Pumpiversary, Podiversary

First day of Pumping with OmniPod
April 24th, 2007, 1st day of pumping - OmniPod

Three years ago, on April 24, 2007, shortly after being diagnosed with type 1 diabetes, Caleb started pumping insulin.  I remember this date as much as I remember his birthday.  There were lots of smiles and celebration.  It was a huge relief.  It meant more freedom to eat, drink and be merry.  It meant less shots and less pain.  It meant me not having to put on a performance pretending that three 50 carb meals and three 20 carb snacks, precisely timed, included exactly what Caleb wanted to satisfy his appetite every day.

Since then, Caleb has used more than 450 Pods, has pumped more than 15,000 units of insulin and consumed more than 220,000 carbohydrates.

He’s also eaten pizza, devoured cupcakes, dined on Chinese food, eaten off-schedule, partaken in indulgent Thanksgiving feasts, and enjoyed goodies from his trick-or-treat bag.  Don’t get me wrong – there’s a lot of healthy eating in between that would make Jamie Oliver proud, but those of you who understand diabetes appreciate how difficult eating pizza and carb-filled cupcakes can be.  Pumping makes it easier for Caleb, if not just simply possible.

As demanding as managing type 1 diabetes is, I think often of what it was.  I am thankful that Caleb has a pump available to him to make it less limiting than just 10 or 20 years ago.

Caleb pumps with the OmniPodThat choice was an easy one for us. Since the day he started pumping, at just 4 years old, he was able to deliver his own bolus’.  He, himself has delivered each dose of insulin while at school, including preschool.  From the beginning, he has helped change his Pod and just recently, at the age of seven, he has started doing Pod changes completely by himself.

Inside Cover

In appreciation of allowing a photo of Caleb to be included in their 2009 annual report, Insulet has made a donation of $500 in Caleb’s name to the Faustman Labs at Massachussettes General Hospital.  Dr. Denise Faustman and her team are doing such important work to find a cure for type 1 diabetes and I’m thrilled that Insulet has supported them.

Caleb also received an autographed poster of Kris Freeman with the inscription, “Dream big, Caleb!”  As you can see, he was over the moon about it.

Caleb with Kris Freeman poster

Caleb wrote thank you notes to both Kris and Insulet.  Here is his note to Kris, spelling, punctuation and all:

Dear Kris Freeman,

I think you should be proud because I am a kid that looks up to you.  Thank you for the poster.  I was really excited when I saw you on it.

You are my inspiration because when I see you, I feel like I’m not the only one with diabetes.

I would always want an American to win a race, but I would escpecially want you to win! Good luck!

extra love From the big dreamer…

Caleb!

Caleb with thank yous to Kris Freeman & Insulet

Thank you to all the pump manufacturers for making devices that make life with diabetes a little better for so many.  Please keep working to make improvements.  As great as pumps are, they are but crude replacements for a functioning human pancreas, and people who live with this every day deserve better.

Super Bolus

Super Bolus by John Walsh
Super Bolus by John Walsh

First things first: this approach works for Caleb. It may or may not work for you. I am by no means suggesting that anyone should apply the following theories to their diabetes care. I am only explaining what I do for Caleb.

For weeks, Caleb’s most predictable BG of the day was pre-lunch. Without exception it had been in range. It was sensor change day and we were operating in the blind start-up period. No worries though because this time of day hadn’t posed an issue in quite a while.

It’s approaching lunch time so let’s do a finger stick. 289.

289?

Okay. Oh well. It happens. There was more fiber in his breakfast than usual and he was a little low at the postprandial check. Ah yes, hindsight is 20/20. Moving on.  Now back to this 298 and we are getting hungry for lunch.

Super bolus.

John Walsh explains it as follows: “A Super Bolus is created when some of the basal insulin delivery is stopped or partially reduced, and delivered instead as additional bolus insulin on top of a normal carb or correction bolus.”

The intent is to get glucose levels back in range quickly without inducing hypoglycemia. Here is how Caleb’s super bolus went that day:

Correction: 1.50 units, plus

Meal bolus for 50 carbs: 2.00 units, plus

Basal for the next two hours: 0.70 units, equals

Total units delivered: 4.20 units.

Lastly (this is critical) turn basal to “off” for two hours.

The change in the timing of the basal insulin makes all the difference.  Front-loading it and delivering it with the meal and correction bolus makes it act faster and all at once, thus bringing glucose levels back in range sooner.  If left as basal, the end result will be the same, but it will take more time and hyperglycemia will last longer.  The same amount of insulin is delivered when using a super bolus, it is only the timing that is different.

Back to life, start preparing lunch.

1/2 hour after superbolus: 169

Perfect. Coming down fast and lunch is ready, let’s eat. 50 carbs consumed.

1 hour after superbolus (1/2 hour after eating 50 carbs): 109

Excellent. The first time I tried this, I panicked a little at this point.  A 109 an hour after a bolus that large is cause for worry.  But his basal had been zero for an hour and he still has food in his system.  Plus his basal will be zero for another hour.

DexCom had been calibrated with that lovely 289, which we confirmed after washing hands with a 288. DexCom showed him cruising between 85 and 100 over the next hour.

2 hours after super bolus: 89.  Wonderful.

I know a bolus of that size is still hanging around in Caleb’s system beyond the 2 hour insulin duration that we use. However Caleb’s basal insulin has just now resumed.  He hasn’t received any basal or other delivery of insulin for the last two hours.  Any tail of insulin duration from that super bolus is required for his basal needs.

And it worked.  He continued to hover with a nice flat arrow through the afternoon until dinnertime when a finger stick confirmed a BG of 98.

I invite you to read more of what John Walsh has to say about using a super bolus. He suggests its use for high glycemic foods or large intakes of food in order to avoid blood glucose spikes. I haven’t tried in those situations yet, but I plan to. He also speaks of pumps giving us the option to deliver a super bolus automatically. The thought of it gives me chills.

In what ways have you used the super bolus?

“Blood Brothers” – Caleb, Nick Jonas and the Yankees

The Danbury News-Times featured a story about Caleb, his love of baseball and his meeting with Nick Jonas. Thank you Brian for contacting us and Sandi for doing such a great job on the story!

If you missed it, here’s my write-up of when Caleb and Nick met.

Caleb holding the Danbury News-Times, April 11, 2010

Ready to Play: Danbury boy shares a bond with pop star Nick Jonas

Sandra Diamond Fox, Contributing Writer

April has finally arrived and children everywhere are practicing for baseball season, which begins later this month. One kid who’s especially excited about playing again is 7-year-old Caleb Schlissel of Danbury.

For Caleb — who has always lived and breathed baseball — the season starts Friday with the Danbury Youth Baseball league.

“Before he could walk, he had a ball in his hand,” says Caleb’s mother, Lorraine Sisto. “For his first birthday, he had a ball-themed party with a cake in the shape of a baseball.”

Caleb plans on becoming a pitcher for the New York Yankees and says nothing will stand in his way — not even Type 1 diabetes, which he’s had for over three years.

That would explain why he chose baseball as the subject of the Bayer “Express Your Simple Wins Creativity Contest” he entered — and won.

The contest involved 17-year-old singer Nick Jonas of the Jonas Brothers pop/rock band, who also has Type 1 diabetes. It was presented in conjunction with Bayer Healthcare Diabetes Care, which develops products that help simplify life for people with diabetes.

The nationwide contest was open to people ages 6 to 18 who are dealing with diabetes. Contestants were asked to put together a 15- to 30-second video demonstrating their “Simple Wins: small, everyday victories for managing diabetes.”

After the public voted online from more than 160 submissions, Jonas helped select Caleb’s video as one of three grand prize winners. The other winners were Bradley Brown, 11, from Pennsylvania, and Lauren Hermsen, 17, of Illinois.

Caleb’s video — which Sisto filmed — shows him playing baseball and talking about how much he loves the sport.

“Everyone in our family (which also includes father David Schlissel, brother Colin, 9, and sister, Lila, 4), is a huge fan of Nick Jonas. We have seen him perform in concert four times,” Sisto says. “We pretty much follow all things Nick.”

As one of the grand prize winners, Bayer HealthCare flew Caleb and his mother to Disney’s Grand Floridian Resort & Spa in Florida for a meet and greet with Nick Jonas and the other winners.

When they first saw each other, “Nick went right up to Caleb and said `I know you’re a Yankees fan. You’re a good man,'” Sisto says. “He had remembered Caleb from his video.”

Jonas spoke to Caleb about his passion for baseball, and about living with diabetes. “Nick was very warm and very caring, and really focused on Caleb,” she adds of the meeting, which occurred in December.

“At the end of the event, they both pulled up their shirts to show each other their `pods,’ the OmniPod Insulin Management System, which supplies their bodies with insulin,” she says.

“I really liked meeting Nick because he has Type 1 diabetes like me. When I talked to him, I didn’t feel like I’m the only one with diabetes,” says Caleb, who is a first-grader at King Street Primary School in Danbury.

“It was very inspiring and encouraging to see a young person who is dealing with this and not letting it stop him from doing what he wants to do,” Sisto says.

Sisto spoke with Nick Jonas’ father, Paul Jonas (who goes by the name Kevin), who was also at the event. He told her his son is happy to be a role model for other kids with Type 1 diabetes.

“He said that when Nick was diagnosed, Nick didn’t have anyone to look up to who had the condition. Nick wants to be to other kids what he didn’t have for himself,” she says.

“This contest was put in place to help inspire kids with diabetes to express and share their simple wins,” says Judy Manning, director of consumer marketing for Bayer HealthCare Diabetes Care, located in Tarrytown, N.Y.

“Life alone for anyone is complicated, but it’s much more so for people living with diabetes. Between (the nuisance of) having to prick their finger to measure their blood sugar many times a day, and the social issues involved with caring for this disease in school and with friends, anything we can do to make it easier for them is important,” Manning says.

“With contests like these, we hope to inspire kids with diabetes to continue living their lives and not let diabetes get them down.”

As a grand prize winner, Caleb also received a glucose meter, a Jonas Nintendo DS game, a CD of Nick Jonas’ song “A Little Bit Longer” about living with diabetes; and an autographed copy of “Burning Up: On Tour with the Jonas Brothers,” a book written by all three Jonas brothers — Joe, Kevin and Nick.

This is the second contest Bayer Healthcare Diabetes Care held that involved Nick Jonas, who was diagnosed with diabetes when he was 13. In 2008, the company held a “Walk in Nick’s Shoes” sweepstakes. Winners got to meet Nick at the Juvenile Diabetes Walk in Los Angeles, Calif.

“When Caleb was first diagnosed, I didn’t know anyone else who had this condition. When I first learned about Nick, for me, it got me over a hump. It’s not easy to do the performances he does which are so physically demanding while managing his blood sugars. Here is someone with this condition who is succeeding and living his dream,” Sisto says. “This means so much to me.”

Since learning about Nick Jonas, Caleb’s parents have become aware of other people in the public eye who share their son’s condition. Two of them include competitive cross-country skier Kris Freeman and Chicago Bears quarterback Jay Cutler.

“We got so much more out of this experience than just the excitement of meeting a celebrity,” Sisto says. “We felt a comfort around Nick and around the other contest winners, which made us feel that it’s going to be OK. Caleb will be able to become anything he wants to be.”

To view Caleb Schlissel’s winning video, log onto http://www.nickssimplewins.com.

He’s just a kid

I’m sitting at the kitchen table after dinner with Caleb beside me finishing his homework.  While he’s working, I scan the computer and come across a video about a young boy living with diabetes.  He is younger than Caleb and there are pictures of lancets and needles and of this boy as a baby and a toddler, smiling and enjoying life and being cute, and clearly living with diabetes.

I realize that Caleb is crying.

I look at him and he says, “I’m not crying about my homework.”  I didn’t realize he was looking over my shoulder. “I’m sad because that boy has diabetes and he’s just a kid.”

“He’s just a kid”?

But Caleb himself is just a kid.

I am not exaggerating when I say that Caleb does not complain about anything he has to do because he lives with diabetes. There may be the occasional hem when we need to change a Pod, or a haw, when I ask him to check his sugar.  But these hems and haws are no different than his reactions to having to make his bed or put away his laundry.

Even when asked what he thinks about living with diabetes, he is relatively indifferent. It’s typically a “good”, “whatever”, “it doesn’t matter” response.  He’s got bigger things to worry about.

To see and hear him get upset at seeing a young child going through everything he goes through, things that never seem to phase him when he does them, left me speechless.

I took him on my lap and hugged him. I had many thoughts and emotions running through me, but no words. We both had tears. That seemed to say it all.

Caleb’s 1st Complete Pod Change – Part One

No bubbles

Caleb has often helped change his Pod, but he has never done a complete change from beginning to end. There’s a level of dexterity necessarily to fill the syringe that fills the Pod. Considering the size of the needle used to do this, I have always interceded at this step. (I once stabbed the tip of my finger with that needle – it left an entry and exit wound and a half inch bruise from one point to the other. That thing is serious.)

But Caleb is seven now, and is showing more independence and responsibility in many aspects of life. Why not diabetes too?

When asked if he wanted to do the whole change, his face lit up, “really?”

With some expired supplies, our extra PDM, and his good friend Rufus, Caleb practiced. He did beautifully. I’ve always thought the hardest part of a Pod change is getting the bubbles out of the syringe. He listened to my instruction and did it with relative ease. Much better than my first time, that’s for sure.

Since then, the favorite thing to do in the house is to care for Rufus with bolus’, injections, bg checks and lots of love.

Here’s the video I put together of this monumental occasion.  Stay tuned for Part Two.

Our Happy DexCom Friends – video trifecta

As we began our CGM adventure with much trepidation, we were embraced, truly embraced, by our friends Bill and Suzanne.

I think the first time I “met” Bill was when he commented on Caleb’s low video and dubbed him a “Diabetic Ninja“.  Shortly thereafter he named Caleb “Diabetic of the Day”  in one of his own videos. Bill was one of the first people who found us through Caleb’s face on YouTube.  I remember how Caleb smiled when he saw that he was in Bill’s video.  As I’m sure was intended, it made him happy.

We have kept in touch with Bill and he and Caleb even have a friendly rivalry over their favorite baseball teams – Bill’s Red Sox v. Caleb’s Yankees.

Through Bill, we met Suzanne.  Suzanne and I tweeted a great deal about DexCom. She answered my unending questions and understood my apprehensions about putting Caleb through another skin piercing process.  She knew of Caleb and Bill’s relationship and asked if a video from Bill might help us prepare for our training.  Of course the answer was, “yes”.

So Bill and Caleb made a deal to make videos for each other.  Here’s Bill’s:

Suzanne also joined in the video encouragement:

To which Caleb responded:

Bill and Suzanne helped us so much through our CGM transition.  They went out of their way to make these videos for Caleb and sent us many heartfelt emails and tweets.  Thank you my happy diabetic friends!

“It’s all about your attitude!” Yours are fantastic, influential and even contagious!!

The Olympics Begin and We Root for Kris Freeman!

Kris Freeman, cross-country skier, is competing with the US Ski Team in this year’s Olympic Games. He is a serious medal contender in all three cross-country skiing distance events.  Kris has type 1 diabetes and like Caleb, uses the OmniPod insulin management system.

We will be watching and rooting! Good luck Kris! To say that you are an inspiration is an understatement.  I am simply in awe of you, your attitude and what you are able to accomplish.  You have my utmost respect and then some.

Vodpod videos no longer available.

Meeting Nick Jonas – Nick’s Simple Wins

We first learned of Nick at our OmniPod training in April 2007.  Caleb was diagnosed only months earlier and one of the things that provided me great comfort was learning about people living full, enriching lives with diabetes. I heard of everyday people – someone’s friend’s daughter or other patients of Caleb’s endo.  There weren’t too many public figures living with diabetes that I found relatable.  So when I heard of a young man who was diagnosed shortly before Caleb, using the same pump as Caleb, and was continuing with his career in the public eye, I was intrigued.

Since then, Caleb has become a true Nick fan.  He owns his music, has been to his concerts, and has various books, magazines and paraphernalia featuring Nick and his brothers.  Caleb enjoys singing, plays the piano, is learning the guitar and recently acquired a set of drums which he practices daily – sound familiar?

When I saw the tweet from Amy about Bayer’s Express Your Simple Win contest last spring, Caleb and I got to work.  In October he  found out he was one of three grand prize winners and would be meeting Nick in Orlando.

Bethel Woods August 2008

Caleb, his brother Colin and I had the privilege of meeting Kevin, Joe and Nick at their concert in Bethel Woods in August 2008.  It was a fantastic experience.  We waited two hours to meet them for about 2 minutes.  As soon as Nick heard that Caleb also has diabetes, his focus was 100% on Caleb.  There were high fives, fist bumps, some words exchanged, a picture taken and huge smiles.  Caleb’s reaction was priceless.  He skipped out of there declaring, “that was totally worth the wait!!”  I saw firsthand the real, tangible influence that Nick has.  Two minutes was a thrill; I couldn’t imagine what an intimate meeting would be like.

Here’s how it went:

Upon checking in at the hotel, we heard, “Are you here for the Simple Wins contest? Is that Caleb?” It was Bradley, one of the other winners, and his mom.  Caleb was so excited to meet them.  That night, Caleb and I stepped out on the balcony of our room and heard, “Oh my goodness – is that Caleb?  We’ve been looking for you all day!”  It was Lauren, the other winner, with her mom and sister on the balcony next to us.  Another great thrill.  Meeting Bradley and Lauren was a prize in and of itself to Caleb.  They were able to talk amongst themselves, whether about baseball, singing, helping the community, or about diabetes, and feel connected.  There was an instant bond.

On the day of the meet, the winners were brought to a grand conference room.  Inside they chatted, took pictures and waited.  First came Big Rob.  He greeted everyone (or perhaps scoped out the room for Nick’s safety) and took pictures.  Caleb was on top on the world.  Rob left and while everyone talked about what fun that was, Nick nonchalantly entered.

The first thing I remember him saying was to Caleb: “I know that YOU are a Yankees fan.  You’re a good man.”  I didn’t think it could get better than that moment.  The four of them spoke of their interests, their stay in Orlando, the music they liked and they talked about diabetes too.  He asked Caleb if he ever went low while he was playing baseball.  It was nice.  It was comfortable.  It was exciting.

They took some pictures, Nick autographed Caleb’s Burning Up book on the page where Nick talks about his diabetes (Caleb proudly declaring, “I read the whole thing”).  Then they sat down and chatted some more.  Caleb talked about the concerts he attended.  Nick recalled being under the weather at one of them.  They talked more about the Yankees and the World Series.  Nick described how he watched the series on a laptop in Italy at six in the morning. Then “Bounce” became a topic of conversation and Caleb was invited to perform his version of Bog Rob’s “chicken wing” and “ham and cheese”.  Big Rob came back in to watch.  It was a reserved performance on Caleb’s part, but still great to see it bring smiles to everyone’s faces.

I spoke with Nick’s father, another kind and gracious man.  Upon thanking him, he responded, “we understand”.  It’s true.  They know.  He explained that Nick does this because when he was diagnosed, he wanted to know of the athletes and musicians and other public figures who were living with diabetes.  The list was short.  Nick understands the comfort it brings, and his ability to provide it.  So he does.

I spoke to Nick.  I took the chance to explain why what he does is important to us.  Caleb doesn’t wonder if diabetes will limit him.  He has virtually always had Nick as a point of reference to know that it won’t.  I don’t think Caleb has yet to even consider if diabetes could be an obstacle to anything he wants to do.  I credit Nick a great deal for giving that to him and I told him so.

As things were wrapping up, Caleb mentioned to Nick that they used the same insulin pump.  They took turns pulling up their shirts showing each other their Pods.

I have never seen Caleb smile so big or for so long.  Ever.

Thank you Nick.  Thank you Bayer.  You have created meaningful, lifelong memories.  The day itself was a thrill, but what I hope is that at least one day in Caleb’s future, when diabetes is proving difficult, he will think back to this meeting in Orlando.  He will remember a young man that was not all that different from himself: a young gentleman, with a curl to his hair, a love of music, a charming smile and the same daily challenges to manage his blood sugar.

I hope he will think of Nick and remember that diabetes didn’t slow him down and it doesn’t have to slow Caleb down either.

“The Day of the Hard Look”

Click to enlarge and read.

There was some news this week in the diabetes community and there have been mixed reactions.  Some are excited, hopeful and encouraged.  Others are frustrated, disheartened and even resentful.

I am a little of both.  I am cautiously optimistic.  That’s how I am in general, and I am the same as it relates developments in diabetes research and potential advances.

A friend blogged about her sadness regarding the outlook for a cure for diabetes after hearing the reactions from others to this week’s news.  The fact that a time frame of five to ten years for a cure has been given to people diagnosed with diabetes for tens of years was a little more than discouraging.  I understand and relate to this.

This is my reply to Rachel:

I don’t think people are made much more skeptical than I am.  I have this book which dedicates a page to every day of the year and describes what people are like based upon the day of the year they were born.  My day is called “The day of the hard look”.  It defines me perfectly – anyone who knows me is fascinated at the eeriness of the accuracy of this book as it relates to me.

That being said, I have hope.

I don’t really understand why people (doctors) need to define a time frame to this. I suppose it’s because it’s something we all want to hear. Giving it definition when it is IMPOSSIBLE to define is what makes this situation that we are in. Once the measurement is defined, we have something to look at and say, “well that didn’t work – they were wrong – they lied – it WON’T happen.”

But I haven’t given up. The time frame may be wrong, but the theory, I believe, is right.

There ARE resources – many resources – tasked to tackle this. I don’t have the slightest clue when their efforts will be realized, but I truly believe they will be. It may be 100 years from now, it may be 10. But I believe this puzzle will be solved.

None of us are sitting around waiting for a cure. We are all doing everything we can to keep ourselves or our kids healthy now.

I think of the people who lived with diabetes in the early 1900s who starved themselves to live another day, every day, in hope of a cure. The cure came for many of them.  It was insulin.  It saved their lives.

Now I am NOT saying that insulin is a cure, because I know darn well that it is not. But for these people it might as well have been. From their perspective it was.

I hate what diabetes does and makes us all do as much as anyone. But, I am so very, very thankful (ok, I’m choking up now) that Caleb has the benefit of the advancements that exist today. Even on the worst of days, when I don’t think I can take another second of the crap that diabetes presents us, I remind myself it could be so much worse.

I don’t know when there will be a cure, but I am still hopeful.

More than that, I am hopeful that along the way there will be many more advancements that will make living with diabetes easier and safer. If there are as many in the next 10 years as there were in the last 10 years, living with diabetes in 2020, when Caleb is just 17, will be a very different thing than it is today.

I have read a lot of the responses to Wednesday’s news and appreciate the varying perspectives that have been shared.  Although different, and at times at opposite ends of the spectrum, I am able to relate to most of them.

I am “the day of the hard look”.  No one who knows me would argue this.  But I am still optimistic.  Cautiously optimistic, but optimistic nevertheless.

CGM impact – is A1C all there is?

Caleb started using the DexCom Seven Plus continuous glucose system in September.  This week was his first endo appointment since starting, a tidy three months later.  I had no apprehensions about this appointment.  In fact, I expected us to be in and out quickly.  We just needed an update to Caleb’s prescriptions in addition to the normal routine.

I was however curious to see what impact using DexCom had on Caleb’s A1C.  His A1C results have always been strong and we seem to keep chugging along.

This quarter’s results were no different.  His A1C was unchanged.  I wasn’t necessarily expecting a change, but I am a numbers and measurements kind of person.  Even if it went up, I could say we were dealing with lows better.  We had introduced a significant enhancement to his diabetes care.  It seemed odd not to have it reflected in “the number”.  If there had been any measurable difference, then I could attribute it to CGM and thus justify its use.  His A1C was not giving me that justification.

So why are we doing this?

My biggest reluctance to starting CGM was asking Caleb to endure more discomfort without realizing a tangible benefit.  He would have to be poked.  He would have to wear the transmitter and carry the receiver.  He would be the one who would be interrupted by all the beeps and alarms.  Of course this is all to improve his glucose control, but that’s not measurable to him.  I would be able to rest a little easier at night.  I would be less stressed when separated from him.  I would be less anxious between finger sticks wondering what was going on inside him.  It seemed he was making all the sacrifices and I was getting all the benefit.  So it would be nice to have something to point to to say yes indeedy, this is worth it – look, your A1C shows it.  There’s no doubt about it.  This was the right thing to do. It’s all here in black and white.

That is not the case.

Caleb’s doctor explained that when you already have tight glucose control, CGM typically will not change your A1C result.  However, the quality of that result is often improved.  In other words, the average of your blood glucose is still the same, but you are avoiding the high highs and the low lows that cancel each other out.  The peaks and valleys are more subtle.  The A1C remains unchanged, but it’s still a “better” A1c.

Hm.  Okay.  So do I believe that is the case with Caleb?  It may be.  I feel like we have caught things quicker and there are less surprises.  We still have highs and lows, but they seem less severe.  I don’t tend to go on feelings though.  I like hard facts.  Embracing this concept, although perfectly logical, isn’t all that easy for me.

After tweeting my concern (and doing a poor job of it because I led people to believe that I was a bit of a lunatic and wanted Caleb’s A1C lower and truly that was not my objective at all) I believe I got the justification that I was looking for. My wise friend, Melinda, helped me get there.  She has a teenage son who has lived with diabetes since he was just younger than Caleb is now.  Talking to her is like taking a magical trip into the future and getting a flavor of what it might hold for us.

I realized, with Melinda’s help, that an A1C isn’t the only way to measure the success of CGM.  From the beginning I have stated that DexCom provided me some relief.  I could see things before my eyes instead of worrying and wondering.  I think I got so used to that so quickly, that I didn’t realize how much of an impact it has.  I know that I am generally less anxious about Caleb’s BGs.  I am wound pretty tightly to begin with, so it doesn’t take much to get me excited.  There is a true, tangible value in decreasing the stress factor.  It’s one that is very important to me.  I know that Caleb has a lifetime of this management in front of him and how I handle it today will impact how he handles it tomorrow.

These are Melinda’s words that eased my worries:

“But HE benefits from having a less stressed-out parent.  They certainly pick up on our cues.  There’s a lot of value in that too.”

I know I do a good job of keeping Caleb’s blood sugars in tight control.  I also know I do a poor job of hiding the impact the out of range numbers have on my psyche.  That is where I need help and DexCom has provided it.

The answer is no, A1C impact is not all there is to CGM.  There is much more. Thank you Melinda and all my Twitter friends for helping me understand that.