Miz S

Not the first, nor the last, lecture.

I took yesterday morning off from work to get a physical with my new doctor, who said I have the body of a 30-year-old athlete.

Naw, not really. But she was probably thinking it, in between writing me referrals for a bone density test AND a colonoscopy. Good times! I can't wait to present my ass to the medical community!

Speaking of medical stuff, Evangeline's 2 year dia-versary passed quietly way back there in March. Evangeline and I talked a while ago about the fact that people seem to know a lot about the symptoms of heart attacks, but don't usually know the symptoms of Type 1 diabetes. She has met diabetics who have real horror stories about how they ended up in the hospital with life-threatening complications such as ketoacidosis because no one recognized their symptoms.

So...not to worry you or anything but if your child/teenager/young adult exhibits any combination of the following symptoms, take them to the doctor:

• unusual thirst.
• increased urination
• extreme hunger
• sudden weight loss despite eating constantly
• fatigue and irritability  (Ha!This can be hard to distinguish from normal behavior in teenagers. Or me.)
• blurred vision

Evangeline arrived  home for spring break of her freshman year in college looking like a frail little skeleton but eating like a horse and downing glass after glass of water. I recognized the symptoms because I am awesome like that, and she was hospitalized within 48 hours of her arrival home. It pays to be a hypochondriac and pore over the health news!

Oh, and while we are on the subject, here are a few facts about diabetes that I might as well lecture you about:

• Type 1 diabetes means that your pancreas basically stops producing insulin. It is usually diagnosed in children or young adults. Type 1 diabetics must inject themselves with insulin everyday or use an insulin pump. In some cases they are tall, lanky, and utterly adorable.
• Type 2 diabetes is the most common form of diabetes. Your pancreas may produce less insulin or your body may become resistant to insulin. It is often (but not always) associated with being overweight and/or sedentary. It can often (but not always) be controlled through a combination of diet, exercise, and medication.
• Diabetics do NOT have to eat special food. They DO have to make an effort to eat a heart-healthy diet and get regular exercise and, if they have Type 1, inject themselves with the right amount of insulin to cover whatever they have eaten.
• Some diabetics have a really hard time controlling their blood glucose levels even though they are doing everything they are supposed to do. This doth suck, because the complications associated with high blood glucose range from serious to horrendous.
• Diabetes medications and paraphernalia are expensive and if you don't have health insurance you are SO fucked.

HEY! Wake up! This is important!

Okay, fine. Be that way. I have to get ready for work anyway. But don't come crying to me when you get diabetes and you don't know the dif between type 1 and type 2.

Evangeline has a bracelet. But some kids get tattoos.

Wednesday.

Evangeline stayed home from work yesterday because she didn't feel well. By late afternoon she was running a fever of 102.3 and sounded piteous when I talked to her on the phone.

The phone call from Evangeline was followed almost immediately by a phone call from my dentist's office saying that they had a cancellation for Wednesday and could I come in to get my teeth cleaned AND DON'T FORGET TO PRE-MEDICATE.

Now I had two good reasons to take off work so I did, by golly.

Evangeline has not been sick, not even a little bit, since she was diagnosed with Type 1 diabetes almost 2 years ago. The reason I know this for sure is because we were warned specifically about the difficulty of managing diabetes during even minor illnesses. The body releases hormones that can can send glucose levels soaring, or your blood glucose can drop severely due to loss of appetite or nausea. Also, over the counter medications can affect blood glucose.

Because of this, I have monitored Evangeline's every cough or sneeze even when she is a thousand miles away at college.

Anyway, she's fine, just feverish and pathetic and paler than usual (I know! I didn't think it was possible either!).

I used the time off today to catch up on laundry and vacuuming and cat boxes because my life is glamorous that way. And I went to get my teeth cleaned and no, I didn't pre-medicate and I lied without remorse when they asked me.

My dentist, by the way, hugs me when I come in. I don't mind this, in fact I rather like it, but I swear she didn't used to hug me and lately she does. I guess she misses me when I'm not there. Don't tell her I lied, okay?

I kind of wish she were my gynecologist, too. I would like her to be in charge of all my orifices.

OH MY GOD EVANGELINE IS LEAVING FOR RUSSIA NEXT WEEK.

Oh, sorry. Did I say that out loud? 

Be on the lookout for ramped-up tension as we move towards January 24th. Do you have any fucking idea how crazy Russia is? WELL, DO YOU???

Puppies! Bunnies! Rainbows!

Check out the fruit bouquet that sweet Kim at Petroville sent me. It looks like flowers! But it's fruit!

I lied. There are no bunnies or rainbows, but if you scroll all the way down you will see some pictures of cats and whatnot.

I am feeling waaaaaaay calmer about this whole insulin pump debacle. For one thing, Evangeline rolled her eyes at me and said, "I wasn't crestfallen, Mom. I was already thinking that it sounded like too much of a hassle to get trained on the pump before I leave for Russia."

Oh. Well. I thought she was crestfallen. I guess I was projecting.

Also, after a long conversation--where I tried very hard not to get tearful-- with the diabetes educator at Children's Hospital, it turns out that she was already not entirely pleased with the amount of hoop-jumping that would have to be done to get Evangeline on a pump before she leaves for Russia AND there are going to be upgrades and changes to the pumps in the next 6 months anyway AND even if we had $6000 to plunk down for a pump right now, it makes no sense to do that because once we change our health insurance, the new provider might say they won't cover any of the ongoing costs associated with the pump because it was a pre-existing piece of equipment.

Exhaling now.

In the meantime, special kudos to both sets of grandparents who immediately offered to buy as many damn pumps as we wanted--Evangeline shall have an insulin pump for every day of the week, by cracky! Not that they're super-rich, but they are super generous. How sweet is that? 

AND...last night I went to bed at 11-ish and slept all the way through until 9am. This is worth mentioning because I have been having horrible sleep issues ever since I got back from the hospital. The worst night was Tuesday night, when I was wide awake until 5am, and then slept until only 8:30am, which could explain a little bit of the general weepiness we've been seeing around here.

But now I'm happy! Woo!

Do not roll your eyes at me, bitches.

You may discuss my personality disorder amongst yourselves.

Oh wait, one more thing and then I swear I will shut up about diabetes and A1c's and glucose, etc. Evangeline sent the following message to her friends after her doctor appt the other day, and it amused me. I reproduce it here for your amusement because I am all about the sharing.

"Allow me to take a moment to brag: I am an impossibly good diabetic. I just went to the doctor, and my A1C is 5.3. I doubt that means anything to anyone, but take my word for it: it doesn't get any better than that. That means that for three months, I've had an average blood sugar of about 99. And since the range of acceptable blood sugars is 80-120, that roughly translates to "Evangeline is amazing and deserves to have her feet (which will probably never have to be amputated due to diabetic complications) washed and kissed by prostrate pilgrims."

Okay, here are a few pictures for you. April was left out for some reason, and I am too lazy to go back and pull another one off the camera. But don't worry, she is still the first doggy wife. Sorry, but the first picture of Pushkin doesn't enlarge. All the other ones will enlarge if you click on them.

"What the hell? Are those puppies and bunnies outside?"

Rosie helps Evangeline check her email.

Working as a team here to catch a moth.

Under the desk doing their paperwork, I can only assume.

I will not be around tomorrow, as I am off to the farm to have a sibling summit with my brother the Goat Daddy, my sister Julie, and my other sister Sarah who has finally agreed to descend from the Adirondacks. So, you guys all have a great weekend, okay?

Chatty If Somewhat Cheerless.

I changed my weblog description from "ever hopeful" to "divine if somewhat scattered". This is how Vicki described me on her blog one time, and I was charmed. Maybe I will change it from time to time when I get bored. If you have any suggestions, feel free to tell me. But be nice.

Yesterday morning I got an excited phone call from Evangeline after her night of debauchery at a friend's house, because the Children's Hospital Diabetes Lady sent information to her email about the process of switching over to an insulin pump. It is a long and complicated process (for reasons that are boring to the average non-diabetic so just trust me on this) but the first step is tonight at the insulin pump information session, where all the different company reps come to demo their products.

On Monday I mentioned that we already know that our health insurance won't cover a pump. I added, airily, that we would just pay it out of pocket, it's about a thousand bucks, we're not poor, wheee! Let's  go out and celebrate with sushi and sake!

I have no idea where I pulled that $1000 price tag out of. My ass, maybe? Because a little research today on the Internet uncovered a price tag of $6000 - $7000.

Evangeline looked crestfallen when we told her that it would have to wait. We can switch health insurance providers to one that will cover part (not all) of the cost, but not until January. So she would not be able to take the insulin pump class until she got back from Russia in May.

This is not the end of the world by any means. She manages just fine on her current insulin delivery system, and it's not a huge deal if she has to wait. But it still arouses my anxiety because I'M HER MOM I WANT TO MAKE EVERYTHING OKAY.  Also, I guess it arouses my guilt because we recently refinanced our mortgage and we have a small chunk of change sitting in the bank (not a huge amount, don't get excited), but it is enough to buy insulin pumps for 3 or 4  little diabetic waifs. We refinanced with the specific goal of fixing up our little mildew-y bathrooms and paying some college tuition.

So. I guess I want to take care of home maintenance and pay tuition bills more than I want Evangeline to have an insulin pump before January.

I do not think for a minute that this makes me a bad mother (she said, defensively), but it does make me feel bothered. I would much prefer to plunk out the money or wave a magic wand or something. I am bothered that our health insurance won't pay, and I'm bothered that it costs so much to begin with.

*  *  *

I have spoken to Amanda's mother several times since my surgery. Yesterday morning's phone call shook me up. Mrs. P said that Amanda is crying a lot (she can't make any noise, but her face wrinkles up into a grimace of despair, it's horrible to see, really) and that she mouths to her mother "Help me please." When I reported this to Josh and Evangeline I suddenly felt quite wretched and thought I might throw up. The doctors have told Mrs. P that they are not optimistic that Amanda will ever regain full use of her arms and legs due to the nerve damage. They are trying to find her a bed in a rehabilitation facility where she can be weaned off the ventilator and get physical therapy. In the meantime, the social workers are trying to find a group home for David to live in. Mrs.P is all worried that Amanda will be abused and raped in a rehab hospital, which wtf? Does that happen a lot? I tried to be a reassuring voice.

I don't even know why I am telling you all this. It is so fucking bleak and depressing, and it will not end well. I can only hope that it ends quickly.

Sorry for being a buzz kill.

No depressing shit tomorrow, I swear. Only bunnies and puppies and rainbows.

But She's Not A Very Good Putt-Putt Player.

Evangeline and I went to Children's Hospital today for her diabetes check-up. Every time we do this, she is nervous that her A1c is going to be really high, and she is always wrong.

The A1c is a blood test that tells Evangeline and her doctors whether or not she has maintained good control over her blood glucose levels in the previous 3 months.  Anything under 7 is good. She was 5.3 this time. She has never been over 5.7 in the year-and-a-half since she was diagnosed with Type 1 diabetes. She is the Little Diabetic That Could.

Walking through Children's Hospital always makes me acutely aware of how incredibly lucky we have been. Not that getting diabetes was exactly a stroke of pure luck, but goddamn, there are way, way worse things that can go wrong with the human body. And hell yes, I am one of those people who takes some comfort in the thought that things could be a lot worse. It killed me today when I saw a young girl in a wheelchair with her limbs and head immobilized. Jesus.

Anyways. I am proud of Evangeline for being so disciplined and methodical and taking it seriously but totally not being a baby about it. Unlike her mother, who is a gigantic baby, or at least birthed gigantic babies, which led to her current predicament.

The other piece of news is that Evangeline has decided that she wants to switch to an insulin pump. She will need to take a class and get trained, and we're waiting to find out when the next class starts. An insulin pump will make her life a lot easier, because she will no longer have to inject herself every time she eats. Right now she injects herself anywhere from 4-6 times a day, depending on how many snacks she has.  The shots are not painful but it's a bother.

So, yay. I'm excited for her.

Naturally, our health insurance will not cover an insulin pump, and they are not cheap. It doesn't matter to us, because we are not poor. We will pay it out of pocket. But it still pisses me off.

That's all I have for you right now. More news as it breaks. Thanks again for all the nice emails.