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Things continue to be hither and thither — hence my struggle to post! Apologies. What always then happens of course is an overwhelming urge to say EVERYTHING.

Not possible. So a quick run through: we think Cleo the cat is with kitten! Her brother is able to tolerate her, phew. We had a party for 30 people last week, and the sun managed to shine throughout! Phew. I’ve taught some year 6 (11 yr old) and today year 5 (10 yr old) school children poetry these last few days too. Really excellent fun. Phew! I delivered a paper to the Poetry and Voice conference at University of Chichester over the weekend. On how different sorts of writing have served different purposes since my son’s diagnosis — and on how the beach hut poems came about. Went well I think, and the whole conference was a stimulating one. Phew!

Not so phew: daughter M, six weeks after cracking her cocyxx in a rounders match (seriously painful, missed two days of school), then jammed her ring finger on her, yes, fingering hand…. So has had to re-schedule her violin exam. Oh dear. Very painful, swollen joint. Little delicate hands. Sniff!

Not so phew too: battles with lows. The heat seems to have had the generalised effect of lowering E’s insulin needs, so last week we had several evenings of unfortunately several hours of dragging around in the 3’s and 4’s… Even with the pump on 0%, eg actually off. It was extraordinarily wearing for him, and a I don’t mind admitting that one night it was a little scary: no insulin going in, already treated two hypos, and gee, 15 minutes later he’s still on 2.5mmols... Disconcerting. But we got up I think half a dozen times that night, and by morning he was okay.

Sigh. Then after 3 nights of going high from too low a temp basal (too little insulin) in the day — we think we’ve sort of cracked it. For now! 90% temp basal in the day, plus 90% of the usual carb counting/ratios. Turn off temp in early evening to stabilise for the night. Unless he’s exercised of course…! In which case turn it to 95%.

Assuming he remembers that he’s exercised.

Assuming that we remember what he’s told us. And that we all don’t crash out on the sofa from SHEER EXHAUSTION while watching the World Cup, where England did SO BADLY. Oh dear.

Did I mention that on the way back from Chichester the car sprung a diesel leak and I ran out of fuel while passing a truck? Scary.

And had to wait on the motorway verge 10 miles from home. Never, ever nice, traffic whipping past at 80mph. I took my linen trousers and sparkly flip flops into the nettles and thorns, up the bank, I can tell you!

And did I mention that because one car is in the shop I did all the driving this morning: child to school, OH to work. And oh, deliver a testing kit to the OTHER child across town, because accidentally forgotten….?!

But we’re here. And we’re okay. As long as we keep our juggling hands free.

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After barely three days’ respite, little girl cat Cleo is on heat — AGAIN. We are gritting our teeth. She is doing something altogether different, but no doubt just as taxing. About another two weeks of this, all being well. We hope for another little mini-break for her. Then maybe making babies. And everyone will be happier… there is too much hissing in the house now, and not just from her brother Schubert, who is fed up to the eye teeth with all her moaning and constant IN YOUR FACE – ness. We keep putting her in the bathroom with a litter tray, food, drink and a bed. Her boudoir, in which she can recline. Fat chance.

AND: a day when E has helped me make a postcard for my hut poems. Okay, he’s done the whole thing (:-)). And here it is, the front image, and the back poem. Splendid job.

Hut postcard

(Sorry, on my computer you need to click once to go to some page in space that says ‘Hut postcard’, then click on that and then it finally downloads. Why? Who knows.)

So we go for a milkshake from the dreaded McD’s. Very unusual. Get a medium milkshake. Read the carb content from the handy placemat. Hurray, McD! Says 70g CHO. Sheesh! We think: a load of carb. Sounds TOO high. Settle on 55g CHO, and agree to pick up the pieces later if he goes sky-high. Two hours later he’s a steady 5.8mmols… Hmm… And still hasn’t gone higher.

So we wonder: Mr McD, what you playin’ at?! If we’d done the full 70g, it would have been hypo city! Oh dear.

Just another day in the land of managing diabetes. And life. And getting through both. For the moment!

Well as half term approaches, so my days at the hut are numbered. Sigh. Being there has been an eye-opener. A gift. And a lesson. Namely: the more time I have, the more head space, the more I write.

This probably seems a simple equation. If x = y, then 2x = 2y.

Not exactly, however. In reality, if time x requires me to sit and write RIGHT THEN, or I won’t get anything done for another week, then yes, I might produce y.

It’s an eked out creative existence, though, one put together *between* other things. I’m lucky, I can usually write something when I have even the tiniest slot of time. I’ve trained myself well!

What I did not anticipate was the exponential effect of doubling or even trebling x. And then adding another variable, let’s call it z. Now z is neither x (time) nor y (work produced), but in combination with x, z seems to have an incredible effect on y in any case.

Z is white space. Z is free fall. Z is nothingness. So if I were to include z in the equation like so: 3x + z = ?…I could only quantify it as zero. In which case it has no effect on the balance of things.

Ah, but it *does*.  This kind of equation for my time at the hut seems better: 3x + z = 3y + z. Where z can be ANYTHING. And even to look at, it expands the equation, it makes it open-ended, infinite, etc. And this expansion is partly what this feels like. Anything is possible.

Saying all this, I have the feeling that what I’m really talking about is trigonometry or even calculus, where equations are not worked out around equal signs, but around functions, or change. And then what you put in can have an exponential effect on the result.  Which is even closer to how I feel…. But I can’t remember anything of trigonometry, and passed college calculus by the skin of my teeth, so oh well.

Suffice it to say that z has entered my bloodstream now, and I will always be on the search for, and respect, the empty space and freedom z brings. It is invisible. And vital. And not a waste of time. So there.

Some more photos then from the last week or two, when suddenly it became summer. I became obsessed with my actual view through the hut window… Rothko-like I thought… and of course wrote a poem about it.

Keeping a blog sometimes feels a bit like staying in touch with an old, good friend. You think oh I need to say this, or I need to say that. A part of your brain holds ‘blog things’. It usually works quite well.

Until you drop a stitch. And of course it unravels down the whole piece of knitting, putting a kind of empty path through the middle of it. Damn.

So this last week and a bit, I’ve dropped a stitch. At least. And it’s been depressing, to think every day, oh yes I can say this, and I can say that — and never get to it.

Reasons are good ones: writing in the hut; and university work. As well as normal life, but hey.

***

So it’s list time, just to cover bases. This is the worst thing: I can’t just LEAVE IT.

1) new infusions sets are working so well we’re in shock. Insertion is much easier, done in a flash, and since we started with them, we’ve had NO error messages from the pump, MORE stable numbers (generally, see below!), and THEY HURT LESS. So an all around thumbs up!

2) we have however had two completely uncharacteristic missed doses, when we all just kind of forgot to give the insulin — within 24 hours. The first time we caught it quite quickly. E was high, but no ketones and feeling okay.  Insulin given, and job done. The second time he’d been running a little high anyway (we think from the end of a cold), and three hours after the missed dose, he was 20 mmols. Ergh. Within a few minutes, he felt bad. A few more minutes, and despite correction insulin being on its way in, he felt positively dreadful. We had to pull over while driving home while he got air. He thought he was going to be sick. And he felt this way for another two hours. For him, there is NOTHING worse than being high with ketones. It took another six hours, running temp basals, for him to come into range. Such is the ridiculously high price of forgetting to do one thing in certain circumstances.

3) We have figured out we think for certain that E actually tends to run slightly LOW when colds are starting and coming out. Unusual I think, but this seems definite now. Then, after the worst is over, he runs high for a couple of days. Oh joy!

4) It’s Sounds New week, which means we have all been rather hither and thither. Esp OH. So I’ve been having to keep about a billion things in my head at once: lunches, drop offs, pick ups, swimming gear, dry cleaners, paperwork. We usually split as much as we can, but this week of the year, it’s always like this — a bit overwhelming! Being a parent and working, being a partner and working — and trying to do a decent, open, sound and not too controlling job of it — is overwhelming sometimes. How’s that for stating the bleeding obvious, as they say?!

5) And yet through all this (and uni work — have I mentioned that?! A bit of a trial to keep up with these weeks, but oh well…), I have been to my hut! Three mornings this week. The work is still coming. There have been big waves. So I’ve made a Big Wave link. I have become aware again — and not for the first time, but for the first time in a long time, 5 years I think — how delicate a quality creativity is. How easily the imagination could be swung from itself, and everything be lost. It’s so important not to disturb the surface — but too, to disturb it, to dip down like a fishing bird, and find something. If you get in there and swim and splash about, you’ve got no chance. So I’ve spent a long time — hours maybe — trailing my fingers in the water: watching, listening, being, making a few notes. And soon enough, as long as I don’t move too fast, I hear a voice — mine and not mine, of course — that is the (maybe temporary) first line of a piece.

I’m so glad that this rich place near the surface hasn’t been wiped out by so many things happening in the last few years. I feel like a poet again, like when I was drafting How to Be a Dragonfly, which happened in a similar rush. To be honest, it’s a source of tearful relief.

***
So, Bigger Waves. Madness, I realise. And sorry about the last minute shift of point of view in this. Like writing a story, I suddenly thought hey I know what I want! I want the pure white froth… But by then it was too late. If it were a story, I would go back and re-do the whole thing with this in mind. But it’s not, so here we are.

So we decide that the best thing to do is finally do a basal test with E. This involves concocting no carb meals so that we can get a good luck at E’s background or ‘fasting’ blood sugar levels. This means frequent testing too of course. But the early evenings and nighttimes have been very problematic of late: seemingly unpredictable, seemingly swinging because of foods (really?), exercise (really?), and growth hormones (probably). And we won’t even go to the issue of the set changes in the last few weeks. Heaven only knows the effects of that.

ANYWAY. So from 6pm yesterday, no carb. Great and inventive dinner of chicken marinated in yoghurt, mint, chili and lime — lightly pan fried — on salad, with some mozzarella slices. Then a sugar free jelly (jello). All of which adds up to maybe 2 g of carb.

SO. He starts a little high (9 mmols) so we have to correct and give half a unit of insulin, but don’t add anything extra for the food. Two and a half hours later he’s still too high  — 9 mmols. (This is without eating anything remember, so MUST indicate that during this time on this day the basal or background insulin is too low.) So we have to correct again. Two hours after that he’s 10 mmols. So we correct. Clearly being pulled high has outweighed the earlier correction. Then 3 hours later he’s plummeted to 4 mmols.

Sigh. This is *precisely* the opposite of what we had thought was going on, and which our adjustments had reflected last week. We had thought he was being pulled low in mid-evening (so we lowered the basal an increment) and he has been sky high in the mornings (so we raised the basal an increment). Whereas last night’s test revealed that — for that day, anyway! — he was as a result too high in the mid-evening and too low in the morning.

Back to square one. Or maybe not. Maybe it’s a one-off. Certainly we feel that his morning rises have been almost entirely hormonal — and irregular, unpredictable in the extreme. This is where we wish for a) smaller increments on the Medtronic and therefore finer insulin tuning and b) a willingness on his part to deal with continuous glucose monitoring. It would help enormously in this case not to just have little windows into his levels, but watch the pattern of it… Oh well. In time.

Add to all this that yesterday was a ‘stay at home’ day, in which he didn’t get out of his pajamas, and really, the test can only be a bit accurate… His levels will be quite different we suspect on a school night. We already run him on two patterns on the pump, with different basal rates — one for school, and one for weekends and holidays — so we no doubt have to do two ‘fasting’ basal tests too, in order to get anywhere.

Sigh again!

***

The good news is that another silhouette (45 degree) set is in. The positioning of the hand and the body can be very awkward and unsettling, but he held on to his nerve and did it. Done!

***

And finally, I wanted to show you what I did on Friday. I looked at life for really quite a long time from this angle. And wrote four poems. I don’t know why the coast has set me on fire in such a way, but it has. As a friend said, they are just coming out of the oven cooked.

I watched the tide come in, and how the angles and rapidity and groups and heights of the waves changed over the day. I’m completely fascinated by this. It’s meditative yes, but also occupies my mind in an unaccustomed and direct way. I focus, really focus, on what’s in front of me.

Enjoy. Notice the filigree patterns of the water on the beach, like lace. And the way that sometimes the waves surge forward, and sometimes they just drop. And that they arrive in groups, and that a third of them are larger than the others… This all just screams poetry to me. I realise this might just be me, however!

I’m sitting in the beach hut, and I’ll admit my mind is a little fuzzy. Two reasons, I suspect, for this: beauty overload; and too many chocolate fingers. They have nothing to do with each other, but both lead me to a bit of a spaced out state!

The sea and the sky are an almost white blue-grey today, and there is only the faintest horizon. I’ve already drafted two poems this morning and expect to do another before packing up for the day. This post, in truth, is me ‘holding back’ from the next piece. It’s not quite time to write it. Not sure why. But a little while longer coming to the boil is what’s needed. Maybe ten minutes or an hour, no more – or the pot boils dry and can’t, in my experience, be re-filled.

Our trip to clinic yesterday was useful, energising, and hopeful. We had done everything right with the new 45 degree sets except pinch the skin in order for the needle to get proper purchase on and guide the cannula in. We all watched carefully as our brilliant Diabetes Specialist Nurse (DSN) demonstrated the insertion on a blue cushion (no Manky!). And then E, with the same quiet clear-headedness and courage he has shown from the beginning of all this, did all the steps on himself.

His father and I watched as what looked like a huge needle catapulted into E, skimming just under the surface of the skin. Perfect. He peeled off the backing tape, removed the needle – leaving the cannula in of course – and voilà. One of his final sources of real distress conquered without any evident hesitation.

So far so good. We discovered two more options to try if these sets prove difficult or not right in some way – again, bless our DSN’s pragmatism.

But right now E is very pleased, as are we. Many more sites for sets will be opened up if he stays with them. And they are much flatter than quicksets.

And you know what: NO PAIN except a pinprick for a couple of seconds. Compared to the teeth-gritting and watering eyes of every set change in the last three months, well…. Any chance to not have to be QUITE so brave he welcomes. And lord knows we want him to take it.

— Posted in the Little Blue Hut

Spring is springing so hard it’s practically bouncing off the page! The sun has shone almost without interruption now for two weeks. The tiny showers have made all the grass green and the tulips livid with life.

1) Thank you to everyone who sent me messages (see About on this site, but I’m afraid you can’t hack into my email, 🙂 ) about my article in Balance, the Diabetes UK bi-monthly magazine. I do what I do because it presses upon me to do it. Just hearing from people and knowing that somehow we all have places to go, and that I might, might be laying one tiny bridge of connection down for folks — this is good enough for me. This is what it’s all about. Thank you. My column continues in the next issue.

2) The beach hut is the BEST THING since sliced bread. I’m writing a lot. The sun is shining. At the end of the day it goes grey, and the horizon mixes the sea and sky. I’m researching coastal terminology and just plain watching the water, the birds, the dogs being walked, the children playing, and the slow flow of the tide. The whole thing is astonishing. I haven’t felt this connected to writing life-wise in years. Years. (Yay!)

3) Daughter M celebrated her 10th birthday yesterday. Like me, she has a tendency to tell everyone she knows and thereby reap the rewards of good wishes! She was in possession of the Birthday Cushion from her maths teacher all day, which she could sit upon, carry with her, flash at everyone and generally enjoy. Her name was emboldened upon the big screen by the school library. Her class sang to her. She ate cupcakes. Her brother downloaded a wonderful arty hand-drawn puzzle game for her as a gift. She soaked up ‘the love’. She is ten, double digits for the rest of her life. And a cracking, special girl, much adored. Here’s to you, chiquita!

4) We are off to clinic tomorrow, to sort out Manky’s sites. Lordy. We are feeling brave and resolute. As I say, the sun is shining. We have raised the nighttime insulin to combat the growth hormone highs which have persisted pretty much constantly now for three weeks. Perhaps soon we can get a night’s sleep! The sun is shining.

Til when!

1) M’s school did speak to the two year groups as promised. M reports it was handled well: an analogy with a key was used apparently, such that the key is the workings of the pancreas. In type 2 the key is a bit broken, not working so well, but a bit. In type 1 there is no key. Somehow this was used to illustrate how the types of diabetes were completely different, and most especially that type 1 is not something you can catch, or something that is the person’s fault, or anything. M did not feel on the spot. And the ‘friends’ who had teased her just the day before said nothing, even though she was sitting next to one. 

It’s interesting, isn’t it, how quiet a bully goes when shown to be wrong?

So all in all, satisfactory outcome! M is infinitely happier now that the ‘truth is out’, and we’re pleased with the school, will write a note saying so.

2) We have yet to try the Bayer Contour USB. Things have been too frantic. We need a bit of head space. And E is, as I’ve said, always slightly resistant to another unfamiliar thing when he’s full swing into his life. And who can blame him? May well be Easter break now….

3) E received a Distinction for his Grade 7 piano exam! Dig it. Barely 14 years old. Absolutely brilliant news.

4) M won a poetry reading competition on the same day. The girl understands it.

5) And I have been given a mini-residency at the Little Blue Hut on Tankerton beach. In which I will sit and write, and walk and think, for three days a week over six weeks, starting 21 April! I am so excited about this I could pop, seriously…It seems so out of reach at the moment to be able to do anything like that — but hey, it will happen. I will finish teaching next week, take a break during which I do my marking, and return to write. To write! To think! To just BE. Incredible. Watch this space.

1) even though you don’t know why something has happened, you know how to make it better — and it gets better. We don’t know why E’s numbers have been so low the last few days. But we have settled things by going for a long term 85% temp basal (lowering across the board), even lowering meal ratios by 15% (eg the amount of insulin to number of grams of carb: this changes in every person, from meal to meal, but usually remains the same for long-ish stretches day to day). And he has stabilised. 

2) the sun is shining.

3) you find your daughter a great pair of shoes that fit for once, and are all European, on sale, and gorgeous and she loves them.

4) you go shopping with your daughter, and she winds scarves all around you a la Gok’s Fashion and discusses things like textured finishes. And she’s only nine years old.

5) you’ve written one poem anyway that begins to starts to seems to get close to some things you might want to say. 

***

Suffice it to say that two nights ago we had a REALLY grim run. E dragged the bottom for hour after hour, with two hypos which made the horrible adrenalin/fear come.

It’s hard to explain this without getting emotional. But it’s pretty awful — really awful — to see one of the three people you love most in the world, and one of the two people you actually brought into the world — in such confused fear. So frightened, and feeling so alone. Because we don’t have hypos, and have never had one. We can’t know what it’s like to be muddled, to be angry and afraid in that way, and feeling not safe. It’s the brain that does this, when starved of glucose. It begins to race adrenalin into the system, which produces panic and fear…

We reduced the insulin big-time, kept giving carb without insulin, and he came up. Eventually. By morning.

And yes, if it weren’t for my children, I would give up my life for him not to have to deal with this. Not to go through this. The everyday relentlessness of it — and oh, as if that weren’t enough, the added one-off panics, the moments of tipping over into frightening lows or sick-making highs.

So yesterday was not a good day. He stayed home from school, completely exhausted. I wrote a poem and tried to answer emails.

We put him on 85%, where he remains.

He made it through his performance last night — which we all attended and enjoyed — and also sang today in a chamber choir competition. He and his sister played and talked for two hours this afternoon. This has happened before: after a crisis, they intuitively want to re-connect.

And yes, his sister. Her day at school yesterday was also pretty dreadful. She cried in Maths and cried during English. She was worried about him. And angry that he was home for the second day this week. That maybe we were taking more care of him than her. And recovering from a cold, trying to understand it all and deal with all this conflict inside her… 

She had a long, honest talk with her father, and her teachers looked out for her.

*** 

She’s okay today. Miraculously, after the unremitting rock bottom two nights ago, somehow we are all okay. Again I say: it’s incredible what you can get used to, how many blows you can take and then get up and enjoy the sunshine.

I started this meaning to sound better….and I hope I do. I feel it. A bit sad, a bit flat. But this is not unusual. I know it will wear off a bit.

And we went shopping. And, I’ll say again, the sun really did shine.

The low gets worse. It scares him. 
It scares you.
You count his breaths. 

You can’t untangle this.
Or stop and start again.
He’s hanging onto your hand.

In that darkness you seal the deal:
your death for his unencumbered life.
You are more than ready to say yes.

You lay your palm on his head
like you used to
back when the fever would pass.

Setting sail

In November 2008 my 12 year old son was diagnosed with type 1 diabetes. The effect of this event on me -- and on our nuclear family -- was like being thrown overboard and watching the ship leave.

'Dealing with type 1' in the family has morphed into another sort of 'dealing' -- a wholesale resituating of parenting, of family dynamics...of life.

At my son's diagnosis I could not to locate a record of what living with a type 1 child in the family is like. I could not see myself or our family anywhere. I longed for a starting point, a resource and a sense of the future. Being a writer, my instinct is to write it. This space, I hope, is a start.

Blood Sugar Ranges (UK)

<4 mmols = low or hypo, life-threatening if untreated
4-8 mmols = within target range
8-13 mmols = high but not usually dangerous
14+ mmols = very high, or hyper, life-threatening if untreated

Bubbles

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Disclaimer

I am not a medical professional. Any view expressed here is my opinion, gleaned from experience, anecdote or available research.