Confidence

The following happened yesterday afternoon, after school. The interaction took place between Joe and one of his oldest and dearest friends. Children, and adults for that matter, can say things out of anger and frustration.


The snow was falling, heavy and wet. Joe was playing with a group of friends in the distance. I approached with Woodchuck. After school lows have been a frequent companion lately. A quick check confirmed it. 68. A juice was spiked and dispensed. Joe knocked it back.

I then gently probed him about a disagreement that he had just had with his friend.

"He was being mean to me mom. I told him that if he kept acting like that he would not have any friends. THEN. He said to me that if I still had diabetes when I was an adult I would not have any friends."

I wasn't really interested in the "he said-he said" business of the incident. There was only one thing I wanted to be sure of...

Before I walked off to leave him with his pals, I casually asked ... not wanting to make a big deal of the situation ... "Joe, you know that is not true?... right? ... diabetes will not make people not like you."

In an authentic, upbeat voice, Joe said "Of course not mom. Diabetes makes me even cooler. I'll always have friends."

I walked away. My heart was light.

A day-in-the-life of confidence despite diabetes, perhaps ... dare I say it? ... enhanced by it.

The "Double Low"

"I feeel soooooooo terrrrrrrrrrrible."

I could tell he was low by the way the "e's", the "o's", and the "r's" were drawn out and by the tone and pitch of his voice. It was 1:28am. Joe was stumbling into my room and climbing on top of me as I woke to his entrance. I released myself from the heap of Joe and hurried to his room to grab the glucometer.

He was moaning, saying it was a "bad one".

He was 50. The low was treated. Afterwards, Joe did not want to leave my bed. "My body won't work". I offered to carry him back to his bed, but the thought of that made him just groan and roll-over. He was on my side of the bed. I retreated to the guest room. Another alarm was set for 2am. Another alarm was set to ensure his blood sugar was in a safe range.

When he woke the following morning...

"That was a bad one mom; not a normal low. I don't get them often. But when I do ... I feel like I am a 20-something. That was what I call a double low."

I questioned, "A double low?"

"Yep, that is what I call those. I have only had a couple, but they are the really terrible, awful ones."

A day-in-the-life of understanding diabetes through my son's perspective.

"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 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".