RB#1: Tranny on a Hill

Boys,

Seems somewhat fitting that we finally get rid of our nighttime lows and now Gregory has ketones.

This blog is intended to teach you how to be independent. For the last 12 years, I have been the one to reason through priorities in your life to determine a plan of action.

Currently, I am the only adult able to care for you. By 12, most children can leave for a week or two without their mother's micromanaging every couple hours, but diabetes complicates independence. Until you are able to reason through these problems, you will forever be tied to someone bossing you around.

HOW TO TREAT KETOACIDOSIS

·         Immediately drink a large amount of non-caloric or low caloric fluid. Continue to drink 8 to 12 oz. every 30 minutes. Diluted Gatorade, water with Nu-Salt™ and similar fluids are good because they help restore potassium lost because of high blood sugars.

·         Take larger-than-normal correction boluses every 3 hours until the blood sugar is below 200 mg/dl (11 mmol) and ketones are negative. It will take much more rapid insulin than normal to bring blood sugars down when ketones are present in the urine or blood. Often, one and a half to two times the normal insulin dose for a high blood sugar will be necessary. Higher insulin doses than these will be needed if there is an infection or other major stress. 

·         If nausea becomes severe or last 4 hours or more, call your physician.

·         If vomiting starts or you can no longer drink fluids, have a friend or family member call your physician immediately, then go directly to an emergency room for treatment. 

·         Never omit your insulin, even if you cannot eat. A reduced insulin dose might be needed, but only if your blood sugar is currently low.

Our plan for today is to keep checking BGs every hour and give Gregory carbs and Humalog each hour until ketones go away. This is easier to do now BEFORE he gets a stomachache and we want his BGs to be stable enough to avoid eating past bedtime.

We will record this on his blue "Whatcha Doin'" paper so that we can compare what we expect to happen with what really happens.

It is incredibly important to thoroughly document

your actions when you are doing something

that can kill you even if you do it right!

Isn’t it frustrating that the better we manage this, the more your body changes, and the more we then have to change path again to realign ourselves with the straight and narrow?

Please keep this in mind as a benefit to STAYING on a good path.

In WoW, if you make mistakes even to the point of locking you out of instances, it all resets each week. But, with T1D, if you digress it actually becomes harder to get back on the proper path.

Uncle Alex and I just talked about this last night. Grandma’s van has a new transmission. Alex explained that when you put a vehicle in park on a hill, you are using the transmission to keep it from rolling backwards. Apparently, the new transmission doesn’t have the rounded edges so having parked it there the very first time with her new tranny, she couldn’t pull it out of park and into gear. 

--- UNFINISHED -- 

GAMBATTE!

-mom

RB#2: /Roll for blame

Boys,

In WoW raids, there were some groups with which we would /roll for a fun way to assign blame because there was no particular person that caused the wipe, but it happened anyway.

We are having a hard time identifying who is actually "responsible" or "accountable" for "accidents" and "misunderstandings".

As I approach this from the perspective of 'teacher' I like to first consult a dictionary to see if the words literally (*cough cough*) still mean what they used to. I like dictionary.com.

re·spon·si·bil·i·ty

   [ri-spon-suh-bil-i-tee]  Show IPA

noun, plural re·spon·si·bil·i·ties.

1.the state or fact of being responsible, answerable, or accountable for something within one's power,control, or management.

2.an instance of being responsible: The responsibility for this mess is yours!

3.a particular burden of obligation upon one who is responsible: the responsibilities of authority.

4.a person or thing for which one is responsible: A child is a responsibility to its parents.

5.reliability or dependability, especially in meeting debts or payments.

ac·count·a·bil·i·ty

   [uh-koun-tuh-bil-i-tee]  Show IPA

noun

1.the state of being accountable, liable, or answerable.

2.Education.a policy of holding schools and teachers accountable for students' academic progress bylinking such progress with funding for salaries, maintenance, etc.

ac·ci·dent

   [ak-si-duhnt]  Show IPA

noun

1.An undesirable or unfortunate happening that occurs unintentionally and usually results in harm,injury, damage, or loss; casualty; mishap: automobile accidents.

2.Law. such a happening resulting in injury that is in no way the fault of the injured person for which compensation or indemnity is legally sought.

3.any event that happens unexpectedly, without a deliberate plan or cause.

4.chance; fortune; luck: I was there by accident.

5.a fortuitous circumstance, quality, or characteristic: an accident of birth.

mis·un·der·stand·ing

   [mis-uhn-der-stan-ding]  Show IPA

noun

1.failure to understand correctly; mistake as to meaning or intent.

2.a disagreement or quarrel.

I think you three have a negative association with all of these words because whenever they get used I minimally get rolled eyes.

None of these are "bad words". (Heck, they have a lot more than four letters!)

In fact, to gain the independence that you want, these are the words you MUST master.  A good resource could Judge Judy. A good question she asks is, "Who else SHOULD be paying for this OTHER than you?"

My impression is that 'responsibility' generally refers to the person while 'accountability' refers to the source of financial restitution.

'Misunderstandings' are never committed by only one party yet often it only takes one person to eliminate them. Whether you misunderstand or are misunderstood, it is your responsibility.

Responsibility for an 'accident' could be the person who triggered it, the person who set it up, or could even fall under the header 'Act of God'. If your RV is destroyed by a hurricane, are you going to sue God? Good luck! Do your best to prepare and insure your property, but recognize that sometimes life isn't fair and you just have to pay up.

David, it is my responsibility that you didn't do as I asked. That's my starting point; however, you need to understand that it is ALSO your responsibility.  This time it was no big deal, but we need to use this minor issue to establish habits that will remain true with bigger issues. 

Life didn't come with a rule book, but we might as well take some notes along the way. ADHDers seem to work better with defined rules and protocol. Let's see how these two new protocols work.

MISUNDERSTANDING PROTOCOL

-> Has a misunderstanding occurred?

     No:  Don't use this protocol.

     Yes: 1. Identify involved parties.

          2. Identify whose fault. (HINT: look at step #1)

          3. Identify versions of misunderstanding.

          4. Eliminate versions that don't make sense

             to EVERYONE.

          5. Restate all valid versions and discuss

             until conclusion is found.

ACCIDENT PROTOCOL

-> Has an accident occurred?

     No:  Don't use this protocol.

     Yes: 1. Triage people.

          2. Triage things.

          3. Clean up.

          4. Brain storm with others

               a. Determine accountability($) /

                  responsibility(person)

               b. Potential

                  Reoccurrence Reduction Recommendations.

          5. Implement solution to reduce odds of reoccurrence.

GAMBATTE!

-mom