Sunday, February 12, 2012

"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


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".


Anonymous said...

Love the photo's. It looks like you two had a great time. Love you, Mom

Jessica said...

We just yesterday had our first piece of Starburst ice gum. Not very useful like that, are they?! That looks amazing, and I am so proud of you and Joe for not letting stupid diabetes stop you from doing things like this!

Amy@Diapeepees said...

This is so funny. A guide that only you would use! Who else would want to combat these kind of frigid temps and then go spelunking, except for you and Joe! (And I'm talking regardless of diabetes!) But lo and behold, there will be one person who will need this info, and they will know where to go. So, I thank you on their behalf. And, I loved your paragraph describing your icy setting, very literary...the writer in me admires a scene set well. (And ps, good lemon memory....)

Our Diabetic Warrior said...

Reyna, what all I can say is that you two ROCK! There is nooooo way you could have got me out there in those frigid temps!

I like the paper towel idea. I use eye remover pads.

Sara said...

My tip is that you should just move to Florida with me. I'm sure there is a skating rink around here somewhere :)

FeltFinland said...

Great timing for this post as we prepare for our trip to Lapland on Friday. Here in Finland we regularly encounter temperatures well below freezing and my last words to Aleksi as he leaves the house each day are 'Tuck in your tubing!' Frozen insulin is a real possibility in the thin tubing from the pump so well tucked in it must be. I plan to use his Tallygear tummietote whilst we are skiing under his ski underwear and his ski trousers, the tubing can be nicely tucked under the belt too , to keep warm. The Blood sugar meter live in my undergarment somewhere(!)or in an insulated pack with a warm gel bag that we can carry in a rucksack. Snacks can also be kept in here to avoid breaking teeth on frozen fruit bars or juice box popsicles! Don't forget plenty of spare pump batteries as well, as the cold can drain them in an instant. Try do the blood sugar check in the gondola on the way up the slope, safe to take off the gloves and out of the wind. It is very easy to drop the bottle of strips too with cold hands so take a spare. All this learnt from experience, often the hard way! The skating trip looks such fun, you can't beat skating on real ice(i.e. not an ice rink)

Unknown said...

I just want to say that you totally ROCK and I love the pictures.

I have nothing to offer as I've only ever managed diabetes in the desert!

Kelly said...

Those pics are just so great...I especially love the last fav for sure! These tips will definitely come in handy for us and the many snow adventures we are sure to share.

Anonymous said...

Great tips. Who knew? Those out and about in very cold conditions can now be prepared. The vastness of the lake, the cave.... so beautiful. Sounds like both you and your little guy are extreme athletes. Skating while the ice is breaking around you! Now that's extreme! Hope you both had fun though.

Leighann of D-Mom Blog said...

I just want to go ice skating on Lake Champlain!

I'm usually that way in the warmer months and cross the lake by boat.

sky0138 said...

thank you for sharing the tips!! I have come across a couple of the scenarios before seeing as how we are in Ontario...I am a huge fan of keeping the BG meter in my bra or my armpit as I stand there watching Emma fly about in the Those gloves with the finger flaps are awesome too...make it much easier to get test strips out of container, etc. and your hands aren't freezing as much.

Sarah said...

WOW! I am coming on your adventures they sound so incredible. What a fun thing to get to do together. As for cold weather tips with d...hmmm...TJ seems to think that foods with chocolate are better in cold as help to keep BG up better than just foods with sugar, so if he feels he's dropping and not just low he loves a small "fun size" bag of m&m's or a few snickers.
I have found that I always need to keep two pairs of gloves for me - one for under that have the fingertips cut off to better handle all the BG checking stuff, and the second pair that are warmer with fully functioning fingers :)
Hope the rest of your winter is just as incredible!

Kelly said...

I had a feeling this post was gonna make me feel incredibly pathetic! Im a desert girl, and can hardly function in our winters of 60's.....SERIOUSLY! I dont do cold, BRAVO to you Reyna! When you need some tips for the desert let me know :)

Anna said...

Global warming...:)

Amanda said...

We do the pump in pants and basal reductions/smarties for sledding and just all around playing in the snow too.

I don't have any extra tips for being in the cold, but I do have a tip for hot Arizona summers, when we go fishing and it's hot, say 90 and 100 degree temps, we keep the glucometer/strips/glucagon in a ziplock bag in the cooler. Those strips and glucometers don't work so well in 100+ temps either. We put the insulin in a ziplock bag with it's own icepack in the cooler as well. Sometimes we don't have a fridge in our hotel room, we keep the insulin in a ziplock bag in the ice bucket, ice on bottom, ziplock bag w/insulin on top.

Anonymous said...

Looks like a great time with great ice. I never realized that cold test strips could give a false reading. But then again, we were surprised some years ago to find out that the glucometer did not function in temperatures in the 20's, which really isn't that cold.
I am so enviousof your expedition. I love to skate on natural ice. I can't find any good ice on the NY side of the lake this year--guess I should have shelled out the money for the ferry and headed to Vermont.

Jonah said...

If the meter (or at least, an accu chek aviva meter) won't do anything but display a thermometer sign, take out the battery and warm it up between your hands- that usually does the trick for me

If you just can't test and you're exercising, eat as if you were low anytime you think you might maybe feel low.

I wear swimming trunks with pockets and put the insulin in those pockets when it's subzero out.

I expect to need a deeper setting on the lancing device because of the cold.

Now that I use Dexcom I'm a lot more reluctant to test on my fingers if it's really cold.

Rachael said...

That looks like so much fun! I only have ever gone ice skating, and I split my pants LOL! And really, you shouldn't eat yellow, or black snow!

shannon said...

so loving those pics. also lovin this phrase: "easily succumb to dentition pressure". i mean.

also, thanks for the tip of covering the test strips to avoid false lows from cold temps! rock.