Happy Halloween: Tricks on Me!



Batgirl



Barbie Princess



The Bumblebee

Happy Halloween!  This is just our second year celebrating Halloween with Diabetes.  I have read SO many wonderful posts filled with ideas for successfully managing Halloween and diabetes.  It was great for me to take bits and pieces of each of these posts and develop a plan that I thought would work for us.  I loved reading all the different perspectives so much that I have decided to include the links at the bottom of this post.

After reading the insights of many fellow D Mamas...  this is how we decided to handle Halloween this year.  We let the kids participate in ALL of the Halloween hoopla.  School parties, Costume parade, Bobbing for apples, Cupcake decorating, Candy Corn toss and relay, and TRICK or TREAT, of course!  I believe that there is a limit on the amount of candy that all of my kids should consume...factoring in diabetes or not.  With that being said, I do let my kids have a day or two of overindulging on candy.  Ally is not a very big candy person, really.  After the initial excitement wears off, I am willing to bet that her bowl of candy would sit untouched for weeks.  (Not the same for Jessi...she'd sneak the candy day and night until every single piece was gone.)  So, we planned to let the kids pick out a few pieces of candy each day that they may enjoy....covering the carbs for Ally's with insulin, of course.  I think that if I took their candy away right off the bat they would be heartbroken.  Plus, it's kind of like when you are on a diet...You tell yourself that you can't have something, then you tend to crave it even more.  After a few days, the rest of the candy will just "disappear" and something special will take its place in the candy bowl.  (Right now, I'm thinking something simple like new fancy chapstick, fingernail polish, etc.)  I liked some of the suggestions that I read to keep the candy that could be stashed away for treating lows...however, as I mentioned before, Ally is not a big candy eater and she would rather eat a glucose tablet than a piece of candy.

I was prepared!  I hoped that I would be able to ward off the crazy HIGHS following large amounts of overindulgent candy binging!! 

But let's Face the Facts....

Halloween = Candy + Excitement = Sugar High for sure!

BUT the TRICK was on ME!  Ally was LOW.  Low.  low.  ALL.NIGHT.LONG!  What I had not expected was that Ally's soccer team would end their season in the top of their league.  They advanced to a tournament, which was played this Halloween weekend.  After playing two soccer games and trick-or-treating fun on Saturday, it didn't matter how much candy Ally consumed.  I didn't even bolus for it!  Keith and I tag-teamed and checked her every other hour....she was low every single time.  Juice after juice (because this is the easiest way for us to treat the nighttime lows - Ally can drink a whole juice box in her sleep without waking up) we kept getting a low reading.  Finally we decided to add a pudding to the mix and that seemed to sustain her until morning. 

So, with so many ideas and lots of thought, our Halloween with the big D didn't turn out at all as we'd planned.  Wonder what we'll try next year!

 

A Pluthera of Perspectives on Halloween and Diabetes....for future reference:   (Let me know if I missed your Halloween post, I'd love to include it!)

Candy Hearts

D-Tales

The Superhero and The Princess
Our Diabetic Life
I Am Your Pancreas
The We CARA Lot Blog
Houston We Have A Problem
The Princess and The Pump
Welcome To Our Crazy, Happy Life
D-Mom Blog

Bare Naked Pancreas

My humorous friend Reyna, from BetaBuddies, started the whole gettin' "Naked with your Pancreas" thing!  So here I go...Bare-ing it all for you!  (No, not THAT!  Ally's pump settings...)

1. What kind of insulin management mode do you use?
Ally pumps insulin 24/7 using the Purple Medtronic MiniMed Revel.

2. How often do you inject/change pump sites?
We change Ally's pump site every 3rd day.  We recently switched to the new Mio infusion sets and really like them.

3. What type (s) of insulin do you use?
Novolog.

4. What are your basal settings?
Wow, Reyna needs to teach me how to do that!  She has 7 different basal settings for Joe....impressive pancreatic work my friend!!

Ally, on the other hand, only has 2 different basal settings.  (I still have so much to learn and this is an area where I really get nervous...so the endo always helps me set these numbers.)

12AM: 0.35 units/h
8 PM: 0.40 units/h


5. What are your correction factors ?

12am - 6am it is 1:230
6am - 12am it is 1: 140

6. What are your meal ratios?
I have heard others say this too...Ally is more insulin resistant with breakfast than the rest of the day.

Breakfast 1:20
Rest of the Day 1:25

7. What do you do for activity and/or PE?
At this point, we do not make any changes for PE at school.  It's hard because one day may be a very light activity and another day very strenuous.  Ally keeps her insulin pump on for PE and so far it does not seem to bother her...wearing her Tummietote by Tallygear, of course!  She also goes to the clinic and checks her BG and has snack shortly before PE, so I know that she is not going into the acitivity low.  She also checks her BG at the end of the day (which is right after PE) before getting on the bus, so again I feel comfortable that she is not low after this activity.

Ally is also a swimmer and a soccer player (and is going to try basketball this winter).  We take her insulin pump off for all of these sports.  This is another area where I feel like I don't have it all figured out yet.  (Ok, let's be honest...there isn't really much about diabetes that I can say, "Yep, got that figured out!")  What works for Ally seems totally different from what I hear other people do for activity.  See, Ally tends to run high after exercise.  Immediately after anyway.  HOURS later she drops.  I mean like 12 hours later!  So, sometimes I pre-bolus for her basal before these activities...and sometimes (even though I KNOW she won't go low during exercise -she never does!) I still worry about her going low, so I don't pre-bolus for the basal and just correct the high after.  Some other "naked truths" in this area have given me the idea that possibly I should set a temp basal a few hours AFTER her exercise.  Although, I'm still trying to figure out the timing of that since it is usually so many hours after.

8. How do you manage Pizza, Macaroni and Cheese, or any other "difficult to manage" foods?
Oh those wonderfully, awful foods!!  I'll take Halloween candy over those foods anytime.  Our MiniMed pump has a really cool "Dual Wave" feature...which I am learning to use.  Sounds like the "combo" that I hear some of you talk about.  You can do a % of bolus upfront and stretch the remaing % out over an amount of time that you choose.  It has taken a little bit of trial and error...and we still don't have it right!  I also think that what works or one child may not necessarily work for another, so even when I get ideas from other wonderful D-Mamas, I have to make changes to fit Ally's needs.

9. How do you prefer to manage your logs/data?
We download Ally's pump and CGM to the CareLink online program.  It is great!  I can look at all kinds of reports...and the best part, my endo staff can log on and see all my data if I need help making changes.  However, I do still keep a simple log because I only download every 2 weeks.  I need to see it on a daily basis to help me make decisions about activity and carbing or bolusing!

Ok, I took Reyna's challenge and exposed myself "as a naked pancreas" to the whole D-OC.

Who else wants to play?

D Takes a Back Seat

For possibly the first time EVER (well, since 2.10.09 anyway), Diabetes took a back seat last night.

Lexi has had strep throat, but has been on an antibiotic for 3 days and I thought she was getting better. 

Ally's soccer team made the tournament, so they had an extra practice scheduled last night. 

We were rushing around in our usual..."get off the bus at 4, check BG, hurry up and do homework, eat dinner, put soccer clothes on and get to practice by 6" mode.  Lexi was really cranky, I felt her and thought boy she feels really warm.  Fever is 103*!!!  How did that happen?  She had seemed fine all day.

In the midst of this chaos, Jessi somehow fell and landed on her arm.  She is a tough cookie, who takes plenty of spills.  So, when she was complaining that it really hurt and her arm was just hanging there, I figured we'd better go have it checked out.

You see where this is going?  My younger 2 girls, the non-D ones, were on the forefront of my mind...which is completely out of the ordinary.  Ally is usually my first thought, at all times.

So, Keith and I traded off at the soccer field.  He had taken Ally to practice.  I arrived, traded him for Jessi, and stayed at the soccer field with Ally (and a cranky Lexi in tow) for the second half of her practice.  He left for Urgent Care.  I was worrying about Lexi's fever and trying to get her to drink something...anything!  And I was worried about Jessi...she's usually so tough, but was really hurting :(

Soccer practice ended, Ally came off the field.  First thing I always say is, "Let's get your pump back on." (We take it off for soccer.)  I realized that Keith had brought her to practice and left in a hurry with Jessi.  "Where is your diabetes bag?" (Which holds all the usual - blood glucose meter, juice, etc etc...oh yeah, and right now HER INSULIN PUMP!) 



She says "Daddy has it."  I panic....WHAT?!!?  Now, it's bad enough when we forget her diabetes bag and are temporarily without her meter or fast acting carb, but her pump...that thing that keeps her alive????  We jumped in the car and I started calling Keith's cell phone and texting him.  No answer.  I decided to guess which Urgent Care he had taken Jessi to and drive there to retrieve the goods.  As I pulled out of the park, my phone started ringing.  "Keith!  You have her pump!"  He told me to calm down (that's a usual comment that he makes to me :)  Then he said that the diabetes bag was sitting on the bleachers at the soccer field.  Oh my goodness!  We turned around and made our way back to the field.  And yes, almost in the dark, we were able to retrieve the pump.  (I decided not to lecture him about leaving a $6000 life-saving bag unattended on the bleachers!)  All ended well.

**(Ok, I'm updating this since I forgot to tell you what happened with Jessi's arm.  Jessi has had Nursemaid Elbow before, and they say that once it happens it can happen again more easily.  Basically it's when your elbow pops out of place...not fun and very painful!  The doctor popped it back into place and did xrays to make sure there were no fractures.  After a little motrin and a really big brownie she is doing just fine.  As a side note...if you read about Nursemaid Elbow, it implies that this is caused by a parent yanking on a child's arm.  Both times we have taken her in for this they make you feel like a big loser!  But the reality is that she fell BOTH times that this happened!)

Jessi assures me that she will be able to hold her trick or treat pumpkin with no problem!

And on another note....I am so proud of my friend Hallie for taking the Driver's Seat and advocating for Type 1 Awareness last night.  To read about her speaking engagement at the Lion's Club, visit The Princess and The Pump!  Her words are very moving.