"Are you nervous, bud?"
"Nah, not really."
"Well, yeah. But I'm trying not to be. I want to save it up for tomorrow."
That was what Joseph said the night before his return to diabetes camp-- where last summer he'd gone swimming, boating, fishing, and played all manner of outdoor games with kids like him.
Kids who understood intimately what it was like living with diabetes.
Yes, it was awesome.
But, while Joseph could barely contain his excitement, I fought hard to stifle my anxiety.
You see, every time I thought about him at camp, I remembered the not-so-great things about last year's experience-- the out-of-control highs, the overnight accidents he kept hidden from his counselors and bunk mates.
Those painful blood sugar "shout outs" during which his numbers were always the highest.
And on that first day home-- his desire to abandon pumping and return to shots.
All of this happened in part because we pulled back his insulin dosages to avoid sending him low after the many camp activities-- and, because we assumed the camp doctor would make dosage changes if necessary.
Sadly, this turned out to be a bad assumption.
"Mom, do ya think I'll have some of the same kids in my cabin?" Joseph asks, as we pull into the camp parking lot just a couple of minutes past our scheduled drop-off time.
Man, I sure hope so . . . I didn't look into that. Hmmm. And dang it, we're gonna be late.
I look at Ryan, and right away he knows what I'm thinking.
I really want to spend some time with these people.
"It's probably not a bad thing if you're not the first person to meet with the medical folks in his cabin," he says with a smile that's both reassuring-- and slightly mischievous.
I don't get his meaning at first. But then, he continues:
"I mean, it's good they'll get the chance to warm up some before sitting down with you."
"What? Do you think I'm gonna be more of a challenge for these people?"
Now he's smiling broadly-- "Oh, Yeah."
And now I'm smiling too. The man knows me well.
Less than half an hour after our arrival, we're in Joseph's cabin-- and already, he's hangin' with his buds (two of which were in his cabin last year) choosing his bunk, and unpacking his gear. Ryan and Evan help him, while I take a seat in the common room opposite the nurse assigned to the cabin.
We review Joseph's basal rates, his insulin-to-carb ratios, and his meal plan.
"I guess we're all set then," she says with a smile, as she begins to close Joseph's folder.
"Actually, not just yet."
I take a deep breath.
"Now, because Joseph has a history of severe nocturnal hypoglycemia and nocturnal enuresis, he's gonna need to be checked at midnight and 2:30 AM-- every night. His endocrinologist put this information on Joseph's medical form and in a separate letter. And, I really just want to make sure that these checks happen."
She looks at me a moment.
"Well, we'll check him in the beginning and see how it goes, because often it's not necessar- "
"No, I'm afraid it is very necessary. Last year, Joseph wet the bed every night.
Prior to coming to camp, he hadn't had an accident overnight in months. And when it did happen at home, it was always because he'd had a sustained high blood sugar overnight."
"Well yes, but-- "
"And just last night, he experienced a hypo that kept him low -- despite repeated treatment -- for over half an hour. "
I pulled out Joseph's log and showed her the graph. Suddenly, she looked very concerned.
"Okay, this sounds like we need to make sure we check him. Some parents come in and tell us that they'd just like us to do the overnight checks and really, it's not necessary, but this is different."
At these words, the knot in my stomach -- almost miraculously -- begins to loosen.
It'll be all right this time.
For the next several minutes we review the sliding scale that Ryan and I put together for treating highs and lows overnight. When we're done, the nurse looks up at me and asks:
"Would it help if we got him up to use the bathroom at midnight? There are actually five other boys who wet the bed in this cabin alone. Their parents simply ask that we wake them to urinate at midnight . . . Hmmm . . . I wonder if it's because of high blood sugars for them as well. Though, it's probably just bed-wetting. Two of my brothers had that problem."
"Still, five seems like a lot of kids," I say. "It's hard not to think that it could be diabetes-related, don'tcha think? I mean, Joseph's endocrinologist has told me -- and I've read -- that this is a very common issue among diabetic children."
"Hmmm . . . Maybe."
Soon, I relinquish my seat to a another smiling, slightly nervous parent, and then I'm back in the next room with Joseph.
He is unpacked, and beaming.
Taking him aside, I quietly tell him that five other boys in the cabin will be getting up at midnight to use the bathroom-- and they'll wake him up, too.
"This is gonna be so much better than last year, Mom," he says, with an unmistakable look of relief.
"Hey bud, let's go down to the lake and check out the water before we leave."
Moments later, we're standing by a very still, very beautiful lake that is just one long set of wooden stairs below Joseph's hilltop cabin. Almost immediately, we spot a small frog between some tall reeds at the water's edge.
And Joseph almost catches it.
"That kid is gonna be catching frogs all week," Ryan says, as I stand next to him waiting (but not really wanting) to say goodbye.
Finally, Joseph asks if he can rejoin his friends in the cabin. We smile and tell him, "Sure." He gives us each a quick hug before bounding up those wooden steps-- two at a time.
Never looking back.