Wednesday, March 22, 2006

Midnight Adventures

Bleary-eyed from last night... The baby woke up every 2 hours. The Husband was low at midnight. I asked him to check his sugar and he got up, went to the kitchen (why doesn't he just keep a meter on his bedside? I don't know because he won't tell), then came back without checking. I remind him that that's what he was supposed to be doing. We both go into the kitchen and he checks - 46. I pour a glass of juice which he directly puts down on the counter. And he tries to check his sugar again, re-using the same strip. Feeling of dread - are we going to get into a crazy, go-nowhere, irrational discussion? Because we've had plenty of those when he's this low. This time, just a mild scuffle about why he can't re-use a strip, and that his sugar probably hasn't changed since he hasn't had the juice. Ok, he remembers now that his last check was 46 and drinks the juice. He wanders around the kitchen, agitated. I try to calm him down, wait for the juice to take effect.

Meanwhile the baby woke up but I've been ignoring her up 'til then. But now she's starting to wail. Should I stay out here with Husband, or go in with baby before she wakes the rest of the household? I go in to baby because hubby seems ok. He comes back to bed 10 minutes later, whew.

Next morning he's pissed off because his sugar is 266. Turns out he drank a second glass of juice during the midnight adventure after I went to pick up baby. Then he's angry at himself because he did so. Sigh.
But then he says, "Maybe I wasn't thinking straight because I was 46." Wow - that's the first time I've heard him admit anything of the sort.

Thanks to folks who've posted comments. It's really very encouraging for me to keep writing!

Monday, March 20, 2006

Kicks for Nix

Kicks for Nix

The other day hubby was swaying in the kitchen, uncharacteristically quiet with a little smile on his face. You guessed it, he was really characteristically low. I suggested he check his sugar and he said, "The problem is that it's a well-known fact that low blood sugar causes a euphoric feeling". So he enjoys his "euphoric feeling" for a few seconds more and goes to check his sugar (54). His friends call that his "kicks for nix (nothing)". I suppose that's slightly better than getting kicks from his old recreational drugs - which, I hear, contribute to impaired sperm motility...

To tell or not to tell?

I wonder whether he self-debates to tell or not to tell me. Sometimes I'll walk in the door and he'll bombard me with a litany of his BG readings for the day. He'll usually do that when they've been uncontrollable (182. Bolus. 210. Bolus. Beer. 220) or (58. Juice. 58. Juice. 60 - maybe he should drink beer instead of juice, but I won't suggest that). Writers of fiction use the word "uncontrollable" too glibly:
"Uncontrollable sobbing and crying"
"Uncontrollable gaiety"
"Uncontrollable desire for power"
"Uncontrollable bowel movement"

Umm, ok - that last one I'll allow. But a diabetic unsuccessfully normalizing a BG in the midst of life (physical activity, emotional winds, infusion set temperaments, meal carb and fat contents, ...) - now that's uncontrollable.

On the other extreme of telling and not telling, he was driving us all home from the park last weekend. As soon as he stepped in the door, he headed straight for the fridge and a glass of juice. He checks his BG 10 mins later, and he's 39. 39!! Or, another day we got ready to go to Target and he checked his BG. He drank a juice and drove (I very rarely ask him what his BG is, so I assumed he was in the high 60's or 70's). When we arrived at the store, some 20 mins later, he casually mentioned that he was 41 before leaving. But, he pointed out (almost triumphantly?) that he had no symptoms and that I didn't notice anything, did I?

In both cases he deliberately did not tell me - to what end? So he could drive (not that I'm a bad driver, in my own defense)? So he could prove that he's still in control even when he's so low??? He must truly believe that his low BG doesn't cause any impairment. Or want to believe that.

Sex, lies and videotapes
Well, just the last of the three actually. Goes to show how titillating my life is. Every morning after a nighttime "save", he asks me how I knew that he was low. I describe the shaking, foot-jerking, sweating, incoherent ramblings. And the next time, he asks me again, almost as if he doesn't believe his body could morph that way. Even 8 years ago, 5 years into our relationship, he consistently refused to drink anything when I woke him in the middle of the night. Out of desperation, and a sneaking-suspicion intuition that his conscious beliefs did affect his hypoglycemic behaviors, I videotaped him. We watched the inky dark pictures the next morning and he seemed mystified, angry, and embarrassed at the man with tightly-pressed lips who was turning his head away from the juice I was trying to give him. He apologized to me, which nearly broke my heart. Since that very day, he has not once refused any juice or glucose I've given him at night.

Thursday, March 09, 2006

Nightmares and Insurance

Yesterday hubby went to pick up older kid from school, then ran an errand with him. Before he left the house, his BG was 98. When he returned 40 minutes later, it was 36 (he didn't notice). Again, nightmare scenarios flit across my mind. What to do? Maybe I should ask him for solutions; the problem is convincing him that there is a problem.

That so clearly illustrates the inadequacy of single BG monitoring. They're only a snapshot in time, entirely missing trending: Is the BG going up? Plummetting down? No way to tell unless you check yourself at continuous intervals. And who has the time, or tolerance for pain, or money for the test strips to do that? And while I'm at it, here's the rant against insurance companies. How ridiculous is it to not cover test strips??! How do those not fall under the rubric of "medical care"? The companies do pay for yearly checkups (preventive care), why not test strips? Don't those provide preventive care as well? Here's the math: my husband spends about $200 on test strips per month. One ambulance trip to the hospital costs about $1000. For one trip (and we're not even counting the cost of hospital care, if only to monitor for x hours), you have 5 months' worth of strips.

Monday, March 06, 2006

Kids & safety; Dogs 4 Diabetics

My nightmare as a parent

Yesterday was a wake-up call (besides being no, no fun). We had gone to a restaurant for lunch, it was small with only a handful of occupied tables. Because of these circumstances, it was the first time my utter paranoia allowed me to not have my 3-year-old in sight (I usually have him within my sight every second we're out of the house).

Well yesterday, he decided that he was done with lunch and climbed out of his chair. The baby fussed, so my husband lifted her from her seat onto his lap. When I looked back for the older one, 10 seconds later, I couldn't see him. The next 10 minutes were bedlam as I ran around, ran outside back, ran outside front, calling for him. 10 minutes doesn't sound like a long time, but for a parent searching for a missing toddler, it's eternity.

My husband finally found him under our table, playing hide-and-seek. The nutty kid was laughing, delighted at having tricked his parents.

Lessons from this incident?
1) Continue being paranoid about keeping the kid in sight.
2) Always tie him to the high-chair (must figure something out with chains because he can un-click himself)
3) Decide what to do about husband going out alone with nutty kid.

#3 has been simmering for a long while now (3.5 years, to be exact). The worst scenario is that hubby becomes severely hypo and loses track of kid or cannot adequately supervise him. Couple this with the fact that hubby does not share my paranoia and does not keep him in sight every second. I remember reading about a study which found that fathers had a higher tolerance for having their children out of sight than mothers. That's certainly true in our case.

So until they find The Cure, or husband's on some sort of continuous BG monitoring, what are the choices?
1) They never go out alone, and I resign myself to tagging along to Circuit City and Sportmart for the next 10 years. Hubby's response is that he's always brought the kid back before, right?

2) Make sure husband's much more vigilant when they're out, although I'm always on pins & needles until they safely return. How to "make sure"?? And I'm sure there are many, many, diabetic parents who take care of their children alone on a regular basis. How do they make sure they're safe?

Dogs 4 Diabetics

Just had to share news of this organization. Unfortunately, they currently only operate in the San Francisco Bay Area, and only for type 1 or brittle diabetics.

They train dogs to recognize the early signs of hypoglycemia. I think it's absolutely amazing. This is non-invasive continuous BG monitoring! According to them, the dogs recognize a dipping BG before the person exhibits any behavioral symptoms.

And yes, I did suggest it to my husband, but his immediate response was that he doesn't want a dog. Ok, I understand his reasons (he had 2 pet dogs die terrible deaths when he was young). I could probably push him, but I also vacillate between the benefits (Continuous BG monitoring! Safety for him and the kids!) and the cons (how much energy/time/room/money do I have left over after the full-time job, the toddler and the baby? and do I want to subject my kids to unnecessary pain when their pet passes away?).

The organization is supposedly doing research on how the dogs achieve their detection. Wouldn't it be incredible if they could isolate those chemicals and create an electronic detector?

Friday, March 03, 2006

Continuous Glucose Monitoring & Nagging

Continuous Glucose Monitoring

I've spent the last week delving into the shady (so much info, so much still lacking) world of continuous glucose monitoring. Imagine my excitement when I stumbled on "LifeAfterDx--The Guardian Chronicles: A internet journal from one of the first T1 Diabetics to use the Guardian RT continuous glucose monitor." What a great read! But disappointingly, the RT (1) is only available in select US cities, (2) is not yet covered by insurance (sheesh, the whole shebang's expensive), and (3) requires the hubby to carry another monitor (he's currently on a pump). He already gets grumpy carrying his regular BG meter with him. So, I'm not even going to suggest this to him for now.

Additional delving leads to the discovery of "Use of the Paradigm 722 System to Improve Glycemic Control in Adult and Adolescent Subjects With Type 1 Diabetes". The 722 eliminates the extra monitor because it's integrated into the pump... And clinical trials are usually free to participants... And there's a recruiting site 3 miles away from us!

I excitedly email hubby the link. When I get home, his reaction: "I think I want to wait because it's not exactly what I want." What he wants, of course, is a pump which will automatically adjust the insulin delivery based on his BG. I want to scream. But I just look angry and convince him to call them.

...The next day, I call him from work to nag him again to call them. Which he does. But another disappointment - this site is only recruiting 12-17 year olds.

*A note on "nagging": Perpetuating the stereotypical wife-as-a-nagging-shrew? Yes, but damn the man, I have to force him more often than not to take care of himself:

Me: Go see the doctor for that lung-expelling cough you've had for the last 2 months.
Him: What can they do? It's getting better anyways.

Me: You're low. Can you check your sugar or drink some juice?
Him: I'm not low.
(repeat that last exchange about 5 times then go to the next exchange:)

Me (He's obviously low. His BG must be in the 30's): Here, drink some juice.
Him: I'm not low. No!
(repeat that about 6 times. What do I do now? Wait until he passes out to stick some glucagon into him?)

Ok, so it's gotten slightly better lately. He'll actually go check his BG or drink juice when I give it to him. We're still working on the driving when his BG is only in the 50's:
Me: Let me drive, you're still very low.
Him: But I'm totally in control.
Me: You think you're in control, but you're still very low. Let me drive.
(repeat last exchange 6 times). Meanwhile, I'm getting angry, he's getting angry.

It must be all about control

He was diagnosed when he was 20, in the prime of his wild oats sowing. When I met him, he was 33 and still wildly out of control (his BG regulation, I mean). He was adamant about not letting diabetics control or hamper him. Which in theory was possible. He was put on the pen (long-lasting at night, fast-acting during the day) a year after his diagnosis. He was very proud of the fact that he could eat whatever, whenever he wanted. Well, I lost count of how many hypo's I helped him out of the first few years (more on those in future posts). In his mind, he was in complete control.

My arrival into the picture coincided with better regulation because I was nagging him. So when he fights me helping him with his regulation, I suppose he's fighting: (1) handing more control to me, (2) admitting that he does not have complete control over himself, and (3) admitting that the diabetes does affect his life. #3 is a strange one, considering the obvious impacts on his everyday life, but denial will take you a long way. And after 13 years of marriage, I know how stubbornly he can deny...

I try to be sympathetic, I really do. But when it's 3am, and I'm getting up for the 3rd time that night (toddler nightmare, baby nursing, husband nosediving into a hypo), and he doesn't want to drink/eat anything for his hypo, I do get angry at him. Then I feel guilty, because he didn't ask for it, did he? And he's so low, he's totally out of his mind, so how can I expect him to be rational?