Malfunctioning mobility

Testing bg outdoors can be challenging. Especially when there's a meter of snow and you're chasing a child in it. What tends to happen is that you:
A) drop something in the snow, the lancet pen, the strips, the meter, the lot.
B) you get to the child, open the strip bottle with cold, clumsy hands and manage to chuck the strips all over the snow,
C) you get to the child, get the strip in the meter but can't get any blood out of the small and frozen fingers. And when you do, the meter has either died or complained of EEE(rror) (Accu-Chek, please notice that sometimes you just have to measure in -15 C).

Spring is on its way, I hope, but I'm still bloody tired of having only two hands. So when we were given the chance to try the new Accu-Chek Mobile, I was relatively excited. What, no strips? We've always used the MultiClix Pen, so lancets weren't such a problem, but the roll of strips sounded fantastic.

Eli was impressed by the thing. It was quite big and bulky, but it made a whirring sound and you could see the "strip roll" turning. And even though his eyesight is perfect, he was also impressed by the bleeping function for the blind. I turned that off pretty soon, fourteen loud bleeps at 2 am is enough to wake up the neighbours. And I have no intention of letting them know we can't control Eli's blood sugars ;)

The idea itself is great, but there are a few glitches.
The test roll, for example. The meter fell on the table once, maybe a 4 cm drop. The other Accu-Chek meters have been thrown about, chewed and dropped in bowls of soup and they still work fine. However, this one has a sensitive spot. The test pad area is fine paper and as we found out, it breaks easily. And when the roll breaks, you can't use it anymore. This happened to us when we were out and of course we were stupid enough not to bring a spare roll/cassette. But luckily we were at the hospital and the nurse managed to find one. That was a pretty bad day. First we looked like the worst parents ever, not having any spares on us. Then Eli had a hypo and my bag was empty bar from painkillers. Even the hospital vending machine was empty. So we had to ask the nice nurse again.

But back to the meter. Another problem is the lid/cover for the test area. I might have weak fingers or something but I have to really ram it open. And I tend to forget to close it. The meter does remind you very politely after testing, but after browsing for previous test results and setting 'flags' and reminders, you forget about it, stick it in your bag and probably break the test roll again.

The last complaint I have is the pen. It's awfully flimsy and, for some reason, the mechanism is different from the other Accu-Chek pens. My finger wants to press the button by the numbers, but you have to click the top instead. I find this makes it difficult to get the lancet end of the pen tightly on the fingertip. Also, the other night I tried to measure Eli's blood sugar in the dark and kept wondering why I wasn't getting any blood. I came out swearing to see what was wrong with the pen and realised the tip cover had come loose.

All in all, it's not a bad meter. It has loads of fancy functions and the display is good and clear, Aviva Nano style. Maybe I'll get used to it. I am quite pleased with the lack of old strips, normally they are absolutely everywhere, in the beds, in the dogs mouth, in the washing machine...

Anyone else tried this one yet? What do you think?

Clickety Click Click

A word about clicker training. I had a vague idea of it before The Dog arrived but had absolutely no idea how powerful it is. I'm pretty confident I could get Molly to talk, walk and get a job just by using the clicker method.


I won't attempt to explain the ideas behind conditioning, as that would be a tad boring. But if you've never heard of Pavlov's dogs or behaviorism, have a look at http://en.wikipedia.org/wiki/Classical_conditioning. Unfortunately conditioning has negative connotations and it's often thought that it must include punishments. But forget poor Alex in A Clockwork Orange, it doesn't have be like that.


Clicker training was first used for pigeons and after that, on all kinds of creatures, including bears and whales. I wouldn't recommend attempting to clicker train the bear you encounter in the woods, it might not work. The most famous (or best-selling) clicker trainer is probably Karen Pryor. Have a look at http://www.clickertraining.com and you'll know what I mean. I actually have one of the clickers featured on the page and it's nice and subtle.
Wikipedia has summed up all the misconceptions about clicker training nicely, so if you're sat there huffing and puffing and bah humbugging, have a look at http://en.wikipedia.org/wiki/Clicker_training#Common_Misconceptions


The clicker can be used just for basic training or for something more specific. In our case, we are using it to teach Molly to (first) find the hypo scent and react to it. The idea is that in the future, she will alert us whenever Eli stinks of hypo. And that's what it probably is to a dog. Even though it is still a bit of a mystery what it is exactly animals can smell. It's under research and being taken seriously. Have a look at this article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC27564/


But to put it simply, clicker training is about positive reinforcement. The dog does something that you want it to do, first by accident, later on purpose. You click the moment the wanted behaviour occurs and then follow with a treat. Sausage and cheese are Molly's favourite but it could be anything. And no, you don't end up carrying bits of liver around for the next ten years. Later on, the clicker is not needed and the reward can be verbal or just a pat. Though in Molly's case, there is no reason why we can't keep giving her the (tiny tiny) sausage pieces, especially to motivate her to wake us up in the case of night time hypos.

The equipment then. Pretty much every pet shop sells clickers, or you can just use a jar lid, like the ones they have on baby food jars. I bought one from the pet shop, the blue one in the picture. It was the quitetest they had but it's still bloody loud, hurting my ears and probably the dog's, too. I got another one from our trainer and this one has a softer click and it also clicks easier. This means I'm not late with my response, trying to jam the clicker button down. The black one in the picture is a Karen Pryor one and I recommend it if you want to buy one. And that mitt was knitted by my nana. That you can't buy.

And on other unrelated issues: it's almost April and there is still loads of snow. It's strange and annoying, I'm losing hope of ever seeing the ground again. See!

The snow also means Molly has access everywhere, being so bloody light she doesn't sink in the snow. Unlike me, trying to chase the dog with snow up to my thighs, swearing profusely. Spring and all the fresh smells make puppies go mad, humans (or me, anyway) just headachey and tired.

Grrr.

What to do when people think that 24.5 is a 'decent' reading? Somehow I disagree. And so does Eli, a weeping, pale, tired mess, begging for more water. I can't 'rage bolus' as this isn't my body but I do get the sense of just forcing it down, NOW!

Tired of the peaks and the overcompensating and measuring hourly from those poor, bruised fingertips. Eli is only four so his fingertips are tiny. And he's petrified of measuring anywhere else.
The Novopen has become the enemy, too. After hitting a sore spot a few times in the last weeks, Eli won't have any insulin unless he can examine his thighs frantically for 'the nerve spots'.

Bad day today, made worse by my dentist appointment, looming ahead :(

Molly is great, though. She's cut down on the turds and prefers real food now. Sausages drive her insane, you wouldn't think a tiny dog can jump up to the fridge. She slept in the kids' room last night and only woke them up once by stepping on their MP3 player. If you've heard 'Baby Elephant Walk',  you know it's not a lullaby.

Now she's dreaming by my feet, making a funny sound in her sleep that sounds just like a car alarm chirp.

Linking

Have a quick look at my blog list, found at the bottom of the page.
Just to mention a few:

There's Shiv, a young woman whose had diabetes since she was a small child.
http://clickofthelight.blogspot.com/

Then there's Becky, also a young woman, but only diagnosed about year ago.
http://instructionsni.blogspot.com/

Also have a peep at Waving and Drowning, written by a mother of a type 1 child.
http://wavingdrowning.wordpress.com/

There's also Sam, who was diagnosed with type 1 "after throwing up over a couple of girls in my class whilst watching Oliver Twist." when she was just eight :)
http://www.talkingbloodglucose.com

You might also want to say hello to Northerner , who is running and rhyming with type 1.
http://diabetespoetry.blogspot.com/

I would especially recommend the blogs if you're unfamiliar with the incredible hassle type 1 diabetes causes every bloody day. I am only the mother and there are days when I feel quite confident my son will have a good life. Then there are those black days, when it all seems hopeless and I can't stop mulling over all the possible complications and problems he will have when he grows up. The worst days are those when Eli keeps asking is he going to get better soon.


And for your information, nice ladies on the street, he didn't ask this before you idiots told him that he'll get better soon. He was quite happy with his dysfunctional pancreas until complete strangers pointed out that he's ill. (Insert explicative here).

Anyway, have a look :)

The Boy

If you know Eli, you know he is a tad sensitive. Clever, beautiful and fun, but oh so sensitive. Unfortunately he takes after me. I was one of those kids who didn't really get the joke. Hiding hiccups so no one would scare you, as that would make you cry. You must know the sort. Growing up with two sisters toughened me up, though, as being kicked in the back from one direction and having porridge thrown at you from the other can make you very angry. No point crying, throw the remote at them instead ;)

Anyway, Eli has never been into raucousness, unless it was in a safe environment, with daddy, that is. A puppy, as you might know, is raucous. Even this one. See, we managed to find a puppy that fits this family perfectly. Antisocial and cautious should be written on our post box under the name. But Molly is a puppy. And puppies jump. And run. And nibble. And jump. And jump. And jump. Especially when they are very small. When the puppy sees another (human) puppy running around, squealing uncontrollably, that MUST mean they want to play. Now our human puppies do this, but only one of them wants to play. The other one squeals in pure panic, arms flailing in the air.

So we had communication issue there for a while. Eli would come out of his room in the morning, scream and run. Molly would get up and run after him. Mayhem ensued. Grumpy (= just tired, we're never normally grumpy...) parents would yell equally at all directions, hoping to gain peace and quiet. Obviously that only made it worse. It got to a point where Eli would hide on the sofas and chairs and only get onto the floor if Molly was kept away by someone. It did look like a crappy scenario, considering Molly was supposed to be Eli's assistant dog. It's difficult to assist when you're stuck in another room.

But somehow, it did get better. Molly calmed down, just ever so slightly. We were able to contact the dog in that small, thick skull and she listened. Eli calmed down, too. He realised he could ask Molly to sit or lie down, and she would. Imagine that. The routine changed and now there are two different children in the house for Molly. One is for cuddles and company, the other one for rolling on the floor and running around. Handy. The gender stereotypes don't apply here, though, as it is the little princess in her fairy wings and pretty shoes that is growling and crawling on the floor, when the Lego engineer sits and calmly plans his savings plan for the future, wearing his sister's skirt. Oh how I love them both.

It is a great feeling to connect with your dog, as cheesy as that may sound. The clicker training helped, Molly seemed to understand that she can communicate and get us to do things, too. The general screaming has diminished, though not disappeared completely. But with two under 5's, there will always be some screaming. Hopefully from now on it'll be done by the kids. Or we can at least pretend that is the case. As an adult, surely I am able to express myself in an adult manner. You'd think so, wouldn't you?

Must mention this

I had to write another entry today, I was so happy with the response I got in the discussion forums when I mentioned my blog. I haven't a clue what I'd do without the internet. I've been able to contact a large number of people online for support, advice and just for general ranting ;)

The internet has also been pretty much the only source of information concerning hypodogs. Organisations and private dog 'academies' are stingy with their knowledge and it can be quite disheartening trying to contact people by phone. After the 12th "I'm sorry we can't help you, but we do take Visa and Mastercard", you do start feeling like an eejit for even trying. I am only asking whether they think it's possible to hometrain a hypodog (clearly they don't...) and, if they haven't hung up by that point, do they think it's better to freeze the samples or not.

I'm really hoping the training works out and the whole thing takes off. Charities cannot provide dogs for everyone in need and if individuals have the will/the skills/the patience to at least begin training a dog, it cannot be that bad.

Hope the mothers, whose day it is today, have a fantastic day :) I still have some weeks to wait before I get coffee poured all over me in bed (not as romantic as it sounds), being in Finland, the land of awkward bank hols.

Basics

To update, this is what has happened so far.

We got a small boy. (He was followed by a small girl, who may occasionally appear in the blog, too. Usually as a distraction. A gorgeous distraction, may I add.)

The small boy got diabetes. This wasn't on our original to-do-list.

The small boy got in trouble with his lows.

We got a puppy. Not an easy task. After declining offers to buy mixed breed puppies straight from the airport in the middle of the night, we found a good breeder. She was willing to sell us one of her Havanese puppies a bit cheaper as the pup had a strong underbite, making her less likely to be the Crufts Supreme Champion. This was fine by us, as we're not really into shows anyway. Even if Molly would have been presentable enough, we would have been kicked out of any shows for being scruffy and untidy. We're students. Poor students. Poor students with children. Poor students with children and no sense of style. Enough said.
We chose this particular breed as I have some experience of Havaneses. They are also known to be extremely social, good with children (!!!!) and fairly intelligent (?). They are small dogs and relatively easy when it comes to grooming.

We searched for more information on D.A.Ds, or hypo-alert dogs, or hypodogs or diabetic assistance dogs, or whatever you want to call them. There is a lot of unofficial information online, news on research projects and discussion forums. DAD's are common in the States and considered as official assistant dogs. In the UK there are some hypodogs and experienced trainers. In Finland, the country we've managed to get stuck in, there is all of one official dog that is being trained as a hypodog. That dog is being trained in an institution and then handed 'ready' to a family of a small diabetic boy.

Concerning the training , the Americans are very quiet about their specific methods, which are supposedly 'groundbreaking' and 'unique'. This probably means they are fairly simple and executable by dog owners with the help of a trainer. But that would be quite unprofitable for the companies.
If you are considering training a hypodog, a good place to start is http://www.diabeticalertdog.com/forum/. There are a lot of opinions on methods and particularly on the scent acquirement.

We searched for a dog trainer. And found a brilliant professional, experienced in scent training. She came to meet Molly and was greeted by a scared, shaky mess. It didn't look good. Molly was petrified of other people. Strangely, she was comfortable with children, even when there was twenty of them piled on top of her "stroking" the poor creature. But adults were huge, smelly and unpredictable. So the next step was to socialize Molly so we could at least leave the house without nervous vomiting by the post boxes.

It took a few weeks but now we have a pretty normal dog. She is comfortable with people, though a little cautious at first. She is so comfortable on public transport (we don't own a car) that the snoring begins as soon as she's curled up on the bus. I got her a carry bag which opens. It's easy to bring along and lift it on the seat next to me or on my lap, creating a safe haven anywhere. We also use it in cars, whenever we can get a lift somewhere. I secure the bag with the seat belt and the dog is safely tucked away, not pestering the driver or chewing on the handbrake. Nor would she fly through the windscreen if there was ever an accident.

Molly had her first private lesson on Friday and it looked promising. We had already begun clicker training before the lesson so she was familiar with it. I got a new clicker from the trainer, with a softer click, a lot nicer for the ears. With the help of the spanking new clicker and Molly's favourite treats, we've got as far as getting her to smell a jar. Which will eventually contain a saliva sample. Which will be collected from Eli. Who will happily stick cotton sheets in his mouth when he's hypo. Yeah, right.

We are only in the beginning and it's a loooong way before we can trust our loyal mop to wake us up in case of hypos. But there is no harm in trying. The worst case scenario is that Molly doesn't learn a thing and we end up with a pet. A pretty cute one, who loves the kids and who love her back. So it's not that bad.

Here it goes.

This is Molly, a four-month old Havanese puppy. She is pretty daft, being a puppy and all. Hopefully she will grow up to be the next Lassie, though smaller and dirtier. At the moment she is enjoying her own turds and generally, any piece of crap she can wolf down before we get to her. Despite her disgusting taste, our intention is to train her to become a hypo alert dog. This would mean that, in the future, she could smell low blood sugar - also known as hypoglycemia - and alert us about it.

This is where we come to Eli. He is four, too, but in years. And he has type 1 diabetes. Which he dislikes occasionally, asking when it'll go away. 'Never' is not the answer you want to give to your child. But hopefully the future will bring better treatments and more options. Until then, all we can do is make it easier for him.

One problem with type 1 in children are the lows and not spotting them. When a small boy is engulfed in his pile of Lego, no amount of shakes, sweats, headaches or hunger will get him out of there. Combined with sudden crashes in blood glucose levels, this can have disastrous results. The lows often happen at night so we, the adults, have to get up to check the levels to make sure Eli will still wake up in the morning. As horrible as it sounds. This is where Molly steps in in all her stinky glory. If she can A) learn to smell the lows and B) learn to alert us when the lows occur, then C) we can fix them. Easy peasy. Hopefully.

The purpose of this blog is to record Molly's training and hopefully give information to others considering training their own DAD (=the acronym sometimes used for 'Diabetic Alert Dogs').
Whether the blog will be updated on time, or at all, is another question.
Wish me luck.