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Archive for March, 2012

Paying Attention

Rainie and I went to speak to the three Health-Ed classes at the local high school. After introducing Rainie and myself, I told the students that I was there to discuss diabetes, service dogs, and low blood sugar alert dogs, and that I really hoped for a question and answer format rather than a lecture. It was interesting to watch the direction each class took. One session was focused on diabetes and the difference between ‘type 1’ and ‘type 2’, while another one wanted to know about diabetic alert dogs and how Rainie does what she does; and the third class wanted to go to lunch, so I mostly lectured. It was fun to be there, share what I know, and help to lead the discussions.

At one point, as I was describing how Rainie alerts me when my blood sugar is falling or rising rapidly, what it looks like, and why it is important for me that she does it, someone asked if every alert is important and life-saving? I responded saying, “No. Every alert does not mean that I’m in true danger. The alerts mean that I need to pay attention to myself – that I need to pay attention to my blood sugar.” This is the same response I’ve given to that question in the past.

But, since those classes, I’ve been thinking about a lot about that answer and the section where I said, “I need to pay attention to myself.” I’ve realized that, until now, Rainie’s alerting me has brought about a stimulus-response reaction in me. She’d alert and I would do my blood sugar, reward Rainie, check my pump or need for food, and calculate what sort of correction I needed to do. I’m realizing that this is not what ‘taking care of myself’ means. There is so much more to taking care of any body, and especially one with diabetes. What is my mood? How much stress am I in? Could I use some exercise, to laugh or cry, or take some time out? When did I last eat, and what was it? Do I feel like I’m getting sick? Or, am I bored and want to go play? All of these things affect my body and influence my blood sugar control. And Rainie is attuned to these, and more. Sometimes I’ll realize she’s led me to a place to sit down, or blocked my path so I don’t walk into someone or something. She senses people who are approaching and will lead me around them, or encourage me to interact. I’ve been surprised when she tries to take me to the other side of the street, only to realize that some ‘gang-members’ were approaching on the side we had been on. And my favorite is when she beacons me outside by catching my eye and flicking her head to follow her outside. There she’ll sit next to me on the step so we can watch the birds. I love watching the birds. She senses so much more than just my blood sugar. I need to pay more attention to Rainie, and myself.

While we were at the school, Rainie was a model service dog, curling up at my feet, and walking up and down the aisles, letting the students pet her as she went. At one point, she stopped, stared and sat-up in front of one particular young woman. Rainie was exhibiting her typical ‘alerting behavior’, and the girl seemed extremely knowledgeable about the technicalities of diabetes. Having not asked the classes whether anyone had diabetes, I can’t help but wonder whether she has diabetes. I will probably never know.

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One of Those Days

No one ever said life with diabetes would be easy. And these last few days have been a challenge for me – my blood sugars have been down and down-er, and downer still, then they bounce back up, then down again. I call these “super-ball days,” and they are frustrating and infuriating! Poor Rainie! She has been alerting me on all the changes; but regardless of how many warnings she gives me, the volatility continues.

It is amazing for me to be able to write and tell you about me my life with diabetes. I was raised to be embarrassed by it, and not tell a soul. My parents wouldn’t allow me to go to a diabetic youth camp – they didn’t want me to see myself as ‘sick’ or ‘impaired’. In fact, the first person I ever asked to help me when I was hypoglycemic was my soon-to-be-husband, Rick. And we met when I was 26!
Now I think, “Why not?!” There is nothing to be ashamed of! I am proud of who I am. And Rainie?… well, Rainie makes it easy for me to talk about my life and diabetes. People are always asking me about her, and diabetes, and what she does. And, once people see Rainie, they are more interested in her than they are with me.

I’ve experienced many medical advances in the almost 56 years since I was diagnoses as an infant. I remember my mom boiling my glass syringes to sterilize them, and watching her re-sharpen my needles on a sharpening stone (disposables became available In about 1960, and they were too expensive for my family to afford). We tested my urine for sugar using “test-tape”. If there was sugar present, the strip of test-tape changed from yellow to green. This was the only way we had of guessing whether I was ‘high’ or ‘low’. There was no accurate way to know what my blood sugar was truly doing. When home blood sugar testing became available in the early 1980s, the machines where larger than a paperback book; and each test took 2 minutes to perform. This was a big change from using urine testing. As is well-known now, blood sugar testing gives diabetics the ability to have an exact reading of their blood sugar right now! I went on the pump for a short while in 1982, and the thing was huge! It was about 4.5 inches long and 2.5 inches wide. When I went back on the pump in 1991, it was about the same size as they are currently, but there was no ‘bolus wizard’ or ‘square-wave’ or ‘dual-wave’ bolusing, and all dosing was done in .1 unit increments. The tubing was not removable, so I had to shower and bathe with my pump wrapped in a plastic bag, and remove it when I went swimming.

Needless to say, much has changed: Diabetics may now choose to use pumps, CGMs, and pre-filled syringes. The meters take mere seconds to use and can communicate with the pumps. There are also computer ‘apps’ that can help us keep track of blood sugars, insulin, exercise and identify trends, as well as offer programs that help figure out ‘carbs’ for meals, among other things… Life is sure more convenient than it was not too long ago.

However, this does not mean that a diabetic’s life is easy. There is the constant trial of balancing insulin with food, exercise, stress, emotional factors and illness. Each meal is still a math calculation as we try to count the carbs, and take into consideration all the other factors listed above. I know that when my insulin is out-of-control, I feel lousy. The best way to describe it is: I feel like I’ve got the flu. And, no matter what doctor I talk to, he or she reminds me of everything that can go wrong. The complications of diabetes are endless (retinopathy, neuropathy, intestinal problems, disorientation, amputation, coma, shock, and death are just a few). I’ve realized that I can only do my best, and that’s all I can do. There is no such thing as ‘perfect control’ when living a life with diabetes.

And for me, diabetes is taking its toll. I think I’m a little less tolerant than usual because I went to the eye doctor a couple of days ago and got a not-uplifting prognosis on my diabetic eyes. I am possibly developing glaucoma in the eye that had diabetes-related surgery performed on it in July. A friend asked, “How do you feel?” Truth: I feel scared and angry and grateful! Angry at being diabetic and how hard it is! Even though I try to keep my blood sugar ‘under control’, I am what is called a ‘labile’ or ‘brittle’ diabetic. Every singe day my body responds differently to my inulin; and when my blood sugar bounces around, so do my moods and energy. And somewhere, deep inside, I feel grateful that my complications aren’t worse. And I’m grateful for Rainie. She’s brought me out of my shell while helping me with my diabetes awareness and my depression – and she does this as she showers me with the unconditional love that only a dog can. I love her and can’t imagine my life without her. She knows just when to put her big furry head in my lap, look up at me, and bring me back to the here and now.

Hold the Popcorn

On one of the rainy days last week, a friend an I decided to go see a movie. Why this movie won all sorts of Academy Awards, I have yet to figure out. I found it kinda long and slow, but I’m not a movie critic. Rainie, however, found the theater’s floor a veritable feast! She kept finding things to reach for and lick, despite the fact that I’d put a blanket down for her, and this was the first showing of the day.

Finally, I thought she’d settled down, when I felt a gentle paw on my lap. She was alerting me. I remembered she’d alerted me at home after lunch, and my blood sugar was a little high (180). I wasn’t worried then because I had just eaten. But I was surprised when she alerted again so soon. So, in the dark with the help of a flashlight, I tested my blood sugar. It was much higher (260). I gave myself some corrective insulin, and decided to wait – but Rainie wouldn’t let me wait, nor would she settle down. She kept pawing at me, and soon she was in my lap. I tested again and discovered my BS was in the mid-300s. Way too high for me! I was feeling sort-of panicky, so with the help of my trusty flashlight, I pulled out my pump’s cannula. Wow! I found that when I’d replaced my pump site in the late morning, the cannula had crimped against my skin and I hadn’t gotten any insulin for the past few hours. Rainie had alerted me to my blood sugar rising and her alerts intensified as my blood sugar became way too high.

I still don’t know how the movie ends…

Rainie was not specifically taught to alert me when my blood sugar is high – she taught this to herself. When she does alert on my rising blood sugar, she alerts well before ketoacidosis sets in, so she’s not alerting on the fruity smell that ketones produce. I’m not sure that science knows exactly what the dogs are smelling/sensing when they alert to highs. Rainie’s alert for ‘highs’ is different than her alerts for ‘lows’ because she is very nervous when I’m high.

Here is Early Alert Canines‘ definition of what a diabetic alert dog is and what they are trained to do: “Diabetic alert dogs” are trained to be able to recognize the biochemical scent that a diabetic’s body gives off as his or her blood glucose begins to change. These dogs learn that the biochemical scent is a command to the dogs for them to carry out an “alert” action–which means that their diabetic partners can receive an early warning to help them avoid acutely dangerous hypoglycemia (low blood sugar), and curb damaging hyperglycemia (high blood sugar).

Because hypoglycemia can cause acute and severe problems (including coma and death), and because hyperglycemia can contribute to long-term diabetes complications, it is imperative for a diabetic to receive early warnings, which allow them to verify their blood glucose levels and treat themselves according to current consumer technology as advised by their physician.

We Were in the Right Place at the Right Time!

It looked like so much fun! I could hear the laughter from the parking log. A group of kids from the local high school were using inner-tubes and snow-saucers to slide down a very long, steep, muddy hill. The mud was everywhere. Some of them had used it as war-paint on their faces.
Rainie and I were heading towards them after hiking up a different trail. As we walked, Rainie was becoming very nervous, trying to lead me toward the voices… faster… and faster. By the time we neared the kids, she was dancing frantic circles around me. I let her go and told her to “Go Say Hi” to the hoard of welcoming kids. She dashed into the group, nosing every teen she passed, while avoiding the hands reaching out to pet her. She found who she was searching for – one particular boy who had run most-of-the-way up the hill. Rainie stopped in front of him and stared. She then turned to another one of his friends and jumped up, as if to try to tell him something. Then she returned to staring at the boy.
As I watched, I realized she was alerting the boy, and trying to tell the other kids that he needed help. As I approached, she leaped toward me, and led me to him. “Why won’t she leave me alone! What’s she doing?”–he was obviously annoyed. I quickly told him that Rainie is a diabetic alert dog and she’s acting the way she does when my blood sugar is dropping. I asked, “Are you diabetic?” “Yes,” he answered. I asked him whether he had a meter, and he said he’d left it at home. After he sat down (with a concerned Rainie on his lap), I did his blood sugar with my meter. It was 51. Having nothing of his own to eat, I gave him some of my glucose tablets. By this time, he had become shaky and disoriented.
After things settled down, Rainie was one happy dog! There were so many people rubbing her belly that I can only imagine she must have known, somehow, that she was a star. (A very muddy star, but a star none-the-less!)

All day I’ve been musing, wondering, how often do we have the chance to possibly save someone’s life?

Children and Diabetic Alert Dogs

DSC04562Parents often say they’ve looked into getting a diabetic alert dog (DAD) for their child, but were told it is impossible because the child is too young. I suggest that they look into Early Alert Canines. EAC places dogs in families with young diabetic children, as well as with diabetic teens and adults.

I feel strongly about the benefits an alert dog can bring the family of a child with diabetes. How I wish I’d had a diabetic alert dog (DAD) when I was growing up. It would have been so wonderful to have a companion when I wasn’t feeling well and not knowing how to tell my parents what was wrong. I was born with diabetes, and remember crying a lot because I felt so terrible at times. My parents often thought I was having a temper tantrum, when, in fact, I was too young to tell them that I needed help. They had no way to check my blood sugar because the technology hadn’t been invented yet.

Now, we can check our blood sugar by pricking our fingers and using a drop of blood to get a quick read out on a meter. Some diabetics are unable to sense what level their blood sugar may be without checking – this is called hypoglycemic unawareness. They rely completely on the ‘finger stick’ to know if their blood sugar is high, low, or all right. Parents always have hypoglycemic unawareness regarding their child’s blood sugar level. Since they have the responsibility of controlling and balancing their child’s food, activities and blood sugar, they, too, must prick their child’s finger many times a day. And for anyone with insulin dependent diabetes, especially those with hypoglycemic unawareness, nighttime is especially dangerous. The possibility of going too low while sleeping can be life threatening. Parents often set alarms multiple times throughout the night in order to test their child’s blood sugar to ensure the child’s safety.

Diabetic alert dogs are trained to warn the diabetic (or parent of) to rapid changes in blood sugar. The dogs provide this alert day and night, waking the individual if needed.
Early Alert Canines is one of the few organization that places trained dogs with young diabetic children and their families. The dogs are trained to smell changes in the child’s blood sugar levels and alert the parent or caretaker before an emergency arises. One dog has been placed in a family with three diabetic children under age 6. The dog oversees the children at all times. At night, he sleeps in the hallway between the children’s bedrooms, and alerts the mom when any one of the kids’ blood sugar begins dropping rapidly. He then brings her to the appropriate child. In the previous posting, “Rainie Meets a Jedi Knight”, if an EAC dog were present in Jason’s home, there may have been no emergency after all.

As a nurse, and a diabetic with an alert dog, I can only imagine what a diabetic alert dog could do for a parent’s peace of mind, sharing the responsibility for monitoring their child. Looking back on my own childhood, I wish I had an alert dog. The dog would have been able to express what I, as an infant and child, could not. The dog could have affirmed to my parents that my blood sugar was dropping, and that I was not cranky from teething pains, growth spurts, adolescence, etc. In retrospect, I believe my whole family would have been happier.

Please, share your story with me or tell me what you are thinking!

Rainie Meets a Jedi Knight

I want to share this true story.  I call it “Rainie Meets a Jedi Knight”

Not long after Halloween, I was walking my dog when a little boy named Jason came running with his cape flying behind him as he swung his light-saber from side to side. He was yelling, “Hey! Is that a Ewok?” I laughed and introduced him to my golden retriever named Rainie. He wanted to know why she had a red jacket on. As I explained to Jason and his mom that Rainie is a diabetic alert dog and that she notifies me when my blood sugar is dropping rapidly, his mom began to cry — Jason had just been released from the hospital after being found unconscious due to low blood sugar. As we were talking, Jason looked up at me, with his arms around Rainie’s neck, and said, “If I had a dog like Rainie, she would keep me safe – just like my light-saber.”

(I will refer to this story in my next post.)

 

More About Early Alert Canines

IMG_1947Many people ask me about Early Alert Canines and why I am so involved. I’m so passionate about EAC because Rainie, my low blood sugar alert dog, has truly changed my life. With her, I am never alone in dealing with the moment to moment trials of controlling my blood sugar. She is here to alert me when I’m dropping quickly so I rarely go dangerously low. And, she senses when I’m having a bad day and is here to comfort me. I can’t imagine my life without her. I have had to get used to getting so much attention and openly choosing to share the fact that I have diabetes. I’ve learned that by saying, “Rainie is a diabetic alert dog and lets me know when my blood sugar is dropping rapidly,” people are paying much more attention to Rainie and what she can do, than they are to me.

Now, here is some basic information about Early Alert Canines, including contact numbers. This is the same information given on our Facebook page:

Early Alert Canines is a 501(c)(3) non-profit organization that is dedicated to training medical alert assistance dogs for children, teens and adults living with insulin-dependent diabetes.

“Diabetic alert dogs” are trained to be able to recognize the biochemical scent that a diabetic’s body gives off as his or her blood glucose begins to change. These dogs learn that the biochemical scent is a command to the dogs for them to carry out an “alert” action–which means that their diabetic partners can receive an early warning to help them avoid acutely dangerous hypoglycemia (low blood sugar), and curb damaging hyperglycemia (high blood sugar).

Because hypoglycemia can cause acute and severe problems (including coma and death), and because hyperglycemia can contribute to long-term diabetes complications, it is imperative for a diabetic to receive early warnings, which allow them to verify their blood glucose levels and treat themselves according to current consumer technology as advised by their physician.

These dogs are a diabetic’s best friend, life-savers and life-changers.
These highly trained dogs are placed at no charge to the recipient.

For more information, send us a message today!
Email us at: Info@EarlyAlertCanines.org
Visit our Web Site at: http://www.EarlyAlertCanines.org

To support Early Alert Canines, please consider sending a donation today!!

Early Alert Canines
1641 Challenge Drive, Suite 300
Concord, CA 94520

tax ID#: 27-4237968