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Monday, January 31, 2011

Things Diabetes has taught me this month... January edition

-I cannot make a meal without weighing the ingredients. The other day I was making dinner for a friend who just had a baby, and I kept putting things on the scale to figure out the carbs. It has just become so automatic. I finally got in a non-weighing groove towards the end... oh the freedom!

-Even after 2 1/2 years, this disease still has the capacity to break my heart. Elise told me the other day that she was sad that she eats a different snack than the other kids at school. At Elise's pre-school, they provide the snack for the kids; animal cookies, cheese crackers, cheerios, etc. To make things easier, I always packed a snack for her in different carb increments; 7g, 15g, and 20g, along with a note for her teacher instructing how much to give Elise depending on what her BG was. Even at three, Elise is noticing how diabetes is setting her apart and she doesn't like it.

-My daughter is more responsible at three than some adults I know. Elise takes a tap/ballet class on Thursday nights. At the end of class, her teacher gives the kids the option to get a stamp on their hard, or two skittles. When the teacher let me know this at the start of our first class, I told her to let Elise decide which one she wanted. And she always picked the stamp. But the other night, my Mom (who was here visiting), noticed that when the skittles were offered, Elise shook her head with a very sad look on her face. Apparently the teacher noticed too, and came over to me and said, "I think she really wants the skittles." I told her no problem, and Elise was so happy she wanted to have one skittle then, and keep the other to have the next day. Now how sweet/sad is that?

-Elise is not to young to start having conversations with about her care. The two incidents above taught me that Elise is very aware about what is going on, but might not have the words to express how she is feeling. So I sat her down and discussed both the snack and skittle situation; telling her we would figure out a way to make it work, but if she's ever feeling sad about her diabetes, she can come tell me. When we finished talking, she was beaming from ear to ear and gave me a hug saying, "I just love you so much Momma." Me too, little girl. Me too.

I've decided to change the title of these recurring posts from "things I learned about diabetes", to "things diabetes has taught me". It seems to fit better.

Friday, January 28, 2011

I got nothin'

I promise I'll stop just posting pictures of the dexcom and post something of substance soon. The last three or so days have been a little on the craptastic side. I've decided to start the paperwork on officially changing my kid's names to Crabby and Clingy. I swear they're conspiring in the night to gang up on me...

Onto the one thing that's making me happy these days. At least D is behaving. Of course, now that I've thrown that out into the universe, the universe is probably going to throw it up right back on me. It's okay. At least I have these pictures to remind me!



Look! From last night until this morning, her BG didn't go below 100 or above 200 (it looks like it dips, but finger poke said 134). Even better, the arrow didn't go beyond slightly down or slightly up. And look again... our high alert line is back! I don't know if you noticed in the other pics, but that line has been missing for awhile. We were having some horrible nights awhile ago where the dexcom kept alarming that she was above her high threshold. But she would always wake up in the morning in range, so we couldn't really correct her. So we turned off the high alert so we could get some sleep. And now, her high threshold isn't 200. I just put that in there because it makes me happy.


This morning from 6:45 until 9:45... I totally OWN breakfast (at least on days she doesn't have school).

Amy's comment on my last post made me chuckle: "Hahahahahahahahahaha! I totally see one of those fifty's style cartoon blocks of a woman in an apron and a spoon in the air declaring "Making breakfast my bitch"."

Something like this?:

Wednesday, January 26, 2011

I'll take it


This is Elise's BG from about 3 am until 9 am today. I wish it were about 100 points lower, but note the bea-u-tiful flat line. And that, my friends, includes breakfast.
Joanne... making breakfast her bitch since 2010.

Monday, January 24, 2011

You shall not pass

About a month ago I wrote a post entitled "One disease to rule them all" where I talked about how Diabetes affects all facets of your life.

In keeping with this Lord of the Ring theme, I was thinking about a scene from the first movie of the trilogy.

The Fellowship (Frodo et al) is travelling through the Mines of Moria when they are attacked by some orcs. As they are trying to escape, a great booming echos through the chamber, causing the orcs to scatter. Only Gandalf realizes the great terror that is about to confront the Fellowship, and orders everyone to run.

Gandalf then turns to face the Balrog (think big, scary, fiery demon), and in one of my favourite scenes in the movie, Gandalf slams his staff into the ground and commands the Balrog, "You shall not pass!"

(Have I totally geeked out on you yet?)

Don't you wish that this would work with diabetes? How awesome would it be go all Gandalf on it's ass when diabetes is threatening to ruin a fun time for your child?

Like when we're at a birthday party, there's cake and Elise's BG is 350.

Or she wakes up on the morning of a special day at pre-school, and she has ketones of 2.1 from a stubborn high overnight BG.

Or she can't join her skating lesson because her BG is low and will not come up as she watches the kids skate and cries because she wants to be out there too.

On days like those I envision diabetes like the balrog; all ugly and mean. Getting in our way and stopping us from living our life. I would love to slam Elise's lancet into the ground and yell, "diabetes, you shall not pass". I wish I had some wizardly power to stop diabetes and throw it into the bottomless pit in which it belongs.

Alas, I am no wizard. And although I lack the magical powers to figuratively kick diabetes in the groin, I will not let it defeat me.

I will remember that the 400 glaring at me from the meter is just one number in a very long line of numbers.

That there will always be more cake.

That diabetes has the power to ruin one day, but not every day.

My daughter is bigger than diabetes and better than diabetes. And so am I.

Thursday, January 20, 2011

Factor THIS! (a repost)

We often get asked how we are able to achieve such good A1Cs and reasonably stable (unless something crazy is going on) blood sugars. I believe part of it is owed to the fact that I weigh Elise's food and use carb factors. We find that being off by 5g can make all the difference between a high/low BG and an in-range one. Of course, this will change as Elise gets older, but for now you will always find me with my trusty scale, and list of carb factors (that are mostly in my head).

I wrote this post almost two years ago, and thought I'd re-pot it for anyone who is interested.


*****************

When Elise was first diagnosed with diabetes, I was overwhelmed by trying to count carbs. A calculator and scale became my best friends, and I am never without a piece of paper and a pen when I'm fixing Elise a meal.

But the math part was very difficult for me, and I often had to write out the equation on the paper to get my mind around it (for example, if 1 oz of banana has 6g of carbs, than how many carbs are in .7 oz of banana). This especially sucked if I was in a hurry.

Then someone on a message board told me about carb factors. I read their explanation, but my poor little brain was so blitzed from all the new information I was learning, that I couldn't make sense of what they were telling me. So I put carb factors on the back burner until a time when I wasn't feeling so stupid.

Well, the fog has lifted and I am a carb factor convert. If you haven't heard of carb factors before, here's an explanation:

Different foods are made up of different parts: carbs, fat, fiber... etc. Carb factors are the percentage of a food that is made up of carbs. Let's use a banana as an example. They are 20% carbs, or have a carb factor of .20. But how do I figure out exactly how many carbs are in the little bit that I give Elise for a snack?

To figure out exactly how many carbs are in that piece of banana, all I need to do is weigh the banana (in grams, not ounces). Since I know that any portion of a banana is 20% carbs, all I need to do is multiply the weight by .20 (the carb factor for a banana). So if a banana weighs 15 grams, the amount of carbs in that banana is 15 x .20 or 3g of carbs.

You can even use carb factors for pre-packaged foods. Elise LOVES goldfish crackers, but can't eat an entire serving. To figure out the carb factor for her crackers, I just divide the amount of carbs in a serving (19g), by the serving size (30g). Remember, all weights MUST be done in grams for it to work. So goldfish crackers have a carb factor of .63. To find out the carb factor of any packaged food, it's always carbs divided by grams.

So easy! All you need is a scale that weighs in grams, a calculator, and a list of carb factors. I'm working on compiling my own list and hope to post them on my blog soon. Apparently, you can also find a list of carb factors in Pumping Insulin by John Walsh (I've never actually read this book, but that's what I hear).

I've started labelling all my packaged foods that Elise eats with their carb factor. The cheerios container has a big .71 on it.

Figuring out the carb factor for homemade food is easy too! Just figure out the # of carbs in each ingredient and weigh the whole thing and add up all the carbs and divide the total carbs by the total weight and you now have the carb factor for your food. So when I made a stew for dinner the other day, I weighed all the veggies and other ingredients that went into it. The whole pot of stew had 80g of carbs. When it was done, I poured the stew into a container, weighed it, and it came to 1560g (not including the weight of the container, of course!). Then I divided 80/1560, and found that my stew has a carb factor of .05.

If you need to convert ounces to grams, there are just over 28g in an ounce.

I hope I did a good job explaining carb factors. I know they have really made things easier for me.

Edited to add: I can't believe I forgot this part. A totally easy way to find the carb factor for a food item is to go to Calorie King's food search, type in the food and click search. Then select the item from their list and when you get to the page where you can select a serving size type 100 and choose g from the drop down box. Then in the nutrition box, find the carbs, move the decimal point over to the left two spaces and you have that items carb factor... easy!

Edited further to add: As per Danielle's request, click here for a list of some (I wish it were more extensive) of the carb factors we use most often. It's also a mobile site, so you should be able to access it on your phone.

Wednesday, January 19, 2011

Attention Target shoppers

I just got back from yet another Target excursion (pjs at 75% off... woo hoo!), and saw that they have 6 oz. packages of smarties for $1! They're located in the dollar spot with a bunch of other candy. I'm thinking that $1 for 6 oz is a pretty good price, so you might want to stock up.

Of course, your market may vary, but hopefully you'll be able to find them at your Target and stock up on some cheap sugar!

Monday, January 17, 2011

Hey Doug? SHUT IT!

I was overwhelmed by all the sweet comments on my guest post at Diabetes Mine. Well, except for one commenter that left me decidedly underwhelmed. You can read our exchange below:

Doug said: At least the Cat lady was trying to relate. Her only experience with the disease was through her cat. Give her credit for trying, (even though it offended you) rather than the vast masses who cant relate and don’t try.I know you wont (sic) see the parallels, BUT in the same way that your experience with your daughter is MUCH different than the cat lady’s with her cat. Your experience with your Daughter is at least as different as mine with MY disease. Yet I wouldn’t belittle you for making analogies from your experience with your daughter…

My response: Doug – I have to respectfully disagree with you. As someone who is an animal lover and a mother, there is nothing that compares to the pain of having a child whose health is compromised. You have no idea what it is like to hold down a 12 month old so you can inflict pain on them, and you can’t even explain to them that it’s for their own good. I have lived through the grief of having to put down my 3-year old dog because she broke her back in an accident. As painful as that was, this is much, much worse. We are supposed to outlive our pets. But as parents of T1 kids, we are burdened by the fear that we could outlive our children. And that sucks.

Doug's response: I dont (sic) disagree with the fundamental difference between a child and a pet. I was SIMPLY trying to highlight that the woman in the OP was simply trying to relate in the way that she can. Trying to get all the mothers out there outside their own heads for a second. Yes you have a great responsibility and yes its tough, BUT there are other challenges as well. While you worry about what happens today to your child when you hold them down, I would say that its at least as difficult for your child to realize when they grow up that they cant (sic) take a day off. They go to bed every night wondering if they will wake up … “there is nothing that compares to the pain of having a child whose health is compromised.” Everyone has challenges and everyone’s challenges are important to them. Because your challenge includes the word “mother” doesn’t automatically rise it above all others. Does your concern about your child’s health automatically trump my concern about my own health ? Does it give you the license to publicly belittle another ? The drama associated with the pain of shots and BG tests, is increased when you feed into it. Yes sometimes its painful, but its required, and you are not doing it because you want to – you are doing it because you have to. My $0.02

After having to collect all the various pieces from my head exploding (especially after his last comment), I decided to respond via my own blog.

Reason #1 why Doug needs to shut it:
Methinks Doug has never had the pleasure (or pain) of being a parent. There is nothing, NOTHING like watching your child go through something painful. I do not say this lightly, but I would trade places with Elise in a heartbeat. Yes, I worry about Elise today. And I will worry about her tomorrow. And the next day. And for the rest of my life until I skip off this mortal coil. Just because she grows up doesn't mean my worries are over.

Reason #2 why Doug needs to shut it:
I never said I was any better than anyone. Or that Elise having diabetes trumped anyone else's illness. Maybe my reading comprehension of MY OWN FREAKING COMMENT is a little off, but I never said that being the mother of a diabetic child makes my challenge, more challenging. But it is MY reality. And I will write about it. AND if Doug doesn't like it, tough nuts.

Reason #3 why Doug needs to shut it:
One should never compare your child to their cat. At least, out loud. If you want to do it in your head, where everyone is allowed to be crazy... then fine. Would you ever tell the mother who just lost their child to cancer that you understand what they're going through because you also lost your pet to cancer? My God, no. Not unless you are the worst person in the world. Then don't compare your pet having diabetes to my child having diabetes. And P.S., I'm not comparing having a child with diabetes to losing a child to cancer... just trying to show why one is just as ridiculous as the other.

Reason #4 why Doug needs to shut it:
I'd like to know what he means by saying we as mothers "feed into the drama of shots and BG tests". What the crap does that even mean? I try to do the exact opposite, we act like the shots are no big deal and just a part of the routine, like brushing your teeth or writing angry blog posts about idiots.

Reason #5 why Doug needs to shut it:
I wasn't belittling anybody. I am always very polite when I deal with stupid comments. If you had even read my post, you would see that. But, since I am a rational, thinking human being; the lady's comments bothered me. And so I shared them in my post (which was about dealing with stupid comments).

Reason #6 why Doug needs to shut it:
I made the video for a few chuckles. For fun. For laughs. Get your head out of your butt Doug and learn to see the funny side of life.

Whew... okay, I know some time has passed since my little exchange with Doug, but I was so pissed when I first saw what he had written that my first draft of this post was pretty much all expletives and creative ways to cause much pain and suffering in his life.

Really, this post doesn't accomplish much but make me feel better. And I do. So now I will wash my hands of this whole "Doug" business and get back to being the best pancreas I know how.

Oh, and Doug? You can suck it... thankyouverymuch.

Saturday, January 15, 2011

I:C Roll Call

Okay D-moms and D-dads... I need to know, what is your child's insulin to carb ratio at dinner time? Over the last 2 weeks, Elise's has been creeping ever upward (or is it downward?).

She used to be 1:20. But we kept experiencing lows, so we tried 1:25. Nope. Then onto 1:30. I was going to try 1:35 tonight, but she was 216 before dinner, so I did 1:33. She STILL went low and needed 10g of carbs to get her into the mid 100s. The lows are happening exactly 1 hour after she's done eating.

We've also had to lower her overnight NPH dose by 1 unit. We've had 3 nights in a row of battling low after low after low and getting no sleep. Each night we'd lower her dose, and we'd still have to feed her up to 25g extra just to get her into the low 100s.

I know, I'm trying to make sense out of the non-sensical. But I guess our next step is to go to 1:40. Is that a normal I:C for a 3 1/2 year old? Is Elise just really sensitive to insulin? Could she still be honeymooning 2 1/2 years later?

I'd love to hear what the I:C ratio for other kiddos are, just to compare.

Friday, January 14, 2011

D-Feast Friday: Italian Sausage and Tortellini Soup


I've said it before and I'll say it again. I love this time of the year and all the soups and stews that the cold weather inspires me to make. I love the smell that permeates the house from a pot full of soup, simmering on the stove top. I love cleaning out all the veggies that are about to head south, out of my crisper. Love, love, love.

Here is one of my favourite recipes... mostly because it uses wine in the broth. Pour some in the broth, pour some in me. Pour some in the broth, pour some in me. Since I'm nursing right now, it all goes into the broth. Boo.

Ingredients:

1 lb. sweet Italian sausage
1 small onion, chopped
4 cloves of garlic, minced or chopped
7 c of beef broth
1 c water
3/4 c red wine
4 large tomatoes, seeded, peeled and chopped OR
1 can of diced tomatoes
1/2 tbsp fresh basil, chopped
1 tsp dried oregano
8 oz. tomato sauce
2-3 carrots, peeled and sliced
1 zucchini, chopped
1 yellow squash, chopped
1 pkg (8 oz) fresh tortellini
3 tbsp. fresh parsley

1. Brown sausage in a large pot. Remove and drain fat, reserving 1 tbsp of drippings.

2. Saute garlic and onion. Stir in broth, water, wine, tomatoes, basil, carrots, oregano, sauce and sausage.

3. Bring to a boil, then reduce heat. Simmer (without lid) for 30-45 minutes.

4. Skim fat from soup (ugh, HATE this part, but SO worth it!)

5. Add zucchini, squash and parsley. Simmer for 30 more minutes.

6. Add pasta in the last 10 minutes.

This soup is so rich and flavourful. The carb factor (without pasta) comes out to about .03. I usually spoon out a bowl of soup without the pasta for Elise, then add the pasta after I weigh it. I think I've figured that the Buitoni tortellini I use have about 2g of carbs each.

This soup is also yummy if you sprinkle some Parmesan cheese on top. Enjoy!



Wednesday, January 12, 2011

What is the sound of one hand clapping?

Elise was in her room, reading.

I was in another room, nursing Mattias.

I checked Elise before I started nursing. 99 and holding steady on the CGM. It's almost dinner time and that's a completely normal number for her at this time.

10 minutes later... "beep, beep, beep", says the dexcom.

"Elise?" I ask. No answer. Crap.

"ELISE?" I bellow. Silence. Crap-on-a-stick.

"ELISE! ELISE! ELISE!" Nothing. CRAP CRAP CRAP.

Off comes a very hungry and protesting Mattias. I put him in his crib and run down the hall to find Elise asleep.

Or is she?

CGM says 90 steady. Meter says 134. Mom says a silent prayer of thanks.

A Dexcom beeping and silence from your child; two of the scariest sounds in the world.

Monday, January 10, 2011

A survival guide to life with D while adding a newborn to the mix

After 4 months of taking care of a 3 year old with diabetes and a newborn, I consider myself to be the wiliest of veterans. And now, I shall bestow that wisdom (such that it is) upon you. Some of what I have written are things that really helped me. Some are sad attempts at humour (see if you can tell which is which!!!). Of course, like all advice, it should be taken with a grain of salt (and shot of tequila), and consider the source; someone who may or may not be suffering from a wee bit o' the crazies.

*************************

So you're going to have a baby! Congrats! Babies are awesome!

What's that? You also have a tiny type 1? Okay, okay... no need to panic. You can do this. You can. I've been doing it for over 4 months now, and I'm still alive and mostly sane. Here's my little guide on how:

Before the baby is born

1. Write up a care manual for the person who will be caring for your child with type 1. Unless you already have family nearby who is well-versed in your child's care, the manual will help set your mind at ease, and give the care-giver the confidence that they will be able to handle any situation that might arise (while also scaring the poop out of them). I have a spiffy 11-page thriller that covers everything from emergency phone numbers, to giving shots. I've also included things like; how to check a BG (in case of brain fart), using the CGM, an explanation of carb factors and some of Elise's favourite foods. If you'd like a copy to help you write your own, just contact me and I'd be happy to email it to you.

2. Make food ahead of time. Like, lots of food. Like, the apocalypse is coming and you need to feed your family for a year, food. There are a ton of great "freezer food" websites out there. I looked up a bunch of recipes, spent a few days making up the dishes (complete with carb counts), and stacked them in my freezer in the garage. Now, if I have a particularly hellish day, I know that at least I don't have to worry about dinner.

3. You'll need to learn how to check BG one handed. Because it will always happen that as soon as you sit down to feed your baby, your other child will need his or her BG checked. To practice this, hold your cat or small dog (or if you don't have one, a sack of potatoes will do) in one arm, while cleaning and poking your child's finger and loading the strip into the meter. Bonus points if you don't get an Er5 on the first try. Extra bonus points if you can learn to give a shot one handed.

4. I swore I never wanted a pacifier baby, but the pacifier has been an invaluable tool in keeping Mattias occupied while tending to Elise's needs. Buy pacifiers. Lots of them.

5. Make a recording of a baby crying. Play it, at full volume, while you're attending to your child with type 1. Try to ignore the feelings of being a bad Mom and the tears that threaten to fall. This will help dull the feelings of guilt when it happens for real.

6. If your insurance covers it and/or you can afford it, get a CGM. This was, without a doubt, one of the best tools we added to our arsenal this year. I'll explain why below.

After the baby is born

1. I'm a logger. And no, not a plaid-wearing, cut-down-trees type of logger. I use logs to record information pertinent to my kids. For Elise, that means carbs, shots, and BGs. For Mattias; poops, pees, eating and sleeping. Use a baby log. Seriously, it helps you to remember when you last fed your baby. Or how much. And you can answer the "how many wet diapers a day" question the pediatrician likes to ask with absolute certainty. Again... I have a great baby log and would be happy to email you a copy if you'd like.

2. This one depends on your personality, but being on a schedule does make life a lot easier. But I loves me a schedule, so don't force it upon yourself if it's not how you roll.

3. When you are going to be doing anything with the baby that might take a bit of time (feeding, bathing etc.), check your child's BG to set your mind at ease. There is nothing like settling down to nurse your starving baby, only to hear your other child say, "I don't feel good" (or whatever the phrase of choice is for a low). This is where a CGM is awesome. I can not only see her BG, but make sure she's not dropping.

4. When you do sit down to nurse/feed, or bathe your baby, make sure you have everything you need within arms reach. This usually means meter, and something for a low. I started carrying smarties in my socks (if I didn't have any pockets).

5. If you don't already have one, start a blog so you can rant about how you are losing your mind. Print out all the wonderful comments the people from the DOC leave and roll around in them. Naked.

Hopefully somebody out there will find this helpful. I wish I had known what to expect before Mattias came along. But I did it. And you can too. Promise.

Friday, January 7, 2011

Pssssst, wanna know my secret?

Okay, this might not be a thrilling secret for you, but it definitely is for me. Last week, I received an email from Allison Blass at Lemonade Life saying that she and Amy Tenderich from Diabetes Mine wanted to know if I was interested in doing a guest post on Diabetes Mine.

Squeeeee!

I mean, uh... sure. You know. Whatever.

(but really SQUEEEEE!)

Anyway, it seems a lot of people like my video, "What NOT to say to the parent of a Type 1 Diabetic", and they asked me to write about how I respond to people that make those hurtful and sometimes strange comments.

And so I did.

Thank you to my wonderful husband and also to Meri for reading and re-reading (and re-reading) my post; pointing out where my verbal diarrhea needed to be *ahem* plugged, and gently reminding me that sometimes writing a post at 3 am while sleep-deprived AND sick can lead you to not making much sense (kinda like right now, I'm afraid).

And a big thank you to Amy and Allison for allowing me another place on the world-wide-web-information-super-highway to insanely ramble on.

The internet... now with even MORE Joanne!

Oh yeah... you can read it by going here.

Wednesday, January 5, 2011

Thank you for being a friend

Why am I quoting the Golden Girls theme song? It could be because Elise has an unnatural fascination with the show she calls, "The Grandmas." And no, I don't actually let her watch it... it's a little "mature" for her age. She just happened to wander into the room when I was watching it while nursing Mattias. I had to turn it off when Dorothy called Blanche a word that sounds like "smut" (just substitute an "l" for the "m").

Every once in awhile, she still asks me if she can watch "The Grandmas". In fact, she just asked me as I was firing up the old blog for this post... and voila, a title was born.

Now, onto my reasons for this post. First and foremost to say thank you for all the lovely comments on my post about not wanting a pump for Elise. To say I was overwhelmed would be a huge understatement.

I was so afraid to hit publish on that baby. Not because I thought you guys would want to storm my house and burn me at the stake for such hearsay, but I honestly thought that not wanting a pump for Elise made me a bad Mom. Or at the very least, a sucky stand-in pancreas.


It did my heart good to read comment after comment of support, stories of MDI-related success, and echos of "same". I loves me some D-O-C!

My second thing is that I'm still struggling with the "to-pump-or-not-to-pump" dilemma. Mostly because Fred and I are planning to take the kids to Portugal sometime this year, and the thought of travelling on NPH makes my stomach cramp a little bit. Granted, we've done 3 airplane trips on the stuff, but this will be the first time our attention will be divided between two kids, and let's not forget that Portugal has a 6 hour time difference.

I also wanted to ask what would be some good questions to go armed to the pump class with. I really wanted to do a lot of research, but haven't been able to devote much time to it due to illness and a sick, clingy baby that has suddenly decided he wants to do nothing but be held and nurse 24/7.

And last... I do have one more secret... but I'm not telling yet. And no, I am NOT pregnant. Do you think I'm freaking insane?

Monday, January 3, 2011

Don't judge me

I have a secret, and I feel the need to tell you. And when I do, I don't want you to judge me. I just need to get it out. Maybe because one day I'll look back and be able to see what an idiot I was. Here goes...

I don't want a pump for my daughter.

Whew... I said it. I feel better now. Maybe you're reading and re-reading the above statement; scratching your head and asking yourself what I've been smoking. Let me explain.

To do that, you might need a little background. Elise was only 12 months old at diagnosis, and we caught it VERY early. She was put on diluted Humalog and diluted Humalin (NPH). She was put on NPH because it is the only long-acting insulin you can dilute. Her daily doses were 2 units of diluted NPH at breakfast (no fast acting), and 1 unit of diluted Humalog at dinner. If you translate that into full strength, her carb ratio at dinner was 1:100. So you can see, she was on a pretty small amount of insulin at first. A pump was never offered as an option, and of course, we didn't know enough to ask.

So 2 1/2 years later, we're still on NPH as a long-acting insulin. I have had people tell me that it is a horrible insulin regimen. That it's archaic. That we're doing a disservice to our daughter. And yet, we're still using it. Why?

Because for us, it works. Elise's last 4 A1C's have been 7.1, 7.1, 6.6, and 7.0. Unless we're dealing with some unholy hell like an illness or growth spurt, her numbers typically range from 90 to about 200 during the day. I know what to expect from NPH. I know how to tweak it. I understand how it works and how to make it work for us. But, it is a very stress-inducing insulin, and there are days when I am so over it that it makes me cry.

And still I say I don't want a pump. So why? Why would I say something so dumb?

Because I don't want everything that comes WITH a pump. I don't want to deal with sites that get ripped out.

Or air bubbles in the tubing.

Or infections.

Or scar tissue.

Or bad sites.

Or a site that bleeds.

Or seeing yet ANOTHER thing attached to my daughter 24/7

Or any of the other problems I've read about that happens when you pump.

For us, trouble shooting a high BG is fairly simple... either her insulin to carb ratio has changed, we messed up on her carb count (something that rarely happens since we weigh everything she eats and use carb factors), or the insulin has gone bad.

Easy.

A pump involves way more trouble-shooting. Something I don't think my brain can deal with right now.

Having said all that... we are taking a pump class this Thursday. And I will go into it with an open mind, and really listen. I know there are a lot of positives about a pump. And maybe in a few months you'll hear ME ranting about how awesome it is.

Stranger things have happened.

Wanna know another secret? I'm not so good with change, and I think out of everything, that's what's bugging me the most.

Saturday, January 1, 2011

Things I learned about Diabetes this month... December edition

-I don't think I will ever be okay with how diabetes stole part of Elise's childhood. The other day I had the TV on and a commercial for Pillsbury cinnamon rolls came on. When Elise saw the cinnamon rolls, she turned to me and asked, "what are those?" When I told her, she asked, "are they good?" My almost 3 1/2 year old doesn't know what a cinnamon roll is. She doesn't even know if they're good. And that makes me sad. It's not that she'll never be able to have one. There are just certain foods I don't want to do battle with at this stage of her life.

-Even after 2 1/2 years, I still do battle with little glimmers of hope that she has magically been cured. The other day, her BG went almost 9 hours steady around 100. This was after breakfast, morning snack, lunch and afternoon snack; there was absolutely NO spike. Then right before dinner she started to creep up. Those 9 hours made me very happy.

-Diabetes has screwed up my sleep cycle something fierce. Even though I am exhausted, I can't go to sleep without the help of my friend Tylenol PM. If I don't take something, I lie in bed for hours, unable to fall asleep. I don't know why. I don't know what changed. All I know is I'm exhausted and I HATE having to take something to help me sleep. Does anybody else have trouble sleeping?

Happy New Year everyone... here's to a great 2011!