Tuesday, May 25, 2010

Finally a pump update!

So here I sit on the couch at 3:45 am while the rest of the house is asleep.  Why?  Because diabetes is keeping me up.  It has been two weeks since Taylar started using the OmniPod (is that all?) and things have definitely been interesting.  Overall her numbers during the day have been pretty good.  Actually, no, they've been great. There have been occasional lows which I don't like and am not really used to though.  We've handled them he best we could and I'm convinced the change in weather has a lot to do with it.

The first week was a bit overwhelming learning all there is to know about the pump but by now we pretty much have it down. (Except for extended bolusing which I'm very anxious to use especially for when we eat pizza.  But I won't get into that now because "Taylar vs Pizza" could be a blog all it's own!)  Of course the biggest benefit is not drawing up syringes or dialing up insulin pens.  I hardly use the sharps container anymore which has been a good thing.

So part of this whole thing has been checking Taylar overnight at 12am and 3am.  Oh yes, that has been a blast, let me tell you.  I've tried handling it in different ways.  Staying up until 12 to test, trying to sleep before getting up at midnight, attempting a nap during the day.  Honestly, it doesn't matter how I do it because in the end it leaves me T I R E D!  And, like tonight, sometimes it leaves me A W A K E!  Just can't win sometimes I guess.

Before dinner last night we changed her pod site to her back.  She never put it there before so I was a little nervous that it might hurt.  But like usual, Taylar took a few deep breaths and moved on. 

For these two weeks we have been adjusting the basal rate set for 8pm - 12am to bring down her midnight highs.  And we're talking 272, 365, 488, and 255 just to name a few numbers from this week.  Lovely, huh?  It started out at .3 basal rate.  Up to .35, up to .40.  It doesn't really matter what we changed it to, she's still high at that time.  Talk about frustration!  Yesterday I called our nurse educator (yet again) and left a message saying I assume I should up it to .45.  She called me back laughing saying, "Hey, you don't need me anymore."  (Yeah right!)  So tonight .45 it is.  That sounded like a lot, it should do the trick.  Right after changing the pod I made the basal rate change for the night. Blood sugar check was 120 before bed.  Her target!  Ooh, happy Momma! 

So bedtime....I went through the whole bedtime routine and Taylar started complaining that the site hurts.  Mind you we just changed it 3 1/2 hours prior.  She tried laying in different positions but she really seemed uncomfortable.  After about 30 minutes of trying to convince her that it was fine (because yah, I would know how it feels right? Not!) we changed the site.  This was a first.  It was a new pod and it was now 8:30 (She's usually asleep by 8pm) and Taylar needs her beauty sleep.  (I'll just leave out the part that I had planned on grabbing my iPod and going for a nice long walk by myself after she was in bed. Note to self: Never plan something for yourself because chances are it probably won't actually happen.)  Let the frustration kick in here.  Ugh!  The site looked fine but obviously it didn't feel very good, poor kid.  We did what we had to do and by 9pm she was back in bed and sound asleep.  I pouted as I folded laundry and then had some ice cream with praline sprinkles.  (Hmm, probably not the best decision but my emotional eating could be yet another blog all on its own!)

Midnight check at the new, increased again, basal rate was... 273.  Waahhhh!?!  I gave a correction and rechecked at 3am...201.  What the?

So THAT is why I'm sitting here in front of the computer while everyone else is sleeping.  The diabetes monster is having its way with me and won't get out of my head.  I'll call our nurse educator in the morning to see what in the world we should do again.  ::sigh::

Oh my goodness, it's 4:30am and I hear birds chirping outside!  Maybe I should try and go back to sleep now.  My hubby leaves for work in an hour and my youngest, Carissa will be up about an hour after that though.  Maybe I should just stay up.........Actually, maybe I should grab the iPod afterall and take that walk.  But sshhhh, don't tell anyone!

Friday, May 21, 2010

Foodie Friday - Mini Microwave Triple Chocolate Cake

Who doesn’t like chocolate cake? It is an involved process to make a chocolate cake from scratch including all that yummy frosting, however, which happens to be a good thing in a house with a child who has diabetes. This certainly isn’t like my Mom’s birthday cakes but it serves a purpose for dulling the urge for chocolate cake. On occasion the girls make these mini microwave triple chocolate cakes all by themselves for dessert. This recipe comes from my Hungry Girl cookbook which I love. All of her recipes are so different and include nutrition facts which is a plus. Here’s the recipe for one individual microwave cake but put out two ramekins and measure the ingredients for two!

Mini Microwave Triple Chocolate Cake:
Per cake w/ topping: 27g carbs


2T cool whip free, thawed

1T Hershey’s Lite chocolate syrup, divided

2T devil’s food cake mix

1T vanilla yogurt

For the topping, stir together Cool Whip and half of the chocolate syrup. Put this in the freezer for firm up a bit while you make the cake.

In a very small microwave-safe dish (like a ramekin), combine cake mix and yogurt. Stir until smooth and blended. It doesn’t seem like much but it will puff up as it cooks!

Microwave for 1 minute. Allow to cool for 3 minutes.

Remove chocolatey whipped topping from freezer and spoon over your cake. Drizzle with the remaining chocolate syrup on top. Enjoy!

Monday, May 17, 2010

Better late than never.... If There Was a Cure...

I have had quite a week.  Taylar has been on the pump for 6 days now and the tiredness and newness is taking a toll on me.  I had every intention of taking part in the daily diabetes blog, but I just couldn't keep up.  I had a good cry yesterday, pulled myself up off the floor, put it behind me and feel a bit better today.  Eventhough blog week is over, I have to participate in the "if there was a cure" day.

I would no longer pray for a cure, but instead praise God that one was found!

I would sleep soundly at night and not become stressed if Taylar slept in a bit in the morning.

I wouldn't hate myself for leaving small bruises on Taylar's arms and buttocks from giving her injections.

I would re-gain a kitchen cabinet that right now it stocked wtih diabetes supplies.

I wouldn't withhold or force food based on what blood sugar numbers are on the meter.

In fact, I would throw away our meters, lancets, lancing devices, test strips for glucose and ketones, control solution, pods, insulin, alcohol wipes, pens, glucose tabs, glucagon, syringes, and anything else I missed.

I would erase the phone number to Children's Hospital from my memory.

I would not panic if I left the house during the day and left my cell phone on the counter by mistake.

I would drop Taylar off at her friends' houses or at their birthday parties without having to give explanations or just staying myself.

I would let Taylar swim, jump, run, and dance for twelve hours straight if she wanted to and not once stop her to do a test or drink juice.

I would not hear another child ask, "Hey, what's that thing?" in reference to Taylar's new pump.

I would not cry as often as I sometimes do.

I would not miss filling out paperwork for school and activities that include a heatlh history.  It would be like it used to be....blank.

I would enjoy cooking and baking again because I wouldn't have to worry about the carb counts of foods. 

I would never look up food in Calorie King anymore!

I would take the kids out for hot fudge sundaes and only leave the house with my wallet.  No supplies.

I would be overjoyed and thankful.

Friday, May 14, 2010

Let's get moving. Exercise.

Okay, so I missed a couple of days...but hopefully I'm back and will have time to participate the rest of the week!

How do we get moving?  Well, we are a family that likes to be outside so weather permitting, after school the girls are outside.  Now that Taylar rides her bike well  and spring has sprung, we go for bikes rides very often together.  We usually go for about two miles.  I have a bike bag attached to my bike so I always keep some glucose tabs in there.  I also try to remember to grab Taylar's monitor, my cell phone, and a water bottle too.  We have never run into a problem blood sugar wise when we've gone on a bike ride but it's good to be prepared.

Swimming!  Taylar is a fish and loves to swim!  I can barely talk to her when she's in the water because she is constantly underwater doing flips and handstands.  My parents live a mile away and have a pool that we visit very often in the summertime.  In addition my in-laws have a place on a lake that we visit on weekends in the summer as well.  I have never been successful telling Taylar to take a break from the water at the lake so I'm interested as to how this summer is going to go.  I plan on stocking up on some gatorade or something!

It's not exactly "pool weather" here in New Hampshire yet but since August every time Taylar has gone swimming at a hotel or at the local Boys and Girls Club she has gone low.  I just recently figured out how to handle it though.  The solution was simple really.  At first I would have Taylar do a blood sugar test and have a snack before she swims.  This wasn't enough because her swimming is so strenuous.  In addition to testing and having a snack I bring a juice box along and have her sip away at it every 15 minutes or so.  Since adding the juice she has not gone low when swimming.  I do, however, watch her blood sugar for a few hours afterwards though because sometimes she is a victim of the lag effect.

On her own Taylar is always dancing and performing for us!  I would have to say that dancing is the most consistent form of exercise she gets.  We are always summoned to her room to watch her latest routine to some great NickJonas music!  She has been taking dance for 5 years and the girl is only 8!  It is her first love and great exercise!

Whether you walk, bike, dance or swim, it doesn't matter.  Just get out there and move!

Tuesday, May 11, 2010

Making the Low Go

Day2: Making the low go

How we treated two recent lows Taylar had:
Last night's meter reading: 64... at midnight.  Ugh!  Too much jumping on the new trampoline so close to bedtime.  BUT I'm so glad I followed my instinct and checked her at that time.

I urged her to drink 2 oz. juice and eat a 2 oz. chunk of banana spread with peanut butter to make it last a little longer.  I rechecked at 2am and she was 146.  Zzzzz.


Meter reading: 45 after school yesterday.  (I have no idea where this came from but I instantly went into stress mode.)  Taylar had 2 watermelon flavored glucose tabs (which happens to be her new found favorite flavor) and a small spoonful of frosting left over from her birthday cake. (Score!)  After waiting 20 minutes her reading was 96.  Not high enough to go to dance class for an hour so she had a graham cracker with peanut butter.  We eat the sticky, yummy, nutty stuff a lot in this house.  She was 117 after dance/before dinner so we managed this low okay.  She was wiped out though after dance and after having such a low, low, poor thing.

Monday, May 10, 2010

Topic 1: A day in the life....with diabetes

 - Wake up around 7:15am and do blood sugar test

 - Use sliding scale to figure out Novolog dose per Taylar's "set in stone" 50-55 grams of carbs breakfast; 2 units.  Mix, by syringe, along with 12 units of NPH and give her a shot.

 - Because we are on a saline trial for the OmniPod, Taylar and I then work together to give a saline bolus to cover her breakfast.


- 8am - Eat said breakfast consisting of a set amount of carbs using our digital kitchen scale to weigh and measure.  Get dressed, brush hair...all that other good stuff while I...

 - Make Taylar's lunch for school consisting of yet another "set in stone" 45-50 grams of carbs.  And, because of the pump trial, write down a big "50" on a slip of paper and put it in her lunch box so the school nurse will know how much of a saline bolus she'll get at lunch.  Otherwise, she usually does not get a shot at lunch because the morning NPH covers it.  However, if I go over the set 45-50 carbs at lunch it makes her sky high because the NPH can't handle it.  Oh yah, throw a morning snack in her bag also.

 - Attempt to make the bus before it drives by and ask Taylar to re-check her bag for the PDM and remind her to go right inside and give it to the nurse when she gets off the bus.  I also remind her to see the nurse at her morning snack time.

 - 10:30 Taylar has her snack with the rest of the class at morning recess. BUT before she goes outside she sees the nurse for another saline bolus per the carbs on her packaged snack.

 - 12:00 Taylar goes to lunch but leaves five minutes before her class to check in with the nurse.  She does a bg test and bolus covering her 45 g carbs is delivered with the PDM (that we remembered to pack! Yay!) 

 - Meanwhile, at home, I wait for the phone to ring between 12:00 and 12:15 for a "she's high" or "she's low" phone call.

 - At 2:00 Taylar grabs a snack from her afternoon snack stash and eats it in class because her morning NPH is about to peak and I don't want her to be low at 3:00 when she gets off the bus. She's the only one having a snack at this time. (She doesn't go down for a bolus this week because once we start the OmniPod for real this 2:00 snack will go away.)

 - 3:15 off the bus.  Check Taylar's backpack for the PDM!  Do homework and play outside (hopefully) and then she'll bug me for a snack around 4:00.  Because dinner is a whole hour away I have her test.  Depending on what it is she may have something small to hold her over until dinner is ready.

 - 5:00 is dinner time. Do a bg test and dose Novolog pen depending on how many carbs she is going to eat, usually around 55.  She usually gives herself the injections with the pen, so I just watch.

 - Grab the PDM and deliver a fake bolus based on her food.

 - 7:00 is bedtime snack time.  Do bg test and give her 14-18g carbs and shot of 4 units of NPH to cover her at night.

There's a lot of eating going on every 2 hours!  It's very difficult living by the carb count and by the clock but months ago we figured this is what worked best because we are fairly "routine" household.  (Don't ask me what her numbers look like on most weekends though!) 

Tomorrow will be our first day using the OmniPod with insulin and not saline!  I can't wait for Taylar to have more freedom to eat when she's hungry instead of because the clock tells her to.  I also can't wait until she has a 70 carb lunch!  Oh the horror! :)  

Friday, May 7, 2010

Foodie Friday - Creamy Carrot Salad

Well, here's my second recipe, just in time for the warmer spring weather.  I made this salad the other day just by going through my fridge and seeing what I had.  You may have all the ingredients on hand too so measure everything together, stir it all together, chill it, and serve.  It's that easy!

Creamy Carrot Salad
Makes 8 servings
4C grated carrots
1 small can crushed pineapple, drained
1/2C mayonnaise
1/2C raisins
1 tsp. sugar
1-1 1/2C cool whip
1/2C shredded coconut (optional)

Combine all ingredients and chill for about two hours before serving.  
Serving size: 1/2C
20g carbohydrates each

If you omit the coconut the carbs drop to about 17 carbs.

Wednesday, May 5, 2010

Four days in

Well, it has been four days since starting the saline trial on the pump.  Let's see.... one day I forgot to send the PDM remote to school and one day Taylar forgot to see the nurse at snack time for a bolus.  All things considered, not too bad!  I now have a sticky note on the front door to remind us on our way out to meet the bus in the morning to pack the PDM.  For tomorrow I actually put a small sticky note on her morning snack too that says, "Remember to see the nurse!".  Hey, anything to help us with this new schedule, right?  We're so far into the school year that changing what we've always done has been a bit tricky.  And on top of all the pump issues, we had to adjust Taylar's insulin because she had been running in the 200s for three days in a row.  Like we needed that.  I called our diabetes nurse educator though, who we LOVE and I think is a genius, and just like that...bam.. "normal" numbers and no more 200s.  Thank you!

We've also done two site changes since Saturday and they have gone well.  Taylar likes to use baby oil to peel the pod off and I like it because it will help keep her skin smooth and soft.  She has not shown any irritation which is great.  We were with some of my husband's family tonight to celebrate Taylar's birthday which is this Sunday, and she chose to do the site change in front of them so they could see how it works.  I was pretty proud of her.  We all were actually.  The anticipation of the cannula inserting is getting a little bit easier and I assume will get even better with time. 

Overall I can see how using the OmniPod (or any pump I'm sure) is going to make life a little bit easier.  Dare I say I feel like it will give us a little more freedom?  We have been on such a strict schedule since last August that I forget what freedom feels like.  I also feel the pod is a good choice for Taylar personally where it just attaches to her body.  She tends to always have busy fingers so not having external tubing is helpful in that.  It also fits her activity level and withstands how many times a day she changes her clothes! Ha, ha!

Saturday, May 1, 2010

Hooked up

What a day!  We waited all day for the OmniPod representative to come to our house for our 2:30 appointment.  I don't think I stopped praying all day.  The morning went by okay and we were able to distract ourselves but the afternoon was tough.  Taylar started asking questions and seemed to be getting nervous but also excited at the same time about the pump.  Me? I couldn't think of anything else all day and never even ate lunch.  Of course I didn't realize this until 4:30!  Not that missing a meal would hurt me much, but still.  This is such a big step and we are only 9 months into this whole diabetes thing, so it's all very overwhelming.

The girl who met with us was named Megan and she was very nice.  She is a podder herself which made Taylar happy.  There is such an instant connection when she meets other people with diabetes.  Her smile says it all.  It's the "Hey, I'm not alone in this" smile.  My parents joined us for the training as well.  My Mom is 100% on board with learning as much as she can.  She's the one I volunteer with and attend JDRF meetings with.  She would do anything for Taylar...or Carissa, or me & Eric for that matter!  I have the best Mom in the world.  My Dad was able to help with Carissa which was nice because of course, as if on schedule, she woke up from her nap at precisely 2:31...right after Megan arrived. Ugh!

Megan walked us through the PDM remote's nitty gritty settings and how to set basal rates and deliver boluses.  Taylar showed a lot of interest in it but then hid on the couch as we were getting to the last menu to review.  She knew it was time to put the pod on.  This was the hardest part of the day for all of us.  She ran from the couch to her sister's bedroom to avoid the inevitable of being "stuck".  My husband Eric went in to get her telling her she can do it and it will be fine, etc.  Then came the tears.  There's nothing like seeing your kid cry because they're afraid.  It was totally the fear of the unknown, and nerves even though all of us (except Carissa) wore a demo pod (with the cannula inserted) at a previous appointment in Boston.

She half-heartedly peeled the backing off the pod and stuck it on her abdomen while sniffling and clutching onto Rufus, her JDRF bear, as tight as she could.  There were a few more whimpers out of fear and a few more tears while we used the remote to activate the pod.  The anticipation of waiting for the stick was the worst and at that moment seeing Taylar's face I just wanted to take it all away.  It was killing me. 

When we finally heard the click of the cannula being inserted and told Taylar it was all done she calmed down very quickly.  What a trooper!  At this point I looked at my Mom and she was white as a sheet.  I don't think she was breathing through this whole process!  Moments later after reassuring us that she was in deed okay, Taylar put her sandals on and went outside to play in the yard.  That's it.  All done.  She was fine.  She was fine. 

My parents stayed over for a while afterwards and we all got to get some much needed fresh air in the yard on this beautiful 70 degree spring day.  Mom and I kept talking about how hard it was to see Taylar upset but then as we saw her racing Carissa to the swings, shooting hoops with her Grampy, playing catch, and making mud pies in the sandbox we knew everything would be just fine.  GOD is in control.  He always has been and always will be.