Supply... meet demand.

So HB and I recently had to change our insurance when he switched to a new job and under this new insurance policy I am not able get the my insulin pump supplies from the same manufacturers/suppliers as I was before.  Fortunately this change didn't mandate an entirely new brand of pump, so the hoop jumping I've been doing is relatively minor in the grand scheme, but I can't even begin to comprehend why this whole process is so. darn. complicated. 

First things first, I contact my Dexcom CGM's intermediary supplier to give them my new insurance information.  I've had a horrible time of it trying to work with this company to begin with so it wasn't too much of a shock when they announced that my insurance isn't accepted in their pharmaceutical branch but maybe - only maybe - their durable medical department could assist…  they, of course, didn't return phone calls or process my prescription for two weeks until I'd practically run out of sensors (3 days were left on the one I was wearing) when finally the company's management and I made sense of what should otherwise have been a very straight forward process.   Headache number one conquered (and "case management" officer identified for my file - time will tell on how she does). 

The second phone call I made to update my insurance information was to Medtronic, the makers of my MiniMed insulin pump.  For the most part, their customer service is ON IT and I love to work with them.  This time, however, my heart nearly broke when they flat out said they don't accept my insurance directly and that I'll need to start working with an intermediary supply company to get my infusion change supplies instead of working directly with Medtronic.  Given the terrible support I've had with these types of companies before, this was a bad-news-bears kind of moment.  Having been assigned to a new company, I called them to set up my account and start my next supply order which, much to my relief, seemed to go smoothly. 

Unfortunately my sense of relief came too soon.  When my supply order arrived, I found that the supply company decided to change the reservoirs I use in my pump from the 1.8 mL size to the 3.0 mL size given my recent increase in insulin use.  This is all well and good, minus the fact that the pump I use only fits a 2.0 mL size reservoir at the largest… meaning I'm up a creek with a bunch of supplies I cannot use for the pump design I've been wearing since 2011.   AWESOME. 

I call Medtronic to see what my options are - either I return the un-returnable medical supplies that I cannot use OR I see if a larger pump is covered under my current pump warranty (expires spring 2015 - eep!) and their legal definition of "medical necessity."  Fortunately, since their customer service rocks as I said, they were quick to discover that YES! I am entitled to a new pump… but it's on back order for at least 5 to 6 weeks due to increased demand for the 3.0 mL size snazzy, updated MiniMed pump.  Knowing I can't use the supplies I have on hand and can't  go without insulin for the next month and a half, Medtronic generously covered a box of the 1.8 mL size reservoirs for me so as to get me through the wait time.  Thanks, Medtronic! Grumble, supply company, thanks for screwing with my supplies and demand!

Note the size difference... 

Long story short, my new pump finally arrived and I'm in the process of updating my settings in pump #3.  I don't so much mind the larger size of the pump, it still fits in my pocket after all, but the ordeal of programming is a pain!  I have 10 different basal settings to transfer over (total daily basal currently 24.975 units), 4 different carb-ratios (ranging from 11g  to 15g carbs per every 1 unit of insulin) and don't even get me started on the random alarm/system settings I use to keep on top of my glucose treatment.  I know it will all be for the best once this whole two-month insurance-change deal is over, but for the time being my head is still ringing from the knock-on effects this hypothetically simple process caused.  

Maybe when it comes to my next three-month supply order this fall, it'll be straight forward.  At least one can hope. 

Actively Passively Aggressive.

With HB starting a new job and our switching insurance providers (thank you US Congress for removing pre-existing conditions clauses!), the bureaucratic flaming hoops pushed my three month endocrinology check-up back from June to July and I must admit I am feeling anxious about my next A1C.  I'd been slacking back in December with a general apathy toward the world of diabetes and let my A1C increase into the abnormal range with a reading of 6.5.  Feeling self-depricating and flat out pissy about my inability to be under 6.0 without constant focus on my blood sugar readings, I remember Dr. Rogacz looking at me and plainly saying "get over it, perfection just isn't gong to happen."  You can imagine the dismissive internal monolog my brain launched into at this...

Obviously this particular "get over it" method of diabetes management is beyond my scope of comprehension, so I decided to implement a more passive-aggressive approach toward my pancreas by starting on the Dexcom G4 Continuous Glucose Monitor (CGM).  Instead of making me prick my finger or forearm several many times a day to check my glucose levels, my CGM enables me to weekly insert a (rather bulky) sensor into my abdomen and then passively glance at the number and trend line displayed on my i-pod sized display screen.  Letting the CGM do the active work of testing every four minutes (yes, essentially constant), I can pretend I'm non-diabetic all I want without having to endure bruised and sore fingertips.   Granted, I have to calibrate the sensor daily (+) so I am not test kit free, but at least there is some emotional distance between me and my pancreas that didn't exist when my apathy shot my A1C up to 6.5.  

In a circular logic kind of way, my creative interpretation of "passive diabetes management" with the CGM is actually much more actively aggressive than it was before -- even when I was testing 10+ times per day during the pregnancy with GV.  By rarely testing my blood sugar but regularly monitoring the constant sensor information about my glucose levels and trend patterns, I lowered my A1C from December to March all the way down to 5.9!  It seems that despite my continued annoyance with the reality there's no "getting over" being diabetic, I owe all credit for my sanity and overall health to the technology that I'd previously been avoiding...  ironic.

Perhaps in being curious about what another three months of CGM usage will do to my next A1C I am actually starting to take Dr. Rogacz's advice to some degree and I'm finally curbing my apathy towards my diseases.   I definitely have my hopes up that I'll have an even better reading than 5.9 this go around and, as much as I may try to pretend otherwise, that shoots my "don't give a dang" facade straight in the foot.

My July 3rd appointment can't get here soon enough.

Long over due...

I honestly can't remember the last time I sat down to write something more than an email or news letter... how sad.  The last several nights I've been mentally kicking myself for letting yet another day pass without getting back on the proverbial horse, but then exhaustion takes over and within a matter of moments my alarm clock is going off and somehow all of the good-intentioned-tomorrows became a stream of oh-well-yesterdays.   While I can't anticipate this to be terribly pretty, let this blog post be the end of that and a return to what fuels me.

The last several many months have been chalked full of this, that and the other thing - some of it important and worth mention, much of it common and likely beyond my memory at this point.  Instead of focusing on what's been, however, HB suggested I simply list out what I could have written about and move on with it (with or without further details as necessary).  Makes sense and starts a clean slate, so here goes:


* My Dad had a massive heart attack two days before GW's 4th birthday in October so we cancelled his party and flew to Colorado.  Upon arriving, GW promptly came down with a passing virus and deliriously missed the whole trip while riding out the Motrin-wave.  Fortunately, while serious, the heart attack wasn't fatal and my Dad's made as solid of a recovery as one can and GW recuperated with a few weeks to thoroughly enjoy his birthday gift (the helmet) for Halloween.

* We raced in and finish the 2013 Marine Corps Marathon in 4:50:25 (goal was between 4:30 and 5:30).  Having missed the last 10 miles worth of distance training due to unhappy kids wanting no more than two hours in the stroller at a time, I hit the wall at mile 18 and limped it in the rest of the way with excruciating IT Band pain.  Thank goodness I had amazing support from HB and our awesome friend TS, I couldn't have done it without them.  THANK YOU!

* One thing I am not thrilled with from that day is my disastrous judgement with regards to my pump... I chose to keep it on me instead of leaving it in the car so as to enable me to get food at the finish line.  Unfortunately, the sweat and salt build up that happened during the course of the race broke my pump beyond repair - effectively preventing me from eating at the finish line anyway.  Thank Heaven, at least, that we have insurance that covered the cost of getting a replacement, because otherwise the cost of running 26.2 miles just became much, much, much more expensive!

* The pain I felt in Marathon wound up leading to an IT Band release surgery that took me off my feet and out of running for two months.  My doctor said that he was glad to have done it because my Band is the thickest he's seen and that it's no wonder stretching wasn't enough.  The surgery largely fixed the issue and I haven't had issues with it since starting back into running.  At some point I may need to go in to have the right knee done as well, but as of now I am a-okay!

* I gave in... I got a Continuous Glucose Monitor (CGM).  I can't remember what it was specifically that made me change my mind, but I've forfeited another portion of my abdomen to yet another diabetic device, which, surprisingly, is very handy and not nearly as obnoxious as I anticipated.  I'll definitely have to write more about my Dexcom G4 so I will make a note to save this topic for later.

* GV turned 1 year old in November and is the biggest bundle of joy you can imagine.  She's talkative, curious, friendly, incredibly smart and very engaging - particularly when she ought to be quiet at mass.  She eagerly wants to do everything GW is doing and, in spite of his initial protests and her flagrant acts of retaliation, they appear to be growing on one another with actual (there is nothing censored about these two) affection.

*  Much of the time I would have otherwise spent writing over the last year has been spent volunteering for Team Red, White & Blue. Admittedly, it does not provide me the same sense of accomplishment I get when I've written a piece I'm proud of, but there is definitely a happiness involved in creating a positive community that enables a sense of connection and belonging that didn't exist for me - and for many - before.  At just over one year into building our local Community we have roughly 300 members and I think it's about time to reclaim some of my own life and that starts here...

In the coming weeks I hope to finish some blog drafts I've had sitting around collecting dust and, with a little bit of luck, I will actually start some new ones.  I anticipate that in a similar sense to running, starting to write again may be initially painful and it may be difficult to find my stride.  However, I have faith in muscle memory and I'm sure my fingers can find their way one after the other just as one does when starting exercise again... if not, one has hope that HB is an excellent editor and all that is irrelevant to you!

Fingers crossed.

Post MCM IT Band 3 Mile Hell.

It's been nine days since HB and I finished the Marine Corp Marathon.  The tips of my toes are still numbly tingling, my knees continue to ache with every bend and my weight is still lower than it probably ought to be in spite of my excessive eating.  I feel like the world has been in slow motion ever since that mile 18 marker where each step became labored and each mile - now each day - seems longer than the last.  Obviously the change with daylight savings time can take some of the responsibility for this, but I have a hard time looking much farther than the tip of my nose for a better place to lay responsibility for my under-trained, over-stubborn pain.

I went into the Ortho yesterday - the beloved Dr. Hawken up in NOVA - and had him look at my knees.  Pleased to see I had zero swelling and to hear I've actually been stretching, he wasn't surprised to learn I finished the race or that I plan to continue my version of "short distance" running.  However, when HB outed me as having complained that my knees hurt worse during the marathon than the rest of me did giving birth to GV, Dr. Hawken narrowed his eyes and my options.  Identifying the non-aggressive approach as physical therapy and cortisone shots, he felt the boney structure of my knees once more and admitted the likelihood of continued pain following this treatment unless I were to wise up and pick a different sport.  Knowing me, as he does, he therefore recommended I skip the blood sugar chaos caused by cortisone, cut to the chase (ha) and go directly to the aggressive approach of surgery.

Explaining the details of a "release," Dr. Hawken outlined how he'd make a small incision and then punch a nickel sized hole in the IT Band to reduce friction at the knee.  Granted, surgery is surgery is surgery and shouldn't be taken lightly, but given the facts (my passion for running, the persistence of this pain and the permanence of this solution) and that he successfully fixed the carpal tunnel in both of my wrists in 2011 (not to mention HB's knee in 2012), I'm totally on board.  So sometime mid-December I'm going to have my right knee done and, once that is healed, I'm going to go back in the spring to do the left.

Course, in full knowledge of my current discomfort and what's in store for its remedy, I decided to give into my recent self-deprecating feeling of under-accomplishment (yes, post 26.2 miles I am feeling indolent) and go running with Team RWB tonight.  Having spent the past week hobbling stiffly like an injured grandma - if you can even call it that - and mentally whining my way from room to room, it shouldn't have been a surprise to me when less than ten steps into the 3 mile loop my knees went straight back to their rating of 12 on a 1-10 scale of pain... But since I didn't stop for the last 8 miles of the marathon, there was no way I was walking my head-lamp wearing self back to the car on my own to mope.

Hard not to feel motivated with these guys!! 

So, with HB's encouragement and the company of one very motivated RWB teammate, DN, I made it the full loop without stopping.  The last little bit I was able to kick up the speed a notch (logic: run faster, sit down sooner), but I know for darn sure that I am going to feel it tomorrow.   I am hoping to power through a 10k Turkey Trot and at least one more half marathon between now and the scalpel, so maybe by the will of God and perhaps a mix of my stubbornness and pain killers I'll get it done.  I'm already putting hopes of personal record (PR) times aside - which, if I am being completely honest, is very big of me.  I guess I am becoming nicer to me in my old age, go figure.

All for now.  BG is 107 and I'm going to bed.

Endo Check Up

I am so beyond frustrated with myself for having thoroughly dropped the ball on my blog posts recently... with the best of intentions I keep logging on to start writing and then immediately get distracted by something shinny and wind up hitting save after typing the most basic reference note to come back to in my "free time."  What with unpacking the new house, GW starting pre-school, GV being just moments away from walking and trying to really sink my teeth into my work with Team RWB, I've hardly had time for sleep let alone a coherently written sentence.  Fortunately for tonight, however, I told myself that I am not allowed to unpack another box until I put on background noise and, in order to do that, I decided I need to publish at least one timely blog update first.

So here it is.  

I went in for my every three month check up with the Endocrinologist this past Wednesday, Sept 11.  Beyond the issue that I couldn't provide recent blood glucose logs to her because I've lost my pump download USB in the move, I knew going into the appointment that it wouldn't be a stellar one.  The last couple months have been beyond difficult for me and not because of stress from running, Vermont or any of the other drama that has magically appeared, but because of the gosh darn fact that I'm diabetic.  I'm just done with it and I don't want to play any more.

I am sick of checking my blood sugar so often that my forearms get bruised and my finger tips are painful to touch.  I am sick of needing to count every dang tortilla chip I eat to make sure my carb counting is right.  I am tired of shopping for clothes with an eye to where to put/hide my pump rather than what actually looks good.  I'm frustrated that people glare at me in mass because my "pager" is going off.  I'm annoyed that my training runs resemble more of a staccato sprint than a crescendo of distance because of carb stops.  And, dagnabbit, I am jealous that HB gets a milkshake with his meal and doesn't bat an eye at the massive amount carbs he's inhaling absentmindedly.  It's just not fair.

Yeah, yeah, yeah, I know - life isn't fair.  And, yeah, I got it - God gives us what we can handle.  But that doesn't diminish the acrid reality that chronic is as chronic does and I don't want to "is" or "does" any more.  And, going into my appointment today, I knew that this attitude would come back to bite me  in the butt with my HgA1C reading.

Back at the beginning of June, my A1C was a 5.8  - which as you recall is within the limits of "normal." Today, it's up to 6.1, which in all reality is pretty tight for most diabetics, but is wildly loose for this one.  Between my current (hopefully ephemeral) apathy for the disease and an increasing difficulty with hypo- and hyperglycemic awareness it was no surprise to me that the numbers were up into the abnormal range, however marginal. I rationally understand that I need to do better and that it's just a matter of exerting a bit more effort into self-care, but, seriously, what stay at home Mom has time for self-care? Maybe some have figured it out, but I certainly haven't.

Of course, Dr. Rogacz was generally encouraging as usual and, knowing me far too well, she went out of her way to merely make a gentle nudge on the CGM topic rather than hit me over the head with my own bad attitude.   The latter would probably have been far more effective and appropriate, but I think she knew that I'm ready to give in to her this time anyway and give a CGM a chance since I'm already blowing off active participation in my disease... and since HB wont let me do that (however super model skinny that'd enable me to be) and our NFP requires better of me, I'm planting a white flag of general diabetes resignation and forfeiting the other half of my abdomen to Dexcom.

Sigh...

I don't know what my deal is... perhaps I'm just overextended?  I'm trying my hardest to be the best parent, wife, catholic and veteran advocate I can be, but I know I need to seriously step up my game at writing, home decorating and (oh yeah, supposedly doing a marathon) running -- maybe if I drop out of diabetes 101 the rest of life's course work wouldn't seem so heavy?  Figures, the one thing I don't want, is the absolute one thing I can't get rid of...

Diabetes, I seriously don't like you.

GW Starts School

My (not so) little man officially began pre-kindergarten today.  Ever since he had his interview last spring, he's been asking and asking and asking to go to school and I think it might have shocked him a bit when we actually said "yes, today you can go!"  So dawning new shoes (size 2!!), a plain "Just GW" shirt and his beloved dinosaur backpack, he raced through breakfast and marched to the car with absolutely zero trepidation. 

Course, just because he isn't nervous, that doesn't mean that us parents are in the same boat.  But in attempts to ease nerves for all concerned, the school invited parents to attend the first day with their kids today and, in probably the most adorable move ever, HB asked if he could be the one to take GW.  Obviously I was a bit sad to miss seeing the little guy in action for myself, but from all reports it sounds like he did a marvelous job.  On the playground he played on the bikes and with the trucks in the dirt; inside he made a bird puzzle and, during circle time, he even introduced the little girl sitting next to him because she was too shy to say her own name... awwwwwwwww!

Of course he's commented several times since he's come home about the pretty long haired brunettes in his class and their resemblance to certain princesses he admires (Kate Middleton and AS - you know who you are), but at almost 4 years old I've come to grips with the fact that this kid has excellent taste in women and I'm going to have to keep him incredibly busy with sports.  In fact, I've signed him up for piano lessons and soccer lessons already...

Let the age of school children begin! Congratulations GW, I'm so proud of you!

11 Miler

Since getting back to Virginia, I've really been struggling to find time for training runs.  Between unpacking the new house, wrangling the high-energy GW and fully-mobile GV and dealing with knee pain, things just haven't been falling into place for me to hit the trails.  Unfortunately, with only a handful of weeks left before the Marine Corp Marathon (Oct 27), I can't really afford to be missing as many runs as I am, but it is what it is and I've at least got running on my to-do list... that burns calories, right? 

Each week HB and I should be running four days, with short runs on Tuesdays and Fridays, medium runs on Thursdays and long runs on Sundays.  Lately we've done our short(-) distances on Tuesdays (thank God for RWB because it is at least one run we do consistently) and the occasional distance run when we randomly feel guilty about having missed our Sunday run goals.  Today was one of those days.  Last week we completely missed our 10 mile run when we drove back from Vermont (does 10+ hours in the car count?), so today we made a point to get out for tomorrow's 11 miler BEFORE we had an opportunity to miss it.  

We went over to the Mount Vernon Trail along the GW Parkway next to the Potomac River in NOVA and, aside from being a bit longer of a run than pleasant, it was a great outing.  Holding roughly a 9:30ish pace, we loped along the trail and randomly raced a family with two under-10 kids on bikes between water fountains.  By mile 9, both HB and I were feeling the distance and we were lapped for the last time by our young competitors who patiently waited at their car for a good-natured "na-na-na-na-boo-boo" in triumph.  Having managed to finish our desired distance despite pain and a sincere dislike of energy-goo, we accepted our defeat and happily congratulated the future Tour De France champions on their resounding victory.  While they might not be in our competitive age group, those two were an excellent reminder that finishing far outweighs winning -- after all, I'm running for me not for any competitive necessity.  Even if that means I'm thoroughly walloped by an 8 year old.

Welcome to the DC Metropolitan Area - let's go running!

Monday blues...

What a way to start a Monday!  So, with only 3.2 units of insulin left in my pump, I woke up this morning with the necessity to do an infusion change before breakfast.  Injecting just enough insulin to cover a cup of coffee (the only saving grace), I gather my things and sit down in front of my computer with the intention of watching the finale of Top Chef Master while jabbing myself in the stomach.

But before I get the episode pulled up and before I get a chance to doctor my coffee with the appropriate amount of sugar and cream, I open my email and find a recall notice from Medtronic about faulty insulin pump reservoirs (multiple lot numbers for models MMT-326A and MMT-332A).  Well, what do you think I have?  Yup - only recalled equipment.

Instructing me to "1. switch to your back up insulin injection plan" and "2. call us to expedite a replacement box" I find myself, pre-coffee, attempting to make long distance calls on my computer from rural Vermont to my doc in Virginia to get a "back up insulin injection plan" prescription to cover the now until... when the replacement reservoirs can get here.

Ug... no solution yet, more later.

Awe-mused.

For a myriad of reasons, today I've felt completely floored by the world around me.  On one hand knocked down by my diabetes and on the other hand blown over by the beauty of Vermont, it seems like a good night to just sit down and possibly grab a glass of wine before I fall over.  Course too many glasses of wine and I'll fall over anyway, but that is easily avoidable.

So I went for a run this evening and, instead of making it back to the house in a blaze of "that was easy" glory, I had to cut the run a half mile short.  To switch things up, I decided not to take my usual town road route which begins down hill and ends on a grueling uphill climb and instead went up the mountain on a trail that'd starts at the end of the driveway.  Like all of my runs, the first mile was painfully tedious and the second mile began to loosen me up, but unlike the rest of my runs the third mile went down hill in a bad way.  The trees next to me began to feel like they were encroaching the trail, the path in front of me started oscillating and my head seemed to be swimming with spots similar to an optical migraine. No longer confident on my feet but thoroughly aware of my distance from home and my isolated location, I walked the remaining 2640 feet with a sincere hope I'd make it back with no more issues than I already had.

Upon getting to the house and flopping into a chair I checked my blood sugar.  I'd dropped to 41 mg/dL -- no wonder I felt off.   I thought my blood sugar was high enough before the run to not require more mid-way, but I can only thank God that my stupid assumption didn't result in anything more unsettling than the "what ifs" and "could haves" that are gripping me right now.  And while I hate the way my head feels when I have hypoglycemia, the dizziness that resulted from todays run and bound my butt to that chair for a good 40 minutes was punishment enough for me to plan better for next time.

While that spell took a bit to recover from, I found myself back in that same chair again after dinner in what I would consider a greater sense of stupor than earlier in the day.  Having corrected my glucose and eaten a full dinner, this second turn can only be associated with the emotional and mental shock that comes with having "old souled" children. Let me explain what happened:

As is usual post-supper, being the quintessential lover of dirt and all things nature that she is, my Mom took her nightly stroll through the property to appreciate the greens, browns and otherwise of the evening.  While quite picturesque on any given day, the John Constable clouds and amber glow of my favorite kind of mid-summer sunset of this particular occasion motivated her to take GV along just in case - given the Hollywood perfection of it all - Matthew Macfadyen were to come through the brush as Mr. Darcy professing his undying love to Miss Bennett.  The trees were glowing, sky was radiant and every particle of the world felt magically charged as if freshly formed by the hand of God.

Walking first from the kitchen porch down the narrow walkway past the nightshade bush, they turned down the hill and followed the lane past a very tall, likely very old sugar maple tree.  With several low hanging branches and a rope swing to rest upon, my Mom stopped to admire the essence of happiness the twinkling fireflies and rustling leaves caused just above their heads.  Comfortably enjoying the secure embrace of her Grandmother's arms, GV had until this point been quietly watching the dogs roam the grass in front of the barn, the swooping birds singing their evening recounts of the day, the small garter snake returning to its home amidst the raspberry patch and the silver wisp of temptation blowing across Grandmama's forehead.  But, even with life's distractions continuing around her per normal, something amid the stillness below that maple tree took hold of her attention... it was in that moment that with exacting deliberation that she reached for the wavering colors of the sunset as if to embrace them as a familiar comfort.  The way my Mother reported it was  that "without a doubt, if I hadn't been holding onto that child she would have leapt into the awe and floated away."

Now perhaps I give my seven month old more credit than due, but I cannot help but wonder what she knew about the evening that we did not? What angel did she see or greater-than-self connection did she make that we as adults have closed our minds to?  I know my Mom and I fully appreciated the glorious evening and the plum dumb luck that it is our good fortune to enjoy it (sans-hypoglycemia), but it was something beyond appreciation that GV expressed - something I am not sure there's an appropriate word for in our language, let alone my vocabulary...

And so I am sitting here stupefied.  I find myself swimming in thoughts and perhaps just as jumbled as I was earlier in the day.  I rarely take the time and capacity to register the world around me beyond the peripheral and my kids seem to display the ability in spades. I mean just yesterday GV discovered the second hand on the wall clock and seemingly understood the passing of the quantifiable with every tick... outside of a foot race, I cannot even remember the last time that an individual second as opposed to an entire minute was directly relevant to my conscientious thought.  It must be for reasons like this that so many of great writers took to these mountains in search of their muse and why some,  Frost and Thoreau for example, found it.

With that, I think I'll continue to bemuse myself and have that glass of wine after all.

Flooding

When it rains, it seriously pours here in Vermont!  I guess this is a weird year here in the Green Mountains with almost constant thunderstorms, but seeing as we're new and have no reference for whether this is abnormal or not, we're attempting to adjust, both literally and figuratively, to the torrential downpours and resulting flooding!

In hopes of keeping this place standing another 160 years, we had a structural engineer out to check out the house and give us a to-do list of what is absolutely necessary for stability.  Fortunately the buildings are in pretty good shape - note: this does not mean project free - and, with that good news under our belts, we were able to learn a lot of interesting tidbits about the historical construction, for example: many of the vertical support beams in our barn are original hand planed posts that were likely salvaged from another barn and brought in to construct this one before the main house in 1865; the flooring we discovered in the living room (and now the downstairs bedroom as well) is the original random plank wood flooring and it's in great condition; and the rubble foundation is unique for it's time because the rock size is markedly larger than most in the area due to the large field rocks used.

The dark patches around the rocks are
historic AND current water marks...

As happy as I am to learn these neat details and to have such historic charm oozing from every corner, this last bit of info about the foundation is actually structurally relevant rather than simply aesthetically pleasing... So old cellars in farm houses like this were purposefully designed to be porous so that the temperature would be lower and humidity higher to create a safe, natural food storage environment.  Some places, apparently, even cut running streams through their basement floors to get the moisture necessary to accomplish this aim.  Well, this place doesn't need that stream, not only because we have a magical thing called a refrigerator, but because the walls seep water with every rain shower - which, as you can imagine, is great for old school cellars, but not so awesome for modern storage or utility.

So after days and days of non-stop storms and a conspicuous absence of HB with a bucket (the previous owner took the sump pump and we're having basement work done later this fall), my Mom and I discovered about 4 inches of standing water on top of the half concrete, half dirt basement floor (thank goodness for wellies!).  Grandmama did some bailing with her "spare" energy and got quite a bit of the water out, but making an executive decision that we cannot care about everything, I've decided to ignore the literal flooding in the basement and worry about the figurative flooding elsewhere...

With my first paper due later this week, I've been trying to focus my non-running, non-playing, non-projecting time on an in depth, analytical reading of Gertrude Coleman's 1911 book Suffragette Sally.  Finding it hard to focus with so much activity about, I've tried to hole up near the one grounded outlet in the house (which of course is in the kitchen) to knock out several well written, highly cerebral (aka non-JVBC-personal narrative) pages while the other two- and four-legged house inhabitants entertain themselves elsewhere.

But, alas, concentration is for the birds as we're in full swing of several (because why would they come one at a time?) exciting firsts.  And since being a positive parent is - big picture wise - far more important than this one measly paper, the needs and accomplishments of GW and GV drown out the never-ending, water-logged to do list:

GW proudly showing off his first school
Summer 2014

1st first: Attempting to get GW ready to officially begin school this fall, we enrolled him part time in the day care program associated with my grad school.  Having never been in such an environment before, he's all sorts of atwitter about the toys, the games, the big kids, and (Heaven help me) THE GIRLS.  OMG.

Unfortunately he is the only 3.5 year old there and he's at that in-between stage where he's too big for the little guy-group and too young for the big kids group, but apparently he is happy to float between the groups as necessary and explore, interact and play with whomever is around.  Giving all of the credit for his success to his incredibly extroverted, confident personality, my first-timer parent worries are subsiding and this all seems pretty darn cool.

2nd first:  The big down side to GW's school experience, however, is that after a morning full of all out romping, he's getting home and refusing to nap.  With some degree of dread I have to acknowledge that we have finally reached that point where, even with extra physical activity and stimulus, he (note: not me) no longer requires an afternoon respite.  Of course he turns into a gremlin just in time for dinner and becomes thoroughly impossible until tucked into bed, but my stubbornness and HB's pigheadedness have genetically transferred to the little man and there is no convincing him that maybe, just maybe a nap is still a good idea.

First tooth, front and center!

3rd first:  GV is getting her first tooth.  With sopping wet onsies and a ear-piercing scream that seems to only be off-set with constant nursing, we're attempting to get her through this painful time with some degree of remaining sanity.  She's incredibly satisfied with her new found talent of biting and, Lord help me, I'm still planning to breast feed her until 12 months for auto-immune purposes... fortunately she prefers to chew on my shoulder than elsewhere, but seriously, ouch.   It's an excellent thing she's cute!!

4th first: until recently, GV has been a relatively quiet child.  She does NOT like talking to strangers and, even with just us around, she reserves most of her squeals, coos and goos for particularly enjoyable moments.  But, as of last week, she has turned a new leaf and said her first word. While lying in bed with us and basking in the morning sunlight, GV roles over, sits up and look at HB's chest hair with an expression of deep contemplation.  She then reaches out and, in a 7 month old kind of way, begins to grope at his chest saying - I kid you not - "tickle tickle!"  Needless to say, when we reported this new development to GW, the resident tickle monster, he was beyond pleased with his protege's progress.

Granted, these firsts aren't negative things and therefore cannot be claimed against some universal karmic insurance policy for parents, but it is a lot of new all at one time and each change on its own is worthy of individual response, care and encouragement.  I think some day I'll look back on this and nostalgically ponder how amazing it was and how I managed to keep things a float (ha), but short of getting a few of those in-pool lounge chairs for the basement and perhaps a paper drink umbrella or two, it might not be as pretty in execution as will be in memory.  Water pails, tantrums, blood and homework... what a great combination!

Rugged Woman

For whatever reason, as a child I developed a habit of cleaning whenever I got stressed and that quirk, for better or worse, remains today.  I guess it all began with a desperate attempt to put some aspect of life in order when all else was out of hand, but now it's almost a cathartic distraction from whatever might be weighing me down.  Typically this means pulling out my magical Dyson vacuum cleaner, scrubbing the kitchen floors or sorting a large pile of donations for Salvation Army or Goodwill, but today was different; nothing short of renovation would do.

The last couple months have been simply overwhelming.  HB and I - somewhat randomly - decided to go house hunting and wound up purchasing a new home for our family in Virginia just two days before driving to Vermont.  Of course this purchase meant we needed to sell our current VA home and, much to my ignorant surprise, that meant so much more stress than any other simple ill timed move we've  done previously due to the necessity of showing the house...  Seriously, you try packing with two dogs, two kids and potential buyers under foot! Agh, what a nightmare!

Then, of course, we had the necessary shift in zip code for my six weeks of school in Vermont.  While this year our housing choice is far more stable (perhaps an ironic word) than either of the rental properties we experienced last year, this house of ours is 160 years old and, by and large, original.  So on one hand this means immense charm and fascinating history, the livable reality is that the word "project" thoroughly summarizes every inch of the place.

Thus, combining all of this and coming home to find an unfortunate oops of dog mess on the floor, I came to realize that no amount of windex or laundry folding would cut the stain of my stress.  Grabbing the hammer and handing my Mom a crow bar, I demolished several old, rotten shelving units from our rubble-floored basement and set her to the task of removing what we'd rather not clean: the carpet.

The thing about this old house is that somewhere along the line (likely in the unpropitious decades of decorating that were the 1950s -1970s) someone made choices to superficially add to the house things like a new ceiling here or a new carpet there without much effort.  Unfortunately, this means all of the completed "upgrades" weren't done well, but fortunately, this also means that most of the original house is still intact - including the random plank wood flooring!!  Talk about a best case scenario find! It's going to need a bit of restoration work (like everything else...), but that's for another time and another blog post...

Anyway, so with a gigantic roll of carpet, a disgusting pile of former shelving turned rubble and an old smelly couch thrown in for good measure, we call the amazingly accommodating local go-to hauler guy to arrange for a pick up.  Thinking that our front lawn would simply just need to look like some back woods place in Appalachia for the time being, I was blown away when he asked if I could give him a half hour before showing up... same day service? Who knew that still existed?! Sweet!

So thirty minutes go by and here comes LW with his huge flat bed truck.  Having exhausted herself with the crowbar and been unceremoniously handed a now wide awake baby, Grandmama supervised our efforts to toss the trash.  Sharing the load between us, LW and I tossed the bulk of the refuse over our shoulders into the bed of the truck.

Watching me hop up and back down with loads of rotten wood, LW turns to my Mom and says: "she's some sort of rugged woman, isn't she?"

To which she confidently replies, "Colorado women are made of stout stuff!"

Now, you might be wondering at this point what the heck this long rambling blog post about cleaning and stress and carpets has to do with diabetes?  Well, when this local Vermonter who has a) weathered a many frozen winter here and b) clearly worked honestly and hard his whole life bothered to pay me the compliment of being "rugged" my heart sang.

A lot has changed in my life since my diagnosis and I'd be lying if I said the self-pitying thought of being "sickly" hadn't crossed my mind a time or two, but today was like before.  I didn't look weak today.  I didn't appear diseased today.  I wasn't stuck sitting some place waiting for my blood glucose to stabilize today.  I was just as tough as ever and that, my friends, was way more cathartic than I could have asked for.  

Take that stress.  Take that diabetes.  Today, you don't get to win.

Let Marathon Training Begin!

Geography lesson: this is Vermont,
NOT Idaho.

So this past Saturday, after an 11 hour car ride in which we sang Jingle Bells 3,026 times, stopped for coffee 5 times and made word games of town names at least 17 times (seriously PA, "Lackawanna"?!), we made it up to Vermont in one piece.  GW was a great sport about it, like usual, and I am pretty sure GV would never like to see her car seat again... too bad for her we need to drive back to Virginia in August!  Never the less, we made it here and - given our immense to do list of house projects, course work and marathon training - hit the ground running. Literally.

With one week to go before our no-sh*t 16 week training program begins, I decided to take the first opportunity I had to get a little jog in.  Figuring that although there are some killer trails to run around Bread Loaf Mountain, being an unaccompanied diabetic I probably ought to stick to something "trafficked" (this is Vermont after all and far less populated than Virginia) just in case the worst happens and I pass out... because, face it, I'd rather have some random Subaru driving stranger find me than an opportunistic cougar!  So opting to run down Vermont Route 125, at high noon I strike out to finish the 3.8 miles from my campus to our place.

Talk about stupid.

Between the midday heat emanating from not only the golden orb directly overhead but the black, hot pavement beneath my feet, the intense humidity and the elevation change from 59 feet back in VA to 1,430 feet in VT, I was a pathetic pile of sweaty mush by the time I actually made it back to the house. For those of you who know that I'm from Colorado and that my home town is at 5,003 feet, this post is probably a gross disappointment, but having last lived in the Centennial State in 2007 I can honestly say that East Coast humidity felt more natural to me today than the slight change in elevation!

The only saving grace for this run - beyond having gone out for it at all - is that I at least made the correct decision to start my pre-training-training going down hill rather than making a round trip run or a one way trip up the mountain.  I think my future runs need to either be much earlier in the day or (prepare for immense vexation due to the gorgeous natural playground I'm in) on a treadmill...  I mean, seriously, I can't afford to fall behind on the 16 week schedule without running the avoidable risk of under training and injury.  Maybe when I get my feet back under me I'll attempt to hit the pavement again?  Or better yet, when HB comes to visit (for he couldn't come with... so sad), actually check out the Green Mountain National Forest trails that start just feet from the front door.

Sigh...

Whatever, I went running.  All for now.

Endo Check Up

It seems funny to me how our perception of time changes based on whatever it is that makes up "normal" every day life.   Last fall, when I was pregnant with GV, I had so many doctors appointments that my days, perhaps even my hours, seemed to be measured in trips up and down the I-95 corridor to Fairfax INOVA Hospital.  But now that I'm back to "normal," fireman rain coats and matching wellies accent my routine far more than white coats, which are soooo last season.  Doctors appointments now merely indicate the passing of yet another three months -- either in the form of a well baby visit for GV or a routine endocrinology check up for me.

The latter is what I did today. 

The past couple months have been ROUGH diabetes wise and, to be completely honest, I've been dreading this appointment for fear of the criticism I feel is entirely appropriate for my self care.  It isn't that I have been slacking on the job or purposefully blowing off my blood sugar (although, to be fair, I simply forgot to bolus once... yikes), it's just that I'll be going along just fine and then WHAM! my blood glucose is in the high 200s and there is no simple explanation for it.  My pump will indicate that I have enough active insulin in my system to cover the correction, but my glucose will have shot up like the insulin wasn't even there and, quite similiarly to when I was pregnant, come crashing down an hour or two later.  Without understandable rhyme or logical reason for this, I've just been rage bolusing and enjoying a few extra doses of whatever something sweet I'd happen to be craving at the time (currently pecan pralines).

Thus expecting an abnormal HgA1C, which if you remember is anything above 6.0, I brought my support group along for the telling finger prick that would inevitably quantify the amount of flack I'd justifiably be given.  Dispensing with the "oh what an adorable baby" and "you must be such a good big brother" comments and getting down to it, I held my breath and gritted my teeth as I waited for the results in the same manor I did while checking the mail box for my college acceptance letters...

Doctor Rogacz entered the room.  We exchanged our pleasantries and, with little ado, got down to my diabetic trials and tribulations.  Explaining that some things have changed - I'm running more, I've been under more stress and that I'd been sick without singular cause - but that most of my lifestyle factors remain the same, I blushed in embarrassment as I handed her my blood glucose logs for the last two weeks which included daily ventures into the 200s.

"Hmm, I don't know what to tell you," she said. "The timing of these highs are inconsistent and you've got a number of lows as well.  But your HgA1C is good at 5.8 - so you're doing something right even with these numbers."

SHOCK.

Reading my face and plainly hearing HB's comments of "I told you so" (he relishes those opportunities), she then not only didn't give me a hard time about my hyperglycemic excursions she was incredibly encouraging of my dedication.

"You're never going to have perfect blood sugars, no matter how hard you try, so try to relax.  You're doing a great job!"

Frustrated with the medical recommendation "to relax" I professionally dodged her compliment with a question or three about my marathon training to which she merely said "do what you have to do to not pass out" which, in endurance running and diabetes management, I take as excellent advice.

So without jabs about my continuing lack of CGM, lectures about abnormal blood sugar ranges or prescriptions for whatever else might be ailing me, I felt like I dodged a bullet today as we walked back to the car.  I thoroughly expected my HgA1C to be in the high 7 range and I lost significant amounts of sleep last night because of anxious dread of medical criticism... but I guess all that worrying was for not.   My Nana, may she rest in peace, always said that the things you worry about never come to pass and until now I'd figured that was just her way of recommending I "relax" but, hey, perhaps she was right.

We'll see where I'm at in another three months.

6 Months, already!

I feel like I am that stupid groundhog in Punxsutawney, Pennsylvania.  I've stepped blinking out into the spring sunlight and instead of spotting my shadow as I expect to see it (for it has, after all, been spring for sometime now), I've found it much altered by my companions.  No longer is my little boy little and my bitty bundled newborn bitty, but rather there is a tall beanpole and a bouncing (literally) baby in their place.  I'd much prefer to think of my "blink" as more Rip Van Winkle-esk than admit that time is flying as fast as it is, but when reality is measured in growth spurts and a handful of months mark milestones that years or decades mark for us adults, I humbly acknowledge my preference is irrelevant.

Six months have passed since November and my two little wild flowers - for they certainly are not weeds! - are ever so much more of themselves in personality and in substance than they were.

Top: "What's she doing?" on December 2, 2012
Bottom: Pre bedtime exchange on May 7, 2013

Today was GV's six month well baby appointment which she cooed through with flying colors.  Measuring in at 26 inches in length, 17 pounds 11 ounces in weight and a head circumference of 17.5 inches, she continues to keep near the top of the growth charts. Of course she wasn't exactly pleased to have her vaccinations, but with some clean shaven snuggling from HB (a much appreciated break from his "too scruffy" face) she was back to her sweet, smily self within minutes.

Left: Hospital snuggle with HB on November 28, 2012
Right: Oh so fashionable road trip on May 23, 2013

She's not quite ready to start crawling yet and her little teeth haven't broken through as of now, but I'm expecting that by the time we get to Vermont in late June she'll be on full throttle in every direction.  I'm not too eager for her to be starting the next phase as I thoroughly love this snuggly, immobile age, but the way she is increasingly interacting with and venerating her older brother makes me wake up each morning wondering what "aww moments" the passing days will bring.  They so key off of each other and it warms my heart the way they exchange smiles at the mere sight of one another and laughs with each play session.

I often tell GW how much I appreciate his help with his sister, but I've got to brag about how much of a God send GW is to this tired, frazzled Mom.  For one thing, back in December he learned the words to the Christmas carol "Jingle Bells" and, on top of the overly adorable rendition of the song he does, he figured out that when he sings this to GV she - no matter what - stops crying.  Much like his infant response to Edith Piaf, she instantly ceases screaming and watches him "dash through the snow on a one horse open sleigh" with glittering eyes and complete adoration.

He also is teaching her to bounce.  Previously, when I'd place GV in her bouncer seat she'd sashay her weight from foot to foot and then scream until picked up.  But when GW began to fiddle with the toys around the seat and bounce in front of her with the encouragement "bouncy baby, bouncy baby!" she pushes both feet into the floor and squeals with harmonic glee.  Freeing my hands for a moment or three, I send a silent prayer of gratitude upward for such invaluable help and all around happy sounds.

While I cannot peer into the future and guarantee an everlasting bond between these two, I ardently hope they continue as they have started.  I hope they aren't too eager to grow out of their already becoming too small size 5T and 9Mo clothes and into the fads of their generation, but such is life and one day - I pray not too soon - they'll have independent lives and families of their own.  Between now and then, I hope my groundhog like self will miss my shadow once and a while and drag out their childhoods for as long as God will allow.  I'd be lying if I said it was entirely rainbows and poptarts, but  I'll take the bad with the good and love them regardless.

Left: GV home coming on November 29, 2012
Right:  sweet snuggle on May 15, 2013

Run as One & Historic 10K

Holy cow, this has been a running weekend! Not in an intense, incessant kind of way - we didn't do any crazy distance or personal best pace or anything like that - it simply was.

Yesterday morning we drove up to Washington DC for the Team RWB & Team Rubicon joint event "Run as One."  With the aim of raising awareness of veteran suicide,  a 100ish of us ran a three mile loop around the national mall from the base of the Washington Monument, around the Lincoln Memorial and all the way back down to the Smithsonian Castle.  Wearing matching grey t-shirts and flying the stars and stripes at the front of the pack, the run leaders kept the pace such that we were truly running as one and in honor of Neil Landsberg and Clay Hunt, both veterans who committed suicide earlier this year, sticking together.

While our stroller was the only one participating in the run, the location and purpose of the event brought out more than one VIP...  Lou Nemec, the national athletic director for Team RWB; Tommy Sowers, the Assistant Secretary of the Department of Veteran Affairs; and retired General David Petraeus.  Stars and Stripes published a neat article about it (see it here) and if you check out the pictures of the run you can see my handsome HB doing his thing with the stroller.

Of course we had to get a picture... who'd believe us otherwise!

And today, we ran the first annual Historic 10k.  Part of the MCM Event series, this race does the last 6.2 miles of the Historic Half Marathon route - which, for those of you not familiar with the route through Fredericksburg, Virginia, includes the notorious Hospital Hill (a long, step hill that, appropriately so, passes the local emergency room doors...).  HB and I considered running the half, but having a) not trained for it, b) heard rumors of stroller bans (seriously, who bans strollers?!) and c) decided possible injuries are not worth it, we agreed that the 10k was more appropriate given our larger running goals this year.

So at 5:00 this morning we got up, laced up our shoes, bundled the kids and made our way over to the start line in down town Fburg.  With the only stroller participating in the 10k, we took turns pushing the kids around the undulating route and fed off of the continuous encouraging comments from spectators and Marines alike for our "hard core" parent skills.  Course when we hit Hospital Hill and our energy tanks appeared to be empty, a guy from the local running store volunteered to push the kids for a ways to give us a break - nice, but nope! With the motivation we finished the hill and brought it in for a time of 59:02.   Which, given the fact we were exhausted and it was raining pretty hard by the end, I am pretty proud of.

Assuming there is no reason not to, I am totally tackling the half every year I can from here on out... it's an awesome event and, ya know, 13.1 miles doesn't sound so bad any more.  Granted marathon training hasn't really started in full force yet (that begins first week of July) and I'm still only running between 3 and 5ish miles on any given outing, but half of the sport is mental and dagnabbit I'm stubborn enough to have that part, at least, covered.

Now, where's the ice...

Team RWB

Over the last handful of years I feel like my identity has morphed into something I never expected.  When I was younger, I had this black and white plan of what my life would look like along the way -- I'd achieve a certain level of education, I'd become an integral cog in one of the government's hush hush agencies, I'd quickly move up the ranks in obscure positions I'd happily leave to other's imaginations and I'd generally be seen as a successful, glamorous person -- but the unexpected began to happen and suddenly my future became what my compulsive organizational behavior had fought so long to prevent: grey.  

I don't say that in any negative sense, but rather as more of a acknowledgement of my former rigidity and as an acceptance of the control I simply do not have.  Since 2009 I've weighed my options and made assertive choices to step away from "The Plan" in an attempt to "let go and let God" do what is right for me and, more to the point, my family.  I acknowledge there is a certain degree of passivity in this lifestyle outlook, but I'm tired of trying to force the square peg (plan) through the round hole (life) when there is a more simple way...  I am not what I expected, but I am passionate about what I've become:  

I am the wife of a veteran.  I am a mother of two.  I am an endurance runner.  I am a type 1 diabetic.   

As random as this topic may seem, I bring it up because today was a big day for me where I felt like all of my "new" pieces melded together in one cohesive positive direction.  Typically my being feels ripped in twenty directions -- the mother in me needs to be cuddling or cleaning something, while the wife in me ought to be packing a lunch in the kitchen or showering more often, the runner in me should be at about mile seven already and the diabetic is reminding me that, oh yeah, you still haven't finished your coffee.  But today, today I was cohesively all of those things at the exact same time and for a bigger purpose than myself...  let the ramble about Team RWB begin. 

A few weeks back, right after the Boston Marathon bombings, HB and I were introduced to a veteran's support organization that works to build communities and combat PTSD through physical activity and positive social interactions.  Side stepping the dingy VFW bar scene, Team RWB validates the modern American veteran and their families by connecting veterans to one another, creating a common purpose and a positive post-active duty group identity.  It acknowledges the hardships OIF/OEF veterans have endured and by placing one foot after the other actively defies the social stigma that disabled vets cannot do for themselves...  Team RWB bridges the gap between all of the well intentioned civilian non-profits that act on behalf of veterans, the Department of Veteran Affairs and the veterans themselves by bringing simple person-to-person "let's go do something" humanity back.  

Given that HB and I are out running all the time anyway - we're gearing up to start our marathon training after all - it took next to no effort to get a weekly Team RWB 3 mile run set up in our area.  For the past several weeks it's just been the two of us with our incredibly patient duo in the Bob stroller, but, as I already said, today was different - someone came!

With one new member, the group is still dominated by my family, but I feel elated that it took one step in the right direction today.  I'm so hopeful that with time and persistence I'll be able to grow the local team and that one day we'll have ourselves a vibrant, constructive, healthy community for vets in the Rappahannock area...  I mean the reality is, folks, that PTSD is no joke and with 22 new vets committing suicide a day there is something that we as a country - as a community - are doing wrong.  Many of our current vets joined the military when war wasn't just a possibility, but a given and to transition back to civilian life after all they've been through is a truly daunting mission.  

Not only does Team RWB give them an off base, non-VA Clinic place to find support and camaraderie they loose when no longer "in," but it gives people like me a chance recognize what they've done and lost by doing what I'm already doing: living the life their bravery and sacrifices have enabled me to live.

So, today, I was every bit of me and then some.  I jacked my sugars up a bit, took my insulin pump off, laced up my minimalist shoes and went running with my husband and kids; and all to support our vets.  Next week I'll do the same and the week after that and the week after that too.

That's who I am.  Who are you?

Food introduction

Although it may not seem like there is very little method to my madness, I believe we've hit a tipping point where counting GV's age in terms of weeks is no longer rational.  Up until this point she has been, for example, "twelve weeks old" rather than "three months old" because, at least in my mind, a week is so much shorter than a month and the sound of just a handful of weeks drags her infancy out perhaps a moment longer in thought than it is in reality.  But now that we need more than ten fingers and ten toes to count the number of weeks she is old, the tides turn and twenty-two weeks sounds audibly cumbersome compared with a "mere five month" reference.

So, at five months old, our beautiful little Dolly is doing wonderfully and it's been a week full of notable milestones: she rolled over from front to back and then from back to front for the first time and, after glowering at GW for eating waffles in front of her, she's had her first introduction to solid foods.  I'd initially planned to only breast feed her until six months given the positive research such a diet has shown for infants of type one diabetics, but seeing as that date is technically two weeks away (24 weeks old on Tuesday May 14) I decided that she is ready given her ernest protestations when she too isn't presented with a full plate of food at the dinner table.  (Honestly, I think that if she truly had her own say in things, she'd be running and eating steaks already...)

But once again, in spite of the fact that she's child number two, I feel completely foiled in my parenting knowledge and experience by the role diabetes is playing in our family (not just my) life.  When GW began eating solid food, I remember the momentous weight of the occasion being thoroughly placed on his act of eating rather than on my choice of cereal products.  With GV, however, I'm spending hours of time surfing online medical journals and diabetes resource pages trying to make sure that the external environmental factors I actually have control over don't unintentionally exacerbate the biological possibility of islet autoimmunity.  So while I am completely thrilled that she has (proudly) eaten three full bowls of rice cereal, I feel the weight of my off the shelf selection as a consumer each time I lift that tiny spoon to her gleeful mouth.

GV's first solid food

Now, to reiterate my disclaimer, I am not a medical professional --  I am only a mother 
making as informed of choices as I can in the hopes of doing what is best for my children.  

I have absolutely zero knowledge as to whether what I am doing is right or if - Heaven forbid - 
it is wrong,  so if you're like me and searching for a "recipe for success" you need to use
your own best judgement and ask your pediatrician or endocrinologist for their medical advice.  

That said, back when I was researching what impact my diabetes would have on breast feeding I learned that there is a possible correlation between the introduction of cow milk proteins and the later life development of type 1 diabetes.  Seeing as this whole line of thought started with my research on formula and since it is typically the first non-mother's milk food to be introduced to infants, I'll start there:

The American Journal of Clinical Nutrition published a 2010 research study that indicates the large size of bovine protein may be too difficult for infants at "high risk" for diabetes (children of type 1 diabetics, with type 1 siblings or those that have tested positive for autoimmune antibodies) to digest and may lead to the onset of islet autoimmunity.   In an effort to reduce the possible impact of this environmental factor, the study suggests that such infants be fed breast milk as long and as much as practical but if formula is warranted to only use highly hydrolyzed, hypoallergenic forms like Alimentum, Nutramigen and Pregestimil due to the smaller, non-cow milk proteins used.

I admit the repetitive use of "may" and "possible" doesn't provide much comfort to the concerned parent in me, especially in light of the price tag assigned to hypoallergenic formula, but seeing as this is the only study I've come across with anything remotely close to a definitive "cause" for diabetes (even these researchers state more studies are necessary) I'm willing to work with their results.  I mean, even non-diabetic parents are cautioned against the introduction of cows milk in the first year of life anyway.  Straight cows milk is significantly more difficult for infants less than 12 months old to digest and, even if the correlation to diabetes is uncorroborated, there is conclusive evidence that indicates early introduction of cows milk leads to iron deficiency anemia, an increased risk of a milk allergy and potentially life threatening dehydration.  In my mind, those risks alone are worth consideration and avoidance of bovine proteins!

Having learned this about the liquid end of things, I obviously looked into solid food introduction as well and, unlike formula, I learned the most important factor about cereal introduction is not necessarily what but when it is started.  So working with the general medical community's consensus that all parents should start all infants on iron fortified rice cereal (again, to avoid iron deficiency) -- I chose an organic brown rice cereal based on the nutrition label you see here -- I used my pediatrician's guidance to start solid foods around 5-6 months, the age infants are physically ready for more than breast milk.  Before this time frame, infants don't have the proper gut bacteria necessary to break down solid food safely and there is no nutritional need for more than breast milk or formula then anyway.  Not to mention, starting cereals any earlier than 5 months is linked to an increased risk of not only developing diabetes but obesity, eczema and celiac disease!!  But, all cautionary fear-mongering aside, assuming a baby is at the very least 20 weeks old and showing physical signs of interest in solid foods - putting hands in mouth, practicing a chewing motion, watching and mimicking eating motions - go ahead and get your camera ready!

I know what you're thinking: all of these baby-feeding guidelines seem completely overkill.  And, you know what, I am with you.  I feel like I have opened the medical journal version of Pandora's Box and am falling insulin pump first into a rabbit hole of hypochondria... but I made the active choice to learn everything I can about my disease, for better or worse, so that I can run it instead of the other way around.  I can't passively wait and see what my pancreas has in store for my kids with clear conscious, so overkill or not, at least this degree of research helps me sleep at night.

You have ...

While walking around the INOVA Fair Oaks Hospital last week doing this test and that scan an unwelcome knot began to coil in my stomach on top of the other obnoxious symptoms I've been experiencing.  But unlike the unidentifiable pain in my back, twinge in my abdomen, all encompassing fatigue and plummeting blood sugars, I know without a doubt the cause of this gnarling, rancid, snaking sensation: sheer dread.

The idea of more white coats, of being hospitalized and generally of being sick again makes me thoroughly miserable.   I'm 27 years old for goodness sake!  I'm supposed to be spry, youthful and energetic - you know, able to leap tall buildings in single bounds and all that jazz.  But, as sorry as I am to admit it, ever since I got sick in 2011 there has been a persistent shade of gloomy-blue in my life...  I'm sick and, until they discover a cure, I'm not going to get better.  Of course, it's unfair of me to say that I haven't gotten better with the use of my insulin pump and incessant glucose testing because the fact is that I no longer have DKA and my diabetes is not getting worse.  However, when my chronic condition regularly gets me bumped from "I'm sorry you are sick, but wait your turn" to practically having "STAT" stamped on my forehead the moment I walk into medical buildings for efficiency purposes it's a little disheartening.

Now, I fully appreciate that my doctors are thorough and that they never feel comfortable labeling anything as "just a virus" or whatever because of the possible worst case scenario, but dagnabbit people! With absolutely none of the tests coming back with clear results, my GP advised that I come back into the hospital on Friday to be rehydrated.  When I flat out said "no, I can drink my own dang water, thank you" she then requested that I at least follow up with the following morning at their immediate care clinic, which I thought perfectly reasonable.  But then, on Saturday morning, when the next two doctors to examine me found zero trails to follow they seemed to be pursuing the medical equivalent of an invisible yet mischievous pooka down random rabbit holes... worth it? I think not.

Now I might be stubbornly calling the hunt off too early and there's still a possibility that I may have to eat some hospital version of humble pie sometime in the next couple weeks, but without a reason for more poking and prodding I'm done being the poor, pitiful patient.  If it's something as simple as a virus, then sleeping on the couch a while longer should put me right.  If it is more than that, then, well, I'll have some more definitive symptoms to follow and we wont waste our time trying to track down something it's not.

With that, it's nap time.  GV in the crook of my arm and GW in "the boat."    

Wait and see.

I apologize for the hiatus in posts over the past two weeks. Between my shear bewilderment over the Boston Marathon bombings and a horrific stomach pain that has had me sleeping since Monday I've been quite without comment.  But after having spent the majority of yesterday and this morning at the doctor's office running tests, it's about time I get back to it.

So Monday afternoon while driving with HB to get landscape rock for our yard my stomach and lower back began searing with pain.  Leaving him to load the 4 tons of river rock in to the truck, complete the landscaping and generally do everything that involves moving, I've been on the couch and barely eating ever since.  Finally opting to go see someone about it yesterday, the doc found my bilirubin levels to be high and ordered a complete blood panel and abdominal ultrasound that was completed this morning.

Thus far we haven't learned anything from the lab results and the ultrasound found nothing conclusive, but we have learned one thing: with an underlying, chronic condition general practitioners seem to automatically assume that diabetes is the cause of all of my problems.  Now, if my HgA1C was high and I truly had "poor diabetes management" as they accuse me of, then I'd nod my head in silent resignation that I've made myself worse with apathy. However, since my A1C is stellar and I test my sugar so often I have perpetual bruising from my lancets I refuse to sit passively by and take undo criticism of my self-care.  I mean at one point this morning the sonographer went so far as to ask if my stomach pain is because of "improper use of my infusion site" - perhaps a logical question if it wasn't in a completely different abdominal quadrant from where the pain is!

The thing is, while diabetes could be a problem and is regularly a bitter annoyance of mine, right now my diabetes is a reassurance that something beyond the norm is wrong and here's why: Before I began feeling ill on Monday, my blood sugar was completely stable, but especially over the last two days my bgs have been falling lower and lower without a relevant diabetes explanation...  Yesterday afternoon my glucose levels were low (63 mg/dL) so I corrected with a handful of saltine crackers.  But when I checked my blood sugar a few hours later at dinner and it was even lower (61 mg/dL), so I adjusted my basal to 70% of it's usual amount to account for being sick and I skipped a meal bolus for the minimal food that I ate.  Assuming this would set me up for stability via hyperglycemia over night since I had to fast for the ultrasound, I checked my post-dinner two hour postprandial, my bg was still low at 68 mg/dL... I grabbed a quick correction snack, adjusted my basal rate even lower to 50% and went to bed.

You'd think with half of my normal basal rate and a correction I'd have woken up this morning with my blood sugar well into the 100's - if not higher - but nope.  For the second day in a row, my blood sugar was down even farther to 41 mg/dL!  Since I couldn't even have water before this ultrasound I couldn't correct with either solid or liquid carbs, so at 7 AM I suspended my pump and removed it with the assumption that my sugars would naturally go up without my persistent basal dose.  Makes sense, right?
Well, yes, but it didn't work. Three hours later at 10 AM my blood sugar had merely gone up to 48 mg/dL... not awesome.

I've since had breakfast and found a temporary fix to my hypoglycemia, but that's beside the point.  The silver lining of my exhaustion, pain and zero appetite is that my diabetes is providing another quantifiable symptom to go from.  Typically when diabetics get sick the body releases extra hormones that cause a decrease in insulin efficiency and therefore causes unavoidable hyperglycemia,  but for whatever reason, something else is going on right now.  How obnoxious.

I guess we'll just have to wait and see what comes to pass.