For those of you who know me, you know all about Mikayla's latest troubles with Lyme, reflux issues, scarlet fever 3 weeks ago..etc..

Today I took her back to the doctor for what I thought was a yeast infection from the meds they gave her for the scarlet fever.

I had mentioned that she was thirsty all the time and urinating ALOT to the doc last Friday and was told it was probably from the meds for the SF...

Last night she drank a full 8 oz glass of water every 1/2 hour and went to the bathroom almost immediately. So I took her to the doctor today, as they thought maybe she had a urinary tract infection...

Turns out she has type 1 diabetes. Her levels were so high they wouldn't even register on the meter and she was so out of it that she was swaying everywhere and almost passing out.

So we went to a branch of the hospital that is devoted to juvenile diabetes and spent all day there learning how to do testing and how to give her insulin shots, what she should eat.etc..

For those of you who know Mikayla, she is a pretty brave little girl who isn't afraid of much...she even loves snakes..

her one fear???? Needles!!!!!..

This was one of the worst days of my life. I am so physically and emotionally drained that I feel like crawling into the corner and crying...forever.

My husband is in Florida as his grandfather committed suicide ( he is 85 and could no longer use his legs and was in constant pain) and he is there comforting his mom and attending the funeral,

So I had to deal with everything all by myself. Poor Mikayla was stuck with needles about 20 times and is miserable. It took 4 of us to restrain her to get blood and an entire diabetes staff of nurses, nutritionists, secretaries, etc..spent about 30 mins calming her down enough so I could learn to give her the test and give her the insulin shots.

I think that the fear of the unknown was far worse than the shots..I did her blood test and gave her my first solo insulin shot tonight and we both managed to get through it very well.

i am so proud of her for the way she is attempting to adjust to this new way of life and for trying her best to keep a positive attitude.

She has been through so much in 6 years, that her continued strength, unquestionable faith, and spirit simply amaze me.

I think I cried almost as much as she did today...

The hospital gave her a tote bag called "The bag of Hope"..it was filled with tons of information about diabetes, books for kids, videos, and even a beautiful teddy bear named Ruby who also has diabetes.

The bear even has patches where she has to have shots like Mikayla and this bear really was a life saver today during training.

Mikayla is all cuddled up on the couch with her new bear, sleeping..she looks peaceful Looking at her now, you'd never know the hell she went through today..

Me? I'm still a nervous wreck and needed to come here to my lymenet family, for comfort, advice, prayers and support...

Thanks for always being there...

However, she is absolutely thriving. I just returned from the high school musical where she danced and sang, and she is right now at Friendly's having ice cream with the rest of the cast.

I can see what you have ahead of you, like a landscape that is so familiar, and want you to know that I and many others who have dealt with this over the years, are here to help.

The stress of type 1 diabetes is not understood by many people...don't let that bother you, and rely on support from people who do.

Also, the combination of problems can make getting medical care more complex.

I'm so sorry for what you gurs are going through.

I don't know if this information is something you can use, but by coincidence I recenlty helped a friend with diabetes 1,
and spoke to a woman at the site I'll copy below.

She uses Chinese herbs that tone the liver, GB, pancreas that greatly help diabetics she works with.

She said in early phases, it has reversed types 1 ..and also in many type 1 cases, the therapies are extremely helpful..tho patients still require insulin.

She is very approachable, and I don't know if she's worked with children..just thought I'd pass it on.
http://www.sensiblehealth.com/

The other thing my friend is doing is the alternative diet to reverse symptoms and side effects of the illness.

The newer alternative diets high in veggies can be far more effective than the Standard Diabetic Diet reccomended, and I imagine easier to learn to eat this way at a young age..
if this is something you are interested in.
It, again, is very supportive and can in some caseslower the amount of insulin needed and help in lots of other ways.

I can try and find the one she is using.

I don't know about the Lyme relation, as I haven't dealt with it first hand. I do know they can be related.

Blessings to you all,
Mo

I don't know if it is suitable for children, but there is a great book called 'The Diabetes Solution' by Dr. Bernstein (forgot first name) - he has had Type 1 since he was young (can't remember how young). He is now in his 70's and has been able to control his Type 1 diabetes - I believe without insulin - by this diet.

It is a VERY restricted diet, however, and like I said may not be easy to do with a child. But, can't hurt to check it out, I guess.

I know exactly what you are going thru, my daughter was dx at 13 years old and when they sent her home from the hospital, we stopped at the grocery store, we were trying to figure out what she could eat. Amber and I just stood in the middle of the aisle and cried, I just knew what ever I fed her would kill her.

She will be 28 next month and has given us a wonderful Grandson.

Things will get better, she will learn the routine and it will BECOME routine very soon.

Things are so much better now than they were even 15 years ago when Amber first got it. It is not near as confusing, the needles are very tiny. In time she can get a pump, my daughter has one, she can swim with it and everything.

And unlike Lyme the patients are believed and there are some great activities for JD kids, you need to go online to the Jouvenile Diabetes Foundation and see everything they have, they even have a camp for kids with Diabetes.

I will e=mail you my phone number. If you need to talk, feel free to call.

We were fortunate that we had some real close friends that their daughter was DX at 11 months (yes months) Try and figure out what that baby needs? Anyway they came to the hospital with all the greatest stuff that was on the market. Injectors, testing pens instead of the old (gueateen sp) kind that the hospital was still using.

Just remember the worst is the fear of the unknown, as you learn more about this disease and realize this is something she can LIVE with your fear will suside, because you then will know everything is going to be O.K.

My prayers are with you, and as hard as it is to believe she will even get used to poking herself. Everyone will think she is so brave that she can do this by herself.

Love Cindy ><>

I am glad that you have such loving friend to help you try and cope.

Missy my heart just breaks for you and Mikayla
I am crying as I write this.

I know we all want to help you...
and steer you towards the positive...
But Hun..... Its OK to cry!!!!

I was there when Mikayla was crying,
and begging you ..
please mommy don't do it again...
it hurts
Damn I am still shook up over that!
And I couldn't sleep a wink all night either... must be that Twin thing

And yes I have to agree-
I have never met a child with so much love to give and strength and faith to pull her through. It amazes me too !!

And yes, She IS a real trooper Mis...
But then again so are YOU!!!
I was awed by the way you handled testing her and giving her the shots.
I know inside you were crying...
and I saw you tremble...
But you put on your brave face for Mikayla

Missy I love you and I couldn't Love your children more if they were my own!
We WILL get through this.. I PROMISE !
I love you and will always be here for you!!
Kisses ~ Nikki

Mikayla had a rough night, I had to prick her finger every 2 hours( even while she slept)

She is being as good as anyone facing something like this could be and I am awed by her strength...

I wish I had a tenth of her strength, and while I will never question my faith...hers seems stronger than mine at the moment.

When I got Mikayla settled in for the night, It hit me like a ton of bricks, and I allowed myself a mini breakdown...

Well actually I cried most of the night.

And when the sun came up this morning and I had to prick her finger for the test at 6:00 am..it hit me... that it wasn't a bad dream..it's real and I am very scared, confused, pissed off ! and way to overwhelmed....

I want to share something with you all..for those of you who have ever experienced anything like this you will understand what I am saying...

Yesterday morning, I woke up with a start at 2:30 in the am. Mikayla was once again in the bathroom. And her rash in her private area was irritated again...

As I had mentioned this to her doctors several times, I had decided the night before, that as the docs weren't concerned about it, that I would wait to take her in for a follow up on Sunday or Monday when her pedi would be in.

So at 2:30 am yest. morning, this feeling that I can't quite explain, came over me. It started at my toes and went all the way to the top of my head.

It was like I had a warm chill going through my entire body and a voice or something..told me I had to take Mikayla to the doctor now!

Even then, I debated taking her to the doc yesterday as I though I might have been dreaming. SO at 7:30 am yest, I decided that as she missed so many days from school this year due to lyme, reflux and the scarlet fever, that I would send her to school and take her to the doc on Sunday.

At 7:45, I was standing in the kitchen when I felt something swish through me..( for lack of better terms) and once again a voice loudern this time ..said " Take Mikayla to the doctor now"..

I have never experienced anything like this before and knew as I was standing up, this wasn't a dream. So I called the doc at 8:00 yest and made the apt for 9:00...

At 9:30, I knew she had diabetes and realized how serious the illness had progressed. While we were in the office she actually went into some type of shock and her levels went off the chart and they gave her the first does of insulin...

For those of you who believe in stuff like this, I'm not so sure I did until now...this was a very moving moment.

And I have to add that the specialist for our county and neighboring counties, happened to be working one of his 2 days he works at the clinic..yesterday..

And he happened to be on lunch break when her body went into overload and he saw her immediately!.

And as if this wasn't enough, the nurse who trains parents on testing and injecting insulin was in thier other office, an hour away and for some reason had no appointments. she made the hour drive to the diabetes center and met me there 5 mins after we arrived.

Now I'm a big believer that some things are just coincidental, but I would have to be a fool not to believe that a higher power was working for Mikayla yesterday...

I and my family truly believe she was being watched over yesterday, by a guardian angel or something I don't quite understand...but believe in none the less...

Well, I am all cried out at the moment. My sister called me at 6:30 and I had just pricked Mikayla's finger while she slept and I was crying again...

So my sister, Nikki, is coming to spend the day with us today to help me. My husband is still in Florida and as strong as I like to think I am.. I am not afraid to admit this has taken a toll on me and I need a shoulder to lean on.

My God daughter turns 4 today and Mikayla has been so excited about going to her princess party for 2 months.

I wanted to cancel it, but her doctors and nurses insisted that it was important that I let her go to the party, so she won't think Diabetes has ruined her life.

I need to try to keep things as normal as possible for her.

So as this is a big event, as my God daughter won a Princess party..with a real princess is coming to the party to give the girls a make over, new hairdo's and dress them all up like princesses..they even get to decorate and take home a princess cake...

The doc's insisted I take her.. As I am keeping her sugar levels stable by giving her the insulin and diabetic friendly meals..

So she is out of danger..

I was worried as the party is about an hour and 10 mins from home, but the doc calmly informed me that there are 2 hospitals on the way and that the nearest hospital ( or even our pedi's office) is an hour away from my home..

So it's really only 10 mins further than the pedi. My sister is going to drive us, as even though I am trying so hard to suck it up and deal with it in front of Mikayla..I'm not ashamed to admit I'm a little scared.

Mikayla woke up when I was crying on the phone to my sister this morning and I quickly tried to pull it together.

My son Derek woke up as well and asked me why I was crying.... Mikayla was patting my back trying to comfort me and told him " Because she has to prick me everyday"

Here she is 6 years old, confronting yet another illness, and she is comforting me!!!

She told me that it was okay, that the shots didn't hurt so bad and the pricks hurt, but not too much... and that it would be okay...

The whole time she is hugging me and patting my back, telling me it will be okay! amazing...

Now I'm crying all over again..

Well, I have to go get ready to be made over into a princess with my daughter....

Thanks again for letting me vent and for always being there. I'll check back later..your stories and experiences are truly helping me...

For those of you who don't know, "ticktalk" is my twin sister Nikki...

Thanks for posting Nikki, well now you made me cry all over again

Thanks for coming with us today, it means more than I can ever say...

Also, there is absolutely no need to restrict your daughter's diet, once you get going with this, especially with the pump. Pizza, candy, ice-cream and cake, the works. In fact, to avoid lows, Mikkayla may need more sugar than most!

Callouses will soon form so that the pricks don't hurt much (my daughter has tested 10-12 times/day, including overnight, for 10 years and the callouses make her an awesome guitar player!).

Is there a way we can communicate? Does Mikayla attend school? There is a lot of help available...which you will find easily or others can help you find.

as a nurse...I would have to disagree with the above poster somewhat..in the beginning until you know how mikayla will 'fall' as a diabetic you need to be very careful of what she eats..and watch her highs. I'm sure the docs told you this. She could spike on you very quickly in these early stages...

once she is established after a few months you'll feel more comforable with her highs and lows. SHe needs to be consistant with her blood sugar levels until most docs will consider putting her on a pump...but once on one they are like having a new pancreas adn you CAN eat anything as long as you remember to bolus the short acting insulin for it right away. This is when mikayla will feel normal again..she will be able to eat many foods like her friens can..

but just be very careful inthe beginnig while they are still finding out what short and long acting insulins work best for her, what carries her through the day to keep her on a steady level and not drop her very low or get her very high into dangerous levels again..that's why they want you to watch her diet closely...it can spike so quickly...I"m sure they showed you how to test her ketones in her urine if her blood sugar is over 300 etc...

remeber she is just starting thism and it will take a little while until her body adjusts to it...AND to findig he correct doses of insulin etc...but you guys will get there.

sounds like you have one brave little girl there...hugs andkisses to you both..

I have NO personal experience with Diabetes...this is just something that I have to offer...nothing more, nothing less.

I would only ask that you understand that when I see something happening to a child...I refuse to shut up.
(I am the same with Lyme, and Cancer...of which I have FAR too much experience.)
\
Here is a pasted copy of my e-mail to Missy, take it for what you will,,it may help, it may not.

Dear team,

Please enjoy the following personal experience and share this story with others. However please be sure you do so in the correct manner. It is highly unusual that a recently diagnosed type 1 diabetic would have a reaction like the one you are about to read.

It is imperative that you make no claims that the Mangosteen Juice will do for others what it did for this individual, but you may tell others this story which was so kindly shared. Just tell them, ``try it; we think you will be pleased with the results.'' Then ask them to forward any significant results to us so we may likewise share them with others in the hopes that others will have the chance to try this product to see what it may do for them, if anything.

April 27, 2005

We had noticed that our six year old daughter had not been herself lately and complained of being tired constantly and went to the bathroom quite frequently. She was drinking a lot of water, but we had given her a new water bottle which she liked, so we did not think much of this. We were not aware that these were signs of diabetes. One morning, she woke up and did not have the strength to get herself out of bed. I got her out onto the couch and called an ambulance. By the time we got her to the hospital, the Doctor said that this was the last day and if we had waited any longer, she would have been in a coma.

So, on January 18, 2005, our beautiful six year old daughter, Savana-Lee, was diagnosed with Type 1 Diabetes. We are vegetarians and our children have never had any dairy products, meat or white sugar, so this diagnosis was a horrible shock to us. We were determined to immediately do whatever we could to turn our little girl's life back to the way it was.

It felt like a knife in our hearts to see our normally happy, energetic six year old crying, scared and having to get finger pricks done 4 to 6 times a day and having to see how frightened she was when she saw the needle coming.

We just couldn't sit back and say "well, this is the way it is and she'll have to live with it and we'll have to watch her suffer". No way! I knew in my heart that there must be something out there to help her, something that the Doctor's didn't know. We started by really changing her diet. Then sixteen days after Savana-Lee was diagnosed, we read about a product, a mangosteen juice. We started her on it that afternoon and to our amazement, her bedtime blood test, which was usually 13 to 20, was now 3.5! From that day on, her numbers kept dropping drastically and we kept lowering and lowering her insulin dosage. Soon we came to the point where it was a full time job just trying to keep her from passing out all day! Her blood sugar was dropping so low. She went from 25 units of insulin a day down to just 1, yes only one unit and that was still too much! After 24 days on the Mangosteen Juice, her Doctor took her off of insulin completely! Her doctor said that this never happens and to keep on doing what we were doing.

Forty-one days after diagnosis, Savana-Lee was insulin free!!!

It has now been about 5 weeks and her blood glucose numbers are still in check.

Now, we sit back and watch her smile as she sips away on her Mangosteen juice. That's more like it!

Thanks so much [Mangosteen Juice].

Karen & Jimmy Fuller

I am going to ask Dr Taylor about this one...although I know what part of his reply is already...inflammatory response...stop/control it.

His website www.myremedi.com

Best of Wishes,

Trout

Magnesium is supposed to help diabetes. Marnie knows more about that.

If you, or Mikayla, have another rough time, perhaps 2 mg valium would get you through it.

Dr B works with an endocrinologist who travels from the midwest? for one day to see his patients. Perhaps she could help you. Endocrinology problems are common with Lyme.

Type 1 is an autoimmune response, which is genetically determined (and probably triggered by a pathogen) and involves the destruction of insulin-producing cells. This is a different disease than type 2 diabetes, in which the body still makes insulin but the body isn't using it effectively. Only 5% of people with diabetes have type 1, which is permanent and lifelong.

There is a honeymoon period after diagnosis of type 1 when insulin needs drastically plummet, especially with young children. But after that, the highs return and you are left with a life-long need for insulin. (Perhaps this is what happened with the juice)

Type 2 diabetes can be very much helped, even put in remission, with improvements in diet and exercise, since these lifestyle factors can affect insulin effectiveness. This isn't true of type 1. Nothing reverses type 1. (In the honeymoon, some doctors have tried minute amounts of insulin to delay the inevitable, but this doesn't reverse it)

People get confused because some type 2's do take insulin. This is different from a type 1 who has NO insulin, and is completely dependent on external injected insulin to stay alive.

Homeopathy, supplements, exercise and all sorts of modalities might make the injected insulin work more efficiently. But with type 1 diabetes, a person will always need insulin to live every single day of his or her life. Going without insulin for even a few hours can be life-threatening.

We just get very freaked out when people start talking about going insulin-free or even reducing insulin. There's nothing wrong with taking insulin if your body doesn''t make it...it's essential to life.

I have to stop reading this thread because I get frustrated with well-intentioned misinformation, and I'll drive everyone crazy w/details, but Lymebrat please let me know in a separate thread if I or my daughter can be of any help.

The American Diabetes Association has a great site (and magazine)...including a great sample 504 plan and health care plan for school. The Juvenile Diabetes Research Foundation has support groups and also folks who will support you in the early days. Diabetes Health in San Francisco is the best publication.

In California, kids are put on the pump right at diagnosis, but on the East Coast MD's are slower to put kids on the pump, although this seems to be changing. Go for it!

Things are much more natural and flexible on the pump, although it is still a lot of work, and involves a lot of testing. Pumpers can pretty much eat anything at any time, as long as blood sugars are okay. Not too many shots on the pump, but every few days you do have to insert a needle that puts a plastic catheter under the skin (then the needle is pulled out).

The beginning is hard but it will get much better. Carry glucose tablets everywhere! Please take care. Our thoughts are with you.

[This message has been edited by Lyddie (edited 14 May 2005).]

So sorry you guys are going through this.
I hope yor daughter is feeling better soon, and you too!!

Yes, visit the American Diabetes Assn. site. They have an excellent magazine, DIABETIS FORECAST, with monthly articles on 1 & type 2; plus a KID's section of articles.

They also have a FREE ONLINE WEEKLY newsletter. Sign up for that.

best wishes to all

I am so sorry about MiKayla. Today is the first day i have free time (hired a babysitter so i could have some me time).

I popped in to see how everyone is doing.. now i am just crying my eyes out over MiKayla.

Hope ya'll had a wonderfully great princess party, Hugs to you.
Ya'll in are my thoughts and prayers always..

I will post an update on our lyme family in general.

When first discovered, she was in the psych ward..They then thought all of her problems were from the diabetes..HOw I wish that had been true..But she was hospitalized for 4 days to stabilize..She has been in once since..AND if there comes a time when she is very high and no matter what you do, nothing gets better, fight to get her back into the hospital..Sometimes the meds can really mess up the blood sugars..Do not play around if there is a series of highs or off of the meter readings..

But my daughter also has some serious psych issues and recently read some info on those meds and in one report, Prozac was found to be a possible culprit..

A friend of ours has a daughter with type 1 that they think may have been directly caused by a vaccination..

NO one knows proof positive,what exactly cause either girl's diabetes, but you can survive and thrive with diabetes..It is tough and takes a lot of education but it is possible..Unfortunately it is more difficult, I think, to control it when you have lyme disease..They seem to work against each other. And it is definitely horrid if you throw in the psych issues.

School causes a whole new set of issues..You must have a good repore with the nurse and teachers and there may be a need for education for them.This may be needed every few months or annually with new classes. We had a few very problematic teachers..I asked for a meeting with all .

I took a big styrofoam ball in with push pins in it..It showed the number of finger pricks she had in a month..A few tacks fell out and I said oh that is for when you have to redo the test because the machine wasn't working properly or you did not have enough of a sample. I also took in cherry lip balms(dollar store specials) to represent the number of shots in a day..

Additionally, I took some lancets in case any of them wanted to do a finger stick to see what it felt like..No takers..

Then I poured out her meds onto the table..And started telling more of her story..A number of them started clearing their throats..One later came up and was crying..But none of them treated her poorly after that. They can blow off what you say, but an actual visual demo stays in their memory..

Lyddie is very knowledgeable and can probably offer more advise than any of the rest of us. She has had some real baptisms by fire..

You will need to go with a restricted diet until things stabilize..I think for our daughter it was a few months..Then there was a honeymoon and we thought she was doing so much better..It was short lived.

The Dr has managed to enable our daughter to eat almost everything by covering all of her carbs..But it doesn't work when her lyme psych things are raging..He refuses to order a pump for her because of these complications.

There are also ultra fine lancets and needles..They are so much easier to use..And the pens are greater..You do not have to draw up the meds..Just dial and give the shot.

It is also less painful in the stomach..Some of the new lancet pens can use the arm..My daughter rarely has enough flow for that..Another good idea is to drink enough fluids to help with the blood flow..

Good luck..There is great current research and this may soon be a fixable disease..

I'm really sorry this has happened. It's just so unfair. I hope each day gets a bit easier, though I'm sure it'll never be easy.

Sending up prayers for you and your family. Give Derek a hug from me, will you? He's probably afraid this is going to happen to him too.

For ALL of you!

My e-mail address is [email protected].

Nikki You are both so blessed to have each other, I am very close to my sisters and my twin daughters share a special bond also (only one has diabetes)

It is wonderful to know that probably by the time Mikayla is a teenager there may be a cure for type 1 diabetes, they have made so many great strides in research just in the last several years its truly unbelievable.

We were away from home when my daughter was dx, the Dr. yelled at me for just coming straight to the ER without calling first (he thought she had the flu) When they got her blood work back she was over 700. he apologized and told me she would have died if I had waited.

I am proud of you for listening to your mothers instinct. This is why God gave it to us.

Take Care and God Bless
Cindy ><>

PS. Keep a journal, it will make everything easier in the long run and it will get Mikayla used to seeing you write everything down so when she starts taking care of this herself it will be a good habit.

Thanks so much for all the posts.. it's so nice to know I have all of you to lean on at a time like this.

The princess party was alot of fun. Mikayla had such a great time and it took her mind off the diabetes for a little while.

Her pedi called me this morning and told me that the meters they used to check her levels yesterday only went up to 900...Mikayla's read "high" which meant it was over 900 when she went into the diabetic shock.

And her keytones were extremely high as well..these two combined are a great cause for concern and I have to continue to monitor her every 2 hours and am keeping a journal of everything she eats and her reading before and after meals or snacks.

Today her readings are ranging from 378 - 595. Which is still very high as a normal range is somewhere between 70 and 120 ( i think that's what they said..I know it's 70)

(There is so much to learn about this type of diabetes that it is truly overwhelming..I am sure in a couple of weeks I'll be a pro..but right now I feel very inadequate and very scared..)

They are more concerned with the insulin making her levels drop below 70 which is why I have to keep charting her readings and I have glucose tablets on every surface of the entire house...seriously I have at least 10 tablets in every room.

I am taking no chances!!!

Lyddie, thanks for clarifying this...At my training session and again today when I talked to the pedi, I was forewarned that many people confuse type 1 and type 2 diabetes.

And that type 1 can not be cured in any way shape of form by dieting, supplements etc... I was told about the honeymoon period where her pancreas may work a day or two and produce insulin..

and warned that this is only a temporary thing and that it is not to be mistaken as remission, as it only lasts for a short period of time and that Mikayla's body is not capable of ever producing enough insulin to keep her stable.

So while I am not discounting anything said here, and I truly appreciate all the advice and suggestions..

I am so overwhelmed with trying to learn the "basics" to keep my baby alive, I simply can't even contemplate experimenting at this time.

I am so scared and overwhelmed that I feel like vomiting everytime I have to mix her insulin in the syringe and inject it in her arm.

Believe me if the doctor gave me any hope that there was another way or hope, other than sticking a needle in my precious daughters fingers every two hours and giving her insulin shots everyday, I would sell my body on the street corner to find a way to get her the treatment that would spare her this pain and fear...

I feel so inadequate right now..I am flying by the seat of my pants and pray to God that I am doing everything right. it is so damn scary injecting the insulin into her little body.

And everytime I stick her fingers, (which now both hands look like pin cushions) I silently pray/beg that the reading will be below 500.

Which is still ungodly high in my opinion, but the docs said that was the magic number... as her sugar levels have been so high for who knows how long, that it will take a bit for her levels to get back to normal.

Today when it hit 595 I was shaking so hard I had to sit down.

Luckily I have found an inner strength I never knew I had, to not show my fears and anger when Mikayla can see me..

To her I am the bravest and bestest mommy in the world and she draws strength from her belief that I am this incredible mom..

So even though I feel like a fake, I will continue to put on a brave front so she can continue to feel secure in my ability to be the super mom she thinks I am...

In truth it is me who is drawing strength and faith from my 6 year old daughter!!!!!..she is wise beyond her years and is taking this life altering news better than her mom

I wish I was able to be as capable as she thinks I am. Inside I am so afraid and irate that this is happening to her...

I know it's not rational to feel this way and trust me I am so thankful that I listened to the voice that told me to get her to the doctor yesterday, as who knows what might have happened if I hadn't taken her in when I did...

Thankfully by the grace of God, I will never have to know what might have been and I know once I get over the fear of the unknown, I will be better able to adjust to our new lifestyle.

I keep reminding myself how fortunate we are to be living in a time where there is excellent treatment for type 1 diabetes and that with proper insulin doses to regulate her levels, she can lead a relatively "normal" life....

She is very fortunate, I know that...honestly I do.

But right now I am still in my anger stage and need this time to adjust..

Smokey, Lyddie and Lisa, I will write more when I have more energy..I am drained right now...but I wanted to be sure to thank you for letting me know that I'm not alone and for giving me the websites to find the help I need for this disease... I was up all night reading and learning...

Okay, I should try and get some rest, it's hard to sleep when you have to wake up every 2 hours..but thankfully with the new testing machine they gave me, I can do most of the test without waking Mikayla up...

She only wakes up when I prick her finger and falls right back to sleep...

I hope I am making sense, I am so tired I feel like I am babbling with the keyboard..

Thanks again!

~Missy

You are doing so great!

Something I thought of, when our friends 11 month old got it, they used to test on her toes... more than her fingers. I didn't know if they told you that you could do that.

Just so you know the honeymoon period may last longer than a couple of days, sometimes months.

I really want to encourage you. Think back when you brought your first baby home from the hospital, and the first few days even weeks we feel so inadequate and scared, then we become experts on our own babies, what each cry mean, what comforts them. Then we realize were OK, actually were pretty darn good Moms. This will be the same way. You will be an expert on your daughters diabetes. Remember God will not give you anything you can't handle and he will be with you every step of the way, just as He gave you what you needed to recognize something was seriously wrong and get her in to the Dr. right away. He will continue to to guide you through all of this. ( I hope this makes sense).

God Bless
Cindy ><>

I had followed the regime myself, albeit for mildly abnormal glucose readings NOT TYPE 1 however.

DLL

I'm not sure but I think that with injections the cost of insulin (long-acting plus short-acting) would be about $100-125 per month. I have never bought syringes w/out insurance but they aren't all that expensive, I don't think, even if for 150 syringes per month.

Every person with diabetes deserves and has a right to an insulin pump. A good endocrinologist would write a letter of medical necessity. A patient's HgA1c levels (3 month average blood sugar) goes down drastically on the pump!

Insulin pump companies have programs to help low-income or uninsured patients get a pump. I helped advocate for an elderly friend who did not exactly meet their income guidelines, and Minimed still helped her out. Medtronic-Minimed, Animas and Deltec are all good pump companies who seem pretty dedicated to patient health.

There are government programs for children, the elderly and others who can help with this too.

Some people actually CHOOSE not to use a pump. One thing I dont understand is that testing strips are not covered by insurance.

So far as restricting the diet. It is not good for anyone (diabetic or not) to eat garbage junk food. My father often comments that I am much more restrictive about my food intake than he is as a diabetic.

Healthy food habits are learned from parents. It is a shame that our society sees restrictive in terms of not filling our bellies with McD's.

On a side note, in the early days of medicine Type I was believed to have been caused by an unknown virus either in womb or early in life. There are some researchers that are starting to look at this theory again.

In the book where they ask you to write down her blood sugar numbers, I use 1 of the columns on the left to report this:

L 1,2,3,4,5, R 1-5 ---

it's my method of keeping track of what fingers I'm poking for my BS no.

I can't remember which one I did when.... so I came up with this method for myself.

I take 2-3 daily. So I start on the outside to poke, then inside, & if needed....middle for a 3rd poke daily.

Hope this method might help you out. It sure has saved on my sore fingers.

You are a trooper.

I do understand the basic differences between the two types of Diabetes...but, I just wanted to send you some info...whether it helped or not.

Try to relax....don't allow yourself to get too run down...you may relapse.

Trout

The first few months are definitely the hardest. There is so much to learn and I know you must feel overwhelmed. I did, and I also went through a period of mourning - I guess for my child's future, but actually in the time since he was diagnosed, his diabetes has rarely slowed him down or prevented him from participating in anything he was interested in. It is very hard with a young child to develop that mindset (- to let them participate in almost all activities), because I wanted to protect him from every possible hurt, slight, danger or disappointment. It was very difficult for me to not overprotect him. Although, in the beginning, I don't think that is as applicable because you have to protect them from low blood sugars, ignorant people, etc. . The year my son was diagnosed our situation at school was a nightmare with a very uncooperative and ignorant first grade teacher. I hope you will be in a more supportive school environment. Since then, most of his teachers have been great and very conscientious about his care. Believe it or not, her diabetes care will eventually become routine and you can relax more about the activities she might want to enjoy. Just make sure she never leaves the house unprepared for a low. You can get glucose tabs in little packets of 2 each and they are very easy to carry this way.

A couple of practical suggestions. Our son was terribly afraid of needles and would hide behind furniture and kick & scream at test time until we got his doctor's okay to use his toes for testing. His toes weren't nearly as sensitive and he soon became much more compliant. His three year old sister even got in on it to show that she could be brave too. The doctor only would allow this for the first year because of possible foot complications, but he voluntarily gave it up before then. Later we switched him to a meter that would allow forearm testing. There is also one that allows palm testing. Our son is now 17 and has been back to pricking his fingers and like Lyddie's daughter, the callouses make for some awesome guitar playing.

Also, before we started him on the pump, we bought an injector for his shots. The needle is prepared, then loaded into the injector, push a button and the injector quickly pushes the needle in and to the right depth. Much easier and he liked to do it himself.

When we did start him on the pump at age 8 or 9, life became much easier. Our doctor gave us a prescription for Emla cream to numb his infusion site prior to insertion. We had tried ice, but that didn't work as well. Just keep in mind that it takes 30-60 minutes for the cream to become effective and you have to get the cream off prior to insertion so the adhesive in the infustion set will stick to the skin. Until he was about 13, he loved doing demonstrations on the pump for his class - most of his teachers were very accomodating and it helped dispel some of the mystery for his classmates.

With the pump, he was able to eat a much wider variety of foods and the timing of his food was no longer as crucial. The downside is, there is a temptation for them to eat everything under the sun, especially once they reach adolescence.

I would encourage you to read as much as you can about type 1 diabetes. The ADA has a good website with some very good suggestions pertaining to school and 504 plans, etc. We subscribe to Diabetes Forecast and we used to subscribe to Countdown (JDF) and another publication whose name is escaping me at the moment.
Check out your local library. I think I read every book on diabetes that ours carries.

As hard as it is, please believe me that in time it will become easier. And even though it becomes routine, you do still have to remain ever vigilant for lows and highs. From your previous posts I can tell that you and Mikalya are very strong and I am sure you are very proud of her for being such a trooper. I am keeping you in my thoughts and wishing you all the best.

One more thing, it is almost universal for type 1 diabetics to go through a honeymoon period in the first year where the pancreas starts to produce some insulin again. We went several weeks with no insulin at all in that year. It is a cruel trick of nature and very easy to let your hopes get up, but if you are prepared it is not as difficult when the sugars start to elevate again.

There was a post on Lymenet a few weeks ago about a boy in Japan who received an islet cell transplant from his mother and was cured (previously donars were deceased), so there is always hope that one day this disease will be beaten.

Suzy
(Sorry this was so long)

Thanks for all the posts..

****Update****

Mikayla's sugar levels were ranging from 425-490 today. Her doctor calls me a couple of times a day to check on her and assures me that this is okay.

When I went to the pharmacy to get her prescriptions filled, she was dizzy and scared the day lights out of me. Luckily the pharmacists was there and said I was doing everything right and that it will take a while for her levels to get back to normal...

THE good news is that I am no longer almost vomiting everytime I have to inject her with the insulin..phew!

She is still dropping weight...does anyone know when her weight will stabilize?

Mikayla only had 2 crying spells today and is truly taking this life altering change, much better than I ever could have hoped for..

We have to go to the diabetes clinic tomorrow and the hospital for more testing and training.

I think they are concerned about her keytones being so elevated and want me to test her urine now as well.

I feel so ignorant about all this and have sooooo much to learn.

I will let you know how things go tomorrow...

Thanks again for all the help and support!

~Missy

p.s.

She's going to have ketones with blood sugars that high. I don't understand why they are still so high...Was Mikayla inpatient at all?

My daughters' blood sugar was 29 the first night she was diagnosed. They overdid it a bit with the insulin. Is MIkayla's doctor afraid of a low? Is he/she an endocrinologist or primary?

Mikayla will stop losing weight when her blood sugars come down and the glucose from food is absorbed in her cells instead of coming out when she pees.

Maybe other people had experiences that were different from ours, but my daughter was inpatient for 5 or 6 days and they brought her down fast. Scary that way, but she sure didn't have ketones.

Can they step things up a bit for Mikayla? Maybe the clinic will get Mikayla on a program that is a bit more aggressive, Monday.

--Annie

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You're doing great. This can't be easy.

I'm really glad you have a few expert Moms like Lyddie, Smokey, Lymemomtoo, SueZ Q, Kara and the others who know this illness and are here to help, especially when you are learning so much. (I like the newborn analogy.)

Between that and your family and the Docs, she's in great hands.

Many Blesings,
Mo

Were off to the diabetes clinic today, so I'll update you all when I get back..

Lyddie she was diagnosed by the doc on call at her pediatrician's office. And as fate would have it the pedi endocrinologist was at the clinic that day. ( he only works there 2 days a week...and he was on lunch break and saw her immediately)

I was told that 3-5 years ago, she would have had to spend about a week in the hospital, but now things are made to let the child go home so it's less stressful on them.

Plus we had to spend over 4 hours at the juvenile diabetes clinic with 4 nurses, a nutritionist and her new diabetes doctor met us there as well.

I learned how to give her teddy bear ( who also has diabetes) shots first and I also gave her the second shot of insulin on my own ( of course with nurses standing by)

I also learned how to do the blood tests, and how to record the reading, keep a food diary, plan meals, etc.

Her doctor calls me every morning and afternoon to check her blood sugar levels which have dropped to 400 this morning

The level usually goes up when I do the test 2 hours after she eats, and I was told this was normal.

The reason they told me they are taking this slowly is that we have no idea when the diabetes started and they know that when she was in the office her levels were over 900 ( or higher as meter only went to 900)

So from what I understood, they didn't want to lower the level too fast or she'd go into some type of shock...so they are lowering it slowly.

As for the keytones, I really don't know much about it, other than it was high/elevated or whatever they call it and concerned her pediatrician.

I was told that I am suppose to be testing her urine at home and that they will teach me how to do all that today at the diabetes clinic.

I was very impressed with the diabetes clinic..it is a branch of our local hospital and the entire first floor is dedicated to diabetes and there is also specialists who do pediatrics.

The nutritionist spent some time with us using realistic looking food in correct portion sizes to teach us what a carb was in diabetic terms..which food are good to eat..

She told Mikayla about splenda and how she can no longer eat sugar etc..

They gave her a beautiful teddy bear who also has diabetes and it has colored patches at the injection sites and we got to help Ruby ( the bear) by giving her insulin shots and testing her blood.

Mikayla even got to prick my finger and test my blood, but she got too scared and couldn't do it, so the nurse did it for me.
( and it did hurt a little I must say )

Mikayla goes to the Children's hospital at Dartmouth ( Chad) for her cyclic vomiting syndrome, but so far they haven't set up an appointment for her to be seen for the diabetes.

Someone at some time mentioned sending her there, but the doctor at the diabetes clinic is excellent ( or so they say ) so I'll wait and see what they say today...

I feel like I am flying by the seat of my pants, but overall, I think I am dealing with all this pretty well.

We went to the pharmacy yesterday and I was advised to buy a diabetes bracelet which was way to big and the chain hurt her wrist, so my husband used some cording to put it on, until we can get a child size one.

The clinic gave me the address to order cute ones for kids, I just haven't ordered one yet...

And I bought a diabetes cookbook yest. and found some sugar free candy at the pharmacy..but noticed it is sugar free but does have sugar alcohol..so I'm not sure if she can have it..I'll have to ask the doctor about that today..

Okay, thanks again everyone..you have been a blessing!!!!

I have to get Mikayla ready to spend the day at the diabetes clinic.

Wish us LUCK!!!

~Missy

They may be talking about avoiding "insulin shock" which is low blood sugar. I believe that if Mikayla has been very high for a long time, then she will actually feel low at a higher blood sugar than is normally considered "low," so maybe that is why they have to be careful. LIke I said, inpatient, they sure did bring my child down quick but it was problematic...

The only other thing is that once Mikayla does come down, she'll start having lows. Lows happen a lot, frankly. Noone warned us about this and if I could change one thing about our first week, it would be to know that. We went grocery shopping and my daughter started crawling on the floor (she was 4) and couldn't walk, so I had to grab some juice off the shelf. Noone had told me to carry anything with us.

Juice boxes are good but the fastest are glucose tablets, as we have all mentioned already. We wouldn't go anywhere without at least a whole tube of them. They come in jars and tubes. Buy jars, and use them to refill the tubes. The medical folks will probably tell you all this anyway.

Lows are EASY to treat so I don't mean to scare you at all, just let you know what our biggest challenge was at first.

I was trying to remember if it was Mikayla who had the cyclic vomiting. If you look back to some of your posts, I suggested that this vomiting might result from high ketones. One of my kids (ironically, not my child who has diabetes) had episodes of vomiting from "ketotic hypoglycemia, but ketones from high blood sugars also do this. This may have seemed off the wall to you back then, but I wonder if this was a first sign...? I remember suggesting to you that you test Mikayla's blood sugars when she was having the vomiting. Hopefully, if that is at all related to the diabetes, she won't have those episodes again. Or maybe it's unrelated, just a thought.

We see a very aggressive doctor in Waltham for diabetes: Stuart Brink 781-890-3610. He travels all over the world helping children, including orphanages in China and Romania, and is on the board of JDRF. He's excellent with young children. He is an advocate of tight control.

We decided to do very tight control because fluctuating blood sugars seemed ot have such an effect on personality and functioning for our daughter. With near-normal blood sugars, she sparkled (the kindergarten teacher's word) and she got fuzzy and out-of-it if her sugars were above 200.

I read a letter to a magazine by another mother who said that tight control had "given her back her child" who had been emotionally "labile" with looser control.
This may not be relevant to Mikayla, but i was grateful to this mother so I mention it for your later consideration.

At 15, blood sugars don't seem to affect my daughter as much but for school especially it still seems important to stay between 70 and 180 or so for focus on learning. Not that she always achieves this...

Right now you are dealing with the basics and reading your e-mail brings back a lot of memories about what that was like!
Hang in there and again, let us know if we can help.

A thought..We had our daughter at the diabetic ed bldg, a part of the complex..The head nurse was to give her a flu shot..This was the year that she was diagnosed..She inquired about numbers and how our daughter was doing. It was rough at that moment..

She stopped everything and did a stick and did not like the results..We had her numbers with us and she was very upset..She told us to wait.

She went thru to the diabetic section and came back with a new Dr, one that specialized in pediatric diabetes and a completely new med protocol.

We had been mixing two types of insulin and it has been a couple of years, I can't remember what it all was..But she had her switched to Lantus and humulog..It has been a great help..

If you continue to have trouble getting the numbers down, and do not take the above meds..perhaps you could inquire..Our daughter is now on NPH and novolog..It has helped with control..

Also there are many meds that affect blood sugars to either extreme..Read all of the fine print in the med enclosures..

And there was a time when we had to hospitalize our daughter do to inability to get it down..Demand this and fight for this if necessary...Insurance does not like to do it..

The Dr thought she was being non-compliant..Which is frequent with teens..Well, the hospital didn't get it down either, so the Dr finally apoligized to both of us.. There was something that was affecting it that no one could control.

Stress can also wreck havoc with blood sugars..

Our daughter went on the pump in 3rd grade (she's now finishing up 9th) and the fine-tuning that the pump enables us/her to do has made all the difference.

The pump has a continuous "basal rate" of insulin which is programmed. You can actually program up to 12 rates per day, so that, for instance, you have much less insulin at 1am when they run low, and much more at 4am when they run high, etc. Then you program "boluses" of very specific amounts of insulin, determined by a formula of carbs to insulin (say, one unit for every 12 grams) which matches insulin exactly to food eaten.

If it is raining and the insulin rate is higher, then the sun comes out and you are going bike riding, you just turn the insulin down! With injections, you are stuck with what you took and have to drink lots of juice to exercise in that situation.

On the pump, as long as you are doing okay, you can eat anything anytime, so pizza after play practice, parties, etc, are never a problem. You can also eat an appetizer, do insulin, eat the main course, do insulin, have a cookie, do insulin, and decide to have another cookie and do insulin! No problem with sugar or any other food.

(BTW diabetes research has debunked the idea that people with diabets need to avoid sweets..actually, white bread, rice and potatoes make blood sugars spike more than ice cream, candy or cake, which have fats that slow down the spike. Fruit can really make blood sugars soar too.)

On the West Coast, MD's put newly diagnosed kids right on the pump, but they are so much slower on the East Coast. I really don't understand why. We use the Minimed Paradigm-have tried others but always return to Medtronic-Minimed.

Lymemomtoo, what was your experience with initial care? I have heard that Dartmouth runs kids high and wonder why it is taking so long to bring Mikayla down.

We realized that the reluctance to do anything "tight" with kids may stem from fears of liability. The kids have a right to feel well asap no matter how stressful it is for the rest of us! (Or how much legal danger doctors feel they are in.) And we certainly did have stress with lows at first. What happened with your daughter at first?

I just wanted to thank you all again for all your help in helping me adjust to all of this..I truly appreciate you all sharing your stories and experiences!!!

***** Update*****

Mikayla is doing a little better today. we spent the day at the diabetes clinic and they treated her like a princess..they even gave her a princess pen

We met with the doctor, 2 nurses, a diabetes educator and a nutritionist. And her PCP calls every day to check her levels..so in truth I think she is receiving better care this way than she would have being admitted into the hospital...

And stress was a bit of a factor in this decision as she went through some pretty heavy testing when they diagnosed her with the cyclic vomiting when she was 2 and she hates hospitals almost as much as needles.

Her levels are ranging between 380-555 the past 12 hours and the doctors are not concerned about this..they are more concerned about her levels dropping too quickly.

Mikayla got dizzy again yest, and even though her number was 428, the doc said that as her levels were 1000 on Friday 428 is low for her at this time and her body thinks is reacting to what it thinks is a low level.

I swear the more I learn about this, the more confused I get.. but I think I am doing pretty well.

The educator and nurse told me yest that of all the parents who have had to deal with a child going into diabetic shock, and everything involved in taking care of the child, that I am dealing with it better than any other parent they have seen...

I don't know if they were saying that to make me feel better or not, but it did help me to not feel so inadequate.

Sometimes I get so overwhelmed, I wonder if I will ever be able to remember everything and second guess myself all the time..

But I know in time Mikayla and I will be old pros at all of this.

They did up her insulin 1 unit for 3 days and will up it a unit at a time until we can figure out the right does..plus with the honeymoon period, it seems like it will take some time to get everything stabilized..

We meet with the nurse again on Thursday and the nutritionist, educator and nurses next Tuesday..so I'm glad there not just leaving me to do it all on my own.

The educator told me that for now, I am on a need to know basis ..she said that if she told me everything I would need to know about type 1 diabetes, I simply wouldn't be able to remember it all, they have briefly explained everything and are concentrating on teaching me the basics now and will go into more detail about pumps..etc at a later date when I'm not so overwhelmed.

And I was also told to make sure I have juice boxes, crackers with me at all times and that I need to have glucose tablets in every room of the house, my purse, school the car etc.at all times just incase her levels drop.

Yikes, talk about scaring me to death, but I am glad they spent so much time drilling this into my head as I now am very confident that I would know what to do if her levels dropped into a dangerous zone..well almost 100% confident

Lyddie, I do remember you mentioning the keytones, but I never really understood what you meant until now. I do remember they tested her for diabetes when she was 2, but I don't think they have in the past 4 years.

Like Lyme disease, unless you are having to personally deal with the disease, one simply can not understand the disease in it's entirety..at least I couldn't.

I thought like alot of people think that type 1 diabetes is the same or similar to type 2 diabetes..when in fact only about 5% of all people who have diabetes have type 1...

Okay, I have to run to the pharmacy to pick up a special order of a new gauge of lancets..they are much smaller and we tried it yesterday and it didn't hurt Mikayla as badly as the other ones we were using...

I'll keep you all updated, thanks a million for all your advice and support!!

Sorry- I know you need to need to have confidence in the people who are helping you, and I know the information overload is overwhelming. Congratulations on the compliment!

I tried to e-mail your sister so we could get this off Lymenet, but couldn't get through...Sounds like you feel comfortable with the help and advice you are getting so I would love to talk once you get past this first month.

I think your sister has my e-mail (my real name is Pamela)...if not I will violate my own policy and put it on here.

The combination of Lyme and diabetes will eventually be an issue. Suzy, lymemomtoo and I all correspond, so feel free ...Right now you're doing an amazing job...I dont' really want to say welcome to this small, select club (dealing with this combo), because it's not a good thing...but welcome anyway!

Thinking back, I remember that she had a severe spell of vomiting. It lasted for a couple of months..off and on..No one ever diagnosed it but her Endocrinologist said it had to be RSV...NOw that you mention the cycling vomiting, I wonder if it may also have been related in some way to diabetes.. NO other children at school or nearby had any such symptoms.

I agree that lows will happen and from our experience, they are only dangerous if you do not treat them. But it really freaks out the school nurse..I remember a low once from gym class.

She had been accidentally hit in the face by a badminton racket..The nurse called me about a low and I was more worried about her face. But I also knew that the nurse had given her crackers, etc.

But the school will use the threat of lows as justification to not let the children keep their meter and insulin on them..My daughter has had major problems with this..She will often have a high just because she doesn't want to miss instruction to go to the nurse..A big school so a lot of time to go and come from the nurses office and a minimum of 10 minutes missed.

When my daughters lyme symptoms are not causing psych problems, she is in fairly good control. But currently blood sugars are off.

I think the pump would be an asset but the endocrinologist will not consider it until she is in better control and the psych issues are better..This may be a timely thing since she is 18 and college is not in the near future..So there is a potential insurance problem.

She has been taught to cover all carbs with the 12 to 1 for insulin..But the mind must be clear to do this. And the OCD problems cause her to not let me handle any of her diabetic needs. And it isn't for lack of trying..

But with an 18 year old with suicide depression, I loose all battles. Actually am chastised by the psychiatrist for forcing any issues but then am also chastised for letting my daughter manipulate us. No wins here but hopefully time will bring some cures..

If low blood sugars are present it's better to have them have juice or glucose tabs to bring up the level quickly rather than crackers or carbs...carbs will actually bind wiht the sugars and slow down the rate that the blood sugar will rise. So if you eat crackers and have some juice and retest in 15 minutes you're going to find that a blood sugar that was at 50 might have only raised to a level of 60 or so because of hte carbs 'slowing' down the rate of absorbtion of the juice sugars....if you just drink juice and have some glucose tabs WITHOUT carbs then the blood sugar will rise from 50 to about 110 or so in a 15 minute time period usually, the child's shakiness or feeling weak will go away..THEN getting some carbs into them is a good idea to maintain the blood sugar level....

I hope all htat made sense..this is how I maintain all my kids here at school and it's worked well for years. THis is based on their physicians's medical management plans...their all alittle different based on each child, but this is the general 'gist' of them.

keep up the good work missy, you're doing great!!

I haven't been around here in months but I came on today just to check in and have been reading this post for at least half an hour and crying for you and your princess.

I was dx with type 1 diabetes at age 13 and now I'm 22. I didn't know I had Lyme until 7 months ago but I'm pretty sure I've had Lyme since I was about four years old.

I also believe that Lyme contributed to the autoimmune response involved in diabetes.

Anyway, my heart goes out to you and your little Mikayla. The first few weeks are so tough but you will get through.

It sounds like you have a great medical team behind you. They are good to teach you the basics and then you can deal with the more complex issues.

The first week there were three or four things that I knew how to count and cover with insulin so that was all I ate.

Slowly, I learned how to count more foods and how each would affect my blood sugars.

Just know that you are not alone and that things will get easier.

But until they do, also know that it is okay to cry and to ask for help and to be angry. Let Mikayla know that it is tough for both of you but that she doesn't have to be strong for you. (That is not a job for a six year old.)

As far as practical tips, I can offer these hints. They are in no particular order and you may take them or leave them.

-Try a few flavors of glucose tabs and find a favorite. I like rasberry but there are grape, orange, and a few others as well.

-Get a special bag for all of the diabetes supplies and let Mikayla decorate it. It is just a small way to make it less sterile and foreign.

MEDport and DIA-PAK both make bags designed just for carrying diabetes supplies.

-Give her choices whenever possible. Which finger does she want poked? Graham crackers or Ritz crackers? Shot in the arm or the tummy?

-Find out how comfortable she is with sharing about her diabetes. If she doesn't want the "whole world" to know, find a quiet or out of the way spot to test her sugar and give her shot. If she wants to show off her bravery, then let her.

-Try to have everything ready before you call her away from what she is doing to test. Have the meter on, strip in, poker cocked and ready. That way she doesn't have to wait and watch in anticipation. Same for shots.

-Make baggies of snacks that are already counted out. 15 teddy grahams, 7 Ritz crackers, or whatever she likes to eat. And/Or write the number of pieces per "carb" in thick black marker on the box. Remember that the printed serving size usually doesn't have 15g of carbohydrate in it.

-Take care of yourself! Ask for help with groceries, laundry, etc. Steal a nap if you can. Take a bath. You can't keep your kids healthy if you aren't healthy.

I just returned from a week in Washington and was shocked to read your post. Truly, my heart goes out to you and Mikayla.

I am a type two diabetic and right now I have one suggestion that was over looked when I was first diagnosed five years ago.

The diabetic educator/nurses may have mentioned this, but if not this is important to know regarding glucose test strips. The test strips need to be kept below 86 degrees and not stored in the refridgerator (check the vial package instructions.) Also, use the test strips within three months of opening the test strip vial. Thus, it might be a good idea to work off of one vial until that vial is empty. Also, test strips are very sensitive to light and heat exposure. Thus, it is important also to close the lid to the vial once you have removed a test strip.

When I need to test and am not at home, I leave my meter in the car but carry the test vial or vials in my purse. This way the vial or vials will not be left in a car that is too hot.

It seems like you and Mikayla are in good hands. I commend you on the fantastic job you are doing working with the professionals in learning how to meet Mikayla's new needs. Compliancy is most important in managing diabetes. Be sure to get enough rest and know that it will get easier over time as the whole family adjusts. I will keep you all in my thoughts and prayers.

We were lucky, originally this was proposed by the area supervisor at the Dept. of Public Health. This person told me that if we did it that way, there would be a whole class (75 kids) raised with my daughter's diabetes, who would be matter-of-fact about it and helpful if, say she ever got "too pale" on the soccer field.

This is pretty much how it has gone. Kids
love any new gadget like meter or pump, and when a softball hit her hand, the other kids tested her blood for her! It's all just part of normal life for them all.

With the school, the idea was that according to the law, she should not miss any classtime, and going to the nurses' office for care would impact her education (my daughter tested a lot when younger).

As a result, an aide or extra nurse was usually hired to care for the two kids with diabetes, Now, of course, she takes care of herself and this is no longer necessary.

Before kindergarten, the school went to town meeting and asked for extra money to hire a part-time extra nurse. Their argument to the town was that it would cost more money to send them out to another school.

Massachusetts recently passed a law that says kids with diabetes can do their tests and shots in the classroom. There have been cases through Section 504 (Office of Civil Rights, Fed. Dept. of Education) where this has been established as well.

Of course, this is a matter of choice, but it has worked out well for our daughter and for her classmates.

The other thing is that the school needs to make sure staff members are trained in glucagon for rescue, and although a lot of us parents always go on field trips, you are not obligated to do this and a nurse should be provided.

The American Diabetes Association, as some of us have mentioned, has a great sample 504 and health care plan. Since it is now May, maybe you can reread any posts about school over the summer, once blood sugars have stabilized and you have a spare minute.

Hi Everyone,

You guys are awesome... I can never thank you enough for all your encouragement, support, advice and prayers...

I have been crying most of the day..

Today is my birthday and Mikayla and I decided to celebrate by having a picnic lunch and then a trip to see Grammy and Grandpa in the woods ( what she calls my dad and step mom)

Things were going fairly well and then out of the blue Mikayla became very fussy, and agitated. Then when I suggested she have a snack as I was told to do this if her moods changed, she became very aggressive and she actually hurt my wrist by pulling on my hand.

I was shocked. So was my dad....Mikayla is a sweetie. She was elected the class friend and is getting the citizenship award..she is truly a sweet little girl...

Of course she has her moments, she is a redhead afterall but nothing remotely like this.

I took her blood sugar and it was 428..about the same as it always is that time of day. So I gave her a snack and literally within 5 mins she was back to her old self.

I called the doctor and his nurse said that it was because her sugar level is off.... and that kids often behave differently when this happens..

Yikes, just when I think I'm getting it, something like this happens. And now Mikayla feels badly that she hurt my wrist. She truly doesn't even remember tugging on it...now that is scary!

She had eaten about 1 hour and 45 mins before this happened, and I give her a snack every 2 - 2 and 1/2 hours, so I'm not sure what happened.

The nurse said that while she is in this is honeymoon stage it is going to be difficult and every day will bring its own challenges.

If I could have anything for my birthday it would be that this would all just go away..I know that isn't going to happen, so I'll wish that her sugar levels will stabilize so we can manage it and she can lead a somewhat "normal" life.

I am feeling so overwhelmed... Heck, I'm crying as I write this..it seems like that's all I have been doing today...Please tell me that the nurse is right and this will get better once her sugar levels stabilize...it is so difficult seeing her like this

Well I have to get going. My husband and I had reservations at my favorite restaurant tonight, but as it's an hour away, we cancelled it.

My sister and husband insisted that I take a break, so I am dropping the kids off at my sisters and going out to eat at a restaurant about 4 mins from their house.

I am so nervous about even being away from her that Long!!! But I will give her the insulin and dinner before I leave and have a bag all packed with snacks, glucose tabs, juice, insulin, all the doctors numbers, the test kit and of course her diabetic teddy bear..

And I plan on eating with my cell phone in my hand!!!.. I'm not kidding...I know I'm probably over reacting, but I will never forget the image of her in diabetic/insulin shock last Friday..I see it every time I close my eyes!

Well I have to get going, my husband and kids are waiting for me.. I have to put on a happy face and celebrate my birthday with the kids. Mikayla even made me a special present so I wouldn't be so sad..here she is 6 years old, being pricked so much she looks like a pin cushion and getting shots twice a day and she is worried about me...she is amazing!

thanks again for everything and I promise I'll email you all when I have more strength and time!

quote:

---

Originally posted by Lyddie:
Lymebrat, how's Mikayla and how're you doing?You are probably too busy to check in so I am bopping this up for now. Is Mikayla coming down and feeling better?

---

Lyddie,
could you edit this out? [the boxes] I think that's what is making the screen too wide. I'm having trouble reading it, as I'm sure others are.
Thanks!
How'd you do that anyway??!

PAGE 2 IS HARD TO READ BECAUSE OF THIS
------------------
oops!
Lymetutu

[This message has been edited by Lymetoo (edited 18 May 2005).]

also, federally, it's still a law that only nurses can inject a child with glucagon sticks for very low blood sugar. THe ADA is trying to change htis, however, every year the nurses have fought it and it has failed legislation and htere is a reason we have fought it. THere could be many reasons htat a child goes into a coma, and only a licensed nurse can fully asssess a child and make sure it's because of low blood sugar and that hte glucagon NEEDS to be given or it can really injure a child. For instance , one of my diabetic s is also a seizure child, and can become unconscious from seizures, if someone gave her glucagon without testing her and boostedher bloodsugar more it could really be a problem. If an untrained person who cannot fully assesss a child gives the glucagon it can cause disastrouse results.....some children go into a coma if their blood sugr is too high, and you've just boosted thier blood sugar alot...

so we nurses have fought to keep it so nurses alone can assess a child to give the glucagon, that's why nurses always are supposed to be in a school building if there is a diabetic child on premises...I"m never allowed to leave the building...

the only other person who knows thier own child and who could test them quickly enough to know whethr to give hte glucogon sitck etc would be the parent at home ...plus they know thieir child better than anyone....

so if a school is presently allowing any staff memeber to inject 'in case' a glucagon stick they are going against federal regaulations of the Nursing regulations for diabetic children. THe bill jjust once again went before legisltion this past month and failed again....

IT IS THERE FOR THE SAFETY OF THE CHILDREN. THEY NEED TO ALWAYS BE PROPERLY ASSESSED IF HTEY SHOULD FALL INTO A COMA..NOT JUST GIVEN AN INJECTION...

just some inportant info from a nurse that deals with many diabetics every day...they're like my babies and I watch over them very carefully....

Lisa

Glucagon regulations are a big problem. EMT's cannot administer it, so if a child with diabetes stays after school for sports or for a play, technically, the school nurse should be there- for ALL school-related activities, so that someone is there to do glucagon. This is at any age, not just younger children,

Most schools can't afford this. ADA is trying to pass legislation on this, to allow aides or teachers to do it. I have had public meetings with selectmen and with our regional Emergency Medical director to try to get the EMT issue resolved. basically, NOONE will do it ...

School nurses aren't allowed to train staff to do glucagon,either,so our school (wink, wink) had me train coaches and teachers
and wrote me a letter of thanks, to prove they hadn't!

Glucagon is not going to cause a coma from a high. It takes a few hours for that to happen. It really can't do any harm. Besides, the protocol calls for a blood test first.

Another great issue is that school nurses aren't allowed to make insulin decisions, They need a doctor's order. This doesn't work at all with "tight control." The very essence of tight control is adjustment of insulin. Endocrinologists would never be able to take that many phone calls. So our
school gave my daughter a cell phone and if she needs an insulin adjustment or a shot at all (she's on the pump), she has to call me and then I tell her what to do. Again, they allow me to do it to avoid doing it themselves. The whole situation w/DPH regulations is a big problem.

What I am saying is that in our town, the solution to every regulatory problem has been to rely on the parent, which makes it awfully hard on us parents (not to mention family incoome). There are years when the nurses have called me every single hour of the school day.

The new Massachusetts law actually allows kids to take care of themselves. I personally don't agree with this. it's an easy way out for everyone who is dealing with regulations, but not safe for a kid under 12. I think this law will mean schools will be even less responsible for kdis with diabetes,and they won't fund nurses to help the kids because, after all, it's now legal for the kids to do it themselves. End of liability for the schools, so end of funding.

[This message has been edited by Lyddie (edited 18 May 2005).]

My daughter went crazy when she ate a bagel in the early weeks. When her blood sugars fluctuated (and I mean between 40 and 300, which is normal at first) she was not herself and was "emotionally labile."

I forget if I wrote this before, but this is the reason we did tight control, not just to avoid complications.

I told the MD that the hardest part of the new-onset diabetes back then wasn't the shots or the tests or the getting up all night, it was that my daughter was not herself . More stable blood sugars took care of this.

So what you are experiencing (with Mikayla acting different) is common and will get better. Hang in there!

The RI nursing Association is in favor of the bill, as long as the Dr., nurse and parent are in agreement that the child is able to handle the testing in the classroom and is safe in doing so. In other words, can count his own carbs, handle drawing up his own injections, or bolus' if on pumps etc.handle blood bourne pathogens etc...

but currently, there is no bill in RI that supports a child testing in the classrooom. The federal government backs 'any state that decides to allow for testing for any child, however has left it up to the individual states, and then the individual school systems to make up their own regulations regarding the allowance of glucose monitoring in the classroom.'

THis is why I said, just check with your own state. Some states have passed the regulation already, some have not. If Ri"s passes in June, which it should, then all schools can have a policy in place by Sept. 1, 2005 for their Diabetic children.

As a school nurse in our district we have very strict medical management plans from our endocronolgist's on each of my diabetics children that tells me what to do in every situation for each 20 pt over or under their blood sugar may be etc..or how to administer their insulin depending how many carbs they eat etc...the management plan tells me also when to administer glucose tabs and juice , and when to have them test for ketones, as well as drink water if their over a certain level. These plans are very specific so that we have no contact with the parents at all during the day, we just follow their medical management plan...even the kids on the pumps, (changing out the sites etc. if the resoivoior goes dry, or the alarm won't stop going off etc..) we follow their plans also. We have all their drs on call if we have any questions, and of course have the option to call the parent if we have any problems, but usually since the medical managment plan is so precise we can follow it every day , for every situation and hve no problems. If we have a serious prblem of course we do call the parent.

THis system has worked great for us for years. We have Joslin clinic formulate hte plans for us,so they're excellent for each child. THey are written into our kids 504 plans so the parents are very happy with the plans.

Lisa

Lisa

[This message has been edited by lla2 (edited 18 May 2005).]

quote:

---

Originally posted by lymebrat:

Hi Everyone,

You guys are awesome... I can never thank you enough for all your encouragement, support, advice and prayers...

I have been crying most of the day..

Today is my birthday and Mikayla and I decided to celebrate by having a picnic lunch and then a trip to see Grammy and Grandpa in the woods ( what she calls my dad and step mom)

Things were going fairly well and then out of the blue Mikayla became very fussy, and agitated. Then when I suggested she have a snack as I was told to do this if her moods changed, she became very aggressive and she actually hurt my wrist by pulling on my hand.

I was shocked. So was my dad....Mikayla is a sweetie. She was elected the class friend and is getting the citizenship award..she is truly a sweet little girl...

Of course she has her moments, she is a redhead afterall but nothing remotely like this.

I took her blood sugar and it was 428..about the same as it always is that time of day. So I gave her a snack and literally within 5 mins she was back to her old self.

I called the doctor and his nurse said that it was because her sugar level is off.... and that kids often behave differently when this happens..

Yikes, just when I think I'm getting it, something like this happens. And now Mikayla feels badly that she hurt my wrist. She truly doesn't even remember tugging on it...now that is scary!

She had eaten about 1 hour and 45 mins before this happened, and I give her a snack every 2 - 2 and 1/2 hours, so I'm not sure what happened.

The nurse said that while she is in this is honeymoon stage it is going to be difficult and every day will bring its own challenges.

If I could have anything for my birthday it would be that this would all just go away..I know that isn't going to happen, so I'll wish that her sugar levels will stabilize so we can manage it and she can lead a somewhat "normal" life.

I am feeling so overwhelmed... Heck, I'm crying as I write this..it seems like that's all I have been doing today...Please tell me that the nurse is right and this will get better once her sugar levels stabilize...it is so difficult seeing her like this

Well I have to get going. My husband and I had reservations at my favorite restaurant tonight, but as it's an hour away, we cancelled it.

My sister and husband insisted that I take a break, so I am dropping the kids off at my sisters and going out to eat at a restaurant about 4 mins from their house.

I am so nervous about even being away from her that Long!!! But I will give her the insulin and dinner before I leave and have a bag all packed with snacks, glucose tabs, juice, insulin, all the doctors numbers, the test kit and of course her diabetic teddy bear..

And I plan on eating with my cell phone in my hand!!!.. I'm not kidding...I know I'm probably over reacting, but I will never forget the image of her in diabetic/insulin shock last Friday..I see it every time I close my eyes!

Well I have to get going, my husband and kids are waiting for me.. I have to put on a happy face and celebrate my birthday with the kids. Mikayla even made me a special present so I wouldn't be so sad..here she is 6 years old, being pricked so much she looks like a pin cushion and getting shots twice a day and she is worried about me...she is amazing!

thanks again for everything and I promise I'll email you all when I have more strength and time!

God Bless,
~Missy

---

Tight control requires frequent tests and adjustments which should be supervised or done by a nurse, where the kid is, so that the child doesn't miss out on learning. If laws change and allow aides to do this, it will certainly be much better for nurses.

The kids in your school may have much higher HgA1C's. My daughter's doctor is very aggressive, does not support rigid guidelines for care, supports flexible judgements, and my daughter's HgA1C is in the 5's.

Insulin doses vary tremendously depending on exercise in the last 24 hours, having a cold, what you eat, whether you have a headache, etc.etc.
Furthermore, one kid will take 4 units for a given blood sugar and another will take 1.

Throw in Lyme disease, antibiotics, Plaquenil, SSRI's whatever Lyme kids end up dealing with IN our case pneumonias, sinus infections, surgeries, head pain, kidney inflammation,yeast infections, you name it) and you have a blood sugar picture that is not too consistent.

We need someone at school who will THINK about it, not just follow formulaic orders. Nurses can't/don't do this.

We get along great with our school nurses, principal and teachers because I have just done whatever most helped my daughter's health, which is to handle the diabetes 24 hours a day for years (at this point she does most of it herself, since she is 15). My pleasant availability has relieved them of many problems, including regulations- but there should be a better way.

My sister and her husband met us at the restaurant and I ended up having a good time..I did however call my sister to check in on Mikayla 3 times in 1 hour..

I have to take Mikayla in to the diabetes clinic tomorrow and we are going to discuss her highs and lows and what to do when she has these mood changes.

Mikayla is very upset that she unintentionally hurt my wrist..I keep telling her that I'm fine, but she is such a loving little girl that it bothering her..so I'm hoping the doctor and nurses can explain what happened better than I can.

Someone asked about how she could be in a honeymoon period with 400 numbers... I'm not sure, but that is definitely what they are calling it.

Her numbers go from 298 to "Hi", which means it is higher than the meter will read which I think is 600.

Her doctor told me not to worry about the high numbers as she was already over 1000 and that with the insulin shots, she should not go much higher than 600.

And that although 600 is very high, her body considers it low compared to the 1000 or above she has had for who knows how long.

SO for now, I am suppose to be concentrating on lows..even 300 is a low for her as her body "thinks" the level is dropping, as it has been running on over 1000 level.

So when she gets dizzy, shaky, fussy, yawning all the time, etc, I am suppose to treat it like a low and give her a snack.

So far this has been working well. If I notice any of these signs, I give her a snack and within 10 - 15 mins she is fine.

I'm not real up on all the terms yet, I am just taking it one day at a time and trusting my instincts.

I have been reading everything I can get my hands on and find the juvenile diabetes web site to be very helpful.

You have all been a great deal of help as well.

I'm not certain what will happen at school yet and will cross that bridge when I get to it..I am on over load and can only take this one day at a time, otherwise I would be too overwhelmed and feel more inadequate than I already do.

I do know that Mikayla's diabetes doctor has talked to the school nurse as she told me that they were working on a 504 health plan.

We live in a small community with our own elementary and high schools. There is a head nurse if you will who oversees both schools, she is very informed about diabetes..

we also have 2 other full time nurses at the elementary school level as well, who are fully trained in diabetes.

The nurse has called me several times at home to check in on Mikayla and informed me that they will make this as easy on Mikayla as they can.

They are going to test her twice a day, and the doctor has given me everything I need to send into the school with her.

They even asked me if I wanted them to hire a tutor for Mikayla until she can get back to school...

Mikayla loves school and at this time her teacher is sending home work with her brother that she "can" do if she wants. Mikayla loves having homework and when she is able, she does her work and sends it in with Derek the next day.

So far it seems like the school and school nurses are being wonderful to us and they truly care about Mikayla... and thankfully I don't foresee any troubles with sending Mikayla to school and feeling certain that she will get great care in their hands.

But I will be sure to come here and seek help if I run into any troubles..

Well thanks again..I think I'm going to try to get some sleep. I haven't slept in days. I think all the crying I did today has taken it's toll and my body is telling me to get some rest.

I'll let you all know what the doc says tomorrow at the clinic..

In reference to your episode with Mikalya's uncharacteristic mood swing, I'm afraid you will see emotional levels swing in correspondence to changes in blood glucose levels. Highs and lows both bring on episodes of agitation and irritation with our son and with other diabetics we know.
Tighter contol can help this. We haven't been as successful with tight control during the teen years, but hopefully if you establish good habits while she is young, it will carry over. I know this will sound sexist and I apologize to any male readers, but anecdotally, it seems like girls tend to be more successful in keeping tight control during those teen years, but you have a long time until you have to worry about that anyway.

Have you gotten a medic alert ID bracelet or necklace yet? Very important. Our son quit wearing his, but at least he carries a card in his wallet and his pump is fairly visible. There are some cute styles available now- woven, available in different colors. They look like what we used to call friendship bracelets. Look in the back of some of the diabetes magazines and you will see ads for them.

Also, make sure your doctor gives you a prescription for an extra glucagon emergency kit for school and if Mikayla goes to any type of day care or other program after school, make sure they have one there as well and that someone has been instructed how to use it. Our son is leaving in the morning for a 5 day school trip and he is taking one, but I am nervous because no one has any experience with using one. Of course, I don't either, since the situation has fortunately never arisen, but at least I have an understanding of what to do.

My heart goes out to you and Mikalya. Reading your posts brings back alot of familiar feelings. I remember how difficult those first few months were. It feels like you have to be your own doctor in a way - there are so many decisions to make every day - how many carbs, how much insulin, how will exercise effect current blood sugar, changes in blood sugar caused by illness or stress, how to handle school, family and friends, social events. . . the list goes on and on. But as I said in my previous post, it really will become second nature in time.

The first year, I kept a detailed diary of every bite of food he ate, his insulin doses, glucose, etc. Eventually, I learned how to count carbs (I wasn't taught this in the beginning, believe it or not) and just kept it on his glucose chart, but I was really obsessive in the beginning. I also didn't want to let him out of my sight, but I eventually loosened up there too. And, it is normal to react with grief. I lost 30 pounds myself in the first month and spent portions of each day in tears. The stress is phenomenal, but I can tell you & Mikayla are both strong and are hanging in there. Every day I wish I had a magic wand that I could wave that would take away these diseases from our children. I've made your birthday wish a number of times myself and both of my children know that if I could, I would gladly take their diseases for them, unfortunately it just doesn't work that way. We just have to be there for them to support them and to make sure they get the best medical care possible.

Well, enough rambling. Wishing you and Mikala all the best and hoping your journey into this frightening new world soon becomes easier.
Try to take care of yourself during this time too.

From our point of view, this is a civil rights issue. The blood involved is a tiny drop, which is absorbed and neutralized by a swab. A kid with a band-aid is more of a threat. (And my kid doesn't have AIDS either. This hysteria about blood comes form the AIDS crisis).

Going to the nurses' office every couple of hours to test would affect my kid's equal access to eduation.

This is like saying you don't want a kid with Lyme in the pool with you because you might catch Lyme!

quote:

---

Originally posted by Lymetoo:
[b]Lyddie,
could you edit this out? [the boxes] I think that's what is making the screen too wide. I'm having trouble reading it, as I'm sure others are.
Thanks!
How'd you do that anyway??!

PAGE 2 IS HARD TO READ BECAUSE OF THIS[/B]

---

You are doing great! It sounds like you have a wonderful team supporting/educating you and Mikayla.

After you read through these posts you might want to print all of them out so you can refer to it later, I think in our desire to share with you, help and encourage you, that you may get overwhelmed thinking you have to learn everything all at once, some of our situations you won't experience for awhile, and just look how much you have learned this past week.

Our Dr. told Amber that she and I would end up being the experts on her diabetes.

Trust yourself Mommy, remember This too shall pass. Soon it won't be so upsetting.

God Bless
Cindy ><>

I'm surprised that your school system's nurses aren't in charge of this...we are told we must be totally current.
we have meeeting with parents and physicians monthly to update 504's and send home daily logs with info...it's quite an undertaking..but it's part of my job to keep up with their needs...I have 4 very brittle diabetics, adn they are very time consumsing to manage...but they are sweethearts, and I love they aare part of my day everyday...

Ila2: Your attitude is certainly different from our nurses, and would perhaps be most welcome by us parents here. But if regulations prohibit nurses from making certain decisions (insulin dosing) I can't imagine how it would work. As I said, for us, esp. w/Lyme causing variability, insulin doses change all the time. All kids w/type 1 are "brittle," but much less so with very frequent testing and fine-tuning insulin doses for how they are "running" that day.

This is enough for poor lymebrat. I apologize! A DPH official suggested a long time ago that my child test i the classroom nad supported the school funding nurses to got to the child every couple of hours. This made a tremendous difference in my child's life and health, and I just wanted to pass it on as a choice that can be made down the road.

[This message has been edited by Lyddie (edited 19 May 2005).]

I came across the following article this morning and thought you and your husband might find it helpful: "Diabetes Care in the School and Day Care Setting" published by The American Diabetes Association in 2005. This article can be found at:
http://care.diabetesjournals.org/cgi/content/full/28/suppl_1/s43

If you do find this article useful, it might be a good idea to print it out now for future reference and review it when things seems less hectic and overwhelming.

Wishing you and Mikayla a better day. Hang in there, you are doing great!

Extra wide screen is extremely hard on us late-stage lymies since we can't scroll back & forth & be able to comprehend anything.

Yes, please edit the post Tutu referred to for all of our benefit....thanks so much.

If I knew how, I would fix it in a second. I'll ask my teenage son, when I see him (not too often). Thanks for your patience.

IN fact we use their medical managament plan to send to our endocronologists for each individual diabetic child to be filled out , because they are so specific....

great article.

I thought this article might be a "keeper." The ADA is a great resource for both the professional and the lay person.

When I taught in the RI public school system, I never knew what guidelines school nurses followed in their care of diabetic students. Your update regarding this issue has been enlightning....thank you.