A Morning with a Child with Type 1 Diabetes (Why It Takes Us So Much Longer To Get Anything Done Anymore)
Getting kids ready for school in the morning was never easy in the first place, especially for the one with "skin sensitivity issues." In other words, "NOOOOOOO! I AM NOT WEARING SOCKS TODAY!!! OR SHOES!!!" "Stop rushing me!!!" Ummm…
Our routine has become more complicated. For a person who has always enjoyed the pride of never being late, each day is a new challenge. We now have many more added steps (not to mention countless extra thoughts) added in, thanks to my youngest child's diabetes.
Below I have written out our normal, getting ready for school procedure. Included in it, in the purple, I have added the extra steps we now have to take because of the T1D:
1. Wake up the child. (We never had to do this before, but now we have noticed that high blood sugars lead to sleepiness, making it harder to get up in the morning.)
2. Hope we aren't starting the morning off on the wrong foot with crankiness due to any possible misstep.
3. Brush hair. (Must been done while child is entranced in watching TV. Because have you SEEN how much hair she has?) If it is summer, entertain and reject the possibility of a ponytail to keep hot hair off the neck.
4. Set up the kit for blood sugar test. (We call it the prick.)
4a. Wash hands.
4b. Make sure lancing device has a new needle in it.
4c. Check to make sure we have enough alcohol wipes and bandaids for the day.
4d. Unwrap a bandaid for the morning prick.
4e. Prepare a test strip to go in the meter (not putting it in all the way, because if you don't use it quickly enough, the meter shuts off and the strip records an error. Because the strips cost roughly $2 each, and we go through at least 6 in a day, this is a big deal.)
4f. Coax child away from the TV. (She's a little Type A about all this, so it is her decision that we never prick her without her fully aware.)
4g. Choose a finger to prick. Sometimes, depending on how many pricks we have had recently, her fingers may still be a little torn up and not well-healed, so this could take a while to figure out.
4h. Open the alcohol wipe and wipe down the finger to be pricked and all the fingers on the other hand that she will use to squeeze her finger.
4i. Insert test strip as she "primes" her finger to draw blood to it. (She is a slow bleeder, and it is often hard to get enough blood out before the meter shuts down.)
4j. Wait for her to say her required introduction of, "Do it quick!" (And not too close to the nail, or to the middle, or on the wrong side…)
4k. Prick her finger and squeeze.
4l. When the appropriate amount of blood has formed a bubble, dip the strip in and wait for a result.
4m. Wipe off excess blood and apply bandaid.
4n. Throw away used products.
5. Get BS (blood sugar) reading and…
5a. Record it in the log book.
5b. Calibrate her Dexcom with it.
5c. Record it on the meal log book to enter into the breakfast formula.
6. Figure out what she's going to have for breakfast.
6a. Into this thought process now is not only nutrition, but trying to remember how certain foods have affected her BS in the past, and if it has happened enough times to consider that a food "definitely" will always affect her BS in such a manner.
6b. If she is requesting certain foods, see how we can work it in to still be within a reasonable amount of carbs.
7. Calculate the carbs in the breakfast, enter that into the breakfast formula.
8. Finish working out the calculations for the formula and determine insulin needed.
8a. Record insulin amount in log book.
9. Prep insulin shot.
9a. Put on needle and prime injection pen.
9b. Get ice pack.
9c. Choose an injection site on her body and point it out to her.
9d. Pinch site "really hard" per her direction.
9e. Administer shot.
10. Clean up shot.
10a. Dispose of any sharps (needle/ lancet) in sharps container.
10b. Return ice pack and injection pen.
11. Make and serve breakfast.
12. Eat my own breakfast.
13. Cajole child into getting dressed.
14. Check on the lunch, packed last night.
14a. Double check that the necessary calculations are noted in the meal book. (Also done last night.)
14b. Pack the meal book in the school bag to go to the nurse at school.
15. Check special for the day and make sure library books are packed if needed or sneakers out for gym.
16. Make sure homework and extra snacks are in bag.
17. Help with socks and let her put on shoes while I turn off TV.
18. Put on Dexcom monitor, coat, and back pack.
19. Wait to solve any meltdowns, the best I can.
20. Take her out to the bus stop.
All of this takes place in about 45 minutes. During that time, I used to also be able to throw away all trash the rest of the family left out for me, wash the breakfast dishes, and clean the cat liter. Those chores are now fit in later in the day.
And keep in mind, all of the above is assuming everything goes smoothly, and no other surprises get thrown in. Some of the other issues that we have had to throw in just last week included:
* finding a Santa hat for the Sing-Along
* writing an excuse note for an older child's absence
* tracking down some chapstick to take care of lips at school
* super gluing the velcro back on the sneakers
* just needing extra snuggles
You know, and all that parent stuff. Also, I have 2 other kids.
After she goes, I'm not on my own yet. I need to make sure my cell phone is charged, because I will be on the phone with the school nurse 2-3 times during the day. I will also be touch with the endocrinologist's office several times a week.
If it's Monday, we also need to scan the log book page and message it to the doctor's office for an update to her formulas, noting any extra factors that could have led to highs or lows. (For example, a low after running around at recess, or not finishing a meal.)
We are still pretty early in our diagnosis, so we are still working out hospital bills from when she was in the PICU, insurance claims for her medication, and applications for a pump to administer her insulin. As I write this, I have the phone on speaker on hold with the pharmacy, waiting to hear if my co-pay reduction will be verified. The time on the phone currently stands at 1 hour and 2 minutes.
Once she comes home from school, we do it all again with dinner. Then homework, a bath, and one more prick and shot before bed.
I didn't want to share all of this with you so that you would pity me (or us). It's not a request for any one to help us to find a "better way to organize our life."
It's a plea for patience with us. When I forget to bring chips to a party, trust me, I was just impressed with myself for making it out the door. When you see me without make-up, I just didn't think it was worth my time that day. There's so much more on my mind these days.
And when my daughter is a little late to school, it might have been because she's tired of it all and needed an extra long hug from Mommy in the morning. I'm not going to deny it to her. She does have it tough.
So, thank you for understanding. It's our life now, and we are adjusting to it. If you are a praying person, please pray that a cure comes quickly for Type 1 Diabetes. Until then, we're praying for endurance. Because we're all a little tired.
Passion Under Grace,