The other day, Lia was running high so I walked from the High School where I teach and went to the building where the 4^th grade is housed to make sure she didn’t need to change her infusion set.  I had the bottle of Humalog in my pocket to try to bring it to room temperature. Her blood sugar was within normal range, so I returned to my school. In the office, a friend of mine asked me if her glucose levels would stable out after being on insulin for a while.  I told her that it would not, that this would be a lifetime struggle for her and that the insulin I was carrying was to keep her alive.  As I said these words, I quickly had to leave the room to compose myself. Although I know very well what the insulin does, it was sobering to say those words aloud to someone else.

Since Lia’s diagnosis, I have not spent a lot of time thinking about how I feel about diabetes. With all the carb counting, figuring of boluses, night time blood tests, and everything else that comes in the day of a parent of a child with diabetes, I don’t allow myself the time to think about it.  I’ve done a lot of reading, mostly about how to manage diabetes, but also some about the long term effects of the disease.  I prefer not to think about the latter because if I do, I can’t function. I don’t want to read about what can happen if her kidneys fail, or her eyesight worsens, or anything else that might result in complications from diabetes.  What I focus on, is how we get her through another day as safely as we can.

I am not angry about the diabetes.  We will probably never know what caused it, though I am confused, since of the three kids, Lia is the one who was breastfed the longest, had the most natural foods given to her from the first days, and was home—unexposed to whatever her two siblings were exposed to in the daycares of their early days. I try to approach the whys in the way that I approach everything else:  it doesn’t really matter why—it just is—so learn to deal with it the best you can. When I get angry, it is at myself for making an error with a bolus or some other asinine thing, and it’s difficult for me to let it go.  But mostly, I feel tired: from all the things mentioned already, but really just tired of not knowing if I am managing things correctly—ever. Despite all our efforts, we never really know whether we’re doing things right, and more often than not, it is Lia who gives us the correct advice.  As a parent, that is frustrating to me.

Lia’s upcoming birthday is bittersweet for me.  I should not be feeling sad for the marking of another year in my little girl’s life, but this will be her first birthday with diabetes.  There is a part of me that wants to give her everything she wants—no matter what it is.  Mostly, I wish so much that she didn’t have diabetes, and of course I can’t deliver.

As I prepared to write this entry, I reread a journal that I kept when Lia was a baby. It is a sporadic account of her early days until February 2004 when she was 2 years and 5 months old.  I wish now that I had kept better records, but time is a precious commodity and I am sure I squandered it doing things like mopping my floors or doing the laundry.  Krista and I got a good laugh reading about when Lia dumped a roll of toilet paper into the commode and then proceeded to give herself a “spa” treatment. Or how when she first began drawing, she would make little swirls with her crayon and then look at it and exclaim, “Whoa!” The recurring theme in those entries is that even as a baby she was strong and independent and that she was, and still is, our comic relief at the house.

Last year, Steve planned her a dinosaur dig party.  He built a pit that looked like a real archeological dig site —complete with “fossilized” bones.  I enlisted one of my students (who is now at Johnson Wales Culinary Arts Institute) to make her a dinosaur cake.  She loved it all and was so very happy that day.

This year, she wanted a sleep over with her friends, so she wrote out the invitations on ruled notebook paper (I had given her some very nice card stock, which she politely refused) and gave them to the little girls at school.  On the morning of her party, I took her to get her ears pierced—something she has wanted to do but has been afraid to go through with. Our dear friend, Jessie, artist extraordinaire, made Lia the greatest looking Harry Potter cake we’ve ever seen.  Her excitement was a beautiful thing and, lucky for me, Steve captured it in a video so that I can relive that moment over and over.

What I want to do is to make this birthday as memorable as possible.  She’s been counting the days to her birthday for the last six weeks, and while I am not certain that what we’ve gotten for her is exactly what she wants, I know that our little girl will react in the way one might react to winning the lottery—as if she couldn’t imagine anything better.  That’s just Lia.

Happy Birthday, Lia.

Love, Mommy.

So last week we took full advantage of a four day test run on the iPro Continuous Glucose reader from Medtronic. This is a small device, shaped like a horseshoe crab but much smaller, about two inches in length, that attaches to the skin and continually captures blood sugar readings, while the person with diabetes goes about their normal routine. At the end of the test period, the CGM is removed and the data downloaded to a computer, where it is analyzed and compared against other collected information such as exercise, food and insulin intake, so that patterns of glucose fluctuations can be marked and adjustments made to the diabetes care plan.

Though we don’t have the data yet and cannot attest to its usefulness, the alternative testing to CGMS involves skipping meals and/or testing each hour for four to five hours, making bolus or basal adjustments, and retesting. Not something Lia or anyone else in the house was too excited to undertake. So at our last quarterly checkup we asked about the CGMS. The staff supported it and a month later she was outfitted (the tape was the worse part of it; see a few poorly shot photos here).

Outside of the obvious interest in learning more about how Lia’s blood sugars behave throughout the day, is how we all sleep at night, or don’t as the case may be. That last comment will ring very familiar with some, but to others I should explain. To do that I’ll need to backtrack.

I mentioned before our eagerness to learn all that we can about Lia’s diabetes. That’s true in every aspect of her care but one: Nighttime lows, which makes little sense when you consider that during the waking part of the day someone is always with her. Should we not be more concerned of those times when someone is not?

But other than arming ourselves with an understanding of the likely causes, nighttime hypoglycemia remains a weak link in our armor against diabetes. I don’t know why that is. It may have to do with fear (here’s an excellent  post about fear); or it could be that ignorance is truly bliss and to be any wiser is folly. After all, isn’t our world affected enough with the knowledge that lows can and do happen, anytime day or night, and the consequences can be fatal? Is that not all the call that is needed to get one of us up once or twice after dark to check Lia’s blood sugar levels? Would any more general knowledge — frequencies of occurrence, tales of courage or loss, the likelihood that Lia would wake on her own if she happens to go low, or even a computer-generated chart of her nighttime averages — give us the prudence to sleep straight through?

It is probably not information that would be wasted. It would be rare if that were the case. The treatment of diabetes is a lot like fighting a war: to avert disaster, know your enemy and know yourself. But is a four day clinical test substantial enough to put to rest any worry?

At a data-collected glance, the most challenge we have with her blood glucose levels are just before she goes to bed. Most of her meter readings — seventy-five percent last week, including those taken at two a.m. — are in range. There was only one case of hypoglycemia and it was minor and could be easily explained (incorrect bolus at breakfast time). She wakes most mornings within a few points of her target.

So maybe our worry is unwarranted. Maybe we’re losing sleep over nothing. Our bodies and sometimes our minds scream out: Yes, yes, you are. But our hearts cry something other.

The security of knowing first-hand, of really knowing that she is safe and sound is a thing no parent can truly relinquish, not to stories or knowledge or detailed computerized data.

Fear sometimes is impossible to let go, regardless how much you know.

– Henry David Thoreau

But where do you begin? What does more, not less, community look like? Who do you turn to in shaping alliances that will make for a simpler, more coherent, reliable and fulfilling future for ourselves and our children? How does our health, our financial well-being and our values add or take away from the sum of those remedies.

Getting to those answers may require a new way of thinking, at least for me it might, but even then when I break the concept of community down to its most trouble-free form the task sounds almost too easy, Food Rules easy: Make friends. Keep them close. Do good things for one another.

Of course, you don’t have to be a recluse (or a troglodytic writer) to make more of it than that.

Take Thoreau for instance. In his own words: “I lived alone, in the woods, a mile from any neighbor, in a house which I had built myself.” Later he tells why. “I went to the woods because I wished to live deliberately, to front only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover I had not lived.” And yet… “I had three chairs in my house; one for solitude, two for friendship, three for society.”

That is a form of community I can grasp. Personal, precise, and practical.

When I think back forty years to when I was a child living first in the mid-west, then the southeast, community at that time, for a young boy anyway, was the street you lived on, the school you attended, maybe a turn at the city rec league or cub scouts, with friends of the family get togethers every once in a while across town, where you would be introduced to kids on other streets, students at other schools, and discover other opportunities to connect. It wasn’t big, it didn’t cost anyone a cabin-load of cash, and it wasn’t very complicated. It was simple, ideal and hands-on.

Times have changed of course, some for the better, especially in terms of advancements in science and technologies that make it easier to find and stay connected to the people and matters that are important to us. But too there has come an unwanted casualty of this essentially novel new world. For many, two of the three chairs sit empty, or are only occasionally occupied.

The answer why is complicated, but the better question is how to change it. We all know how to make friends (Rule 1), but if what we want is a simpler, more reliable community, we need to consider what it means to form friendships that are built to last.

Take this recent conversation I had with my brother as example. He lives in another state, a two day drive to get there, and works in the coal mining business. We were talking about the over-dependence on the planet’s natural resources and I wondered aloud how, if the peak oil theorists are correct, would I want where I live to be different.

Well, for starters, I said, it would cost more to travel so I’d want us to live closer.

But what if they’re wrong?

I guess then there’s no foul, no harm. We get to enjoy each other’s company more often, and without all headaches that will accompany the end of the modern world.

Big deal, you might say, he’s my brother. Family looks out for itself. But a few years ago when gas went to four bucks a gallon and the economy started it’s landslide that hasn’t stopped yet, did we all run home to family and circle the wagons? No. We drove less. Rule 2: Keep them close.

The third rule — which are not rules at all, but something I just made up (to admit to anything other would sound like preaching, which this already feels too much like it is) — suggests that doing good things for one another is the cornerstone of friendship, and it is. Unfortunately, I think, it’s also the most difficult to maintain and probably the number one reason those other two chairs might sit empty.

But if Lia’s diabetes has taught me anything it is that one of the most essential facts of life is that we cannot be all things to ourselves. We need others and we need to not feel alone, and if one day the world does overheat or the oil wells run dry, the good that will come from making friends, keeping them close and doing good things for one another might prove a worthy ally, in any kind of weather.

Then Lia — I have struggled for months how to say this in active voice: had she contracted, developed, or simply come down with diabetes? — was nonetheless diagnosed with Type 1 and I created this web log as a place to write about our experience. Why I chose the internet and not a private, paper cardboard notebook to do this, I don’t really know. It wasn’t to share with an audience. Though the support and acknowledgement is irreplaceable, having it read is not really that important to me. Perhaps it would be were what I wrote for Without Envy fiction, but when you are writing about real life you have in your mind this true perfect image of what should be said and you can never quite achieve it. Words like sadness, joy and frustration fall short, so the feeling just goes nameless, truly understood only by others who share in the circumstances. In matters so close to the heart any degree of obscurity is a difficult thing to accept. Maybe it is that way with fiction too. But with fiction, liberties from the truth are to be expected, it’s permissible to look the other way.

What is important, of course, if for no other reason than to make peace within myself, is to write about this experience in detail and how I feel about it. The worry then and the namelessness of my worry might evolve into something else less ethereal, less tiresome. Eventually, it might turn into practice and as such become just one more detail in the story of our lives, so that the emotion will lose some of its power to arouse fear and cause paralysis. Or as Shakespeare so beautifully put it: Give Sorrow Words. The grief that does not speak/ Whispers the o’er-fraught heart, and bids it break.

To this end, I have lately been thumbing through a book by Louise DeSalvo, Writing as a way of healing: how telling our stories transforms our lives. In it she mentions a zen proverb that I found especially inspiring. It goes: how you do anything is how you do everything. That got me thinking about the restrictions I had imposed on this public journal in regards to our anonymity. From the outset I had been careful to not use last names or the names of places or anything else that might needlessly give away more about ourselves than I wanted revealed. I knew how unkind the world could be and preserving some level of privacy was important to me, and to us as a family. It still is, but the direction behind it has changed.

It used to be I thought paradise was forty acres of wooded land in the middle of nowhere. No neighbors. No passing cars. No unwanted external intrusions. All the garden and wild meat we could eat. It isn’t any more, though there are days I still long for that. But Lia’s diabetes, amongst other things (peak oil, climate change, a growth-oriented economy), has triggered in me a practical awareness of our undeniably inescapable vulnerability. It (they) requires a shift in perspective, a rejiggering of priorities, and perhaps a bit more willingness for more community not less; more trust, more sharing, more appreciation and reliance for the companionship found in our fellow humankind.

Trust though is a difficult thing to surrender and there will always be the need for mindfulness and discretion. But the threats we face are not nameless, and nor should our selves be to one another. Isolation can only serve you so much, because how you do anything is how you do everything, whether you are sharing some small piece of yourself with a stranger or opening the door wide to let enter a friendly new neighbor.

Maybe that is why a little bound notebook wouldn’t do.

Lia’s Walk to Cure Video

It was a silly little game, but we all liked it, even when the supernatural was not tempted and the poems made little personal sense to the reader or anyone else, which was often. Lia, for instance, seemed to have the knack for always stopping on Robert Frost’s, Whose Woods These Are I Think I Know, (which may have made perfect sense looking back). She liked the poem so much, she had the page dog-eared and went ahead and read it anyway, whether she was commanded to stop or not. To her, life can be both mythical and in our power to control it, such was her dinner and a poem.

Often, people took more than one turn in the hopes of fate giving them a better verse, something lovelier or simply more direct. Disappointment, even in something as fickle as chance, is a difficult thing to accept. More than once, we had to just close the book, leave serendipity for another day, and get on with cleaning up the table. But, as I said, we all liked the game and out of it grew some appreciation in all of us for poetry, family, and tradition.

I don’t write poetry — well, I don’t write poetry well, that is. I don’t think so anyway. Other than one recent occasion (in case you missed it, here is the link to the very special, Six Until Me), I haven’t tried my hand at it in many, many years. But I love poetry and when I write prose I write with the same love and gratitude for the way words can be carved and shaped into an evocative, aesthetic rhythm. Poetry is to storytelling, what music is to sound.

Unfortunately, we haven’t been cracking Bartlett’s or any other poetry book after dinner lately. There is no good reason why. Energy. Focus. Desire. So much has been on our minds. What time has there been for daydreaming poets, for lyrics, or irony, when there are boluses and blood checks and other worries on which to attend?

The truth is there is no excuse. This occasion means too much to us as a family. So in honor of returning this tradition to our table, I offer this, the very first poem I turned to this morning (honestly). It’s by Henry David Thoreau. The title is My life has been the poem I would have writ:

My life has been the poem I would have writ,
But I could not both live and utter it.

Now just to show how well this “diving rod” doesn’t work, the second one fate picked for me was To My Dear and Loving Husband, by Anne Bradstreet.

Good thing we aren’t relying on this to find water.

I think there is something strangely alluring to a child and an empty school building. It reminds me of when I was her age and visiting my father’s uncle who drove a school bus in some far out country school district in northern Ohio. I can still remember the thrill of him taking us for a Sunday afternoon joy ride in the enormously long (back then) yellow bus.

For the drive over we took what we call The Big White Truck, which for Lia is always a treat, but not because it is big, it isn’t, but because she gets to sit in the front seat. This puts us on even par, at least conversationally speaking. Just two dudes — a new favored term she has recently picked up — ridin’ in a truck, yappin ‘bout the day.

I was feeling nostalgic for other reasons as well. This year Lia will be in the fourth grade and as such will be moving to another building. This is good news for us as a family because that means that Franca and the girls will all be at the same campus, which brings us both great assurance from a diabetes care standpoint — this school has no nurses, mom and dad are the nurses — as well solves for us a number of logistical problems, primarily, for me anyway, avoidance of cutting my workday short to attend the dreaded carpool.

But a new campus also implies something lost: The early mornings of waiting with Lia in the car at the library, talking and listening to music until the school doors opened, then holding hands as we walked down the street and past the flag pole and up to the school’s front steps; later in the day, sunny afternoons waiting outside on the sidewalk to pick her up, sharing a wave as she found me in the crowd of other parents, listening as she told me about her day as we walked back to the car; the occasional side-trek to the park or the library, which, sadly in hindsight, never happened often enough. To make matters worse, in the fourth grade building there are fifth graders to serve as reminder that just around the bend are the sixth and seventh and eighth graders, who are just a short skip and a jump from the high school, of which I can’t possibly consider for fear of discovering that a blink is truly all that it takes and then you are there, years ahead of this one certain moment.

Lia is old enough to know this too but to a child time passing is different. It is something of which to look forward to, to dream upon and make wishes — who you might become, where you might live, what work you might do — and yet…

As we head to the school that day in The Big White Truck, her mood suggests also a special sadness. Whether she is old enough to appreciate it or not is another matter, but I sense this tinge of regret in her that all children eventually come to discover, that life does indeed hurry by.

I will miss our walks, she says, but her grin betrays her. She has said this for my benefit and I love her even more for it. It is one of those cherished moments you’d like to freeze in time, the beloved gift of a glimpse into someone’s true heart.

Our wistful moment is short lived, as most are, and we have moved on further down the road. Our discussion has moved on too and we are talking about barns and how it would be nice to have one on a farm, with cows and chickens and tractors. Lia turns to me and says, Daddy?

Yes, sweetheart.

When we grow up, she begins.

I look at her suddenly with puzzled amusement, and she stops. I regret my intrusion at once, the suggestion is just too farfetched, though also extremely appealing. But I am too late with remorse. Lia has already realized her verbal mistake. It shows on her face in embarrassment and I feel for her disenchantment. It is one of adulthood we all share eventually, there is no turning back.

And so she starts over with the proper beginning, and we continue down this path, where my daughter, and all of my children, in fact, keep proving to be miles ahead of me.

We returned to the lake over the Fourth of July weekend to share in a longer visit with our friends from Connecticut and though none of us noodled or grabbled or otherwise did anything risk-worthy of a video, we did come across two young men hand-fishing for catfish along the shoreline. My good friend, Mike, and I were standing on his dock fishing when they asked did we mind if they noodled past.

At the time I had no idea what they were even talking about and went on fishing, but watched after the two boys with interest as they went about probing beneath the surface with their hands and a stick searching for probable nests. The way they felt unseen before them reminded me of searching the nightstand for my glasses in the dark, minus of course the caution (read: fear) of being latched on to by something fierce and toothy. I found also a poetic semblance in their ambitious blind hunt to the treatment of Lia’s diabetes.

Such cause for waxing lyrically may have been due to my state of mind, which after the unceremonious case of forgetting the dog, was convinced that the rest of the summer would be going much in the way of her blood sugars: A plethora of mind-numbing highs, mixed with a few startling lows, some brief, unpredictable moments of rest and contentment. For both Franca and I it had begun to feel as if much of our days and nights would be spent on the periphery of living, bound down by the sole occupation of chasing phantoms. It was a sentiment we felt sure would be backed up with scientific proof during Lia’s next endocrinologist visit, which occurred the week following our lake trip.

Fortunately our fears, like the worry of those catfish hunters who sometimes poke something they wished they had not, were not realized. The two boys got their fish, a thirty-five pound channel cat, lurking beneath a boat ramp a few houses down from our friend’s. And despite the struggles we’ve had with adapting to pump therapy, Lia’s A1c came down to 7.8.

Our relief, of course, was immense, as was that of those two fishermen when the great water cat came clean of its guarded obscurity with no injury to either of them. And after the elation settled and those wonders we’d brought to the surface and spoke of and then turned loose and after the doorway in which we’d come to know them had gently closed and we were left standing alone untroubled by the effort of our accomplishment, at peace even perhaps, we thanked ourselves for the warriors in all of us who never stop searching, probing, and reaching into the next hole.

It is the experience of our hands that we learn from, which fingers to prick, which dark holes to avoid. We are being taught to take it one day at a time, one shoreline after another, celebrating the rewards of everyone’s hard work and  mulling over the things that went wrong. But such discovery has a hard-edged strangeness about it, an awareness that leaves us weary. Yes, with it comes empowerment, but there is always the troubling forethought of what might linger in the unknown. For tomorrow is another day and fear too can be motivating. Parents of children with chronic sickness know this maybe better than most. As Franca put it to me as we were driving away from the doctor’s office with our good news: Every time I leave there, I can’t help but feel like crying.

Worry is worry, however, and the distraction to everything else in the world is the same no matter if it’s set in the future or comes from the past or the present. That was our thinking last weekend anyway when Lia suffered a low of the sort that jerked us square back to the moment and reminded us that this beast still has teeth and can bite.

It was Saturday, close to noon, and for breakfast Lia had eaten cereal with milk. Milk, depending on the type, sometimes has the tendency to raise her blood sugar hours later, and in fact when we tested her blood before a mid-morning snack it was above three hundred. Lia suggested the culprit was probably the cow’s milk because the variety she’d had wasn’t the 2% Jersey milk we’d recently switched her to and which seemed to keep her glucose in check, but the heavier Holstein whole milk. But because people, especially parents, are capable of believing whatever it is they want to believe, even when the truth is staring them right there in the face, both Franca and I chalked up her high to unknown factors and gave her a bolus to correct it. An hour later Lia was watching television when she told her mother she was feeling shaky, her preferred way of announcing to us: something’s just not right here.

Franca had tested her blood thirty minutes earlier and the mid-morning bolus we’d given her seemed to be working as she was now at the high end of her target range. But with Lia feeling strange she tested it again and the bottom had dropped out of it and Lia was suddenly looking and acting in a way she hadn’t behaved before with any other low. Her eyelids drooped, her speech was sluggish, she had trouble focusing. So she gave her a glucose tab and waited for it to take effect but grew more concerned when Lia complained that her heart was racing and she gave her another. When after another few minutes had passed and there was little improvement in how she felt, Lia started to cry and everyone’s confidence was then shaken.

I think you should go get Daddy, Lia said.

Franca offered her a juice box then and went and called me from the bottom of the stairs.

I came down and found Lia sitting in the chair, her eyes were closed, she looked to be sleeping. What’s wrong? I asked and sat down beside her.

Franca went through her symptoms as Lia looked languidly at me, then her eyes closed and her head lolled backwards. Honey, wake up. I patted her cheek. Can you hear me?

We were calm, but inside Franca and I were both on the verge of panic, each of us wondering was this what it was like when someone loses consciousness from hypoglycemia. Should we get the cake frosting? Was our next step the glucagon shot?

After a little more coaxing we got her to sit up and she drank some of the juice and we held her and waited for all those carbs she had eaten to do their thing. It seemed a long time in the way a long time can feel to the parent of a suffering child, but it wasn’t. Twenty minutes after her low was first reported Lia was feeling much better and back in her target range.

We spent the next few hours watching for the rebound high but it never came, proving perhaps that Franca had done well in treating the low so aggressively; and we kicked ourselves around the curb for not listening to Lia and going against our practice of not double dosing for the milk in the first place, a strange reaction when all you were trying to do was to make things right. But, like Elphaba learns, even good deeds can end in disaster.

The next day Lia’s numbers were perfect until the late afternoon when they shot back up over three hundred. We were visiting friends at their lake house, all of us: the kids, the dog, diabetes. The day prior was still fresh in our minds of course and Franca and I were both sporting that damned if you do, damned if you don’t attitude, so we dosed her for the high, because the devil you know is better than the devil you don’t know, and the devil right then was high blood sugar.

The bolus worked as it was supposed to, but the damage to our attention was already done. Still frazzled from the day before. Frustrated by the wildly swinging ups and downs. Exhausted from middle of the night blood tests. Sick of holding this damn beast at bay. Like the proverbial eggs in the frying pan, by the time we left that afternoon for the two hour drive home we felt as if our brains were fried.

We hadn’t been on the road long when Franca’s phone rang.

I wonder what we forgot, she said wearily and only half-jokingly as she took the phone from her purse and answered it.

We were all thinking what it could be, silently running through an inventory of what things we had brought when Franca said out loud: The dog.

Great, I thought, knowing the ridicule to follow. Fried and now scrambled.

As a result we were rewarded with the majority of her blood glucose readings in target range and a three month HbA1c two full points lower than when she was diagnosed. But besides being hurtful to Lia, the shots were time consuming, inflexible, and less precise than we wanted to be. The strongest thing they had going for them was that in theory a shot has minimal lasting impact in the course of a day. You deal with it and move on. Lia could dose and as long as that dose was marginally accurate she could within reason forget about diabetes. The key word, of course, is marginal, which when held up against the sexy appeal of technology doesn’t stand a chance. Add to it the reality of what it means to deal with diabetes and move on and we naturally leaned toward the pump.

So it has been three weeks since Lia switched over to the Animas Ping and while there have been some great improvements to her treatment, chiefly the absence of needles, the verdict — for us anyway — is still out on the MDI vs. Pumping debate. On the one hand, it is much easier to dose. Just enter a few numbers, press Go and voila, insulin delivered. The remote meter makes it even less intrusive, enabling us to not even bother Lia except for the blood test. The logbook reflects blood sugar results similar to what we were getting on shots, perhaps a bit higher as we are still trying to learn the pump’s capabilities and fine tune the many settings; and while we haven’t yet had a glycated hemoglobin test while on the pump, all indications are that it will be acceptable.

So why not stop there, with acceptable? Why muddle things up with second-guessing the reasons for abandoning what had so far proven to be an effective means of treating diabetes? Lia prefers the pump. It works well. Her numbers appear fine. Everyone is happy to be rid of the shots. Why can’t I be content with that?

Part of the reason why is the complexity of it all. Our expectations were high on the pump, either because of our lack of understanding or it being oversold to a couple of amateurs. The pump is no silver bullet. It is an intricate piece of equipment that requires extensive thought and expertise to use it to the fullest of its capabilities and achieve tighter blood glucose control. Tighter control, however, it appears at the moment, is synonymous with greater worry, and possibly even risk.

I’m not opposed to worry or work, especially if it will benefit Lia, but we are still newcomers to diabetes and there is much I’d still like to learn about it, and time I’d like to devote to research and advocacy. I wonder if the energy to calibrate the pump to Lia’s insulin requirements would be wiser spent, at least in this early diagnosis stage, better understanding the effect food and exercise has on Lia’s blood sugars. It feels at the moment like taking off in a plane without having thoroughly learned how to land it.

Complexity is one thing. It can be overcome through knowledge and experience, two things of which are both in short supply around here. But the other reason I am not quite sold on pumping over the shots has less to do with technology and Lia’s treatment than it does her way of life. It comes back to that minimal impact thing. MDI, as sad as it may sound, fit our lifestyle nicely. We eat real food, enjoy both vice and virtue in moderation, and take seriously the health of our mind, body and spirit. The shots, since she had to take them, became simply another part of the way we live our lives. Not a preferred part, mind you, but a part nonetheless. They were a few seconds of discomfort. We tried not to dwell on them, only the results.

But any loss of the privilege to live life unattended is the same no matter the treatment. Whether it is a shot taken before a meal or the programming of a highly specialized device, ultimately it will be Lia’s overall health that will direct us. I just hope that as these and more and more options open up to her they don’t come at some greater cost.

To find out more about the research being done for the treatment and cure of Type 1 Diabetes, click here. To get started as an JDRF diabetes Advocate, click here.