Posts Tagged ‘diabetes’

Book Review: Sugar Surfing

Dear Reader,

This is a bit of a departure because I don’t blog very often about my daughter’s diabetes, but I wanted to give a book review of a book I read recently, Sugar Surfing by Dr. Stephen W. Ponder.

A little background info so you know where I am coming from: My now 13yo daughter was diagnosed with type 1 diabetes (T1D; aka juvenile diabetes or insulin dependent diabetes) almost 12 years ago at age 19 months. I think we are fairly diligent D-parents though I don’t claim to be an expert by any means (and nothing I say here should be taken as medical advice). My dd was on multiple daily injections (MDI) of NPH, humalog, and ultralente for the first nine months after diagnosis, then pumped using the Cozmo (RIP Cozmo) insulin pump for 5 years and then when back to MDI (Levemir and Novolog currently) by her own choice for the last 6 years or so. She has been using the Dexcom Continuous Glucose Monitor (CGM) for about 18 months now.

Dr. Ponder is an endocrinologist specializing in diabetes care and has had T1D himself for quite a number of years. The main thrust of his book is to discuss how one can best manage blood glucose (bg) levels of a person with T1D using the relatively new technology of CGMs. As such it fills a much needed gap in the literature out there on dealing with T1D.

My overall recommendation is that anyone with T1D or helping to care for someone with T1D should get this book and read it. I would particularly recommend it to those new to T1D and those who may have more experience but who are using CGMs. I do, however, have some hesitations about the book which I will get to.

Sugar Surfing is written in a conversational style and begins by discussing the author’s own experiences with T1D, having been diagnosed in the days before fast acting insulins, pumps, and even home bg testing. I love these sorts of stories so I found these bits rather interesting. One intriguing tidbit arising from this part of the book is that Dr. Ponder, while clearly knowing well that diabetes care has advanced leagues beyond how it was in his youth, seems nostalgic for those earlier days. In particular, he mentions how much less stress was involved in caring for diabetes way back when because one couldn’t know or even attempt to control all the many numbers involved. I kind of get this and I think it’s an interesting observation. It could be good to think more about how the pressure on those with T1D and those caring for them (particularly parents) may have increased with the advances in care without perhaps the same degree of increase in the support and understanding these people need.

Which brings me to what I think is the biggest contribution of this book — Dr. Ponder does a wonderful job of laying out all the factors that can influence bg and of showing how very uncontrollable it can be. My own experience was that when my very small daughter was sent home from the hospital we were told “do this and this and then her bgs will be this and that.” And then we got home and she was in the 300s for the first few weeks and we thought we were complete failures. I understand why the staff wanted to make it sound simple for us, that they didn’t want us to be overwhelmed at the start. But we were also misled in many ways and the result was confusion and a sense of failure. I think this is not an uncommon experience. I really wish I had had Ponder’s book much sooner. Though over the years, I have learned how very uncontrollable T1D can be on my own, I would definitely recommend reading the earlier chapters on all the influences on bg one has to try to cope with to anyone new to the world of T1D. It may be daunting, but it is realistic and that, I think, is a very good thing.

One of the quibble I have with Dr. Ponder, however, is in how he talks about our ability to control all those numbers. I find he is a bit inconsistent of this point. On one hand, he outlines all the influences on bg, many of which we clearly cannot control (eg. growth hormones, stress); on the other, he makes statements like this:

“In fact, almost any of the ever present forces that influence one’s blood sugar level can be managed with Sugar Surfing principles.” (p. 44)

“Control” is a big word in the diabetes world. We speak of “controlling bgs” after all and doctors (and nosy family members)  ask us things like “how is your control?” The comforting part for me in the first part of this book is how Ponder makes me feel like there is so much I can’t control. But then he turns it around and really makes it about controlling again after all.

(Warning: if you don’t like religious talk, skip this bit.) One of the things I say on this blog is that our worldviews (though I hate that term) are important; they affect everything we do and even in a book on something as seemingly practical as bg control, they seep through.  A big part of what I have learned from my dd’s T1D is that I cannot control everything — not even these things that are very essential to keeping my child alive. It is not that I say “Oh, I can’t control it therefore I am not going to try.” I do not use the fact that these things are so hard (or even impossible) to control as an excuse for bad bgs.  Instead, I do everything I can and leave the rest to God. Because He can and does control everything. My take on this book would be that Dr. Ponder has looked at these same factors which make bg so hard to control and he comes away still trying to control them. How does he do this? Well, on one hand he has certain principles and tricks he uses (which he gets to in the latter half of the book). But he also relies on himself:

“Ultimately, you must believe in yourself and your equipment. Tapping into your “Power Within” is a driving motivational force behind Sugar Surfing.” (p. 114)

If there is any statement in this book I disagree with, it is this one. It all comes down to who is ultimately in charge. In my view, it is God who ultimately causes my best efforts to either succeed or fail. In Ponder’s, despite how long he spends telling us how very much in T1D is uncontrollable, he is still in control. One more little quote before I move on — Dr. Ponder says at one point that “I no longer fear [diabetes] like I did in my younger days” (p. 47). I think this is a very telling statement. One gets the impression that it is this (quite understandable) fear that has driven him to be where he is today. All of which is to say that while there ia a lot to recommend in this book, I have some fundamental problems with the worldview that underlies it.

Now, to stop psychoanalyzing strangers and return to the main point — in the latter part of the book Dr. Ponder gets to specifics of how he manages his T1D. In general, I wish the tips and tricks he uses were laid out a little more clearly. I do like his use of his own CGM readouts; the visuals are very helpful. Personally, there were only  a few specific things in this book that I found new. Others I had either encountered on the internet previously (eg. the idea of waiting for the bend to begin eating) or somehow managed to stumble upon myself (Ponder’s i-chain method of bolusing for high fat meals is much like what I was doing anyway). More than specific methods, however, I was inspired to be more diligent in addressing bg numbers when they begin to stray from our target zone rather than waiting till they actually cross those lines.

A few more notes on the practical details in this book:

  • Ponder says that his methods work for both pumpers and those on MDI. As someone who uses MDI I really appreciated this. It feels like there is a lot for pumpers out there. On the flip side, there were times when he presents techniques that work for pumpers but left me still frustrated looking for a way to do the same things with MDI (of course if I could get my dd to pump again, that wouldn’t be a problem).
  • As the parent of a teenage girl, I was left wanting more info on dealing with the effects of hormones on bg. Of course, Ponder is giving us info based on his own experience and he has never been a teenage girl so the oversight is understandable. Still one must not expect to find answers to every question in this book.
  • Ponder spends a chapter on dealing with kids with T1D the main point of which is to say that his techniques can’t all be applied to children. I could easily see how this book might provide more frustration than help for parents whose kids due to their age or compliance are not going to be able to make use of most of the techniques herein.
  • Discussing the issue of kids and compliance, Ponder says that “for some reason which I don’t understand” teens who don’t comply “are still allowed to wear an insulin pump” (p. 116). I completely disagree with the idea that insulin pumps are somehow a reward for good diabetes behavior or that bg control and/or compliance will somehow be improved by taking away a kid’s pump.
  • Ponders’ advice on calibrating your CGM, specifically saying to only calibrate in the middle of one’s bg range, is contrary to other advice I have heard.

To draw things to a conclusion, while I would definitely recommend Sugar Surfing and think it fills a great need in the diabetes community, both with its portrayal of the realistic challenges of managing T1D and with the specific methods it presents, one should not expect that this book will answer all questions or solve all the problems associated with T1D nor can I agree with Dr. Ponder’s fundamental assumptions about how much control we are able to have.

Nebby

 

When I Most Hate Diabetes

Dear Reader,

I actually wrote this post a month or two ago but it still holds true. Since then diabetes has actually turned 7. We didn’t have cake but diabetes did get to choose what to have for dinner (pancakes; always a dinner and not a breakfast food around here because that many carbs don’t work well in the AM and cake on top of it seemed like a bit much). Diabetes also got  a small present–a kit for making pompom bugs. And now, without further ado, here is the actual post . . .

I most hate diabetes on Sabbath mornings. I don’t think there is a single Sunday morning worship service when I haven’t checked my dd’s blood sugar. And she has had this disease for almost 7 years!! How many services is that? Today was particularly bad. Her bg was 400 before we left for service. I know that was due to a high carb breakfast and not pre-bolusing. Her numbers during service were actually not bad. They ranged from 175 to 225 or so. A little high but way better than 400. But she felt bad the whole time. So she kept signaling me and I kept checking. Now, being distracted during service is not new to me. I have 4 kids now ages 10 through 5. They mostly sit well through service but that hasn’t been the case for very long. If it weren’t for D, I still would have had plenty of distraction in the past 7 years. It is the nature of the distraction I think. That this evil thing is interfering with our worship. That my dd almost never seems to just feel well for an hour and   a half on Sunday mornings. Plenty of other times she has been places for that length of time and not had to check herself at all. Her art class comes to mind. She goes through many art classes without checking and is just fine. But worship seems to bring out the bad numbers. I hate it for myself but I hate it more for her. Is she going to come to associate worship with feeling bad? She needs to worship too. Will she ever be able to just do that without diabetes interrupting life? The only up side I can think of is that diabetes is I guess doing part of what it is supposed to do–making us long for that time and place when all disease and sorrow will be wiped away. Maybe that is why it bothers me so much. Sunday worship is supposed to be a little taste of what waits us in eternity but instead it ends up as a reminder of the infirmities of this life.

Nebby

Faith and Hope, Diabetes-Style

Dear Reader,

If you are in the diabetes world, you know that it is walk-time again. October is the time when JDRF hosts big walks to raise money for research to cure Type 1 diabetes. Though my dd has had type 1 for almost 7 years now, this is never something I have really gotten into. It is not that I don’t want a cure to this disease. It’s not that I don’t think it is evil and  a pain in the backside. But the language of the diabetes community, especially at this time of year, has always turned me off.

There is a lot of talk about  “faith” and “hope.” The “faith” is in the scientists working for a cure. The “hope” is for a cure. Now, I am big on faith (you will notice almost all my posts are in the category “theology” which probably makes that category useless here). But faith is only as good as what you have it in. For faith to be meaningful or beneficial, it needs to be in something that is worthy of that faith. Now, I do not doubt that the scientists trying to find a cure are doing their best. I am sure many really care about their work and are intelligent and diligent. But for all that, they cannot control their results. They can do their best but they cannot assure the results.

And then there is hope. The hope of the diabetes world is in a cure. Usually parents of more newly diagnosed kids are very big on this. And by “newly diagnosed” I mean the first 5 or 10 years after diagnosis. But a funny thing happens as people’s kids reach their 10 or 15 year anniversary of D, the parents become cynical. There is less talk of hope. A lot of these people have been told for a long time that a cure is 5 or 10 years away. Eventually, they stop believing the promises.

The problem with hope is the same as the problem with faith: you have to have it in the right things. The Bible says that “Now faith is the assurance of things hoped for, the conviction of things not seen” (Hebrews 11:1). I think a key word here is assurance. We can want a cure, we can wait for it. We can even hope. But there is no assurance if a cure in this life. Don’t get me wrong, it would be nice. I would like a cure. But I do not base my life on it. It is not what keeps me going, because it has not been promised to me.

There is a cure which has been promised. In Christ, God promises His people that He will ultimately cure all their infirmities, both physical and spiritual. If my daughter does not have a cure for diabetes in this life, I do have hope because I am assured that she will not have it in the next. A cure in this life would be a bonus, but it is not something I can base my life on.

Nebby

Diabetes Circus

Dear Reader,

It’s been a while since I posted about my dd’s diabetes (okay, I did post about the church’s pancreas, but I mean a post mainly about diabetes). Our pastor called us last night to check in and very kindly asked how Sparrow is doing with her diabetes. And my mind drew a blank. I tried to make faces at my husband, but he at least initially did not interpret them correctly. Later when he mentioned that we check her blood sugar in the middle of the night every night, he did correctly interpret the ugly faces I made at him over his use of the pronoun “we.” In my husband’s defense, he does, as I always say, his his one-seventh of the work. He does night checks Friday nights. Realistically, it just would not work for him to do more nights. He has to get up and be coherent and wakeful for work most days. And I know from the days of screaming babies that if he is supposed to get up, it often involves me first getting up and poking him for ten minutes till he is responsive and able to care for the child in question. So mostly it is just easier to do it myself. And I do find that if I am able to go for a while with one night check and at the same time evrey night, my body adjusts and I am able to get up and go back to sleep easily at that time. Of course, we never get very long stretches like this. Things are always changing.

Which brings me to what I actually was starting to say. I just never can seem to think of an answer to “How is Sparrow doing?” You would think I could come up with a set answer and just have it ready to repeat. There are just so many changes, daily, hourly sometimes, that it is hard to say. Over the long term, yes, she is doing well for her age. Her A1Cs are where the endo wants them to be. She is happy. She is healthy (apart from the diabetes). Nothing catastrophic has happened, either in the long-term complications arena or the short-term seizures and extreme low arena. But either of those is possible any time. Which is why we are always on our toes. Diabetes is a deep sea and even when the surface looks calm from the outside, we are swimming in it and can attest that it is never calm. The currents are always swirling around us, this way and that.

I am going to mix my metaphors now, because when I started this post I was going to compare diabetes care to a tight rope walk. I feel that I am always on my toes. When someone asks how things are going, I

a) am startled at the interruption in my walk and my mind goes blank .

b) know that from their outside perspective things might look okay. They see us moving forward over time and no one has fallen yet. In this analogy I picture the lion tamer working right under me and no net so that if we fall, all is lost.

c) want to say, “Well, I am really worried about the next inch. It looks pretty uneven and precarious. And then after that of course will come the next inch. But that is too far away for us to predict now what it will be like. So really I am just focused on this inch.” In this analogy an inch is no more than a day. If something else is going on like a birthday party or church event, the inch I am seeing is probably a few hours I am trying to make it through.

d) all of the above. Of course, this is the right answer.

And that is how Sparrow’s diabetes is going. Thanks for asking.

Nebby

Pancreases in the Body of Christ

Dear Reader,

We ordained a ruling elder at our church last night (for you non-Presbyterians, this is a spiritual leader primarily in charge of teaching and shepherding the flock; it’s called other things in other denominations). Among the many sermons we heard was one on the role of leaders in the body of Christ. We know that we are a body, analogous to the human body. Each one has a part to play. In this analogy I think the elders and deacons are major organs like the heart, brains or lungs. Their role is obvious and we all know what they do and why it is important. But there are  lots of other organs and parts out there. When my now 8yo daughter was 1, a small cluster of cells in her pancreas called beta cells stopped doing their job. They stopped producing insulin. Now I did not even know we had beta cells. I knew we had pancreases but I didn’t know what they did. But it turns out that my dd would have died without medical intervention. All because of this little cluster of cells. So I guess my point is that we are all aware of the big contributions from our leaders or other prominent figures. But there are a lot of people out there doing small things too. Things you may not even be aware of that are nonetheless essential. And if you are a small person, doing unnoticed tasks, you are still a necessary part of the whole. And if you are not doing anything, why not? Everybody can do something. Even my children put out Bibles and psalters in the pews before service. last night they wiped off tables after refreshments had been eaten. Children too should be taught to take part. Doing what needs done should become a habit early on so they will do it automatically as they get older.

Nebby

Kids and Diabetes Complications

Dear Reader,

Does anyone else with a cwd (child with diabetes) find that it is hard to avoid conversations about the complications? Now, I am a realist, I think. I am not in denial about how serious my daughter’s disease is. But she is 8. I want to be able to control what she hears about the possible complications down the road. At eight, she just doesn’t need to know everything right now. I am sure it is different for different kids and at different ages but my dd is the over-conscientious worrying sort and I don’t feel she needs to know everything now.

Yesterday at the park with a couple of friends, we entered into a conversation with a dad there whom we didn’t know. He heard my friend discussing some issue her son is having and one thing led to another and he began talking about his girlfriend who has D and the eye  problems she has because of it. He didn’t say if it was type 1 or 2 not that it matters. And of course he didn’t know I had a cwd. I was watching my dd who wasn’t too near us but then she started to come over. Fortunately my friend changed the subject just in time and I don’t think my dd heard any of it. I realize the end result is that this is kind of a non-story. Nothing bad happened. But it could have. And even people who know a child has D don’t tend to watch what they say. To me this should be something like the facts of life that yes kids need to know at some point but it is the parent’s prerogative to decide when and where and how they learn everything. And you wouldn’t go and explain it all to someone else’s kid. Of course it is also like the birds-and-the-bees in that they apparently are going to hear it whether you are ready for them to or not and so you had better head it off and tell them first before they hear it on the playground.

Just because I am venting about this all (you can tell by all the run-on sentences that this is an irritated if not angry blog post), I do have  a story that was a lot bigger in terms of consequences. We were visiting family. The husband has type 2 and at his wife’s urging turned on D-life (a TV show devoted to diabetes). They kept it on very loudly through the whole show even though it was talking about various complications of D. And they knew my dd has type 1 and they knew she was right there. My husband and I tried to distract her. Later we asked her what she had thought of the TV show that had been on. She did look worried and asked us if it was about type 1  or 2. We told her that the show itself was mostly about  type 2, but anyone with D can get other problems because of it and that is why we check her bg and take care of her so she will stay healthy.

So, I would love to hear from other parents of cwds what you have told your kids and at what age.

Nebby

A Billboard Disease

Dear Reader,

I saw a billboard this week from JDRF showing 4 cute children, presumably with type 1 diabetes, and saying they need a cure. And I thought, “Wow, I have a child with a billboard disease.” Something that merits a large sign by the side of the road asking for money. It is not that I hadn’t seen signs like this before. It just hit me hard this time. And I thought of what other diseases of conditions I have seen billboards about in my life. Various cancers probably. Birth defects. Brain and spinal injuries.  And my little girl has a disease which falls into this category. Admittedly when she was first diagnosed this was in the forefront of my thoughts. But now mostly I don’t think about it that way. I think it is hard to. If you are always thinking how serious it is, you can become paralyzed with fear and depression. I get up every night at least once to check her blood sugar. I know that nights are dangerous. She could go low and not wake up. But often diabetes is just very tedious. It is a dozen finger pricks a day. Juice boxes and glucose tabs and insulin shots. At least 5 shots a day. It’s a pain in the butt. But on the other hand, it is just one part of our lives. You can’t let it take over. It is hard not to let anything that you spend a lot of time on take over your life. If you are home taking care of your kids, it is very easy to let your life become about them and forget that there is more to you. I don’t want us ever to forget that there is more to Sparrow than this disease. It is important. It is serious. But I hope it is not the most interesting thing about her or us. I guess I am glad there are billboards to let people know this disease is out there and that it is serious. But I am not sure I’d like to ever see her on a billboard. The kids on the sign are children with diabetes. And that it all I know about them. But hopefully there is a lot more there to know. Hopefully this disease will not define their lives.

Nebby

Little Miracles

Dear Reader,

I have a number of hobbies I dabble in. Among them are gardening and baking bread. I am not necesarily good at everything I do, but I enjoy doing them. What I like particularly about these two things is the mystery involved. You plant seeds, you water them, and then maybe something sprouts. Similarly with bread, you put in the yeast and other ingredients, put it somewhere warm, and maybe it rises nicely. Now maybe for some people who garden and bake they always get the results they want, but I don’t. I can do all the right things and still sometimes it doesn’t work. But then sometimes it does, and that is really rewarding. But it is out of my control. I can give the seed or yeast all they need to do their thing but the results are not up to me. It is something in them that will either rise/grow or won’t.

These are little things. It doesn’t in the end matter if they are successful for me or not. I can buy veggies and bread if I need to. But the same principle applies to many other things in life, doesn’t it? Think about having kids. We can want them. We can try to have them. We can even count days and try to predict ovulation and try to get everything right. But there are no guarantees. It either happens or it doesn’t. It is funny to me that in this area as in many others we can do a lot more to prevent an outcome than to cause one. That is, we can be 99.9% effective in preventing pregnancy, but we often fail to cause pregnancy when we want it. It is the same with my gardening and bread. If I want plants not to grow or bread not to rise, I think I would be great at that. I bet I could kill plants really well. But making something grow is a lot harder. All our technological advances and it seems we are better at destroying than creating.

Unfortunately, there are so many things that we really, really want to control, and we can do everything right, but we still can assure the outcome we want. My daughter’s diabetes is like this. We can do all the right things and still get bad numbers. And again if I wanted bad numbers I bet I could get those really easily. But getting good results is ultimately beyond me. The result, as it is in all these areas, is in the hand of God.

Another area where we tend to really, really want a certain outcome is with our kids. Maybe we are concerned for their salvation. Or maybe we just want them to be well-behaved. There are gazillions of resources out there to tell you the right way to raise them to get the results you want. But in the end, there are no guarantees. You can do everything right and still not save your kids. Of course this is because it is not up to us to save them. That is God’s work. But we don’t want to just trust Him to do it, do we? We want to know it’s going to happen. So we buy every parenting book out there and try every approach. But even the best approaches may fail. Ultimately, all we can do is do our best, place the best things in front of them, and pray that God will produce the result in their hearts that we want, namely saving faith. It is really the same with all the people in our lives. We so often want to change them. We may see real needs and we may even go about it in the best way but we can’t change someone else.

All of this is actually why I am attracted to Charlotte Mason hoemschooling. Because Miss Mason seems to get this. That all we can do is place the best things before our kids. And it is up to them to learn it or not. Surely if we give them a bad intellectual diet, they are likely not to do well (though even then they may fool you). Once again it is easier to destroy than to create. But even with the best materials, we cannot get in there and control the results.

Maybe that’s why I like gardening and baking.Not because my success rate is great (it’s not). But because sometimes there is success. A little proof that things can work like they are supposed to. And if I fail, well, at least the stakes weren’t too high.

Nebby

Bittersweet Diabetes Moment

Dear Reader,

If you have poked around a bit here and feel that my outlook on th whole diabetes thing is a bit, well, schizophrenic, you may be right. My last post was pretty positive on it I think. This one not so much.

My kids had their last day of tennis class today for the summer. Typically I sit nearly on the bleachers watching, but today, I went a little further down with my younger kids while the older two had class because my 6 year old wanted me to throw balls for him to practice. So I wasn’t observing what the class was doing for a while. I guess that had a relay race and since it was the last day everyone on the winning team got a munchkin (i.e. donut hole). My 8 yo cwd (child with diabetes) very carefully put hers back in the box and said she had to save it till later because I was not there to check her blood sugar and bolus her for it. After class she got it back and brought it over to me and explained the situation. Needless to say, I am really proud of her for her maturity and responsibility in refraining from eating the little donut. Though I wouldn’t have been upset if she’d eaten it either. I didn’t end up giving her insulin for it because although she was 176 it was after tennis and her bg did not go up. It’s just one of those moments that makes you sigh. I still stand by my previous assertions: diabetes is evil but it is able to teach a little girl a lot more responsibility and self-control than she should need to have at 8 years old.

Nebby

D-Day (re Diabetes)

Dear Reader,

I think I surprised someone this week by mentioning that we celebrate Diabetes’ birthday in our house. It is October 26th. That was the day my then 1 year old daughter was diagnosed with type 1 diabetes, a chronic, life-long, life-threatening, high-maintainence illness. So why on earth do we celebrate this? With cake and presents no less?! One year we had a cake in the shape of her insulin pump (okay, the pump was a rectangle which is easy but it was decorated to look like a pump).

We didn’t celebrate d-day the first couple of years. I don’t think I was up to it then. And even now I will admit it is a semi-morbid thing to do. I could claim we are celebrating my brother’s birthday which is the same day (happy birthday, Uncle Richard!) but he lives far away so that is not really true.

Now, I am the first to admit that diabetes is evil. And I mean that in a technical, theological sense. Diabetes is a result of the fall. It entered the world with sin and death and all sorts of other illnesses and injuries. But I also believe that good can come out of evils  like this.

One of the first reasons to celebrate d-day is that it is not so much the day my daughter got a chronic illness (she had probably had it for a couple of months before that wonderful ER trip), but it was the day she didn’t die. And she could have. Kids die from undiagnosed or too-late diagnosed diabetes in this country. But she didn’t die. And so far she has kept not dying even though diabetes continues to be life-threatening.

D-day also just marks an important milestone in our family. I don’t know who my dd would be if she didn’t have it. She doesn’t remember not having it. I don’t think I know who I would be without it. I don’t think I even know who I would be if I slept through the night more than one night a week (up checking those blood sugars, you know). I bet I would have more energy and more patience.

What are some of the good things that have come from diabetes in our life? I think our kids are more consceintious. They look out for each other. And they know more about carbs than many adults. They are tougher about getting shots or blood draws. We don’t put up with whining about those things around here. All of us have learned not to sweat the little stuff. Smaller illnesses do not daunt us. We have met some great people because of diabetes that we probably never would have met otherwise. We are more grateful just to have everybody wake up in the morning. We are more aware of our own weakness and vulnerability and therefore more aware of our own dependence on the Almighty (which is a good thing). I guess I can sum it all up by saying that while the circumstances of our life are worse (and diabetes care can be very, very tedious and frustrating), who we are is better. And which is really more important?

Nebby

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Blogging about education, theology, and more

Afterthoughts

Blogging about education, theology, and more

Homeschooling Middle East

A Homeschooling/Unschooling Adventure from Bahrain to Dubai that's a story for anyone, anywhere who's interested in offering their kids an educational alternative. Please have fun visiting and have even more fun commenting! We have now moved to Granada, Spain and I will write again once we've settled down!!

Exclusive Psalmody

For the Encouragement and Preservation of Biblical Worship

Charlotte Mason Institute

Supporting an international conversation toward an authentic Charlotte Mason education - awakening to delightful living