Day 23 - A teaching moment

I am behind on my National Health Blog Post Month again, so here I am playing catch up.

Day 23's prompt was "What's something your doctor taught you or you taught your doctor?"

Kortnie's first Endocrinologist was a Type 1 Diabetic himself, he was older and had a weird sense of humor, he was kind of nonchalant, he actually had a combined practice up here on the mountain.  He was a pediatric Endocrinologist, but there aren't enough patients here for just that, so he also saw other kids in pediatrics.  When we first moved here we tried a few different pediatricians for our kids, he was one of them, we didn't like him so we just moved on to the next guy and finally settled on a family practice close to our home instead of a specific pediatrician for just our kids. 

Enter Diabetes 2 1/2 years later and we were back to this certain doctor, he was the only specialist within 180 miles who could take care of Kortnie's T1D, so we felt he was the only choice for us.  We still didn't like him, and now we liked him even less.  I was relieved when he retired, even though now we have to drive to Phoenix for our appointments.

One time we were there for an appointment and he wanted to look at Kortnie's pump settings.  Her pump is locked so that she can't accidentally push random buttons on the front of it and mess up the pump or accidentally give herself insulin.  It locks much like a cell phone does.  To unlock, you hold down two buttons at the same time.  So, she handed her pump to the doctor, remember when I said he was T1D himself, well he actually used the same pump as Kortnie as well, he did not know how to unlock the pump!  Crazy-ness, you'd think a specialist doctor who had the disease he was treating and used the same pump would know about the lock feature, but no, Kortnie taught him how to unlock it.  Ironic I think.  It would be funny maybe, but since I already wasn't fond of this guy it just turned me off even more. 

We do have a diabetes educator at our hospital, who we love.  She mostly deals with Type 2 Diabetes patients, but she's told us that in the past few years she's had a lot more diagnosis of Type 1 up here on the mountain.  She and the hospital cover a wide area of patients, they people within 100 mile radius around Show Low where the hospital is, people from several different small mountain towns.  Over the summer she has started doing trainings with nurses from the hospital on Diabetes, it's an all day training and she goes over the different types of Diabetes, she invited me to come do a talk during the training about being the mother of a Type 1, and Kortnie comes and they ask her questions too.  The training was so well received that the hospital has decided to hold it twice a year, so I went back in the Fall and did the training again.  I was honored to be asked to come share some of my experiences, answer questions and just put some awareness out there. 

You can read about my talk and the experience at A Chance to Advocate and Educate.  I hope to be invited back to the next training, I admit that first time I went I was nervous, but now that I've gone twice I feel like I have more to add and am more comfortable talking to them. 

World Diabetes Day

 

Today is World Diabetes Day.  Every November 14th is WDD.   You can find out how it became a thing here.  November 14th is the birthday of Sir Fredrick Banting, who in 1921 created Insulin.  Before 1921 a diagnosis with Type 1 Diabetes was a death sentence.  Thanks to Sir Fredrick Banting and his discovery of Insulin, many lives have been saved. 

 

You see in a "normal" person, their pancreas produces insulin, insulin breaks down carbohydrates and turns them into energy.  A Type 1 Diabetic's pancreas does not produce insulin, with out the injected insulin that Dr. Banting discovered, they would starve to death.

 

So, November 14th is set aside by the International Diabetes Federation and the United Nations to raise awareness about Diabetes.

 

The blue circle is the IDF's official symbol of Diabetes Awareness. 

 

 

Here is a timeline in pictures of how Kortnie looked before and after her diagnosis.  In the first picture she is on her way to her first day of Kindergarten, August 2009, she is plump, rosy, and healthy looking, in May we had been told she was obese.  The second picture is September 2009, 8 weeks before her diagnosis, you can tell she has started losing weight, her neck and face are skinny, I thought she was growing into herself or losing her baby weight, I was remembering being told she was obese just 4 months prior.  The middle picture is her 2 weeks before diagnosis, her neck and arms are so thin, her head looks too big for her body, her skin was pale and dry, this is when I started putting it together that something wasn't quite right, but I thought she might have a flu or mono, I didn't have a scale at home, when we took her to the ER and they weighed her, she had lost 14 pounds from when she had gotten weighed at school in the beginning of August.  The fourth picture is 3 weeks after her diagnosis, 3 weeks after starting on insulin, she still looks thin in the neck and chest, but her arms and face are have gained back some weight, her skin is better, but she still looks tired.  The last picture is Christmas, about 7 weeks after her diagnosis and starting on insulin, she has gained most of the weight she lost back, her energy was back, the light in her eyes was back, she was Kortnie-Licious again!  I will be forever grateful to Dr. Banting and his team.

Here are some moments in the history of diabetes.

1. In 1500 BCE, ancient Egyptians recognized diabetes in people who urinated frequently and lost weight for no apparent reason. It was not labeled at that time but it existed.
2. A Greek physician named Arateaus recognized that the urine produced from people with diabetes was sweet and termed it Diabetes Mellitus.
3. In 1776, Matthew Dobson actually measured the urine for glucose and found it to be increased in certain people.
4. In the early 1800s, diabetes was considered a clinical entity but the prevalence was not really documented. No specific treatment was used and usually within weeks to months the disease was fatal.
5. The last 200 years have helped us understand many of the underlying causes of diabetes, ways to decrease risk factors of diabetes, and actual treatments. The outlook has definitely improved, with good results when therapies are used.
6. Treatments have been effective, but still no real cure has been discovered.
7. The disease of ancient times involved insulin deficiency (Type 1).
8. In the early 1900s, Edward Sharpey-Schafer thought the lack of insulin was the cause of diabetes.
9. Frederick Bating and Charles Best discovered insulin by reversing diabetes in dogs after inducing it. They did this by extracting pancreatic islet cells from healthy dogs; they later purified the insulin, and along with James Collip and John Macleod, were the first to treat a patient with diabetes using insulin.
10. In 1936, Harold Himsworth proposed that more people had insulin resistance than insulin deficiency (Type 2).
11. The discovery of biosynthetic human insulin replaced animal insulin, which eliminated reactions to insulin.
12. Over the years we went from checking glucose in urine samples to using glucometers and checking blood sugar. In the beginning, blood glucose meters were only available in the hospital. Over time they became smaller, more sophisticated, and were made available for home use.
13. New classes of oral diabetes medication have been discovered working on the pancreas, liver, muscle cells, gut hormones, and kidneys. Some that remain are cheap and reliable, and some are gone due to excessive side effects.
14. Insulin injections went from glass syringes and long needles (which needed to be sterilized and reused), to disposable syringes with short, attached needles. Even easier are the disposable insulin pens which just require the click of a button.
15. Pumps have made many lives much easier and eliminate the need for multiple daily shots. The added flexibility helps with an easier meal plan and exercise plan.
16. Continuous Glucose Monitoring (CGM) assists people in identifying blood sugar trends, and is crucial for those who suffer from hypoglycemic unawareness.
17. Ketone testing has gone from testing urine with strips to blood ketone testing, which is more efficient and reliable for testing for Diabetic Ketoacidosis (DKA).
18. New technology and medications are always being developed since diabetes is big business. The future looks bright. Hopefully we will gain progress in the fight against diabetes.
19. On the darker side - 2012 shows that insulin deficiency (Type 1) accounts for 10% of diagnosed cases (autoimmune) which can be controlled with exogenous insulin (insulin injections). About 90% of the cases are considered insulin resistance (Type 2). This has become evident in the past 40 years and has created an epidemic world wide (causes may include inactivity, food portions and weight gain, along with genetics).
20. The most recent statistics from the ADA are: 26 million people in the US have diabetes; 79 million have pre-diabetes with an increased risk for diabetes. One in three will have diabetes in 2050 if dramatic changes are not achieved. The yearly cost of diabetes to the nation is $174 billion.
21. The need for a team approach with multiple follow up appointments has proven results, whether in person (one on one, class) or on the phone. Having a physician, CDE, dietitian, social worker, podiatrist, pharmacist and ophthalmologist is the best way to follow all the organ systems involved in diabetes

Dear Diabetes

Dear Diabetes,

On this date, November 8th, 3 years ago in 2009 you came barreling into my daughters life.  Actually, I'm pretty sure you came into her life awhile before that, but it was on this day, 3 years ago that we found out you were here, and here to stay. 

We've fought the good fight for 3 years, we'll keep on fighting forever if we have to.

 

I will never forget that day, looking down at my little girl so tired and weak, sleeping in her daddy's lap in a church pew, looking like a bag of bones, while I was up on the stand participating in the Primary program.   I will never forget telling my husband, "I'm taking her to the ER, right now" and marveling at the fact that he didn't even try to tell me it would be okay to wait until tomorrow morning when the doctor was in.  I will never forget how she just laid there in that big hospital bed and was too weak to fight off the needle stealing the blood from her arm.  Soon after someone came and told me she had Diabetes, I had to wait a good hour and a half after that to call Brian, he was still at church with no cell phone.  I will never forget the doctors telling me that she was in bad shape and they couldn't keep her at our local hospital, they were afraid she'd go into coma or have a heart attack, they said she had to be flown to Phoenix.  I will never forget them strapping her to a travel gurney and loading her into that helicopter.  Thank the Lord the let me fly down with her, my one and only unforgettable helicopter ride was anything but enjoyable.  I will never forget sitting in the PICU with Kortnie and crying at the site of 7 different tubes of stuff going into her IV. I will always be forever grateful that Brian didn't get there until the next afternoon, by then we were out of the PICU and in a regular room, Kortnie looked so much better, he won't have to live with that frightening image in his head.  I will never forget those 5 days we spent in the hospital, Kortnie, Brian, and I, away from our other kids, missing them like crazy, and scared of how much our lives were changing.  I will never forget the fear, the anger, the fright, the despair, and the confusion I felt. 

 

 I don't know what Kortnie remembers of that time, because I am afraid to ask her.  She does say that you, dear diabetes, you suck.

 

3 years with Type 1 Diabetes, Kortnie added 'It sucks!'

 

 

The other day, we were at Walmart which is right across the street from the hospital.  A helicopter took off, likely flying someone to Phoenix, Brian and I stood in the parking lot watching that helicopter fly away, I said a prayer for whoever was in there.  I looked at Brian watching that helicopter and he told me, "that makes me sad", I told him it made me sad too.  Every time I hear a helicopter fly over my house, I get scared that something has happened to Kortnie at school and that helicopter is going to pick her up.  I can't shake it, it's been 3 years and I can't shake the fear.

 

You know what though, dear diabetes, you have changed us, all of us, and maybe, just maybe, some of those changes are okay.  We eat a little healthier, we've met so many wonderful people, we've made friends in real life, and friends in our computers, we've learned so much, we've been able to teach.  Kortnie is strong, really strong, you have made her extra strong.  You have also made her better at math.  You have given us compassion too.   You aren't winning and you never will.  We will continue to fight, to live, and to strive to advocate and teach, and to look for a cure. 

 

Kortnie and her girls from the Aztec Cabin at D-Camp

 

Kortnie and Sugar at the JDRF Walk

 

 

Kortnie at the JDRF Walk to Cure Diabetes 2012, fundraising for a cure.

 

 

 

Don't get me wrong, I hate you, and I try not to hate anything, but I really do hate you, I would kick you to the curb, or take you from Kortnie anytime.  I'll keep the stuff you've given us though. 

 

Today we celebrate, 3 years of kicking your ass.  You still scare me, you still suck, you will still try to take over our lives, but we won't let you, you won't beat us, we'll keep fighting, forever.  You haven't just invaded Kortnie's life, but you've invaded my home, the lives of my family, you mess with one of us, you mess with all of us.  We've made beating you a family affair, with all of us working together, you don't have a chance. 

A 3 year D-Aversary celebration ice cream cone. Yes, she can eat that!

 

Graham and Stasia say it sucks too.

Watch out diabetes, we've got our eye on you!

 



Sincerely,
Kortnie's Family

 

 

 

Day 8 in the Wego NHBPM, the prompt was Write a letter to your Health.

 

 

Kortnie's Diabetes Fact of the day

 

3 years today, living with Type 1 Diabetes
11,000 finger sticks
1,260 syringe injections
320 site changes
16 doctor visits

14 blood draws
5 days in the hospital
2 eye dialations
1urgent care visit
1 ER visit
1 helicopter ride
All because of Type 1 Diabetes
 That's only 3 years, she is only 8 years old, she needs a cure.



 

 



 

 

 



It's true what they say about Monday's

My poor Kortnie, I feel so bad for her sometimes.  Ever since she was a little baby she's always been my sickest kid.  Once she was diagnosed with T1D, she actually didn't get quite as sick anymore, we figured it was beacause we finally knew what was wrong with her and we were working hard to treat her and give her a healthy life.  Well, we are coming up on 3 years since diagnosis and while we've dealt with a few colds and one or two stomach bugs, we've not had to deal with anything too awful. 

Saturday morning she had a soccer game, Saturday evening we went to the fair.  Blood sugars were good, we had a fun day, at the fair we ate some junk food, funnel cake, french fries, lemonade, and hot dogs.  I bolused, the BG's stayed good.  From 10:30pm Saturday night to 8am Sunday morning she was kind of high but 230-280.  I figured it was residual from that dang funnel cake and lemonade.  By 10am Sunday she was back at 112, we had breakfast and went to church at noon she was 81 and still had Insulin On Board (IOB), I gave her 3 smarties and sent her to her Sunday School class while I stayed in my class.  We got home from church around 2:30 and she went to the bathroom, then came out and started telling her dad stomach hurt and she went to the bathroom during church and just now at home and there was blood in her pee.  He called me upstairs and told me, she hadn't flushed the toilet so I went and looked.  Not gonna lie, I freaked out.  Jumped on the computer and started googling.  I figured that she probably had a UTI (uterine tract infection), but there was also stuff about Kidney Stones and Kidney Disease and how people with Diabetes have Kidney problems.  So I started asking her questions and figured that yeah, it probably was a UTI.  Next I went into some of the D-Mom and PWD groups on Facebook and posted a question about it.  I got lots of advice and encouragement, here.  I am so grateful for the DOC (Diabetes Online Community)!  I called her Endocrinologist and they said it sounded like a UTI as well, and that I could give her tylenol and push fluids and keep her at home and take her to Urgent Care in the morning or ER that night if she was really in pain.  She did go to the bathroom several times that evening, we monitored ketones and they stayed around the trace-moderate range, her BG's were pretty good too so I wan't too worried, just feeling bad for her that she was in pain.  I have never had a UTI myself, but some of my friends told me that they pretty much suck and are painful.   A friend of mine and a fellow Diabetic brought her an AZO pill that is supposed to help with the pain and also turns the urine kind of bright orange or yellow.  That little pill seemed to help her and get her through the night. 

Monday morning I was supposed to go to the hosptial and give a talk to a group of Nurse's doing a training session and all the different types of diabetes.  I've done this training class before.   I was supposed to be there at 9am, Kortnie had wanted to go with me, but I told her she had to go to school.  Well, plans changed, I was at the Urgent Care with her by 8am, we were still there at 9am and I called the hospital and told them that I was at Urgent Care and was going to be late, they of course were okay with that, my talk is about being the parent of  a T1D, and well, this little trip to the Urgent Care and messing up my plans for the day fits right in with that doesn't it? 

I told the docs at Urgent Care that I prefered the Walmart pharmacy, but they must have written down Walgreen's instead, because they sent our prescription to Walgreens.  Oh well, I can run over there and pick it up, not a huge deal, even though I already had to go to Walmart to pick up test strips and a few other things. 

After we were done at Urgent Care we headed over to the hospital, I gave my talk, the Nurse's asked me some questions.  One of the questions they asked me was "Do you ever get a break?"  I smiled and told them not really.  One of the nurses asked Kortnie "How do you feel about having diabetes?", she thought about it for a minute and then said "it sucks!" but she was smiling when she said it and they all laughed and there was of a chorus, of empathy and "I bet's".

Next we went to Walmart, stopped by the Pharmacy and they were still out of test strips, I had called in the prescription the previous Monday, it had been exactly a week and they were still out.  What's up with that, the pharmacy tech decided to just pull them off the OTC shelf for me.  I'm not sure what the dang difference is between the prescription and OTC strips is.  Well, actually there is no difference in the strips, I'm sure the difference is all in the paperwork and behind the scenes stuff.  They told me to go shop while they got it all ready for me.  So I went and shopped, got the stuff on my list, headed back to the pharmacy to pick up the strips.  We are standing in line and Kork says she feels low, she checks her BG and she's 43!  Yikes.  Good thing I had juice boxes in my cart!  I popped open a box of Capri Sun's and she sucked one down and sat on the bench by the Pharm counter while I waited in line.  Had to laugh, here she is low, while waiting in line to pick up a new batch of test strips.  I mean it's one of those moments where you either laugh or cry.  I got the strips and she said she was feeling okay so we went over and got in line to pay for our other stuff.  Hopped in the car and went across the street to Walgreens for her UTI meds.  She was feeling better and her BG was up to 112, so we stopped at Subway for lunch.  I gave her the first dose of antibiotics and she said it was yucky. 

Then we headed home, she was so tired, I could see it in her face, we got back to town around 12:30, I was going to let her come home and have a nap, but she wanted to go to school.  So, I dropped her off at school.  Let her teacher know about the UTI and she would need to go to the bathroom.  She has access to the bathroom already according to her IEP, but it also says in the IEP that if she's going to the bathroom a lot, she's probably high and needs to check, so I just figured I'd clue her in on the UTI.  Her awesome teacher told Kortnie, "oh those are no fun, I've had them before, I'm sorry you don't feel good, don't worry, if you have to go to the bathroom, just get up and go, even if I'm busy you just go, you are definitly not supposed to try to hold it in okay, I won't collect a stick from you".  Awesome!  (the kids get popsicle sticks at the beginning of the week and then as rewards for various things throughout the week, usually if someone has to use the bathroom she makes them "pay" a stick to go, she doesn't make Kortnie "pay" with a stick though)

I picked her up at 2:30 and she told me she had fun at school and that she only had to go to the bathroom twice, and that she was feeling better.  She went to Soccer practice yesterday afternoon too, even though I wanted her to stay home and rest, but nope, she wanted to go to Soccer and play and have fun with her friends.  This girl, she doesn't let anything keep her down for too long.  She's my Hero.  I look at her and she looks so tired, I know that Diabetes wears her out sometimes, and I know this UTI has her beatdown and probably the combination of Diabetes and UTI is even worse, but she just keeps on keeping on.  I don't even know if she knows what it feels like to feel good, I think she probably feels crappy so much of the time, that feeling crappy is just her version of normal.  I wish I could take all of it away from her, it makes me sad, but I don't want her to see how sad it makes me, because even though she says having diabetes "sucks" she seems okay with it most of the time.  The fact of the matter is that even though I want to take it from her, I can't, so I have to let her be okay with it and not make her think it's such an awful, terrible, sad thing...even though it is!  When she wants to rant and rave and be mad, I'll let her, by golly, but for now, she's okay with it all, so I guess I will be too. 

A chance to Advocate and Educate

A few weeks ago the Diabetes Educator at my local hospital called and asked me to come in and give a talk at a training session she was doing for some of the Nurses. The training session was going to be about the Different Types of Diabetes. The focus was mainly going to be about Type 2 vs Type 1, but she touched on Gestational and LADA as well. Anyways, she asked me to come in and give a 5-10 minute talk about what it's like to be the mother of a Diabetic and a kind of "day in the life" of managing diabetes. She also asked my permission to use a picture of Kortnie. I agreed to both. We live in a Large Community made up of Small Towns. Our local hospital is not very big and usually sends the more intricate cases down to Phoenix which is a 35 minute helicopter flight or 3 1/2 hour ambulance ride. We also do not have a Pediatric Endocrinologist anywhere on the mountain at this time.

So, this was my first opportunity to really be an advocate for my daughter in a professional setting other than school. I had been thinking about what I wanted to say for the 6 weeks prior to my talk and finally the day before I was to go in I sat down and wrote something up. I was so nervous!

Here is what I wrote up.

Good Morning, my name is Amanda, my daughter Kortnie is 8, she's had T1D for 2 1/2 years and has been pumping just over 2 years. Miss J asked me to talk a little about what it's like being a parent of a T1D. First of all, I'll tell you about a typical day for us regarding Diabetes Management.

7:19am-We wake up, her BG is 124, 38 carb breakfast, we weigh and measure all of her food, this day she had cereal and milk, we calculated and dosed her insulin, we call it a bolus
11:32am-She wants to go to a friends house, her BG is 176, 36 carb lunch, we bolus and she goes to play
2:16pm-She's 269, that's high but she's been playing outside and it's hot, we do a correction bolus
6:21pm-We're going swimming , get to the pool and check, she's 421! Wow, that's high, what should we do, make her sit out while the other kids swim? Give her a full correction bolus? Pump on or off? She seems fine, she wasn't showing any indication that she was high, maybe she was just excited that her friends were gonna go swimming with her. My husband and I decide to give her 1/2 the amount of insulin we'd usually give, take her pump off and let her have fun.
7:27pm-We always check her one hour into swimming, she's 77 now, wow, she dropped fast, I gave her 1 glucose tab, left her pump off, swimming will be over at 8
7:55pm-Out of the pool, she's 55, I gave her a juice box and put her pump back on her, go home for showers
8:41pm-Dinner time, we made spaghetti, her BG is 87, that's a good number, gave her 1 cup of spaghetti and 1/4 cup of sauce, we bolus for 55 carbs, I used a Combo Bolus, that's when I give her 65% upfront and let the other 35% "drip in" over the next 4.5 hours
9:37pm-Kortnie says she's feeling low, she's 57, We give her a juice box, but keep the Combo Bolus active
10:34pm-Bedtime for everyone, she's 154 and feeling good, I'm happy with that number
2:32am- I wake up every night around 2:30 and check her, she's 348, Dang! Spaghetti and Juice Boxes have caught up to us. Correction Bolus and back to bed
8:03am-she's 116, Great Wake Up number

We check Kortnie's BG 10times a day, we change her cannula every 3 days at least, every 3 months we make the 3.5 hour drive to Phoenix where she sees a specialist and has an A1C done, once a year we do extensive blood work and an eye dilation.

On sick days we check every 2 hours and monitor ketones. When our kids are sick we try to manage them at home but sometimes it gets away from us and we have to bring them to the ER. I realize that the last thing you want is an overzealous parent acting like we know it all, but we live with this disease every day. We just want what's best for our kids and with Type 1 Diabetes every minute counts when they are sick.

I had a closing type of statement written up but at this point they started talking and asking questions. They said that they do like when a parent knows what they want and are informed that their big issue is getting doctors to listen to them after they've listened to parents. They asked a few questions....some they asked were....How has her diagnosis changed your family? Do you utilize the glycemeic index or just strictly count carbs? They were amazed how much she fluctuates throughout the day and how much the swimming affected her and they asked about other sports. They asked about how much care she does for herself and how I'm doing at teaching her how to take care of herself. They asked about school. They asked about how we handle sweets and we talked about letting kids be kids despite their diseases. They even asked about cooking, like how do I cook and do carb counting. They asked about her pump and she got up there and showed it to them, she was a little ham, which was nice because sometimes she doesn't want to talk about her Diabetes at all.

It was a great experience and I was honored to be asked to come talk and after I left I thought of a million other things I could have talked about. I hope that Miss J asks me to come talk again sometime.

Later on that evening I heard from a friend of mine who works at the hospital (not as a nurse but something else, I think she works with the heart monitoring machines or something), anyways she talked to a nurse who was at the training session and that nurse told her that I did a great job and it was one of the more interesting trainings that she'd been to. Yay! I wish I could've stuck around for the whole day of training but I had kids to take care of, next time I might get a babysitter and sit there all day!

The nurses and I were given a poem at the training as well, I'd like to share it here. It is exactly how I feel, there is no Author or otherwise I'd post the Author's name. Does anyone know who wrote it?

A Mother's Anthem

I am the mother of a diabetic child.

I don't know what it's like to go to sleep at night and know for certain my child will wake up in the morning.

I don't know what it's like to sleep the whole night through without waking up to do blood tests on my sleeping child.

I don't know what it's like to prepare a meal without a calculator, measuring cups, and a gram scale.

I don't know what it's like to drop my child off at school and know she will always be in the charge of someone who knows how to take care of her.

I do know what it's like to force feed sugar in the middle of the night knowing I am sacrificing my child's teeth to save her life.

I do know what it's like to draw up insulin at 2 A.M. and pray to God I'm not too sleepy to make a fatal error in judgment, technique, or calculation.

I do know what it's like to sit underneath the dining room table holding my sobbing child, explaining to her, "No we can't take a break just this one time," while I inject insulin into her already bruised arm.

I do know what it's like to walk away from the pharmacy counter with an armload of supplies and realize I've just gone through another box of 200 syringes.

I do know what it's like to help my child march bravely past the juice and cookies at the school reception that was supposed to be her reward for achieving Student of the Month.

I do know what it's like to look into my child's eyes and tell her she has an incurable disease and explain to her what that means, and then to be comforted by her when I'm the one who can't stop sobbing.

I do know what it's like to love and cherish my child every minute of every day, to know that I may someday donate a kidney to her, and that if she were in need of a heart, mine would be out of the question, because it broke a long time ago.

I am the mother of a diabetic child.