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An Overnight Field Trip With My Son — And His Diabetes

Susan Lanzoni: "I came to farm school with a bag of glucose tablets, alcohol wipes, sets for infusion, needles, insulin and emergency glucagon." (Grant MacDonald/flickr)
Susan Lanzoni: "I came to farm school with a bag of glucose tablets, alcohol wipes, sets for infusion, needles, insulin and emergency glucagon." (Grant MacDonald/flickr)
This article is more than 6 years old.

I am too old for farm school, but I went anyway.

Looking for a white farmhouse and a bevy of kids, I edged up the dirt road on a damp New England spring afternoon. I was greeted by my son’s sixth grade teacher and shown to my own tiny bunk a few creaky steps up from the boys’ narrow, interlocking beds. I lingered near the door of the main bunkhouse and watched the circle of middle-schoolers leaping and yelling “hi-yah” to the cardinal directions. During games in the horse barn, I retreated to my bunk, with a curtain at the door and a small window opening out to the main eating area. I stayed out of sight while the kids watered the ducks and pigs.

Before the field trip, Conrad said to me in frustration, 'I am supposed to be away, not with my mother.'

I appeared a few minutes before dinner, motioned silently to my son, Conrad, in the crowded line-up of children, and we stepped out of sight to the hallway. There, I surreptitiously handed him his glucometer. During a dinner of shredded chicken and rice, I squeezed onto a back bench so I could eye how large a portion of yellow rice he spooned onto his plate.

I came to farm school with a bag of glucose tablets, alcohol wipes, sets for infusion, needles, insulin and emergency glucagon. I put a huge jug of juice in the kitchen fridge.

My son has Type 1 diabetes. This is the diabetes that is not in the news very often. When people talk about “diabetes,” they usually mean Type 2. Few know that Type 1 is an autoimmune disorder that has nothing to do with dietary habits. It usually affects young children, but sometimes adults, as well. It is on the rise, although no one knows why. Conrad's immune system destroyed the beta cells in his pancreas that make insulin, so he needs round-the-clock injections, or infusions from an insulin pump. He is 11, and has had it for four years. He remembers quite well the hot August day he was diagnosed: Friday the 13th.

Parenting a kid with Type 1 means you are, first and foremost, a medical manager: You calculate insulin dosages — from the small drips of insulin he needs continuously (basal rates), to the larger doses for eating meals (boluses). You count carbohydrates, weigh food, figure out which foods are “slow” or “fast” to digest (glycemic index), assess daily exercise and growth spurts, and always, always carry quick sugar – juice boxes, gummies, glucose tablets. In my household, we estimate carbs and insulin doses and only sometimes hit the mark. We are clumsy imitators of the fine-tuned, instantaneous adjustments a healthy pancreas makes.

We have made it through some frightening episodes. After playing three soccer games in a Labor Day tournament, then eating a big pasta dinner, my son’s sugar plummeted to 29 mg/dL (70 is low normal), a level that would leave many adults unconscious. We gave him so much juice and so many gummies, he threw it all up. There was the day at the beach, when he played in the surf and sand without his insulin pump. His sugars skyrocketed, and he shook with nausea and dehydration. We are better managers than we used to be, but there are still unexpected, extreme lows or highs that leave us emotionally wrecked afterwards.

Before the field trip, Conrad said to me in frustration, “I am supposed to be away, not with my mother.” He doesn’t do sleepovers, and if he’s at a friend’s house, he calls us every two hours to report his glucose levels. We don’t hire babysitters. When his sister turned 13, we figured she had more experience with Type 1 than most adults. When I explain to others how we manage the disease, I often hear, “When he gets older, he’ll take over, and you won’t need to be so involved.” This is not reassuring. I think of a friend’s father who reaches over at night to check if his wife’s brow is wet with sweat, a sure sign that her sugar is dangerously low.This disease is a family affair.

Holed up in my little bunk at farm school, I waited for my son at bedtime. He charged up the stairs, and I removed the old infusion set and attached a new one. It is a device with a needle and a plastic cannula that delivers insulin from the pump into his muscle. I tested his sugar levels. He told me to hurry up and rushed back down to his friends.

Two hours later, I crept down the steps and squatted by the first bunk in the room where 12 boys were sleeping. I leaned over and pricked my son’s finger. A small bead of blood appeared, and as I touched it to the strip on the glucometer, I muffled the beep as it registered. When I first started pricking Conrad's finger while he was asleep, he screamed. Now, he doesn’t even wake up.

When I first started pricking Conrad's finger while he was asleep, he screamed. Now, he doesn’t even wake up.

Bodies shuffled under covers. One boy mumbled in his sleep. My son’s sugar was on the low side, so I put the straw of the juice box to his lips. He barely woke to suck a little down. When I tested again later that night, his sugar was too high, so and I gave him a dose of insulin.

That night, I checked him at midnight, 2 and 6 a.m. It is hard not to be cautious at night, especially with a new routine; most people wake up when their sugar goes too low, but some do not.

But before that long night, I leaned back in my bunk and heard the teacher call for lights out. He began reading "The Fenway Foul-up": “Yowza, Mike ducked down as the ball sailed overhead. That one is out of here!” I heard giggling, and I could pick out my son’s laugh. For that moment, anyway, Conrad had forgotten all about me and why I was there.

Susan Lanzoni Twitter Cognoscenti contributor
Susan Lanzoni is a historian of science and medicine

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