Highest, Hottest

Today I was remembering the brief run of daily posts I put up at the end of last year, and how easy it felt to post every day. There weren't necessarily a lot of comments, but even without the dialogue it was an interesting process.

We've been keeping really busy this summer, with lots of barn time and play dates. The weather has been spectacular, so we're going to try camping soon. We won't go for long - three nights or so - but I think it will do Avery's blood sugar a lot of good to spend a few days running around outside. 

This picture was meant to be a lot more interesting, but the shutter speed on my phone camera let me down again.

I'm working on some projects for Christmas. I've got a gansey going - have just divided for the armholes. It will be a vest rather than a full sweater, because the recipient gets hot easily and doesn't like sleeves too much. I'm knitting it on 2.5 mm needles so it felt a bit slow at first, but really it has progressed quickly. Here is the swatch.

And over the past six months I have been making ice cream. I'm disproportionately obsessed with it. I literally lie awake nights dreaming up new flavours. Like I have a plan for a truly stunning and completely original flavour, which I can't even share with you because I'm hoping to get rich off of it someday. But here is my margarita ice cream - lime, salt, and tequila.

Carolyn, you remarked that Canadians measure blood sugar differently. You're quite right. A U.S. blood glucose number is (randomly) 18 times a UK or Canadian number. So when Avery was running between 17 and 22 (UK or Canadian) for four days, in the US she'd have measured at between 306 and 396.

It's nice to be talking to everyone again!

'chronic': adj, syn 'ongoing'

"It's life, Jim, but not as we know it."

Since Avery was diagnosed, we've had some frightening days. She had a four-day sustained high, for example, when we could barely get her blood sugar below 17.5 no matter what we did. The pediatrician told us to throw out the insulin cartridge and start using a new one. It worked: somehow, the third vial out of a 5-vial blister-strip pack, was ineffective. I had only changed it less than a week before, so it wasn't old...??

Anyway. Who knows?

Then, Avery had a low one night at eleven o'clock. I treated the low (liquid sugar followed by a carb-protein snack) but ten minutes afterwards, she threw up, and went low again. I was out of juice, and out of pop. She drank a few tablespoons of maple syrup, and then threw up. I mixed up some powdered iced tea, and she drank it, and then threw up.

After two hours and seven low treatments, enough of the sugar had absorbed despite the vomiting, to bring her her blood sugar up high enough that I let her go to sleep.


Today Avery's pediatrician began the process of getting her an insulin pump. There is a certain amount of learning that must take place before a family 'qualifies' -- they want to be sure you are not under the impression that the pump will make your life easy. You have to understand the effects of food, exercise, sleep, insulin; all things that affect blood glucose. Once you can manage it 'old school', you can ask for the luxury of a short-cut.

I'm pleased that the BC government is so selective about which patients are 'candidates' for pump therapy. This is a $7000 device, and the disposable infusion sets, changed every 2 to 3 days, are $20 each. I'm a taxpayer too, and I like knowing that, as far as possible, families are assessed as to their ability to use it responsibly.

It's hard to manage this disease. It's all a question of damage control - you are always a few steps behind, playing catch-up. My hope is that the insulin pump frees her up a little bit. It would be great if she could eat without a conspicuous injection, or if she could skip a meal that she really doesn't want.

It looks like she'll get her pump in September. First we have to decide on a model (I think our decision is nearly made), and then the pediatrician will order it and we'll begin training. Normally it wouldn't take that long, but it's summer and, between his holidays and ours, September is not far away.

I want to thank everybody for chiming in, in the comments. I really appreciate your words, and your positive thoughts, good vibrations, and prayers...all have come in useful in the past few months.

Next time I won't be away so long. I'm beginning to see that we're all going to be okay, and that someday there may even be time to do some housework, write a letter, sew a dress, bake a cake, read a novel, and decorate for Christmas. After all, you can't just stop everything, can you? 

You gotta bash on regardless.

And then you shift your priorities.

This blog has been pretty quiet for the past month. Sometimes I get busy and I post a lot, and then sometimes I get busy and I don't post at all. Most of the time it's because life has gotten hectic with small things - rarely with One Big Thing.

But this time it was One Big Thing. My daughter Avery, whose real name I'm using here for the first time, got very sick on the last weekend of April, with what I thought was a stomach bug. On the third night, when the vomiting started again and she had been hyperventilating for several hours and the bad feeling I had just wouldn't go away, I took her to emergency.

Within about 3 minutes the triage nurse had it figured out. At first he thought she was hyperventilating from anxiety after all the vomiting. You could see, too, that she was badly dehydrated. She breathed into a paper bag for about 45 seconds while he was asking me her date of birth and so on, and suddenly she took the bag off her face and gasped, "I might throw up." He smelled her breath and reached for a glucometer.

Do mothers go into denial sometimes? Absolutely we do. I had noticed the frequent urination over the past couple of weeks, but I had put all my anxiety into the kidney disease basket...in fact I had decided to ask her doctor to order a 24-hour urine collection.

But as soon as I saw what he had in his hand, I knew what the bad feeling was. Once or twice over the past month I thought "She's been up to pee twice tonight. Diabetes? No, don't be silly. Don't overreact."

Her blood sugar was 23.5.

It's a surreal feeling to see an entire emergency room unit scramble into action at 3 AM, because your daughter has a stomach bug. It's a surreal feeling to sit next to your 9 year old - whose eyelids are barely visible, her eyes are so sunken - biting your tongue because all you can think to say to the doctor is "You must be mistaken." It's a surreal feeling to watch them, when they can finally get a line in to her shrunken and dehydrated threads of veins, put insulin into her IV.

And then to watch the colour and the life come back into your daughter, and to know it's not just the saline, the phosphorus and the potassium, but because she is getting dextrose and insulin.

Insulin. "But - but -" I think to myself stupidly, "Insulin is only for diabetics."

It can't be. It can't be. She's perfectly well. She has always wasted away when she has a virus - all her life whenever she gets a cold she shrinks down to a wisp, and then within a few days she plumps back up. You must be wrong. There's some other explanation, I know it.

Can't we talk about this?

I want what's behind door number two.

But what we got was Type 1 Diabetes. And what nearly killed Avery that night was diabetic ketoacidosis. She had every one of the symptoms on that linked page, except for coma and, thankfully, some of the symptoms listed under 'cerebral edema'.

We spent five days in hospital while they slowly brought her blood sugar down and her electrolytes up. I only realized how close she had been to fatal complications when the doctors and specialists who visited her every day would mention small things: things like "I haven't seen a child that sick from diabetes for a very long time." (That was from the pediatrician - himself a Type 1 diabetic.) "Avery, today is the sickest you will ever be in your life, I promise. You will never be this sick again."

And "She was very sick," said one nurse to another, then the diabetes nurse educator added to both of them, "She was incredibly sick."

I can't even describe how much better she looks in this photo. 

I wish I had taken one 12 hours earlier - you wouldn't think it was the same child.

We have been home now for 12 days. Our whole life has changed. From a household that would lie reading books in bed until 10.30 in the morning, shuffle into the kitchen and throw a few pieces of bread into the toaster, we have become a family who does sugar checks every four hours at minimum, and schedules (unbelievably balanced) meals for 9:00, 1:00, 6:00 and 9:00. Nothing gets in the way of mealtimes anymore - because I can't manage it all, in my own mind, unless there is some predictability built into the system. I have to know exactly what is going in to her body, and administer insulin within a certain timeframe around her meals.

My crappy little entry-level Samsung Galaxy smart-phone has become my bestest, best buddy. I have alarms set for 2 AM, 5 AM, and 8 AM. I have an app that links to a website where I log every single thing Avery eats, with a carb count for all of it, as well as the result of every finger-stick blood sugar test she does (we're averaging about 8 or 9 a day), and every injection she gets of both kinds of insulin. I had to get a text plan so that I could contact the pediatrician four times a day with her pre-meal blood sugar numbers, and he could text me back with the dosage.

Will we be okay? Yes. We will be okay.

Will this settle down so that I don't need to keep such obsessive records of her food? Yes. I'll get used to it.

Will I eventually know the insulin dosage myself, so that I don't need to text the pediatrician? Yes. In fact they're giving me "the math" tomorrow, and then I'll be doing my own insulin calculations.

Will I ever, ever get used to the fact that my daughter has Type 1 Diabetes?

I'm sure I will. The disease is manageable, if not controllable. The daily grind of it will be exhausting, but we are willing and able for it...after all, we still have Avery with us. The tests, the injections, the careful juggling of food and exercise and meds...all of that is cake compared to my child nearly dying.

The question is, will I ever forgive myself for not seeing the signs of it, and therefore allowing her illness to progress long past the point of danger. Will I ever forgive myself for all the ginger ale and popsicles I fed her, thinking her blood sugar was low after all that vomiting?



I'm not holding my breath.

Practice Makes Perfect?

Erudite Mondays at HalfSoled Boots

Volume 12 Number 3

Just finished the most interesting book: Life After Life, by Kate Atkinson. She's the author of Behind the Scenes at the Museum, which I absolutely loved. Life After Life is just as good.


Life is full of mistakes, missed opportunities, tragedies and endings. But what if we could go back and try again, and keep trying until we get it right? The same life, every time, but with a moment of recognition, an undercurrent of caution at every crucial moment lived before? It's the snake with the tail in its mouth...the continuity and inevitability of life.

Ursula Todd is born on a February morning in 1910. The cord wrapped tightly around her neck ends her before she begins.

Ursula Todd is born on a February morning in 1910. The cord, though wrapped tightly, is cut in time to save her life which, this time, lasts a little longer.

The date of her birth never changes, but the date of her death is different almost every time.

This book is about more than reincarnation, though: it's about the complicated beauty of family. It's about selflessness, and the gradual awakening toward a larger purpose. The author does something very subtle, very clever with the reader's emotions. I was halfway through the book before I realized that my feelings of anxiety, frustration, doom and perplexity were not simply an independent response - were in fact engineered by her. By the end, I could only marvel at how deftly she turned me into Ursula Todd herself: I didn't so much identify with her, as I took on her experience as my own.

I am crazy about this book. I was sorry when it ended (or did it?), and will be recommending it to everyone.

HSB Book Rating:
Reread? Yes.
Give to Others? Yes.
Bookplate? Yes!

3/3

Well, that was a bust.

Hi Susie!
The run, you ask? Going NOWHERE. My friend dropped out, then my daughter dropped out, and then I'm afraid my MOJO dropped out.

I'm going to carry on with the training, but due to all the waiting around for schedules to mesh, I am nowhere near ready to run 10K on pavement, and we're only four weeks from the race. I'll just have to give it my best shot and try again next year.

It's Easter Sunday tomorrow. My parents are coming over for dinner, so I have some cleaning to do. I hate cooking a big feasty meal in a messy house.

Last Wednesday my youngest daughter turned 9 years old. What?!?! Sigh. Tomorrow afternoon sometime I should be about eighty, and wondering what the heck happened.

Here's the cake I made her:

I've never worked with fondant before - it was surprisingly simple, and the finished product is disproportionately impressive. Win!

Nigellissima!

Everybody knows I love Nigella Lawson. I have her new book, Nigellissima, her tribute to Italian food. It's a great book - lots of flexible options and "inspired by"-type dishes.

I haven't read it quite cover to cover, but nearly. I sat on the sofa the other night with a huge glass of Shiraz, flipping through the recipes, and wishing I could make her macaroni and cheese without having to get up and walk into the kitchen. The book, like all her other ones, makes me feel languid and decadent.

Nigella's books are usually hefty, filled to the brim with delicious recipes and chatty notes. Nigellissima, however, is uncharacteristically slender and understated. Much like Nigella herself, if the internet is to be believed. I'm hoping she doesn't go whittling herself even further - she looks great, of course, but I don't trust thin cooks. The thing I've always loved about her was her sublime unconcern with her weight, and her perfect - neither defiant nor apologetic - acceptance of her luscious figure. "Bosomy and bottomy", to use her words. If her next book is a volume of slenderizing recipes involving things like flax and steamed skinless chicken breasts, she will get a strongly-worded letter from me.

I've made two dinners from this book so far. One was a finger-licking, chin-dribbling feast of "chicken under a brick" - or 'bricken', as I'm calling it. This was unbelievably, smoothly, voluptuously delicious (my fingers just typed "volumptuously" twice, and I liked it both times). It's a whole chicken, spatchchocked (cut through the backbone and laid flat on a baking sheet), marinated in various spices and unguents (I have a small jar of preserved, salted lemons that really came into its own here), and then roasted hot and fast under a foil-wrapped brick. Shockingly good: the only thing I had to complain about is that the damn brick put paid to the Bakelite handle on my saute pan, which I unthinkingly used to lift the whole shebang out of the oven. It was just a few pounds too much, I guess, although my husband pointed out that now, at least, the pan fits into the dishwasher a lot better.

The second meal was a true feast. It was a whole leg of lamb, deboned, butterflied, and dressed with balsamic vinegar, olive oil, slivered garlic, sea salt, bay and rosemary (my addition). It, too, had a hot, fast roast (425 for about a half hour) and a fair bit of resting time. The only problem with THIS meal was that I didn't have enough people around my table to do justice to a whole leg of lamb. Mmm, delicious.

My favourite thing about the book is the way Nigella does NOT use a bunch of chi chi Italian names for the dishes. She uses good old English, which keeps the confusion to a minimum.

The low-down:
- LOTS of meat dishes in this book.
- And a LOT of seafood. Yerch. I am allergic to shellfish and I will end up cruising right on by huge sections
- Delicious-looking desserts
- Nigella's comfy, confidential food-writing turns up in spades and makes the whole thing worthwhile. 

My score - 4 out of 5. And to be fair I'm only deducting a star because a) there is way too much shellfish, which is less Nigella's problem than Italy's problem; and b) Nigella has gone a bit diet-ey.

Mangia!

Disrespectful and Juvenile

Seen the new Playtex ads?

Clever? Yes. Amusing? Sure.

Harmless? No.

The one good thing I can say (besides "nice nature photography") is that they at least deal out the body shame fairly between the genders. But men don't have a long complicated history of their genitals being labelled unclean, disgusting, smelly, and a turn-off. As far as being bombarded by media images designed to make a person feel that they are physically undesirable in their natural state, men are new to the game.

These print ads are in magazines, such as Glamour, that target young women. These young women deserve better than this hurtful propaganda.

If you want to give feedback to Playtex on this subject, the easiest way is to leave a comment on their Facebook promo page. It may be more effective, though, to complain to the magazines carrying the ads (probably many, but I only know of 3 - Glamour, Shape, and Sports Illustrated). If a magazine gets enough negative feedback on an ad, they don't run it anymore, and they don't pay for it. Maybe Playtex pulls the campaign.

Given the state of the culture we live in, I don't expect much; but I am hoping, nonetheless.