Bo Goes to Class with Austin

Bo 'chilling' in Austin's classroom.

Last Sunday, Austin and I took Bo with us to religion class -- a once a month, three hour class held in our church's activity center. The class is comprised of  a hundred or so seventh and eighth grade students, parent volunteers and church staff. The format consists of large group lectures and small group discussions. The students gather for the large group in a gymnasium set up with tables and chairs, and in classrooms for the small groups. They get a snack break and have time to socialize. In many ways, the environment mimics a typical school setting with crowded halls of kids passing one another, food crumbs on the floors, bells, public rest rooms, gym bleachers and classrooms. Sunday was Bo's first time in class but not his first time in the space. 

Bo handled the noise and activity beautifully. He settled under the table in the group lecture and under the desk in the classroom. A few times he rested his head on our feet in what we refer to as 'chill' position. He even alerted.

Bo hanging with Austin when class ended.

My presence continues to be a distraction to Bo when Austin is handling him. Bo will stop walking with Austin to look back for me. He did this when Austin was leaving the gym with him to go to the classroom. I was about 20 feet behind the two of them.  

When Bo alerted in the classroom, he broke place to come to me and alert rather than alerting to Austin. In talking with Helen about Bo's preference to alert to me over Austin, she suggested having Austin be the person to give Bo his high value food reward when he alerts. This week, I started bringing Bo to Austin every time he alerted and prompting him to alert to Austin. We appear to be making progress; tonight Bo alerted Austin while they were awake in bed.

Bo 'under' in the large group setting.

Bo settled at Austin's feet in the gym

Video: Finding Hidden Scent Sample

Austin was out of the house this morning, so I took the opportunity to do scent training with Bo. I put Bo on his place and then hid the sample out of his view. I returned to him and gave him the 'find low' command. This is one of the videos I took of him finding and alerting to the low sample.

Taking Bo to School

Guest post from Austin:
School has recently started and while I miss summer, I enjoy seeing my school friends. This did however get me thinking about Bo going in to school. I know he recently passed his Public Access Certification Test (PACT), so he is definitely qualified but is he really ready? Am I ready? I really want him to come to school with me but I'm not sure if I can focus and still watch Bo. I believe I can do it but I still need to keep up in school too. After just two days working Bo when we went to Dallas, I  was worn out. I think the time zone difference and less sleep made it worse but it was still a lot of work for me and Bo. If I am doing that five days a week for six hours that is a lot to balance. We hopefully will start working Bo in school for one hour at a time. I hope my mom and Helen will be able to schedule a time for Bo to take the PACT with me in school.

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College Campus Offers a Host of Distractions

Boy and Pup at Dartmouth College

Austin has been asking about Dartmouth College for the past year. Today, after a hike of Mt. Sunapee and lunch at Salt Hill, we decided to drive to Hanover and walk around Dartmouth's campus. It was a beautiful day and the Green was speckled with college students playing lawn games, reading, and lounging in the afternoon sun.

I handled Bo when we first got there but Austin took over after about 15 minutes. We walked down one side of the Green, through the busy Main Street sidewalks, and between class buildings before taking a break on the lawn in front of the Fisher Ames Baker Library. The energy of the college campus was palpable and walking among the students spurred conversations about college life. As we passed classroom buildings Austin asked, "How do you know where your classes are?"  Then while walking by the Visual Arts Center he announced, "You would never see me in that building." A Geisel School of Medicine sign prompted a conversation about the difference between undergraduates and graduates. 

Our visit was brief but no less enjoyable.  It provided many opportunities for boy and pup to practice the public access skills they've learned over the course of our journey. They did great too -- working with confidence and ease -- among a host of distractions. In fact, if I dare say so myself, they rocked this outing! 

Lowest A1C Test Result Since Before T1 Diagnosis

I received Austin's latest A1C test results this week and I was so happy I could have cried. His average blood glucose control for the last three months was 7.1 (which converts to 157 mg/dL). It's the lowest it has been since before his T1 diagnosis. While it's still not as low as I'd like, it's below the American Diabetes Association's A1C target of 7.5  for children with Type 1  -- for that I'm very happy.

I credit his 7.1 A1C to Bo's alerts and the fact he and Austin spent most of the summer together 24/7. Their 'togetherness' provided the opportunity for Bo to catch more reward range blood sugars than during the school year when they are apart from 8 am to 3:30 pm. 

What I consider most remarkable about Austin's 7.1% A1C is not the fact that it was achieved with the help of Bo's nose but rather it was achieved without a continuous glucose monitor (CGM), without a disproportionate number of hypoglycemic events, and with the presence  of growth and puberty hormones. 

If Austin had a continuous glucose monitor it would provide valuable blood glucose trend data that would help us fine tune his basal rates more precisely. We have talked about getting him a CGM but he is vehemently opposed to having another site on his body. (He has an insulin pump site already.) 

When it comes to A1C numbers, Austin's endocrinologist wants to see a low result but does not want that result to be the effect of a large number of low blood glucose events. Thankfully, Austin's 7.1 A1C was a result of staying mostly between 90 -200. Bo is trained to alert on highs starting at 170 and when he is with Austin he is typically alerting right between 170-185. 

At 13, Austin is in the throngs of hormonal changes that are known to make diabetes management even more challenging. As we adjust Austin's insulin therapy during this period of rapid growth, it's helpful to have Bo alerting on high and low blood sugars before they pass from 'not ideal' to dangerous. 

The next milestone on our journey is registering and licensing Bo with the NH Governor's Commission on Disabilities as a trained service dog. Once that happens, my plan is to begin talking with Austin's school about scheduling short visits to trial boy and pup working together while class is in session. There is no guarantee that Bo will alert to Austin in school but I'm hopeful. If boy and pup are able to successfully work together under the distractions of a busy junior high, I'm confident Bo's nose will help us maintain or even reduce Austin's A1C through the school year.

A Major Milestone Met

Bo passed his public access certification test with me last Friday. I took the test with him at a local Walmart Supercenter.  A friend joined me to take video and help out with the test items. Helen administered the test and brought her Collie Paddington to help with a test item requiring another dog.

When I originally scheduled the test date with Helen, we talked about whether Austin or I would test with Bo. Austin wanted to take the test and felt he would be more relaxed than I would. I felt that I would be a distraction to Bo if I was at the test but not handling him. Helen told us it didn't matter to her but cautioned us that if he were to fail, she was required to document it.

Austin and I originally decided he would test with Bo but when I had to reschedule the original test date to the following week, I realized Austin would be in school. After explaining the situation to Austin, he agreed that I should go ahead and take the test with Bo rather than wait for a date that would work with his school schedule.

Unloading from vehicle in a busy parking lot.

I was nervous the morning of the test. I tried to distract myself by keeping busy. I took Bo for an off leash walk and then I did some training with him before walking him on leash.  I also played with him outdoors. He rested on the 40 minute ride to meet Helen. Once the test started my nerves calmed and I felt confident in Bo's ability to work in public.

Bo worked with the distraction of another dog in the store.

He unloaded and walked through the parking lot. He waited on command at the entry to the store and then walked with me through the door when I gave him the 'with me' command. He performed sits, downs, and down stays. He remained down while I dropped the leash and walked away from him. He came to me when I called him. He held his down position when I handed the leash over to another person and walked out of his sight where I remained for a short time before coming back to him. He maintained a heel position while I let go of his leash and draped it over his back. He navigated tight spaces between shopping carts. He ignored adults and children. He behaved politely in the cafe where people were eating and food was being prepared.

Bo heeling without me holding his leash.

The test didn't take long and to my surprise it felt anticlimactic once it was finished. In my mind I built the test up to be a Herculean feat. In reality, it was no different from our typical public outings. Bo did the work we've trained him to do and I did the work Helen trained me to do.

With this milestone on our journey met, I'm looking toward the next -- for Bo to take the PACT with Austin at school. There is still more training to do in school, as well as conversations to be had with school representatives before this happens but I'm confident we will get there. For now, I'm enjoying the pride of accomplishment that comes from hard work and grit.

Book Review of Elle and Coach

Elle and Coach by Stefany Shaheen with Mark Dagostino is a heartfelt, authentic, engaging, inspiring, empowering and myth breaking story of life with Type 1 (Autoimmune) Diabetes and a Diabetes Alert Dog. Stefany's gift for writing and storytelling makes for powerful prose that captures your heart and mind.

As the mother of a child with Type 1 Diabetes and the owner of a Diabetic Alert Dog, I was able to relate to the story on a deeply personal level. Throughout the book there were parts where I found myself thinking: 'wow, I feel that way too' or 'I do that also.'

The chapters flow into each other making for an easy and quick read, while the imagery and detailed descriptions bring the story to life -- allowing you to experience a range of emotions including happiness, sadness, heartbreak, disappointment and even mama bear anger.

In telling her story, Stefany tells the story of thousands of Type 1 families across the nation. Reading it will touch your heart and open your mind. I promise you will be talking about it and sharing it with family, friends and co-workers.

Reward Range Thresholds

When it comes to Bo's nosework, I expect alerts within his low and high reward range thresholds. For a high it's 170 to 220 and for a low it's 70 to 89.* An alert that allows us to treat Austin's blood sugar before it gets dangerously high or low, is one that meets my standard of a successful alert.

Dangerous highs may result in ketones and may put Austin at risk for long term complications associated with high blood sugar. Dangerous lows may put Austin at risk for short term conditions such as seizures, coma, or in the worse possible case, death. In general, if Bo alerts on a blood sugar above 220 or below 70 I consider the alerts helpful but not successful. 

There are two scenarios when I make an exception to this standard. They are: 

1. When Bo alerts on a low below 70 or a high above 220 upon Austin arriving home after being separated from Bo. For example, when Austin sleeps at a friend's house and Bo stays home. Bo has alerted outside his reward thresholds  (higher than 220 or lower than 70) upon Austin arriving home. I consider this a successful alert because Bo was not with Austin to smell his blood sugar when it was in the 170-220 range.
2. When Bo is re-alerting on a low that's dropping or a high that's rising. He may give his first alert within his reward thresholds but continue to alert well beyond the 220 or below the 70 until Austin's blood sugar is in non-reward range (above 90 and below 169.) I consider this acceptable because these alerts serve to let us know there is either an issue with treating the low and it's still dropping below 70 or still rising above 220. 

Bo is not perfect. He is a living, breathing animal and his ability to work can be influenced by many factors including but not limited to: 

• How full or empty his stomach is;
• How energetic or fatigued he is physically or mentally;
• The number and strength of distractions that are present in his work environment.

Alerts outside of his reward thresholds don't happen frequently but they do occur and when they do, they provide me the opportunity to evaluate the influences at play and modify his scent training to address them.

I'm interested in hearing from you. What are your experiences with regards to out of reward range threshold alerts? What are your expectations around your DAD's alerts? What exceptions, if any, do you have to your expectations? What other thoughts do you have on the topic of alert reward ranges and thresholds?


* Reward thresholds vary among DAD teams.

Today I Turned Three

Today I turned three.



I slept late with my boy.

I took a morning walk with my friends.

I retrieved my Papa's hat.

I played 100 things to do with a box.

I held my paw on the riser to get a treat.

I practiced sits, downs and stands on the step.

I practiced 'touch' with the easy button.

I played fetch.

I alerted to my boy's blood sugar and got rewarded.

I worked at Lowes and met these statue dogs.

I hung out on the front lawn with my Mama.

I ate an ice cube filled with kibble and carrots.

I took pictures with my boy and Papa.

I got hugs and love from my boy.

I posed for pictures.

I snuggled with my boy.

I got a birthday treat and I really liked it.

I celebrated with my family and Gil and Syl.

I turned three today.

Our three year old pup. August 23, 2015.

Boy and Pup Working in Public

Austin checking after Bo alerted low.

Austin and Bo are making even more progress in their work together. During a recent shopping trip boy and pup worked side-by-side with only a few bumps over the course of the two hour outing. The first being Bo lagging behind Austin at the first store in an effort to check-in with me as I followed behind them. I recognized I was distracting him, so I trailed off in another direction and caught up with them a few minutes later. While shopping at the outlets, they encountered three dogs at once. Two of the dogs were with one handler and the third dog was with another. All three dogs were interested in Bo. Typically, Bo doesn't have a problem ignoring another dog but these three (at the same time) got his attention and he was distracted. He lost his focus on Austin for the short time it took all them to pass one another.

Bo alerted Austin to a low while at Nike. 

Bo did alert to three lows while we were shopping. He caught a 61, 83 and 87. He alerted to Austin first and me second on the 61 and 87. He alerted with a paw swipe and bow and we checked immediately to validate his alert. Once validated, I prompted him to show me his signal for a low and then I gave him his food reward. Following his reward, we gave him the 'all set' command and sat while Austin treated his blood sugar.

At Bob's Store Austin and his friend were checking out an end cap with different sport balls. Bo was at Austin's side when Austin decided to toss a pink bouncy ball to his friend. His friend caught the ball but then bounced it back to Austin. The ball bounced right in front of Bo and he was rock solid. (I reminded Austin he should not be playing ball in the store.)

Checking out balls at Bob's Store.

Taking a nap while shopping at Bob's Store.

Waiting for their turn to check out.

Two hours of school shopping.