The Ramp

"Joe, pull Dexter outta your pouch and eat your bunnies!"

I wonder if I sounded a bit "nerdy" to the teenage boarders and skaters and bikers? Joe took his bike, his Rollerblades, and his skateboard to our local Skate Park yesterday. He consumed about 45 grams of free-carbs just to keep his blood glucose in the 70s and 80s.

The ramps and jumps are a bit intimidating at this particular park. Joe flirts with them a bit as he rides and rolls over the lower portion of the ramps. He is slowly creeping higher and higher up the inclines. His confidence wanes when he is on ramps that are over 5 feet. He rides and skates up them without hesitation. It is the going down that seems to make him stop and take pause.

I was encouraged by his reserved caution, as I looked up and watched him struggle with going down a rather high ramp while he sat at the peak perched on his bike. I could see the desire, the want, of conquering the fear of going down. The internal pull of his fear was visible. The older boys were encouraging to him. I stood back and watched the conflict conveyed through his eyes, his face, and his body. After many minutes, Joe decided he wasn't ready. He slid down the ramp while supporting his bike. He did not seem disappointed in himself. He simply stated "I am just not ready for that ramp".

Which brings me to my post...

A staff member from the Tim Thomas Hockey Camp called me yesterday afternoon. The connection was static-y, which in part, added to my feeling of isolation as I tried briefly to explain Joe's situation with camp, Type 1, lows, exercise.

I started out with a "thank you" for calling me back...blah, blah, blah..."My son Joe is in your camp next week in Vermont ... blah" ... "He has Type 1 Diabetes...insulin pump...blah...blah...blahbitty"... "Do you have a trainer that travels with your staff?"

Static-y...wind-ily...connected staff member responds with "well we do have someone that is CPR certified."

*ugh*

How do I even go into anything about anything with this guy over the phone?

I found out that they divide up the campers by age and ability. The groups will consist of about 15 kids. A coach will be assigned to stay with the group throughout the day as the campers go through different stations. They will be on the ice for 3 hours and then they will be off the ice for 3 hours for outside play, hockey videos, lunch...etc. Joe's schedule will not be known to me until I drop him off Monday morning.

Upon conclusion of the phone call, the pleasant staff member did say that I could give Joe's coach my cell phone number when I drop Joe off on Monday. I almost choked on my spittle at that point, thinking "you bet your bippy he is gonna have my cell phone number and a crash course on lows."

Explaining to the general public that a low blood sugar is something that must be dealt with immediately is complicated. It is difficult to convey that Joe may become a bit "off", confused, or be totally "normal" with a dropping glucose level. The lows can come on suddenly and they must be tended to...and Joe may not be in his right mind to help himself in this situation as the only fuel source for brain cells is glucose. The lows are one thing. Then add in what must go into eating: the blood sugar check, the carb counting, the bolusing, the "he must eat everything" ... and ... the compensation of insulin doses for activity, well, it is too much to communicate in an abbreviated manner for a week long camp.

I am looking down the "ramp" much like Joe was yesterday.

Am I ready?

Here is what I have come up with:

• Joe and I talked about a basal reduction for the day of 35% (I said 30%, he said 40%, and then he compromised with 35% ~ fine).

• I tweaked the Play Date Cheat Sheet for camp, keeping it simple...1 page.


• I will briefly go over the Camp Day Cheat Sheet and emphasize the importance of treating a low blood sugar with Joe's coach. I will have my cell phone number highlighted at the bottom of the Cheat Sheet.


• I will have Joe carry Woodchuck everywhere with him. It houses his glucometer and sugar sources.


• I am going to only partially bolus for breakfast. My biggest concern is Joe skating with breakfast IOB circulating. He will drop over a 100 points in 30 minutes with breakfast IOB lurking in his system. I can always correct a high before I leave him if need be.


• I will pack separate bags for snacks and lunch. Each bag will contain a carb count to make it simple for Joe to bolus.


• Buying TracFone today or tomorrow so that Joe can "practice" calling me over the weekend.


• I think I will go in every hour or hour and a half on the first day and go from there.

I wanna make it down the ramp. I wanna have the courage to push off and go. However, I think I may need to slide down the "ramp" on my butt.

A day-in-the-life of a glimpse of what it takes to send Type 1 to camp or anywhere really. It takes courage.

"Rodent-like" MacGyver-ing

Sometimes, in this life, I feel the rules don't apply to me. Like the Rule of 15's... sometimes I tweak that a bit. Or, like a month ago ... when I was going 32mph in a 25mph zone and I got pulled over by the Fuzz, I immediately asked the officer for a reason as to why I was being detained. He gave me a little guff and then let me know. I was internally eye-rolling my Lancome fringed eyeballs and internally muttering a "For goodness Sake isn't there like a 10mph grace-speed with the whole speeding thing?".
Well...

Yesterday...

I found out why, the hard way, you are supposed to use that little plug-cap that is enclosed with the box of Animas Insets. Now, don't get me wrong. I did, at one time, use them. I used them for every bath. I "plugged Joe off" for every dip in the pool or the lake. I did...years ago. Truly, I did.

When you are dealing with diabetes and the non-stop routine and management you start to cut corners a bit. Or... *ahemm*... at least I do. I count carbs down to the gram, I pop sites into Joe as sterile-y as possible, I mother bird like a pro... but apparently I cannot be bothered with this cap-thingy. Frankly, I haven't used it in years. We have never had an issue due to my plugging exclusion. No infections. No clogs. No anything. It was a corner I was fine with cutting in the grand scheme of things.

So...

Back to the story...

We are vacationing. We are visiting Cape Cod.

Yesterday was the first time Bridget and Joe have ever played on an ocean beach. There was digging. There was castle making. There was crab saving. There was a pump~site~clogged~with~beach~sand. And. Once again, managing Type 1 in Joe's life provided us with adventure and the ability to effortless-ly entertain any on-lookers ... and trust me...there were a few.

Here is how it went down:

Joe emerged from making "low~tide~crab~sanctuaries" for a blood sugar check. 5~4~3~2~1. A 156 was obtained. He wanted to munch on a few potato chips. Fine. I am not a carb~tight~wad, as many of you know. I figured I would let him have a few chips for "free", but would plug him in and crank in a couple of hours of basal before he went back to wave-jumping and crab-saving. I go to plug in the pump tubing to his site. I line it up and start to insert it...it falls short of the "click". I flip it around...try to cram it in again...no "click".

The Removed Site (note the tan color in the set)

The pump insertion site was filled with sand. Joe calls for a site change and exposed his cheek. Dave was my assistant. I needed one. Slapping in a site in the middle of a wind-swept, sandy beach requires some mad pancreating skillz. IV 3000s were blowing in the breeze...IV Prep was precariously placed on a towel ... We used the old cartridge. It still held about 36 units of insulin. And, we used the old tubing too to avoid the whole unloading, re-loading, and priming steps that the pump would require.

Once the site was in and 2 hours of basal were given, I looked in Woodchuck #2 to see if we had a plug. I did have a plug, but it was for the Contact-Detach system. It didn't fit the Inset. Dave then MacGyvered the system by using the connector off of the new set. He went all "rodent~like" and chewed off the tubing. We then plugged the new site with the connector and covered the whole set~up with the IV 3000.

The Chewed-Off Tubing MacGyvered Plug

It worked like a charm.

A day-in-the-life of realizing the rules are there for a reason... sometimes.

That Is NOT On My Playdate Cheat Sheet...

What sending Type 1 on a Play Date looks like:

A few days ago...

The water mushroom and the blaring music were a concern.

I lounged on my chair by the pool. The cell phone was poised on the arm of the chair. My eyes scanned it regularly for any sign of a call, a message, a notification. I was with Bridget and her friend. Joe was at his friend Adie's house. The phone is a constant companion during Joe's absence. I have trust and faith in Joe and in Nikki, Adie's mother. They may need me though.

The green notification light started blinking.

My right hand refreshed the phone. Damn. I missed the call. It was them.

I call them. The peripheral background noise makes the call difficult to interpret. Nikki let's me know that Joe was 63. I think that is what she said. I repeat into the phone staccato-like "six" "three". She confirmed. Something about sugar or Starbursts was mentioned. I ask in a loud cave-woman-y voice "He.took.sugar!?" Again, at least I can hear the "yes" that is delivered in response. Nikki goes onto say something about Joe wanting a snack and he was mumbling something at her like "combo bolus". Well.... Ok then. This isn't on my Play Date Cheat Sheet.

Joe gets on the phone.

The lisp-y, the nasal-y, and the soft spoken-y really isn't working for me here. The noise of the water 'shroom splashing and the Pop Rock spewing from the speakers is too much. I heard "snack" and "combo". I interpreted the issue as "Joe, are you wanting to eat now? ... are you calling because you don't want to wait the 15 minutes to recheck your blood sugar? ... and you want to do a combo bolus to cover the snack?"

I heard a "yes", with the emphasis on the slightly drawn out "s" that we all know and love in the lisp.

Fine.

I understood.

I tell him to do a 0%:100% extended over 30 minutes (this is NOT intended as medical advice). I tell him not to enter in his BG, assuming he will correct with the 12 grams of carbs he just consumed for the low. I can pick out an "OK" from his end. Then, abruptly, the call is ended. He hung up, ready to man his pump with the instruction given I assume.

Bridget comes at me from the snack bar. She is shaking two Tootsie Pops like they are maracas to the beat of the music with confidence and sass. I continue to scan my phone.

A text came in... "Don't worry... we r all good!"

I responded with ..."I know he is in good hands!"

A couple of hours later, when Joe is back with me, he checks his number. A 108 graces the glucometer screen.

A day-in-the-life of critical thinking as he expands his independence.

Click here for my original post on "Play Dates".