Pain in the Butt

Half the time Daniel does a site change, he does it on his own. Half the time I help him. We know how important it is to rotate sites so he doesn't get a goose egg under the skin and have trouble absorbing insulin. Per our diabetes nurse, we try to do about 6 different spots in one area, like the right side of the stomach, then do 6 more in another area, like the left side of the stomach, and then move on to the back of the arm, the butt, the side, etc. Daniel hates doing his thighs, so we've stayed away from that area. Too bad, because that would be an easy access for him.

It would be helpful for him to have arm extensions and a head that twisted all the way around, like an owl, to reach some of his sites on his backside. I don't know how people do it who don't have moms or partners around to help. I guess you get resourceful. Daniel's not there yet. So he directs me to put it there... no, *there*... and have the attachment for the tubing pointing kind of sideways... a little more... and I don't always get it right. Today he was complaining about his pain in the butt because I got the angle wrong yesterday.

I could say something about teenagers being a pain in the butt. Quite often they are! But then again, I'm not the one with a cannula sticking out of my ass, so I'll shut up and try for a better angle next time.

I Was On My Way Out the Door...

I called to Daniel, "time to change your site!" He's pretty much at the point where he is changing it on his own, and I think he likes me there for moral support. I had to leave for yoga class, so if he wanted me there for support, it had to be NOW! So down the stairs he came and said, "don't worry, I don't need you to be here. You can go to class." I said fine, and was going to head out, but turned around to take the insulin out of the refrigerator for him as he's pulling out the other supplies. I had picked up the insulin prescription yesterday at CVS.

As I'm walking over to Daniel with the box, I glance down and see a strange name where Daniel's name should be. I stopped, went back to the fridge and got all three boxes. They don't have Daniel's name on them. I said, "Daniel, there's something wrong. This isn't your insulin."

Daniel said, "I just pulled out the site." He comes to look at the box. "Well, anyway, it's novolog."

I looked at the box, and I looked at Daniel's box from his finished bottle. "It's not the same insulin. The box that didn't belong to us said Novolog 70/30. Not right. Not good.

I grabbed the boxes and the receipts from yesterday and shot over to CVS -- probably a little too fast -- going over in my head what had happened the day before. Picture it -- a long line, later in the evening. Two or three pharmacists busy in the back, two people working the registers. I'm finally at the front of the line, and the girl behind the register finishes ringing up her customer, then folds her arms down on the counter and says, "God, I just want to go home!" I smile, thinking, yeah, it's been a long day, I want to go home, too.

I give her Daniel's name and she goes to look for the prescriptions (keytone strips and novolog). She gets the strips and then looks in the refrigerator for the novolog. She looks and looks and I say to her, "look in the door of the refrigerator," but she doesn't hear me and can't find it. She walks back over to the pharmacist with the paperwork in hand, and the pharmacist says, "It's in the fridge! Look in the door!" So register girl goes back to the fridge and looks in the bottom, and in the back, but NOT IN THE DOOR.

I call out a little louder, "LOOK IN THE DOOR." She finally does. Picks up three boxes rubber-banded together, turns them around, looks them over, and says, "okay," and puts them in the CVS pharmacy bag. I took them home.

So I flew back there tonight and thank goodness there was no line. Register girl is behind the counter again, and I restrain myself from leaping over the counter and into her face. I explain that I received the wrong prescription, the wrong medication, and that my son needs his insulin NOW. She goes back into the fridge, pulls out three more rubber-banded boxes, and says, "Daniel, right?" YES.

I get the boxes and triple check them. They are Daniel's. She smiles at me. "Okay! All set!"

I dropped the boxes off at home and hit the road to try to make it to yoga. On the way I called CVS and spoke to the pharmacist and explained what happened. I said that it was lucky I happened to grab the boxes and look at the name. Daniel wouldn't have looked, he would have just injected. I found out later that 70/30 novolog is a combination of fast and slow acting insulin. Daniel only uses fast acting insulin. I don't like to think of what could have happened. The pharmacist said he would remedy the situation.

I hope so. Register girl needs to know that she could have caused an awful problem. Tired as she may be, if she's dispensing medication, she has to focus on what she's doing.

Never walk out of a pharmacy without opening the bag and looking at what they gave you. Check the name, check the medication. You might save your life.

Smart Insulin?

There was an interesting article in my Google Alerts today about Type 1 diabetes. You can read it here. The JDRF is announcing the kick off of a project to develop Smartinsulin insulin, which will recognize when the body's blood sugar is rising and release insulin to cover for it. Then when the blood sugar settles down, it stops the release. It would require a once-a-day injection.

No word yet on saving fingers from lancet pokes.

Levemir & Gluten

I subscribe to a message group, celiac@childrenwithdiabetes.com, and I'm so glad I do! I found out today that Levemir has gluten in it.

I had a discussion with out endo just last week about perhaps switching Daniel to Levemir from Lantus because of his high evening numbers. I don't even want to think about what a mess that would have been.

I'm surprised & concerned that there isn't a red flag on all diabetic celiac patient files that says NO LEVEMIR! GLUTEN!!

Why the hell do you need gluten in insulin, anyway?

Contingency Plans

Yesterday it snowed. It also sleeted and rained, sometimes separately, sometimes together! I work at a small private school, and we were inundated with phone calls from our parents, asking if we were closing early. Often we like to take cues from the county public schools. We kept checking their web site to see what they would do. Nothing. Nothing.

This week in the public high schools, the kids were taking mid terms. This is a county that usually closes schools when a snowflake is spotted in the far western corner of the boundary; however, I think they were gritting their teeth yesterday, waiting out the weather because they did NOT want to mess with the mid term schedule. We decided at our school to cancel after school activities and asked parents to pick up all children at the end of the school day so that our after care providers could shut down and make their way home.

Parents started trickling in after lunch to get their kids. I heard stories of accidents, slipping and sliding, trucks turning sideways... I was a little nervous, thinking about my kids on the school buses. I work part time, and get out of work just as Daniel is getting out of school. He's not allowed to use us cell phone during the school day, so after I got out I called Daniel to find out if he was already on his way. I was thinking that I'd rather pick him up this time... but he was on the bus with his friends and they were just starting off. So I headed off to my daughter's middle school & my youngest son's elementary school to get them. The weather kept changing. I drove through bands of snow, sleet, and rain. While waiting in the pick-up line at the elementary school, the precipitation changed back to all snow for a while. The flakes were enormous and heavy. It looked like ostrich feathers were falling from the sky.

When Nora and Dominic returned from sledding, later, they were completely soaked.

The heavy precipitation caused a power outage last night. Daniel had 2 friends over celebrating the end of mid terms. I had just gotten one in a long line of leftover dishes cooked in the microwave when the lights went out. AGH!

Luckily I can still light the gas on the stove when the power is out, so leftovers took a little longer to cook, but not much. We ate by candlelight. After his friends left, Daniel and I played Scrabble. I started wondering how long the outage would go, and thought about generators and whether we should get one. We've thought about getting one on and off for a few years. There have been a few times when we have lost power for a few hours, and once for most of a day. Back then we didn't have medicines to deal with.

How long does the insulin keep in the refrigerator once the power goes out? I know the insulin pens can be stored unrefrigerated, but that's usually after they are opened. What if the power goes out and the temp in the refrigerator slowly goes up? I started thinking about all kinds of natural disasters, and what it must be like to live in a place that is prone to earthquakes, hurricanes, tornadoes, etc., and have diabetes.

I am going to call the companies and find out what they say, and go from there. I think we need to have a back up medicool kit, or something like that at least, just in case. A contingency plan.