You've Come a Long Way, Baby

Our Experience with the Insulin Pump

At 10 years old, our son got his first insulin pump. This was a huge benefit in helping to regulate and control his blood sugars. Although the learning curve was great in the beginning, having the pump, has been such a blessing in so many ways.

Insulin pumps replace the need for periodic injections by delivering rapid-acting insulin continuously throughout the day using a catheter. Insulin is stored in a small plastic reservoir (about 200 units) which is enough for 2 to 3 days worth of use. The user must change the infusion site every 2 to 3 days to prevent blockage and high blood sugars. The body begins to attack that little cannula after a few days just like it does a splinter or any other foreign object.

The usage of an insulin pump has several “advantages.” The first advantage of pump use was tighter blood glucose control, one of the most important reasons. Another advantage of pump use was being able to sleep in the morning and not having to follow such a rigid schedule based upon the peaks of insulin taken with daily injections. A third popular reason for using a pump was the ability to not be caught without your insulin and the ability to vary the insulin dose based upon activity, meals and other factors.

I have posted a picture of the first insulin pump. It was approximately the size of a small microwave. All I can say is that I sure am glad they continued to perfect this technology.

Modern pumps use a special small syringe, which resides in the pump and is connected to the wearer via a small cannula (like an IV needle/catheter). The cannula sits up under the skin in the fatty tissue layer and deposits the insulin in bolus and basal intervals. Basal insulin is the continuous insulin that the pump gives in small increments all day and night long to keep blood sugars stable. Finding this right amount is tricky, especially going through puberty, as these demands are constantly in a state of flux. As our son matures, his insulin needs will become more stable. Bolus amounts are delivered after eating meals and are determined by the number of carbohydrates consumed. The pump configures the amount to deliver based on what the user enters.

There are no restrictions on the activities of pump users today. Watertight cases are available to allow for swimming. People on pumps have done everything from running or biking across America to hiking up Mt. McKinley. In addition, many professionals, such as 1999’s Miss America, use pumps without anyone ever knowing. People using a pump today perform all types of jobs and participate in any activity they desire--the pump never holds the user back!

In the works right now is a closed-loop system pump, which would act like an external pancreas. It would monitor the blood sugars without the person having to do finger-pricks, continually inputting this information into the system and knowing exactly how much insulin to deliver.

None of these advances in technology are perfect; far from it, but they sure do make diabetes much easier for the patient and caregivers. Nothing can replace a cure but we are so thankful for this technology.

Happy Birthday, Insulin, Our Friend

Insulin. What a brilliant invention! Where on earth would diabetics be without it? Stuck in the middle ages most likely, on their death beds with diabetic ketoacidosis (DKA). Nice. But we owe this wonderful invention to three men: Frederick G Banting, Charles H Best and J J R Macleod. And this year, insulin is 88 years old.

On 11th January 1922, insulin was used on diabetic patients for the first time. Before this, life expectancy for those with type 1 diabetes was a year or two.The following is copied from the diabetes UK article on this:

"On January 11, 1922, Leonard Thompson, a 14-year-old boy with diabetes, who lay dying at the Toronto General Hospital, was given the first injection of insulin. However, the extract was so impure that Thompson suffered a severe allergic reaction, and further injections were cancelled.

Over the next 12 days, James Collip worked day and night to improve the ox-pancreas extract, and a second dose was injected on the 23 January. This was completely successful, not only in having no obvious side-effects, but in completely eliminating the glycosuria sign of diabetes.

Children dying from diabetic ketoacidosis were kept in large wards, often with 50 or more patients in a ward, mostly comatose. Grieving family members were often in attendance, awaiting the (until then, inevitable) death.

In one of medicine's more dramatic moments Banting, Best, and Collip went from bed to bed, injecting an entire ward with the new purified extract. Before they had reached the last dying child, the first few were awakening from their coma, to the joyous exclamations of their families."

Amazing isn't it, to think that insulin is still so young. What a brilliant breakthrough in medical science, too. It really makes me realize how fortunate we are in this day and age to be able to use insulin, and all thanks to those three brilliant men.

I would love to go back in time, and give Banting a high five and tell him that his work has saved thousands of lives. How his work and research has given hope to so many who had no hope.

I sometimes think I wish my son had never gotten diabetes. But then, I think, it could be worse, much worse. There are many suffering with diseases for which there are no treatments. At least, I think, we have insulin and it's not a cure, but it sure will suffice until we find one. That's my next hope. That we find a cure! Until then, I am so thankful for insulin; this strange smelling liquid that keeps my son alive and able to live a fairly normal life. Thank you Mr. Banting. Thank you, Insulin, Thank you, God!

Insulin is a diabetic's friend. We met someone several years ago that struggled with type one diabetes that shared that thought with us. We always wish that our children, loved ones, family members didn't have to take insulin. We wish or we really want to deny the disease. But we can't. And, therefore, we must see insulin as our friend instead of our enemy.

So happy birthday old friend. Thanks so much for all of your help!

Diabetes 101

Well, I hope that you will continue to "humor" me.

Since I'm on the rant about diabetes I thought I might educate you a bit.

I met a lady the other day that used to work at one of the area hospitals. She was the diabetes educator and I was telling her our story and we were commenting on how amazed we were that people really don't understand or know what diabetes is or what it isn't.

So, I decided I would spend a few posts talking about this, since it is something that has touched our family, something we have become well educated on (not because we wanted to but because we had to) and something that I feel really needs to be more understood.

I will start by explaining what diabetes is and then talk about some common myths.

Diabetes: The word "diabetes" is borrowed from the Greek word meaning "a siphon." The 2nd-century A.D. Greek physician, Aretus the Cappadocian, named the condition "diabetes." He explained that patients with it had polyuria (a lot of peeing) and "passed water like a siphon." When the word "diabetes" is used alone, it refers to diabetes mellitus. The word "mellitus" means "sweet". There's a lot of interesting facts here, but one I found fascinating is many years ago before they had meters to test blood sugars or even dip sticks to test the sugar in urine, they discovered that the urine of diabetic persons would attract ants. I guess because of the excess sugar. Interesting...

Anyway, there are two main types of diabetes mellitus -- insulin-requiring type 1 diabetes and adult-onset type 2 diabetes. These two conditions are distinct and different diseases in themselves. There is also a gestational diabetes which occurs during pregnancy but this would still fall under the category of type 2 diabetes.

Okay, so what are the differences between these two diseases? First off, Diabetes Mellitus is a disease that affects that body’s ability to produce insulin and/or the body’s ability to use it. Insulin is a hormone that is made by the pancreas which helps the body store energy (glucose) for later use. Like all hormones, our body needs to keep these levels balanced to prevent damage to other organs. Current acceptable blood glucose levels should be between 80 and 120 before meals. Unfortunately with untreated diabetes, these levels can get extremely high and become life-threatening.

The difference between the two - Type 1 diabetes is where the body no longer produces insulin at all. For some reason, (doctors and scientists do not know why) the pancreas does not make insulin at all. This can be caused by a number of factors which are unknown, but there are theories. The most popular theory is that there is a virus that attacks the insulin producing cells in the pancreas (called the islets of Langerhans) and destroys them - an autoimmune process. But for whatever reason, the pancreas does not produce anymore insulin, therefore blood sugars rise to dangerous levels. There are many things I find interesting here: many juvenile diabetics (another term for Type 1 diabetes - because many who are diagnosed are young) are diagnosed at around 6 or 7 years old. Why is this? I have wondered if it's related to immunizations. Is something causing the body to attack itself? Oh well, that's another topic altogether, isn't it??

I'm not going to bore you with all the details of this process and what happens to the sugar in the body and how the cells can't function, etc...; it really is quite fascinating how it all works. But suffice it to say, Type 1 diabetics do not make insulin, period. This is what Kendall, our son, has. Type 1 diabetes is not curable.

Type 2 diabetes is altogether different. Type 2 diabetics do not make enough insulin to support the body. Usually the reason is being overweight. Their bodies just do not produce enough insulin to be able to circulate throughout their system and keep the blood sugars normal. While still a dangerous condition if left untreated, it is curable. Type 2 diabetics can usually take medication to make their pancreas produce enough insulin; and if they lose the excess weight, they can become non-diabetic again.

One more comment here: Why do diabetics pee so much and get so thirsty? Well, it's because their bodies are not able to use the sugar they've taken in and so it passes right out through the kidneys. And because the kidneys are working so hard to get rid of all those toxins the excess sugar produces, they are working extra hard and wanting more fluids to flush it all out. Makes sense! Our bodies really are amazing!

Now the myths:

1. We've gotten this question a lot - especially when Kendall was younger. Will your son grow out of this (kind of like asthma)? NO! Remember, I said that this disease is not curable; once the pancreas stops producing insulin, it can never recover. Unless God heals him.

2. So, Kendall cannot eat any sugar, right? No, that's not true either. Because if Kendall couldn't eat sugar, well, he couldn't eat much at all. This is an area that I would like for people to understand better. Much of what you and I eat turns to sugar once it enters our bloodstream. All starches and carbs turn into sugar, even healthy stuff. Breads, vegetables like corn, peas, legumes, carrots. All fruits turn into sugar. The key is converting these sugars into energy that the body can use. That's why God created insulin.

3. Kendall got diabetes because he ate too many sweets, right? No. That's not right at all. In fact, what he ate had nothing to do with his developing diabetes. They don't know why some people develop it and why their bodies attack their insulin-producing cells. (Interesting thing, there are infants who are born with Type 1 diabetes - figure that one out!)

4. When Kendall is feeling a "low" (low blood sugar) you need to give more insulin, right? This is a common misconception. NO, please don't give the person more insulin. When a person is experiencing a low blood sugar, it means, for some reason that they have too much insulin circulating in their bodies. The best remedy for this is to give a high sugar snack or fruit juice to raise their glucose levels and counteract the insulin. If not, they can go into a diabetic coma and die.

It's a very touchy balancing system. We've had a couple of these low sugar episodes where we had to take Kendall to the emergency room to get glucose in an IV. Very scary, indeed!

5. Diabetes is genetic. It can be, but not always. My dad had type 2 diabetes, because he was overweight and did not take care of himself, but we have no Type 1 diabetics in our family. I have become acquainted with many Type 1 diabetics who had no diabetes in their family.

Okay, well that's enough for this time. Hope it wasn't a total bore!

What a Difference a Decade Makes!

Yes, I did say "decade". I know the old saying is really "what a difference a day makes" but I hope that you will humor me here.

10 years ago our son, Kendall, was diagnosed with Type 1 diabetes. Many of you already know this information and you're like, "yeah, whatever, big deal". Well, really it was a BIG DEAL for all of us and especially for me, the over-protective, watchful mom.

I'll never forget the day or the events that transpired. It's like one of those most cemented events that is placed in a person's psyche.

Kendall was 6 at the time and was not feeling well. As a matter of fact, he had not been feeling well for days, and was really starting to worry me. We had noticed weeks before a pattern of "tee-teeing" frequently and drinking to beat the band, but that was about it. Didn't think much about it, although I will have to say I did ask a good friend that had some nursing experience if they thought it could be diabetes and they said "no". So, I dismissed it.

We were preparing to make a trip up to D.C. to see my mom. All three children and I. Hubby was in a new job and couldn't go, so we were getting packed and ready. But Kendall just didn't look right to me. I don't know if you want to call it mom's intuition but I would say that the Lord nudged me inside. I called the doctor's office to make an appointment. And we were on our way to Athens within the hour. When we got to the pediatrician, he looked Kendall over and immediately suggested we go see an endocrinologist. In my mind, I was not thinking anything serious. Looking back, I really don't know what conclusions he drew, but he must've thought something or did a blood test or urine test without me knowing, but at this point, I still had no clue.

The next part of the story is not a memory I cherish; as the endo. that we saw that day is what I would call "crude, rude and socially unacceptable." This guy seriously had no "bedside manner" about him. In fact, we went into the office, sat down, he took Kendall's blood sugar and immediately looked at me and said "your son has type 1 diabetes." No "I'm sorry", "I know this is difficult", etc... They immediately gave Kendall a shot of insulin and told us to proceed to the hospital. All the while, I'm still kind of in a brain fog, not knowing what is really going on. Poor little Kendall, he's just following along without a care in the world. (Note, I have other stories about this endo. and his very uncaring attitude to us during the weeks and months that followed - but I won't bore you!)

The next few weeks were quite a whirlwind for me. I am not trying to paint a somber picture for you or one where I want pity, I'm just telling you how it was. I took all of this quite hard and at different points along the way was asking God why He would allow this to happen to my son.

Ten years later, here we are. Kendall is healthy (as healthy as a teenager can be with diabetes) and does just about anything and everything he wants. He eats what he wants and acts like a normal teenager. (How do normal teenagers act, anyway?)

But God taught me a lot along the way. I learned a trust that I could never have fabricated on my own. I learned that there are other people out there that care and that want to comfort and show their support. I learned perspective; meaning being thankful for what we have and not comparing to others. Someone else has it worse than we do. I learned compassion. I learned that God really never does take us through anything where His grace does not go before us and sustain us. I learned thankfulness and gratefulness and contentment. And I've watched God fashion a young man before my eyes; a young man that loves Him and has a heart for Him and a young man that has diabetes. But diabetes does not identify who Kendall is. Diabetes is just a characteristic, just another mark that makes him unique and uniquely able to have compassion and the ability to minister to others with similar frailties.

God's still teaching me. I'm glad to be able to say that. I worry for the day when I am not supple, soft or pliable; when I no longer am teachable and able to receive correction and remodeling.

So, this post is really a thank you note to God. Thanks for seeing us through a difficult decade. But thanks also for allowing Your grace to be our bulwark. Thank you for giving us the gift of a son and all that entails. Teach us not to question but to rely on You completely. For, as I've told Kendall several times, since that day of diagnosis, I believe that You, God, did not cause this condition, but You allowed it for a reason. We may never see the reasons while we live here on this earth but there is a purpose, there is a reason, there is a destination.

A Case of the Blahs

Did you know that the word “blah” is actually listed in the dictionary? Webster defines it as “a feeling of dullness, boredom, lethargy, likened to a winter’s day.”

I guess that sums up the way I’ve been feeling lately. I couldn’t quite put my finger on what the problem was. I just knew that I wasn’t my usual self. I hate using the word "depressed" cuz it just sounds "depressing", but if I felt any way in particular, that about sums it up.

I have to admit: sometimes the blahs just seem to creep into my life unannounced. I’ll be going along just fine when, all of a sudden, it feels like my engine begins to run on less than all cylinders.

I know one thing: I am very thankful that my Lord understands and doesn't condemn me or reject me when I'm feeling this way. (I wonder if Jesus ever faced the blahs....)

“For we do not have a high priest who is unable to sympathize with our weakness, but we have one who has been tempted in everyway, just as we are-yet was without sin” (Hebrews 4:15).

Amazingly though, there is one thing that always, always takes away the blahs. And a lot of times, when I can almost start feeling them coming on, I realize I haven't spent any quality time with the Lord. It amazes me how it's such a temperature gauge for me. But when I start feeling "yucky", I can almost always trace it back to not taking that time that I need with Him.

I allow the "tyranny of the urgent" to steal away those precious moments with the only One who can bring balance to my life. The Lover of my soul. I know it and yet I still do it, over and over again. I choose the urgent in place of the REFUGE! Why do I do this? Why?

Oh wretched man (or woman) that I am! Who can deliver me? Jesus can!! Jesus can!! Jesus can!!

One of my all time favorite songs by Matt Redman goes like this:

When my heart runs dry
And there's no song to sing
No holy melody
No words of love within
I recall the height from which
This fragile heart has slipped...
And I'll remember You
I will turn back and do
The things I used to do
for the love of You
Lord, I'll remember You
I will turn back and do
The things I used to do
for the love of You

You are my soul's desire
You are the hope within
You bring my heart to life
You make my spirit sing
I recall the height from which
This fragile heart has slipped..

And I remember You.