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.  

The Learning Curve ( Always More with Diabetes)

I do not profess to know everything there is to know about type 1 diabetes.

First, I do not actually have type 1 diabetes and secondly, my kids are still growing and hitting new stages of living with type 1 diabetes.

What we dealt with at age 3 is very different than what we will be dealing with at age 13 or 33 or 83. 

Our life with type 1 diabetes changes hourly sometimes.  Nothing like a new infusion site at 10:00 p.m., only to realize that it failed at 3:00 a.m., to remind you that type 1 diabetes is fickle at best.

I am also careful in not getting caught in that trap of perfection with managing type 1 diabetes.  This is a journey and we live a real life that centers around raising two little girls and incorporating type 1 diabetes into our life (not the other way around).  Kids first, diabetes second.

We try our best but it will always be an art, not a science.

This mentality helps me when it comes to things like the A1c appointment (or that dreaded Parent Report Card).

At our appointment yesterday, as I listened to advice that our Endocrinologist provided regarding options for better type 1 diabetes care, I had to resist the urge to defend myself.  The conversation went a little bit like this:

"Are you pre-bolusing before meals?"

We (our family) nod in unison and explain that the girls bolus and then eat.

"But you don't wait 15 minutes?  That might help."

I wasn't even sure why I felt defensive in the first place.  It wasn't as though we were doing anything wrong.  I actually had to remind myself that we are at the A1c appointments for suggestions just like this.  Helpful suggestions like waiting a little bit longer before eating.  Why did a simple suggestion bother me so much?

There is nothing wrong with getting opinions and I know it would be foolish to suddenly start rejecting new ideas just because I felt defensive. 

Instead, I got my thoughts in order and realized what I really needed was an idea on how to make pre-bolusing 15 or even 10 minutes ahead happen. 

I asked our Endocrinologist, "How do you tell two very hungry children that before they can eat, they must sit at the table and wait for 15 minutes?  This is a real life family after all.  When they are hungry, they are hungry and it is difficult to say wait."

In turn, she nodded her head and agreed with us. 

This question sparked up a very helpful brainstorming session between all of us; our Endo, the girls and myself.  It also helped to remind our doctor that sometimes things aren't as simple as they seem.  Yes, waiting for 15 minutes is a great idea, fantastic even.  Truthfully though, it is difficult.  When someone is hungry without diabetes, they just dive right in.  No waiting is necessary. 

We ended the conversation by solving it with mom (me) making an announcement in the morning.  We decided that when I wake them, to put in their breakfast carbs while they are still upstairs in their beds.  Forgetting lunch altogether and dealing with it best as we can.  At dinner, mom making another announcement for what dinner will be and asking the girls to pre-bolus before even stepping foot in the kitchen.

It's not perfect, but it works.  Most importantly it is a helpful suggestion and one that I know will improve our girls care at this age of type 1 diabetes life.

Thank you Ms. Endo!  We'll let you know how it goes.... to be continued!

National Slurpee Day - A Kids First, Diabetes Second Freebie



Today, is National Slurpee Day (I may have just made that up but who cares - my kids would love this to happen every day!) in honor of 7-Eleven's birthday.  As a mom of two kids living with type 1 diabetes, I have professed my love of sugar free slurpees before.

No carbs to count.
No dosing insulin.
No stopping-what-you-are-doing-to-test-your-blood-sugar.

Just kids first, diabetes second, great taste, beats the heat and a whole lot of fun!

Here is my original post.  Oh, and for today only, your slurpee in the mini 7-11 size is FREE!  Enjoy!