Missed Alerts as Training Opportunities

I often read about amazing DAD alerts but I rarely read about missed alerts. In my experience missed alerts are part of the journey. I think it's important for people to hear about them and understand how we use them as training opportunities. 

This morning Bo missed an alert. He was lying on my bed as Austin slept nearby. He showed no signs of smelling a low. He sat at my side on the bed as I prepared Austin's meter for checking. The test strip sucked up the blood droplet and the meter read 87. This is a number within Bo's reward threshold. I looked at him for signs of smelling the low (i.e., air scenting, sniffing vigorously, staring intently at me) but he showed no signs. 

What did I do? I used it as a training opportunity. I cued him to 'go sniff' Austin and I told him 'he's low.' He then started alerting. I cued him 'off' the bed and prompted him to 'show me low.' He pawed me and bowed at my feet. I called him with me to get Austin a juice box and I cued him to 'take juice' and bring it to Austin in bed. 

Why he missed this alert could have been due to any number of reasons. (i.e., Austin's blood sugar may have been trending up. The technology we use to measure Austin's blood sugar is allowed at +/- 20 point margin of error. His full belly from breakfast may have left him content and unmotivated to work.) I don't know for sure the reason; what I do know for sure is we always check on a schedule regardless of his alerts. There have been times when he has caught a high or low that we would have missed and, like today, there are times when we catch a low or high that he misses. This is one of the many reasons we are called a team. 

Video: Practicing Load Up in Wash Room

Every day I spend time training, exercising and playing with Bo. On the days I don't work, I spend more time doing each of these activities than on days I do work. I'm always trying to find new ways to engage him and keep him busy and interested. Today, we practiced the load up command by having him load up into the bathtub. Usually I'm giving the 'load up' command to prompt him to get into a vehicle or to get on Austin's bed. 

We've Got a Thinking Dog

This afternoon Bo did something he's never done. He paw swiped Austin's pack as a secondary alert. This alert came as I was preparing to check Austin's blood sugar. Bo had alerted high and I was waiting on Austin to check. Apparently I wasn't moving fast enough because as I sat waiting, Bo gave the pack two paw swipes and then looked at me. 

I wasn't able to capture the alert when it happened but I was able to prompt the behavior after the fact and get these pictures. This behavior surprised me because I've never trained him to alert in this manner. I believe it's a great example of what a 'thinking dog' looks like. 

Note: Bo has participated in Austin's blood sugar checks since he was a young puppy. We've always included him in the checking process. When we give him the 'let's check' command he follows us to get Austin's pack. He waits next to us as we prepare Austin's glucometer and stays with us until we validate his alert or if he didn't alert until we tell him 'all set.'

An Open Letter to the Parents of a Child Newly Diagnosed with Type 1 (Autoimmune) Diabetes

This is the face of a child with Type 1 Diabetes

I was sitting by myself watching Austin play in a basketball game when a friend approached me with a fervent purpose and look in her eye that I've come to know as meaning only one thing. My reaction was visceral and like a reflex response, I deferred to general pleasantries in my attempt to delay the inevitable. 

Each time I hear of a new Type 1 diagnosis my heart breaks, my stomach sinks and I find myself holding back tears. A few days after hearing my friend's story of her nephew's diagnosis, I shared with her this open letter to the parents of a child newly diagnosed with Type 1. I wrote this letter some years ago in response to the news of a new diagnosis. I'm publishing it here in the event it can bring a calm and peace -- even if for a fleeting moment -- to the mom or dad who has just been told their child has a disease for which there is no cure. 

I am so sorry your child was recently diagnosed with Type 1 Diabetes. You don't know me but I know how your world has been turned upside down by this diagnosis. As a mom who experienced the same diagnosis, I can reassure you that your child will be okay. In fact, he is going to be a stronger more mature and empathetic child because of the experience he has living with Type 1. 

Though you may not think so today, you too are going to be okay. Your grief over the loss of your 'healthy' child will subside; your feelings of fear and anxiety will be replaced with confidence; and your guilt will be reconciled.  

In fact one day you will discover a gem that is only revealed because of this experience that today fills you with raw emotion. It will likely take months, maybe even years but it will happen and when it does you will accept why your child was allowed, by a loving God, to live with Type 1. 

Stay strong. 

The Gem in the Journey

One of the most joyful discoveries on this journey has been the realization that I can help other D-moms who are on a parallel path to raise a DAD for their children. For much of our journey, I have been a recipient of other D-parents' gifts of guidance and encouragement. Recently, I have had the opportunity to share what's worked and what hasn't worked, and what we've learned from others, as well as what we've discovered on our own. Being in a position to share what I've learned on this journey for the simple sake of helping another D-mom has truly been the gem in the journey. 

Determining if an Alert is Ahead of the Meter or False

Bo leashed-up with Austin.

This morning while Bo was leashed-up (tethered) to Austin downstairs, I heard Bo whining. I stood near the top of the staircase and listened for a minute. His whining was persistent. Austin told me Bo was not alerting to him but knowing whining can be a pre-cursor to an alert, I asked Austin to unleash Bo. I wanted to see if Bo would come to me and alert. No sooner had Austin removed the leash and Bo had found me in my room and alerted.

I checked Austin and he was 123 -- an in target range number. Austin had insulin on board that was working on breakfast carbs he had recently consumed. Given this information, it would appear Bo's alert was false as opposed to being ahead of the meter. However, two hours earlier Austin had been playing in a basketball game. We know exercise has a delayed effect on blood sugar, so it was possible that his blood sugar was trending down. Like we always do when Bo alerts outside his reward thresholds, we told him were were going to watch. Austin leashed back up with Bo and I took a seat on the couch next to them. Twelve minutes after his first alert, Bo broke place and came to me on the couch to alert. This time Austin was 87.  I rewarded Bo, gave Austin a 17 g (uncovered) snack had Austin leash-up again with Bo before I went back upstairs. 

Not long after leaving them, I heard Austin telling Bo 'all set' and 'we are going to watch.' This didn't make sense, as we were not watching. I called to Austin asking if Bo was alerting to him. He said he was and he thought we were watching. (This is what can happen when you have a 12-year-old boy who is immersed in a video game with his friends.) I went downstairs to re-check and Bo greeted me with another alert. This time Austin's blood sugar was 70. It had been 17 minutes since his alert to the 87 and since Austin had eaten 17 g of carbs. Our pup was smelling a downward trend in Austin's blood sugar. 

I've learned it's important to watch false alerts to determine if they are in fact false or if they are ahead of the meter. Our criteria for qualifying an alert as being ahead of the meter is a blood sugar in reward range within 15 minutes or less from the time of the original alert that was out of reward range. Typically, Bo re-alerts within 10 mins of his first alert when he is ahead of the meter. 

Do you have a process for watching false alerts? What does your process look like? What are your criteria for determining if an alert is false or ahead of the meter? 

New Book about Life with a DAD Coming this Summer

Elle & Coach: Diabetes, the fight for my daughter's life, and the dog who changed everything by fellow D-mom and DAD owner, Stefany Shaheen is sure to be a heartfelt and inspiring story that will raise awareness of Type 1 (Autoimmune) Diabetes and the difference Diabetes Alert Dogs make in our lives.

Elle & Coach will be available in bookstores August 2015. It's currently available for pre-order at Water Street Bookstore and RiverRun Bookstore, as well as on Amazon.com. The list price is $27 and a percentage of the proceeds will support Type 1 Diabetes research.

I pre-ordered a copy through Water Street Bookstore and learned Stefany is signing and personalizing books.

You can follow Stefany on Facebook and Twitter, as well read about Coach and Elle on her Counting on Coach Facebook page and blog.

I invite you to 'Share' this post on your social media pages to spread the news about what's certain to be a story that raises awareness of Type 1 and the benefits of specially trained Diabetes Alert Dogs.