Category Archives: health

education, family, health, JDRF, Juvenile Diabetes, research

It's a matter of continuing education

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The JDRF teen council for Vancouver Island put together a video to go out on YouTube as a way of raising awareness among their peer group and anyone with sufficient tech savvy to operate the site about diabetes and the upcoming walk. Our daughter is one of the teens on there and Mark was asked to help with editing the final version.

It’s a fun thing for the kids, of course and Mark likes anything that involves technology. We’ve all posted the final product on our facebook accounts and forwarded it to anyone who isn’t connected otherwise. Seems pretty straightforward.

Maybe it’s ’cause we live with this so much, so constantly, we were pretty sure it covered the bases but there is still room for a few of the old misconceptions to creep in to what it’s all about. Since posting the video a friend of ours did a commentary on his podcast about it. This is a good thing as his podcast is far more popular than ours. This is the “any publicity is good publicity” school of thought. Anyway, somewhere in his meditation he started talking about the epidemic of diabetes and how we need to pay attention to nutrition and to exercise more.

I’m sure he didn’t realize it but it sounded a lot like he was speaking of diabetes as if it was all one illness. I’m sure that wasn’t his intention and that he was leading from one thought to another without necessarily drawing a line between them. So, with all due respect, I’m gonna spin a little on this one small issue that plagues diabetics.

Hands up anyone, how many types of diabetes are there? Anyone? Hello?

Who guessed 3? And how many can be traced to lifestyle? 1- unless you consider pregnancy a lifestyle.

There’s Type 1, aka Juvenile Diabetes or Insulin Dependent Diabetes. It is the result of an auto-immune reaction by the body towards the cells in the pancreas that manufacture insulin. So far there is no known reason for it, no cause, no detectable trigger. Of course there are a lot of theories – and I’m not talking about the dancing under a full moon without one’s foil helmet theories that seem to abound – some of which tie other auto-immune diseases like rheumatoid arthritis as a possible family genetic link. Why it starts is still at the white mice and electron microscope stage.

Then there’s Type 2 or Adult Onset diabetes. This is the one that is causing all the fuss, grabbing all the headlines. It is becoming epidemic in our society and it is controllable by diet and exercise. To some extent it is inevitable because as we age our insulin production decreases and the cellular tendency to resist insulin increases. The scary thing is it is appearing in children and this is what grabs the headlines. Long story short, over fed, under exercised children are at risk of Type 2 diabetes BUT not all children who have diabetes are Type 2.

When you have an infant, however, that is diabetic you can be pretty sure it isn’t because mom was using chocolate milk for the 2:00 am feeding.

The 3rd type of diabetes is Gestational Diabetes. It can occur in the 2nd trimester of pregnancy but more often in the 3rd trimest. It looks a lot like Type 2 in that there is increased insulin resistance and an inability of the pancreas to produce sufficient insulin and may require insulin injections for the mom. The American Diabetes webpage has a decent amount of information on the subject; here’s a link to their page on gestational diabetes. I’ve used the American site because it seems the Canadian site is mostly concerned with Type 2 issues.

So, yes, it is important to eat right, exercise and take care of your body – eat leafy greens, take vitamins and cram in fibre. Every day another page gets written in the owner’s manual of this lump of mortal flesh and we really can’t afford to skip the few basics we know actually work. Eat right, get plenty of fresh air, look both ways before crossing the street and work together to keep learning as much as we can.

Oh, and to always say thank you.

government, health, Juvenile Diabetes, medicare

It hurts other places too

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direct costs for aproximately 1 month:

Pump supplies – infusion sets – $318

– syringes – $118.

test strips $ 75.00

insulin $135.00

Pharmacare is an interesting system. It covers some things but not others, lancets but not test strips, for instance or one type of insulin but not another. It was also ‘improved’ so that it doesn’t start covering drugs until a you’ve paid out a certain amount on your drugs. At that point it starts at a scaled percentage of the cost, gradually increasing the amount it covers.

It resets every January 1 and despite paying in over $1,200 a month with all our different prescriptions, we still haven’t hit the pharmacare threshold and it is the end of March.

A good extended medical plan helps a whole bunch, fer sure and I can’t imagine how families without one manage to cope with all the costs. Yes, it is evenutally, tax deductible but between refund time and the next year, most folk like to eat and maybe pay the rent and, believe it or not, go to the odd movie. Yes, poor folk deserve a movie now and then too.

If it wasn’t for our socialized health care system, we’d have gone under a long time ago. That is why, next to Dr. Banting, my big hero is

Tommy Douglas

But more about him later.

family, health, Juvenile Diabetes

wrestle a bear

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This was a column I wrote for the Esquimalt News, May 2005 and later used as a podcast on Babas Beach.

There is a long list of things I hate about my daughter’s diabetes. I mean things above and beyond the obvious ones of her having to puncture herself several times a day to measure blood sugars or administer insulin. Or all the things the future holds if my angel doesn’t keep her blood sugars in a reasonable range: blindness, kidney failure and limb amputation, to name a few.

Nope, there are a few other things, admittedly a little further down the list of concerns and irritations this pancreatic spanner caused when it was tossed into the general works of my life. Yes, I said “my life”. Sometimes, believe it or not, it really is all about me. If I can take on all the guilt and blame that goes along with the price of admission to parenthood, surely I can also lay claim to some sympathy time for those moments when my little bundles of joy bring home injured birds, weird friends, contagious diseases for which I have no immunity and the odd chronic illnesses for which there is no cure.

Yes, I know, she is the one with the insulin pump keeping her alive by means of a thin tube of plastic and a wicked long needle she has to re-insert every three days into another place on her tummy. She is the one who has to do the finger pokes and take insulin and get paraded in front of a series of medical professionals on a regular basis, every one of which asks the same questions and stress the same need to be vigilant about her blood sugars. Not only does she get the standard haranguing from parents about her homework, the current bio-hazard rating of her bedroom and “who was that boy you were talking to?”; she also has to put up with being reminded several times a day to do finger pokes, what was your last blood sugar, is it time to change your pump site, how many carbs are in that cookie and did you increase your insulin enough to take care of it?

Here is the true evil of this particular illness: it hits kids. From babies to teenagers it robs them of their childhood and burdens them with the dark truth of their mortality. If there is one thing I hate the most about this wretched disease it is that my daughter was robbed of those precious years of her childhood dreams of immortality. When she was 10 she had to grow up overnight and realize life could end for her in an instant.

How can this be about me, I hear you ask. Well, let me put it this way; ask any mother if she’d stand in front of a gun to save her child or face down any threat to her baby. I’m pretty sure most fathers would gladly arm themselves with a butter knife and fight a bear if it would save their little girls from one broken heart. Now, ask which will hurt more, a bullet, a bear or the knowledge there isn’t anything you can do to keep the hurt and the broken heart out of your baby’s life?

Being a parent of a child with diabetes means knowing he or she has to physically hurt themselves repeatedly throughout the day in order to stay alive. It means dealing with the emotional fallout when a well meaning adult- who doesn’t know there are three types of diabetes, two of which have nothing to do with the current catch phrase of “lifestyle choices” – teaches your daughter’s class that diabetes is caused by being fat, lazy and eating too much junk food.

Then there are those dear folk who insist on taking her or me or her grannie aside to tell us insulin only makes diabetes worse, she should be taking this vitamin or going to that naturopath or eat a diet of tofu and groats. Fortunately, my daughter has more sense than a lot of adults.

I guess it is more accurate to say we are a family with diabetes because it affects every single one of us. Even the dreaded big sister, who will smother me in my sleep for what I am about to reveal, knows she can’t protect her rotten little sister from this one cowardly bully. Hard to believe, I know but it’s true. One day at school her class was lined up for a vaccination against one of the many Ite-esses starting with the letter H. A girl in the line kept whining about why do they torture kids this way, gawd, like, the size of the needle, the pain, how sick she was last time…the usual things. My first born fixed this classmate with her patented dead fish stare and said “quit your complaining, friend, my sister has to do this four times a day. Be grateful.” She may have used a fewer words and slightly more pithy language but that was the gist of it. Now I have to go into the parent protection program.

Okay, there are a whole of things I really don’t like about juvenile diabetes. At this time of year, however, I’m supposed to be upbeat and talk about how close medical research is to actually sending this particular demon back to the seventh level of hell where it belongs. And it is; it really is getting closer every day. But close only counts in horse-shoes and hand grenades, as the old saying goes. And lab rats don’t work for free, y’know.

So, when it comes to my daughter I’ll swallow my pride, brow beat my co-workers, friends and family to pledge me in the June Walk to Cure Diabetes. Whether I like doing it or not, at least it is one way I have of actually doing something. And it is a little less painful than wrestling with a bear.

If you want more information, go to the website www.jdrf.ca . If you don’t have a computer, call the foundation, toll free, at 1-877-287-3533.

family, health, Juvenile Diabetes

Good night nurse

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I learned of Trudeau’s death when taking a few minutes to grab a coffee in the parents’ lounge on the Pediatric Ward. It was my third day there – I’d been sleeping on the floor by R.’s bed each night until, finally, one of the nurses suggested I see if a bed was available in the parents’ quarters just down the hall. I suppose they’d hoped I’d go home each night but that wasn’t going to happen until I was sure she was out of the woods.

It was something I had to do. The thought of her waking up in the night – and she was being woken up two or three times a night for blood work at this point – surrounded by strangers was not a good one. After all she’d been through, the least I could do was be there when the nurse came around to take a little blood.

Once R stabilized on the insulin and her fluids were back up, they took out the IV. It had been very handy for all the blood tests needed to keep up on her metabolic state of affairs but IV sites are notorious for infections. So, for some blood work they could get enough by warming up her fingers and using a large lancet, milking the blood into small vials. For most of it, though, the quantity needed really called for getting it from the arm. The inside of her elbows were getting pretty chewed up from all the needles the blood work required.

On the third night it was a new nurse who came around with the tray. She seemed a bit put out at having to come to the ward – maybe she’d planned a nice quiest night, maybe she’d been held over on her shift, I don’t know but there was an attitude I hadn’t seen in any of the other blood-letters.

She grabbed R.’s arm, looked at it, snuffed. Went to the other side and grabbed that arm, snuffed again. With a heavy sigh she took up her needle and started the tie-off. She inserted the needle, muttered – she’d missed, pulled it back a bit and pushed again, muttered, pulled it back and angled another way. By now R was getting distinctly uncomfortable and was whimpering. I was appalled at what I was seeing and gripped the bed rail to keep from leaping across the bed to grab the woman by her throat.

She clumped over to the other arm and started again. Same thing, pulling back and angling another way, pulling back, angling. R was in tears now. The nurse just tossed her gear on the tray and said someone else would have to give it a try, she wasn’t getting anywhere and off she went. I was shaking by this point, followed her out and went to the nurse station.

“I don’t ever want that woman to touch my child again.” The nurses looked up in total surprise. They had grown used to my being there, sleepy at times, encouraging always and making little humorous comments to keep spirits up but this time I was white. “If she comes near R., I will put her through the wall.” One of the nurses came with me and took a look at my dear’s little arms which were actually swollen to the point she couldn’t bend them anymore. I described what I had seen. The nurse said that I could have told her to stop at anytime and that protocol is if the needle misses on the first try, it is to be removed completely and the other arm used.

She called up another phlebotomist – a sweet, obviously gay male nurse. He took a look and was shaking his head. They’d have to use finger vials because there was no way any of her arm veins could be used with all the swelling there. He apologized profusely and said he would make sure to take care of R. himself from now on for any night time blood work.

The ward nurse confided to me that the other leech, the night butcher, as I took to calling her, had a reputation for being impatient with children. She wasn’t usually called out to the ped’s ward. All I knew is she wasn’t going to be allowed within sight of me for a very long time.

family, health, Juvenile Diabetes

You know it’s bad when the doctor looks scared

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I’ve never dragged my children anywhere but when the cab arrived, I had to physically drag R. outside. She didn’t want to move and was barely conscious. Even at 10 and having lost weight overnight, she was too heavy for me to actually hoist over my shoulder or anything as heroic looking as that. I suppose that’s what the made for tv movie would have for directions…

Maureen:

come on, sweetie, you’ve got to get up, the cab is here

(pulls child to sitting position, turns to get shoes as child flops back on couch)….

no, sweetheart don’t lie down again…here, let’s get your shoes on…

(takes deep breath, grits teeth, steely glint appear in eyes)

Oh, the hell with it,

(reaches down, puts arms under child’s arms)

come to momma!

(grunts and in one swift move pulls child up and then over left shoulder)

if the doctor wants you to wear shoes, she can damn well put them on you herself…

(grabs coat, purse and in one swift motion pulls the door open and then slams it behind her. scene shift: pov: through a car window – background sound, car engine idling, cab dispatch radio and a local country music station weave together – camera focuses on front door of house as woman emerges with child slung over shoulder. The door slams and she runs down the steps towards the cab)

I see either Jodie Foster or Sigourney Weaver playing me.

Anyway, repeat process of dragging, sweet talking and coaxing the semi-comatose child out of the cab, into the elevator and into the doctor’s office. At this point the hard edged receptionist didn’t even wait till we sat down – she grabbed the other arm and helped me guide my baby into an examining room.

There are two things Dr. Sidhu can be counted on: if you have the first appointment in the morning, she will be there at least 10 minutes after you arrive. The other thing is that once she is in the examining room with you, you have her total attention. No one ever complains about waiting an extra half hour or more past the scheduled appointment time before finally seeing her because you know when you need that extra time, she’ll be there for you.

So, in comes the good doctor, smiling and apologizing for being late. She stops in mid-sentence, takes one look at the patient, then at me and asks, “how long has she been like this?” I start with the camping trip and she stops me before I get more than a few words out…”No, I mean like this…” I’ve never heard her use that voice before, no nonsense, give me straight information right now and only the vital details type of George Clooney on ER voice.

She grabs a glucose meter, and a lancet, takes R.’s hand and pokes a finger to get a drop of blood (this is the first time I’ve seen this done anywhere outside of a blood donor clinic; now it is a four/five times a day routine sort of thing). We look at each other in surprise when the test strip fails to soak up the drop of blood. Dr. Sidhu looks closer… it can’t take a reading, she says, because the blood is too thick to be absorbed. I look closer. It’s like syrup. Suddenly the doctor is holding out a sample bottle and pulling us both down the hall to the private bathroom.

So there I squated, attempting to hold my daughter upright on the toilet with one arm and holding the sample jar between her legs, patiently cooing like when she was much younger, still in toilet training. “Can you pee a bit for me, sweetie?…come on, just a bit…thats a good girl. Do you want a drink of water? will that help? Here, let me put a warm cloth on your hand…finally she manages a dribble and fortunately I’m able to catch it in the jar. It’s amazing what constitutes a victory some days.

As I pull her clothes back on and drag her back to the examining room, the doctor takes the jar, stirs it with a stick.

You need to get her to the hospital right now. I’ll call an ambulance if you don’t have a car here.

Mark just gets to the waiting room as we are discussing this – he couldn’t concentrate at work and drove to the doctor’s office.

The doctor stressed the importance of going directly to the hospital. She will phone ahead but don’t wait. If for any reason the emerg desk hasn’t gotten the message tell them this is not a fuck around situation and get her inside. Okay, that’s the screen play version, I don’t think the good doctor would drop the f-bomb regardless of the situation. (Dr. Sidhu would be played by Archie Panjabi – the older sister in “Bend it Like Beckham” because she’s the only Indian actress I can think of who is anywhere near as tall as my doctor – she’s a big girl…like a lot of Indian women, actually)