Wednesday, August 9, 2017

Diabetes -- Decisions and Consequences of

It's been almost 2 1/2 years since the girls were diagnosed with Type 1 Diabetes.

Living and dealing with this chronic disease has become our new way of life.  Our new way of thinking.

Not a day goes by - not even an hour most days - that we aren't thinking about T1D in one way or another.

Checking blood sugars; counting carbohydrates; calculating insulin ratios; monitoring continuous glucose meters throughout the day and night; changing pump sites; pokes to insert the CGM; making decisions on basal rates based on illness, exercise, and moods; all this and more, fills our days.

As parents of a child or in our case children with type 1 diabetes, it falls on our shoulders to make decisions.

Simple ones......

Not so simple ones.

As we make such decisions we're thinking about their blood sugars RIGHT NOW; what they'll be in a couple hours; how certain foods and activities may impact those blood sugars; what long term effects the blood glucose levels we are seeing will have on them.

It's a lot to deal with day in and day out.

Physically and emotionally.

One such decision is how to handle the desire for snacks and the pangs of hunger when blood sugars are already high.

My general rule has been.... if BG is high, limit carbs and focus on protein.  Or... alternatively, give a correction, drink water, and wait a time before snacks are given.

It made sense to me.

Carbs raise blood sugar....  If blood sugars are already high, more carbs would be a bad thing.  Right?

Just recently I caught little Miss Selah trying to 'sneak' a bit of frosting from a brownie cake I had made for our 4H meeting.
Decorating cakes - knowing she can't just
'lick her fingers' as she goes along.

Not such a big deal.  A normal behavior for a kid.  What kid (or adult) doesn't like to 'nab a little frosting' as they walk by the cake plate?  I know my older kids do it when cake is in the house.  I myself will seize a bit of frosting or a crumb of cake as I pass the island where the cake is sitting.

In the average child it would be...... NO. BIGGIE!

However, for Selah or Trinity..... it could quickly become a VERY. BIG. DEAL!

If she eats -- especially straight sugar like that -- without taking insulin (particularly if her blood glucose levels are already elevated) it could become quite serious, quite fast.

What to do?

We don't limit carbs - even treats - for this very reason.

Adding a border - drooling a bit over
the frosting she can't just 'taste' as she goes.
Yes, our girls with type 1 diabetes eat cake, ice cream, candy, even the occasional slushy -- just like every other kid.  We just have to dose the appropriate amount of insulin -- which can be a lot -- and monitor their overall blood glucose levels after the fact.  (Granted, this is not the 'norm' for their diet.  As with all our children, we try to limit the treats to keep a healthy balance.)

We didn't want to get into a situation where the girls felt their disease was a punishment and hence push them toward 'sneaking' food to get that which they felt they were missing out.

Yet, here we are.

That simple decision I had made to limit carbs during snack time based on blood glucose levels was back firing.

It's made me revisit what our approach should be.  It's also caused in depth discussions regarding the importance of ALWAYS dosing for ANY food.  Conversations were had about how sometimes none of us are allowed to have the 'treats'; healthy food is always better.  I also acknowledged how it's got to be difficult for an 8 yr old to see her 9 yr old sister partake in carb heavy foods while she's stuck having a slice of turkey or cheese.  Such practices may also need to be altered - one way or the other. Maybe differently on different days.  Some days everyone has carbs, other times everyone has protein.

I know she needs to realize this is her life.  It may not be fair; it may be hard; yet... this is the lot she's been given.

However, I watched as she fought the tears that were threatening to well up in her eyes.

She just wants to be a kid.

She just wants to be able to eat a little frosting without all the fuss.

She just wants crackers instead of cheese or nuts.

I wish it were so.  I wish I could take it all away.

So, as we round the corner of the third year living with type 1 diabetes - I'd like to write that it's gotten so much easier; we have our routines and life is 'normal', but.....


I don't think living with type 1 diabetes will ever truly be EASY.

..... or NORMAL for that matter.  At least not in the sense of what most consider 'normal', what most live as 'normal'.

What's normal about having to poke your finger to check blood sugar levels before you even think of putting any morsel of food in your mouth?

What's easy about having to have a 2 inch needle injected into your body every three days to insert a new canula just so the life saving insulin can be administered EVERY time you eat?  Or jabbing yourself with a syringe ANY time you choose to ingest a food that converts to glucose in the body. Plus the additional times if you misjudge how many carbs were in the last meal you ate and your blood sugar continues to rise despite the insulin you've taken to combat that scenario.

What's typical about being awakened in the middle of the night to drink a Capri Sun juice box because your blood sugar is plummeting and you're in danger of having a seizure due to too much insulin for whatever reason or your body reacting to said insulin more quickly or effectively that other times.

What's fair regarding having to think about whether or not a snack of crackers is ok or if it will spike your blood sugar too high so you should really opt for the less coveted piece of cheese, deli meat, or handful of nuts?

No, it's not any easier today than it was 2 1/2 years ago, but... it is less raw.  It's not typical compared to what the average family goes through each day, but it is our new way of life.  It's not something we  would have chosen, yet it's not something we can ignore or neglect either.... hence,we do what needs to be done.

Day after day.  Hour upon hour.  Minute by minute.

Plus...... we know how strong our girls are and we know they WILL persevere; thrive; live full and active lives.

Finished product from Showcase Showdown team cake decorating competition.

Even through the tears and unfairness of it all.

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