Kortnie at the 2011 JDRF Walk to Cure Diabetes, Tempe Town Lake, Tempe, AZ

Thursday, April 25, 2013

How T1 makes me bend my parenting rules

Today has been a crazy D-day. 
First, this morning, my kids woke up late, they were slacking in getting their chores done.  The rabbit was out of its cage.  Normally, before D, I would have insisted that the chores be done and the rabbit be put back in his cage before breakfast.  If you ran out of time to eat before school starts, then too bad, so sad!  You go to school without breakfast.
Well, a T1D kid can't really skip a meal, so I had them all come in and eat and let the rabbit roam the back yard all day.
Then, Kortnie called me from school at 11:25am, "I forgot my lunch".  I was out running errands, I came home and guess what?  No lunch in the fridge.  These kids are supposed to make their lunch for the next day as soon as they get home from school the previous day.  Sigh....  I didn't have time to even think about what I could grab her from home, I was in the middle of errands, I had Graham and 2 daycare kids in the car.  Normally, I would say again "too bad, so sad, you didn't make a lunch last night, you didn't make one this morning, you don't get lunch today"
Again,  a T1D kid can't really skip a meal, I picked her up from the nurses office, and took her over to McD's for a happy meal.
On the way to McD's I told her to check her BG and pre-bolus for her lunch-we were in a hurry, because I wanted her to get the food, get back to school, eat it and have time to run around the playground some.  Midday exercise is important for kids, and even more important I think for a T1D kid.  She opens her test kit, and guess what?  No test strips.  Are you freaking kidding me?  You used the last one this morning at breakfast and didn't get some more!?!!  Normally I would say again, "too bad, so sad, you were not prepared!"

But....NO, we need to check, it's 11:25 and she hasn't checked since 7:30, she needs a check, and she needs to eat.  So I tell her, "check the blue bag" (a bag of D-stuff we keep in the car for times like this)  I had just re-stocked the blue bag for our upcoming road trip.  She got the test strips out, tested, and put the vial of strips in her test kit, and bloused for her meal.  I told her "after school today, you better remember to replace those strips in the blue bag!"  We got her lunch, and I dropped her back off at school with 30 minutes still left of her lunch/recess time.
Around 2:10pm (school is out at 2:20) I get a call from the nurse.  "Kortnie is 58, we gave her a juice, but she says she still feels really shakey, I don't think she should ride her bike home today."  Normally, I would say....no just kidding in this situation when my kid is not feeling good, I would go get them...
Of course she can't walk home!  And, of course, I have one sleeping daycare kid, and Graham and the other daycare kid are playing nice.  Sigh.... I load up all 3 kids in the car, drive the 1/2 mile to pick her up, get there and she's in the office with out her stuff.  I walk her to class, get her stuff and remember that I am supposed to get her friend too.  So I get her friend and we head home. 
I get home and remember that she rode her bike to school and the bike is still at school. 
Oh well!

Fast forward to dinner tonight.  I made lasagna and garlic bread, she loves lasagna, she asked for a big piece.  I got her a big piece, and we bloused for 85 carbs (that is a lot of insulin!)  She was eating her food an said she didn't really like it and asked could she not finish it.  Normally, I would say, "no you asked for it, you eat it, or you don't get anything else!"
I told her to try to eat it.  She picked at it and picked at it for 45 minutes.  The sauce was spicy tonight, I didn't really like it either.  Finally she sighed and told me "I ate all the noodles out of it and finished the bread, can I not finish the sauce parts?" 
I guess so.  I'll just keep a close eye on her blood sugar tonight.
Then she asked me if she could have some chocolate almonds.  Normally I would say "no, you didn't finish dinner, you don't get a treat"  But... I figured the chocolate almonds would help the blood sugar not to drop, as she was 99 when she asked me if she could have them.  So I said yes and she got her treat. 
Dang it, stinkin' Diabetes, you got the best of me today, tomorrow I will get the best of you!

I wrote this last night as I was waiting out the blood sugars. 
At 8pm she was 99, she had the chocolate almonds with no insulin.
At 10pm she was 69 with 1.76 units of insulin in her system, and out like a light.  I got a juice box and coaxed her to sit up and drink it.
"Come on Kortnie, drink, you're low" I put the straw to her lips, she kept batting it away, finally she drank it.  I suspended her basal insulin for 30 minutes. I laid down and set my alarm for 11:15pm.

At 11:15pm she was 150 with  .59 units of insulin on board.  Just right.
I went back to bed and set my alarm for the normal 2:30am.
At 2:30am I apparently turned off my alarm and fell back to sleep.
At 4:29am I woke up having to use the restroom and realized I missed my 2:30am check.  I rushed into her room thinking, "please be breathing, please be breathing", I poked her and she moved.  Phew, thank goodness!  I checked her blood sugar and she was 89-a little lower than I like for sleeping.  I reduced her basal insulin by 40% for 1.5 hours, went potty, and went back to bed. 
At 6:05am my alarm went off to wake up for the day.  I went to the girls room and told them to wake up, they both wiggled around and made some noises, I went back to my room and snuggled up with Brian for a little bit.
At 6:15am my 2nd alarm went off, the girls were up and Graham was in my room snuggling with me.
I finally got up around 6:30am.
At 7am Kortnie's blood sugar was 147-not bad, not bad at all, although I do prefer her to be a bit lower first thing in the morning, but considering the day we had yesterday, I'll take a 147.

Wednesday, April 24, 2013

Aims testing and T1D

Last week Kortnie's school did AIMS testing, these are the Arizona Instrument to Measure Standards testing.  They are apparently a big deal, the schools and school districts get funding based on the children's grades on these tests.  I believe that next year the kids will have to pass these tests in order to advance to the next grade levels.

So, Kortnie's school is pretty pro active in getting parents on board and encouraging us to get them good dinners and breakfasts before testing as well as reminding us that the kids need lots of rest.

Kortnie usually wakes up and has breakfast around 7, school starts at 7:50, so she does have a bit of a post-breakfast spike in blood sugar in the mornings.  Testing was going to start at 8:05am.  I was worried about the blood sugar spike. 

I got her up right on time, but had her eat before she got dressed.  I also prepared breakfast for them.  I don't usually cook every morning, we eat a lot of cereal and oatmeal.  The kids like it, and generally we don't buy the super sugary stuff. 

Also, the kids would be having a snack at school before the test.  This I guess the school does so that kids aren't hungry during testing-sadly there are some kids who don't get breakfast at home in the mornings.  I didn't want Kortnie to be left out, but I wasn't too keen on the snacks they were giving the kids.  Oh, the snacks were just fine, but not really what I wanted for Kortnie.  They had juice and crackers mostly I think. 

We don't have a 504 in place for Kortnie, (we are doing one next year when she moves up to the big kids school) but her teachers and the other school staff have always been open with us and worked around our needs.

Our plan for Kortnie went this way...

-The night before we tried to have good dinners, no carby pasta or pizza that makes her spike throughout the night
-To bed at 8pm, read until 8:15pm and then lights out, I was diligent about her nighttime checks, to make sure she woke up at a good number in the morning
-Wake up at 6:15am,  eat at 6:30am, made them eggs, strawberries, and peanut butter toast one day, and the other day we had egg sandwiches and strawberries, both days they had milk (Vanilla Almond Milk for Kortnie)
-I sent in snacks for her, 3 peanut butter crackers, 1 slim jim, and Healthy Balance Juice. 15 carbs
-I made her a chart to follow on taking BG and snacks
     1. Check BG
     2. If number is over 150, eat snack and bolus for 15 carbs
     3. If number is 105-150, eat snack and bolus 10 carbs
     4. If number is 85-105, eat snack and bolus 7 carbs

     5. If number is lower than 85 or higher than 250 call mom
-I also made sure that the basket we keep in Kortnie's classroom had plenty of low snacks and other supplies, because they technically were not allowed to leave the classroom during the test.  Most of the time Kortnie tests and treats in class, in extreme or stubborn low and highs she goes to the health office, with an escort of course. 
-I clarified with Nurse, Principal, and Teacher that if Kortnie had any extreme lows or highs during testing she would be able to leave the classroom, they were fine with that, but said in lieu of an escort (usually a classmate or teacher), the teacher would have to call the nurse or office staff to come get her. I also clarified that if she needed to use the bathroom then she would be able to.  I did advise Kortnie that she needed to use the bathroom before class and that she should only use her bathroom privileges if she REALLY needed to go.
-Her second sets of testing were in the afternoon after lunch.  I made sure we packed her lunch without excessive carbs and with protein.  I didn't limit her, I just paid better attention to what she was taking and helped her to make good choices.  I told her and the nurse to call me if she was High or Low at lunchtime, like above 250 or lower than 80.  I also told her at recess to run around a little, not to sit on the steps and talk with her friends.  Basically I told her to get her wiggles out, figured that might help the spike.  And then after lunch I had her follow the above plan for snacks before the test. 

Overall, she did really good.  She was responsible (with the help of her wonderful teacher), I never got a phone call about crazy numbers.  She said the tests were easy, but it wasn't any fun to have to sit still and quiet while the other kids finished (they had to sit and read books if they finished early).  I looked thru her meter and her numbers were all good, I can't remember what they were exactly, but I do remember thinking they were good numbers and I wished we could have numbers like that all the time. 

It does go to show that with planning, diligence, good cooking, rest, and hard work from both Kortnie and I we can keep better numbers.  I'm not going to lie though, it was exhausting, the planning, a few extra checks, making sure our "team" was all on the same page.  And luckily Kortnie's body was cooperating and not growing or trying to get sick or anything.  I am all on board with doing the extra work to keep her healthy, but sometimes a kids gotta be a kid and sometimes, a mom has to let them.