Feral Children

The conversations I have had with my husband in recent days have been quite comical. I have felt the need to specifically request for him to do certain things while I am away. It isn’t that I think he can’t handle it – I know he can – but we parent a bit differently and I don’t want our kids to feel like something in missing in my absence.

Some requests I have made this week:

“Please feed the cats”. It sounds like a no brainer but my husband hates them more than I do and I wouldn’t be surprised if one or more were no longer with us when I return.

“Please put Em’s hair in a high pony”. I don’t want to come home to a girl that has a permanent kink in her neck from craning to see out from under her hair.

“I don’t care what this place looks like from now until 11 on Saturday night but it would really be best for everyone if when I get home the kitchen is clean, laundry is done and the toys are put away”. Enough said.

“Encourage the babies to use words when they want something. I really don’t want to return to home full of children that grunt, groan, whine and cry instead of using language to communicate”.

“Eat all of the gluten in the house. Eat as many gluten filled meals as you can think of and just get it out of our house”. I am actually pretty tired of cleaning the kitchen not just 3 times a day but sometimes 2 additional times so that I can have a safe meal.

Am I going to come home to a house full of feral children? Will they be running around in dirty diaper shirts, unwashed faces, full diapers, no capability to use words to communicate with jam covered hair and sticky fingers?? Probably not. A few non-essential things may get missed while I am away but overall they will have a great time with their dad. Probably a better time than with me as the rules will be relaxed and he is more brave in taking them out to do things. He did say he might just cut open a bag of cheerios and put it on the floor for them to graze off of. And every time I reminded him to do something his response was one word: Feral.

Ready, Set, Go?

I'm getting prepared for a trip to Vegas that I have been looking forward to for months. My life has changed so much since I was there 9 years ago. I am now married and have 3 kids. I also now have Type 1 Diabetes and Celiac Disease. This trip will be a little different than the last one!

I do plan to have a GREAT time with my sister. While I may be a little more annoying to wait staff in restaurants and I won't be drinking nearly as much as I did on my last trip, I do plan to have heaps of fun. I won't be partaking in yard long margaritas but I will carefully be having a few (dozen?) of my new drink of choice: vodka-soda with a twist of lime. Delicious!

Since I have 3 small children and we have all been sick this week I have spent most of my time staying on top of the never ending pile of laundry in our house so that I actually have something clean to take with me. But who am I kidding? I plan on shopping for new stuff the day I get there so I may pack light anyway.

So, my dilemma today has been to decide how on earth I am going to pack all of my "accessories" in a small enough "purse" so that night club staff won't think I am smuggling in a small child. My diabetic friends know what I talking about. I lined up all of the things I thought were important enough to pack in my purse and I came up with this:

• wallet
• camera
• cell phone
• lipstick and compact
• Lactaid
• Insulin pen and needles
• Blood glucose meter, test strips and lancet
• Glucose tabs

I decided this was all a little too much to be hauling around for several hours in the evenings. So I took a deep breath and made some adjustments. I clearly HAVE to take my testing supplies, insulin and glucose tabs. I also need ID, money and health info for emergencies. I decided the camera could stay behind (no one needs evidence of their time in Vegas anyway), and I could just cull my wallet for the necessities. The Lactaid isn't essential either as I can avoid dairy but it is small so I thought I could squeeze 2 in there. My lipstick and compact were also "optional" but I'd rather have them than not. I can't decide on the cell phone and may need to get creative with that one. 

I managed to get almost all of it in this little bag!

I couldn't fit the glucose tabs so I put some single tabs (4X4g) in one of the small pockets. I figure I will always be within 10 feet of a bar and can get some sprite or juice if necessary so I have enough for an emergent situation until I can get someone to get me some juice/pop. The cell phone won't fit so I may just leave it behind. If I think about actually needing my phone to call 911 I wouldn't be in any state to call for myself anyway if paramedics became necessary. Plus, every person within 100 feet of me will have a cell phone if I really need one.

Tomorrow I plan to call to enquire about the Tournament of Kings menu at the Excalibur. It is extremely unlikely that their dessert is gluten free but I'm hoping that the soup, cornish hen and potatoes are. If not, we will have to eat somewhere else and then see the Thunder From Down Under instead! HAHA!

The Good, The Bad and The Ugly.

The good news is I have a confirmed diagnosis of Celiac Disease. The bad news? I now have to go gluten free. And the ugly is that I have an endoscopy today. That was unpleasant.

I will say that they fire you through those procedures at the hospital like an assembly line. That GI clinic is like a well oiled machine; a revolving door of patients getting tubes put up or down various body cavities. I was "fortunate" enough to have mine down my throat today and not up somewhere else, if you know what I mean. There was a certain Calgary Stampede celebrity in there this morning too but I won't say who on here for privacy reasons. If you really want to know you will need to send me a gluten free offering for that kind of information.

The nurse did a great job getting a vein the first try (my veins are hard to get for some reason) and I was fully informed and gave consent to the specifics of this procedure. Everyone was very professional and caring and I did not feel like just another patient. They were kind and treated me with respect, even when at my most vulnerable.

Endoscopy is done to take a look at the small intestine and I now have 5 beautiful pictures of mine to keep forever (Yay). The gag reflex is pretty strong and I would say mine is even stronger than most. I gag when I have to touch raw meat or change the garbage. The procedure itself is fast (like 3-4 minutes) and from the time I was wheeled in to speak to the doctor and was wheeled out again it was maybe 20 minutes. Drive through endoscopy. Here's how this went today:

Nurse "Do you want to be sedated?"
Me "Yes, please, but please don't kill me."
Nurse *laughs* "Oh, I wouldn't do that." She places a mouth piece over my mouth to keep my teeth and mouth open and injects sedatives into my heplock. "It works really fast so close your eyes."
Me - I try to ask if I will throw up from the sedative but my mouth is inoperable and my world is spinning, everything goes black but I am still semi-conscious and somewhat aware of what is going on. Gag, gag, gag, gag. I am actually trying to swat away anything that is anywhere near my face. My face is wet and they are trying to wipe it while I swat at them and this tube is down my throat. I am thankful the procedure is done when you are on your side and I can now understand why.
Nurse (as she is trying to hold my arms down so the doctor can finish) "Just try to breath. You are ok. We're almost done." And the scope is out.
Me *crying*
Nurse "Are you ok? It's ok, hon. It's all over now."
Me *black out*

The sedatives they used today were Fentanyl and Versed. I felt like Will Ferrell in Old School when he nailed himself with a tranquilizer dart. I haven't been quite myself for the rest of the day.

*foul language warning*

(*Rant warning* Versed is used in early labour sometimes but I know that they give Fentanyl to some mothers later in labour and I am astounded that anyone thinks this is a good idea! You're not allowed to do much of anything for 24 hours after that stuff but new moms need to figure out how to take care of a new little person while all dizzy and disoriented?? Plus, if I feel this way, imagine how a newborn baby must feel after they get a shot of that via their mom *end rant*).

Manic Sunday?

Today started out pretty laid back, really. We had a crazy week and I am so incredibly thankful that Clint was able to take Thursday and Friday off so that I had very little stress getting to various activities and appointments. However, the kids decided that Sunday evening was the time they were going to completely lose their minds and make mummy crazy. I was counting down the minutes until we could put them in bed and when it was late enough I did not waste one single moment getting them tucked in.

I love our children but oh my were they nuts tonight. We have this bin for blocks that fits perfectly over a child's head down to their shoulders. That was the coveted toy this evening and sparked many crying and screaming fits. Emily would have it over her head and run around the play room with it, falling over this way and that; Colin would pick it up off of her head while standing on the couch and throw it across the room; Nathan would pick it up and put it over his head, spin around, fall down and wouldn't give it back to Emily who would be expressing her irritation with her brothers VERY vocally. Add to that business that Colin took the push-popper (noisy toy) and ran around the room, running into whatever he came across, including both siblings. Nathan took a blanket and pretended to be Super Nathan, jumping from the couch multiple times and spinning around knocking his brother and sister over. Have you ever seen Kindergarten Cop?? That scene where the kids are all running around like feral animals?? And Arnie goes all Terminator on them? I am quite proud of myself that I didn't lose it but I was so close to curling up in the fetal position and just rocking myself quietly until it was 7:30.

I'm not sure what prompted this little spurt of crazy but I sure hope that we all have a good sleep tonight and awake calm and patient (me) tomorrow. I'm going to go have a drink now ;-)

Lactose and Carbohydrates and Gluten, Oh My!!

When I was about 15 I started having some, ahem, digestive problems. My super intelligent older sister had had similar symptoms and had started taking lactase (brand name Lactaid) with any dairy and found that helped relieve most, if not all, of her symptoms. I followed her advice and avoided dairy for a few days and when I tried it again, this time with the magical Lactaid, voila! No symptoms. It was like I was given my life back. I will say that it was a few years before I really had it under control as I didn't always know what was in my food (I was 15 and living at home) nor did I really think too much about it. My mom just couldn't believe that this was my problem and she even tried to kill me once with a quiche. After that episode I think she got the point. I never had the lactose intolerance tests done as this seemed to so obviously be my problem.

Then this year I was hit with this Type 1 Diabetes (T1D) crisis. An autoimmune disease. Autoimmune means that, for whatever reason, the body is attacking healthy cells. In T1D the body is attacking the cells that make insulin. No one knows for sure why it happens but they do know there is some genetic link. But what makes that genetic marker "turn on" and present as diabetes?? One of the theories is that a viral infection of some kind is the trigger. Apparently in schools where there are chicken pox outbreaks the community sees an increase in the number of T1D diagnoses several months later. An interesting theory but definitely difficult to prove. Another theory is that a stressful event is the trigger. I would say that being pregnant with twins and then having 2 babies and a toddler has been a stressful event. Days and months on end of stressful events. I think it is a little coincidental in my case that as soon as I started to feel normal again and had things under control that was when I started showing diabetic symptoms. Why is it important to know why? Well, if we can figure out why it happens then maybe we can prevent it in others. I would love to know how to prevent this from happening to my own children as I'm sure that at least one of them is also a "lucky recipient" of this oh so fantastic gene.

If you are diagnosed with T1D where I live the endocrinologist sends you for blood work to screen for Celiac Disease. Celiac Disease is another autoimmune disease that damages the small intestine. They do blood work that tests for certain antibodies and if those antibodies show up in the blood work it is an almost certain diagnosis of Celiac Disease. If you are diagnosed with CD you must never eat gluten. Ever. The list includes anything made with wheat, rye or barley (as well as others). Have you ever looked at the ingredients of the food in your cupboard? If you were to gut your pantry of gluten you'd probably have a very empty pantry afterward.

So why am I talking about Celiac Disease now? It turns out that in my antibody screen my levels were 10 times what a healthy person should have (normal is less that 20 and I was greater than 200). I will have to have an endoscope done to look at my small intestine and take some samples for testing. They shove a tube down your throat and look at your small intestine with a camera and then take teeny, tiny tweezers and collect samples. They better knock me out for this one. At this point I have been advised to continue eating gluten until the tests can be run to verify the diagnosis. I'm trying to enjoy my favorite snacks/meals now as I will almost certainly need to make changes in the very near future. This actually terrifies me. What kind of damage am I doing to myself while I continue to eat gluten?? I am actually looking forward to going gluten-free, as hard as it will be, because I am hopeful that I will just feel better. At least I will be able to manage this little lovely with diet. Insulin therapy is enough, thank you very much.

With all that is going on I am constantly watching my kids for signs and symptoms of both T1D and CD. I am more than a little paranoid and have checked the blood sugar levels of 2 of my 3 kids when I thought they were acting weird (both were normal). My husband outed me at our last diabetes appointment with my nurse and told her I even tested one of our cats (also normal). I have since tested the other cat too (normal). So now I have to consider doing blood work on my kids to see if they have Celiac Disease too. I don't present with "classical" symptoms and it could very easily go unnoticed in my kids. It is amazing to look at the looooong list of symptoms for Celiac disease, many of them NOT digestive symptoms. Depression. Lethargy. Migraines. Infertility. Miscarriage. Irritability (I bet my husband is looking forward to me going gluten-free to see if that helps!). From the reading I've been doing it appears that as many as 97% of people with Celiac Disease are undiagnosed. I guess that means I am in the lucky 3% that knows and can actually do something about it.

FYI, November is Diabetes Awareness month. Please visit http://www.diabetes.ca/awareness/ and donate today :-)

Danger and Opportunity

Life is mental right now. When I say it is mental I mostly mean that I am going mental with everything that I'm trying to manage. Some days are great and I feel like I have total control over what is going on in my body and other days I feel like I'm falling apart, physically and emotionally.

Since September 22nd I have had 13 appointments for my own medical purposes, had lab work done 3 times, taken my children to various appointments, taken my older son to preschool and swimming classes, and attended 2 births as a doula. This was me "scaling back". I scoffed at my diabetes nurse when she suggested I try to cut back on things for a little while. I have 3 kids under the age of 4 and the idea of scaling back is somewhat laughable.

When I look back at this month I realize that I actually HAVE scaled back. The problem is that I have scaled back in areas that I get great enjoyment out of for my own emotional well being. I've only adventured out on one playdate this month (fun but exhausting) and haven't done anything for purely social purposes. I have a coffee date with two girlfriends on Sunday morning and I am giddy with anticipation to get out of the house (sans kids) and NOT have to see any doctors, nurses, dietitians, psychologists or lab techs. Don't get me wrong - they are all great - but enough is enough. I am now attempting to find a balance between giving our children the life that they deserve while also making sure that they have a mother to enjoy it with them who hasn't gone completely nuts (or worse).

Now for some technical data. Type 1 diabetics need to have lab work done (at minimum) every 3 months. They do a blood test called hemoglobin A1c (HbA1c) that measures the average blood glucose concentration over a period of time (about 3 months). When I was diagnosed my A1c was 11.5 and I guess that is uber bad. I think that is about as high as it can go without something really terrible happening. Healthy non-diabetics would have a number more like between 4 and 6. Type 1s aim for a number between 6.5 to 7. The good news is that in the short month since my crisis I am now at 9.0 - a huge improvement in a short time.

In terms of blood glucose levels I am self testing a minimum of 10 times a day; always before meals and 2 hours after as well as at bedtime and anytime I feel "low". My finger tips look like a war zone but I am a little OCD about checking my numbers at this point. Non-diabetics can expect to see their blood sugar range anywhere from 3.8 to 7.8, although most often their bodies would keep the numbers closer to about 4.4 to 6.1. As a diabetic my ranges are more difficult to control as I am doing it with injected insulin so my targets are between 4 and 7 pre-meal and between 5 and 10 two hours after I eat.

Prior to this I had experienced what the average person might consider hypoglycemia - basically an unwell feeling, maybe some shakes, a foul mood and an urgent need to eat asap. Prior to my diagnosis I maybe had that happen once or twice a year, at most, and it was nothing that a little food couldn't easily fix. This is what I assume the average non-diabetic experiences when they wait too long to eat and we've all been there. In these cases blood sugar levels are likely in the 3.8 to 4.4 range and the body with a perfectly normal pancreas will very likely compensate before something really bad happens.

True hypoglycemia is somewhat like this but much, much worse. In my case my legs go to jelly, I get confused, I have trouble walking and my heart races. It is a scary feeling and makes my whole body hurt. After one of these episodes I am exhausted emotionally and physically and the rest of the day is usually a write off. I have been experiencing some lows while we figure out how much insulin I should be using and how my daily activity effects how the insulin works in my body.

I put the kids down for a nap yesterday and felt like it was dipping. I checked and it was 4.1 - low but not extremely low - so I had a quick snack. 10 minutes later I was at 2.6 and could barely function. A scary time since I was alone at home with our kids. I treated with sugar and got it to start coming back up just as Clint was getting home from work. Severe hypoglycemia can cause seizures and loss of consciousness. Neither is an option for me EVER, much less when I am at home parenting by myself.

We have an emergency glucagon injection kit that Clint will hopefully never have to use on me. If he finds me unconscious he will need to inject the glucagon into me. This is basically the same thing EMS would inject if anyone ever called 911 for me. Now, when I heard about this little kit all I could think of was that scene in Pulp Fiction when they have to stab the overdose victim in the chest with a giant needle. I picked up my glucagon a couple of days ago and it is MUCH less dramatic than that (thank goodness!). It really is just a simple syringe and he would inject it in my stomach with no stabbing effort required.

I spoke to someone at the diabetes clinic today that told me that the Chinese word for crisis is 2 characters that each mean "danger" and "opportunity". The danger is all of those scary things that I am at higher risk for (heart attack, stroke, kidney failure, blindness, etc.). The opportunity is that I now have this whole team of people helping me to figure out how to live a long and healthy life. This crisis is my job right now but I get to make decisions, inform myself, make choices and problem solve. I am the CEO of my diabetes, not the other way around.

Expired Pancreas

Just when I thought I was finally getting our home life organized and becoming Super Mommy, I have been given a swift kick in the gut. The pancreas to be more exact. It turns out I am the "lucky recipient" (the words of my nurse) of a gene that basically stamped my pancreas with an expiration date.

About 6-8 weeks ago I started having some symptoms... extreme thirst, frequent and excessive peeing, weight loss even when I wasn't really trying.... and I knew something was not right with my body. Denial prevented me from making an appointment with my doctor and I just kept hoping that it was just my body resetting after my last pregnancy and finally being done with breastfeeding. On September 22nd I went to my GP and got the bad news that I am a diabetic.

Now, she couldn't tell me what kind of diabetic I was (Type 1 or Type 2) and I have to admit that I really hoped it was Type 2. You see these people on the Biggest Loser that get themselves into great shape and basically "cure" their diabetes. They don't have to take meds or insulin and just need to be reasonable about diet and exercise. Diabetes wasn't brand new to me - I had gestational diabetes and required insulin when I was pregnant with the twins - so my GP had me start insulin that day. I still had all my supplies leftover from last summer thinking that I would never need them again.

The next 48 hours were dramatic and I ended up in the emergency room by 3:30 the next afternoon. My body had been suffering long enough and needed fuel. With no insulin to help the glucose entering my body to fuel my cells and brain, I actually felt like I was wasting away. Truth be told, I have never felt that bad. When I got home that night I collapsed in bed.

The next morning I went to the diabetes clinic (they fit me in on a Saturday even though they don't normally do that) and I met with a nurse and a dietician. I was told then that I am a Type 1 diabetic and will require insulin multiple times a day for the rest of my life. What? Why? How? Is there any chance you are wrong and this will go away? That my body will "fix" itself? Nope and Nope.

I had so many questions: How on earth am I going to manage this with 3 kids at home? What are the chances that any of our kids will develop it? What restrictions will I now have on my diet? How do I explain this to my family/friends/colleagues?

It sucks. I'm trying to find new routines for everyday things like providing meals for my family and taking Nathan to preschool. I feel like this is going to be my 4th baby - this baby requires 24/7 attention from me, I need to feed this baby carefully and always be aware of what this baby is doing. I can't leave the house without a drink and a snack for this baby and I need to always remember this baby's medication. However, this baby will never grow up, learn to take care of itself and move out. I am also a single mom to this baby since Clint and other family members can't really help me take care of it and I will never get a night or weekend "off" from this baby as it will always be with me. No babysitter in the world can take care of this baby for me.

I'm learning so much right now and slowly getting my blood sugar under control. I've been struggling with how to tell people about it or even if I should tell people about it. I decided to just rip the bandaid off and get it out there. I'm not embarrassed but I'm not at the point yet where I feel like I want to explain every detail to everyone I tell. People are generally misinformed and/or uninformed about diabetes. Here are some things I've learned so far that should help with the questions I pretty much would prefer not to talk about as well as some safety information in case of emergency:

1. Type 1 is most often diagnosed in childhood or adolescence but can occur in adulthood as well (my pancreas "expired" at age 33).
2. I am insulin dependent. My pancreas is producing little (if any) insulin at this point. I take insulin with every meal as well as slower acting insulin at bed and in the morning for a total of 5-6 injections a day.
3. If I feel crappy (and right now frequently even if I don't feel crappy) I will prick my finger to check my blood glucose. I'm sorry if that makes anyone uncomfortable but the alternative is me having a seizure and/or losing consciousness if I am hypoglycemic.
4. If you are going to be eating a meal with me I will need to inject insulin into my stomach. I will attempt to be discreet but you are more than welcome to look away if it makes you uncomfortable.
5. If I appear confused, drunk or otherwise not myself, please sit me down and give me some juice, sugar or other sugary treat. I have glucose tablets in my purse and if I am conscious you can give me 4. When I come around tell me what is going on since I likely won't have any idea what is happening.
6. If I am unconscious please call 9-1-1 and tell them I am a type 1 insulin dependent diabetic.

So, there it is. I have no doubt that I will be OK as I'm a planner and will take care of this. I'm angry that this is happening but also thankful that we were done having kids before it happened. I'm also so thankful that we have such great medical systems in place to help me cope and manage it (so thankful for universal health care!!). Insulin was invented in 1923 (by a Canadian) and life expectancies were only months prior to that so I'm also happy that I live here, in this time to deal with this illness. I'm also so happy that our family now has medical coverage through Clint's work so it won't be as much as a financial burden on us either. I am having a good day today but also know that not everyday will be a good day and I will be OK with that. I am fortunate to be an intelligent person with a lot of family and friends for support. I plan to live a long, healthy and happy life regardless of my useless pancreas.