Monday, July 18, 2011

Summer camp and the diabetic child

Last week was a a busy week for us.
Our regular routines were put on the back burner while we tried to do what we could to comfort our dear friend and her family after the tragic and sudden loss of their son.
In the meantime, Grant and Ashlyn were at summer camp with a group of children from our church.
This was Grant's 2nd year to go to camp, and Ashlyn's 4th.
Old hat for us.
No big deal.
Well, when you live with Type 1 really IS a big deal.
Since she was diagnosed with diabetes just over 2 years ago, her daddy has been able to take the week off of work and go along as an adult "sponsor."
He would drive one of the church van's and help get all the kids settled in,
and just be around if anything happened with one of the kids.
It was very comforting for me because I knew he knew that this is not a condition that can be ignored
or even "let go" for the week.
If there were any questions, or if she got sick or if her blood sugars dropped low or went high....he was there.

But this year.....several months ago my husband announced to me that he had the opportunity to take a course for his job that would expand some of his skills.
He was excited about it.
Out of the 52 weeks in the year, it fell on the exact same week as summer camp for Ashlyn.
Getting her packed for camp is a little bit more complicated than getting her non-diabetic brother ready.
I started the week before pulling all their outfits and labeling every sock and toothbrush and making lists of the items we needed to purchase for them.

When packing doubles of all her insulin supplies {I always pack doubles in case something gets lost or broken!},  I realized that she only had two humalog cartridges left as well as only 1 thyroid pill left.
That meant calling the pharmacy to get these prescriptions filled.
When I called, they claimed they didn't have any prescriptions for her.
So I had to make another phone call to the diabetic educator who told me 2 weeks before that she would call those in just in case I didn't get everything together for the mail order service in time {which I did not!}.
She was out of the office until next week, so I had to wait for someone else to call me back.
After I spoke with the 2nd diabetic educator, she told me she would call everything back in for me.
I called the pharmacy back and found out that the first diabetic educator had indeed phoned in the prescriptions 2 weeks ago, but the incompetent person I spoke to on the phone hadn't noticed the reason for the prescriptions being "cancelled" was because they were holding them until I called in for them!!
Then,  I was told they didn't usually stock insulin cartridges and that I could pick them up the following day.

EXACTLY why I have to start this ridiculous circus of a process DAYS in advance!!

In the meantime, I also called and spoke with the camp nurse just to refresh her memory about my daughter and the previous conversations I've had with her about my daughter coming without a parent.
She was extremely conscientious and knowledgeable, and my husband had only the highest praise for her since she has been the nurse at the camp for several years.
She agreed that it would help her to have a detailed instruction sheet with all of Ashlyn's current insulin-to-carb ratios, correction scales, and medication routines.
I emailed this to her and she emailed the menu and daily schedule they would follow.

I prayed with them as we dropped them off on Monday morning, and they waved a happy good-bye!

My first phone call from the camp came that night.
It was really just an update and to let us know that Ashlyn was doing fine and that she had a low during evening chapel which she recognized and they easily corrected.

We went on with the our week, and by Wednesday evening were pretty exhausted from the emotion of the funeral {see previous blog post for details!}

5:30 am Thursday morning
My cell phone rings.
It's the camp nurse.
They aren't sure why, but Ashlyn had fallen out of the top bunk in her cabin and seemed to land on her face on the cement floor.
She was unresponsive when her counselor reached her, so she assumed she needed to use the {emergency} cake gel in her diabetic bag to bring her blood sugar back up.
Obviously, she also tried to check her blood sugar but mistakenly put the test strip in the meter upside down,
so it wouldn't operate properly for her and gave her an error message.
She had called the nurse, and by the time she and the other nurse got to the cabin, Ashlyn was responding but was very agitated, disoriented, complaining of her head hurting, and crying loudly.
She had a swollen lip, the nurse said, and some blood in her mouth and a scrape by her nose.
She let me try to talk to her, but it sounded to me like she wasn't even fully awake.
She kept crying, "I want my Mom...."
The nurse told me that when they got to her, they tried to check her blood sugar but that the meter wouldn't work for them {referring back to the upside down test strip}, so she had to run back to her cabin for the extra one I had packed {SCORE one for Mom!!!}.
When they finally did get a reading, her blood sugar was 115.
This led us to believe that her blood sugar had gotten low since this was some time after the counselor had given her the cake gel.
Of course, by now the entire cabin full of girls was awake.
We mutually decided that they would monitor her and if she started throwing up {which she was saying she was going to do}, they would have to take her to the ER to get checked out.
I hung up the phone.

My husband and I laid in the bed staring at the ceiling.
We knew what they were dealing with.
We wished we were there.
At the beginning of this year, when we all got so sick, Ashlyn woke up a couple times walking through the house in what seemed like a panic.
She was crying uncontrollably and even when we got her to sit in the bathroom, it took her awhile to really wake up.
This is what she was doing for them.
I knew she wasn't sick, but figured she was just exhausted, had not gotten enough sleep, maybe subconsciously realized she was low, and when she tried to get up, fell out of bed knocking herself out.

About 45 minutes later, the nurse calls again.
She had started throwing up, and were going to take her to the ER.
They were trying to get her to check her ketones, but she was still groggy and had forgotten to do that.
I told them I trusted them, and had to let it go at that.

Several minutes later, another call.
It was a paramedic.
He said they were called to check her out, and that she looked fine except for the bruising on her lip.
Her head and stomach weren't hurting her as much and she was more coherent by then.
It was up to us if we wanted them to transport her to the ER.
We all mutually decided to to just keep her at the camp and let her rest that day.
The nurse told me then that some of the campers with Ashlyn had noticed that she was "flopping around" before she fell off the bunk, and the nurse said it sounded to her like she had been "convulsing."
I'm not sure it was that serious, since we here know she's a "mover and a shaker" anyway when she's in bed.
NO ONE likes to share a bed with Ashlyn!!

Anyway, as the morning went on, she threw up the 7-up I suggested they give her, but slept till lunch.
She was up by lunch, her blood sugar was 60,
 ate some food,
and was in the pool with her friends by 2:00pm.

I don't know that we would have done ONE thing differently if we had been there.
These wonderful nurses were on top of EVERYTHING, and had written down every number.
They were second-guessing themselves and regretting they hadn't given her a snack at bedtime when her blood sugar was 107, but then I don't think I would have either.

This is exactly why I want the Dexcom!!
It would've told them if she was heading up or down or if her blood sugar was stable.
It could have given them a reading when the counselor couldn't get the meter to work.

We are going to the endocrinologist for our quarterly review this morning.
I plan to fill him in on all these little details, and hopefully he will agree that this is something that we NEED!
Then we can get the paperwork going to see how much our insurance will cover on this puppy!!

Thankfully, she was fine the rest of that day and night and got home safely to us Friday afternoon.
I've already told Tommy that either he or I WILL be going to camp next year!
Oh, and Friday evening I got another call from the nurse.
They had forgotten to send home her Glucagon kit with her.
SCORE two for Mom!!!
We always have an extra on hand, so we're good until they can send it back to us!!

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