Monday, June 13, 2005

I Actually Smiled in a Picture and The Story of a Diabetic Seizure

First off! The LA Times printed their feature piece! It's really a lovely article overall, with a photo that I REALLY like.

Onre guy I know told me he was amazed I had actually smiled in a photo! And to be honest, I rather like the effect! The photographer was SO NICE~it was easy to smile for him! He saw my Cure Diabetes bracelet and knew right away what it was because his girlfriend has Type 1 Diabetes. We talked for quite some time about it!

I talked the reporter's ear off about diabetes, but he didn't take any notes and it wasn't because he was so wrapped up in what I was saying. It was because, sigh, HE WASN'T GOING TO WRITE ABOUT IT. I really wanted to raise awareness so that was disappointing... BUT, I did try, and I think I'm just going to have to write an article about diabetes myself.

Overall, I thought the article gave a really good sense of what the book's about and mostly got my publication story right. For additional reviews of the novel (The Washington Post,The Chicago Tribune, Cosmopolitan, Tatler, Glamour (UK) etc...) you may click here to go to my Readerville page, which has the most recent updates... scroll down. (For some reason, the only ones the reporter quoted were unsigned reviews from publishing trade journals and one from a professor at a religious university.) There's an excerpt at the Readerville page too, so you can see what you're in for. It's a novel that pushes buttons, that's clear. My favorite review of all time is from Mark Farley at Waterstone's Notting Hill Gate... "Stuck up middle finger punk fiction." Rock on...

(By the way, the talented Colleen Curran and I will be discussing reviews, reader responses and many other topics on Beatrice sometime soon. Colleen's novel Whores on the Hill has also drawn sparks of controversy and passionate reader responses. Bravo, Colleen! I think anytime you can spur the villagers into rushing into their barns to get their torches, you've done something right.)

Onto the public service announcement for the day... a true life story of a diabetic seizure. This happened to a friend and she's agreed to let me post what happened and what she did. I think it's really useful to know about this in case there is a person with diabetes in your life. She really kept a clear head and fortunately her story has a happy ending. (All names have been changed. The mom I'm calling Cheryl.)

Hopefully some of you parents and friends can learn from Cheryl's story... and, if you know someone who thinks diabetes is "no big deal" or you're "making too much of your child's diabetes" or that by focusing closely on diabetes you're "making diabetes too important in your child's life".. (and I, and people I know, have heard all these things.. even though it's been proven time and again that children whose parents are highly involved in diabetes management, advocacy and outreach run much less of a risk of long-term complications!) ... have them read this! I read a very sad story the other day about a man who died from a serious hypoglycemic incident. Cheryl saved her daughter's life.

Cheryl writes:
Theresa had a severe hypoglycemic seizure this morning at 3:30 am. We've had diabetes in our family since Michael was diagnosed 1/1996 but this was the first time we've ever lost consciousness. I won't go into all the numbers and details - I know it was a mix of some bad luck and miscalculations - but I thought I'd share these insights from the experience with you:

In the thick of it;
- Split the paper prescription label on your glucagon so you don't have to fight with it when you need to open it.
- I tried to inject the glucagon holding it like a regular syringe and the needle bent. It was as thick and sharp as a tack. I had to hold it like an ice pick and JAM it into Theresa's rear. She was struggling against it even though she was unconscious. I couldn't have done it without Michael (her 12 year old) restraining her.
- The 911 guy was great. After I administered the glucagon and we were waiting for the paramedics, he said, "Get all pets and animals out of the room." Huh? "Do it!" he commanded. I quickly understood why. 4 to 5 (I'm not sure!) guys were soon in my crowded hallway and Spot - who would not hurt a fly - was going nuts on the other side of my son's bedroom door! He probably just wanted to say hi, but Spot was one thing I did NOT need to deal with just then. Good advice.
- If your child is also celiac, grab something gluten free for him/her to eat on the way out the door. This is not the first time I found that ERs have only graham crackers and the like!
- Give the sibling something to do! As I said, as a single mom, I could not have pulled this off without the help of Michael (12) and Dana (7). I think it kept them calm to have something to do, some way to help. Michael called 911, got the glucometer, helped with the glucagon, took care of Spot and then at my request comforted Dana. Dana turned on all the lights, got me towels, helped me get dressed and flagged down the paramedics. I have today praised them repeatedly for their composure and teamwork. I have also listened as they relived their fears.
- God bless good neighbors! I rang the neighbor's doorbell at 4: 15 and didn't even have to say a word. They swooped up Dana and Michael (who were being brave but were petrified) and off I ran, confident that they were in good hands. I did the same for their young daughter when their toddler son collided with a coffee table, hence acquiring a very fashionable Harry Potter-esque scar!
- I decided to bring her to the ER when she was physically stable (it seemed) but not mentally lucid. Very scary. They asked her where she was, she looked around her room and answered, "Lake Tahoe", where we have been only once, 2 years ago! Dr. Littenfeld today endorsed this decision. He thought it best to go to the ER until total stability was confirmed. I chose Stanford, not the closest, but they are attached to Lucille Packard and I have strong feelings, from experience, that children are best treated at a children's hospital.
- I don't think you can ever tell anyone effectively to keep calm, but I do keep calm in diabetic crises and it really helps me, the professionals and my other kids.
- I am going to teach my neighbors how to administer glucagon!

- She is very tired and weak today and her thoughts are quite foggy and muddled. I have her on 50% basals and less than 50% boluses and she is still going low but not feeling it.

OK, Here's how I have kept guilt at bay, mostly:
- There are 365 days in a year and most of them go pretty well!
- When Michael was first diagnosed, our fantastic endocrinologist said something to this effect: In every diabetic's future, there lurks an ambulance ride, an ER visit, a glucose IV drip. Keep doing your best, but when these things happen, do not feel that you have failed or that things are somehow 'worse'. You haven't and they are not. It's all just part of life with diabetes. Deal with it but don't dwell on it.
Cheryl writes further to explain what may have caused the low:
- We ate dinner at Chevy's and eating out carb calculations are never as exact as at home, at least for me...

- She didn't bolus 4 (as I had told her to) at dinner. She bolused about an hour after, while rollerblading, which meant she had more insulin on board when I checked her pre-bed blood sugars than I realized.

- She rollerbladed hard for about 45 minutes after dinner, and I don't think I took that into account enough.

- I did take these things into account, though, so when her BG was just over 200 at 9:30, I did not correct, as I normally would have, a little.

- Since I checked her before bed at 9:30 ( very late for her) and I went to bed at 11:00 (very early for me), I did not test her at 11:00. I normally test her around midnight.

- Also, I had been supecting that her nighttime basal was too high, because she was waking up around 80, which I think is too low for a kid. But I was still in wait-and-see mode. An error, in retrospect...

- Oh yes, one more thing. Six days prior she had the slight 'tummy bug' that has been going around our school. She had a tummy ache and I couldn't get her BG above 100 all day on the previous Thursday and she stayed home from school just feeling bad on Friday but felt fine by the evening. From my experience, even slight illnesses can influence BG long after the symptoms are gone.

So I think if you put all that together, in our case on Wednesday, you got a big disaster! Hope there's something in all this for you to remember to avoid the same!
I'm really appreciative of Cheryl's willingness to share this online. I hope it can help others in a diabetic emergency. We have our quarterly endo appointment today, so wish us luck!