Tuesday, January 27, 2009

Meal Ideas: Chicken Soup

It's a balmy 31 degrees F as I type this (about 0 degrees C), and ice is threatening to fall from the sky. My mind keeps wandering back to last Friday when it was almost 80 (about 25). Texas has some weird, weird weather. So it seemed only natural to post a good, EASY chicken soup recipe.

What you need:
*A crockpot
*1 carton of chicken stock (32 oz), or you can make your own.
*1/2 C water
*1 C Boneless, skinless chicken breast (cooked) - chopped into bite-sized pieces. I'll sometimes use the leftovers from a whole roast chicken I've made the day before.
*2 cloves of garlic - chopped or minced.
*2 fresh basil leaves - chopped.
*1 C of fresh or frozen veggies - chopped (I use celery, zucchini, carrots, peas, beans, corn - whatever is in my crisper and about to go bad).
*1/2 C of elbow macaroni or any other pasta that would go well in a soup (if you have gluten issues, you could substitute rice).
*I also throw in a pinch or two of dried parsley.

To Make:
*Combine all ingredients except pasta (or rice) into crockpot. Cook on low for 4 to 5 hours. I usually add the pasta in the last hour.

Carb Count:
This is a tough one... it really depends on when veggies you throw in there. I've made it with as little as
3.5g of carbs per 1/2 C and much as 10g of carbs per 1/2 C (although that last one I think I used more pasta than I usually do). The way I figure it out is I add up all the carbs in the soup, and after it's done cooking, I weigh it. Say the total weight comes to 1550 g and the total amount of carbs is 90. I then see what a 1/2 C of the soup weighs, say for example it's 110 g. So using my fancy solving for x equation it looks like this:

1550 - 90
110 - X

In this example, 1/2 C of soup has about 6.5g of carbs. If you totally didn't get how I came to that number, read this post.

Why It's a Great Meal:
*Elise will eat it.
*I can make a bunch and re-heat the extras for another meal. I also freeze amounts that I pre-measure in a muffin tin. After it freezes, I pop them out, wrap them in saran wrap, and put them in a freezer bag labelled with what it is, when I made it, and how many carbs are in each serving.

*Lunch for me, too!
*Cheap to make, and it's a great way to get rid of veggies that need to be used.
*It's healthy! You've got vitamins from the veggies, and protein from the chicken. Serve it with some whole grain toast and some yogurt for a good meal.

Friday, January 23, 2009

The Mourning and the Dancing

It's funny to grieve the death of an organ that most people don't even know what it's function is, much less where it is in their body. But that's what I'm doing. My daughter's pancreas is dying, attacked by her own body. It's treason of the highest degree, and there isn't a thing I can do to stop it.

Norman Cousins, a famous journalist said, "Death is not the greatest loss in life. The greatest loss is what dies inside us while we live. " And while he meant something totally different, I can't help feeling that about Elise's turncoat of a pancreas. The death of her pancreas has totally and forever changed her life.

And while I mourn this death, I cannot help but rejoice that Elise is still "fearfully and wonderfully made", and through the miracles of science, my daughter will grow up and live the life she was meant to.

And so each day I wake up with a prayer in my heart. I pray for the inventors of new technologies that will make dealing with this disease easier. I pray for all the families whose lives are touched by diabetes; that their hearts will be filled with hope and joy, despite their hardships. I pray for the ones living with diabetes, for it is they who have the toughest battle of all.

But above all, what my heart longs for, my soul aches for, and every part of me screams out for, is a cure. I pray that one will be found and that I will live to see it. Wouldn't it be amazing for a cure to be found so soon, that Elise could grow up and not even remember having diabetes?

That is my prayer, would you join me and make it yours too?

Thursday, January 15, 2009

What does it all mean, anyway?

You'll notice on this blog there are a lot of abbreviations, or fancy words that you might not recognize. So I thought I'd make a glossary of sorts that you can refer to. When I use one of my fancy words, I'll put a link to this post so it will open up in a new window and you'll be able to understand the words that are coming out of my mouth (sorry, that's a Rush Hour reference... that movie cracks me up). If I've left any out, just leave a comment and I'll add it.

#g of carbs - this is not a weight, but the amount of carbs that can be found in the food Elise eats. For example, 4 oz. of grapes has 20g of carbs.

A1C - A blood test that is used primarily to monitor the glucose control of diabetics over time.

BG - Blood Glucose. Refers to the amount of sugar in Elise's blood. Her optimal level is 100-200.

Celiac Disease (CD) - a digestive condition triggered by consumption of the protein gluten (found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye). If you have CD and eat foods containing gluten, an immune reaction occurs in your small intestine, causing damage to the surface of your small intestine and an inability to absorb certain nutrients. The decreased absorption of nutrients that occurs with CD can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment. This can lead to other illnesses and stunted growth in children.
No treatment can cure celiac disease. However, you can effectively manage celiac disease through changing your diet. It is thought that approximately 10% of children with Type 1 Diabetes also have Celiac's Disease.

Certified Diabetes Educator (CDE) - multidisciplinary health professionals (usually an RN) who teach people with diabetes. When Elise was diagnosed, a CDE met with us each day in the hospital to teach us how to care for her.

D - Instead of typing out diabetes, I'll just use the letter D.

Diabulimia - an eating disorder in which people with Type 1 Diabetes deliberately give themselves less insulin than they need, for the purpose of weight loss. Failure to administer insulin places the body in a starvation state, resulting in breakdown of muscle and fat into ketones, while at the same time making the body unable to process sugars that have been consumed, so the sugars are excreted rather than being used by the body for energy or stored as fat.

Diluted - Because Elise needs such a small amount of insulin (for now, it will change as she grows), we need to dilute her full-strength, rapid-acting insulin. We do this at home with sterile diluent.

DKA - A life-threatening condition that develops when cells in the body are unable to get the sugar they need for energy. Symptoms include: flushed, hot, dry skin, blurred vision, feeling thirsty, drowsiness or difficulty waking up, rapid, deep breathing, strong, fruity breath odor, loss of appetite, abdominal pain, vomiting, and confusion. Severe DKA leads to difficulty breathing, swelling of the brain, and there is a risk of coma and even death.

Dx - Diagnosis

Endo - short for Endocrinologist, the specialist Elise sees for her diabetes.

Glucagon (kit) - Glucagon is used to treat insulin coma or insulin reaction resulting from severe hypoglycemia (low blood sugar). Glucagon is used in emergency situations when the patient is unconscious. Within the glucagon kit is a vial of powdered glucagon and a syringe filled with liquid (diluent). The dose is prepared immediately before injection.

High - A BG over 200

Humalog - One of the two insulins Elise is on. It is a rapid-acting insulin that she takes before breakfast and dinner. I refer to it as H or DH (Diluted Humalog).

Humulin (NPH) - The other insulin that Elise is on. It is an intermediate-acting insulin with a slower onset of action and a longer duration of activity. Sometimes I refer to it as N.

Ketones - They are produced when there is not enough insulin to help Elise's body use sugar for energy. Without enough insulin, glucose builds up in the blood. Since the body is unable to use glucose for energy, it breaks down fat instead. When this occurs, ketones form in the blood and spill into the urine. These ketones can make her very sick. Healthy people can also spill ketones when they are ill. Elise gets tested for ketones if her BG is over 250 or she's sick. We do this by squeezing urine from a cotton ball (we put these in her diaper every time we change her) onto a ketostix. There are also blood ketone monitors, but right now I prefer the urine test. Untreated high blood glucose with positive ketones can lead to a life-threatening condition called diabetic ketoacidosis (DKA).

Ketostix - Urine-testing strips, also called ketone sticks are small plastic strips that have a little absorptive pad on the end. This contains a special chemical that will change colour in the presence of ketones in the urine. The strips may change varying shades of pink to purple, or may not change colour at all, depending on the amount of ketones (dark purple = bad, beige = yay!). The container has a scale on the label, with blocks of colour to compare the strip after a certain time lapse, usually 15 seconds.

Low - A BG under 80

MDI - Multiple Daily Injections. This is how we give Elise her insulin.

Pedi - Pediatrician. I like to use abbreviations.

Type 1 Diabetes - Once known as juvenile diabetes or insulin-dependent diabetes, it is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to convert sugar (glucose) into energy. Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Despite active research, type 1 diabetes has no cure.

Type 2 Diabetes - Often called non-insulin dependent diabetes, it is the most common form of diabetes, affecting 90% - 95% of the 21 million people with diabetes. Unlike people with type 1, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. Those at highest risk for the disease are those who are obese or overweight, women who have had gestational diabetes, and people with family members who have type 2 diabetes.

I Did It! (all by myself)

Someone who just happened across this blog, and didn't know the whole story, would probably read this post and think, "man, this lady gets excited over the dumbest things." But you know what? I just don't care.

Because I took Elise to eat at Chick-fil-a, all by myself without Fred there to help. I know, how intoxicating, right? This was big for a couple of reasons:

  1. I was going out with a bunch of Moms and their kids. It's really hard to concentrate on talking to people when you have to keep a watchful eye on your daughter to make sure she eats everything on her plate. Plus I was a little nervous about checking her sugar and the potential of giving her a shot in front of all those other people. I especially didn't want to scare any of the kids. As it turns out, her BG was a bit high, but not so much that I needed to give her extra insulin.

  2. She got to eat Chick-fil-a too! Of course I looked up the nutritional info before I went and determined what she could eat (btw, Chick-fil-a's website is wonderful for this). I semi-cheated and brought her some stuff from home, but she seemed to enjoy those Chick-fil-a nuggets!

  3. Although she's 16 months old, I have never taken Elise to a restaurant by myself. I mean, I did when she was little, but not lately, and especially not since her dx. The logistics always overwhelmed me... got to make sure I get there in time (Elise needs to eat at very specific times), check her BG, maybe give her a shot, get the food, make sure she eats everything while trying to eat some of my own food. When I write it out, it doesn't sound that bad, but when I think about it, I get tired.

I almost didn't go (which is typical of me... not trying because I'm scared I'll fail), but I did it, and it's amazing how such a small thing can boost one's confidence.

So D, I politely request that you stick THAT in your pipe and smoke it.

Saturday, January 10, 2009

It Changes Everything.

Sometimes D sneaks up on you, like a sucker punch to the solar-plexus. Everything can be going great; wonderful numbers, no food issues... everything's coming up roses as the song goes. But D is always out there, waiting to take your feet out from underneath you, lest you get a bit too cocky.

For me it happened a few days ago. I tookElise to attend a birthday party for a little friend of hers, a first for her. D wasn't really on my mind, I thought we'd go, Elise would play, have some fun, and we'd go home.

But it wasn't like that at all. Oh, it was at first, but I had forgotten about the food. Because of the timing of the party, Elise wouldn't be eating. I was going to feed her lunch when we got home after the party. But I didn't take into account that I had to watch all the other kids scarf down their pizza, while Elise wandered around eating string cheese.

It killed me, I felt like my heart was being Texas Two-Stepped on. Elise didn't care, she was quite content with her cheese. But what kept reverberating in my brain was, "this is how it's going to be for her, always the outsider. Always different." I hate that I think that, and I know I need to stop thinking of her that way.

I thought maybe she could have some strawberries from the fruit salad, so I checked her BG. She was almost at 400 and that's when the tears started to well up in my eyes. I took Elise and went around the corner, so nobody could see me. I distracted Elise by showing her the fish tank and had myself a good cry for about 5 minutes. I don't know who I was crying more for, me or her.

I returned to the party in time for the cake to be brought out. All the kids cheered when they saw it, and Elise started clapping too. Not because she understood what was going on, she just likes to join in the fun. I almost lost it again watching the kids dive into the sugary-goodness.

I know one day Elise will be able to take part in birthday fun, but for now because of the type of insulin she's on, and because she's so little, it doesn't fit into her food plan. Every time I run into one of these situations, it's like she's been diagnosed all over again. Pain that I had forgotten about rips into my heart and tears threaten to fall seemingly every second.

But, in the end, you do go on. The wound scabs over, and you almost forget about it until the next time D opens it up. It is getting a little easier, I don't cry as often or for as long. And that's what I need to remember... bit by bit, I'm getting there.

Tuesday, January 6, 2009

We Did It!

I'm always very jealous of other Moms when I am eating out in restaurants. The ones who can just plop their kid into a high chair, put a bunch of food in front of them and let them go to town. I can't do that, and I hate it.

When Fred and I go out to eat, I either feed Elise beforehand and bring a bunch of free foods for her to eat. Or I bring her already-carb-counted food with us. Even though I have my handy little Calorie King book that has some restaurants and their foods listed in it, I'm a little distrustful of the people who prepare the food. How carefully do they follow the recipe? If their measurements are off by a bit, that could mean trouble for Elise. (btw, that's not the case for ALL people with diabetes, just for little ones like Elise who are on such tiny carb amounts).

But just a few days ago, we finally took the plunge. We were going to Ikea (loooove the Ikea!), and since it's quite a drive and we were going to be there at dinner time, we decided to eat in their restaurant. I wondered aloud to Fred if he thought Elise would like the meatballs, and he said, "why not try to feed her there?"

Gulp! That was little out of my control-freak comfort zone. But I knew I needed to let go at some point. So I looked up the nutritional info on line, and off we went. When we got there, I also double-checked the info with a member of the kitchen staff. We figured how much she needed to fulfill her carb requirement, and I'm happy to say she enjoyed every morsel! She liked the meatballs a lot more with the gravy. And she especially liked the fries (her first junk food).

I'm also happy to say that we didn't experience any crazy BG numbers either. So, yay us! It's the small victories, right?

Sunday, January 4, 2009

Laugh, Dammit!

Below is a comment I received on MOB (my other blog) on the post where I announced "Death of a Pancreas":

Karen said...
To encourage other parents like me by captioning your blog with "Death of a Pancreas"? How morbid and stupid is that? if your goal is to encourage and enlighten us who have kids with diabetes, you might want to be more positive and check your facts first. The pancreas DOES NOT EVEN DIE with diabetes. Geez.
December 2, 2008 7:26 PM

Here is my response:

Joanne said...
Okay, so I was going to just delete the above comment since it most likely is a drive-by comment from a crazy, but on the off-chance that this person is being truthful about who she says she is, I'll address her rather snarky comment.

1) Believe me, I know EXACTLY what diabetes is. I've been living this hell for the past three months. But "Death of the Pancreatic Beta Cells in the Islets of Langerhans" just doesn't have the same ring to it. My daughter's pancreas has failed to function as it should, and to me, it feels like a death. TO ME. Got that? ME!

2) I'm so sorry that you are so easily offended by a simple blog title. If you really are a mother of a child with diabetes, you should know that the only way to not let this disease get you down is to have a sense of humour about it. You should read some of the things we joke about on the diabetes board I frequent. Actually, no you shouldn't. Your head just might explode from the offensiveness of it all.

3) Since you have blocked your ID, I have no way of knowing if you are a crazy or not. I have no animosity towards you, or your comment. I even welcome a response to my comment if you are so inclined. But please, you handle diabetes your way, and let me handle it my way... We're both (supposedly) fighting the same enemy anyway, right?

I was disappointed that she never came back to reply. My point is this; if you cannot find anything to laugh about while battling this horrific fight, then you are already beaten. If Elise grows up seeing me grim-faced all the time while giving her a shot, then that is how she's going to deal with it too. You need to show your child that their life will be what they make of it, not what diabetes makes of it.

I choose to laugh at diabetes (when appropriate, of course), and respond in my own sarcastic way. It's how I deal, how I show diabetes that it's not the boss of me. So, you can choose to let diabetes bring you and everyone around you down, or you can face it with a smile, laugh, or maybe even a jig... because who on this earth can be sad while dancing a jig?

Saturday, January 3, 2009

Meal Ideas: Sweet Potato Fries

I guess the title of this post is a little erroneous. I don't mean for this to be a meal by itself, but a good compliment to a meal. In any case, thanks to my Mom for giving me the idea!

What you need:
1 small Sweet Potato
Approx. 1 tsp olive oil
1 pinch of salt (optional)

To Make:
*Cut skin off of sweet potato.
*Cut sweet potato into desired length and thickness for fries. I prefer skinner, smaller pieces because they cook faster and are easier for Elise to eat.
*Put pieces into a bowl and toss with olive oil. The amount of oil you use may vary, depending on the size of your sweet potato. Add a teeny, tiny pinch of salt, if you want.
*I use a toaster oven to make mine. I bake them at 400 degrees for about 10 minutes, or until the sweet potato can easily be pierced by a fork. Make sure you flip the pieces every few minutes or so, or they will burn. (I'm guessing the temp/time would be the same for a conventional oven)
*Let cool, and serve!

Carb Count:
It depends on how much you give to your child. Sweet potatoes have a carb count of 26.8g of carbs per 5.2 oz (according to calorieking.com). So if I give Elise 2 oz. of sweet potato fries, then she is getting about 10g of carbs, using the formula I talked about in this post. I always weigh them after they are cooked.

Why It's a Great Meal:
*Elise will eat it.
*I can make a bunch and re-heat the extras for another meal.
*Cheap to make.
*Easy to make with very little clean-up.
*Sweet potatoes have a low glycemic index rating. That’s because the sweet potato digests slowly, causing a gradual rise in blood sugar.
*Sweet potatoes are a good source of protein, vitamins A and C, iron and calcium.