Category Archives: Samantha

Remote Blood Sugar Monitoring

With Samantha about to start in the competitive gymnastics program, we really needed to have a better way to monitor her blood sugar.  In the recreational program which she has been a part of until now, Cynthia or I would sit in the waiting room.  She would stop by and let us test her if she felt low.  With the activity, she did tend to drop during her gymnastics classes.

But for the competitive program, the coaches really do not want the parents sitting in the waiting area and potentially distracting the girls.  I am sure they would make an exception for us but we wanted to give Samantha some more space.  At the same time, we knew that gymnastics was one of those times that her blood sugar needed to be watched closely.

We decided to get a continuous glucose monitor for Samantha.  There is a sensor which is inserted into her skin and replaced every several days.  A transmitter sits on top of the sensor and send the readings every five minutes to a receiver wirelessly.  The receiver has a screen and you can look at recent readings and trend arrows that tell you how her sugar is changing.

The receiver needs to be within about 20 feet or so though.  To make the next jump, we used something called NightScout.  NightScout is a project by several people online to piece together a way to monitor blood sugar remotely.  You connect the receiver to a cell phone using a USB cable.  The cell phone runs a special app which reads the blood sugar readings from the receiver and sends them out to a database you setup on the Internet.  You also setup a web server on the Internet which reads the database and presents the readings to a web browser.  Then, there are apps for the iPhone and other devices which display the data.

The NightScout setup instructions describe how to setup a database and a web server on two different hosting platforms.  Initially, I setup services on these other hosting platforms.  I did this so I could at least test everything and ensure it was all working.  Easiest to follow the instructions exactly the first time.  Once I saw how it actually worked, I was ready to do it my way.

I have had my web hosting with Dreamhost for years and I really didn’t want to suddenly use a bunch of other services.  First, I needed to move my existing web sites (including this one) from their shared servers to a VPS (virtual private server).  The web server for NightScout is node.js based and will not work from a shared server.  Dreamhost moved my existing websites to the VPS without a hitch.

Next, I setup the NightScout database on my new VPS.  I redirected the cell phone to send the readings to my new database and sure enough, I started getting data.  I changed the web server (still at the non-Dreamhost server) to get its data from my VPS hosted database and that worked.  Now I needed to move the web server.

I grabbed a copy of the Javascript source for the node.js server and poked around for bit.  The instructions have you use these other hosting services partly because they are cheap but also they have nice interfaces for configuring everything.  I was working from a command line into my VPS and trying to figure out how to configure things.  When the instructions said to set a field in a form to X, what do I need to do in order to accomplish the same thing.

After browsing the code for the server a bit, I wrote a simple script to setup some config options and launch the server.  After a couple of tries, I got the script right and the server started working.

With that up, I changed Cynthia’s and my phone to pull data from the server running on our VPS.  I decommissioned the services I setup with the other providers.  The entire solution was now running through a VPS I managed.  I wrote a backup script to make sure all of this configuration was backed up every night.  The backups go back to our computer at home.

We even bought a Pebble watch for Cynthia which lets you have the blood sugar readings right on the screen of the watch.  So, here is the sequence of events to get blood sugar readings to us:

  1. The sensor takes a blood sugar reading.
  2. The transmitted connected to the sensor sends that reading to the CGM receiver wirelessly.
  3. The cell phone pulls that reading from the CGM receiver through a short USB cable.
  4. The cell phone uploads the reading to the database running in our VPS.
  5. The web server on our VPS provides that reading and all other data to any client which requests it.
  6. Our iPhones have apps on them which will communicate with the web server on the VPS and display the blood sugar values and trends in real time.

The only requirement is that the receiver/cell phone stay within about 20 feet of Samantha and that the cell phone has a good Wifi or cell signal so it can upload the data.  This will be how we give Samantha more independence while also continue to be able to manage her blood sugar.

Samantha’s Activities

Samantha is a busy girl.  She has been doing gymnastics for the last few months in a recreational program.  She had visions of joining their competitive gymnastics program but that is by invitation only.

Cynthia and I encouraged her to work hard.  We told her that if she focused, listened to the coach and tried her best, she would have her best chance to join the competitive program.

Sure enough, a month or so ago, she was asked to try out for competitive gymnastics and we found out recently that she was accepted.  That means starting after the summer, she will go to practices a couple times a week instead of just once.  And she may be going to gymnastics meets next year.

Not content to wait for that, Samantha asked if she could play soccer this summer.  We were late to register her but she was lucky they had room for her.  So, every week, she plays soccer at a field very close to home.

Gymnastics and soccer are her favorite sporty activities these days but swimming in our pool will probably be up there also as soon as the temperatures go up a bit more.

Dance Recital

Samantha had a great time this past year in a ballet class. She attended weekly classes and was working towards a big dance recital at the end of the term. Before the recital, they did a dress rehearsal and parents were allows to attended the rehearsal and record the show. You can see some of that footage in the movie.

After the rehearsal, Samantha had two performances at Centrepoint Theatre. We got tickets for the first evening so we got the chance to watch most of the show. Samantha was enthralled with the music and dancing and thankfully there was enough room in the aisle for her to dance along. A couple of numbers before her performance, we escorted her backstage and then quickly returned to our seats to watch. She did really well and only fell down once.

Samantha Ballet - 3After her number, we picked her up from backstage and watched the rest of the show. Even though it finished up very late at night, she was still so excited to watch all of the dancers and loved the music.

The next day, she performed again. We didn’t have tickets that night so we waited backstage while she performed and then went home afterwards. Unfortunately we don’t have any footage of the actual performance yet because we weren’t allowed to take pictures or video but we are supposed to get a DVD of all acts soon. So, perhaps I can include a better quality video of her dancing soon.

Samantha is going to do ballet again this year and she is also keen on tap dancing also. So she may end up in two performances in next years recital.

Samantha’s First Haircut

IMG_0421Although Samantha is more than three years old, she actually never had a haircut before. But, the time came that it really needed to be trimmed. More than that though, she got some really nice braids in her hair. Check out the pictures.

Samantha’s Third Birthday

P1050787Samantha had her third birthday a little while ago. We threw a birthday party for her at Samantha’s best friend’s house. We played with their cat who seemed to enjoy sitting in gift bags. We had a Dora piñata but instead of hitting it, you were supposed to pull on a string to open it up so the goodies could fall out. After breaking a piece of trim off the doorway where we had tied it, Cynthia realized that she overstuffed it and nothing was going to come out. Matthew came to the rescue and used some of his karate moves to break it open. Instead of cake, we had cupcakes laid out to form the number 3. Samantha had a great time and we stayed late visiting with good friends.

But that happened several days before her actual birthday. On her actual birthday, the four of us went out to dinner at East Side Marios. After dinner, they brought ice cream cones with a sparkler in it with several staff singing a birthday wish. Samantha was a bit overwhelmed but loved it. With dinner done, we gathered on our bed where Samantha opened gifts from and cards from family. We have some video of that.

Thanks everyone for your birthday wishes.

Welcome to James Eric Rand

Baby James030My brother Steve and his wife Katherine have a new arrival in their home. Their son, James Eric Rand was born earlier this month. You can see some pictures of him here. My mom was in St. Thomas to help out for a few days also. We happened to be in Ottawa at the time but busy with other things and couldn’t get a chance to see him (see the other story for what we were up to). We will definitely be visiting this summer when we get back to Ontario.

Welcome to another member of the Rand family.

Samantha and Matthew Home Again

Samantha had her IV’s removed by late morning today. Her blood sugar and pH levels had stabilized. She was still coughing and had a bit of a fever still but otherwise was much improved. I setup her insulin pump and was back in control of her medication which honestly was reassuring. I guess after doing it for a year, it actually isn’t pleasurable to have that burdened removed. It is just something we do now.

In fact, just after I setup her pump, I gave her half a unit to cover the carbs she had recently eaten with breakfast. About an hour after that, the nurse came in with half a unit in a syringe. She was there and we discussed the insulin when I delivered it and she wasn’t convinced that we should give her more. But, the doctors issued the order and she couldn’t just ignore it. With her support, we talked to the doctors. I showed them the insulin history on our device and that she already had the insulin some time ago. After a quick demonstration of our pump which they hadn’t seen (we were in the ICU so these were not endocrinologists who would necessarily see all the latest tech), everyone agreed that the extra insulin was not appropriate.

So, I had successfully wrestled medicating Samantha from the hospital and from then, I did the blood glucose tests and delivered the insulin. I just had to report to the nurse so the chart was updated.

The next question was when would we be headed home. The consensus was either today or possibly tomorrow. The big concern was that Samantha just did not look too alert or active. My argument was that they interrupted her sleep every hour last night to draw blood for a pH test. Combined with the low grade fever and cough, she was just exhausted. I think everyone agreed and that the best thing for Samantha was to be back at home in comfortable surroundings. By 4:30, we were pulling into our driveway.

I called Randi on the way and asked if we could stop by and pick up Matthew. But, he wanted to stay for dinner and watch a movie with them. She offered to drop him off at 7:00 and he was eager to take her up on that offer. Although Samantha really wanted to see her brother again, I decided to let Matthew stay a bit longer. That worked out well. Samantha really was tired. She wanted to sit on my lap for a little while and watch TV. I tried to offer her some food and she took little bits here and there but not too much. By 6:00, she was asleep in my arms and I took her to her bed.

She has slept very soundly since then. I have tested her blood glucose a couple of times and unlike in the hospital where she would start and cry out, she slept right through it as she used to. Hopefully she will sleep soundly all night and be her usual self tomorrow.

Thanks again everyone for your support. Cynthia is back tomorrow and I may have some more news about house hunting in Ottawa then.

Samantha Improving

Samantha’s blood sugar and acid level are both back to normal. The doctors want to see if she can keep food down so we are going to try some clear fluids soon. Rather than move her out of ICU they hope to release her this afternoon if all goes well.

As I was writing this update the Popsicle she wanted arrived and she is sitting up in her bed enjoying it while watching some tv. So far so good.

February Madness

So much is going on right now it is hard to know where to begin. There are two big pieces of news to tell. First, we are planning on moving back to Ottawa this summer. We may have found the house for us and Cynthia is travelling there right now to see. At the same time Samantha was admitted to the hospital today.

Early this week, Samantha had a fever and a bit of a cough. But the fever was not too high and she seemed ok. At the same time, a house which looks great for us was listed in Ottawa. Our plan was to go to Ottawa in March to look for a house. Work is very busy this month and I just couldn’t afford the time off. The house we were looking at had a pretty good price and it looked like it would move quickly. So, we decided to book a flight for Cynthia to Ottawa on Friday, returning Sunday.

Last night though, Samantha could now keep her food down. For a diabetic this is very serious because her blood sugar could drop very quickly. We checked her frequently and found he sugar level high. We gave her less insulin than we would normally because if she got low, it would be difficult to increase her sugar. Then, she couldn’t keep water down.

I called our endo and she recommended we bring her to the hospital. So, Matthew and I took Samantha to the hospital while Cynthia headed for Ottawa. I figured they would just rehydrated her and do something to settle her stomach. But, it looks like she is somewhat acidotic probably from the days of increased temperature. The vomitting was likely a side affect of the acidosis. That means she needs sugar an insulin to bring her pH back into balance.

They have a couple of IVs in her left arm, delivering glucose and insulin. She is improving in her stats but she is still very quiet except when she cries to go home or for her brother.

Which is another story. Matthew is now allowed in this hospital. They don’t allow children who are not patients. With Cynthia away, I was a bit stuck. Thankfully, Jessica, a good friend of ours, offered to host Matthew tonight. And tommorrow, Randi and her family will have him if Samantha is still here. Thanks to both of you for your support.

Cynthia has a full day tomorrow looking at her favourite house and a couple of others. Unless she sees something terribly wrong we will likely make a conditional offer on the house on Sunday. I will update the webpage as often as I can about Samantha and also about the house news. I may be able to post pictures of Samantha here using my phone so perhaps I will have some up soon.

Again thanks so much to Jessica and Randi and their families.

Samantha’s Second Birthday

P1030295Samantha turned two late in August. On her birthday, we celebrated at home. After a bath, Samantha opened her presents. We gave her a toy laptop which she loved and you can see her playing with it in the pictures. It was a quiet birthday celebration but we had bigger plans for later.

We invited many friends to come join us to celebrate Samantha’s second birthday. We rented a “jump house” for the kids and there was always one or two and often many bouncing in there throughout the day. I bought a case of Canadian, partly to enjoy a beer from home but also to introduce people to Canadian beer but not many took advantage of the opportunity. So, I had Canadian beer in the fridge for a couple of weeks after the party.

I baked a cake and Cynthia decorated it. I did some calculations to estimate the carbohydrate count of the cake because Samantha was going to get to enjoy eating some chocolate cake on her birthday. After opening presents earlier, Samantha was very excited to open more and I was hard pressed to keep up with her.

Later in the evening, some families left but others stayed and we had a BBQ and some more dessert before they came to dismantle the jump house. It was getting late and Samantha was very tired. So, soon after that we said our good-byes and Samantha’s second birthday party was over.

Thanks everyone for your gifts and birthday wishes.