Antibiotics

Today, as I was giving my daughter her last doze of the antibiotics she had been taking twice a day for the last 10 days, praising her for not complaining too much about it (on some days) trashing the left overs of the sticky white-orange smelling liquid to the sink and saying "told you it would be over in no time, now you can forget about the whole thing, you are officially healthy" I smiled and my daughter cheered to herself and went back to play with her brother. I caught myself staring at the empty pharmacy bottle, wondering how it could be like being in that very same situation, only holding an Insulin vial, telling the same encouraging words to my daughter but instead of referring to a respiratory bacterial infection I would be referring to her diabetes.

OBGYNs

Obviously, the next thing on my agenda, after breaking the good news to hubby was to find a good OBGYN for prenatal visits. Seemed like an easy task in theory, since the one I have already seemed pretty good for the routine stuff. So I scheduled an appointment for what I calculated to be around weeks 7-8, not too early and not too late. In Israel that's the perfect time to come for your first prenatal appointment and usually you would be sent directly to a sonogram or best known as ultrasound. That's when you are supposed to get a glimpse at your brand new unborn baby and if it's not too early and everything is fine you are also supposed to get an extra reassurance by watching the tiny heartbeats on the big screen. But that wasn't quite as I expected. After exhausting myself for 55 minutes in the waiting room I was called for some blood tests and some more tests that seemed exactly like a routine visit at your OBGYN plus some more tests, even though I did mention I was pregnant, more than once. The doc explained some basic facts and asked if I had any questions, thinking maybe that since I already have two kids I know all the tricks. "Well, yes" I answered, since for me it's like the first time, I have never been pregnant away from home... "when are you doing the first ultrasound?" I asked, who cared about all these blood tests at that point. "Don't worry, we'll have plenty of time to that on later stages, first we have to confirm that you are pregnant" he said. You mean besides from the fact that I peed on the stick and it turned blue? Combined with the fact that my period is late by two months? What other confirmations does one need in order to get an ultrasound here?! And what could make a better confirmation than viewing the actual baby on the screen?
I tried to ask all that in a nice, calm, polite and educated way but, as with others I guess, it's not that easy to express yourself in your non native language when you are upset. And I was upset, especially after waiting 55 minutes in the waiting room. Did I mention there was not even a single good magazine there?
Well, the doc gave some explanations but seemed overall surprised. He also said that I was not in Israel anymore and in other words that I should let him do his job without so much questioning and comparisons. Then he asked if I needed anything for my morning sickness (oh, why should I get that if I we weren't sure I was pregnant?) and when I answered that that wasn't too bad and that I could deal with it without introducing chemicals to my baby, doc gave me a strange look and asked: "but these are available, why suffer?"
I explained that I preferred the natural ways and that I also gave birth to my two kids without Epidural, which was a source of pride for me up until that moment when he shrugged his shoulders and responded: "so you like to suffer..."
The truth was that I was more afraid of the Epidural procedure than I was of the whole birth process itself, and that the labor pains are over once the baby is born while Epidural's induced back pain (although maybe rare) could last much longer after. Not to mention the possible complication. And regardless, that was my choice and it was never questioned before. So maybe finding the right OBGYN for your prenatal follow ups is not that easy after all...

'Delivery Package'

Back home in Israel, we were always reluctant to buy or prepare anything for the baby beforehand. Totally against the nesting instinct, I agree, and it also takes away part of the fun but who wants to argue with the fear of bad luck?
All the baby products shops there are well prepared to accommodate that and in order to not interrupt with the shopping spree of the new parents' to be, they all adhere to the 'delivery package' concept; you choose anything you want to buy, all the items are packed together and stored (at the back of the store) just for you until the day the baby comes. The most important part is that you don't pay (maybe because most stores in Israel don't have the greatest return policy), but mostly because this is a one sided obligation. They will deliver everything to your house on the same day that the baby is born and the money is paid. It worked great for us as it does with most parents that choose to go this route and in Israel it's probably the majority. But on the flip side it leaves hubby to deal with all the assembly, instructions reading, decorations, package unwrapping, tiny clothing laundry and folding (and much more, the list is pretty long) alone, when he is mostly needed by your side or with the older kids, while you could enjoy doing all that together say a month or two before the new addition to the family. But again, who wants to argue with bad luck... So I thought, to just myself of course, that since the return policy is so great here in the U.S. (at least for the first 90 days), buying everything and storing it at home, in the original packaging of course, could work almost as good as the 'delivery package', only with a different geographical storage location. It does require some degree of creativity in order to sense the similarities but you get to keep the one sided obligation benefit and hopefully keep the bad luck away.

Not really a beer belly

Although it really looked like one at the earlier stages.
This time, as with my older two kids, I was surprised. NOT REALLY SURPRISED, after all it was me who started taking the prenatal vitamins before hand, who discarded the old packs of pregnancy pills and made plans with hubby. I actually thought that after doing it twice it should be pretty difficult to catch me by surprise, especially after I have dealt and familiarized myself with all those signs and symptoms. Women just know (?) when they are pregnant, even before they quietly step into the drugstore and choose between a digital (quite confusing I must add) or old fashioned blue or pink stripped stick to confirm their suspicion. So I had all the symptoms for several months, probably a strange side effect of getting off the pill because they all disappeared once a month, every month. So intuition can sometimes mix up with positive thinking and that could be confusing.The first month I knew for sure that I wasn't pregnant was the first month I finally got rid of all these symptoms. But I guess that every time is different or maybe my memory is just not as good as it used to be (for sure, plus pregnancy is thought to play a role in that too) or a combination of both (probably) and some other factors, but I am happy to say that it is still possible to surprise me, especially when it comes to good things!

Going Home

There is something relaxing, almost liberating, about going back home, Israel for me, especially when it's just for a visit; the scents, the sounds, the feeling that you know and have mastered every single rule in that game. For me it's a source of confidence, of motivation and pride. It reminds me of where my roots are, of who I am and where I am going. Yes, I am aware of all the mess that comes along with it, but for me that's just part of the package. I guess I had missed that too in a way...
So regardless of the unreasonable price for plane tickets to Israel during the summer, regardless of the hot, humid to sticky weather, the lines, the crowdedness all around, we had a great time, we had fun, we enjoyed every single moment of this trip. The kids had so much fun that we had to remind them why we were actually going back to the U.S. But of course being on vacation, not going to school or work, having fun with the whole entire family that had taken time off from life just to spend every single moment with us, how could it not be far way better than every day's life obligations?
I often wonder whether it would feel the same when and if we come back for good, not just for a visit. Probably not, but one thing will surly stay the same; home, with all it's goods and bads, this is where I belong.

Mother's day

Honestly speaking, I really did not expect anything special for Mother's day; growing up in a country where what was thought to be Mother's day, initially, became "Mom's and dad's day" because dads were feeling left out (no Father's day there), and then before we knew it, this dual parental day became "Family day" which is nice but really has nothing to do with us moms anymore. And so the nostalgic Mother's day has been suffering somewhat from cynicism. However, here in the U.S, Mother's day truly is moms' day, and dads have their own day a month later so everyone can enjoy a day of their own, even the grandparents. So even though I had absolutely no expectations, growing up to become an Israeli mom, or maybe just BECAUSE I had no expectations; I had such a great surprise when my two angels came back home from school on Mother's day with the presents they had made themselves just for me, after spending the whole week preparing and crafting. They both have been spending their days in places that really do emphasize the importance of events like these and for the first time I realized how nice this day can be (I do admit, cynicism used to get me too) and how nice it is to hear your kids sometimes say 'thank you mommy' and really mean it.

Vacations

It takes one to realize how much you really need it... And once you have it, it can be pretty tough to go back to your pre-vacation state, at least that's how things are for me. But regardless of the location or time length of the trip, there are several common features in all of my vacations;
1. It starts with thinking of taking some time off. It always seems like I am asking for too much but then, deep into the vacation, it always seems too short and I always ask myself why I hadn't asked for some few days more.
2. For me the hardest part of going on vacation has to do with packing, yes I even prefer unpacking. When I pack I have to decide in advance what I am going to wear and what items I might need during the whole trip, and not only for myself, I need to make those decisions for my kids, and since my husband shares the same mixed feelings about packing, I usually make some of those decisions for him too. This totally eliminates spontaneity. I am not the kind of person who enjoys planning everything through, especially not when it comes to clothes with a dynamic weather like the one we have here. Luckily my daughter is now old enough to pick her own clothes. Unlike me, for her this is a very simple task and within less than 5 minutes she has her clothes ready, organized by days and outfits and laid on my bed, ready to go into our bag. My son on the other hand could bring along his whole closet if we had enough space to fit it in our travel bags.
3. Now the final part is deciding on the location. One of the problems with spontaneity is the reluctance to book vacations too long in advance, and when I say too long I mean more than a week or two before. Luckily in the U.S there are plenty of places not yet traveled (by us) and as long as you are willing to be flexible with dates and locations you can live in peace with not booking your next vacation a year in advance. But one has to keep in mind that most of the good places might be already taken though. And be prepared to explore some off season destinations.
4. Now the last, but not least, and very much common feature to all of my vacations is the trouble with going back. Yes, it's good to be back at home, but usually I feel that I could use a few (additional) days off to adjust back to the day-to-day life. Yes, routines had never been one of my passions. And so, just to help myself and my crew set our minds off the trip we start planning the next one. Not the location, of course, that might break the spontaneity laws, but we go through our calendars and mark possible future dates to take some more time off. Just to make sure we don't forget again how much we really need vacations!

Another one of those nights

Another one of those nights when I long for the moment I'll close my eyes and move directly into deep sleep, elegantly skipping through all the other sleep stages, to make the most out of those 5 hours left until my alarm clock beeps... I take a quick look at my sleeping angels, cuddled in their beds, and my (somewhat noise) puppy, that opens one eye and gives me a tired look. I check my daughter's blood sugar, like I do every night before I go to sleep, it became my new habit about 3 years ago. It doesn't wake her up and sure helps me sleep better, I usually just correct high blood sugars with a press of a few buttons on her pump, and try to avoid those cases of low blood sugar that are harder to fix. But then it strikes me and just sheds away my sleepiness at once... 55. Sometimes low blood sugars wake her up, sometimes it wakes me up. I was hoping it will wake our dog up but other than starring at me from her crate, she doesn't seem to be too worried. Low blood sugars, especially at night, can be dangerous and in most cases are not really expected and therefore not always avoidable. So I rush into the kitchen and make some extra sweet chocolate milk. A cup of juice could have been helpful now but even when asleep my daughter just doesn't like juice. I have abandoned the 15 rule long ago. Basically you need to give 15 gr of carbs to correct a low, then wait 15 minutes and recheck blood sugar. Still too low? Repeat the previous steps, wait again 15 minutes and so on. I prefer solving late night issues of this sort faster, especially when I want to have some spare time left to sleep, some people need that from some reason. And also, I believe that having a high blood sugar for a short period of time is way better than having a low blood sugar for too long, and so Over-treating a low blood sugar is my middle name, right after Over-protective mom. And so I let her have her chocolate milk, she is fast asleep but since she likes chocolate milk so much, especially from a sippy cup and especially in bed, a short cue like:"honey, here is your chocolate milk" just automatically brings her to a sitting position, take the sippy cup out of my hands and drink. But since a 55 might be hard to bring up I have a small bag of gummy candies for her, her favorite. Now waking her up to eat candies in the middle of the night might be almost every child's dream, but she sits up and falls back asleep after chewing on the first candy, still some more candies to go... There might be an easier way to bring her blood sugar up but those candies just do it the fastest and so are the best next thing after a juice box, since sliced bread would just not do. Then I wait for some time and recheck her blood sugar; 200... I sigh with relief, mildly high but can easily be corrected with yet another press of the button. Now I can finally go to sleep. So until there's a better solution, a one that will not pose the risk of hypoglycemia, we will have to settle for a bedtime blood sugar check and keep the chocolate milk and candies handy.

Multi-movie watching

While I am well aware of the fact that today's kids are way more technologically advanced than what we used to be, my son has taken the idea of multi-tasking to a whole new level. He has been trying to watch two different movies at the same time; One on TV and one on the ipad.
Growing up I remember enjoying the TV in the background (no flat TV, LCD or LED of course) while trying to do my homework or studying for exams. Somehow the noise and movements in the background inspired and motivated me to keep going and continue whatever boring task I was doing, with a false notion that I was not missing on the fun. Although doing all that with the TV on surly took me a significantly longer time.
"How can you watch two movies at the same time?" I asked my 5 year old that was deeply into his two movies. I can understand watching a movie and playing an ipad app at the same time but even a super multi-tasker would find multi-movie watching rather challenging. My son takes his eyes off the screen for a moment and with a serious look he says:"I have two eyes you know!"

Type 3 Diabetes

Several weeks ago my family and I attended the JDRF's Type 1 Diabetes Research Summit, that's when I learned for the first time about type 3 diabetes. The kids were having a blast in the other room at the kids program so we were free to attend the adults program. Dr. Desmond Schatz, the medical director of the Diabetes Research Center at University of Florida, and an engaging speaker went up to speak. "how many of you have type 1 diabetes?" he asked and counted the number of hands raised. "How many type 2s?" less hands compared with the first question but still quite a few. Then he asked:" how many people in the audience have type 3 diabetes?" There was one hand in the air but mainly silence in the crowd. All the rest of us just looked at each other wondering what he was talking about and whether there was a new kind of diabetes that we (how could that be? We read every single piece of literature, scientific or not, the minute it's published) haven't heard about... I did remember reading something about deficiency of insulin in brain but somehow I realized this was not what he was trying to direct the talk too. Then he smiled "type 3 diabetes is what those who care for someone with diabetes have" he stated. Parents, siblings, spouses, grandparents, children, even caretakers and the list is very long, we are all affected by diabetes, we all suffer from the same thing, we share the same worries and fears and coming to think about it, we all share the same dream, we all long for the cure. So what I have been suffering from in the last 3 years has a name and definition, maybe not formally but it fits. One thing I can say for sure, the cure for type 1 diabetes will magically cure us too.

Kindergarten Rush

Lately I have been suffering from the Kindergarten rush. My baby boy is going to Kindergarten next year... But other than the anticipation (his) and anxiety (mine, who else?), this is not a sit around do nothing kind of event, my job starts now, no less than 6 months in advance, at a stressful, depressing and unpleasant place called The International Office, or maybe this is just my selective memory speaking. While some states or counties in the U.S don't have enough or any international families to even justify the existence of such place, in our county where a huge part of the population is international, we have the pleasure of starting an otherwise exciting process at this very office. My first experience with this place, 3 years back, was very negative. Partly because we were so new here and everything then seemed different and sometimes intimidating, partly because my daughter was diagnosed with diabetes only a couple of months afterwards and so the whole time period was fused in my head to a one big bad and sad memory, but mainly because we were treated like illegal immigrants that came from a third world country and probably had never acquired any education, and for us; proud Israelis, this was nothing but unacceptable. The only nice moment we had in this office summed up to the five minutes before we were asked to fill out a satisfaction survey... So the motive for their sudden improved behavior was pretty clear, and I made sure they knew about it. Who could blame me for not looking forward for the next time? So now, 3 years later, we had to go there again, a fact that troubled my sleep and occupied my thoughts. I made sure I had all the needed documents, even called in advance to update my check list. To my surprise the lady on the phone was pretty nice and helpful and added some more items to my long list. I had to employ my dad and especially my grandma back home to issue some original formal documents for me and get them to my email inbox ASAP. Amazing what one can do these days with a computer, a scanner and an Internet connection! I remember looking for a local post office branch just to make a long distance call... And there I was, loaded with all the documents, heading to the International Office with my 5 year old son, hoping to get this over with, wishing to create a slightly better memory for my son who is so excited to finally be going to Kindergarten. I held his hand, took out my polished smile and we went in. A nice lady greeted us, she showed us the way to the first station of our journey and we headed down the long hallway. The office was nothing like I recalled from that terrible first visit. The walls were decorated with traditional paintings from different cultures and the corners were equipped with items from all over the world. We signed in and within minutes were called by yet another relatively nice lady that showed us to her office and gave my boy a lollipop, to buy his silence while going through the tons of documents in my pre organized folder. "This place looks nothing like I remembered" I said, wondering whether my memory had deceived me. "Oh yes, you are right, this place was renovated two years ago, it looks much better now isn't it?" I had to agree of course, hoping the rest of the day will be as pleasant as this. From there we went on to English testing and got an exemption from testing "he will be tested at school for English levels when he starts Kindergarten, there's no point to test him now" they explained, and it totally made sense. Then to the clinic, to make sure his immunization record was up to date, this is the part I was mostly concerned about, because the last time they wanted to test my daughter for tuberculosis and lead poisoning, two unnecessary tests if you come from Israel directly to the specific county we live in now, from which I managed to get away with after protesting. A nice nurse welcomed us to a room with a kids play area and a TV, she thoroughly checked the forms issued by our pediatrician and then said: "You have been living here for over two years, correct?" I nodded, lately we had our 3rd year anniversary... "So your son doesn't need any further testing, you can now take these forms to his home school" she smiled and handed me a survey, the same one I remembered from the last visit, only this time I was happy to give them all five! There's a slight chance I became a little more accepting and patient, and also accustomed to the local manners (or sometimes lack of) but no doubt about it, our local International Office has changed dramatically in the last 3 years, it might not be the best place to spend your spare time at, but at least for me this is no longer a bad memory.

Can I have a middle name?

When my administrating officer called me urgently one morning, telling me I had forgotten to provide them with a very important piece of information, I did have some mild stress reaction for a minute there, thinking of the enormous amount of paperwork that I would have to fill out all over again. But then, when I discovered that this important piece of information was actually my middle name, I sighed with relief and even laughed for a few moments, realizing he was not joking. ״I don't have one" I said, smiling to myself. "what do you mean?!" he asked, thinking that I was actually joking. "I don't have a middle name" I said again. ״Oh, I mean the name that comes before your last name, some people use only the first letter but I actually need the full name" he said slowly, in a serious voice, making sure I understand. "Yes, I know what a middle name is, I just don't have one, my parents had never given me one, I only have a first name and a last name" I exclaimed. "Strange, how come?" he asked with an empathic voice.
So I started explaining how having more than one name in Israel can be a drag sometimes, how it is usually used in its full spelling and not only as the first initial, leaving almost no space for your last name on your ID document, and how the majority of people (as strange as it may sound in the U.S) are given only one name, and many times a pretty short one. That also lead early on to having a pretty short and simple signature, unlike the typical fancy American signature. Well, we ended up the conversation with him feeling a little sorry for me, for not being given a middle name and with me feeling pretty unique about my one short name (and signature). But what had also seemed like a good idea 8 years ago when my daughter was born and later on when my son was born, when my husband and I decided to give each of them only a first name, seem like a big puzzle for them now. My daughter asks occasionally whether she can add a middle name to herself, just because all of her friends have it and it makes their names sound more impressive... "Well, sure" I answer "when you are 18" hoping that by the time she gets there she will learn to appreciate it. And my son, he doesn't even ask, he just picked a middle name that seemed cool enough for him and uses it whenever he finds fit.

Tastes from Home

  A great Cappuccino and lots of
feta cheese on my salad are all I wanted

Just like with scents; that have this special almost magical ability, to take you through time and familiar places, there are tastes that can take you through glimpses of your past and even awaken some old memories. On our first visit to Israel, almost two years after we came to the U.S, I was excited, I couldn't wait to feel home again, reunite with the whole family, and I was really looking forward to these tastes of home, those familiar tastes that I grew up on and like so much. But now I can finally say that some of these tastes can be found here, in the DC area, at a small coffee shop called CremCaffe, located next to the Regal cinema at the Rockville, MD town center. The great coffee, the wonderful cakes and pastries, a refreshing selection of items on the menu, the amazing management and staff (and I am being objective) and the atmosphere, that just make home feel a little closer.

Diagonal Crosswalk

As a child I was always taught that Diagonal=Disaster (well, it sounds much better in Hebrew plus it rhymes...) and that roads should always be crossed in a straight line merely because this is the shortest, fastest and safest way, and whenever possible use a crosswalk.

A bird's eye view sketch
of the actual junction

So one day I ran into this strange Diagonal crosswalk, also known as Pedestrian scramble or X crossing, only this is no X, it extends to only one side. The original thing was mainly used in the past for major traffic Intersections of both cars and pedestrians but this one is just a crosswalk from a parking lot to a small street. I am not sure what benefit it provides for the person crossing it but it is quite confusing both for drivers, that have to look for pedestrian crossing from different directions and the person that actually uses it to cross the road has to look for cars coming from 6 different directions instead of the traditional 2 and wait until they all stop. Yet people use it even though the old fashion short crossings are still there. Does it shorten the time it takes one to cross the road? Not really because you have to wait until more cars stop at the crosswalk. Is it safer? NO, the risk is even higher, at least in this specific junction. So I am still wondering what was the initial purpose, at first I thought it was a joke, but I have seen more than one, they seem to reproduce. So, if I find an answer for that I promise to write an update. Until then I am avoiding using the diagonal crosswalk and am choosing the old fashion one that is right next to it.

The real thing

Winter Wonderlands

Places like these make me just LOVE the winter. There is something heart warming, almost magical in the winter atmosphere; the snow, post holiday lights and decorations, heavy coats, cool breeze, hot chocolate, closings and delays that give you additional hours of sleep on weekdays while it is snowing outside and then some free time to play in the snow with the kids or slide down the neighborhood hill... But then there is also ice on your windshield, snow that must be plowed, digging out your car from the parking, bone freezing cold, half an hour of getting the kids dressed with all those layers to protect from the cold every time you leave the house, to name just a few, winter fun. My daughter always reminds me:"if you want to enjoy the rainbow you have to like the rain" so after coming from a place that barely gets rain, where the temperature rarely gets below 50F and 60 is considered COLD, I do appreciate some rain though not so much and not in the summer, and am learning to deal with the cold until the next summertime.

Photograph by Arik Eyal

Positive Thinking

The power of positivity and positive thinking can have a huge impact on our lives and on the way we choose to live them, and yet in many cases I tend to underestimate this power. Seeing the half full is much more than just a phrase, it's a way of life, a nicer one if I may add.
I was driving to work this morning and decided to choose a different route than the one I usually take, thinking that I could save some road time and get more work done if I get to work early (doesn't happen too often but I constantly try). Only I found out too late that I had made a terrible choice and the road was blocked, with no way to escape for the next hour. I could of course choose to get angry and upset, blame myself for being irresponsible trying a new route without checking the traffic first, get stressed up thinking of all the work waiting for me and have a stressful and dreadful rest of a day. But there was great music on the radio and I sang out-loud to just myself, some of my favorite songs just happened to get on air one after the other as if someone hand picked them for me and I had a blast. Then I also got a chance to think through my next project at work and had some productive insights. Amazing what being stuck in traffic on an early (well, it wasn't so early anymore) morning can do. I arrived one hour late to work but I had no regrets for taking that route (well, I didn't have much choice now anyway). Thinking through my project outline actually helped me save some time and labor and I couldn't help but wonder whether the whole thing was just meant to be that way or was it the positive thinking that helped me get a good thing out of a really non ideal situation...

Carb Factor Schools

For us, those affected by diabetes, it's all about the carbs or carbohydrates. We don't care about the calories nor the fat content of the food (well some of us do but not for the insulin purposes). In order to calculate how much insulin is needed to cover for the food, and ultimately keep a balanced blood sugar, we mainly need to know how much carbs it has per what is eaten. That can be pretty complicated but with simple tools and some experience it can become almost automatic. Some of the suggestions can also be used for those counting calories as well, but in many cases the calorie content doesn't give any insights about the carb content and vice versa; a certain food can have a very high fat content and so very high calorie index and yet might have no carbs. Other foods might have a low fat index but still be very reach in carbs. In general there are several approaches for carb counting. Some prefer educated guess work based on portion sizes and food groups, that can make life easier for some but I find it quite confusing, others prefer memorizing carb content or eat fixed dishes at fixed content (doesn't work so well when it comes to kids or if you are a spontaneous type). And some prefer a more scientific approach, I find myself within this group most of the time, maybe it's the scientist in me that takes over. It requires some preliminary work but it really helps you get a very accurate carb count for the food.
A great tool that can be used for eating outside and can be great for all of the schools above (and also for those counting calories) is the app 'Nutrition Menu' by Shroomies, I have it on my Iphone and one can find most of the known restaurants on their list and check out their menu and the nutritional value including carb content for most food items, very user friendly and certainly a well spent $0.99.
Another nice app that I often use, that was actually recommended to me by my dad, is 'My Fitness Pal', it has a great list of many store bought food items from many different brands with their full nutritional value. This app also helps you keep track of your activity levels, food consumption and content and even weight and exercise plan and management for those interested in that feature.
Now the other thing I have found to be very useful is the carb factor. Every food has its own carb factor that can be calculated by dividing the carb content of a portion by it's weight. For example: on a box of cereal you can see that 28gr of these cereals equals 24gr of carbs. Now 24 divided by 28 equals 0.86, and let say you eat 50gr of that cereal brand then 50 multiply by 0.86 equals 43 gram of carbs. By the same way I calculated the carb factor for cooked pasta 0.279 or for most bread like baked goods 0.5, or for any other food my daughter likes. This way I can weigh the portion she eats and calculate exactly the amount of carbs it has. I used to also carry around a small scale in my bag, but I decide that sometimes one needs to let go, so for cases we are not at home I use one of the previously mentioned apps and that usually works pretty well. Now, interesting enough, my husband actually doesn't use any of these fancy techniques, he prefers the intuition way, or the hunch. He looks at the food and gives an estimated number, and when compared to the other ways, his guess is usually more accurate than mine, but I guess it requires special skills that I am yet to acquire.

Wildlife Crossing

Yes, even in places like this, the wildlife gets respect! I have been seeing this sign every morning on my way to the office for the last 3 years and it still makes me smile. I like what it stands for and I can testify that the people working around this sign truly take its meaning seriously. And indeed, the geese that have chosen to live around it, know it. One morning, one of the geese, of all places, decided to lay her egg inside the construction area, only a few feet away from the sign. We were all certain that it wouldn't take more than a few hours for that egg to become a giant scrambled egg, but the construction workers had a different idea. They installed a small fence around the egg that went all the way from pavement into the construction site and left a small hole in their fence to allow the happy parents access to their newly laid egg after hours. This lucky family became the talk of the day. We all followed our own private National geographic show until the new goose was finally born. The family moved out from the construction zone to the front lawn and have been living happily since with the rest of their troupe. Thanks to those nice and considerate construction workers!

Warm sunny winter days

Warm sunny days on a capital winter are precious and should really be well spent. However, it is somewhat unfortunate that if at all, they turn up on weekdays, though if you are lucky enough you might be able to watch them go by from your office window. If your office is not equipped with a window, like my previous office, you might be able to enjoy some of it's left overs when you get inside your car at the end of the day, especially if it was parked in the sun instead of the underground parking lot for this exact purpose. But on days like these, not having at least your lunch outside should be considered a crime.
I was staring at the bench outside my window, wondering whether it would still be sunny when it becomes a reasonable time for me to have lunch. 11:45, I decided not to take unnecessary chances and have my lunch early, while it's still sunny and warm around my pre-reserved spot outside. It was a little too early for most of my colleagues to join me and so, even though I rarely have my lunch alone, I walked outside with a silly smile on my face and took a deep breathe, inhaling as much warm air as I possibly could. It wasn't as warm outside as it seemed from the inside but I didn't really mind, it is the feeling that counts, and as long as you stay in the sun it is pretty nice. I didn't actually get a chance to take the first bite of my sandwich since the sun decided to fade away without further warning, and the typical cool grey depressing atmosphere took over. I don't have anything personal against grey colors, especially if I wear them, but when it comes together with a drop of 10 degrees in temperature, and in the middle of my outside lunch, it really becomes personal. So I finished my lunch pretty fast, couldn't give up the concept of having my lunch in the sun, well, at least what was left of it. Then went back disappointed to my office only to find out the sun was back up in the bright blue sky again. Maybe I'll have more luck next time.

Minivans

I had never thought that I, the tiny cars lover, fan of the Mini Cooper, would find myself driving a minivan (even though they both might have the word 'mini' in their name), not to mention owning one. Back in Israel, minivans are usually owned by families with multiple kids usually not living in big cities, since finding a place to park this thing is pretty tough. Even when we came to the U.S and parking was no longer a big issue (well, only when we visit Manhattan or if I happen to arrive after 9:30 to work...) I still didn't see any reason I should get a minivan and was really happy with our nice looking SUV. But traveling with two kids and sometimes a dog too, a stroller, some bags, games, books, portable DVD player and food supply (one should always have food handy when traveling with kids, even on short trips), we realized that after getting all that into our SUV we could barely spare some space to stretch out our feet. Yet our friends with the minivans seemed to be having a great time on long trips and had plenty of room to sit and even to some extent walk around! Could that be the end of my cool cars phase? Well, I guess many things change once you have kids, including some of your preferences and your views, minivans all of a sudden didn't look like a big balky car anymore, and my kids were really pushing for a car like most of their friends have, for them at this specific phase in their life, a minivan seem much more attractive than say a BMW, go figure. So now, I am proud to say that I am a happy owner of a minivan. A car that was tailored for families, everything you need is just there. I no longer have to squeeze my feet between bags, I can open the side doors with my remote and let the kids in before I even get to the car, our total time to get everything in and have my kids buckled up in their seats is now reduced from 5-10 minutes to less than 1 minute (pretty significant when the weather is bad, and that is unfortunately not rare around here), we can take friends along without exceeding the passengers limit and still have enough space in the car! And most importantly, our minivan comes fully loaded with an LCD screen, a remote control and two sets of cordless speakers, so the kids are busy watching movies instead of asking 'how long is this drive going to take?' or 'are we there yet?' before we even leave the parking lot. On the contrary, they now think that driving around is fun! Yes, even if you're not trying to get anywhere... And we can finally enjoy a quiet and relaxed drive, which adds a great safety factor.

5Z4ZXHYBCMHF

Finally arrived, Pump Party part II

The day the big box with the pump and all necessary equipment arrived was a day of celebration, as if our normal lives were waiting in that box to be unfold. After 5 months of waiting and longing, I was holding this pink (my daughter's choice) beeper looking device in my hand, finally. But this was only a beginning of a new journey and I realized that the next step would be to make my daughter like it and feel confident and comfortable enough to wear it. And so I emailed her teacher and asked to reserve a slot in their busy kindergarten schedule for a party.

Somehow my daughter's Pump party was a lot about carbohydrates, coming to think of it, just like diabetes... I wrote down some words; to teach the class a little about diabetes, about how brave my daughter was, about her new cool pump which they had all decided was actually a Nintendo DS, and basically I stretched almost exclusively the positive aspects of having diabetes; like having to eat candies to increase blood sugar when needed and knowing your body signs better than any physician. Next we went on to some arts and crafts. I made pump models that I cut out from a colorful thick craft paper and let each child decorate their own crafted insulin pump with stickers and colorful glue markers. Now it was my daughter's turn to teach her friends a thing or two about how to use it. We made up a game in which each child was holding their pump creation and a bag of gummy candies (Fruit Snacks in individual small packs work best for us in bringing up low blood sugar pretty fast and it worked great for the party too). My daughter proudly explained that when her blood sugar was high she needed to press some buttons in her pump, but when her blood sugar was low she needed to eat some gummy candies. So in our game whenever she says "high" the kids would press the buttons on their crafted pump and whenever she says "low" the kids would eat a few gummy candies, and no confusions! And finally, there is no real party without a cake so then we all had cupcakes. It turned out to be a pretty cool (well, at least for K aged kids and the school staff) successful party and also we made up a great game. The kids LOVED it! especially the part where they 'had to' eat candies. In fact they have been asking me ever since, on every opportunity, when we would play this game again or have another Pump party.

Pump party part I

The idea of throwing my daughter a pump party came to me while going through online chat rooms of parents of type 1 diabetic kids. The parents discussed the first introduction of the insulin pump to their kids through a party, as a way of making it more attractive and appealing to them. For me, at that time, it seemed like a sweet dream, the day we would finally get my daughter an insulin pump. We were waiting over 5 months to get approved for a pump. A time period that took forever to me, having to give my daughter insulin injections at least four times per day for the first time our lives, realizing we will have to do it every single day until there's a cure, and knowing there is an alternative, in the shape of an insulin pump. A small beeper-looking device that delivers the insulin 24/7 for you, all you have to do is tell it how much and when. No, it doesn't check your blood sugar and make it's own decisions (that's what the artificial pancreas project is all about) but it replaces the four shots per day with one infusion site change or port change every 2-3 days. And it allows you to live your life the way you want it and adjust your insulin accordingly, while on the shots it seemed the other way around; no sleeping late on weekends since the long term insulin had to be taken at the exact same time every morning, no skipped meals or else blood sugar goes low etc. Doing all that as an adult could work if you like to follow a schedule and enjoy routines. For kids and especially young children this could be practically impossible. Especially if they fit into the food trouble makers profile. We desperately needed our life back, our spontaneous way of living, our sleep (late on weekends) and I especially hated having to tell my Ms. Not hungry that she couldn't eat anything that had carbohydrates in it until the next meal since she had already got her insulin shot. Of course she always had the option of getting another shot but somehow for someone that doesn't like to eat anyway, it didn't seem too attractive.
So we decided we had to get her an insulin pump. Only it didn't take too long to realize it was going to be a laborious and exhausting process. We had to take various training sessions, health assessments for my daughter and undergo psychological evaluations for ourselves, as her parents and main caregivers, just to make sure we are psychologically competent for that. No one had assessed whether we were psychologically competent to raise a child with diabetes before she was diagnosed, yet they made us go through those evaluations in order to be approved to give our child the best medical treatment possible. So after going through all that, how could we not celebrate getting the pump? There was no happier than us that day when the $6,000 pump arrived in the mail, we longed for it so much that somehow we got ourselves under the impression that this will be the end for all of our problems, quite a lot to ask from a machine, even from a $6,000 machine. But we were determined to give our daughter her normal life (with diabetes) back and this small device made a huge difference.

More from Little Chef

I was asked by several readers to tell the end of the quiche story from my previous 'Family chefs' post. Once again my kids have shown a complete non adherence to any book about kids' eating behavior. Every reasonable book about kids and food issues, especially those meant for parents to picky eaters suggest to cook with your kids. 'Once they made it they will be open to try it' (taste it I would assume). And so after my 5 year old little chef walked me through his recipe and we got an olive, tomatoes and sour cream quiche, he was patiently sitting next to the oven (yes, he even brought a chair for the event) I was convinced he was going to try and at least taste it. After all, his imagination made recipe consisted solely from ingredients he likes to eat and in a surprisingly well organized combination (I was really surprised he hadn't include chocolate). So when we finally got our nice smelling quiche from the oven, he looked at it with a bit of disappointment and said:"I made it all just for you mom, I knew you'd like it" he smiled. "I like it a lot" I said, munching on my slice. "Don't you want to try it?״ I asked. "No, thank you, I already know in my brain how it tastes like" he said in a nonchalant tone and went back to play. I don't know what these books are based on but I guess my kids just hadn't read them.

Family chefs

The other day my son had decided to help me make dinner. He dragged one of our heavy dining room chairs into the kitchen, climbed up and said we were going to cook his favorite dish. 'What that might be?' I wondered, especially since both of my kids are not exactly food fans, they eat in order to survive, not even one crumb more than that, and even this minimal time they spend eating is a waste of their precious time that could much better be used for play if you'd ask them. "Something really good" answered my 5 year old "you'll see" he smiled and made me his sous chef. "I need green olives, cherry tomatoes and sour cream" he ordered and since he asked for a nice combination of ingredients I decided to go with it. I pulled out a small chopping board, a plastic knife that if you are consistent enough can be used to cut soft vegetables but not little fingers and a large enough bowl, since I had no idea what else we were to use. "What are we making?" I tried again but got the "it's a secret food" answer and "soon you'll see". My son cut the cherry tomatoes and my job was to cut the green olives. He add them to the bowl and asked me to add "4 scoops of sour cream", no more no less. Next he asked for 3 eggs. "Oh, are we making an omelette?" it seemed like a great omelette recipe "maybe we can add some more eggs, this way everyone will get to eat it" I suggested and put a pan on the stove top. "No, it's not an omelette" my son was amused by my lack of basic understanding in secret recipes. "This should go into the oven" he explained. "Oh, is it a quiche?" I tried again. "Yes!!!" he cheered. "So maybe we should add some flour to it? What do you say?", my 5 year old gave me his cute OK and I suggested some salt but he disagreed on that part so flour yes, but we didn't add any salt, that was his dish and I was not allowed to make changes in the recipe. Then we transferred the batter into a baking pan and baked it. It was very much eatable, could use some salt, but otherwise a nice quiche, and my son's first kitchen creation. I wonder where he got that recipe from.

My Afternoon miscommunications

Afternoon is a vague time concept for me since in my home country it is usually used to describe any given time between 4pm to say 7pm. Which also means that for me as a mom this is a time frame I would refrain from scheduling work related meetings since it may risk my ability to pick up my kids from school on time. Basically afternoon starts exactly when noon ends, and noon here is 12 sharp, while back home noon is a lengthy period of time that lasts from 12 to around 4pm. That is also why scheduling a meeting at noon will require additional followup and correspondence to schedule the exact time. Here, I would be expected to show up on 12 for a meeting at noon, only being raised on another side of the globe I was aware of the fact that I would have to switch centimeters to inches, celsius to fahrenheit and move my clock 7 hours back, but I wasn't quite prepared for changing my time perception (not to mention switching from 24hr to am and pm which I still find somewhat confusing). One couldn't know that without a thorough orientation... This could create a wide degree of miss communication, but even now, that I am aware of the discrepancy, I still get somewhat distress when am asked to meet in the afternoon or when attending a lecture that is supposed to end no later than 2pm and get the phrase: "We will cover this in the afternoon" from the instructor, with the thought of an unexpected extension of the talk crossing my mind. I don't think I could ever grow out of my already well imprinted time concepts, but I already know I'd better show up at 12 to my weekly noon lab meetings as long as I am in the U.S.

Just Dance!

I have never liked dancing too much nor would I volunteer to do so in public; like at dance bars or weddings (although you are sometimes expected to take part in it) but I do like sports of any other shape and kind and do appreciate the physical activity involved with dancing. I am also proud to say that both of my kids were blessed with their dad's talent and besides from the fact they enjoy dancing, they are pretty good in it. So when my daughter decided to use her savings to buy the latest Just dance 3
game for the Xbox (thanks to her grandparents it didn't take her too long to save for the proper amount) we supported the decision with 'whatever, it's your money' since it did seem fun for kids but I didn't think it could keep her busy any longer than the other dancing base games for the TV (a few days, maybe a week if the weather is bad outside).
To our pleasant surprise it became her favorite leisure activity, more than just watching TV! And even better than that, it became OUR favorite activity, the whole family was captured; We are not only Just dance 3 addicts, we are heavy users. It started with 'join me for one song mommy' and since 4 people can play at the same time, soon enough we found ourselves dancing in our living room to the sound of the latest songs, following the colorful dancing characters on the screen and burning quite a lot of calories (well, depends on how many song one can do in a raw, by song 2 you start feeling the sweat, by song 4 I usually ask for a break but the kids keep on going). And my daughter always takes first place. So my insights are:

1. We have finally found a game that is both active and keeps the kids engaged for a long time (it's been over a month now and my daughter plays with it EVERY day, in any combination; friends, family, babysitter, doesn't really matter as long as we are willing to move furniture around to make enough space for dancing.

2. Even a non dancing type like me can enjoy dancing (apparently, I am also surprised) and will join the Just dance 3party whenever called.

3. Playing the Xbox with your kids is a great way to have some family quality time, especially with those games that involve multiple (meaning more than 2) players.

4. The fact that you are a bad dancer (well, I am good in other stuff) doesn't mean your kids will necessarily inherit this unwanted quality, it has to be a recessive trait.

Sleepovers

Maybe it's the over-protective mom in me that feel this way but sleepovers at friends' house is a stressful issue. Currently I cannot think of any one person that can host a sleepover and have my daughter included without having to get a long list of instructions from us, her parents. Grandparents are out of the question since they live thousands of miles away from us and have no experience with diabetes treatment, and friends, well, I don't feel comfortable enough to generate such a long list and give it to a friends' parent and even if I did, it wouldn't take away the feeling that we are doing something that might risk our daughter's health. So the question is; does it worth it? Well, depends on who answers. My daughter would definitely say 'sure' while I would say not really, for now, until she is old enough to be completely independent, because, as funny as it may sound, when it comes to her diabetes, I trust my 8 year old daughter much more than I trust anyone else, my girl that by the age of 5 and a half already knew how to check her blood sugar, operate her insulin pump and tell the huge difference between 0.5 and 5.0 units of insulin or any other number with a decimal point, she does a better job than us. That's why I feel pretty confident sending her for play dates on her own. However, this is not really the case for night times, when the story gets a little twist. Once she falls asleep everything becomes solely our responsibility. We need to make sure her blood sugar doesn't turn up to a nighttime nightmare. Late night lows are one of my worst fears and in order to avoid it I make sure we don't over estimate her dinner's carb count and that she has a snack at bedtime, just before she brushes her teeth. I never give her insulin for this snack, Something that creates disagreements with her endocrinologist but raising your sleeping child's blood sugar level is much harder than just adding a little more insulin to correct a high blood sugar, especially when they are using an insulin pump and even more when this pump has a remote control, thank god for that! So I check her blood sugar before I go to sleep, correct it (too high means more insulin but too low means I would need to wake her up, get her to drink or eat something with fast acting sugars and wait 15-30 minutes, recheck and make sure her blood sugar raises to safe enough levels). Then I can go to sleep calm, knowing we are in control. Now, it's not always so predictable, many factors can have an effect on blood sugar at night; physical activity during the day, stress, hormones, site change, hot bath, new foods...you name it. So in addition to preparing a long list of instruction I would need to make a full investigation to that poor friend's parent to make sure the blood sugar at bedtime reflects the actual blood sugar for the rest of the night. Isn't it just easier to host the sleepovers in our house for now?

Promise To Remember

Last Thursday, January 12th, we had the honor to meet with congressman Chris Van Hollen and Joan D. Kleinman, the District Director, as part of the JDRF's (Juvenile Diabetes Research Foundation) 'Promise to Remember me' campaign. We, the proud parents, accompanied our daughter who was invited, along with other type 1 diabetics and family members to thank the congressman for his continued support in the diabetes research and make sure he remembers all of us affected by diabetes and continue his effort and support in moving the Artificial Pancreas project forward and in the Special Diabetes Program (SDP) that funds research for a cure. Congressman Van Hollen has long been a great supporter of the diabetes community, he was honored with the JDRF's Hero award in 2010 and the JDRF’s Congressional Champion Award this last November. The meeting went very well with a warm, laid back and pleasant atmosphere. The congressman took the time to kindly listen to what every single one of us had to say. He was very supportive and understanding and wanted to know how it is to live with type 1 diabetes and how we feel about the latest research developments. Our daughter was very proud and excited to meet a real U.S congressman and we were all very fortunate to have a chance to be heard and learn that there are good people out there helping to promote finding a cure.

So just quit mommy

I think I was meant to be a stay at home mom or at least have a home based office and career. In an ideal world I would be there for my kids when they come back from school, have their lunch cooked and waiting, full of energy and ready to spend the whole late afternoon and evening together. In an ideal world they will of course appreciate it every single day, and I will have my days filled with activities and fulfillment and would not regret making the sacrifice. But even stay at home moms cannot devote their whole time solely to playing with their kids, in fact, some may be so busy at times that their actual quality time with their kids might not be longer than my quality time with my kids.
Ever since my daughter was born I dreamt of being able to work from home. I realized that not working at all is not a financially realistic option and also my time off will never be as fun as it is now since I have to go to work at any other given time that is not off. I also noticed that when I come back home from work, the change in environment and atmosphere makes it easier for me to create a clear distinction between my work and my private life. I also found out that I get my energy load while I am at work, busy with my own things and then going home for my family, while staying at home didn't have the same effect on my energy levels. I might be really tired after a whole day at work but would still have a better mood (it helps if you like your job of course).

So maybe being a working mom that works full time is not such a bad deal for me. My daughter also thinks I should work, she wouldn't be pleased with the thought that I have the whole day for myself while she is busy at school, she'd rather make sure she is not missing anything, but she have different ideas as for the work I should be doing. "Wouldn't It be nice if you could be my teacher In class instead of Ms. Jones?" she asks these kind of questions rather frequently. And I always say: "yes it would honey, but then I would have to give attention to so many kids and won't be able to focus just on you" this part would always end the fantasy, as most kids wouldn't like to share their mom with non siblings, understandably. But one day she came back with a brighter idea. "Wouldn't it be nice if you could be an assistant in the after school activities?!" totally ignoring my already ongoing career for the past 10 years as a scientist. I was planning to just come up with my usual response but she had that part covered. "You will not have to give your attention to all the kids because there are several assistants and you can focus on only a handful of kids; me, Jennifer, Kira, Emily and Jacob". (best friends). "That sounds really cool but I already have a job honey" I answered. But she had that part planned thoroughly as well: "So just quit mommy" she said simply.

It is all in our genes(?)

Maybe it's because I was trained in human genetics and spent over 10 years studying various genetic diseases, or maybe this is exactly why I was drawn into this field in the first place, but for me the inherited genetic excuse has always seemed the easy way out. No one can blame you for having or giving your children a faulty gene sequence, it is not contagious and there is nothing on earth you could do (other than not existing or not having children) to change it. Now, it is a totally different story with the non-genetic; Avoiding the exposure to different kinds of environmental factors, in ideal world of course when we know the exact effect of every single factor on human health and can avoid any unwanted effects. Some might not agree with me on that, stating they'd rather deal with something they have some control over (assuming again that they know what this something is) over the total helplessness in the light of our genes and ways of inheritance, once you have it you are married to it, in the old fashion traditional meaning of marriage, you cannot just click Delete. But the truth is that our genetics and also our environment are both contributors in shaping our life, our health and our future. Bad genetic start point can be corrected to some extent with some effort while good genetics can be totally messed up by the environment.

As a mom, though, I tend to prefer the genetic approach most of the time. Knowing that not everything that happens is my fault. Especially when it comes to the health of my children. Blaming yourself for every possible issue is always the easiest thing to do and for me it has already been set as a default from the day I became a mom, needless to say it doesn't really help. Taking the environmental approach for me it's like putting all this heavy weight on my shoulders, and then everything that goes wrong has to be related to one of the following 3 options:
1. Something that I did
2. Something that I didn't do
3. Both

And for an over protective mom like me that would just be impossible to live this way.
So we are doing the best we can in terms of the environment, hoping for the best in terms of our genetics and are mainly trying to raise happy and healthy kids and live at peace with ourselves.

What some pediatricians will never know about D

"He is experienced with almost any kind of childhood medical condition and has invaluable advice. But, when it comes to diabetes, as miserable as it may sound, he is absolutely totally helpless".

There are many excellent pediatricians that have pretty much seen it all,

from the flu, viral and bacterial infections, childhood diseases to even rare complications, been there, done that, they will easily diagnose and most of the time successfully treat any symptom. Our pediatrician is one of them, the kind that doesn't prescribe unnecessary antibiotics or rush your child to take unnecessary further tests. He is also familiar and experienced with almost any kind of childhood medical condition and has invaluable advice. But, when it comes to diabetes, as miserable as it may sound, he is absolutely totally helpless. Throughout the many years of his clinical experience I guess he hasn't seen many diabetic patients so far. I hope he doesn't represent a big share of his fellow colleagues population in terms of diabetes knowledge and ironically our pediatrician back home was also an endocrinologist, yet my daughter was diagnosed by the less knowledgable one... Though we were the ones that asked to perform a urine test in the first place, only we suspected a urine tract infection (from the excessive urination) and not diabetes (well, I did have a sneaky suspicion but I was really hoping it was just my hypochondriac tendency cueing). So I think we at least deserved getting these news from the pediatrician himself and not his 20 year old trainee who in a by the way kind of speaking asked if we ever heard of a disease called diabetes. After that we were sent to the ER which was the right thing to do but looking back, it could have been handled in a more sensitive way. He also diagnosed her with a severe ketoacidosis, (although urine test showed only moderate ketones and in real ketoacidosis the levels of ketones in urine would he VERY high, but we didn't know much then) which added some more unnecessary panic and turned out that at least this part of his

diagnosis was incorrect (thank god!).

That didn't prevent us from coming back to him since we now have an excellent diabetes team to take care of my daughter's diabetes stuff so we can still use his great pediatrician skills for the more common issues and again we showed up suspecting a urine infection but this time with totally different symptoms and some fever. It happened about 5 months ago but I still get my blood pressure up just from thinking about it. We took a urine test and were asked to wait in his office. Again one of his trainees shows up, she looks very concerned and asks many questions that would usually point they are suspecting a central nervous system damage, and as a former neurobiologist I know too much of it. I am starting to lose my patience (and that doesn't usually happen) and ask to see the doc right away because I am also starting to get really worried. His assistant shows up in the room with a blood sugar meter, a prehistoric one if I may add... This doc hasn't been updating his diabetes equipment in his clinic lately. "Hi sweetie" she turns to my daughter. "this is a device that checks the amount of sugar in your blood" she explains as if we hadn't been using THIS device (well, a newer version of it) at least 4 times a day for the last 3 years... "I know" my daughter smiles politely at her. "We need to check your blood sugar, we just need a small drop, it will only take a second and you almost won't feel a thing" she explained slowly. Luckily my daughter has a good sense of humor so by that time she was really holding herself not to laugh out loud, giving me the 'is this woman crazy or what?' look. "Why is it necessary?" I interrupted the fascinating talk. "Doctor's orders" she said. "We checked her blood sugar just an hour ago and it was fine (compared to a diabetic child with a fever, as viral and bacterial infections are very known blood sugar raisers) and she just finished eating a pack of gummy candies in the waiting room so I am guessing it's going to be a little high and the test won't be too informative" I explained. So she went to ask the doctor and he insisted on doing the check anyway. The health tech or whatever her position was insisted on performing it by herself although my daughter is SO much more experienced in checking her blood sugar by herself, that's how diabetic kids get, but the tech was determined and my daughter couldn't really care less after having go through this at least 3659 times already so I just gave up (unlike me but I was exhausted and just wanted to know what it was all about). The tech of course failed to draw the blood and load it on the test strip and finally let my daughter do it, which she impressively did in less than seconds. The meter showed 250 mg/dL (normal would be about 70-100, diabetic normal would be around 150 for a child her age and a diabetic child on a sick day after a pack of gummy candies I was kind of expecting over 350 mg/dL so for me it was a pleasant surprise). Than the doc had finally decided to show up and I demanded to know what was going on. So he sat down and with a very dramatic look on his face he said: "We found sugar in her urine". I sighed with relief. "Well, of course you would, she has DIABETES" for crying out loud!!! You'd think an experienced pediatrician would know that... "I understand, but we were afraid she was getting into ketoacidosis which could be a cause for her frequent urination" (that explains the central nervous system questions earlier). "Did the you find high level of ketones in her urine?" I was getting concerned again. "Oh, not at all, she didn't have any ketones" he answered. "So why would you suspect she was getting into ketoacidosis?!" I was starting to lose my patience yet again. Our diabetic team communicated with this pediatrician on a regular basis, at least 3-4 time per year. He has every single copy of all the tests and follow ups, beyond ignorance in my opinion it shows lack of responsibility. A primary care physician that has diabetic patients, even just one diabetic patient should really be responsible enough to educate himself in order to avoid situation like that. Turned out it wasn't even a urinary tract infection, just a strange flu. My daughter thought the whole incidence was just hilarious, so I am lucky to have such a witty girl and I hope to find a better pediatrician that knows a little more about the physiology of a rare disease called type 1 diabetes.

Diabetes alert dogs

Lately I have learned that there is such thing as a dog trained to alert for low (and sometimes even high) blood sugar levels. They might not be as accurate and/or consistent as a CGM (Continues Glucose Meter) but are for sure more user friendly and non invasive. As opposed to what many people think; insulin pumps, unless they have an integrated CGM, do not check blood sugar. Diabetic patients nowadays still have to prick their fingers to draw blood for a manual blood sugar meter test, multiple times per day, so it wouldn't hurt to have another set of ears or in this case nostrils, in our house. So I started reading and inquiring about it and found that these dogs are now being recognized as guidance or alert dogs for every aspect it might have. They are scent trained and can tell when their owner's blood sugar is not in range. The web is filled with amazing stories of diabetes alert dogs that have saved their owner's life by detecting dangerous low blood sugars (also known as hypoglycemia). But, and there's a BIG but, a fully trained dog would cost around $10,000 and up (some even over $25,000). There are some states and funds that recognize the need and fully sponsor the pleasure (with several years on a waiting list) but living in an isolated place like Washington DC, we are not eligible for such benefits (waiting list or not). So I decided to train our own family dog to be a diabetic alert dog. Although she is a Pug and dogs from this breed are not considered to be of the working dogs kind, she has a lot of the qualities suitable for guidance dogs; like food motivation which makes them easy to train, a strong prey drive - she hunts down our shoes and my kids' toys persistently and she is a champ in tag of war games. There are several canine training schools that are willing to help with these kind of missions, some give mainly phone advice and some sell tapes with instructions. But before we can even consider scent training we need to make sure she excels in basic obedience first. Well, she doesn't even have to excel, maybe at least learn some obedience... Like come when called instead of making us chase her all over the house, NOT peeing on carpets, no wrecking the house, no nipping on bare feet toes, no grabbing the kids' toys... But she is also just a puppy so I guess we need to give her some time to grow up. Maybe we should go for a CGM after all.

Hello mornings



6am. our quality coffee time together



Hectic mornings are not something unusual for us (as probably for most families with young kids), I may as well call it a weekday typical morning since every morning of preparing breakfast, snacks and lunch for four, sending two kids in time for school, getting your dog walked and fed and still show up well rested and on time for work is our default daily routine. My husband and I wake up around 6 am, this is our quality time together, drinking coffee, chatting and discussing our plans for the day, for me it is also an opportunity to get myself fully awake, for me it usually takes at least 30 minutes, I am not a morning person, but I get by, or get gradually alert while preparing food, packing lunch boxes and making sure our energetic puppy doesn't wreck up the house. Then it's time to wake up the kids, make sure they eat something and let them watch some TV. Some might say it's a bad habit but for my perfect genetic clones, my two totally not morning type kids, seems like there is a maternal way of inheritance for this specific trait, one funny show every morning does wonders to their morning mood and gets them motivated enough to eat, drink, brush their teeth and get dressed with minimal effort and in a timely manner. We never prepare their clothes in advance, this tip has never worked for us since they either change their mind by morning or the anticipated weather doesn't perfectly match how it feels outside and we end up picking new clothes anyway. So I decided to spare us the extra time and effort in the evenings. Then my husband takes child number 1 to preschool and comes back to take child number 2 to school, since they are located on totally different sides of town. That takes off the pressure and clears up the bathroom (and the TV). Our dog gets to have a quick walk outside and then we're off for work. So my average time from waking up in the morning to showing up at work has scored the record of 2-3 hours, but my kids always look happy by the time they leave home for school, so for me it is absolutely worth it!



Juggling your schedule

A well accomplished and extremely busy professor had once told me that she always makes sure to be there on her kids' important events like school performances, assemblies, important sports games, occasional school field trips etc. I asked her how she managed her time right; coordinating all those committees she takes part in, scientific meetings she speaks at, business meetings, teaching courses, mentoring her postdocs and most importantly being there for her family, and she answered simply with one word: "appointments" she said. And to the sight of my confused look she said: "of course I make sure to be efficient and make the most out of my time, but there is no reason why a scientific conference should be more important than my son's soccer game or my daughter's spelling contest, as long as I know my schedule in advance. A person inviting me to give a talk at a conference or asking to make a business appointment doesn't have to know why a certain time or date does not work for me, I say I have a schedule conflict, and that's the true. I have been doing it for over 20 years now and haven't heard a single complaint. Also, I don't make work related appointments on weekends, only family 'appointments'. These are my rules and by following them I live at peace with myself; no regrets, no guilt feelings" she explained, and with that inspiration I realized that being successful, career wise, can indeed go hand in hand with making enough time for your family as long as you are efficient, plan your time right and enough time in advance, and make sure to make and keep those family 'appointments'.

The last day of the year

Sounds dramatic and indeed, when I was a teenager I used to take it very seriously and spend the last evening of the year observing, reflecting, summarizing the last years' happenings and experiences and writing down my plans and wishes for the new year to come; goals I would like to accomplish, places I would like to visit, changes I would like to employ, knowing that on the next day I was going to start fresh. As I grew up I realized that one doesn't have to wait for the new year in order to start fresh, any day can be a great day to make your life better, happier and more fulfilling. And besides, the Jewish new year is an easier time to start fresh since it usually takes place on September, when you start a new grade in school or when you come back from a long summer vacation, so changing some habits will come more naturally.
This last day of the year we planned to spend with friends, a long lunch that will carry on well into dinner. I left enough food and water supply for our dog, knowing that we might be back late at night, we packed the kids and drove to our friends' house. The kids were very happy knowing they were going to meet their friends and we were happy with the adults' company. There was one thing we didn't consider. Allergies. That's because we haven't experienced severe allergic reactions before, until today. Well, I have seasonal allergies, usually around spring time, but it's pretty hard to tell the difference between my allergy and a common cold. Our friends have a cat, a very cute fur ball kind of cat. My kids used to stay away from cats and especially from this specific cat since he is pretty big. But ever-since we got our family dog, my kids became two little Dr. Dollitles and they have to pet and hug almost every animal around. This is a real positive milestone considering the fact they used to run to the other side of the road whenever a dog would walk by. So even though that wasn't our first time visiting them, that was the first time my kids actually played with their cat. They played with some cats before but never with this specific cat. So before we knew it my daughter came to the living room saying her eyes were burning. One look at her eyes and we immediately suspected an allergic reaction. I thought that some water and eye drops would do but within minutes, before we got a chance to actually do anything, her eyes became so swollen she could barely open them, I guess it could only be due to their cat. The allergic reaction was starting to spread to her skin and we decided to rush ourselves to the nearest emergency room. The only place we knew that was open at this time of evening, on the last day of the year. Our experience with this ER was pretty memorable, the day our daughter was diagnosed with diabetes, I didn't really want to see that place again but we didn't have too many choices. So we drove over there, checked in, received our own room and waited for the pediatrician on duty. We waited, and waited, watched some movies, the kids munched on some snacks from the vending machine. My husband used the examination gloves for balloons, the kids were laughing and gradually, to our relief, the allergy started to fade away, my daughter's eyes weren't swollen anymore, just red. It was getting ridiculous to keep on waiting for the doctor and eventually we got some Benadryl and were released home. On our way out we payed for the parking. "Thank you" said the parking payment machine. "Please come back again soon". Not really the kind of blessing one would like to hear checking out from an hospital, I guess these machines were designed for shopping malls or airports, they should really do some reprogramming there. So that summarizes our last day of 2011, at least this hospital will no longer be linked in our memories to that emotional tough day when our daughter was diagnosed with type 1 diabetes, it will just be another hospital.