Tuesday, August 21, 2007


"Mom," Joseph calls out suddenly from the back seat, as we finally begin the long drive home from camp.

"I want to be more responsible for my diabetes care."

"What do you mean, Bud?"

"You know, like do my own set changes."

I catch a glimpse of his earnest expression in the rearview, and am struck with an odd mixture of pride and sadness.

"Really? Are you sure you want to do those yourself-- the insertion, too?"

"Yeah, I do-- not alone, though... I mean... I want you to guide me through it and just... you know... be there."

"Sounds good to me," I tell him, the words catching in my throat.

Soon after his quiet declaration, he's sound asleep....

And then - two nights later - it's time for a set change.

Sitting at the kitchen counter, I pull out his supplies: a new cartridge, infusion set, an alcohol pad, IV prep, IV 3000 tape-- and a small vial of insulin.

Just as I'm about to tear cellophane, Joseph walks into the kitchen.

"No, wait-- Mom, I really want to do this myself.

"Oh-- sorry, Bud."

He drops down into the seat next to mine, and I hand him the cartridge, still in it's wrapper.

And then I take a deep breath and watch-- literally having to sit on my hands in order not to jump in and help him.

"That's it, just smack the cartridge with a pen to get the air bubbles out and- you're doing great, but slow down... take your time."

"I know what I'm doing, Mom," he says calmly, while turning the filled cartridge between his finger tips, looking for bubbles. "I've seen you do this like a million times, and I even did it at camp. It's okay."

And he's right.

Within five minutes, he's done.

"Terrific job, Bud," I say smiling.

"Thanks," he responds with a grin. Then he stands and is about to leave the kitchen when he suddenly turns toward me, holding up his left hand.

I slap it with my right, and for a moment, the tops of his fingers hold onto mine.

And then he's gone.

That was over two weeks ago, and since that day Joseph hasn't looked back -- hasn't asked me to do a single set change-- even when he's been tired or has had a friend over.

He just does it.


I'm so dang proud of him.

But at the same time, sadder each time I sit and watch him do this.

Crazy, isn't it?

After all, this is what I want for him-- I want him to be able to do this stuff on his own.

But still.

The endless set changes, the monitoring, the trying to interpret the numbers-- trying to discover what his body is doing -- the supplies-- God, all those supplies -- keeping track, paying for them -- and always, always being prepared...

At some point, he's not going to need or want me to do any of it for him-- he'll carry this burden alone.

And to be honest, I'm having a hard time dealing with that fact.

Sunday, August 19, 2007

Three Years

Some days -- especially on this one -- it doesn't feel like all that long ago that he didn't have this thing.

Ryan says he has a hard time remembering. Joseph never talks about it-- the way things were back then.

Still, I can't seem to forget.

Thursday, August 16, 2007

So... Camp

For a moment, I look out across grass and trees and paths that lead to one-story camp buildings and cabins, and -- turning upward -- at a sky so perfectly blue that it doesn't seem real.

Then I walk forward and hand my "receipt" to the young blonde woman sitting at the check-in table just inside the campground.

"I'm here to pick-up my son," I say-- feeling both excited that I'm finally going to see him and nervous that something might have gone wrong.

"Terrific! Here you go," she says, handing back a piece of paper. "Just give this to his camp counselor, and you'll be all set."

I thank her, walk forward a few steps, and notice half a dozen tables set up in the grass just beyond the entrance.

Tables covered with swag.

Brightly-colored toys, bracelets, and bags; shiny-new One-Touch Mini glucose meters (in three new colors!), and stacks of white boxes containing Accu-Chek Multiclix lancet devices.


Without hesitation, I make a beeline to the Accu-Chek table and snag a free Multiclix before making my way to the far side of the camp-- to Joseph's cabin.

Strange... I don't see any other parents roaming around... hmmm... I know it said checkout was at 9am.

When I reach Joseph's cabin, I hear loud voices, whooping and laughter, but immediately after I open the door-- nothing.

"And the crowd... goes silent," I say with a grin, as I step into the room.

And then I notice the slightly disappointed look on my son's face.

"Ahh... hey, I can come back in a little while. I haven't even looked at the lake ye- "

"No, no, Mom-- that's okay, you can come in," Joseph tells me with a smile that says he's glad to see me.

"Yeah, yeah," say a number of boys, who are now smiling too, "c'mon in."

And then everyone is talking at once.

"We got the award for catching the most fish!" yells a dark-haired boy with large blue eyes, before dropping to the floor -- into a perfect lotus position -- and proceeding to "walk" around the cabin on his knee caps.

"Mom, I got the comedy award," Joseph says at the same time, "And I swam every day- oh, and you should have seen me in the mud pit-- I was completely covered in mud! And Tommy lost his shoes in there-- Mom, it was awesome!"

"Yeah, the mud pit was so cool," adds a tall, curly-haired boy, "I popped my knee caps like three times!"

Then several boys shout in unison: "Listen to this!"

Suddenly, I'm surrounded by eight adolescent boys -- my son included -- cracking knuckles, toes, elbows-- and God knows what else.

"Impressive..." I say, nodding and smiling at them all.

"Look- look at this," a boy with shaggy brown hair calls out, as he holds up his right hand and bends his finger tips so that they're perpendicular to his fingers.

"Ah yes, that is cool-- no doubt," I tell him, "but can you do this?"

And then I show them all my trick left thumb-- spinning and bending the thing at impossible angles.

"Wow... " they all cry, eyes wide.

"Excuse me," the boy's counselor interrupts -- my thumb in mid-spin -- "if you'd like to speak with the cabin nurse, she's ready for you in the common room."

I'd almost forgotten.


And so I return to the big comfy chair-- again sitting across from that kindly grandmother, her blue eyes bright and shining.

"Oh, Joseph had a wonderful week, just wonderful. And he was such a good friend to Tommy."

"Terrific. I'm so glad," I say.

Silently praying that his sugars were just as wonderful.

"Now, Joseph had some highs," the nurse begins, "and last night he was very high," she continues, sliding his log sheet across the table.


That's the first thing I see.

I swallow down hard, then look at the rest of it.

478 at 9pm, and 1.85 units of insulin; then HI at 11pm-- when he got a set change and 3 units of insulin via syringe.

Dang, that's a lot of insulin!

An hour later his blood sugar was 289.

He'd dropped over 300 points, and his 11 o'clock correction had not even peaked.

They didn't check him again until 8am.

No 2:30 check.

I quickly scan the rest of the log.

Not one check after midnight during the whole week.

Not one.

And immediately I see the pattern-- meal boluses, snack boluses, corrections-- all stacking before bedtime.

Midnight blood sugars that alone seem fine, but if looked at alongside the highs at bedtime show a dramatic downward trend.

And then, morning highs-- rebound highs from overnight lows.

The Somogyi Effect.


"But why wasn't he checked at 2:30-- like we talked about on Sunday?"

"Oh dear--well, the camp doctor felt that it wasn't necessary-- and you see, Joseph did just fine."

Yes, he did, but my God-- what could have happened?

I keep it together-- resolving to speak with the camp doctor before next year.

To make this work.

And then I rejoin the boys.

Just in time to referee a game of "hot potato."