously to the sound of a rear door being slammed repeatedly — Wham!  Wham!  Wham!  — in an attempt to make the warning light go out.  It was not a comforting sound.

Eventually, we were back in the air.  A number of passengers pointed out to the cabin crew that most of us were headed for Minneapolis and were quite likely to miss our connecting flight.  The flight attendants seemed non-plussed.  But, kinder heads prevailed and the plane was held just long enough for all of us to dash to the gate.

We made it to Minnesota, where they know how to handle such things. 

So that was two years ago.  Last year, we flew on Christmas day and some fool on another plane tried to blow up his underwear. 

This year?  I booked us a direct flight.

Filed Under: Family Outings Tagged With: flight delays, holiday travel, power outages, travel with toddlers, winter storms

Archive Edition: Teaching Charity

December 15, 2010 by sue campbell

I’m feeling lazy insanely busy this week, so here is a post from this time last year.  I’m guessing many of you have not seen it, so I don’t know why I’m admitting this is old…

Every year, North Clackamas Fire District #1 does a food drive where they drive through neighborhoods on a Saturday night, blaring sirens, horns and Christmas music, and collecting bags of food. Every previous year, I have turned off all the lights and pretended we are not home. Not to be uncharitable, just to prevent ear damage. This year, it seemed like a good opportunity to demonstrate giving to Nora, as all of our other charitable acts are unseen. Toddlers do not comprehend automatic payroll deductions. So, I grabbed a grocery bag and Nora and I started emptying the cabinets. I explained we were going to give some of our food to people who were hungry. Then I wrapped her in my coat and carried her outside where she handed the bag to a volunteer in a high visibility vest. Then the volunteer gave her a small candy cane. Her first candy cane ever.

Needless to say, the candy cane made a big impression. I didn’t realize how big until the following night. Nora said,

“The fire truck is coming.”

“It is?” I asked, not understanding what she was getting at.

“We need food,” she said. “Go get a bag.”

I dutifully went to the mudroom and grabbed a grocery bag. She scuttled into her bedroom and filled it with wooden food. She then marched to the door and wanted out. I walked her outside and pretended to hand the bag to an imaginary volunteer, but it didn’t quite feel like the right way to play the game. We went back inside and she immediately wanted out again. This was not a loop I was eager to repeat, so I told her to take her bag of food to the living room and wait for me; I’d bring the fire truck. I put on Ben’s big earflap hat and put my hands around a big imaginary steering wheel and headed for the living room making siren noises and shouting “Merry Christmas!” Nora handed me the bag of food. I started driving away and she stopped me and demanded a candy cane. Ahhh! Now the game makes a bit more sense! We spent the next forty-five minutes repeating this trade of fake food for an imaginary candy cane; eventually switching places so she was giving me candy canes, which she kept in her underwear, as she was not wearing pants.

The candy cane obsession continues, as this morning she asked for the pink letter “L” from the refrigerator and began licking it. I’m thinking this is how the charitible instinct is fostered; reinforce the personal benefit!

Filed Under: Anecdotes Tagged With: archives, candy canes, charity, food drives

Tis the Season

December 13, 2010 by sue campbell

She is wearing a boxer short cape.

Filed Under: Wordless Tagged With: antlers, klz, linky, merry christmas

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What kind of blog is this?

This is a blog for PARENTS. True, the writer, Sue Campbell, writes books for kids. But this blog is for grown-ups. It has some swearing and would be super boring for kids. Except for the swearing.

The PODCAST is for KIDS and PARENTS. In fact, my twelve-year-old daughter is my co-host.

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MORE ABOUT SUE: She makes an ACTUAL LIVING from writing words and marketing books and lives with her husband, two daughters, six chickens and one messy house rabbit in Portland, Oregon. And yes, Portland IS that weird. She really couldn't be any luckier.

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