“I Told You So!”

If Rainie could talk, I’m sure there are times that she’d be saying, “I told you so!”

This happened again today.  I was up in my ceramics room trying to create feet on the bottoms of some nearly finished bowls when Rainie began alerting.  I sensed she might be right because my balance and depth perception seemed a little bit off.  Upon doing my blood sugar I discovered that I was slowly dropping, so proceeded to eat a snack, and went back to work.  I wanted to push through and get this job done.  The dryness of the clay was just right – not too hard and not too soft.  But despite my intentions, she kept alerting!  I felt fine.  I had just eaten and needed to get my ceramics work done!  That was until I cut right through the semi-dry bowl with a semi-sharp tool.  She was right.  I hadn’t sensed that  my blood sugar had continued to drop and I wasn’t feeling how unstable I’d become.

As I tossed down my tools and took off my apron in pure frustration, Rainie flopped down on the floor with an exasperated sigh which loudly stated, “I TOLD YOU SO!”  

A Breath Of Fresh Air

I know I will be revisiting a topic from a previous post, but I took Rainie to the retinal doctor’s office again today.  I wasn’t a patient this time.  I’ve been scheduled for eye surgery in a couple of weeks, and I misplaced the paperwork required for the pre-op physical.  Sigh.  I think I’ve misplaced my brain also.  Anyway, this time as we entered, I wasn’t as stressed as usual – but the dread radiating from the people in the waiting room was palpable.  Even Rainie’s happy-go-lucky demeanour became sunken and withdrawn…

…for a moment.  As I stood at the counter waiting for the papers I needed, Rainie’s favorite medical assistant appeared.  Rainie’s tail began to wag as she stretched into her ‘downward-dog’ yoga pose and ending up rolling onto her back for a smiling belly-rub.  By this time magazines were lowered as all the eyes in the waiting room participated in the ‘love-fest’.  As one person came (and asked) to join in, I could see the gleaming desire in the watching eyes of the elderly patients, waiting.  Rainie and I went to greet everyone in the room.  Rainie slowly and respectfully allowed each one to embrace her, and sat in front of a very frail man in a wheelchair.  As he attempted to reach down to her, she gingerly placed her paw in his hand, then her head in his lap.

As we turned away, the man in the wheelchair said, with tears in his eyes, “That really made my Valentine’s Day!” while someone else commented on how each doctor’s office should have a dog.  The last comment I heard was, “That was such a breath of fresh air…”

Given as a gift

This YouTube video was made by one of Early Alert Canine’s newest teams as a Christmas gift to EAC’s head trainer.  Valerie does a wonderful job of explaining about life with Type 1 diabetes (T1D), as well as the role a diabetic alert dog, and the impact that one has on the life of the diabetic, family and community.

https://www.youtube.com/watch?v=OlHdzrZzfXI

Please, enjoy the show!

~Hilary and Rainie

 

Some Doctors’ Offices Truly Need a Dog

Going to the retinal doctor’s* office has always been emotionally taxing.  Upon walking in the door, I am embraced by the overwhelming pall of depression, fear and despair, broken by the occasional glimmer of hope or relief by someone who has just received a ‘good’ report.  Patients, usually with someone there to support them, sit with their heads down, looking at the floor, or with their nose to their Kindle.  Even Rainie tends to become subdued by the general demeanor of the office.

But things quickly change once people become aware that there is a dog in the room.  As we walk in, the medical assistants will often call out, “Hello Rainie! How’s my girl!”  Upon hearing this, heads raise and smiles begin to form.  As I take a seat, the questions begin: “What kind of dog is she?”, “What does she do for you?”, and, invariably, “May I pet her?” – which I allow.

I can feel the collective dread melt as the ‘dog stories’ and memories are shared; and some of these stories are recalled from ‘long-ago’ since I am usually the youngest in the room.  As the often-fragile arms reach out, Rainie will approach and ‘greet’ those who are willing, sometimes resting her head in their laps.  The fears associated with vision-loss are replaced by brightness.

Even the doctor says that the office really needs a dog.

 

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*Retinologists are physicians who specialize in treating disorders of the back of the eye – the retina.  Most of their patients are being seen for diseases such as macular edema, retinopathy, glaucoma, detached retina, or other severe vision issues. I have been being checked for diabetic eye changes (diabetic retinopathy is one of the major side effects of long-term diabetes) since I the mid 1970s.  The emotions in each office I’ve ever been to have been the same.

Making Magic – Early Alert Canines’ “1st Annual 2-4-1 Walk”

At the starting line
EAC’s 1st Annual 2-4-1 Walk

Have you ever had that feeling from deep within that you know you are helping to create something magical?  This feeling truly came to light for me this past Saturday at the Early Alert Canines’ “1^st Annual 2-4-1 Walk” (2 feet, 4 paws, 1 cause!).  About 75 people, escorted by 15 dogs, came together as a community to share their support for EAC, and show their enthusiasm for training diabetic alert dogs.

As we walked around the small lake, admiring the fountain and enjoying the sunshine, we talked.  Here are a few of the stories that were shared with me:

Lalu, a very vocal black lab-golden mix that was teamed with her young (about 6 year-old) partner and her family in April, alerted from across the gym as the little girl’s blood sugar sky-rocketed while she was performing on the uneven parallel bars at a gymnastics event.  This was somewhat embarrassing since Lalu’s vocal volume increases with the intensity of her alerting.

Again, Lalu, who is terrified by water, alerted while her young charge was swimming.  Lalu’s alert for dropping blood sugar is to raise her paw and touch.  As Lalu was alerting, she was walking toward the pool on three legs as she kept her ‘alerting’ paw raised, calling the whole time.

Jedi, was also placed with his new family in April (his young diabetic responsibility is 7). He is the classroom’s favorite ‘visitor’ each day he is bought to work there with his new ‘mom’.  Apparently, all the kids were incredibly disappointed when “Just the Mom!” came on their field trip to the zoo, with no Jedi.  (Bringing a service dog to the zoo might evoke the “pray instincts” in the caged animals.  It is recommended they not be taken to places with wild animals – even caged.)

Both Jedi’s and Lalu’s ‘parents’ expressed how much comfort is having the dogs.  They said there are no words to express what it’s like to have another set of eyes (or nose in this case) looking over their diabetic children.  And the peace of mind knowing they’ll be told about potential problems before a true emergence happens, even if it means being awakened at night, is a great relief.

On a different note, it was great to hear that one of the EAC trainers is making an ‘office-call’ to try to help resolve an alerting issue that is arising at someone’s work.

Even us “old –times” shared stories of our own: my dog, Rainie, alerting me while on the beach; and the quiet assurance provided by Norm to his T1D ‘dad’ who lives alone.  And Jason, is full of stories of how “Eli” alerts him while he’s traveling for work – regardless if it’s on a plane, in a restaurant or hotel, etc. And, yes, Eli even alerts at home and in the car.

It was an incredible honor/pleasure/moment-of-pride for me to see so much participation and enthusiasm for what EAC does.  I want to thank our ‘new recruits’ (dogs in the process of being scent trained), the families fostering them, the newly placed teams, the training/office staff, us “old-timers” and everyone else who have ever supported EAC or donated to our fundraiser.  I hope that everyone realizes that you, too, are helping to create some magic.

Accomplishments Large and Small

Accomplishments Large and Small – Diabetic Blog Week

Blue
The color of diabetes awareness

How often are we given the opportunity to acknowledge our accomplishments, or are actually encouraged to share our pride?  And, how often do we toil to learn a difficult task, one that we should be proud of, just to have it become routine and ho-hum?  For example:  Not many of us remember learning to walk or run, and then stop gracefully – which are all huge feats, if you think about it.  But now walking is routine, and taken for granted, and the effort it took to learn, long forgotten.  I believe, once a habit has become routine, it is human nature to disregard the fact that we had, at one time, accomplished a huge task.  Let’s take today to celebrate where we are, and the path we took to get here.

When I look back at all that I (and my family) have accomplished in terms of living with my diabetes, I can easily become overwhelmed.  Since being diagnosed as a very young infant in the 1950s, these are a few of the skills that I’ve had to practice:

• Giving (and getting) shots
• Using Test-tape (we/diabetics used to test our urine to check for sugar.  That was the only way we kind-of guestimate what our blood sugar  was.)
• Performing and interpreting finger-stick blood sugar testing
• Adapting to constantly changing eating regimens, and personal likes and dislikes
• Learning how to count carbs
•  Learning about different types of insulin and when they peak and valley
• Learning how to juggle diet (with insulin), exercise (with insulin), emotions and stress (with insulin) – all a work-in-progress, while…
• Constantly figuring out how to correct my ‘mistakes’ when I over eat or give/get too little/too little insulin or when my blood sugar doesn’t like the color of my sox (or something), etc.
• Mastering (sort-of) the pump, dealing with depression, dealing with complications –  for me it’s happening mostly in my eyes
• Finding other diabetics to talk to, and
• Getting a diabetic alert dog

Wow!  Those are a lot of skills, and confronting each one deserves a moment of pride, if not a medal.

However, today’s topic for Diabetes Blog Week is to discuss my biggest accomplishment.  This one is easy!  My biggest accomplishment is that I am no longer ashamed that I am diabetic, and that I am no longer bashful about telling people that I have diabetes.  For this momentous step forward, I can thank my diabetic alert dog, “Rainie”.

As a young child I was taught to hide my diabetes at all costs.  I was taught that it was shameful and something not to be shared.  I grew to be a self-reliant “chronic child,” never asking for help, even when I needed it badly.  Despite desperately wanting to go, I was not allowed to go to Diabetic Camp.  My parents wanted me to think of myself as a ‘normal child’; but instead, I felt felt very isolated, defective and alone.  Unfortunately, I sub-consciously kept these beliefs about myself throughout college and nursing school – even after I’d specialized in diabetes.  It was only after getting married that I learned I could ask someone (my husband) for help – he loved me even though I had diabetes!

This was when I began realizing that I have diabetes and I’m ok!

I continued to evolve and open up about who I am.  In 2010 I decided to apply for a diabetic alert dog.  One of the ‘things’ we were warned about is that when you have a service dog’s leash in your hand, people will ask very personal and inappropriate questions: “What is your dog for?,” or “What’s wrong with you?” or many other questions like that.  With a service dog, it’s more difficult to ‘hide’ the fact that you are different.

Happily, I’ve learned to take these questions in stride.  In fact, when people ask me about Rainie and what she does, I’ll usually say, “This is Rainie.  She is a diabetic alert dog and smells for changes in my blood sugar.  I am diabetic.”  From here, the conversation can turn towards Rainie and diabetic alert dogs, or toward diabetes.  It usually turns toward Rainie.  It’s funny because not too long ago, my daughter mentioned that she couldn’t believe how easily I admit to being diabetic.  “Mama,” she said, “It’s not like you.  You’ve changed.”

I’ve been teaching about diabetes to patients, families and groups for years; and finally, after over 55 years of living with ‘type 1’, I’m finding I can proudly say, “Yes.  I have diabetes.”  And I’m glad I finally can.

I have diabetes and I’m ok!

Hot Off the Press: EAC’s “The Scentinel”

Link

Hot Off the Press: EAC’s “The Scentinel”

Here is the May 2013 edition of Early Alert Canines‘ “The Scentinel”, a newsletter full of information on diabetes, dogs, and diabetic alert dogs.

There is one correction:  In the section called “Vet Notes” the medication called Capstar should have been Comfortis.  Both are oral flea pills but the Capstar lasts 24 hours and the Comfortis lasts 30 days.

~ Enjoy!

How do you teach “Compassion” and “Empathy”?

When I was working in the hospital as a nurse, I was always misplacing my stethoscope, only to find it hanging around my neck.  Now, with Rainie in my life, I am perpetually doing the same thing with her leash.  I’ve discovered that the neck is a very handy place to put it – so I’ll always know where it is.  Except I usually forget it’s there.  I was reminded of this as I was hurriedly trying to put everything in order to go talk to the local nursing program’s class that is studying pediatrics and chronic illnesses.  As I was attempting to get Rainie and the gear into the car, I couldn’t find the leash because it was around my neck!

 In preparation for my talk on “the psychosocial impact of choric illness on the individual, family and society” (as well as diabetic alert dogs), I asked the students to read “How Does It Feel” from this blog site.  I wanted to try to show the students the impact a nurse can have if he or she tries to put herself/himself in the position, or shoes, of the client, and look at issues from that orientation.  I discovered this is much easier said than done.  “Empathy” is something one develops with maturity and experience.

Here are some of the topics we talked about in class:

I asked what issue do they (the students) think is the biggest fear of having diabetes, or having a child with diabetes in the family.  The major response I heard was the fear of going blind from long-term complications.  This is not what I was expecting from a class that had already covered the biology of diabetes.  But, at the same time, I could see where they got this idea from – I remember the doctors talking to me about ‘maintaining my diabetic regime’, or I might go blind!!  The doctors were using the scare-tactic on me in order to get me to follow their rules.  This must be what the students are being taught in this program.  I told them I had hoped they would talk about the daily problems of the diabetic’s blood sugar of going too low.  Low blood sugar (hypoglycemia) will quickly cause altered thinking, poor judgment, dizziness, accidents, unconsciousness, and, ultimately, death.  We explored what it might be like living with this constant fear, and the life changes that must be made in order to avoid hypoglycemia and long-term complications.

Next we talked about diabetic alert dogs, and how one might fit into a diabetic’s life, and why.  (Rainie was a star!)

We discussed how the first thing a nurses must assess (measure) when meeting with a client is the client’s fear and degree of acceptance of a diagnosis, and find out what ‘burning questions’ they may have.  Without doing this first, no other teaching can happen – especially if the client is truly anxious, agitated or angry.  And, the diagnosis of “Diabetes” tends to bring with it a lot of fear and anxiety, especially if it is in a child.  We explored how, in a perfect family, the whole family might adapt to the new food requirements and exercise plans, as well as be involved in learning what diabetes is all about.  The family and the patient are the nurse’s client.

I talked about how the patient may have an appointment to meet with a nurse in order to learn or review a myriad of information, but, even though the patient may look ‘fine’, their body might be in a bad metabolic/chemical state due to blood sugar problems.  This makes the nurse’s job of teaching more difficult, and possibly frustrating for both the nurse and client/s.

There was so much we could have covered, but I only had an hour, and the instructor had asked me to show how a nurse would teach someone (a family member, a teacher, a school nurse, etc.) how to give a Glucagon injection.  (Glucagon is a hormone that should be injected into a diabetic if the diabetic’s blood sugar goes so low that she/he is not able to eat, becomes combative, is having seizures, or becomes unconscious.)  I brought two expired glucagon kits with me so the students could actually handle them, and mix the two ingredients together as if they were going to teach someone how to inject the Glucagon.  The example I gave was for the students to teach a grandmother how to give a Glucagon injection to her 3-year-old granddaughter, who was having seizures due to low blood sugar.  Before we cracked the cases open, I asked the class if anyone had ever given himself or herself an injection.  All the faces, but one, dropped with an expression of horror!  “NO!”  I asked, “Why not?”  I suggested that the next time they had to get a flu shot or tetanus shot, to ask to give it to themselves, then imagine what it might be like for a parent to have to learn how to give their first insulin shot to their child, or, as in this case, what it would be like for Grandma.  The room became very quiet … Next, we figured out how to break open the plastic box the glucagon kit comes in, uncap the syringe and needle, inject the fluid from the syringe into the glass vial containing the powdered glucagon, agitate the bottle to mix it, and now teach “Grandma” how to give the injection.  I believe my asking the nursing students to imagine doing this to themselves must have “freaked-them-out” because most of them were “all thumbs.”  After much giggling and dropping of the bottles, my time was up.

For me, this opportunity was priceless.  I haven’t “put my nursing hat on” for a long time.  As for the students, I hope they took away a slightly different perspective of life and the teaching process.

Keeping Hope Alive

I’m always amazed how a little thing, like a simple sticker in this case, can cause an “Ah-ha” moment.

Rainie and I have just returned from our weekly trip to the local farmers’ market, where, as usual, we were soon greeted by a following of kids.  From the distance, I heard little voices shouting, “Look Mommy!  There’s a dog!” or, “Rainie! Rainie! There’s Rainie!”  The kids seem to appear individually, or by swarm.  After greeting them, and inviting the shy ones (including families) to come forward, I usually introduce the listeners to Rainie by giving them my short talk, that goes something like this: “You always needing to ask before you pet ANY dog, but especially a dog wearing a jacket, because that means the dogs are working, and have a special job to do and shouldn’t be interrupted.”  Then the kids are allowed to do what they came to do (pet Rainie), and I’ll answer the myriad of questions that are posed – i.e.” What does Rainie do?”, “What kind of dog is she?”,  “What is EAC?”,  and, my favorite, “How can I find out more information about diabetic alert dogs and Early Alert Canines (which is usually asked by adults) ?”

Recently, I’ve begun offering EAC stickers to those interested, which seems to delight kids of all ages.  (The little ones assume it is a picture of Rainie, and are pleased to be able to take a picture of her home.).  Today, a girl of about 8 approached.  She was shy as she gently knelt down and wrapped her arms around Rainie’s neck.  She seemed very interested to learn about what Rainie does for me and how she was trained.  She seemed to leave only because her mom was calling for her.  She happily accepted a sticker, and Rainie and I proceeded on our way.  Not long afterword a woman, being led by the young girl, came hurrying up to us.  The mom told us that they had been searching the bustling market to find us in order to find out more about Rainie and EAC.  Apparently, her daughter had given the sticker to her, told her about our conversation, and had asked if she could send the sticker to her cousin in Michigan.  This cousin had been diagnosed with diabetes at the age of 7 months, and is now 3 and a half.  His family is having trouble with the toddler going low at night, and has been trying to find information about diabetic alert dogs, but couldn’t find anyone willing to talk with them because the boy is so young.

After explaining that EAC does place dogs with families with young children, I, unfortunately, had to tell them that due to our being so small, and the fact that we offer life-long support to our teams, EAC must limit the placements of blood sugar alert dogs to the Western United States.  The young girl then said something to the effect of: “Well, maybe other groups will learn how to teach dogs for kids from you (EAC).  All we can do is keep the hope alive.”

Fear and Companionship

Comfort is a warm puppy!

Yesterday, I was whisked by ambulance to the emergency room for chest pain.  It was 1:30 in the morning, and I woke up in a fit of violent coughing.  Afterword I realized my chest was hurting, I was nauseated, and dripping with perspiration.  I didn’t know what to do.  Last week, my new doctor had lectured me on the dangers of silent heart attacks in diabetics.  She didn’t like that I’ve had a heart murmur since I was a teen, and haven’t had a sonogram for over 20 years.  She wanted me to have all sorts of tests performed – EKG, stress test, blood tests, and an echocardiogram – immediately.  And now I was having chest pain.  I was scared!

We called 911.  The firemen came first, soon followed by the EMTs.  Everyone was extremely nice.  Rainie, my diabetic alert service dog, was invited to accompany me in the ambulance, but I decided to have her go with my husband in his car instead.  She was obviously upset by everything going on.  Something was wrong with her “Mommy”, and all those people around me were confusing to her.  I was worried she’d be traumatized being jostled around in the ambulance as it went down the hills in order to get into town.

When we got to the ER I was wheeled into a room and about 5 nurses and doctors descended upon me, attaching me to monitors, drawing blood, etc.; but when they saw Rainie, they stopped and invited her up onto the gurney to keep me company.  After a quick ‘kiss’ on the chin, and a nuzzle or two, she settled next to me with her head on my abdomen.  With my husband and Rainie there, I finally began to relax.  I felt comforted and loved despite all the ‘medical stuff’ happening to me.

(I am so grateful that I didn’t have to argue with anyone about bringing my service dog into the emergency room.  The fact that she was accepted and greeted so warmly (by everyone my entire hospital stay) was soothing for me, despite all the stress that I was being put through).

The emergency room doctor encouraged me to be admitted due to the “severe combination” of diabetes and chest pain.  They wanted to rule out any heart and stroke possibilities.   I was hesitant.  I do not like hospitals, yet I decided to stay.

As it turned out, every test ended up being normal (surprising, to the doctors, since I’ve been diabetic for over 50 years).   “It’s better to be safe than sorry,” I guess.  I will never forget the ER doctor saying  to me, “Consider it a day of really bad food!”  I came home, sleep deprived, at 3:00 that afternoon.  It was not the most joyous or restful of vacations, despite the size of the forthcoming bill!