Swine Flu, Part 2

We leave tomorrow for a two week visit with family back east. If at all possible, I will post from there.

In the meantime, for the sake of closure I'm sharing an entry I wrote on May 11th and just now found in a draft folder...

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I write my previous entry, hit "publish post" -- then sit back in my chair.

Thinking.

What if he gets this thing? No immunity. They keep saying those most vulnerable are young kids, the elderly and people with underlying health conditions...

He's been coughing for the last couple of days, no fever.

But still.

So I snatch up the phone and call his diabetes clinic. After a brief conversation with the answering service, I type an email to Joseph's endocrinologist telling her about Joseph's classmate.

Twenty minutes later, I receive the following message from Joseph's doc:

Sandra,

If Joseph gets a runny or congested nose or fever, or a cough, he should go in THAT DAY to be swabbed for H1N1 and started on an antiviral. Treating influenza requires starting meds within 3 days of symptoms. The problem with H1N1 is that no one has any kind of immunity to it, so it could lead to weeks of high glucoses and/or ketones if untreated.

Hmmm. It's just a cold. I know it's just a cold... but what if-

Just then, the front door bangs open-- and I nearly jump out of my chair.

"Hey, Mom- can I go on the computer?"

"What? Oh... sure, Bud."

"Mom-- can I have a snack?" Evan chimes in.

"Okay, Honey. Joseph can you help your sister find a snack? String cheese, an apple... there's some bananas... guys, I need to go downstairs and make a quick phone call.

Minutes later I'm talking to a nurse at Joseph's pediatric clinic.

"Can you get here in the next 15 minutes?"

"Sure, we're only five minutes away."

"Great, and he'll have to put on a mask at check in."

"Oh."

"Bud-- we need to get you checked for swine flu," I announce, returning to the kitchen.

Joseph looks up from the laptop, confused.

"Honey, it's just a precaution. Dr. C wants you to get checked. You may have been exposed, and if you get this thing you could have some pretty wild blood sugars."

So I pack both kids, and off we go...

True to their word, Joseph is wearing a mask the instant we identify ourselves. The two of us are then quickly escorted to a small exam room, while Evan remains in the waiting area immersed in a book.

"Mom, do you think they'll let me keep the mask?" Joseph asks once we're alone. "I could make a YouTube video about this."

"Sure, Bud," I say, head shaking.

There's a light knock at the door, then a lovely young nurse steps into the room -- also wearing a mask -- and it's not long before Joseph is cracking plague jokes. She thinks he's hilarious.

Me? Not so much.

Moments later a doctor walks in. Not Joseph's regular pediatrician, but rather a very small man with dark hair, eyeglasses and -- unlike the nurse -- no mask.

"What seems to be the problem?" he asks.

I fill him in.

"Well, this is all hysteria," he says in an angry voice.

"Excuse me?"

"So much overreacting- "

"But I just explained that my son's endocrinologist advised us to come in and have him swabbed."

"Still, much too aggressive... "

And now I'm angry.

"That may be so," I begin -- struggling to keep my voice steady -- "but this was the course prescribed by my son's diabetes physician."

"All right. We'll swab him."

Then he gets up out of his chair, grabs Joseph's chart and stalks out of the room.

When he returns, the doctor instructs Joseph to sit on the exam table, sets a vial full of clear liquid down on the table next to him, and holds out what looks like an extra long Q-tip.

"Now hold still. This is just going to make you feel like you're going to sneeze."

He then takes hold of the back of Joseph's head and proceeds to ram the swab up one of my son's nostrils-- so hard that Joseph cries out, begins to struggle, and then falls backward on the table while the doctor holds him down and continues "swabbing."

"Whaat? Wait!" I barely manage to get out before the doctor releases my son.

When Joseph sits back up, blood is streaming out of his nose.

"Now I have to get another one!" The doctor growls.

"What?!" Joseph and I say at once.

"You spilled the vial!" On the exam table beside Joseph is a wet spot where the vial once stood.

Without saying another word, the doctor storms out of the room.

"Mom, I hate that guy! That was terrible! This really hurts!"

I'm so angry I could spit.

Before we leave, the doctor returns to tell us that he has no idea when we will get test results.

"Until you know, he must be quarantined."

And so we wait the whole weekend for test results which (thankfully) come back negative.

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Since writing the above entry early last month, I haven't thought much about swine flu.

Until another death is reported. And I read the "but the victim had an underlying health condition" tacked on to the end of the announcement.

Then it's like another little poke in the gut.

Did this person have diabetes?

For a moment I'm gripped with fear.

(It doesn't help that Wisconsin leads the nation in confirmed cases.)

But then, I move on.

Swine Flu

On my way to pick up Joseph, I can't help smiling.

The sun is bright, the air warm, and it's Friday.

Ice cream, that's all this day needs.

Just as my boy climbs in the car, I turn and flash him a grin.

"How 'bout we pick up Evan and then go for some ice cream?"

"That'd be great," Joseph says.

And then he turns and looks out the window.

"What's up, Bud? Anything happen at school today?"

"A kid got swine flu."

"What?"

"Swine flu."

"Wait a minute... is it confirmed?"

"Yup."

"Are you sure, because it takes ti- "

"Mom, they talked to us about it. And there's a note in my backpack. Kids were freaking out. Some parents even showed up to take their kids home."

"Bud, do you know the kid-- the one who got the flu?

"Yeah, he's not in any of my classes, but he's in my grade."

"Hmmm... well, are they closing the school?"

"Nope."

"Really? Huh."

Neither of us says anything for about a minute.

"Hey, Bud-- are you scared?"

"Heck, no. You said I shouldn't be, and we heard that doctor on the radio last week giving all the reasons why we shouldn't panic. No, I'm not scared. I'm just a little mad."

"Why?"

"Because they didn't close the school."

And now he's the one grinning.

So we pick up Evan, have some ice cream and then make our way home. We're not in the door five minutes before Joseph and Evan head outside to play baseball with a couple of friends.

While I sit inside writing this post.

Wondering if I should be scared.

My First Vlog...

... and could the freeze-frame look any goofier?




Will write a post soon... really.

Finally

Have you ever lost touch with a close friend?

Ever let so much time go by without talking that you just didn't know where to begin?

And even when something truly wonderful happens, your shame at having let this friend fall so far out of your life prevents you from sharing it with them.

Well, that's how I've been feeling for quite a while now.

About this blog-- and about all of you.

So I'm just gonna jump in where I left off and see what happens...

Joseph loves the Ping-- we all do.

His new pump and meter arrived over the Christmas break and turned out to be quite the gift.

"Mom, look at this screen!" my boy exclaimed after we powered up the pump, "it's... beautiful."

I had to agree. Definitely more readable than its predecessor.

In addition to the fabulous color screen, I love that we can use his meter to see how much insulin Joseph has on board from another room. And as I mentioned in my previous post, giving him a corrective dose of insulin while he sleeps is sooo much easier now.

So yeah, we're happy.

Now.

This is not to say that the Ping is perfect...

When we opened the box and pulled out the pump, I noticed immediately that the Ping is considerably bigger than Joseph's IR 1200. (Bear in mind, one of the things that drew us to Animas in the first place was the small size of their pump. So this was a surprise.)

Also, I was looking forward to Joseph having the food database in the pump.

You see, shortly after we purchased his IR 1200 four years ago, Animas released the IR 1250--the first of their pumps to include that database.

Sadly, the Ping only has the food database on the meter-- which seems kind of nutty (at least for us) as we don't send the Ping's expensive, somewhat large meter to school with Joseph (where I think he'd most benefit from having access to that food database).

Ah well.

In other news, Evan lost her first tooth!

AND I got a job!

Which is part of the reason I've been MIA.

It's part time (20-30 hours a week) extremely flexible-- and dang cool.

I'll tell you more about it soon.

One last thing.

Joseph is just shy of my height and closing fast... which is sort of freaking me out.

An Early Present

Here we are coming to the end of the year, and what have I been doing?

Stressing about money.

Money for our property taxes, money for Joseph's orthodontia, miscellaneous medical bills, our insurance premiums, CHRISTMAS...

Money for a new insulin pump.

That's right, Joseph's current pump will soon be out of warranty-- and given our history, there's no way we can afford to be without a warranty. Thus, we have to choose a new pump and purchase it before the end of this month.

After much discussion -- and a brief look at the competition -- we've decided to stay with Animas.

Initially I had some reservations about this decision, but we have gotten excellent customer service and Joseph does indeed love his current pump.

And we're all very much intrigued by the new OneTouch Ping system.

This latest technology from Animas includes a glucose meter that is able to wirelessly communicate with the pump.

You can actually operate the pump from the meter.

What exactly does this mean?

Well, for us it means that when we check Joseph's blood sugar every two hours overnight and have to give him a correction when he's high or decrease his basal insulin when he's low, we won't have to:

• Pull back his blankets;
• Roll him over (if he happens to be lying on his pump case);
• Remove his pump while untangling his tubing (which always seems to be wrapped around the clip on his case);
• Give a bolus or change his basals while keeping one eye on the pump, the other on Joseph (because any sudden move can easily rip out his infusion set);
• Maneuver the pump back into it's case as Joseph flails about in his sleep and then rolls once again on top of said case.

Nope, we won't have to do any of the above.

Rock. On.

Ahhh, but there's more...

No, not about the Ping-- but rather, about paying for the Ping.

While we have insurance and have met our deductible for the year, unfortunately, we're still left with a 10% coinsurance payment.

Something like $660.

Uh huh, this is where the stress part comes in.

Or maybe not.

I got a call last Wednesday afternoon from Animas.

"Sandra, we're still waiting for prior authorization from your insurance company, however, we were able to verify your benefits. It looks like you have a 100% benefit."

"Excuse me?"

"A 100% benefit."

"Really?... Seriously?"

"Yes, you see- "

"But wait-- how can that be? Our insurance covers 90% once our deductible is met. I don't understand."

"Well, it looks like you've also met your family's annual out-of-pocket maximum."

"Holy Cripes! Then you are serious."

And now I'm up out of my chair.

"You've just given us an early Christmas present, you know that? This is AWESOME!!!"

The minute I hang up the phone, I'm punching in another number.

"Ryan? Honey, we're getting the Ping for Joseph-- and it's not gonna cost a thing! Can you believe it?!"

I still can't.

Coming Down Off the Bus

I lean back and stretch, before glancing at the time in the lower right corner of the computer screen.

11:35 AM

Joseph should have called by now to confirm his lunch bolus.

Standing up, I stretch again-- then walk upstairs to the kitchen, drop into a seat at the counter and slide Joseph's bright yellow and green logbook in front of me.

Hmmm.... 155 before breakfast-- that means the spike will be a bit higher. But if today is anything like the last few days, he'll probably coast into the low-to-mid 100s.

Hopefully.

We've had some out-of-left-field highs of late, so I'm not entirely confident in my prediction.

A few minutes go by and I look at my watch, then at the clock on the microwave.

Huh.

He should have called at 11:30, right after lunch...

But then I remember something.

It's Friday... the field trip... his class went downtown to see a musical performance.

I get up and rummage quickly through a stack of papers next to the phone-- until I find my half of the permission slip.

"Students will arrive back at school by 11:30 am," it says.

I look at my watch again.

11:45

Relax, I tell myself, he's probably just finishing his lunch...

Several more minutes pass before the loud ring of the phone causes me to jump.

"Hi, Mom," Joseph says, his voice sounding tired, "lunch was 93 grams."

"Cool, Bud-- and what was your bg?"

"81."

"Okay, let's see now - "

"Mom... "

A pause.

"... before that, I was 37."

"What?"

For a second, I'm convinced I didn't hear him right.

"Thirty-seven," he says again, a little more slowly.

"Wha- where-- when were you 37?" I sputter, trying to stay calm.

And failing miserably.

Because all I can picture is Joseph on a loud school bus, packed with middle schoolers.

A blood sugar of 37.

"It was when I got off the bus-- I felt really low and I went to the health office and checked and took some glucose- "

"Wait-- did you feel low during the bus ride back to school?"

"Well, kind of... I mean, I felt hungry. But I figured we were gonna eat lunch once we got back."

"How many tabs did you take?"

"I took five and then ate lunch about seven minutes later."

"So after seven minutes, the glucose brought you up to 81, and then- "

"No, I was 81 after I had lunch."

"Oh, Honey-- you've gotta check again before you eat, to make sure the glucose is bringing you up."

"Well, the blueberry bagel I had didn't really slow things down. I was fine-- and Mom, it was kinda cool the way all the girls were worried and wanted to give me hugs and stuff."

Despite hearing the smile in my son's voice, I can't stop feeling sick about this.

What if he was 37 just a few minutes earlier? While he was still on the bus, miles from the school?

I try to shake this thought as we calculate his lunch bolus.

"Bud, why do think you went low? Were you more active this morning? Did you give yourself extra insulin? A correction? A bolus for a snack?

"Mom-- no, none of those things. I just got on the bus this morning, sat at the concert, got back on the bus- Mom, it happens. I have to go-- recess is almost over.

"All right, Bud... " I say, straining to sound normal, "I'm sorry, go ahead-- I'll... I'll see you later."

Shaking, I sit back down in my chair, and stare through wet eyes at the logbook in my hands. At the "37" I've written in it.

Frightened.

Because I can't find a single reason for that number.

His Voice

In honor of World Diabetes Day, and because this year's theme is again "Diabetes in Children and Adolescents," I'm going to step aside and let my son do the talking: