Forty Days of Diabetes - Day 41

Three Years and Counting

And that's a wrap folks! One more year come and gone. Not just for fundraising but as a "D" family as well.

October 5th, 2012. The day our lives changed forever. Three years ago I got up and left for work like any other day. But there was something there. I knew things weren't right. I honestly thought we were going to get a much worse diagnosis. The lost weight, lethargy, and bruising all over her legs was leading my mind down a much scarier path.

And then the was D. I'd be lying if I said it's all bad. It's a challenging lifestyle but we've had some great experiences along the way. We have people in our lives now, near and far, that we'd never have crossed paths with if it wasn't for D. 

You're 40 day journey may be over but we still have a long way to go. Because D is here day in and day out. It doesn't care if our schedules are busy. If we're trying to celebrate, sleep, study, or just be carefree. It's always here. It will be here when she goes to high school, gets her drivers permit, falls in love for the first time, shops for a prom dress that will hide her pump. It will always be here. 

So we celebrate this day. With cards, presents, flowers. We celebrate because it's not just the day she was diagnosed, it's also the day her life was saved. Because I consider us one of the lucky ones. Because the alternative to her being diagnosed would be not having her here at all. On October 4th, 2012 we were just a regular family. And then there was D.

Forty Days of Diabetes - Day 39

The Things That Keep Her Alive

Caitlin wears an Omnipod. A self-contained insulin pump that holds and delivers her insulin. It's small, lightweight, tubing free, and auto inserts with an introducer needle, at the push of a button. But you have to have a lot of faith in technology to put your child's life in its hands. The Omnipod holds 2ml of insulin. It doesn't sound like much but at 100 units per ml, that's 200 units of insulin. She uses a little less than 40 units per day, so it holds about a 5 day's supply. It would drive a person to crazy to think about what would happen if the pump malfunctioned and delivered a massive amount of insulin. So I don't. Because if I think like that I will likely push myself over the edge.

She also wears a Continuous Glucose Montor (CGM). This small transmitter (top photo) has a filament which is introduced, again with a needle, into her subq tissue. The filament reads the glucose level in her interstitial fluid every five minutes and transmits the data to her receiver (bottom photo). The data is transmitted via Bluetooth to my iPhone. Instead of the static data you get from glucose readings taken hours apart, you're able to see data for the entire day and recognize trends and problem areas to treat highs and lows more aggressively and even avoid them before they become a problem.

As wonderful as technology is, it sometimes fails us. Her Dexcom started alarming at 2am. Extreme low blood sugar. Swedish fish (fast acting sugar for a quick bump) and thin mint cookies (a little fat to slow the absorption) and we were back on track. Until 5:30am when it alarmed once again for extreme high blood sugar. I heard the high pitched screech as I approached her room. Her pod failed and stopped delivering insulin at some point in the night. Without the basal insulin her pump delivers her blood sugar immediately starts to rise. Even just a few hours without insulin will send her blood sugar soaring over 600. Lacking insulin to unlock her cells her glucose has no where to go. Isn't able to bind with her cells to provide the energy her body needs. Her body then turns to burning fat for energy. The by-product of this, ketones, become toxic to the body at high levels. Left untreated she'll progress to Diabetic Ketoacidosis (DKA), a medical emergency.

But thanks to technology, her CGM, I caught this before her blood sugar was dangerously high and was able to head off ketones. And while I stumbled around the house, checking her blood sugar, feeding her, filling and inserting a new pod, everyone else was happily snuggled in their beds. Including Caitlin who never woke for finger sticks, munching on swedish fish and cookies, a screeching pod I had to log roll her and half undress her to get off, and finally a new pod site. Big fat introducer needle and all. She'll wake this morning feeling rested and well, wonder why her shirt is half off, why her pod site moved, why she has cookies stuck in her teeth. But best of all, she'll wake this morning. 

Just another night in the life of a child with T1D.

Forty Days of Diabetes - Day 38

What type Are You?

Do you know the difference? Between type 1 and type 2 diabetes? They are very different animals. In the way they are treated, managed, and especially in the cause.

Simply put, people with diabetes either have a total lack of insulin (type 1) or they have too little insulin or cannot use insulin effectively (type 2). 

Type 1 diabetes accounts for about 5% to 10% of all people with diabetes. In type 1 diabetes, the body's immune system destroys the cells that release insulin, eventually eliminating insulin production from the body. Without insulin, cells cannot absorb glucose, which they need to produce energy. Type 1 is usually diagnosed in childhood or young adulthood but can strike at any time. It cannot be prevented and the cause is unknown. Type 1 diabetics are insulin dependent and will require insulin injections for life.

Type 2 diabetes can develop at any age. It's usually diagnosed in adulthood but is rising in children. It accounts for the vast majority of people who have diabetes, 90% to 95%. In type 2 diabetes, the body isn't able to use insulin the right way. This is called insulin resistance. As it gets worse, the pancreas may make less insulin, called insulin deficiency. Some people inherit genes which makes them susceptible to type 2 diabetes, but lifestyle factors like obesity and inactivity are also important.   Type 2 diabetes can be treated with lifestyle and diet changes, medications, and insulin. 

Forty Days of Diabetes - Day 37

Let's Talk Insulin

Do you know what it is, where it comes from, what it does for you? I knew the basics from nursing school but didn't have a full appreciation for it until Caitlin's life became dependent on an outside source for it.

Insulin is a hormone produced in the pancreas that regulates the amount of glucose in your blood. Type 1 Diabetes occurs when the body's immune system attacks and destroys the insulin-producing cells in the pancreas.  When we eat, glucose levels rise, and insulin is released into the blood stream. Insulin is the "key" that unlocks the cell that allows glucose to move from the blood into the cell to make energy. 

From the 1920s to the 1980s, insulin from animals was used for treatment. In the 1980s, the first generation of man-made insulin, called "human insulin", was created. This man-made insulin was genetically identical to the body's naturally produced insulin. By the late 1990s, man-made insulin analogs were being developed. Insulin analogs are similar to regular human insulin, but they are changed slightly to allow them to act more quickly or slowly than regular human insulin.

But in the end, however it's made or wherever it comes from, a person with T1D is completely dependent on it and will not survive for very long without it. There is no amount of diet, exercise, okra water, or snake oil that will change that fact. Insulin is not a cure for diabetes, it just keeps people alive until we find one.

Forty Days of Diabetes - Day 35

We're 5 days from the end of our fundraiser and I am once again truly floored by everyones generosity. Just when I think we're done, that we've reached out limit, I see the little piggy on her page fill up more and more. In just a few weeks we've reached $3,353 in donations. And they're still coming in!

It means the world to us, especially Caitlin, to know that there are people out there that are pulling for her. That know that T1D is a struggle and that no child should have to endure the constant needle sticks, carb counting, and dangers of complication associated with this disease. 

So thank you, each and every one of you. Thank you for caring enough to help us ensure a bright and healthy future for all those affected by Type 1 Diabetes. Because some day, in the future, I'd love to be able to say that my daughter used to have Type 1 Diabetes. 

Forty Days of Diabetes - Day 34

Halloween?  Yes, please...

I've been asked many times. "What does she do on Halloween?" Um, goes trick-or-treating, of course. Type 1 Diabetes is not a life sentence of "you-can't-eat-that". Some things are harder to dose for than others but she can eat anything anyone else does. In moderation, of course, just like everyone else should. 

Halloween gives us the opportunity to stock up on fun-size packages of candy to treat lows. Manufacturers have, conveniently enough, packaged them in perfect increments of 15 grams of fast acting sugar. Exactly what we treat lows with! The Rule of 15's in T1D is to treat a low blood sugar with 15 grams of fast acting sugar and recheck blood sugar in 15 minutes to make sure it's come up to a safe level. 

So throw those Skittles, Gummy Bears (Haribo only please, I'm a bear snob), Starburst, and Sour Patch Kids in her bag. They'll be put to good use throughout the year. 

Forty Days of Diabetes - Day 33

If I had a duck for every test strip......

They are everywhere, and I mean everywhere. I find them stuck to the bottom of my shoes, in the dryer, dishwasher, bottom of my purse, sprinkled throughout her room like fairy dust. It's almost impossible to walk into a room in our home and not find one somewhere. 

Without insurance the simple act of checking blood sugar can be a financial struggle for some families. The strips we use cost about $1.63 each. She checks a minimum of 5 times a day but most days checks more often. Averaged out over the year our strips would cost about $4,200 out of pocket without insurance. That's before factoring in pump sites, insulin, ketone strips, syringes, Glucagon, and the other assorted sundries that come alone with the joy of T1D. 

I've become accustomed to finding them. Everywhere! I've accepted it, embrace it even, because if there are test strips it mean she's checking. If she's checking she's taking care of herself. if she's taking care of herself she has a better chance of avoiding complications associated with T1D. Like heart disease, nerve damage, kidney disease, and retinopathy.

With JDRF and your help maybe we can get to a point where she doesn't need to check. Or find a way to check with less pain and discomfort. Because they're not only focused on a cure, they're also focused on finding better ways to live with T1D. Help us turn Type 1 into Type None with your tax deductible donation today and help this carefree girl live a long and healthy life without the burden of T1D.

JDRF Team Page

Forty Days of Diabetes - Day 31

5:15am and diabetes has already reared its ugly head, interrupted her sleep. I check her every morning when I wake up. She sleeps through it and I get to poke the fingers she avoids so it's a win-win. If she's high it's an easy fix. Her pump does the math and delivers her correction dose at my prompting. If she's low she has to eat. As delicious as candy and cookies are it's a rude awakening when it's being coaxed into your mouth at the crack of dawn. She's mastered the art of "sleep eating" so it's usually uneventful. I feed her 15g of carbs, she goes back to sleep, I recheck in 15 minutes and treat again if necessary.

If she's very high it sets off a series of unfortunate events. Troubleshooting begins; did her site fail, dose she have ketones, is she getting sick, did we forget to bolus for something last night? Check her blood sugar again, check for ketones, do the math and give a subq injection of insulin, prepare new pump site, pull off old pump site, apply new pump site and auto insert it. That's 5 needle sticks before her feet hit the floor. And if we're very lucky she sleeps through the whole thing. But more often than not she's awake by poke number 3 and very unhappy. 

So imagine for a moment being snuggled up in your nice warm bed when someone sneaks in and starts poking and squeezing your fingers and sticking your abdomen or the backs of your arms with needles. And imagine having to live with this for the rest of your life.

We need a cure.

Forty Days of Diabetes - Day 30

Caitlin's blood sugar is 179, she has 1.75 units of active insulin on board, she ate a protein bar with 25g of carbohydrates 2 hours ago, she's getting ready to eat 1 slice of pizza, a small apple, and 1 cup of milk. Her insulin to carb ration is 1:20 for lunch, her target blood sugar is 120, and her correction factor is 1:75. She's going to run the mile in gym after lunch and is coming down with a virus.

This is a ridiculous amount of information to have to process just to eat lunch. But why is it all important? Because accurate carb counting and insulin dosing are the only way to maintain control of blood sugars.

Every person with T1D works tirelessly with their endocrinologist to come up with a plan that works best for them. We meet with our team every three months to review numbers and tweak what needs to be tweaked. We have target blood sugars for different times of the day, higher during the night to keep her safe wile sleeping. Insulin to carb ratios to mimic the human pancreas; she needs far more insulin for her breakfast than at an other time of the day. And a correction factor which is how many points her blood sugar will drop from 1 unit of insulin, 1:75 for Caitlin.

But why is all the other information important? That  she has insulin on board, had a snack, is going to run, is getting sick? Because it's not just the math. A number of other things must be factored in as well. Active insulin must be subtracted from her correction and lunch bolus to minimize the risk of "stacking insulin" and causing a hypoglycemic event. Has she fully digested her protein bar yet? Protein slows absorption of carbs and can enter the bloodstream up to 3-4 hours after eaten. This in turn can cause a hypoglycemic event, because the insulin acts before the food absorbs, followed by a hyperglycemic event. And strenuous physical activity drops blood sugar while illness raises it. 

The pump does the math, thankfully. Calculates the IOB (insulin on board), I:C (insulin to carb ratio), CF (correction factor) but the rest is up to us. And up to her when we're not with her which is happening more frequently as she gets older. Sometimes we nail it and other times we fail miserably. 

So the next time you belly up to the buffet try eyeballing the foods you're loading up on and carb counting them. Then think about fat, protein, and fiber content and try to guess how long it will take your body to absorb them. Three years ago a buffet would have terrified me. Now? Challenge accepted!

Forty Days of Diabetes - Day 29

Diabetes - The Toll it Takes

Her school trip is approaching. Something the kids get excited about years before they go. Planning what they'll bring, who they'll bunk with. It's been on my mind for nearly as long. Three nights and four days away from home. She's been away longer than that before. It's not the duration of the trip I'm worried about. It's her first time away with no one familiar caring for her diabetes. I didn't think it was on her mind. It's a grown-up worry, not for her. Until she told me last night she didn't want to go. I knew why, she didn't have to say it. And my heart broke a little bit for her. I realized that although she rarely complains about diabetes or makes it seem like a big deal, that it does take a toll on her. That it wears on her and chips away at her innocence a little at a time.

In her world of school, trips to the mall, and sleepovers her diabetes is hers. Her friends and classmates get a very small glimpse of what it entails. They know she can snack in class, carries extra stuff with her, stops at the nurses office before lunch, most don't even know why. Only her closest of friends have ever seen her check her blood sugar or even take her pump out to bolus. It's transparent. At camp it won't be so simple. There are tasks that must be preformed. Bedtime checks, pod changes, maybe even a nighttime low that will require treatment.

She'll go on the trip. I know she does want to go. She's a social butterfly and it would kill her to miss it. I know she's in turmoil, as I am, about how she's going to manage. But we'll figure it out. We always do. Because she has diabetes but I will not let it have her.

Forty Days of Diabetes - Day 28

A Typical Day

I've said it before, diabetes is hard. Not just the constant monitoring, poking yourself with sharp things, and monotony of it. But because it doesn't play fair. You can do and eat exactly the same things and treat exactly the same way 10 days in a row and get different results every single day. And just when you think you nailed something, like how to bolus for pizza, diabetes says F you and everything changes.

The picture below is a "typical day". As typical as it can be, anyways. It doesn't include failed pump sites, sick days, middle-of-the-nights highs and lows, the "what's-that-on-your-arm?" questions, the "my cat/grammy/uncle/pastor had diabetes" comments, the "have you tried changing her diet?" questions, and so on.....

Try setting your phone alarm for every one to two hours and then pause for a few minutes to think about what you ate, did you count your carbs properly, did you remember to bolus, do you have enough supplies with you, do you feel high or low, is your pump site working, are your batteries dying in your pump/meter, does your pump have enough insulin in it for the rest of the day? Now do that along with all your other responsibilities and make it appear effortless. And imagine doing that at age 8, 12, 16, and forever for the rest of your life.

As many as 1.25 million Americans are living with T1D including about 200,000 youth. 40,000 people are diagnosed each year. Between 2001 and 2009 there was a 21% increase in prevalence of T1D in people under age 20. 5 million people in the U.S. are expected to have T1D by 2050, including nearly 600,000 youth.

WE NEED A CURE.

Forty Days of Diabetes - Day 27

Two Years of Pumping

This popped up on my Facebook timeline this morning. Ten-year-old Caitlin looking so brave sporting her Dexcom continuous glucose monitor (CGM) sensor on the right of her abdomen and her T-Slim insulin pump site on the left. This was her first day using her pump. It was filled with saline so we could get used to it before going live with insulin. I still remember my hands shaking putting that first pump site in. And the tears. Mine and Caitlin's!

Two years have gone by and a lot has happened. Caitlin developed a severe allergy to the adhesive in Dexcom sites, we struggled with pump sites for the T-Slim. She hated the one we liked, we hated the one she liked. We went with her choice, of course. And then the Omnipod tubeless pump came along in August which we all love.

TWO YEARS + 5,300 FINGER STICKS + 400 PUMP SITE CHANGES + A HANDFUL OF INJECTIONS WHEN NOTHING ELSE WAS GOING RIGHT = WE NEED A CURE!!!

Please consider a tax deductible donation to JDRF and help us turn Type 1 into Type None. Click on the link below to be directed to our walk page. Thank you!

JDRF One Walk

Forty Days of Diabetes - Day 26

Diabetes is a Team Sport

Burn out in diabetes is a real thing. For the person with the disease and their caregivers. It's an endless cycle of test, bolus, eat, repeat. It becomes second nature but at times can feel overwhelming. 

Children who are given too much responsibility at too an early an age are especially prone to it. I once read that letting a child manage their own diabetes care is akin to allowing them to manage the household finances and investment responsibilities. Except poor diabetes management has the potential to cause serious physical harm. 

We take a team approach to diabetes care in our home. We share responsibility for checking, counting carbs, changing pump sites, etc.. Dave and I take turns getting up for night checks, staying home with her on sick days, and strategize on how to keep her life as normal as possible. The control-freak in me maintains full responsibility for materials management and scheduling but nobody is fighting me for that title. 

We're the lucky ones. Too many families are divided on this front. Expecting too much from their children, challenging one another on proper care or just taking a complete hands-off approach and placing the entire burden on one parent. 

Having a supportive spouse, family, friends, and school makes it all that much easier to play with this crazy hand we've been dealt. 

Forty Days of Diabetes - Day 25

This is What High Looks Like

Do you feel high? Words I mutter to her often. Not something I ever thought I'd be asking my little girl. 

Diabetes is cyclical. It ebbs and flows and just when you fall into a comfortable zone of in-range-numbers and uneventful days it smacks you in the face. After weeks of freakishly good blood sugars we've been struggling to keep her under 300 for days. We go through the process of elimination. Is her pump site good, did the insulin go bad, did our carb counting go horribly wrong? But it's almost never any of those things. It's just diabetes being a pain in the ass. 

It's usually related to an impending illness or growth or puberty hormones. Things completely out of her control. This leads to missed classes, extra time spent in the nurses office, and Caitlin feeling generally horrible. Not just because she's getting sick or her numbers are high. But because she takes the numbers personally and feels guilty when she's out of range. As if she has any control over it. 

Last night's dinner reading threw us both for a loop. We both stared at the screen with eyes wide. HIGH? As in, so-high-that-I'm-not-even-going-to-give-you-a-number, high? We go through the motions. Was your finger clean? Let's check again. Do you have ketones? Let's check. Three finger sticks, one subq injection, a changed pump site, and one little girl whose spirit has once again been broken by diabetes. And what goes up must come down so a day filled with highs is followed by a night full of lows. So we hang out and snack at 10pm checking and waiting until we're happy and safe. And then the rat-a-tat-tat at the door comes at 1am. "I'm 55." And the cycle of eating and checking begins again.

Diabetes is hard. But most days she makes it look easy. I carry her worry and fears for her while she goes about her business of being a carefree twelve-year-old girl. And I will carry that for her as long as she'll let me because she has more important things to focus on. Like fun, and friends, and school, and boy-bands.

 

Forty Days of Diabetes - Day 24

Those 3 Little Words

They roll of my tongue, unbidden. When she walks down the stairs rubbing sleep from her eyes, running out the door to catch the school bus, as I tuck her in and kiss her goodnight.

"Did you check?" 

Because my first thought every morning and my last thought every night is if she's in range. How early do I need to correct and bolus for breakfast? Is she safe to go to sleep? Does she need to snack? 

But I'm trying really hard to get back to what those 3 little words used to be.  "I love you." Because I don't want diabetes to define her. I want to focus on her. How her day was, what she wants for breakfast, plans for the weekend, converse about what she's excited about. I want her to be Caitlin, a sassy, strong, sarcastic little lady who loves One Direction, her Bff's, Starbucks Frappucccino's, and, who just happens to have Type 1 Diabetes. 

Forty Days of Diabetes - Day 23

The Emotional Toll of an Invisible Disease

I don't know what it's like. How it feels to be high or low, to be burdened with equipment, to deal with things beeping and vibrating in a quiet room full of her peers, to be constantly nagged. Did you check, do you have your stuff, do you feel high/low, and so on, and so on....

I know it can't be easy. And I also know that I overlook her emotions sometimes because I'm too focused on her numbers. It's easy to get caught up in but I'm trying hard to walk the line between managing her disease and maintaining her emotional well being. I need to remember to be mom first and nurse second. 

She forgot to bolus for dinner last night which led to a sky-high blood sugar before bed. I was instantly annoyed and she saw it in my eyes. The tears came and then the apologies. A twelve-year-old girl with the weight of the world on her shoulders sobbing and apologizing for forgetting to take her insulin before her meal. I can't remember where I put my car keys on a regular basis. I've gone to birthday parties on the wrong day. I put things "away" in safe places never to be found again.

And that's when I take her into my arms and tell her how brave she is and how strong she is and that I'm so sorry that she's been dealt this hand. Because she's a little girl first and a diabetic second. 

Forty Days of Diabetes - Day 19

1D T1D Style...

The long anticipated One Direction concert is finally here. Getting ready for a day out takes a little extra planning with T1D. Years ago the concert tickets would have been my greatest concern but these day diabetes moves in to that #1 spot. Forgetting a blood sugar meter or pump sites can easily ruin an outing. By always planning for worst-case scenario (lows, highs, failed pump sites) you can enjoy your day without the stress of T1D getting in the way.

 

Forty Days of Diabetes - Day 18

Phone calls......

Phone calls and emails and long, long waits on hold. After three years it has not gotten easier. One would think managing the supply end of T1D would be one of the easier tasks. Every year the prescriptions must be rewritten. Not exactly sure why since T1D is forever. Do they think she's going to outgrow her need for insulin and testing and pump sites? And the filling of said 'scrips is painful. Countless emails and phone calls, hours spent on hold.

It's been one week, 7 emails, 2 long phone calls, and at least a dozen gray hairs since I started trying to fill her latest 'scrip with CVS Caremark. The urgency is lost on the representatives.

"When is her insulin shipping?"

"It's in process."

"When is it shipping?"

"Maybe today."

"We need it now."

"It's in process."

"I need a ship date."

"It's in process."

"You need to give me a ship date."

"I can't do that. It's in process."

"It's insulin. It's a life sustaining medication. I need a ship date."

"Can we elevate this? May I speak with your supervisor?"

"Hold please."

And, suddenly, it's shipping today via next day air.

Forty Days of Diabetes - Day 17

24 days remain until our walk and we're 24% to our goal. If you've been taking the time to read my updates won't you consider donating to such a worthy cause? Your tax deductible donation can help JDRF turn Type 1 into Type None.

Click here to help us turn type 1 into type none

Forty Days of Diabetes - Day 16

My Superhero doesn't wear a cape..

...she wears an insulin pump. I'm reminded of that on a daily basis. When she's battling highs or lows, changing infusion sites, managing her supplies, strategizing how to plan for an outing or bolus for a meal. Making decisions, very adult decision, about her care.

I sometimes forget what a burden this must be. She makes it appear effortless. Until it isn't. When I pick her up from school with an extreme high blood sugar. When I check her at 5am and I have to rouse her from a sound sleep to eat. When we're exhausted and ready for bed and her pump site falls out. There are times when she falls apart and it breaks my heart. Sometimes it's just too much. Too much for all of us. And I have to remain strong and be her rock. But these times are few and far between. She picks herself up, brushes herself off, and moves on. Because sometimes you don't know how strong you are, until being strong is the only option you have.

Forty Days of Diabetes - Day 15

"Is she under control yet"

Diabetes is hard. I'm asked often if her numbers are "under control" yet. In one word, no. You can do everything the same every day. Wake at the same time, eat the same foods, take the same amount of insulin, and have different results every single day. And honestly, who lives like that? Throw in fluctuating sleep schedules, activities, food intake, growth/puberty, and hitting that magical perfect blood sugar level become nearly impossible. But once in a while the planets align and you feel like shouting from the rooftop, "I finally nailed it. I know what I'm doing". And then it all goes berserk again. So you continue to check, bolus, eat, repeat forever and ever....

Until there's a cure.

Forty Days of Diabetes - Day 14

Day 14 - What's in your bag?

At any given time our T1D kids are responsible for thousands of dollars worth of products. They're saddled down with what equates to month's worth of income for some families. In their little bag of tricks they're likely carrying:

$80      glucometer and test strips

$240    Glucagon

$6000  insulin pump

$30      pump sites

$210    insulin vial

$1200  continuous glucose monitor 

$150    continuous glucose monitor sensor

These are things they're carrying every single day. To school, on vacations, to the mall, and to the beach. And sometimes those things don't come home with them. And insurance companies aren't going to say, "gee, I'm sorry that happened to you, let me cover another". It doesn't happen. The small stuff, meter & test strips, insulin, etc.., is easy enough to replace. Most families stock at least 3 months of supplies on hand. Families who have decent coverage and the means to manage the co-pays. Other families must choose at times between diabetes supplies and buying groceries or paying the bills. 

Durable medical equipment, like an insulin pump, is covered just once every four years. Less often than some people replace their cars. Caitlin took a little trip to the beach on Saturday with friends. That little trip will cost us $650 for a new CGM receiver should we choose to replace it. It's not a critical item but it sure helps a lot. She looked horrified while telling us she couldn't find it. But how could we be mad? She's a child who is burdened with a massive amount of responsibility every single day. I'm impressed that in three years it's the first thing she lost.