Highs and Lows

I've posted a lot on diabetes recently and with good reason: having Mary Hannah's condition in the mix is a big change. Overall, her blood sugar readings have been more consistent and predictably reactive to insulin. For instance, if we give her 1 unit of insulin, her blood sugar levels respond pretty consistently by lowering her BG by about 100 points, or covering 25 carbs eaten. Ethan, on the other hand, continues to be an unpredictable roller coaster ride. 1 unit of insulin may have no immediate discernible affect on his BG or it could, who knows. We're looking forward to seeing how he responds to a new pump in a few weeks.

On the behavioral side of things, MH is still adjusting to being diabetic. Not long ago, when her after-school BG reading was really high, she admitted to having a snack at school, but instead of choosing candy, she made a healthy choice: an orange. (For those of you who are confused at this point, oranges and grapes are the two fruits with the highest natural sugar content. A 6 oz orange has about 2o carbs worth of sugar in it, versus a candy like a Jolly Rancher, which has 5 carbs).

Anyhow, I was a little concerned after learning that a few days ago. MH had a cookie at school. She'd figured out how many carbs it had and gave herself a shot to cover it. While I am glad that she is taking the initiative to learn how to do all of this for herself, I'm still not comfortable that she is attentive enough to all the complexities (how much active insulin she has in her system, whether she's been exercising, if she is ill, etc) to be able to do it all without a knowledgeable adult to oversee the procedure. So, I told her that I was proud of her for taking care of herself and that her mommy and I want her to do that, but we still want to be 100% sure that everything is exact, so in the future, if she has the opportunity to have an extra snack at school, to call one of us and verify things before she goes through with it. She agreed to do that.

Fast forward a few days: MH calls me and says, "Daddy, they had some candy at school and I wanted to have some, too. It is a Jolly Rancher and I looked it up, it has 70 carbs. Can I have it?" Now, I remember these types:
but the ones I see most often are a little smaller:

So I said, "Mary Hannah, 70 carbs is a lot of candy, are you sure?"
MH: "Yes, I looked it up."
Me: "Baby, I believe you looked it up, but 70 carbs is a lot for a snack, how about if you save it for lunch time and I'll double check it when I come to give you insulin for your lunch?"
MH: "Dadddddyyyy... please? Everyone else got one. Please? I want it."
Me: "Baby, I know you do, and I'm very glad that you called me to check, but now I need you to trust me and obey, even when you really, really want it. I think that is too much and I am not saying you can't have it, just that you can't have it right now. You need to obey me and wait for just a while."
MH: "I have to get off the phone now, daddy. Please can I have it?"
Me: "No, I'm sorry, but you really need to wait for me. I promise we'll look it up and it can be part of your dessert for lunch."
MH: (sighing) "Okay. Bye."

As it turns out, when I got to lunch, I looked it up in her Calorieking guidebook, she'd been looking at the calories, not the carbs. It was 70 calories and about 5 carbs (the small, assorted kind). If she had given herself 3 units of insulin to cover 70 carbs, her BG would have dropped 300 points. That would probably have put her into seizures or worse. >shudder< I praised her for calling me to check in, as instructed. I told her how I was proud of her for obeying me even when she REALLY wanted the candy and for trusting that I just wanted her to stay healthy. She had a good lunch and got her Jolly Rancher for dessert.

Now, for MY feelings. First, I was was a little bit afraid when she called because I was 99% certain that she'd misread the information. I was glad that we'd had the talk a few days ago about calling to verify things. My heart is both joyful and pained about the situation, though. I am so proud that she was able to obey instead of giving in to the temptation to indulge. It may not sound like a big thing to those of us who can process sugar with no side-effects (spare tires and assorted flab notwithstanding). But I am reminded of a friend who told me about a time when her adolescent son was at a camp one time and all the boys were segregated for talk about "girls and temptation". They passed out slips of paper and asked the boys to write down the thing that tempts them most. Other boys mentioned different female body parts, or flirtations. Her son wrote: "Sugar". So I'm proud that she resisted the temptation to have unauthorized sugar, the temptation to disobey her daddy. However, my heart breaks again when this stuff happens and I am reminded that my baby has to worry about something like this. I hate diabetes.

Thank you, Lord, for the abundant blessings. You surround me all day long with your love and keep my cup full to overflowing. I am assaulted by bitterness when I think about the ways that you want to bless me with diabetes. You give me an everpresent sense of reliance on you for strength. You give me empathy to reach out to other families who are stricken with chronic illness and to comfort them and strengthen them. You help me to overlook obstacles that would weigh down other families because they have not walked where you have caused us to walk. But Lord, oh, Lord... when will you take this disease away from my babies? When will you heal them of their infirmaties? I am aware of both blessing and curses, suffering and healing, but I admit, I don't always understand what I am supposed to feel about these things. Be with my children, your children, and help them grow strong in you, oh God.

Cinderella

So, the other day, Eleanor got a chance to go to the Ballet with Nana and Papa. She had a special dress that she wore and had a great time experiencing "Cinderella" Thanks, Ballet Abilene!


The next day, Ele wore her dress to church and afterwards, I got her to pose for me outside. Enjoy the photos. She is my wonderful princess.

Narcissism, Celebrity Apprentice and Me.

Recently, I read a humorous story in Time magazine by Joel Stein (LINK). It got me thinking a little about how self-involved we all are, and what part society plays into this phenomenon. Dr. Pinsky's results indicate that celebrities are more narcissistic than the general population. So, do they influence us to be more narcissistic or do we feed into their narcissism?

This got me thinking about reality shows where, despite the labeling, reality is not displayed. Between behind the scenes manipulations and producer's wrangling of the circumstances and the editing process to play up the drama and tension, I doubt we get much of a sense of the "real" person, even on reality shows. This past week's Celebrity Apprentice (LINK) was a great example of the product of narcissism in celebrities. While I have to give Joan some credit for her turnaround in her behavior toward Clint Black, her initial responses toward ANYONE that she doesn't like are grounds for dismissal if she weren't a celebrity. Her name-calling and visceral personal attacks are unwarranted and immature. Melissa Rivers seems to have been burdened by some past experiences in High School and I agree with her assessment of being blocked out by Annie and Brande, but c'mon..... how personally are you going to take that?

If you can't take losing at least as well as Andrew Dice Clay or Rodman... well, Melissa, you deserve the public lashing you'll take for your behavior. NOW..... back to the narcissism discussion... do my remarks feed back into how we "socialize" our celebrities to make them narcissistic?

Here are the DSM Criteria for Narcissistic Personality Disorder:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. has a grandiose sense of self-importance
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is "special" and can only be understood by, or should associate with, people (or institutions) who are also "special" or of high status.
4. requires excessive admiration
5. has a sense of entitlement
6. is interpersonally exploitative
7. lacks empathy
8. is often envious of others or believes others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes

I think I've witnessed at least 5 of those criteria in ALL of the Celebrity apprentice contestants at one time or another. Freud would have a field day with this crowd. And the king of them all: The Trump. Thanks for a fun, show, boss.

Take the Narcissistic Personality Inventory! Post in my comments how you did!

(I scored 14)

-jeff

In Memoriam: processing the death of a friend.

Meagan Len Holder, 1991-2009, 17 yrs

Last Thursday morning, I was making breakfast for the kids when I got the phone call. One of my kids from Gorman (a youth group I'd worked with)had been in a car wreck. She'd died en route to the hospital, in a medi-flight helicopter. I was not able to really process the information. I thanked Mr. Laminack for calling and letting me know and then I went back to cooking eggs.

Shock

That is the process by which your brain protects you from emotions that threaten to overwhelm you. Learning of the death of a loved ones typically triggers it. Over the course of the day, I began to absorb the enormity of the information. Meagan is dead. I began to go over memories I had of her. To be quite honest, I hadn't seen her for a few years. My contact with her had been limited to a few online chats or instant messages on MySpace. I knew she was excited to be a senior and was looking forward to graduating. To learned she'd been killed in a car accident... wow...

Later that morning, I got a call from her father. Despite the past 4 years of working as a chaplain at the hospital and the hundreds of families I had walked with during the final hours of a loved one's life... I didn't have any words for him. Our conversation was short, he asked me if I would be willing to speak for her at the funeral. I agreed and he said he'd let me know the details as soon as they got her body back from Ft. Worth.

In the midst of all of this, I looked to my oldest daughter, Mary Hannah. 7 years old (almost 8!). In 10 years, she will be 17, on the cusp of adulthood, ready to strike out and blaze her own trail. The following day, Friday, I was sending her with her grandparents to California. They were going to meet up with their cousins for a day at the beach and a few days at Disneyland, the ultimate memory making trip. Nana and Poppa had been planning this for months and although we were initially reluctant (a bit jealous, maybe) to let her know, we knew she would have the time of her life. This day, though, my thoughts were only on picking her up from school and holding on to her with all my strength.

I think losing a child to illness or to some random tragedy is perhaps one of the most difficult things a parent can experience. It feels more acute if you lose a child when they are young, but losing a child at any age, infant to adulthood, just feels wrong.

The funeral was very well attended. It seemed like most of the town of Desdemona, where Meagan was born and grew up, and De Leon, where she attended high school, had turned out. Many of Meagan's friends honored her by duplicating one of her trademarks: boots with the leg of the pants tucked in. Stories were shared and memories affirmed. Meagan will be missed by her friends. She'll be mourned by her family. Nothing will ever be the same for them, but in time, it will be okay again. Death does that. Here are links to her obit: CLICK HERE and to the Eulogy I delivered: CLICK HERE.

After the interment, I was waiting patiently as people came by to shake my hand and thank me for speaking for Meagan on behalf of her family. My phone rang, vibrating impatiently in my pocket. Stepping away from the funeral crowd, I saw it was my daughter calling on Poppa's phone. "DADDY! I'M IN THE OCEAN!" Without waiting for me to say more than, "hi", she shouted at me over the roar of the surf. She's never been to a beach, much less the Pacific. She told me about seaweed as big as she was and sand castles and waves and getting saltwater in her mouth. I managed to get in a few questions and exclamations before she signed off, "I gotta go, Daddy. I can't hold the phone because I'm all WET!" And then she was gone. I was smiling again. Until I turned around and saw the coffin, waiting for the crowd to leave so it could deliver it's lone passenger to her grave.

I walked back over to the Holders and asked, "Are y'all about exhausted? I'll bet you're tired of everyone telling you how sorry they are. No matter how sincere and well meaning they are, there comes a point in your grief where you really just wish everyone would love you from over there." Donald Wayne nodded. Stephanie thanked me for the eulogy and I gave Jeremy a hug. Then I took my own advice and took my leave of the family.

The drive home took an hour or so and I listened to music on my iPod. I called a girl from my Enid youth group who is also 17 and about to graduate because I felt melancholy. We chatted for a few minutes until I lost the cell signal. When I got home, Ethan and Eleanor ran to greet me at the door. "Daddy! You're home!" I wrapped them up in a big bear hug and smiled.

Meagan is still dead.

I'll be okay again soon.

St. Patricks Day poem for ya

The Wish

I caught a little leprechaun,
quite wise and very old and he said to me,
"You have one wish,
would you like my pot of gold?"

"No thank you," was my quick reply,
"But how about another...
A gift that's truly precious
and esteemed above all others?"

He offered then some emeralds,
rubies, sapphires, pearls
and a host of other treasures
that would make your senses whirl!

As I rejected all his list
his bright eyes flashed with fire
and, angrily, he said to me:
"What is it you desire?"

I said:

"A rainbow's far more beautiful
than its' supposed treasure
and the 'rainbow' that I'm wishing for
is priceless beyond measure.

"I'd like to have the dearest friends
a person ever had
to share in all the good times
and help me through the bad...

"To laugh and sing and joke with,
love and appreciate
as we live life's greatest adventure
that would certainly be great!"

"Oh, now I know you're daft!" he said
as he ran off with his pot...
"to waste your wish on something
you have already got!"

~Author Unknown~

retrieved from: This Website

-jeff

Celebrity Apprentice

I'm not a huge fan of the reality show genre, but I took notice of a promo for Celebrity Apprentice. What caught my attention was the personalities represented on the show, most notably Andrew Dice Clay and Jesse James. Clay represents, to me, a very low class form of entertainer. Not only do I dislike his humor, but his personality. So, I was very pleased to see he was the first celeb to be "fired" by Mr. Frump... er... Trump.
Jesse James, on the other hand, is married to Sandra Bullock. That is one point in his favor. Also, although I haven't watched his show, I have been very impressed with him on CA. He seems to have hidden strengths and I am interested to see how he'll do as Project Manager when his time comes.

What I haven't been impressed by on the show is the absolute chaos that ensues from each team during their projects. I am really surprised that they all are so conflictual. Very few of them seem to be able to communicate and almost all of them have self-images that are over-inflated and just waiting to be punctured by the Boss. Seriously, aren't everyday people able to talk in reasonable tones and without all the conflict or do I just live in a fairy tale world? I know that this show is 90% about ratings and entertainment, but I think it is also a remarkable social experiment putting the result of Hollywood-centric personalities in the spotlight.

For those of you who have watched the first few episodes, here are some observations:
1) I like Annie. I think she is quite possibly the best person on the Athena team. Joan Rivers carries her own self-importance as though she is afraid of breaking it.
2) I think that in the end, a female is going to win the overall competition. Team KOTU has too many disparate personalities. Despite his annoying manner and the conflict he created during Episode 2, I think they lost something in terms of creativity when Tom Green was fired last night.
3) I wonder how well the Donald would fare if he was put into his own messed-up reality program. He's done well by society's standards, but he seems to lack the same qualities that he flogs his contestants for not having.

Interesting. I look forward to seeing how the season progresses.

Narrative Exercise

One of my professors recently assigned us the task of externalizing an issue/feeling/hurdle that I am facing at present. We were instructed to describe it in visual or kinesthetic terms.

Diabetes is a constant companion for our family. It influences the activities we can participate in, what food we can eat, the time we can travel, the money we can spend, how we handle our health decisions, sometimes even how much sleep we are able to get each night. Like a cruel taskmaster, just when we began to be comfortable with Ethan’s insulin regimen, Diabetes attacked our daughter, Mary Hannah. Now, we are relearning the initial stages of the disease. Although very similar, Diabetes has manifested itself in very different ways in each of them. This causes anxiety for me and my wife as we have to treat them differently from each other in terms of how often they have to check their blood sugar, how much they can eat, what items they can eat (they have different foods that trigger higher than normal reactions in each of them). Also, Diabetes has also realigned the structure of our family system. Instead of Ethan being the one child getting the most attention because of his condition, with Mary Hannah and Eleanor feeling a bit neglected in terms of attention, now Eleanor is the odd child out, being the only one without a chronic medical condition that demands our vigilance. In our marital relationship, Diabetes sometimes sits between us and keeps us from having time alone because of our anxiety around child care for us to enjoy our alone time. For Ethan, although Diabetes is a dark monster that afflicts him, it is also a friend that made him special and now he shares his uniqueness with his sister. It is a bittersweet turn of events. For Mary Hannah, who has been “normal” up till now, she is dealing not only with the physical changes in her body, but the social ramifications of Diabetes. The unintended consequences of her disease have made her feel “weird” to her friends. She is the subject of intense curiosity and even a little fear from her classmates at school. Diabetes has teamed up with Depression and Anger to torment Mary Hannah when she tries to go to sleep at night and we often end up rocking her to sleep as she cries in our arms. Eleanor has enjoyed a privileged status as the baby of the family, but her coveted attention has shifted and she doesn’t like it. Diabetes laughs at our family and mocks us as we struggle to find normalcy in this difficult situation. Diabetes is an uninvited visitor in our home who refuses to leave. He’s unpacked and is here to stay. He frustrates us and constantly disrupts our daily living. We put up with him and go through the motions of placating him with blood offerings on test strips and ritual torture of daily injections of insulin. However, he has also brought us closer together as a family. We rely on each other to remind each other to check blood sugars, eat responsibly, exercise together and manage this disease.

The picture above is the plastic jar that we deposit used "sharps" or needles after we are finished with them.

By the numbers:
Average number of finger sticks done daily: 5 per kid. That's 10 lancets used. 10 test strips.
Times each month the kids check their sugar (based on 5 per day): 300
Cost per test strip: (before insurance) $1
Syringes used daily: 5-6
Infusion sites changed per month: 3-4
Amount of carbs consumed before having to get stuck again with more insulin: 25 (that is about half a peanut butter sandwich or 15 M&Ms)

Items that must be carried with the kids at all times in their insulin kits:
1) The kit bag containing all the supplies.
2) Calorie King guide to almost every food and how many carbs each contains.
3) Extra syringes
4) IV prep, alcohol swabs to prevent infection when giving injections
5) Writing tool used to keep a record of Blood Glucose and carbs eaten and insulin given.
6) Fast acting, bolus insulin. MH also has to keep her Basal Insulin with her.
7) Emergency Glucagon shot. If BG drops dangerously low and the individual is unable to take fast sugars orally, this shot chemically tells the liver to dump all the glucose it has stored into the bloodstream. It is designed to be injected through clothing into muscle. Extreme measure.
8) Glucometer to measure those pesky blood sugar readings.

-jeff