We have several questions today that don’t require a full post, so let’s see how many we can answer. But before we get to the questions, check this out. I can’t begin to tell you how excited I am. I will be interviewed on Monday, 9/23/13 on the Conversations in Care show to discuss Diabetes and DAD’s. You can tune in live, or it will be available as a podcast shortly after airing. You can find it here: Conversations in Care
Now to the questions. First up, Jenny Mattingly asks:
“I can’t remember how old Stella is but has she gone on any class trips? If so how did you handle it? Were you given privileges to accompany her? My daughter will be going to 6th grade camp for 3 days (not until spring) and I’ve been told I won’t be able to go to monitor her… Scares me!!! Could you make a post about class trips?…I would love to hear what others think & do in the situation. Thanks!”
Jenny, Stella is 10 and in 5th grade. She has done several field trips with her school. Based on our 504 plan and IEP, The school district either provides a nurse to attend with her, or if one of us can attend, we go in lieu of the nurse. If one of us goes, our cost is picked up by the district as if we were a school employee or nurse and we have to ride on the bus, unlike parental chaperones who pay their own way and drive themselves. Last year my wife went on 3 field trips, and Major went along too. There are no overnight trips scheduled that I am aware of yet, but there is no way we would send Stella off for 3 days without a nurse or one of us in attendance. That would just be dangerous.
Crystal Leigh Duncan wants to know:
“I would love to learn more about the foods that a Type 1 eats. I understand they can have anything with the proper medications but aside from “special” occasions, what does Stella typically eat?”
Now while Pazookie’s and In N Out burgers are not the norm, they are occasional treats. In reality, Stella’s diet (keeping in mind she is a type 1 and not a type 2) is pretty typical of a 10 year old with a few exceptions. She loves pb&j sandwiches, chicken nuggets, milk, cheerio’s etc. The difference is that we measure hers out so we can count the carbs and give her the proper amount of insulin. So if a serving of peanut butter is 2 tbsp’s, we actually measure out 2 tbsp’s instead of just sticking in the knife and scooping it out, so we know she is only getting 7 carbs. For cereal, if the serving size is 3/4 of a cup of cereal and 1 cup of milk, we measure them both out with a measuring cup. We do this with everything we prepare and eat at home. Stella also loves pasta, but pasta plays havoc with her blood sugar. Pasta is also not standard in the measuring department. Some styles and brands are measured dry (at which point, we prepare 2 pots to cook in, 1 for her measured portion and 1 for the rest of the family) and some are measured cooked. We also measure out the sauce that we use. When she eats pasta, we do what is known to as a combo bolus. Some foods that are either high in fat, like pizza or Chinese food, or high in carbs, like pasta, take hours to digest. So instead of giving her all of her insulin requirements up front like we normally do (with these types of foods, she would go low quickly) we set up our pump to give her a some insulin now and some more a little later. It would look something like this (this varies per individual and requires a fair amount of trial and error) (Yes, I just said that we do things by trial and error when it comes to giving our daughter the insulin she needs) (We need a cure, can someone get on that already?):
Her meal of spaghetti and garlic bread would be 100 carbs
Her insulin ratio is 1unit per 10 carbs
Total insulin requirement would be 10 units, but knowing that this is pasta, we will combo bolus.
So we will do something like a 45/55 ratio (meaning she would get 4.5 units now, and 5.5 units later) over 5 hours. Easy, right? Now assume your dinner is 87 carbs, and your insulin ratio 1 per 13. See where that new math comes in handy? Now try that before your first cup of coffee.
So while Stella isn’t on a “diet” we pay very close attention to what she (and the rest of us too) eats. We make sure we never throw away a package that has carb counts on it, and if we make something from scratch, we are very careful to measure everything out. When we go to restaurants (all restaurants that have more than 20 locations in their chain are required to have nutritional info available) we use their info, but after awhile, you get to the point that you can look at a plate and come pretty close to guesstimating carbs.
And finally today, this group of questions from Clara Corinne Lanier Valdes. Clara asks:
“When you go out on instances where you don’t have Stella with you, and you take Major, what is the point to taking him and how do you deal with it when people ask the how does the dog assist in disabilities question? I’m wondering because I have a buddy who has to go to surgery and while she heals she cant take her service dog out, and he might get down in training. So is it legal to take the dog out when you don’t have the disability and are not a registered trainer?
2) What do you do in situations like flying somewhere and have to have both dogs? Do you get hell for using two dogs?
3) When you drive somewhere, Raven is the alert in car dog. What do you do when you get there and cant take her in with you, and take Major in?”
Okay Clara, here goes. We live in California, and California law gives Service dog handlers and trainers full access rights. That isn’t the case in every state, so please familiarize yourself with your local laws. What that means is that I can take my dogs anywhere, whether Stella is with me or not. If she isn’t with me, I still take a dog as it is ALWAYS a training opportunity. We are always working on public access training, and every scenario is always different. The more experience our dogs get the better. As for your friend’s dog, structured walks around the block with obedience work built in and disability specific training can help maintain the dogs abilities. And as for the 2 questions a person is allowed to ask? Here are my answers:
1) Is this animal required because of a disability? Yes.
2) What work or task has this animal been trained to perform? To alert to a hypoglycemic event.
Your 2nd question: We have not flown anywhere as a family since we have had Raven, but I have been with other people as we have flown with as many as 5-6 dogs on a plane. If we fly somewhere and determine we will bring both dogs, my wife or daughter would handle one, and I would handle the other. No one would give us grief. And I would not take 2 dogs if I were the only one flying.
Your 3rd question: If it has already been determined that we are going someplace that we don’t want a particular dog at, we don’t bring that dog. We would never leave a dog locked up in a car, or tied up to a light post while we went inside. We just leave the dog home. All though Raven alerts in the car, that doesn’t mean that my wife or I couldn’t check my daughter’s blood sugar when we need too. We check my daughter often, not just when a dog tells us too. These dogs are here to assist us in protecting our daughter, not replace us. Her safety is still OUR responsibility.
Hope everyone has been getting a little more insight, and if you have more questions, let me know!