Tuesday, December 24, 2013

Elf on the (Hospital) Shelf

My social media updates are full of pictures of elves on shelves - those playful little elf dolls that carefully watch children during the day and fly to Santa at night to inform him of their good and bad deeds. The elves, upon returning to the childrens' homes, often get into a little mischief.

I do not have children of my own, but I very much enjoy the endless stream of elf scenes on my computer and how creative those elves can be. When kids wake up in the morning, they find their elves taking marshmallow bubble baths or riding My Little Ponies.

The parents of my patients comment that the "Elf on the Shelf" is an amazing motivator for good behavior, including good diabetes care. Many of my patients eagerly check their blood sugar and take their insulin without a peep under the watchful eye of their elf. It seems like a win-win for all.

Holiday time should be full of innocent joy like this, but it can be a little more bitter than sweet at work. It feels as though we always get a handful on new-onset type 1 diagnoses too close to what should be a happy and festive time. No one wants to spend the days leading up to Christmas learning how to count carbohydrates instead of simply counting down the time until Santa arrives.

As if on cue, a little 7 year old girl came into the pediatric intensive care unit two days ago with very bad diabetic ketoacidosis from undiagnosed type 1 diabetes. She was so sick that she was not quite conscious the night she came in to the hospital. With the help of IV insulin and lots of fluid overnight, she was back to her usual self by the morning.

She awoke in the morning and stared up at the ICU ceiling where there was an unused hook for hanging IV bags. Her face lit up with excited recognition.

Magically, her elf had found her...even in the hospital!