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Ultimate Puzzle #1

ultimate puzzles
I am starting a series dedicated to highlighting some of the most interesting and difficult puzzles in the world today. Most of these are still unsolved but I will also mention past puzzles that have stumped even the sharpest minds for some time.

I wanted to start with a puzzle that is close to my heart. It’s not a puzzle in the true sense of the word but it’s certainly a problem that is very difficult to solve yet must be attempted on a daily basis. My 10 year old son has been doing so since he was 6. And soon my 2 year old son may be joining him.

Type 1 Diabetes – Hitting a moving target

There are two main types of diabetes. The most common (particularly in the US) is type 2. This type generally occurs in adults and is caused in large part to poor diet and being overweight. The body becomes resistant to insulin (produced by the pancreas, insulin acts as a doorway that allows sugar to enter the cells to be converted to energy). When your body doesn’t properly use insulin the cells don’t get the sugar and it stays in the bloodstream and your blood sugar level goes up. This is corrected by taking additional insulin, usually in pill form. Over time continuous high blood sugar levels can cause a variety of health issues such as heart disease, blindness, poor circulation, etc. This type of diabetes can usually be controlled with a proper diet, exercise and weight loss.

Type 1 (previously referred to as juvenile diabetes) occurs more commonly in children. It is an autoimmune disease which means that the body’s own immune system attacks the pancreas and destroys the islets that produce insulin. With little or no insulin being produced the cells can’t get the sugar which causes the blood sugar level to increase. If it goes too high the person will become comatose and without treatment will die. To prevent this insulin must be administered manually.

finger checkThank to advances in medical science this process has become a little easier. Several times a day my son must prick his finger to draw a droplet of blood. He uses a meter to measure the amount of sugar in his blood.

If the level is above the desired range he must give himself insulin to bring it down. If the level is too low he needs to eat or drink something that contains enough carbohydrates to bring his sugar level back up. If the level goes to low he could pass out or go into a coma. Whenever he eats or drinks he has to determine the amount of carbs in the meal or snack and give himself enough insulin to cover it and keep his sugar level within range.
nutrition label

He wears a device called a pump that contains a small reservoir of insulin and is connected to him via a small tube and catheter that is inserted into his skin.
insulin pump
Every 3 days he has to change out this catheter (called an infusion set). This is the part he dislikes the most. The needle is about an inch and a half long and is inserted in fatty parts of his body like his arms, legs, belly, etc.
infusion set needle
Attached to the needle is the small catheter. The needle is removed and the catheter remains. The plus side of this process is he only needs one needle every three days instead of several needles each day. The pump has an interface that allows him to enter in his blood sugar level and the amount of carbs he is consuming. The necessary amount of insulin is delivered by the pump, through the tube and catheter into his body based on predetermined algorithms.

Sounds easy enough right? So what makes this an ultimate puzzle? The body is a wonderfully complex system. There are numerous factors that affect how the body uses insulin. The insulin my son would give himself to cover the carbs in a meal may keep him in range one day but the same amount for the same meal on a different day might cause him to “go low” (have a blood sugar level below his desired range) or “go high”. It is not an exact science. The variables fluctuate. Things like exercise, stress, illness, food combinations, mood, hormones, all affect blood sugar levels. Getting the right amount of insulin in his body to keep him in range is like shooting at a target on a jackrabbit racing through tall grass while you’re riding a mechanical bull attached to a rollercoaster. It’s frustrating and maddening.

Blood sugar highs and lows take a toll on the body. Over time they can cause many health related issues. Some of them I’ve already mentioned like heart disease and blindness but some additional ones are high blood pressure, mental health issues, and neuropathy (nerve damage). Fortunately my son is very in tune with his body and feels when he is going low and takes care of it. So far we have not experienced the scariest parts of going low or going high although we have come close. It’s a constant battle and always on our minds. It is something that he can never take a break from.

Bearskin Meadow Camp logoOccasionally, my wife and I do get a break from it. Thanks to a place called Bearskin Meadow Camp.

The camp, run by the Diabetic Youth Foundation (DYF), is for children with type 1 diabetes. Their kids camps allow parents the opportunity to let their child go away for a week and have an incredible time doing wonderous things with other children with diabetes. The camp is staffed with knowledgeable counselors and staff that are not only well trained but who also have type 1 diabetes. Parents get a well needed break and the kids get to feel “normal” for awhile. Instead of being the only kid in their class who has to check their blood or read a nutrition label they are surrounded by friends who all do it. It is the highlight of my son’s year. They also have family camps that our whole family can attend. The kids get to do activities, crafts, swimming, hiking, archery, games, plays, etc and the parents attend workshops to learn how to better manage diabetes, what the latest technology is, and also talk with other parents who understand the struggle and the pain and the worry and can be a sympathetic ear when you need it most. Strong friendships are forged among kids and parents. It is truly a magical place.

DYF is a non-profit organization and it takes a lot of money to run these camps. My wife in I co-chair a yearly walk called the Families in the Forest Fun-raiser Walk in the Sacramento, CA area. It is one of their main fundraisers of the year. Last year my son reached his sponsorship goal of $2500 despite the economic situation. This year his goal is more ambitious. He’s trying to raise $3000 which helps kids like him go to the camp. It is a very worthy cause. If you are interested in helping Tyler reach his goal you can donate online at www.firstgiving.com/tylerchilcote. If you prefer not to do it online you can contact me at cowpattybill@yahoo.com to discuss alternative options. But please do not feel obligated.

If you would like more information about the Diabetic Youth Foundation visit their website at www.dyf.org .
dyf logo1
For more information about Diabetes in general please visit www.diabetes.org.

The most important thing to remember is that my son and everyone else with type 1 diabetes is normal in every way. The only difference is their pancreas doesn’t work properly. They can do anything and everything that anyone else can. They can eat whatever they want and they can become whoever they want to be. They are not defined by their condition. They are not diabetics. They are people with diabetes.

Thank you for reading this. I hope you got something out of it. Diabetes management is one difficult puzzle. So for all you puzzle lovers out there, this is one I would love to see solved. Soon.

Cowpatty Bill
aka Tyler’s Dad.

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