While digging out from a record snowfall here in Maryland, I have been counting the days until our family vacation scheduled in May.  My wife, children and I will be traveling to Scottsdale for about ten days to enjoy the pool, golf, Sedona views, and some much needed relaxing.  I will say that this has been the most trying starts to a year I’ve probably ever had.  As our family grew, so did the numbers of illnesses, time off and added stress.  Also, the start to this year has me trying to get in the best shape of my life.  I’ve dropped 10 pounds, my pants are loose and I feel awesome!  I’m pumped to get into my bathing suit and slop on some sunscreen.  There’s nothing better than sitting back or playing with kids on vacation by the pool and then watching them crash from being exhausted and happy.

Enough of me visualizing my vacation and sounding self-centered.  The purpose of this post is to put a call out to anyone interested in guest blogging/writing on Blogging Diabetes.  There are a few specific individuals I am looking for to write on specific topics (see more below).  I am also looking for anyone that wants to write about diabetes or related topic.  I am very open and as long as the post isn’t selling anything I will consider it.  I can fill up to about 10 spots as I don’t want to publish more than one per day.  This is a great opportunity to tap into the Blogging Diabetes audience, doing a little self promoting or just write to help others.

If you are interested, please contact me using this form or write to tony[at]bloggingdiabetes.com.  I’ve written my email address like this to prevent spammers from scraping my email address.  I am very open and will try to accommodate all requests depending on volume. Don’t be shy, send me your ideas.

Specific Topics

In addition to those interested in guest posting, I am looking for the following people to help discuss a few different topics and how they are related to diabetes.

• Dentist
• Nutritionist

Thank you, Tony

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

Guest Writers/Bloggers is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post by Rachel Thursby, a mom of a son with diabetes and writer for a blog called What Life Has Become.  Over the summer I heard Rachel talking about having to work on a stressful 504 plan for her son Tristan.  I had to ask her what a 504 plan was because I had never heard of one before.  After learning more about it, I decided it would be a good topic to share with the Blogging Diabetes audience.  I thank Rachel for the information, her story and how incredibly inspiring parents of children with diabetes are to me.  Please read on to learn about a 504 plan.

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The beginning of a new school year is always exciting for both children and parents. New teacher, new friends and back to a routine. For me, the beginning of a school year is always very stressful.

Every year, I have to prepare a 504 plan for Tristan. Students with a disability have a 504 plan to ensure that they have access to the same education as their peers. It also protects the student with a disability against discrimination according to the Americans with Disability Act.

Writing Tristan’s 504 plan is always very emotional for me. Until Tony asked me to write this post, I never really thought about why it made me so emotional.

However, since Tony asked me, I’ve been thinking about this issue a lot. Here is how I can best explain it.

When I write Tristan’s 504, I feel like I’m writing a map to keeping my son alive. Imagine writing down directions instructing people on how your child should breathe. Pretty silly right? I know that it’s a crazy analogy. We all need to breathe to stay alive. My son’s diabetes needs to be managed in order for him to live.

As parents, we don’t want to think about bad things happening to our children. We know it’s a possibility but we try not to think about it.

Every August, I sit down in front of my computer and I imagine all the bad things that could happen to my son in relation to his diabetes. I have to think of the worst case scenario in order to clearly list what needs to be done in each situation. For me, thinking about it always brings vivid images. In my head, I can clearly see Tristan lying on the floor passed out. It’s not pleasant. It’s not pleasant at all!

I have to put in black and white that he will not be excluded from any activities based on his medical conditional (mental image: Tristan sitting in a corner by himself crying because he’s not allowed to participate). I have to write down that he will be allowed access to water and the bathroom whenever he needs it (it’s pretty sad that for his protection I actually have to put this down on paper).

I need to make sure that he is treated fairly. He cannot be disciplined unless we know what his blood sugar number is. How unfair would it be to discipline him when he’s at 40! Not only that, how dangerous would it be? For his future, I need to make sure that he doesn’t take any “formal” tests if his blood sugar is out of whack. All of that has to be in writing. All of it, every little detail.

I don’t like to think of my son as having a disability. He’s just a little boy. A normal little boy who happens to have type 1 diabetes. But according to the law, he has a disability. It’s now my responsibility to ensure that he is treated the same as everybody else and given to same opportunity to have a bright future.

I’m not looking for sympathy. I don’t want it. I do however want people to understand that there is a lot more to diabetes then meets the eyes. It’s not only a physical conditional. It messes with your mind and your emotions. As much for the child as it does for the parents.

I hate doing Tristan’s 504 plan. I wish that I didn’t have to do it. I am my child’s advocate. I need to protect him until he’s old enough to protect himself. Therefore, through my tears and my fears, every August, I will write his 504 plan without fail.

For more information from the American Diabetes Association:

504 plan information, click here.

Sample 504 plan, click here.

Sample Diabetes Medical Management Plan, click here.

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If you are interested in providing a guest post, please contact me for more information or to submit a proposal.

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

504 Plan for Children with Diabetes is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post by Marc Wolf a registered pharmacist and CEO of Diabetic Care Services.  The tips below are to help parents of children with diabetes shift the focus off of Halloween candy so the kids can have more fun.  Thank you Marc for your tips!

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Today, candy is the central focus of the spookiest holiday of the year.  In fact, the average American consumes 24 pounds of candy in a year, most of which is eaten right after Halloween according to the U.S. Census Bureau.   But for children with diabetes, it can be difficult to enjoy the festivities when all their fellow goblins are in a frenzy to get their hands on mounds of sweet treats.  Some tips for Halloween are:

• Explain to your child ahead of time that they should not snack on candy until you are home from trick-or-treating. (Parents, that goes for you too!)
• Lots of walking can affect blood glucose levels, so pack a healthy snack that you can rely on to battle lows.  This way, you avoid the temptation of dipping into the treat bag for a quick solution if your child’s blood sugar levels begin to drop.
• Choosing which type of candy to pass out is important because there is a good chance you will have leftovers.  If you select the correct type of candy, you can use leftovers to treat lows throughout the year.  According to the American Diabetes Association, chocolate and other higher-fat treats do not work well for treating lows.  Therefore, if you anticipate leftovers, choose hard candy, gumdrops or lollipops to pass out at Halloween so you can use the leftovers to treat lows.
• Do not feel you have to deprive your child of all Halloween candy.  Instead, allow them to choose a fun size, smaller version of their favorite candy.  Just remember to adjust their meal plan based on the number of carbohydrates in the sweet treat. Visit the JDRF web site, or click here, for a list of common Halloween candy carbohydrate values.
• After trick-or-treat hours are over, sit down with your child and help them choose a few of their favorite pieces of candy they can enjoy throughout the week.  To help your child part with the leftover candy, allow them to exchange it for money, a toy or some other special treat (a special dinner, trip to the movies, etc).  
• If you do not want to waste the extra candy by throwing it away, go with your child to donate the leftovers to a hospital or senior center. Not only will your child learn healthy habits, they will receive a lesson in sharing.
• Take the focus off Halloween candy by encouraging your child to create an exciting Halloween costume.  You can even involve the entire family by designating a day to work on homemade costumes.
• Halloween costumes often require plenty of face paint, body paint and colored hair spray.  When the festivities are over, ensure you give proper attention to skin and scalp cleansing and care.  Products like Diabeti-X Hair and Scalp Therapy Shampoo and Dermal Therapy Body Lotion by Bayer, available here, can help to safely scrub dye out of hair and moisturize skin after removing dehydrating costume makeup.
• No matter what the costume, ensure your child wears comfortable, closed toe shoes and invest in special diabetic socks that will keep feet clean and dry. Whether trick-or-treating or at a costume party, it is important to protect feet from potential cuts and scrapes and prevent blisters and soreness.
• Offer to host the Halloween party this year.  You will be able to ensure your child and all the guests, enjoy healthy Halloween treats rather than experience sugar shock.  Use food coloring to turn your favorite dip or sugar-free whipped topping orange, and pair with fruit and cheese or vegetables for a festive tray.  For dessert, dish out sugar-free chocolate pudding in individual cups and garnish with sugar-free whipped topping and sugar-free candy worms for a creepy surprise.

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Here are some Tips from the JDRF for a fun Halloween.

If you are interested in providing a guest post, please contact me for more information or to submit a proposal.

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

Making Halloween Fun for Children with Diabetes is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post submitted by Lorraine who is doing an excellent job managing her son’s (Caleb) type 1 diabetes.  I met Lorraine through twitter, which is an excellent medium to talk real-life diabetes.  From our first few conversations, I knew that she was doing a lot of things right for Caleb and keeping his A1c numbers near perfect.

I want to thank Lorraine for sharing her story and tips to help manage type 1 diabetes.  Thank you Lorraine and keep up the great work!  Caleb may be too young to understand, but someday he will thank you for all the hard work you put in to help him live a better/longer life.

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Managing Caleb’s blood sugar, from a self-admitted neurotic mom

Background:

My son Caleb was diagnosed almost 2 and a half years ago at the age of 3 (almost 4). With so few non-D years behind him, and so many D years in front of him, I have made it my mission to bank as many years as I can with near-normal A1Cs in hopes to minimize those ugly complications when he is older. Caleb has been pumping for just over 2 years, since about 3 months after he was diagnosed. I never set out to achieve a certain A1C.  All I know is I do whatever I can to keep his blood sugars in range.  I am often unsuccessful.  But lots of the time we achieve what we want to. I have never been given any specific guidance on targets or acceptable ranges.  Caleb’s Endocrinologist has always reviewed his results and found them acceptable and not mentioned what precisely they “should” be.

Guiding Principles:

1. I check Caleb’s blood sugar about 12 times a day, including overnight.  Sometimes less, sometimes more.  I check, assess and act.  
2. Everything he eats, I weigh and measure whenever I am able.
3. I do not limit what or how much Caleb eats.  I manage it, but I do not limit it.  There are foods I prefer to stay away from, but I won’t ever tell him he can’t have something because he has diabetes.  Even at school and birthday parties, he eats what the others do.  It usually means 100 plus carbs for a snack and a few extra BG checks, but he smiles as he shoves the cupcake and other junk in his face and that makes me smile.  Everything in moderation – that goes for him and my other, non-D kids.
4. Caleb typically eats 3 meals and 2 snacks a day.  That frequency allows me to be a little aggressive on dosing when I have unknown carb counts.  If I have an uncertainty, I will check and hour and a half after a bolus and if it’s lower than I think it should be, it’s usually around snack time and I can just decrease the bolus of what he eats to mitigate that low without disruption to his schedule.  
5. Caleb seems to go through “waves”.  His insulin needs creep up, up, up….plateau, and then go down, down, down…plateau, and over and over again.  Perhaps all diabetics are like this.  I attribute the waves to growth, but who knows.  In order to keep up with the waves and still keep his sugars in range without constant corrections, I track all his dosing and stats in a spreadsheet.  I used this religiously for months.  As I have learned from it and things have become more predictable, I do not use it as much – only in periods of lots of unexplained BGs.
6. I keep a pretty close pulse on his basal rates.  If there’s a low or high 2 days in a row and I am confident that food is not an issue, I will adjust basal rates.  I know that .05 will have about a 30 point impact on his BG.  
7. Food – Pizza, Ice Cream, Chinese, Bagels, Pasta, anything fried – they all break the rules.  I have charted Caleb’s BG’s for months when he eats these foods and have been able to develop specific extended bolus’ for each.  I keep them in my spreadsheet and in my cell phone.  I continue to tweak them since things are ever-changing, but I at least have a baseline and don’t have to completely freak out when we indulge.
8. Super Bolus.  Of course there are occasions when that nasty 300 pops up.  I don’t mess around.  I find John Walsh’s Super Bolus to be very effective: bolus the calculated correction plus the amount of basal to be delivered for the next two hours.  Then turn off basal for the next two hours.  This front loads the insulin to bring the BG down fast, but prevents bottoming out since the basal is turned off.  This has been particularly useful when we are about to eat a meal that would be awkward to delay (like at a party).  But I am careful with this at nighttime – not quite as aggressive.  For Caleb, I find I need to add a little insulin for those high highs – his normal correction factor needs a turbo charge to tackle those numbers – but of course YDMV.

Those are the highlights.  I’ve been thinking about this as we go through our days to make sure I have everything covered.  I think a big thing is keeping on top of things at night, particularly since that’s about 10 or 11 hours for Caleb.  I check a minimum of two times while he sleeps, but in times of change or when he eats a challenging food, I will check more.  And if a correction is needed, I will always check 2 hours after no matter what.

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One thing that quickly jumps out at me is the care and effort Lorraine puts in to managing Caleb’s diabetes.  She doesn’t just check and react.  There is much more planning, trending and analysis put into his diabetes management than I would expect most diabetics put in, me included.  The theme here is to not be complacent and just wing it.

If you are interested in providing a guest post, please contact me for more information.

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

8 Tips For A Better A1c is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post by Rachel who writes a great blog about parenting a young child with type 1 diabetes.  I enjoy these guest posts because they typically bring a different perspective and insights that I may not experience or know about.  I want to thank Rachel for sharing her story and contributing to the diabetes online community.

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If you peeked into our house, you would see what looks to be a normal family with a normal life. Unfortunately, our life changed forever a little over 4 years ago. Tristan was diagnosed with type 1 diabetes in March of 2005. He was 16 months. He is now 5 years old. I was asked by Tony to share what it’s like to parent a child with diabetes and how we manage the day to day routines that other parents just execute without really thinking about it.

At school

Entering Tristan in school was a joyful moment. Our baby was growing up. J It also brought on a lot of stress and worries. Most parents register their child, maybe meet the teacher once before the school year starts, drop their kids off on the first day and life is normal. They go to work and they come home. Pretty straight forward. For us, registering Tristan meant, 504 plan, meeting with the school principal, nurses, psychologist, parent coordinator and other people that I can’t even remember at this time. For us it meant educating people to make sure that they are aware of the potential danger, that they stay alerts to the signs and that they can react in any given situation. Another issue that came up this year is emergency evacuation of the school. The problem that came up was that Tristan can’t just be put on a bus, driven to another school without qualified personnel with him. After much stress and frustration, the conclusion was that Tristan would be with the nurse at all times. She would be in the bus with him and remain with him until either I or my husband could come and get him.

When at school, Tristan gets his blood sugar checked between 11 and 13 times per day. Before going to PE, he needs to have his blood sugar checked and most of the time, he needs to have a snack to tide him over. Unfortunately, he does at time have to miss things at school because of his blood sugar. He misses class time, PE, music etc. It is very frustrating for him and it makes him sad. I often get the comments from the nurses “I don’t know how you do it”. We don’t have a choice

At Home

The situation at home is a little different. Because there’s only him and his brother, we are able to pay closer attention to him. Therefore, at home, he usually only gets his blood sugar checked 8-9 times per day. Of course, we check him before any meal, usually 2 hours after meals, before we go to bed and around 3:30am. This does not include all the checks that we have to do it based on his behavior. When diabetes is not a factor, when a child has a temper tantrum or a meltdown, that’s what it is. Period. With Tristan, we never know if it’s Tristan acting up or if we are dealing with the big D Monster. So before any discipline can be done, we need to check his blood sugar to know what we are dealing with and handling the situation appropriately.

Tristan has been wearing an insulin pump for a little over 1 year. It does make life easier for us. It affords us more freedom when it comes to meals and snacks. The routine doesn’t have to be so strict. There is also less restriction on intake of food than when he was on shots. When he was on injections, we really had to think twice before allowing him a snack because it meant additional injections and he was already getting a minimum of 4 per day.

With the pump, he only has to deal with needles every 2 days when we change his site. The problem with the pump is if the site doesn’t go in properly. We then have to deal with changing the site again and the possibility of ketones.

Sick days are always very difficult. A simple cold for Tristan is not just a simple cold. Most of the time, it affects his blood sugar which in turn, has the potential of creating ketones. At that point, we have to deal with the cold, his blood sugar being too high or too low and ketones. It means extra insulin or extra food (trying to get a child whose not feeling well to eat/drink something is not a walk in the park), it means blood sugar checks every 1 or 2 hours and it means checking his urine every time he goes to the bathroom. Sick day are stressful and unfortunately, we can’t protect him from catching a common bug.

This week Tristan just started t-ball. Again, something that should be fun for us means stress and planning. We don’t know how his blood sugar will react to the excitement and physical activity. It’s another situation where we have to do trial and error to find the exact course of action that we need to take before, during and after to ensure that we maintain his blood sugar level where it’s suppose to be. It means pulling Tristan out when he’s having fun to figure out what’s going on. It also means having him miss out of some of the fun because he either needs to drink and/or eat something. But most important, it means that once again, Tristan is different. Let’s not forget the looks from other adults/parents that we have to deal with.

All of these things, as much as they suck, have become routine. It’s our life now. What is harder to get a handle on is the emotional aspect of it. Tristan is at an age where he feels different. He knows that he’s not the same and that we need to take extra precaution. The other night, after having tried his site in a different location, he was crying and telling me how much he hated being diabetic and how he wished that he wasn’t. When he was 2 years old after an injection that had hurt him, he looked at me and yelled “mommy you hurt me”. It’s hard. Those are scars that will never go away. I can learn to count carbs and give injections. I can learn what to do in an emergency situation. I can do all that because I know that I don’t have a choice. I need to perform these actions to keep him alive.

However, I can’t learn how to deal with the emotional aspect of the disease. My son has a disease that could possibility kill him. My son has a disease that he hates. My son has to deal with injections that hurt him. My son feels different from other kids his age. And there’s nothing that I can do about it!

Diabetes is a disease that not only affects the patient, it affects the whole family. We constantly have to find the right balance to deal with Tristan as a person, Tristan with diabetes and my other 2 year old son who does not have diabetes. I feel like in March 2005, I was also diagnosed with type 1 diabetes, right along with Tristan.

On top of all the stress of dealing with diabetes, we also have the concern of Connor, our 2 year old getting it. Because Connor has a sibling with type 1 diabetes, he has 5 percent chance of getting it. I know that you are thinking, 5%, that’s not much, it’s nothing. You right, in the big scheme of things, 5% is nothing. Tristan had less than 3% chance of getting diabetes! He got it.

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If you are interested in providing a guest post, please contact me for more information.

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

Parenting a Child With Diabetes – A Real Story is a post from: Blogging Diabetes

Canadian Pharmacy

A special thank you goes to Gary Schmidt for writing today’s post.  Gary has graciously provided his insights and planning in regards to running with type 1 diabetes.  For me, this post was very helpful.  It would be my hope that others are inspired or at least learn a few tricks for running with diabetes.  If you are interested in providing a guest post, please contact me for more information.

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I was diagnosed with Type 1 Diabetes in the fall of 2002 at the age of 28.  I wear a Minimed pump with the Minimed CGM.  Since starting to run in September of 2009, I have participated in two 10Ks, two 10 mile races, a 200 mile relay with 11 other Type 1 Diabetics, the GO! St. Louis Half Marathon and will run the Chicago Marathon later this year.  I am not a doctor and don’t have a medical background, but I like to share my experiences to help and inspire others with T1.
Tony asked me to write about my experiences with the before, during and after care that goes with extraneous physical activity, like running with T1 diabetes.  What follows is what I *try* to do every time I run.  I am far from perfect, but I have a good plan.  Most days everything will go just fine , but others… well, let’s just say every day is a learning experience. 

Preparation
Preparation and planning is the key to a good run.  Having T1, I can’t simply go out for a run at anytime.  I need to be aware of what I have eaten and how much insulin I have on board (IOB).  An hour before a run I will set my basal down to 10% of the normal level and depending on the distance I’m planning to run, I will leave it at 10% for another 30 minutes to an hour.  I like to start my runs with my BG around 120-150 and trending upwards.  To do this, I’ll eat 15-20 grams of carbs about 15 minutes before heading out.  I’ve found that eating right before starting has little or no affect on my BG, so 15 minutes seems to be the right length of time for me.  A lot of other Type 1 Diabetic runners that I know prefer to start with fairly high BG levels.  I perform much better with a lower BG level, so I like to be in the normal range.  If I am high before my run (220+) , I will do a correction that is equal to about 50% of a normal correction.  Having too much IOB is a sure way to have a nasty low while running.  If my BG is in the 200-220+ range, I would skip the 15-20 grams of carbs before the run and naturally let my BG levels come down.

While Running
During runs I will eat 25 grams of carbs approximating every 30 minutes.  I prefer GU Energy Gels, because they are easy to carry and easy swallow while running.  I NEVER, repeat NEVER, go out for a run without at least 2 GUs.  They literally keep me going and out of trouble.  I’ll have a GU after my first 2 miles and if my BG is holding steady, as a result of BG testing or keeping an eye on my CGM, I will delay the second and subsequent GUs as long as I can.  I like to keep my BG numbers between 120 and 150 during my runs.  My CGM really helps me with this, but as soon as I see it start to trend down I will eat a GU.  Since the CGM has a bit of a delay compared to a BG meter, a low can occur faster than the CGM will react to it, so keeping a close eye on the graph is critical.
In case of emergencies I wear a wrist Road ID with my contact information and the fact that I have T1.  I also try to carry a cell phone.  But the main thing is staying out of trouble in the first place.  This can be done with proper preparation and just being smart about the situation.
If you have a the luxury of running with a friend, make sure they know what to do in the case of emergency.  I have a friend that I run the majority of my long runs with.  We talk a lot about T1 and he knows what to do in case of an emergency.

After Running
After running I have two scenarios to deal with.  The first is going high soon after finishing.  Right after a run, my body is low on insulin and potentially high on carbs.  In some cases, I have had my basal set at 10% of my normal level for nearly 2 hours while also eating 50 – 75 grams of carbs.  My practice is to bolus the amount of basal I have missed during my run.  Typically, this would be about 2 units for an hour long run.  I also try to eat at least 30 grams of carbs afterwards to help my body recover more quickly.  I will simply bolus the normal amount to cover these carbs.  The second issue is going low later in the day.  About 5 hours after a run, I will set my basal down to 50% of the normal level for 3 hours and also try to remember to eat a carb/protein snack to prevent late afternoon lows.

Running a marathon has been a life-long goal of mine and I’m not going to let diabetes stand in my way.  Sure, there are a lot of challenges that I have to deal with to be safe, but in the long run better overall health and improved control is worth it.  So, get out there, have fun and enjoy life to its fullest!

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

Running With Type 1 Diabetes is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post by Natalie Kolok, who (with her husband Jeff) has an amazing website called Parenting Diabetic Kids along with a great story to tell (grab some tissues).  I am happy to have Natalie post here because I think she offers a great deal of real-life insight where I am lacking.  She offers resources specifically geared towards children with diabetes and parenting children with diabetes.  Being diagnosed at age 22 with type 1 diabetes, I don’t know what it’s like to deal with diabetes as a young child or teenager.  Please check out Natalie’s website and pass along the information.  Thank you Natalie for your guest post and contribution to the diabetic community!

The Diagnosis
That moment is imprinted in my brain: the day, year, hour and minute of Johanna’s diagnosis.  I remember who was around me and the questions Jeff and I asked when the doctor told us she had diabetes.  Like most parents, I wanted my children to be free of pain and sorrow.  Diabetes shattered that.

In the quiet moments after our arrival home, our oldest child Naomi knocked at my door.  Upon entering, she observed my face and knew I had been crying.  Naomi sat down and quietly asked if it was O.K.  if she didn’t want to trade places with Johanna.  As parents we would trade places with our children without hesitation.  It never occurred to me that others in the family would struggle with this question.  On the one hand they feel lucky they don’t have diabetes, but on the other they feel guilty and worried about the person who does.

 
In the days after Johanna was diagnosed, I had to confront my feelings of sorrow and anger so I could manage Johanna’s diabetes.  There is nothing I could have done to prevent my JoJo from getting it.  Insulin was now one of those life supporting requirements in Johanna’s life. I also learned as parents we need to listen to our child’s concerns, questions and feelings.  They need our support and encouragement. Each family needs to find its own way in managing diabetes.  It doesn’t have to limit our children.  We just need to fit our child’s diabetes regimen into their schedule.

Here is an essay Naomi wrote shortly after Johanna diagnoses:

Diabetes    
Naomi Kolok

My sister was diagnosed with type 1 diabetes at age four. I remember that day like it was yesterday. It was the day before my 11th birthday, April 15th. 
It was a beautiful warm spring day. I woke up and looked out my window. I saw JoJo (my sister), Jillian, Lydia, (my two cousins), my Auntie April, my Auntie Rachel, and my mom all sitting around on our patio. They had come from Florida and Maine for my birthday. JoJo had not been feeling herself all week. I walked downstairs, pulled open the screen door, letting in all that wonderful bright sunlight. Squinting, I saw JoJo’s red hair loosely dangling from a messed up ponytail. She looked up with a pale face and said, “Good morning, Naomi.” Seconds later, I heard the echo of little kids and grown-ups saying the same. I smiled and replied, “G’morning, guys.”  As I walked back in the house to get a bowl of cereal I heard my mom say, “Jeff and I are going to take JoJo to the doctors’ today.” When she came in to get ready, she did so quickly. When my parents came downstairs and picked up JoJo who seemed so tired, I could see the worry in their eyes.  Even as sick as she looked, that red-haired spitfire spirit popped out with a big smile and wave, “Bye, Naomi!”

After they left, everything went back to normal. My cousins were playing outside in the sand box, my aunts were lounging in the Spring sun, and my grandma was in the kitchen making a big sandwich for herself. I went outside to join everyone. I lied down on a fold-out beach chair and started to wonder: What if JoJo is really sick? What if she dies? What will happen? But I remembered her smile and how it reassured me everything was just fine, and she was just going in for a check-up.  It was probably some really bad cold.

An hour later the phone call came. Sadness flooded the house. Happy faces turned cold. The voices of my happy and strong parents were grey and weak. Tears rolled down my burning checks before I ever knew what had happened. My sister was the best thing that had ever happened to me. “What had happened?” I thought. My grandma brought me into my parents’ room and told me what disease my sister was diagnosed with. The dreadful word came out of her mouth slowly and shaky, “JoJo was sent to the hospital today. She has type 1 diabetes.” Of course I had never heard of that phrase before. I didn’t know anything about it. Not even knowing what it was I began to cry, the crying led into sobbing, and at that moment I forgot all about my birthday party. I would have given up all my birthday parties forever for that day to have never happened.

My mom called me that night; I could tell she had been crying. I hardly ever see or hear my mom cry, which brought tears into my eyes. I held them back as best I could. Her gentle voice reassured me, “Naomi, everything is okay. Today JoJo was sent to the hospital, she was a brave little girl. Her disease will be with her the rest of her life. I will explain everything to you later. Right now I wanted to call and let you know we are still having your birthday party tomorrow. I will come home tonight, and daddy will stay here with JoJo.  Tomorrow is all about you, so we are going to make the best of it.” Tears rolled down my face uncontrollably. I was speechless. “Okay mom, but I really want to see Johanna (that’s JoJo’s real name).”

The next day, just like my mom had promised, we had my birthday party. It was amazing, all my friends were there, and the coolest part was when they all started making cards for JoJo. That was a birthday that will be treasured in my heart for two different reasons.

That night my mom was going back to the hospital so my dad could come home, shower and sleep.  I begged her to take me to see JoJo, and she did. Walking into that hospital was one of the hardest things I had done in my life. Everything was a blur. It wasn’t as happy as it had been years before when I came in to see JoJo when she was born.  As I stepped out of the elevator I heard loud noises. “Go Yankees!!!!,” which of course came from JoJo. She was riding in a wagon around the kids’ floor. As I stopped the little red wagon she looked up at me, with those big green eyes. It was different to look at her, but I knew it was the same little JoJo in there.  “Naomi!!” she squealed throwing her arms around me. I began to cry a little, but being JoJo she put her hands to my face, wiped away my tears and said, “Oh Naomi, its okay.” 

Spending that night with her, I learned so much about that disease. But one night wasn’t enough for me. I did school projects on diabetes, I did research on it. I learned how to test her, give her insulin, count up her carbs, and how to be there for her when she needed comfort.

Every day and night in the hospital she got shots. They were not fun to watch, but she was brave and by the end of her stay she was a pro at it. I will always remember that day in the hospital, watching her sleep, remembering all the fun adventures we had together, and the laughs. I knew she was always going to be my little JoJo, but now she was my little JoJo with diabetes. Oh, and trust me, diabetes has not stopped her spitfire self. Diabetes has become a part of our family’s life. Even though I don’t have diabetes, I still deal with it. It will be in my family forever and luckily I know how to take care of it.

JoJo will have diabetes for the rest of her life, and I will always remember when and how she got it. In the elevator I thought I would never see the real JoJo again. When I stepped out of that elevator I knew I was wrong. I could hear her, I could feel her presence, and could sense her. She was a part of me, and she always will be, her and her diabetes. I saw that having diabetes didn’t stop her from loving people, loving herself, and being herself. 

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

Parenting Diabetic Kids is a post from: Blogging Diabetes

Canadian Pharmacy

This is a guest post by Holly McCarthy who writes on the subject of nursing schools and can be reached at hollymccarthy12[at]gmail.com

Type 2 diabetes is a disease in which either the body does not produce enough insulin or the cells ignore the insulin. Type 2 diabetes is the more common form of diabetes. Although there is no cure for diabetes, there are many means like diet control and exercises, by which the blood sugar levels can be kept in check. If diabetes is not kept in control, it can lead to different complications. Most of these complications are a result of the effect of diabetes on the nerves and arteries. Here are some of the health problems that Type 2 diabetes can cause.

1. Cardiovascular disease and stroke. Type 2 diabetics have two to four times the risk of suffering a heart attack or a stroke. People with diabetes are more likely to have high blood pressure, obesity and high cholesterol. These together with the artery damage caused by diabetes can lead to heart diseases.
2. Kidney disease. Diabetes is the most common cause of kidney failure. Type 2 diabetes can take away the ability of the kidneys to filter waste products. Kidney failure is the last stage of chronic kidney disease and it may require dialysis, artificial blood-cleaning process or kidney transplantation from a healthy donor. 40 % of those who need dialysis have kidney failure from diabetes.
3. Foot Problems. The nerve damage caused by diabetes results in a loss of feeling in the feet. This is called neuropathy. The feet become numb and are not able to feel pain, heat or cold and you may not notice injury until the skin becomes infected. Diabetes also causes the skin at the feet to become very dry. Foot ulcers and calluses may form at the feet and if neglected, these could lead to infection. Poor blood circulation to the feet makes infections difficult to heal. In severe cases, this may lead to amputation.
4. Eye disorders. Diabetes causes many eye disorders by damaging the blood vessels in the retina. The major eye disorders are glaucoma, cataracts and retinopathy. Non-proliferative retinopathy is common and does not require much treatment but in proliferative retinopathy, the blood vessels are so damaged that there is leakage of blood. This condition may lead to blindness if not treated properly.
5. Gum Disease. Diabetics have a higher risk of gum problems. People get gum disease when plaque destroys the gums and bone around the teeth. People with diabetes can get gum disease from having high blood glucose levels for a long time.

Other health problems that Type 2 diabetics risk facing are stomach and bowel problems, where the nerves that trigger normal functioning can become less active causing constipation or diarrhea, and sexual function problems. The nerve and artery damage could lead to impotence. It is very important that diabetics be aware of the health issues that they face. There is nothing to worry, as taking steps to keep diabetes in control will take care of most of these health issues. If you are a Type 2 diabetic, make sure that you take those precautionary measures to keep these health problems at bay.

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I want to sincerely thank you for your continued support and subscription. This blog is better because of you.

5 Health Issues of Type 2 Diabetes is a post from: Blogging Diabetes

Canadian Pharmacy