BOOK REVIEW: The Truth According to Blue
Juicebox Podcast Listener review #1
My son is 11 years old and entering 6th grade (also type one diabetic) had these comments. 10 out of 10 stars. Loved the mystery and he was very happy Blue got a CGM at the end. He loved reading about Otis the diabetic alert dog (and is pretty convinced we need one). He really enjoyed the mystery and he was jumping up and down at the end with suspense of what was going to happen.
As an adult reading with my child I thought the book was great, a fun adventure for sure! It put a spotlight on a character that has a chronic illness which you don’t see very often. I also liked how the main character had an everyday life similar to a lot of us. I think it hit all the marks about diabetes from feeling different to accepting your differences and being proud of them. I also liked that the main character, Blue knew how to dive, drive a boat and do all sorts of things that maybe kids with diabetes wouldn’t realize they could do. It had a great parallel with Jules in the book being a “normal” teen and without diabetes she also had challenges in her own life to overcome. I would say it also lent a great message about friendships and accepting people for who they are. I would recommend this book for any middle aged child and even parents too as I was really able to relate to Blue’s parents and how much they worry about her and the ground rules that they had especially around diabetes.
Thank you for the opportunity to review this book. Tracey Vargas
Juicebox Podcast Listener review #2
Reviewers: Jaime (Mom, an elementary school teacher, and T1D) and Natalie (daughter)
Jaime: As an elementary school teacher I know how important it is to have authentic text that children see themselves in. While we have some exceptional multicultural books, I've struggled to find books that include physical disabilities and chronic illnesses. As an avid listener to the Juicebox podcast, I was thrilled to find The Truth According to Blue and for Scott to be asking for reviewers. We jumped and was thrilled to receive the book in the mail a few days later. I let my daughter read the book first. She's a strong reader and will often finish books in one sitting. I wanted to see if this book held her interest, as well as other books, do. To be fair, she isn't a T1D and is going into high school so I knew she would not connect as well to the main character, Blue as others would. However, she still finished the book over the course of a week and seemed to be genuinely interested in it and enjoy the storyline. I'll let her share her thoughts later.
I too enjoyed the book and storyline. The author does a good job of describing the coastal town and the family dynamics that play into how Blue manages her T1D. As a T1D that was diagnosed later in life, I have no connection to the struggles of having parents participating in your diabetic management. I'm also fairly positive that this would be a different experience for every child who has T1D. Regardless, it's still a relatable and realistic portrayal of what one might experience. As a parent, I enjoyed seeing a good relationship presented between Blue and her parents.
Blue's frustration with have type 1 and being seen as the "girl who has diabetes" is extremely relatable to anyone who has T1D. It was nice to read a book that not only included the management but the frustrations as well especially coming from a writer who is not diabetic themselves. The only problem I had with diabetic care in the book was how often Blue went swimming with her pump. I'm sure this is really only noticeable to those of us who know the swimming struggles of wearing a pump. Otherwise, it seemed to be a pretty accurate depiction of a T1D.
The characters became better developed as you got into the book, with Jules becoming more likable and relatable as Blue learned more about her. Both girls are struggling with labels they have been given how they want others to see them. The growth in both characters and the friendship that they develop was enjoyable and realistic to read.
Otis, the diabetic alert dog, is a fun addition and thankfully does not die! I was concerned when Blue was worried about him getting older that he would not survive the book, but he did! As with many stories, the dogs always endear themselves to us and Otis is no different.
With many young adult books, the line between fiction and fantasy is often blurred. The adventures that Blue, Jules, and Otis encounter while searching for treasure is at times unrealistic and dangerous. However, I think without those, it would not be very exciting to read about a T1D with her head in a clear bottom bucket looking for treasure! Even with the problems that the three of them face trying to find treasure, it felt that the T1D information/management could overshadow the story especially if you are not a T1D yourself and know the true effect on one's day to day activities.
Overall, I think many young adult readers would enjoy reading this book regardless if they are a T1D or not. The struggle to find yourself and becoming more independent is universal. Who wouldn't enjoy an adventure story about treasure, two friends, and a really cool dog with a sweet ending?
Natalie:
Everyone enjoys a book with characters who we can relate to and grows throughout the story and this book definitely delivered. Everyone at some point has struggled with who they are and it's great to see those characters in a book; it helps us to see them as more human and not these great characters who we struggle to connect with and see them as distant. As my mother was recently diagnosed I found it really cool to be able to recognize what blue was doing to manage her blood sugar because I’ve seen my mother do what she does. Now as an individual who is not T1D, I did not connect with Blue as much as some with type 1 might, but I still enjoyed seeing her determination and spirit. The way the town was described was lovely, I felt as if I could walk down the street to the Island Bowl and have a good time. I enjoyed following all the characters' relationships improve and even grew to like Jules despite having a bad first impression of her. I do believe that Otis, Blue’s medical alert dog, was my favorite character. I believe that it's always enjoyable when an adorable pup who helps people is one of the main characters. I also liked the fact that once Blue, Jules, and Otis hit a wall they didn’t stop, they kept trying and I enjoy reading about characters who persevere when it seems like they should just stop. By the end despite having had an amazing adventure Jules and Blue found a different kind of treasure, friendship.
New test better predicts which babies will develop type 1 diabetes
from Science Daily, August 7, 2020 - University of Exeter
Scientists at seven international sites have followed 7,798 children at high risk of developing type 1 diabetes from birth, over nine years, in The Environmental Determinants of Diabetes in the Young (TEDDY) Study. The TEDDY Study is a large international study funded primarily by the US National Institutes of Health and U.S. Centers for Disease Control, as well as by the charity JDRF.
In research published in Nature Medicine, scientists at the University of Exeter and the Pacific Northwest Research Institute in Seattle used the TEDDY data to develop a method of combining multiple factors that could influence whether a child is likely to develop type 1 diabetes. The combined risk score approach incorporates genetics, clinical factors such as family history of diabetes, and their count of islet autoantibodies -- biomarkers known to be implicated in type 1 diabetes.
The research team found that the new combined approach dramatically improved prediction of which children would develop type 1 diabetes, potentially allowing better diabetes risk counselling of families. Most importantly, the new approach doubled the efficiency of programmes to screen newborns to prevent the potentially deadly condition of ketoacidosis, a consequence of type 1 diabetes in which insulin deficiency causes the blood to become too acidic. Identifying which children are at highest risk will also benefit clinical trials on drugs that are showing promise in preventing the condition.
Dr Lauric Ferrat at the University of Exeter Medical School, said: "At the moment, 40 per cent of children who are diagnosed with type 1 diabetes have the severe complication of ketoacidosis. For the very young this is life-threatening, resulting in long intensive hospitalizations and in some cases even paralysis or death. Using our new combined approach to identify which babies will develop diabetes can prevent these tragedies, and ensure children are on the right treatment pathway earlier in life, meaning better health."
Professor William Hagopian of the Pacific Northwest Research Institute, said: "We're really excited by these findings. They suggest that the routine heel prick testing of babies done at birth, could go a long way towards preventing early sickness as well as predicting which children will get type 1 diabetes years later. We're now putting this to the test in a trial in Washington State. We hope it will ultimately be used internationally to identify the condition as early as possible, and to power efforts to prevent the disease."
Researchers believe the combined approach can also be rolled out to predict the onset of other diseases with a strong genetic component that are identifiable in childhood, such as celiac disease.
Sanjoy Dutta, JDRF Vice President of Research, said:" We know that while genetics have a strong correlation as a risk factor for family members to develop T1D, most newly diagnosed individuals do not have a known family history. JDRF has been exploring the non-genetic, environmental risk factors that trigger T1D to help develop treatments to forestall or prevent disease onset."
Complete info is available at Science Daily
An Average Day with Type 1 Diabetes
Most days are perfectly imperfect…
If you already listen to the Juicebox Podcast this quick post will serve as a reminder that:
There is a way to eat normally and achieve the A1c that you want.
A great A1c doesn’t necessarily mean that your BG is 85 (4.7) all day and night long.
Just because you haven’t figured something out doesn't mean that an answer doesn’t exist.
If you haven’t yet listened, I hope that this post represents what is possible when you:
Have easy to understand tools for using insulin.
Listen to the Juicebox Podcast at JuiceboxPodcast.com, Apple Podcasts, Spotify or on your favorite podcast app..
Try these episode to start #11 Bold With insulin, #29 Fear of insulin, #37, Jenny Smith, #44 Diabetes Rollercoaster, #62 Unfounded Fear, #100 Revisiting Bold, #105 All About A1c, #121 Insulin, Insulin, Insulin
You can always listen to the Juicebox Podcast or your favorite podcast app but if you don’t have one try one of these. Apple Podcasts/iOS - Spotify - Amazon Alexa - google play/android - iheart radio - .
Getting to Bold
In the beginning of our life with type 1 diabetes I would cry in the shower...
The shower seemed like a good place to vent my fear, frustration and utter lack of confidence. I would emerge reborn having dumped my anxiety down the drain. The guilt and pressure would of course build up again but the venting would usually hold me over for a week or so. During that time I believed that this was how my life would always be. Every time Arden's blood sugar was too high, too low or just plain all over the place, I would think...
"Well, that's just diabetes. There is nothing I can do, it's out of my hands."
Here's the secret though. That's not just diabetes. At least it doesn't have to be.
This blog and the people reading it saved me from that life but not perhaps in the way you might imagine. If you were to go back a decade and read my posts you would see a person struggling as I've described here. The blog was a raw nerve, a mirror to my worst moments, periodic triumphs and ardent fears. I would have an experience and then write about it. It was cathartic for me and the readers felt supported because they saw their lives in mine. This was my original concept of what a blog was for and what community meant. I would share my life transparently and you got the relief that came with knowing that you weren't alone. My daughter's A1c was 9, yours sucked too and we all felt the momentary relief of sameness.
My idea of community has grown
I would make incremental yet unsatisfying improvements to Arden's care. We got an Omnipod insulin pump and her A1c went down, we cut out some foods and it went down again. Still, no great shakes just lower. Eventually Arden got a Dexcom CGM but all that seemed to do was enforce the notion that I sucked at taking care of my daughter's disease. Then one day our nurse practitioner told me that the biggest hurdle in type 1 diabetes management was fear.
More specifically. The fear of insulin
Those words clicked in my head and I began to force myself to not be afraid. This was no small feat as you are reading the thoughts of a person who caused two seizures in their daughter. Twice in the beginning years with type 1 diabetes I gave Arden too much insulin and she had a seizure. Today I realize that it wasn't the insulin that caused the seizures, at least not completely. It was my ignorance about how the insulin worked. When I realized that... everything began to change.
Bold T-shirts
Arden's A1c went from 9 to 8.5 to 8 to 7.5 to 7 to 6 to 5.6
“A platitude is a statement that has been repeated so often that it is meaningless. ”
I figured it out. The next question was what is "it" and more importantly how do I share it with you without the platitudes that often strangle our community. Have you ever heard that, "marriage takes work" or been told to "enjoy this... it goes by so fast"? People love to say stuff but then not give you any details. Have you ever wondered why we don't speak with more detail? I think that some stuff doesn't require more so we don't offer more. We also often don't have the luxury of the time it takes to fully explain. Diabetes however deserves and requires the next level of the thought to be shared, for time to be taken. The tried and true methods should be given to anyone who is interested in knowing them. The problem is that it would be a lifetime of blog posts or a library full of books that you could never read. Still, what if you read the answer but couldn't apply the information or didn't quite understand and needed one more example. We say crap like, "well, that's just diabetes" because it's difficult to do more and those platitudes rob us of hope. One day I got tired of accepting that and wanted to do more. I threw out the old chestnut that tells us that everyones diabetes is different and that experiences can't be thoughtfully applied to others. I ignored that trope because it is not completely true and I knew that I could find a way to extract the basic tenants of diabetes and apply them to everyone. Once I did that the next step was to give the ideas the weight that they deserved and the thoughtful explanation that they required. Above all else, I wanted to provide real tools that were easy to use for the people who were ready to try and hope that one day they would be ready to those who weren't quite there yet.
A Phone call
Recent Juicebox Podcast reviews. Click to expand. Seriously, read them.
When you share online people sometimes contact you to ask questions. As you can tell by this post I can get wordy when I write. So one day when I received a question from one of you and I responded, "maybe just call me". The first time that I spent a half hour on the phone with a stranger explaining the tenants that I use in the day-to-day management of diabetes... it felt weird. That strange feeling was replaced a few days later when that person contacted me again to say that they understood. They made the changes that we spoke about and their child's blood sugars were suddenly and markedly better. I asked that person to keep in touch. I say that to everyone today. "Keep in touch... let me know how this worked out". I say it to everyone for two reasons. 1. I really do care and 2. your feedback helps me the next time that I speak to someone. When that first person reached back out six months later with a significantly reduced A1c I thought, "I wish I could talk to everybody at the same time.".
So I started the Juicebox Podcast
The episodes of the podcast are self-contained, organic conversations that will help you to get to a better place with diabetes. But that isn't the real benefit of the podcast. Those episodes when combined reflect my continued maturation as a person living with diabetes. They are powerful separately but together they are an organic conversation that grows and builds and teaches - both me and the people listening. I never would have believed that it would be so powerful but I see it today in your social media posts, reviews and personal letters.
Here's what I know. When I am Bold With Insulin my daughter's life is better. She is healthier, happier and less burdened by diabetes. I then take what I've experienced and we talk about it on the podcast. You will absorb information and begin to apply ideas in no time. I've tried to replace those hope draining platitudes with simple ideas supported by easy to understand details about how to make them work. I'm not a doctor but I do have a decade of crowd- sourced experiences and a knack for explaining them.
You can help to shape how people talk and live
There are three people reading this post. Those of you who are already being bold, those who want to be and those who aren't sure if you can. If you you're already there, please help to keep the platitudes out of the diabetes conversation. Be supportive without being reductive and encourage people to be bold. If you know the there is more to diabetes than what you've been told. If you can feel it in your gut but can't quite bring it into reality. Please listen to the podcast. If you think that I'm full of crap or just can't imagine things being better. Please, take a leap of faith. A better life is waiting on the other side.
Be Bold With Insulin - Listen to the Juicebox Podcast
On your iPhone or Apple Podcasts
On your Android phone or Google Play
You can also listen on your favorite podcast app by searching for Juicebox Podcast. The podcast is completely free for all listeners.
Flu Season Tips
updated 2/25/20
Flu season has arrived and the sad fact is that no matter how hard you try, sometimes you just can't avoid getting the flu. Dr. Adam Naddelman, MD, FAAP, President, Princeton Nassau Pediatrics, P.A. has a few tips on how to elude the flu, spot the virus in it's early stages, and what to do when you think that you've been bitten by the bug.
Preventative measures (from flu.gov)
Avoid close contact with people who are sick. When you are sick, keep your distance from others.
Stay home when you are sick. If possible, stay home from work, school, and errands when you are sick. This will help prevent spreading your illness to others.
Cover your mouth and nose with a tissue when coughing or sneezing. Flu and other serious respiratory illnesses, like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS), are spread by cough, sneezing, or unclean hands.
Clean your hands. Washing your hands often will help protect you from germs. If soap and water are not available, use an alcohol-based hand rub.
Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
Practice other good health habits.Clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.
Early flu signs
Fever, usually 102º - 104º
Cough
Body aches that can be severe
Once symptoms begin
People who are high risk (chronic illness like diabetes and asthma, elderly or kids under 2) should seek medical care quickly. If the flu is diagnosed within the first 48 hours, antiviral drugs can be prescribed in hopes of shortening and/or lessening the effects of the flu. A full list of who is considered to be high risk can be found at Flu.gov.
For those considered low risk, Dr. Naddelman believes the best treatment is supportive care, including plenty of fluids, antipyretics to reduce fever and body aches, and lots of rest.
Considering emergency medical assistance? Listen to episode 307 of the Juicebox Podcast
Dr. Adam Naddelman, MD, FAAP
Dr. Naddelman stresses the importance of being on the look out for secondary infections with the flu, particularly pneumonia. Signs of influenza leading to a secondary bacterial infection like pneumonia include a high spiking fever several days into the illness, increasing cough and lethargy, and decreased appetite and oral intake. These signs require immediate medical attention.
Once you've kicked the flu waiting twenty-four hours to reintroduce yourself to the public after your symptoms and fever have resolved is considered best practice.
Dr. Naddelman practices pediatrics, but his advice is transferrable to patients of all ages.
This is a very good time for me to remind you that I am not a doctor and that nothing I write on Arden's Day or anywhere else should be taken as medical advice. My disclaimer says it all but you should really contact your own physician whenever you have questions about your or a loved ones health. Especially when the flu is involved.
