Low Blood Sugar Dreams

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I don’t know about you but when I have a low blood sugar at night, I end up having dreams I remember when I awake.  If my low comes on really slowly, and most of mine do, the threat isn’t as immediate and I sometimes find myself in a lucid dream while somehow acknowledging I’m low but refusing to stop the fun.

The other night I dreamt Kelly Kunik, a diabetes blogger, ran and won a marathon.  Last night I dreamt that I was suddenly Angelina Jolie’s secret agent, hired (hmm…I don’t remember getting paid) to hack into a computer (though hmmm she provided a password) and retrieve some secret information before Brad Pitt found it.  Where was Brad Pitt in my dream, you ask?  He was lurking in the shadows trying to get the info before I did!  He was not very skilled at trying to get to the computer because I wasn’t very good and I beat him to it (he was much like his dopey character in “Burn After Reading”).  Then I got the info, whatever it was, back to Angelina “Boss” Jolie and she thanked me with a silent nod (though I never got paid…) and then I ninja rolled on the carpet and leapt out of a window in my black secret agent suit, never to be seen again.

At that point I let myself wake up because my mission was over and my blood sugar was low.  So I muttered to my husband, who had been in my dream dancing at Angelina and Brad’s party, “Aleeeex…”  He jumped up in the most freaky alert way “Low?!”  I nodded.  He brought me juice.  Then I laughed because the last thing I remember from my dream is someone saying “Wow, your Alex can really dance!”  And from what I remember he was doing something undeniably goofy.

Wacky dreams happen to me when I have lows and I find it helps with the sting of resentment towards lows, that’s for sure :)

Does this ever happen to you?  Any crazy dreams you can tell us about that will make me not so embarrassed about what I just shared?

One For Every Year

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My most memorable thoughts about diabetes for each year with diabetes, starting with the first year as an 11 year old:

1994  “I can do this.  No, I won’t go to diabetes camp, I’m just like everyone else, I’ll go to regular camp.”  “Ok, regular camp was fun but I thought I was going to die”.

1995  “Alright, I don’t like this at all.  I’m not sure I can do this.”

1996  “I can’t do this!  But I don’t want anyone to know…”  “I just want to be normal”.

1997  “Recovering from a gum grafting surgery.  So this is what happens when I try to be normal.  Not fair.”

1998  “I wonder what boys think about my diabetes?”

1999  “I hate diabetes.”

2000  “Feeling out of control.  Help!”

2001  “The way things are going, I might as well give up.”

2002  “I can’t do college while panicking like this.  I can’t even pick up a pencil.”

2003  “Can I turn my life around?  Is it possible?  I can’t live like this anymore.”

2004  “Ooooh…alcohol…what a nice way to forget my problems!”

2005  “Alcohol is useless.  Trying to do better.  Trying to do better.  Trying to do better.”

2006  “Eat this not that.  Do this not that.  Change is hard.  Super hard.”

2007  “Wow, I’m doing better…Just keep going.”

2008  “A1c is down.  Weight is down.  I can run a 5k every day.  Getting married this year.  Happiness is totally up.  I can’t believe this is my life now.”

2009  “TWINS!  Must. Have. Sleep.”

2010 “We’re not poor, we’re just struggling. (Can I borrow a $5 for groceries?)”

2011 “Hello DOC!”

2012  “I can do this!  Wait a minute…I am doing this.”

Life ebbs and flows.  When you’re on the up, enjoy it and take steps to safeguard your future.  When you’re down, know that you will be back up again.  Just don’t give up hope.  Giving up hope prolongs the process between going from down to up and we don’t want that.  Don’t give up hope.

The Dangers of Some Diabetes Medications

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*This is a guest post from Barb Stephens from Drugwatch.com, a website which raises awareness to consumers about drug safety information.

There are more than 25 million Americans who have diabetes — that’s more than 8 percent of the population. You may be one of them. If you’re like the majority, you have type 2 diabetes, which means your body does not produce enough insulin or your cells do not use insulin efficiently.

Your doctor may prescribe one or more medications to help you control your diabetes. Make sure you are aware of the dangers of any drug you are given, as side effects for diabetes drugs can range in severity from minor pain to impaired vision to cancer and even death.

Drugs with Severe Side Effects

Thiazolidinediones are the most popular class of diabetes drugs. These medications work by increasing the sensitivity of cells to insulin. Unfortunately, the three drugs in this class have all had serious problems.

Rezulin was the first drug in this class, but it is no long available after being linked to liver failure.

Avandia (rosiglitazone) was the next hit in this class, but it too has been shown to cause severe side effects, including a higher risk of heart attack and liver failure.

Avandia is no longer available in U.S. pharmacies. A few patients still take it, but they have to go through a special program to have access.

Actos (pioglitazone), the world’s best-selling diabetes drug, has also been a huge disappointment.

Bladder cancer is one of the more dangerous side effects of Actos, and in some cases proves fatal.

One study showed that Actos (and Avandia) heighten risk for macular edema, which causes swelling in the eye. Another study showed that the same two drugs raise the risk of bone fractures in post-menopausal women.

Drugs with Less Severe Side Effects

There are other popular diabetes type 2 medications, which all come with common side effects (including low blood sugar). Most of these side effects are milder, like stomachaches, weight gain and gas. Many of these side effects will decrease as your body adjusts to the medication.

Biguanides work by preventing the liver from releasing a high amount of glucose.

Side effects may include nausea, metallic taste in mouth, vomiting, cramps, diarrhea, gas and loss of appetite.

Sulphonylureas work to decrease blood sugar by stimulating insulin release from the pancreas.

If you retain water, have congestive heart failure, or have cirrhosis of the liver, approach with caution.

Side effects may include upset stomach, skin rash or itching, weight gain, breathing difficulties, drowsiness, muscle cramps, seizures and swelling of the face.

Alpha-glucosidase inhibitors stop enzymes that help digest starches, which prevents blood sugar from spiking.

Side effects may include upset stomach, diarrhea and gas.

Meglitnides stimulate the pancreas to produce insulin.

Side effects may include upset stomach.

D-Phenylalanine Derivatives stimulates insulin production after a meal.

Side effects may include dizziness and weight gain.

Dipeptidyl peptidase IV (DPP-IV) inhibitors help insulin to work longer and prevent the liver from producing too much glucose.

Side effects include runny nose, sore throat and headaches.

While the FDA looks into the more serious side effects of these medications some patients have chosen to start filing cases against companies, an example being an Actos lawsuit after incidents of bladder cancer resulted when taking the medication for longer than a year.

You can take an active role in the health by alerting your doctor to any pre-existing conditions and any significant change in your health. You should also read all of the materials that come with your medication.

Author bio: Barb Stephens is a writer for Drugwatch.com. She uses her knowledge about medications to help raise awareness about drug safety and to educate consumers and patients.

My Biggest Worry about Pumps

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“Ketones” by Ana Morales

 

I’m all about people using pumps if they like them (or don’t like them but find they manage their diabetes well with them).  It’s a wonderful device and I’m happy technology like that exists for us.  I used a pump for 7 years, which is plenty of time to experience just what pumping is all about.

So I want to talk about something I noticed during my pumping years and after them.

It occurred to me recently that my numbers rarely go high enough to induce DKA.  I can count on one hand the occasions in the past 5 years where my blood sugar has gone over 350 and it hasn’t been over 400 in 6 years.  I’ve been off the pump for 6 years and find I can’t go back, yet.  One of the most dangerous things in my mind is DKA and very high blood sugars.  I experienced super high blood sugars enough as a teenager to know I never want to go through that again.

When I was on the pump, it was a regular monthly occurrence to have a 400+ blood sugar reading and it was almost always due to a pump or tubing or pump site malfunction.  I knew that my being human provided sufficient variability and error to my diabetes management and I began to seriously resent the pump for adding to that risk simply because I didn’t have the energy to keep up with it’s extra requirements.

What I mean is people who don’t endure these pump issues have very good discipline when it comes to changing their pump site and checking their tubing and changing the site when they suspect they need to.  However, I know that many of us don’t do this.  I completely understand why-it’s hard to keep up this kind of diligence, especially if it means inserting a painfully long needle more times than we’d like.

Those who use pumps should probably be in a very good place when it comes to their motivation to do all that is necessary to successfully use the pump.  I was not one of these people because I resented wearing the pump and as a result, kept my site in too long sometimes and suffered the consequences.  Of course, sometimes, we can do everything right and something wrong can still happen with the pump though the likelihood is very much decreased if we keep up the right routine.

I love using syringes because I get piece of mind each time I give insulin, knowing I don’t have extra variables to contend with (there are SO many as is).  And mostly because I never have a high blood sugar surprise that is a result of my not receiving any basal insulin for a mysterious amount of time.  The danger of very high blood sugar isn’t just that, it’s also the lows that can result from giving insulin over and over again in an effort to push that really high and resistant blood sugar down.

Obviously there is more involved in keeping blood sugars stable.

Reducing my carbs and using shots has made my blood sugars so much more stable, with little extra effort involved.  And to me that’s practically miraculous in terms of gains to my quality of life and health.  So while I don’t mean to say that people shouldn’t use a pump I just think we should each be honest with ourselves about how it works for us.  I realized I was no longer a good candidate and got off the pump and there is nothing wrong with that.  And there is a good possibility that one day I’ll get back on a pump.  They are making wonderful improvements to pumps each year and I’m becoming a more responsible and disciplined person each year.

Very well meaning people tell me all the time, “but don’t you miss being able to sleep in and eat when you want?”  News flash my friends, there are now long acting insulin such as Lantus which serve as a basal insulin.  The NPH and R insulin of the past are just that.

I guess what I’m saying is, are you having a lot of extremely high numbers due to pump issues? If so, work to reduce them with your healthcare team and if you know in your heart that you aren’t keeping up with site changes and all the pump requires, think about your options.  Whatever you do, do it in favor of your health.  Everything else will surely fall into place.

Reminder to Self

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From my head AND my feet.

I recently had a two week stint of…oh I don’t know, diabetes burnout or just feeling “blah” and unmotivated.  I didn’t exercise much for two weeks and I had some processed food and began to need about 25 units of my long acting basal insulin a day.  I’m back on my exercise routine and regular eating pattern and I just wanted to share that I’m down to 15 units of my long acting.  That’s a huge change isn’t it?

I don’t know which I love more: healthy food or exercise.  I feel like I can’t manage my diabetes unless I use the powers of both.

Sometimes I’m jealous of our ancestors.  Exercise was a built in way of life (no cars, no TV, no internet, no food unless you work for it).  Healthy eating was a lot easier (no processed or gmo foods, no two week old produce shipped from another continent.)  See?  They almost had it easier.

How can we make the most of what we have?  How do we exercise smart choices over temptation?

I don’t know about you but what helps me is to meditate and work on being aware of what I want for myself.  This keeps me focused (most of the time) on what needs to be done to get me where I want to go.

I’ll try to remind myself of all this next time I go into a “I don’t feel like it” phase.

29 Things to Be Happy About Today

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Today I turn 29 years old.  While I’m a little bummed that this marks the beginning of my last year as a twenty-something, I’m going to focus on happy thoughts instead.

1.  Despite my children calling me anything but “mama” (they can say “mama” they just don’t want to) at least they are healthy, kind, and have quite a sense of humor.  That’s all I ever want for them.

2.  My husband is out of state for work, which is hard on us, but at least he’s got work.  Others aren’t so fortunate.  (Alex come baaaaaaaaaaaaack!)

3.  I had a first call with my training coach for A1c Champions the other night and it was awesome.  I’m so excited.

4.  My mom watched the kids on that call from the other night.  I don’t know what I’d do without her.  Or my dad.  Every time I need uplifting, he knows just what to say.

5.  Today, if I have anything diabetes related I want to discuss, I have an entire community of people available who help each other out.  A few years ago I had no clue that existed.

6.  My little brother keeps wowing people with his guitar playing.  I won’t lie.  I’m excited at the prospect of having a famous family member one day!  When he was 3, I knew he was going to be something really special.  As usual, I was right.  Here he is from this past weekend.

7.  I have a husband who feels comfortable enough with me to tell me when I’m being an arrogant know-it-all.  I appreciate that level of honesty.

8.  My sister Ana, who has type 1, is about to start her senior year of college.  She is number 4 of us 5 kids and the first to finish college.  I’m so proud of her and am glad I can call her artwork my favorite (and I love that I don’t have to lie about that).

9.  I have two other siblings who I never mention on the blog but I should.  I have a brother named Alejandro who is a year younger than me.  I’m happy he’s fighting to make his life what he wants it to be.  Growing up with him helped me try harder at everything because he was always so smart and athletic and generally good at everything.  I hope he remembers his immense potential.  I have a younger sister named Sara who also should remember her potential.  I’m amazed at how she handles being a single mom to two young kids.  I have been doing it for a few weeks due to Alex being out of town and I’m just about ready to lose it.  And Sara always looks so cute.  I don’t know how she does it.  I’m happy that they are both close by.

10.  I’m grateful I have health insurance.  It’s a big deal and I wish this for everyone.

11.  My brother-in-law gave us his old TV a few days ago.  It’s huge and in our bedroom and I no longer have to watch movies on the computer screen, from the computer chair.  I feel positively spoiled!

12.  I love blogging.  I spent years aching to write and now I get to do it all the time!

13.  I’m happy it’s not Winter.  lol

14.  I love that last night my kids were mocking me.  They repeated what I said with their hands on their hips.  It was hysterical.

15.  I’m very thankful for Lantus.  I’m a fan of my insulin-aren’t you?!  hehe.

16.  I just discovered the show Frasier.  I was too young to get into it when it was on but now I’m watching it from the beginning and I have to say it’s my all time favorite show!  I totally relate to Frasier and wish I had a brother like Niles.  Is that weird?  Don’t answer that.

17.  Yay for TED Talks on Netflix!

18.  My birthday is on Fabulous Friday.  How nice.

19.  I’m attending the best nutrition school ever.  It’s compassion for people and respect for their differences is awesome.

20.  You really don’t want to read more than 20 right?

Thanks for all the birthday wishes, they made this warm and fuzzy post possible :)

Pin A Personality!

 

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I pinned Hope Warshaw, who is a member of Diabetes Advocates and author of multiple books for people with diabetes.

 

We need people to see the blue circle and immediately think, “DIABETES”.   The more united we are under one symbol, the better outcome we’ll have in our advocacy and awareness efforts.

The International Diabetes Federation is behind this mission and are encouraging us to “Pin a Personality”

Here are the instructions straight from the IDF:

“Take a picture of a personality with the blue circle pin.

How to choose a pinable personality?

Your personality can be anyone who you think would profile our blue circle to a wider audience or contributes to IDF’s mission to promote diabetes care, prevention and a cure worldwide.

Your personality could be a local celebrity, a politician, a teacher, a chef, a local councilor or your gym instructor.

Do you have anyone in mind or are you attending an event before November 14? Will you see anyone pinable? Let us know at wdd@idf.org and we will send you some blue circle pins.

Upload your photo to our World Diabetes Day Facebook page or on Twitter using #WDDPin by November 14. Don’t forget a short one liner explaining who your chosen personality is!

Let’s get the blue circle out there and recognized as the global symbol of diabetes!”

 

My blogger friend Stacey graciously pinned a few personalities because yours truly is a wee bit shy about these things…

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Dr. Nat Strand and Stacey with DiabetesSister’s Founder Brandy Barnes.

The Making of The Girl’s Guide, Part 2 of Interview

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Many of you have heard this story before but if you haven’t and happen to be curious here is part 2 of my interview with Laura Kolodjeski from Sanofi talking about how and why I started the blog and what my future plans are.

The only thing I would like readers to take away from my words is that sometimes having diabetes can be the source of motivation in our lives.  It can provide our route to helping others.  It can be a big part of our lives without being the bane of our existence.  I think to some extent that’s what I’ve been trying to do.  Thrive with diabetes, embrace it and learn from it, and use all that energy to help others who have it.

Luckily for me my path on this blog has led me to immense learning and support from the DOC.  So it’s just another example of how life is always full of pleasant surprises and even our having diabetes can ironically dish good things out.

Click here to read The Making of The Girl’s Guide to Diabetes

As always, thanks so much for reading.

XOXO

Classification of Carbs

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I really believe carb counting alone is insufficient when it comes to my diabetes management.  At least the simple way it’s taught.  It’s just my opinion and I’ll explain why:

I’ve found that for ME, there are adjustments I make for different types of carbs.  These are adjustments beyond just subtracting grams of fiber.  A carb is not a carb.  They vary spectacularly and learning their differences helps me keep my blood sugars in range and helps me decide which carbs to avoid.

I classify my carbs:

-Refined grains

-Sugar/sucrose/plain fructose (no fiber)

-HFCS (High Fructose Corn Syrup)

-Chocolate, ice cream, and other high fat desserts

-Poultry/Meat/Seafood

-Fruits and vegetables

Refined Grains

When I eat anything with processed grains like white rice sushi or pizza or cookies, cake, or crackers, I have to watch out for a post meal blood sugar skyrocket.  It doesn’t happen right away which is why it’s often confusing to dose for these kinds of foods.  For example, last time you had pizza you were high afterwards so this time around you give more insulin, only to get low in the middle-towards the end of your meal.

I find that about 30 minutes after eating anything with refined or processed grains, I have to give another dose of insulin.  An insulin pump option on a dual or square wave bolus works well for a lot of people, but from what I gather, people with and without pumps have a hard time keeping blood sugars in range with processed grains.

Sugar

Eating something like candy made from glucose or sugar or drinking plain 100% juice or sugar sweetened beverage is a bit different.  I find that if I’m going to consume this within a reasonably fast amount time (as opposed to snacking over a period of 30 minutes) then I count carbs and using my 1:15 scale, I give just that amount of insulin.  Then I wait 15 minutes for the insulin to start working (more if I’m not in range).  I find that the insulin cancels out the sugar carbs pretty well and there is no shocking aftermath.

High Fructose Corn Syrup (HFCS)

This one is interesting.  At least for me (remember, this is just what happens in MY body).  I find that candy or beverages made with HFCS works like when I eat refined grains.  But that makes sense to me when I think about corn being a grain!  It’s easy to forget because people serve it to kids and say “eat your veggies”.

High fat desserts

This gets it’s own category because of the large amount of fat (and because they’re my favorite!)  I try to stick with dark chocolate for a low dose of sugar.  I also make sure to buy desserts that do not have HFCS in it as a sweetener.  I try to get the gourmet kind with minimal ingredients and then I count carbs and give insulin in the middle of eating since the fat content really slows down the absorption of most of these foods.  If there is a lot of sugar I give insulin prior to eating as usual.  I’m referring to a dessert like high fat truffles, mostly.

Poultry/Meat/Seafood

I count carbs and then add a tiny extra amount of insulin to my carb count depending on how much I eat.  I don’t have to do this unless I’m really filling up on this protein source.  I love how these foods fill me up and do very little to my blood sugars.

Vegetables and Fruits

I’m a fan of these, especially in terms of carbs.  As you are well aware, the high antioxidant, vitamin, mineral, fiber, and water content of these foods makes them wonderful for our health.  I definitely don’t need as much insulin for these foods.  I count the carbs and then omit for fiber content.  Fruit is something I stick to consuming in it’s natural state and in small quantities.  The sugar in fruit is fructose and too much overloads the liver, causing fatty liver problems.  Oh and it definitely affects blood sugars.  My favorite are cherries, they are very low glycemic.  Have you tried them for a low?  It takes so many!

I know I didn’t talk about legumes or nuts.  I don’t eat legumes anymore.  I think I ate too many as a kid.  I treat legumes like vegetables and I treat nuts like meat.

With any food:  If I eat a lot, I need to give a little extra insulin for the full stomach effect that Dr. Bernstein has talked about in his books.

I adjust for a few other things.  I’ve mentioned them before but here we go again:

-BM status.  Eww, I know.  But being backed up might make a person anticipate a need for more insulin.  The opposite of that issue= less insulin.  So watch out for major lows if you get food poisoning!

-Stress.  If I’m stressed, I have to give a little bit extra insulin to combat the stress hormones and their affects on my blood sugars.

-Exercise.  Different types of exercise require different diabetes management approaches.  Read Ginger Vieira’s book for that info and so much more-even worksheets for getting all these changes right!

-PMS.  Days before I start, I need to up my basal insulin.

-Sleep.  If I stay up late (past midnight), I have to give some extra insulin (unless I’m active).

-Sedentary.  If I’m being sedentary more than two days in a row due to sickness or diabetes burnout or whatever, I definitely have to up my basal insulin substantially (by 30-40%).

-Too much artificial sweeteners.  Certain artificial sweeteners in high doses do contain carbs (it’s a small amount per serving so they’re legally allowed to round down to 0) so if you’re binging on diet coke, check your blood sugar and stay alert to a sneaky increase.

That’s all I can think of.  It’s just an example of how you want to be aware of how your body reacts to different types of food and activity.  You can see why I stick with meat/poultry/seafood, vegetables, and fruits.  Much better blood sugar stability and less variability for me.  But when I do splurge, at least being aware of how those foods act differently help me manage them for those occasions.

I write all this out because you can have tighter blood sugar management.  It helps to learn yourself and the foods you’re eating.  Again, get Ginger’s book or ebook and discover how to improve your blood sugars.  I highly recommend it.

Leashes Aren’t Only for Dogs

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Aurora took this picture of “daddy chasing brother”

Alex is going to be away a few weeks working out of state which is leaving me going from cliff hanging to free falling.  Or so it feels.

It’s not just that I’m doing more by myself but also, Alex and I are used to doing everything together so it’s hard to have him away.  And of course, there is the issue of having twin toddlers and how they are at an age where it’s much easier to have a one adult per child ratio happening.

Just the other day at the grocery store, Henri took off running as I was paying.  I left Aurora by the cart and took off sprinting after him.  Henri is the fastest little boy I’ve ever seen and of course, he’s mine.  Just as he was about to pass the last set of doors before getting to the street, an elderly man saw him and his lunatic mom (aka-me) a ways behind him, screaming “STOP Henriiii!”  The man shuffled his feet to the left and then to the right repeatedly while bent over with arms spread to the sides to prevent Henri from getting past.  The man looked exactly like a center on the basketball court.  Henri tried one last attempt through the man’s legs as the stranger whom we’ll call “light on his feet Bob” snatched him up and handed him to me.

I was so embarrassed I apologized and thanked “Bob” and he said while grinning, “Nah, honey, now you see why they say it takes a village?”  A village of kind, nimble footed souls, yes.  Then off I went in search of Aurora who had picked up a few bags of M&M’s, clutching them close to her chocolate loving heart.  It’s funny, she’s never had M&M’s before, doesn’t see TV commercials, and yet her instincts tell her they’re good.

So that’s why we don’t go out often enough.  Let me ask you all a desperate and serious question.  Would it be awful to use those …child leashes-I mean restraints?  I keep cringing at the thought of using them but I cringe even more to think of one of my kids meeting a car while on the run.  They do it a lot.  They think it’s funny to see me freak out.  Did you see one of the latest Modern Family episodes where Cam and Mitchell use one for their daughter while at Disneyland?  Did you see the way the family reacted?  Like it was inappropriate and ridiculous looking?  Like they were treating her like an untrained puppy?  WELL.  That’s what I’m talking about.  And they were two adults for one child.

My mom had five kids and she says that she has learned that twins are uniquely difficult (not more, just uniquely) because of how they’re at the same developmental stage.  And I think that’s what is tough for me.  I can’t go anywhere safely or without tons of stress but almost everyone imagines I should be able to (as I imagined I’d be able to before actually experiencing this wonderful madness).  It’s not that I feel judged.  I just don’t feel quite understood.  Even some of my siblings don’t see what’s so challenging about it.  And then there’s the third baby I have to take care of-my diabetes.  The combination makes me feel like I’m risking the kid’s safety too often and my health, too.

That’s it.  I’m ordering child restraints right away.  Thanks for listening.  And next time we all see a kid-on-a-leash, let’s think about how the parent behind the child is simply scared that their little runaway will run away and get abducted or struck by a car.  Or injure a helpful stranger trying to stop them.

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