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Posts tagged ‘Hyperglycemia’

Rainie’s Been Sick

DSCF0817Rainie’s been sick.  A ‘hot-spot’ had gone awry, blooming into a huge systemic infection.  My rambunctious, energetic, smiling girl had become a small ball of fur with her tail tucked, holding her ears flat, hiding in any small space, lethargic, not following me as she usually does, not wanting to go for walks, and not alerting – just sleeping and watching with those big, brown, questioning eyes.

Finally, she’s coming back to life.  She must be feeling better. Late last night she brought me one of her dolls, and this morning she ‘tossed’ a ball in my direction and scampered to get it after I rolled it across the floor.  And, she’s beginning to alert again.  It’s so nice to have her back!

IMG_0269

(2 days later)  With every day, more of her personality appears.  She’s becoming her true impish self.  This morning I was awakened at 5a.m. with ‘the tigger pounce’.  This is when she wakes me up by jumping on me, thus, letting me know I need to check my blood sugar.  And, of course, she was right.   (My blood sugar was 85.)  Sometimes I feel like I want to be annoyed, being woken up so early; but how can I?  She’s doing her job with a big exuberant smile.

And on our walk, more of a gentle stroll, really, Rainie raised her nose high in the air to smell the breeze.  I could see her nostrils twitching as she caught whatever scent she was zeroing in on.  She slowly followed her nose, turning her head, then body around, until she looked straight at me, bounded to me, and alerted.  Yep, I was dropping.

As I sit here typing, someone with a wagging tail is coquettishly flaunting her favorite ‘stick’ at me, trying to inviting me to play.  Oh, it’s good to have her back!

( If you haven’t met Rainie yet, she is my diabetic alert dog.  She has been trained to identify the metabolic odors a diabetic produces when their blood sugar drops rapidly. ~~~~~~~ And her favorite ‘stick’ is actually a 2-year-old Nylabone chew bone that she carries around with pride and joy.)

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Three New Teams Graduate at Early Alert Canines!

"Lucy" and her boys

“Lucy” and her boys

Yesterday, Early Alert Canines celebrated another major milestone.

Three diabetic alert dogs teams were officially ‘handed their leashes’ in an emotional graduation ceremony.*  One team consisted of “Mr. Brooks”, a petite, yellow Labra-doodle and his new mistress, a long-term diabetic, soon to be retired, who lives alone.  However, for two of these celebrated teams, the ‘clients’ are actually families with multiple diabetic members.  In one family, “Lucy”, a happy and energetic yellow Lab-golden retriever mix, watches over a family with three young boys, two of whom have diabetes; and in the other family, “Bender”, a mellow, loving, gigantic black Lab/golden retriever mix alerts to three home-schooled children and their father.

All of these dogs are alerting to both high and low blood sugars.  Lucy and Bender have been trained to alert one of the parents if their charges’ blood sugars are dropping at any time, day or night.  One of Lucy’s ‘guys’ cannot sense his blood sugar at all (called hypoglycemic unawareness), and her special skills and talents are especially important for this ‘human partner’.  In the five months since the dogs have been placed in their new homes, there has been a decrease in the number of ‘dangerous lows’ and ‘unbelievable highs’, and an overall improvement of the diabetics’ blood sugar levels.  These are very busy dogs!

We like to say that diabetic alert dogs (DADs) are life-saving dogs and a diabetic’s best friend.  They are trained to alert when a diabetic’s blood sugar drops rapidly so that steps can be taken to prevent serious situations.   And low blood sugar can lead to unconsciousness and death.   So, yes, they can literally help save lives.

They also help to save lives in a more figurative manner. Their warnings help to bring a sense of peace of mind and security by providing yet another ‘warning system’ to keep the diabetic’s blood sugar in check.  The dogs can often sense the fact that the blood sugar is going to drop, before it actually does, thereby giving a truly advanced warning of impending danger.  They provide a sense of companionship for the diabetic, and another “set of eyes and ears” (and nose – in this case), for parents of diabetics.  For the parent of a young diabetic, the dogs help allow for a more restful day and secure sleep, knowing the trained DAD will alert them, even waking them up at night, and bring the parent to the appropriate child if there are multiple diabetic children; and for parents of older diabetic children, say, in college, it is a comfort for the parent to know that, even when away, their child has another ‘early warning system’.  And for the ‘more mature’ single person with diabetes, the DAD helps provide the same physical security and companionship, peace of mind for self, family and friends, and the knowledge, to all, that self or loved-one has another helping ‘nose’ and is never alone.

CONGRATULATIONS to all the teams, old and new.  May you continue to have a life of fulfillment and happiness, and peace of mind.

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* To achieve “graduation status”, the new teams must demonstrate an 85% or better alerting accuracy rate.  This means that the dog must correctly alert t >85% of the blood sugar changes tested and recorded by the diabetic client, in multiple and various situations; and the client must recognize the alert and respond appropriately.

 

 

The “Mobile” of Life with Diabetes

IMG_1021“What is diabetes?” and “Why do diabetics need service dogs?” These are questions I’m often asked and have lectured about many times.  Until I read the lead article in the last edition of Early Alert Canines “The Scentinel”, I’d never thought of talking about diabetes in terms of what life with diabetes entails.  I had always spoken from the scientific or physiological orientations of diabetes – describing what is physically wrong with the body, and what a diabetic needs to do in order to take care of  themselves from a medical perspective.  Although I’ve lived with diabetes my entire life, and know every aspect as well as anyone can, I’ve never thought about describing diabetes from the “psychosocial” perspective.  (Psychosocial is a fancy word that means the psychological, social, and non-biological impact a disease has on an individual, family, and the society.)

Beyond the fact that the diabetic body does not produce insulin (or enough insulin), life with diabetes is a difficult and complex balancing act – for some reason, I’ve always visualized it as a mobile.  We must try to balance the insulin we give ourselves (for type 1 diabetes, or deal with not enough insulin if you have type 2), with the food we eat and exercise we get.  Some of the other factors influencing the balance are illness, growth, emotions, stress, medications, amount of sleep, hormones, etc.  And, if that isn’t enough, part of taking care of the disease includes constant monitoring with finger sticks, gathering data, counting carbs, pumping or injecting insulin, and/or taking other medications, calculating ratios, thinking backward while projecting forward, and correcting imbalances, as well as talking with doctors and reaching for support.  Oh, and I forgot to include trying to lead a “normal” and active life.  Keeping the ‘mobile’ of life with diabetes is, to say the least, challenging.

Another aspect of life with diabetes is less apparent to the observer. It is the stress and fear of living with this chronic disease.  There is the fear of “losing control” or having low blood sugars.  Untreated low blood sugar can lead to loss of balance and coordination, confusion, impaired thinking, bad decisions, vision changes, agitation, loss of consciousness and possibly death.  Friends and family members share these concern about the diabetic – especially parents of young diabetics.  Parents often wake-up multiple times a night to check their child’s blood sugar to ensure the child’s safety (and to try to increase their own peace of mind).  Diabetes affects the child because she knows she “doesn’t feel good” but may not realize it is because her blood sugar is out of control.  And children are often ostracized for having  diabetes because they are ‘different’.  We often check our blood sugar because of “feeling funny” or before driving, taking tests or doing physical activity to try to avoid problems and ensure everyone’s safety  Also, there are the physical discomforts (which makes me cranky) and ever-present fear of long-term complications which come from the blood sugar’s varying highs and lows.  All of these affect the diabetic and those who love and care for this person.

I am amazed to write all of this!  I feel like I should be overwhelmed; yet, for me, everything I’ve written about is part of my daily life

Rainie love

Rainie love

Now, to attempt to explain why someone like me (someone with diabetes) would have a service dog:  A diabetic alert dog’s fundamental job is to alert the diabetic, or diabetic’s care-taker, to sudden changes in blood sugar so that precautionary measures can be taken.  My diabetic alert dog, Rainie, alerts me to both highs and lows in any location – in the house, while I’m asleep, while we’re out and about, on airplanes, in restaurants, hospitals, libraries, at the movies, etc.  When she warns me, I am able to take steps to avoid the situation worsening and becoming dangerous.  I tell people that when Rainie alerts me, she is warning me to pay attention to my blood sugar – it is changing quickly.  With her, I feel safer.  I have another ally and tool to assist me in monitoring my diabetes.  She is my constant companion.  I no longer feel alone, or as overwhelmed in dealing with this disease.  Parents who have alert dogs for their diabetic children have another way to monitor their child.  Since parents have no physical sense of their child’s blood sugar levels, the dog’s alerts give them advanced warning, insight, and, hopefully, peace of mind.

I’d like to repeat what Devin stated in her article:  “Though it is critical for every diabetic to understand the underlying cause of his or her condition, we might generate greater public understanding if we start talking less about what doesn’t work in our bodies and more about everything we do to set that right. The next time someone asks about your diabetes, try telling them what you are doing to take care of yourself (sic). It might give them a better understanding of diabetes, and it will certainly clue them in to how totally awesome you are.”

Early Alert Canines’ “The Scentinel” Issue 2

Early Alert Canines is pleased to release the second issue of “The Scentinel!”

http://library.constantcontact.com/download/get/file/1108404407988-31/November2012.pdf

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What does it feel like?

Twin Sisters
Leslie and Rainie
Both Diabetic Alert Dogs

“What does diabetes feel like?” This is a crucial question when you’re caring for, or dealing with diabetes, and its life-impact. If you have your own experiences, please comment, so that more of an understanding can be shed.”

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Sometimes Rainie’s nose amazes me! I was driving past the kids’ playground to get to the part of the park we hike in every morning when Rainie uncurled from the floorboards, and frantically began smelling the wind coming through the open window. She was obviously in some distress, so I pulled into the parking lot, leashed her, and let her out. She immediately led me to the play area, and began alerting on a little girl who was running up the slide with a pink pump clipped to the back of her pants. Little pink-sweatered arms soon encircled Rainie, as I talked to “Emma’s” mom. Yes, her blood sugar was low (65), after having refused to eat breakfast. As Emma’s mom and I talked, she mused, “I wonder what it feels like for her when she goes high and low?”

This is a question I’m often asked, “What does it feel like?” It’s taken me a long time to figure out how to explain the answer . I’ll try to describe how it feels to me. (Please remember that I’m describing this as an adult diabetic. When I was young, I had the same feelings, but no words to describe them with.) And as I describe the differences between ‘low’ and ‘high’ blood sugar, please realize that a diabetic often fluctuates between the two states many times a day due to the nature of diabetes.

Low blood sugar, or hypoglycemia, might be fun if it weren’t so scary and disorienting. Hypoglycemia is potentially life threatening because the brain’s only fuel-source is sugar, and with too little sugar, the brain cannot function properly. Therefore, most of the sensations of low blood sugar are brain-based. If my blood sugar (BS) is dropping slowly, the symptoms may be unnoticeable at first and slowly become stronger;  and if my BS is falling rapidly, I catch the symptoms as soon as I can. The first symptoms tend to be a general ‘fuzziness or blurriness’ in my thinking and perception. It is very easy to not even realize anything is wrong, and slowly become agitated and frustrated because ‘things just aren’t right’. I may also get very cranky or whiny.  One of  the most aggravating symptom of low blood sugar is frustration.  I like to describe it by saying, “On a scale of ‘one-to-ten’ my frustration tolerance is ‘a negative-three’.”  It gets in my way of dealing with every aspect of life, including my ability to make decisions that involve taking care of myself.  Everything becomes annoying – kids, traffic, choices, loved-ones (and others), work, my low blood sugar alert dog, etc.  I often figure out my blood sugar is falling because I’m so easily frustrated.  Living in this frustrated state is especially infuriating on those days when my body is extremely sensitive to my insulin, so I’m dealing with low-blood sugars for many hours at a time.  These periods of insulin sensitivity often happen for no reason I’m award of, and cannot be planned for or avoided.  When they do happen, it’s difficult to be patient while taking care of myself, and dealing with others.  I can only imagine what it is like for other people having to be around me! As my BS continues to drop, my thoughts and reflexes get slower and slower, and my coordination becomes poor.  It becomes more difficult to understand conversations and new ideas. I may also make relatively impulsive decisions. These are the times I’m glad I have my low blood sugar alert dog, Rainie. Her alerts keep me from doing things (like driving) when I’m still feeling ok, but could easily put myself, or others, in danger. (I am not drunk – although I may look that way.) As the blood sugar continues dropping, I become physically unstable, emotionally fragile, and easily overwhelmed. I’m dizzy, clumsy, disoriented, teary, sensitive to light, easily confused, and unable to make up my mind (which is really bad because it means I can’t even decide what I want to eat in order to correct the situation). Even though my lips and fingertips may be numb and my vision may be blurry from the low blood sugar, I get angry when people begin to question me and offer help – often becoming defiant. And I need help! And at the same time, I’m somehow unable to take care of myself. And I’m scared! If things were to continue, there is a good possibility I would become unconscious, go into ‘shock’, and, in the worst-case scenario, die.

The symptoms of high blood sugar, or hyperglycemia, are much more physical than low BS’s are. The first thing I notice is a deep headache. Then I get thirsty and agitated – very ‘squirmy’ and unable to concentrate and be still. I crave water to try to dilute my sugary/syrupy blood. I’ve noticed my tongue feels like it’s a dry cotton-ball sometimes. Then, my body begins to ache. Every part of me feels toxic, as if I’ve got the achiness of the flu. I don’t want to move because it feels ‘too hard’ – like walking through mud. And my brain feels that way too. Sometimes I just want to curl up in a dark, cool room and not move. If my BS gets high enough that I begin to ‘spill ketones’, I can get very nauseated and vomit. High ketones are poison to the brain. I’m also very sensitive to the fact that a few hours after high BS begins, my vision gets blurry because the sugar in the blood makes the lenses of the eyes swell.

High blood sugars can be very stubborn and not respond to extra insulin the way low blood sugars respond quickly to sugar. Often, with high BS, the body is resistant to the insulin because of adrenaline released as a protective mechanism by the liver. This can happen as a response to low blood sugar, exercise, excitement and all sorts of emotions like fright/fear, crying and laughter. And at other times, I am extremely sensitive to my insulin and am ‘low’ for hours on end and have a hard time bringing my BS up. Frustratingly, sometimes blood sugar control seems impossible, as if it’s influenced by the weather or color of socks I’m wearing – there seems to be no rhyme-nor-reason to it. Unfortunately, even though it may only take a few hours for the blood sugar to ‘get back under control’ with either insulin (for ‘highs’), or sugar (for ‘lows’), it takes many hours for the cells in the body (and the emotions) to get back into balance.

It’s easy to get wrapped up with the severity of diabetes. But it’s a part of life, just like joy, laughter and friends.

Life with diabetes is a true seesaw. High and low blood sugars happen. It’s part of living with the disease.  If you have diabetes, or know someone with diabetes, please be patient, and be present. We all have ‘one of those days’ occasionally; unfortunately, for someone living with diabetes, ‘those days’ happen almost every day.

Please help me explain what it feels like for you – whether you’ve got diabetes, or are part of the community that knows and supports someone with diabetes. ~h

What does it feel like? (Diabetes Blog Week Con’t)

Today is day 3 of the Diabetes Blog Week, and the question of the day is, “What is one thing you would tell someone who doesn’t have diabetes about living with diabetes?”  I’m going to repost this blog I wrote a couple of weeks ago in response to a question that each of us with diabetes has been asked.  (Being a nurse, I’m asked it professionally as well as socially.)  The question is, “What does it feel like?”

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IMG_2620 Sometimes Rainie’s nose amazes me! I was driving past the kids’ playground to get to the part of the park we hike in every morning when Rainie uncurled from the floorboards, and frantically began smelling the wind coming through the open window. She was obviously in some distress, so I pulled into the parking lot, leashed her, and let her out. She immediately led me to the play area, and began alerting on a little girl who was running up the slide with a pink pump clipped to the back of her pants. Little pink-sweatered arms soon encircled Rainie, as I talked to “Emma’s” mom. Yes, her blood sugar was low (65), after having refused to eat breakfast. As Emma’s mom and I talked, she mused, “I wonder what it feels like for her when she goes high and low?”

This is a question I’m often asked, “What does it feel like?” It’s taken me a long time to figure out how to explain the answer . I’ll try to describe how it feels to me. (Please remember that I’m describing this as an adult diabetic. When I was young, I had the same feelings, but no words to describe them with.) And as I describe the differences between ‘low’ and ‘high’ blood sugar, please realize that a diabetic often fluctuates between the two states many times a day due to the nature of diabetes.

Low blood sugar, or hypoglycemia, might be fun if it weren’t so scary and disorienting. Hypoglycemia is potentially life threatening because the brain’s only fuel-source is sugar, and with too little sugar, the brain cannot function properly. Therefore, most of the sensations of low blood sugar are brain-based.

If my blood sugar (BS) is dropping slowly, the symptoms may be unnoticeable at first and slowly become stronger;  and if my BS is falling rapidly, I catch the symptoms as soon as I can. The first symptoms tend to be a general ‘fuzziness or blurriness’ in my thinking and perception. It is very easy to not even realize anything is wrong, and slowly become agitated and frustrated because ‘things just aren’t right’. I may also get very cranky or whiny.  One of  the most aggravating symptom of low blood sugar is frustration.  I like to describe it by saying, “On a scale of ‘one-to-ten’ my frustration tolerance is ‘a negative-three’.”  It gets in my way of dealing with every aspect of life, including my ability to make decisions that involve taking care of myself.  Everything becomes annoying – kids, traffic, choices, loved-ones (and others), work, my low blood sugar alert dog, etc.  I often figure out my blood sugar is falling because I’m so easily frustrated.  Living in this frustrated state is especially infuriating on those days when my body is extremely sensitive to my insulin, so I’m dealing with low-blood sugars for many hours at a time.  These periods of insulin sensitivity often happen for no reason I’m award of, and cannot be planned for or avoided.  When they do happen, it’s difficult to be patient while taking care of myself, and dealing with others.  I can only imagine what it is like for other people having to be around me!

As my BS continues to drop, my thoughts and reflexes get slower and slower, and it becomes more difficult to understand conversations and new ideas. I may also make relatively impulsive decisions. These are the times I’m glad I have my low blood sugar alert dog, Rainie. Her alerts keep me from doing things (like driving) when I’m still feeling ok, but could easily put myself, or others, in danger. (I am not drunk – although I may look that way.)

As the blood sugar continues dropping, I become physically unstable, emotionally fragile, and easily overwhelmed. I become dizzy, clumsy, disoriented, teary, easily confused, and unable to make up my mind (which is really bad because it means I can’t even decide what I want to eat in order to correct the situation). Even though my lips and fingertips may be numb and my vision may be blurry from the low BS, I get angry when people begin to question me and offer help. And I need help! And at the same time, I’m somehow unable to take care of myself. And I’m scared!

If things were to continue, there is a good possibility I would become unconscious, go into ‘shock’, and, in the worst-case scenario, die.

The symptoms of high blood sugar, or hyperglycemia, are much more physical than low BS’s are. The first thing I notice is a deep headache. Then I get thirsty and agitated – very ‘squirmy’ and unable to concentrate and be still. I crave water to try to dilute my sugary/syrupy blood. I’ve noticed my tongue feels like it’s a dry cotton-ball sometimes. Then, my body begins to ache. Every part of me feels toxic, as if I’ve got the achiness of the flu. I don’t want to move because it feels ‘too hard’ – like walking through mud. And my brain feels that way too. Sometimes I just want to curl up in a dark, cool room and not move. If my BS gets high enough that I begin to ‘spill ketones’, I can get very nauseated and vomit. High ketones are poison to the brain. I’m also very sensitive to the fact that a few hours after high BS begins, my vision gets blurry because the sugar in the blood makes the lenses of the eyes swell.

High blood sugars can be very stubborn and not respond to extra insulin the way low blood sugars respond quickly to sugar. Often, with high BS, the body is resistant to the insulin because of adrenaline released as a protective mechanism by the liver. This can happen as a response to low blood sugar, exercise, excitement and all sorts of emotions like fright/fear, crying and laughter. And at other times, I am extremely sensitive to my insulin and am ‘low’ for hours on end and have a hard time bringing my BS up. Frustratingly, sometimes blood sugar control seems impossible, as if it’s influenced by the weather or color of socks I’m wearing – there seems to be no rhyme-nor-reason to it.

Unfortunately, even though it may only take a few hours for the blood sugar to ‘get back under control’ with either insulin (for ‘highs’), or sugar (for ‘lows’), it takes many hours for the cells in the body (and the emotions) to get back into balance.

It’s easy to get wrapped up with the severity of diabetes. But it’s a part of life, just like joy, laughter and friends.

Life with diabetes is a true seesaw. High and low blood sugars happen. It’s part of living with the disease.  If you have diabetes, or know someone with diabetes, please be patient, and be present. We all have ‘one of those days’ occasionally; unfortunately, for someone living with diabetes, ‘those days’ happen almost every day.