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4:18am, this morning...

I was enveloped by the warmth entrapped by the bedding, my eyes crusted closed. "Get up...check the time" is what my mind was telling my body. It was prodding, trying to remind the slumbering, resting, not-wanting-to-get-up me to go check on Joe's blood sugar. I had corrected him for a 265 at 2am.

My mind chimed in yet again, "I wonder if I would hear him if he had a seizure?" I tossed. Somehow I then pictured Joe on the ice, during a game. He was seizing in his gear, in the offensive zone. A coach was kneeling by him. I ran out. Immediately the Glucagon was readied and dispensed into one of his deltoids (the easiest place for me to access the padded-up Joe). I then checked a number and yelled for someone to call 911.

I then woke up.

One eye opened, one shut, I stumbled into Joe's room. The glucometer was readied clumsily; test strips dropped, lancet fumbled for as his Delica is easily missed by my tired eyes ... it blends in with the navy blue finish of his chest of dresser drawers. Joe is nestled into his bedding, just as I was in mine minutes prior. I uncovered him just enough to expose a hand. In his sleep, he pulled it from me. He frequently "fights" the night-time checks in his sleep; his body recoils from the disruption of his slumber. The first poke was a no-go. As Joe withdrew his hand, the blood bubble was smeared and subsequently lost. Instead of re-squeezing the finger to form another blood bubble, I go for the sure thing. I poked again. He pulled his hand away. "Buddy, I am just doing a check" was whispered by me in hopes of ending the battle. While he remained sleeping, his hand steadied in cooperation. 5-4-3-2-1. A 104 was obtained. A sugar was dispensed to head off a further drop to a sleeping Joe.

I am now up for the day.

A day-in-the-life of caring for my child with type 1 diabetes during the night.

"Ma ... This is WAY too hard core for an Elementary School Field Trip..." ~ Joe Maher 2/11/2012

The title ... word-for-word ... was muttered by Joe, outta the blue, as we traversed the ice rapidly and efficiently aided by a solid, steady, hefty tail wind. We were keeping our eyes peeled for cracks and fissures that we would need to avoid or carefully cross.

Yesterday I took Joe to skate a large bay of the lake, Lake Champlain.

The skin on my hands was losing it's pliability as it was exposed to check Joe's blood glucose prior to our departure. I checked. Warmed my hands. Tied one of his skates. Warmed my hands. Tied his other skate. Warmed my hands. And then dealt with myself and my skates. Yes, it was that cold. I believe with the windchill the temperatures were bottoming out a bit below zero.

As we skated out to our destination, an island with caves, the snow looked like desert sand blowing under foot. Ice sail boats were gliding effortlessly across the glass-y surface in the distance. Ice shanties and lined fishing holes were dotting the ice. Sheets and chunks of ice had been pushed up as the lake ice had split and cracked and fresh water from below emerged and froze. The scene was a bit surreal. We were "extreme skating" in a sense.

When I packed for our adventure, I felt the nag of the "what if's" plague the periphery of my mind. Not only the normal ones... like what if Joe or I fall in the lake and fucking croak? But the "diabetes what if's". What if I don't have enough sugar? What if the saline solution freezes for the glucagon reconstitution? What if I need help? Nothing scares the BEJEEZUS outta me more than being away from Joe's diabetes supplies and sugar sources. Nothing.

Ice Sail Boat

Cave

Since Joe's diagnosis, I have been determined to never let diabetes interfere with his innate right to be an active child. He should never not do something because he has diabetes. As many of you know, Joe is an active boy and his activity level seems only to accelerate in the winter months. Managing type 1 in the cold can be a mechanical, a logistical and a blood sugar nightmare.

Here are some tips that I have picked up along the way. Trust me, I learned many of them the hard way.

1) UNA-BOOB ~ Glucometers only function at certain temperature ranges. I have had the glucometer not read Joe's blood sugar number due to the cold. It would give me an error message. I have found that tucking the glucometer into the inner breast pocket of my coat keeps the glucometer warm enough so that it may function.

2) HOT HANDS ~ If I want to keep the glucometer in "Woodchuck" (our diabetes care on the go bag... see right hand side-bar under "Joe's Pancreatic Pit Crew"), I house an "activated" Hot Hand hand warmer in a child's sock, and then place it in "Woodchuck" to keep the glucometer warm enough to perform.

3) PUMP-IN-PANTS ~ If your child is a pumper I recommend pulling their snow pants up and over the pump. This keeps the pump warm by using body heat. I have had pumps lose their prime and stop delivery when not adhering to this tip.

4) STRIP WHEN YOU ARE READY! ~ Don't pull the test strip out of the canister until you are ready to roll with the blood sugar check. I also cover the blood receiving end of the strip with a paper towel square (I cut up paper towels for blood wiping and store them in the glucometer case) until the finger is lanced and the blood bubble is ready to be "tested". When I have not done it this way I have gotten some seriously false LOW numbers.

5) As with any activity... CHECK OFTEN ~ I check about every 30 minutes to an hour due to Joe's tendency to drop quickly while participating in winter to his heart's content.

6) MAKING THE LOWS GO ~ Joe runs low while playing in the cold. He has had a "LO" reading on his glucometer while he is running up and careening down sled hills. He has had numbers in the 20s and 30s. When he was three, four and five I would decrease basals by as much as 80% about an hour prior to outdoor activity. Now that he is older, I find that I rarely need basal reductions. I usually feed Joe "free carbs" prior to prolonged outdoor winter activities. I have found for us, the free carb feeding to be the easiest and best way to manage this sort of thing. I usually give Joe 3/4 cup to one full cup of milk prior to heading out to sled or to skate. This seems to hold him for about an hour... then I boost his number as needed with fast acting sugar sources.

7) STARBURSTS BECOME ICE GUM ~ Starbursts are extremely difficult to chew when they become cold. Avoid "gummy" or "chewy" sugar in the cold. We stick with glucose tabs in cold weather, as they are easily chewed. I am sure smarties or any other chalky sugar source will easily succumb to dentition pressure as well.

Figuring these details out did not come over night. It took me M-O-N-T-H-S... and I was frustrated... and I was in that place that we all visit now and again... that "helpless" place that our psyches take us to when we are unable to get a handle on the numbers for prolonged periods of time. Know, you are not alone and in time you will determine what works for you.

Here is an awesome "reliable" source of cold weather diabetes tips from the Children With Diabetes Website.

Do you have any cold weather tips? And p-uh-lease...don't say "Don't eat yellow snow!"

A day-in-the-life of LIVING with "D".

Beef Taco On The Ice

"You are being difficult Mom ..." the line then went dead. (an "ungrateful little troll" may or may not have fleeted my thoughts)

He was done with me. I was of no use to him. Never mind that my ass was in the middle of the Lake Champlain, teetering on skates while the ice was popping and snapping underfoot. There was no way I was looking up the carb count on his beef taco from my Droid. Never mind that he had a perfectly good substitute school nurse with accurate carb counts at her fingertips right there beside him. Never mind that he and I had gone through the whole lunch menu that morning...item for item ... and I then made a computerized printout of his choices, the carb counts, and then even totalled them out and then attached the printout to the daily log I send into school with him. I even tried to expand on the "deliciousness" of the beef taco as he told me he would prefer the turkey sandwich. I described the juicy beef, the crunchy shell, and the added bonus of toppings. I knew he would like the fucking taco.

Ugh.

As a parent of a child with type 1 diabetes, I am married to my phone when Joe is not in my presence. I have been called with blood sugar issues while shopping, while running, while driving, while toileting, while eating, while vomiting, while cleaning up the carnage left in the wake of Oscar's attack on used feminine hygiene products, while... you get the picture ... the calls come at anytime. To date, skating this lake, with the epic views, with a slight breeze on my back, with the sun on my face has been the most surreal place to receive a call from Joe.

A day-in-the-life of fielding calls from my number 1, type 1 Joe ... who, for the record, shoulda listened to my description of the beef taco in the first place.