"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".