Tuesday, July 17, 2012

It's Summer Time - Not Schedule Time

Our morning routine is completely out of whack. 

For those that might know this, I am a plan and schedule kind of girl.  Surprisingly, type 1 diabetes and I actually co-mingle very well. 

While I take the middle-of-the-night blood glucose check, my husband regularly takes the early morning shift.  During the school year, our oldest daughter only sleeps an hour past "daddy's testing" and is quickly up, eating and out the door.  This plan and schedule helps to keep blood sugars right on track.  Rarely do we have an issue.

So where is that plan and schedule during the summer?

Well, it is surely not happening right now.  Both girls are sleeping in (heck, they are asleep as I am typing this) and quite possibly could sleep until 10:00 a.m. or even later.

Who knows?  I have completely lost control of my morning schedule.  I can't even predict it. 

This morning sleeping is very different from the toddlers and little girls that used to literally bounce out of bed at 6:00 a.m. in hopes of immediately finding a Wiggles television show.

(Sidenote:  I STILL sing Fruit Salad, Yummy Yummy! when I make fruit salad.  Google it people.  Highly addictive!)

That is not happening now. 

In fact, my oldest daughter has been sneaking a sip or two of my coffee and asking for Starbucks. 

Let me be clear. 

That is not happening now either.  Sorry oldest daughter.

The sleeping in phenomenon is not a big deal to the rest of the world.  I am sure if someone that does not live with type 1 diabetes will simply scratch their head at reading my words and declare me nutty.

And maybe they will be a little right.

Because the simplest things like sleeping in DO make me nutty and not because of a lack of plan and schedule.

Surprisingly, it boils down to keeping them safe while we mess with that plan and schedule.

Once those girls wake up, they will need breakfast and that will happen around 10:30 or even (gasp!) 11:00 a.m..  In our pre-summer vacation pump settings, 10:30 a.m. was a lower insulin to carb ratio and a lower basal rate.

For example purposes to illustrate what I am up against,

6:00 a.m. to 10:00 a.m. is 1 unit of insulin for every 6 carbs.

10:00 a.m. to 12:00 p.m. is 1 unit of insulin for every 10 carbs.

Without changing that I:C ratio, my girls will be trending up and not able to compensate for the carbohydrate riddled breakfast foods like cereal, waffles, fruit or toast.

Don't let me even get started on Basal Rates.  My normally active kids are sleeping in longer which directly effects the amount of  basal insulin --- except that this is the time of day noted as the 'Sunrise Effect' which tends to elevate blood sugars by causing insulin resistance.

The only way to figure out basal rates for this time of day is to wear a CGM and test BGs like crazy to figure out typical trends.  Even by doing so, there is a second phenomenon called 'Mom Worry' which keeps me looking at the clock to see how long my children have fasted overnight -- ultimately, without food, they are going to go low. 

Truthfully, that worry is hard to keep in check.  It is so much easier when they are up and awake so they are aware of hypoglycemia symptoms.

The later breakfast eating causes more problems.  If I stretch out the lunch time to 12:00 or 12:30 p.m. or even 1:00 p.m., no one is very hungry and worse, pump settings need to be revisited a second time.

The domino effect happens for afternoon snack and dinner... which I can tell you is happening around 7:00 p.m. (not the 4:30 after school/before sports practice time).

And who wants to sleep after eating a meal?  So bedtimes are stretched and of course, because we are experiencing extreme physical growth due that lovely thing called puberty, the girls need a bed time snack.

Which last night, ended up being around 10:00 p.m.? 

What?  Is that right?  What happened to my schedule?

So what is a mom to do?  Enforce strict timings on her children or try to just go with the flow?

I choose the later and will adjust the heck out of the I:C and basal rates and maybe even tweak the early a.m. BG goals to account for the extra zzzzzzzzs.

This is summer after all.  That magical time in our lives when kids are home, creating memories with their family and enjoying all of the wonders of childhood. 

Blissfully, my girls understand none of this.  They are just happy (and well rested!) children.

To me, that is completely worth it.  

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