Thursday, December 22, 2011

Belly Rolls (Is Proactive Care A Joke?)


I was going to publish a post that I had written on school holiday parties but it didn't feel right after yesterdays' "belly rolls" (trying to avoid the big P-word because my own stomach is in a bit of an upheaval today).

Instead I am choosing to write on something else that feels more important.

Proactive Type 1 Diabetes Care

I know.  Weird, right?  I mean in the world of type 1 diabetes, pretty much everything is at some point reactive. 

For example, you take a blood sugar reading and suddenly out of nowhere you are staring at a 353.   What do you do?  REACT.  Drop in a dose of insulin either through a syringe or through an insulin pump.

Your child refuses to eat all of their dinner and suddenly you are faced with a deficit in carbs for the pre-bolus that you gave 20 minutes ago.  What do you do?  REACT.  Against your better parenting judgement, you reach into the pantry for something out of the Halloween candy bag and offer it up.  You need carbs in that belly and they need to go in now.

The middle of the night blood glucose check reveals a low, low, low of 47.  What do you do?  REACT.  Lights on, juice in mouth and a couple of glucose tabs for good measure.  And if you are like me, you also react by not sleeping for the rest of the night because you are still on edge.

After all of that reacting, it is hard to feel like you can be proactive.  But sometimes you can.  You can almost beat that diabetes monster at his own game.  I say almost, because we can't completely cure it. Yet. 

Here are five proactive type 1 diabetes care tips that I have found helpful.    I hope you do too.

1.)  Supplies, supplies and more supplies.  You can never have enough.  Stuff those supplies everywhere.  Places we keep testers include the car, my husband's office (won't tell the whole story on this but once met him on the highway on our way to an amusement park because we had no test kits!), the neighbor's house, school, purse(s) and Grandma's house.  I am not an alarmist by any means, but I do keep a backpack loaded and ready with supplies in case we need to leave in a hurry. 

2.)  Bedtime snacks with fat and protein.  If your child can eat dairy, this is your opportunity to become parent of the year.  1/2 cup of ice cream has this magical quality of being the perfect combination of carbs/fat/protein that can usually sustain a small child through a night of fasting.  With my own girls, I can really see a difference on the nights that we do this.  Better glucose numbers = sleeping for all of us.  Thank you Mr. Breyers!  Oh, peanut butter sandwiches and cereal with milk work great too.

3.)  Plan for the unexpected.  I am sure that most likely you do.  I feel like a girl scout every single day when we leave the house.  Beyond the bags of supplies stashed everywhere, I also keep food in every single corner.  Kinda like a rogue squirrel, I literally have a bag of nuts AND candy.  Let me tell you, our family is fun on a road trip.  We know how to really, really picnic.

4.)  Use that technology.  First up is the wonderful combo bolus.  My friends, this is the best feature on an insulin pump.  It really helps not only with buffets, but certain problem foods like pizza and pancakes.  A little insulin now and little delivered later when the slow carbs are still being released.  Another simple item is the cell phone.  I am not in the least bit embarrassed to say that my oldest daughter received a cell phone at age 9.  It has kept her safe time and time again.  Nothing feels better than a text telling me what she is eating and bolusing for.  She does this without me prompting because it also feels good to her.  Lastly, the Continuous Glucose Monitor.  Even when blood glucose numbers are shifting quickly, the CGM spots trends that clue you in on the direction.  Not to mention that it alarms.  The middle of the night is still scary, but it is entirely LESS scary with our friendly CGM. 

5.)  Don't be afraid of Glucagon.  Have a plan worked out with your endocrinologist on how to administer mini-glucagon shots and WRITE IT DOWN.  This is one area where I need to improve.  When the time came to knowing exactly how much to dose, my mind went blank.  Thankfully, I had a good friend in the DOC who could walk me through it.  I will be writing our plan down and taping it on the wall next to the emergency contact list.  I am also going to share our story one more time with the endocrinologist's office to see if there was anything I could have improved on.  It never hurts to have a second (or twenty) pair(s) of eyes reviewing what you have done.

When you can proactively kick the Diabetes Monster before it can kick you or your child, I can most assuredly say nothing feels better!

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