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Posts tagged ‘hypoglycemia’

“I Told You So!”

IMG_1227If 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!”  

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A Mother’s Letter (and, An EAC Success Story)

Laura and Darwin

Laura and Darwin

Early Alert Canines has just finished another team training where two adults with diabetes were placed with blood sugar alert dogs, as well as one family with a four year old daughter with diabetes.

The young family has been home with their dog, Darwin, for almost one week.  Face Book postings are telling the wonderful story of how Darwin is reveling in his job of alerting to high and low blood sugar changes.  Sometimes when a dog first goes home with his new partner, it takes a while for the dog to adjust to the new routine, new people, and new environment.  NOT DARWIN!  In the few days he has been in his new ‘forever home’ he has alerted the mother of his new young charge, Laura, at pre-school, at home, during soccer practice and during dance class.  Good boy, Darwin!

I would like to share this ‘post’ written by Laura’s mother, explaining how difficult it is to regulate a young child’s diabetes, and what a gift Darwin has already been in their lives:

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It was brought to my attention that with all the posts recently about how great Darwin is at helping us manage Laura’s type one diabetes, as well as posting about highs and lows, that people might perceive it that we didn’t have control without him. First of all, T1D Managment is an art, not a science. The body is always changing and so do insulin needs. When Laura is getting sick, we know ahead of time from wacky numbers. When she’s stressed, we can tell from the numbers. We are constantly changing insulin ratios to try to match her insulin needs. As you can imagine, it’s a daily battle that is hit and miss. Large swings in the numbers is normal, while not ideal. One has to be most concerned about lows and chronic highs.

Prior to having Darwin we would have to rely on trying to read the signs of highs and lows from Laura’s behavior and mood. She’s 4. Sometimes a 4 year olds behavior is similar to a diabetic having a low. With Darwin, he smells a difference and he can let us know. Laura can tell us if she’s low if she’s relaxed. But in the soccer situation, she showed no visible signs of a low nor did she mention anything. Darwin helped us intercept that before it got very dangerous.

We have also used a continuous glucose monitor that works with her pump. The CGM can give us an indication if she’s on the way up or down. It’s not 100% accurate and there are delays in the readings. There is a 20-30 minute lag time generally. Darwin will, in most cases, be able to catch a low before it happens. The CGM is also one more piece of equipment Laura has to have punctured into her. As a mom, if I can get similar or better information from a black fuzzy doggie rather than a sensor stuck in her I will use the dog.

That being said, new technology is always in the pipeline for T1D management. When the new stuff comes out, Laura will have it.

In future posts I will be more clear about how Darwin has changed the way we handle things.

Type one diabetes sucks. I will use anything and everything to make sure Laura is as happy and healthy as she can be. For now and for ever.

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T1D means Type 1 Diabetes.

Type 1 diabetes (T1D) is an autoimmune disease in which a person’s pancreas stops producing insulin, a hormone that enables people to get energy from food. It occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, called beta cells. While its causes are not yet entirely understood, scientists believe that both genetic factors and environmental triggers are involved. Its onset has nothing to do with diet or lifestyle. There is nothing you can do to prevent T1D, and—at present—nothing you can do to get rid of it.  (Juvenile Diabetes Research Foundation)

A person who has been diagnosed with T1D must take insulin in order to say alive.

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

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”?

IMG_2538When 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

IMG_2530I’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.”

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.

 

 

February Edition of the Early Alert Canines “The Scentinel”

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http://library.constantcontact.com/download/get/file/1108404407988-37/February2013.pdf

Welcome to the 3rd edition of Early Alert Canine’s “The Scentinel”.

For some reason, seeing the newsletter in print makes me reflect on what we/EAC have accomplished in the two years and three months since the initial group of us first sat around a kitchen table to begin visualizing what we wanted Early Alert Canines to be.  (We even needed a name.)

We knew we wanted to create a non-profit organization to train and place low blood sugar alert dogs with adults with diabetes, as well as families with young diabetic children.  And we wanted to be far-reaching in the clients we serve. Thus far, in our first year of placing these life-saving dogs, we have graduated 5 certified teams, with three more graduating in March.  We have teams in Oregon, Los Angeles and throughout the bay area.  There are also 3 teams with families with diabetic children – thus far.

A training center was needed.  What a chore this was.  And we did it!  We’ve created a beautifully remodeled site, not far from a large shopping mall, public transportation and San Francisco.  The location provides many of the learning opportunities needed for training the dogs and teams.

Our trainer wanted to continue the research needed in training diabetic alert dogs, and provide documentation of her process.  Even though Carol had previously trained and placed over 60 DADs, the opportunity to train these dogs for families with very young children was new.  Needless to say, large strides have been made in this area.

Of course, there was, and is, the continued need to develop the non-so-obvious infrastructure that an organization requires – office work, applications, work, outreach, fundraising, developing our reputation, attaining dogs, etc., etc………
Thank you for coming along for the ride.   Please enjoy the newsletter!