Staying motivated

Photo by Don Ricker photography

Sunday morning I was tired. Seems pretty normal right. It happens to all of us every once in a while. Just rest and you'll bounce back, right?

The problem was that like every Sunday morning, I planned to get on my bike. On Sunday mornings, if I'm able to ride outside I do, but for the last 3 months it's been indoors on a stationary bike trainer. Why do I do it? Simply put, life usually just makes more sense when I'm on a bike. It may be the monotony of riding indoors, but lately I'm finding it more and more difficult to pedal on Sunday mornings. I'd much rather just lay on the couch for a while or even sleep in. Given the number of people who eventually fail at maintaining any type of regular exercise regimen, it seems like what I am going through is to be expected. As humans, we have a hard time getting and staying fit. Consistency is the key. It doesn't need to be a 3 hour workout every day, just 20 minutes 6 days a week is often enough yet many people have a very hard time of making this a habit.

Managing Type 1 Diabetes is not much different. It requires a little work consistently throughout every single day (365 days a year). We spend 1 to 2 hours performing physical tasks required to manage Adele's Diabetes. That's between 7 and 14 hours per week. We cannot cram all this work into 1 day and then take the rest of the week off. Staying motivated is key...

So, if we look at the number of people actually able to stick to an exercise routine (or a healthy diet for that matter), it isn't surprising that so many people living with Type 1 loose motivation at times causing them to have sub-optimal control and eventually run the risk of developing long term complications. Is it possible to stay focused at all times while playing a game that has no time outs and never ends?

So after all this thinking, I got off the couch, got on my bike and started pedaling...

When it's all that you know...

Adele was diagnosed with Type 1 Diabetes on October 31st, 2002 at the age of 2 1/2 years old. Unlike her parents, she doesn't remember not having Diabetes. Needles, finger pokes, sometimes not being able to eat, sometimes being forced to drink juice and/or eat is really all that she has known.

As soon as we stepped out of the hospital in November, 2002, as parents, Adele's Diabetes has been our disease. She's 8 now (will turn 9 this spring) and it's our duty to teach her how to manage it so that she will one day become independant. She can check her own blood sugar. She can give herself an insulin bolus using her pump. She knows that if her blood sugar is below 4.0 that she is low and needs to drink a juice. And she knows that if her sugar is above 8.0 (or even 9.0 I guess) that she is high and may need an insulin bolus to bring this down.

We can teach her the rest of the theory and even a few of the tricks that we use to maximize our chances of coming out ahead while playing the Type 1 game. But we'll also need to teach her about the long term complications of Type 1 Diabetes - like renal failure requiring dialysis, blindness, amputation, heart disease. Right now she has no idea of what it really, really means to have Type 1. Tonight while changing her infusion site (catheter inserted under the skin) she looked at me and told me that I was lucky to not have Diabetes and that she wished that she was like me and her mom. Ouch. What could I say? I've so often dreamed of being able to transfer the disease onto myself... but I can't.

So I explained to her that this is the reason why we participate in the Telus Walk to Cure Diabetes each year, organize and ride in the Mike's Bike Shop Cyclebetes 200 ride for JDRF and why we do everything that we do to promote and support JDRF and help researchers find a cure to end all of this. And then I gave her a great big hug...

Increased insulin sensitivity

Adele started swimming lessons this past weekend. Every Saturday and Sunday morning from 10 to 11 am.

On weekends, she tends to sleep in a bit later, usually until around 7:30 - 8:00 am. This basically means that the insulin bolus to cover her breakfast is peaking 2 hours later, which is during the swimming lessons. Saturday, Adele's sugar was only 4.6 just before her swimming lesson and the 1.6 units that she had received for her breakfast was peaking. How much did she need to eat to avoid going low during her swimming? I guessed 24 grams of carbs (2 Fruit to Go bars) and her pump disconnected. I was very uneasy during the entire swimming lesson watching her from the grandstands. Other parents were relaxing drinking their tea/coffee and chit chatting while I was anxious hoping that Adele's sugar was good. I almost went to check her sugar half way through the course. I hate disturbing her that way and Adele hates it also.

Why was I so nervous? The first reason was that this was her first swimming class. I did not have any data to base my decision on. Some physical activities bring down Adele's sugar more than others. I really didn't know how "hard" they were going to swim and how Adele's sugar was going to react. The second reason is that for the past few days Adele has become more sensitive to insulin for some reason. The cold/flu that she had last weekend is gone, so the extra insulin needed to keep things in check during the illness is no longer needed which means that insulin scales need to be backed off. I have been gradually doing this for the past 4 or 5 days now but still was not sure that it was enough.

Adele's sugar was 5.8 after her swim, so my guesstimate was good. We won this time. But I still need to back things off even more. As you can see in the pic below, 2.7 before her bedtime snack tonight is way too low!

We'll try to get it right tomorrow... You've got to learn to be flexible when playing the Type 1 game !!!

Very busy week

Adele and Chris Jarvis at the support group Curling event

The JDRF Research Symposium was really interesting. Awesome I should say! Canadian rower and olympic medallist Chris Jarvis was very inspiring. As a lifelong athlete who can only dream of competing at this level, I have tremendous respect for anyone with enough talent and dedication to not only reach the olympic level but also win a gold medal. And on top of that have to achieve this while playing the Type 1 game. To me that is simply amazing! Chris Jarvis is a true hero and role model.

I was quite nervous doing my presentation at the symposium. I presented Islet transplant recipient Jason Turner. Apparently I didn't seem as nervous as I felt for those who were listening. I am very happy and proud to be able to contribute in any way possible to help find a cure for Type 1 Diabetes. Attending the symposium has also made me very, very motivated for our Mike's Bike Shop Cyclebetes 200 bike ride to cure Type 1 Diabetes on September 12th this year. I can't wait. It will surely be even bigger and better than last year!

I also had the chance to discuss with Chris about Continuous Glucose Monitoring (CGM). The Minimed pump has an integrated CGM. A sensor inserted in the skin continuously mesures glucose levels and a transmitter sends this data at regular intervals to the pump. A graph displaying these glucose values over time (in a 3 hour window) appears on the pump screen. The insulin pumping functionality of the pump doesn't take the glucose level into consideration when delivering insulin though, but you can set alarms that indicate low and high levels. It's not a pancreas, but it gives real-time values that you can use to better predict highs and/or lows. It's still very new technology and still needs to be tweaked in my opinion, but still very promising.

Last weekend Adele came down with a cold which caused her blood sugars to shoot up dramatically. She climbed to 23.2 from 6.9 in a few hours after lunch on Saturday. I had to be much more aggressive with insulin to bring these higher numbers down. I guesstimated on how much more she needed and we checked every hour for the rest of the day to see if it was enough or too much. Adele's cold got better as the week went on and as expected I needed to be less aggressive with insulin to avoid subsequent lows. That's how the Type 1 game goes, as soon as you get all insulin scales right, it all changes again and you have to start over. Thanks for reading...

JDRF Research Symposium

Sorry for the lack of posts in the past week or so...

I am looking forward to attending the JDRF Research Symposium here in Moncton on Thursday, February 12th. I am presenting one of the invited guests - Jason Turner. Here is my presentation speech:

Good evening! My wife Michèle and I are very passionate about being involved in any way that we can to help find a cure for diabetes and we are very moved to be part of this event tonight.

Our daughter Adèle was very sick in the summer of 2002. She started losing weight in the spring. She also had no energy and never wanted to play like other kids her age. After many tests and doctor visits, she was diagnosed with Celiac disease. I was also diagnosed with Celiac disease as well one month later. Then, one month after this, in October on Halloween day, 2002, Adèle was diagnosed with Type 1 or Juvenile Diabetes at the age of 2 ½ years old. Our world had been turned upside down. From that point on, our life has been a constant battle trying to balance her food intake and insulin while trying to maintain as normal a life as possible.

Adèle gets her blood sugar checked between 10 and 15 times a day and sometimes as much as 20 times if she is sick with a cold or a flu. She gets her insulin via her insulin pump. We change her pump infusion site every 3 days or more often if her sugars are high. She also sometimes gets insulin injections via syringe if her sugars are high before we change her pump infusion site to ensure she gets the full insulin dose to lower a high blood sugar. Since Adèle is terrified of the long needle that needs to be inserted under her skin when changing her infusion site, we apply a topical anesthetic cream on the skin in order to make the site change less painful. My wife Michèle gets up AT LEAST once each night to check her sugar to make sure she doesn't go low. Adele almost never wakes up when she goes low. It is a rude awakening to find Adèle’s sugar in the 2’s or even in the 1’s in the middle of the night scrambling to wake her up so she can eat some much needed fast-acting sugar.

Adèle is currently in grade 3. She is an only child and talks about becoming either a doctor or a teacher when she grows up. To Adèle, a cure would mean no more needles, no more mood swings because of blood sugar fluctuations, being able to eat what and when she wants like her friends, being able to go to sleepovers and simply being a normal 8 year old kid.

To us as parents, a cure would be a dream come true! A cure would mean peace of mind that Adèle won’t have an insulin reaction when we’re not there to keep an eye on her and to be able to stop worrying about long term complications. A cure would mean a much needed relief from the constant emotional, physical and financial strain caused by Diabetes. Juvenile Diabetes is a very, very complex disease to manage for an educated adult, which is why we are terrified of giving her this HUGE responsibility in a few years.

Since the Type 1 diagnosis, we have gone through the usual mourning phases: shock, then disbelief, anger and asking “why us?”. After all this, the next logical step would be acceptance, but we choose not to accept the current available treatments as Adele’s life sentence. This is what drives us to do all that we can to help find something better for Adele and all others living with Type 1 Diabetes. It’s what motivates us to participate in the Walk for a Cure each year, to keep pedaling my bike in our annual Mike’s Bike Shop Cyclebetes 200 ride, to meet with our local MP as part of the JDRF Kids for a Cure awareness week, to continue to raise Type 1 awareness and support JDRF’s mission. A cure for Type 1 diabetes is out there just waiting to be discovered and JDRF is the vehicle that will enable this to happen before it’s too late for Adele and all others living with Type 1.

Moving on to our next guest speaker, it my pleasure to introduce Jason Turner. Jason was the 79th person in Canada to be accepted into the world famous Islet Transplant program at the University of Alberta Hospital. Driven by a passion for helping people with diabetes, Jason started Edmonton's first support group for people with diabetes in hopes of helping others avoid the complications he has had to face. He has become a much sought after speaker on the ravages of diabetes. Jason successfully completed a diploma in Library Technology and Information Management from Grant MacEwan, and is a skilled researcher, able to find answers to most any question. His main passion continues to be helping people with diabetes, a challenge that he gladly faces and considers every day. Please join me in welcoming Jason Turner.