Sugar Surfing Into Summer

We live in a small Midwestern town, where it’s a winter’s winter about five months out of the year. In deep winter, the temperature (not the windchill, the actual temperature) can reach -24 Fahrenheit. In mid-March, just when the snow, salt, and ice threaten to become a forever feature, there’s a little less gray and the icicles drip away. In the next month, the snow melts, tulips emerge, and the town’s most popular ice cream joint opens for the season. There’s always a line of people and taillights, celebrating a baseball game or summer evening.

Having type 1 diabetes does not prohibit what people can eat. People with T1D can eat anything; however, many people choose to limit or eliminate certain foods simply because it makes blood sugars potentially easier to manage. Right now, we don’t eliminate food, but eat a little bit everything in moderation. When we get an ice cream, it’s a celebration.

Recently, we’ve discovered the power of pre-bolusing and are starting to practice some of Dr. Ponder’s Sugar Surfing advice. It can be nerve-racking to pre-bolus a large amount of insulin for a restaurant meal or special treat, particularly when there’s little control over when the carbs will arrive. Matt is a lot better about waiting out the downward slide than me. I nervously check and recheck the CGM.

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on our way back from the local ice cream joint

But then the sugar starts to kick in— the rise is more gradual and less extreme. The insulin action time better matches the carbs. We’ve figured out if we give enough insulin to cover for 30 carbs that by the time we’re through the line, with a strawberry ice cream baby cone in hand, that his blood sugar usually evens out to about 145 half an hour later. I’ll take a rolling line after ice cream any summer night.

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Hello, summer. 

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“I Can Spell to 100”

I didn’t have time to be nostalgic about my youngest kid participating in Kindergarten Round Up, (a preview of elementary school for preschoolers entering Kindergarten next fall). Instead, there was a flurry of emails to the school administration, nurse, and staff. There were meetings, apps were downloaded, and then the morning of Kindergarten Round Up rolled around.

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It’s hard to bolus for emotions.

Just a quick glance at Henry’s face shows how excited he was, and a quick look at his blood glucose on his Dexcom CGM (continuos glucose monitor) shows how anxious he was to attend the same school as his big sister.

Adrenaline is a hormone that’s secreted during stress, and it raises the blood sugar. We’re learning that many things raise or lower blood glucose: a growth spurt, illness, puberty, exercise, emotions, a unicorn jumping over a blue moon after a black cat crosses its path, and just because.

Days before we walked through the school doors, I knew it would be another vacillating moment of living with diabetes: a challenge to preserve the typical experience, while ensuring safety and health. And it was. Henry’s first introduction to school was meeting with administration and the nurse, listening to us talk about his blood sugar. But he’s heard us talk about his blood sugar so much that it’s old news, no news. But Kindergarten, that’s new news. He was bouncing, happily telling everyone, “I can spell to 100.”

And he can spell (and count) to 100. If a blood glucose of 300 is any indication, this kid is excited to go to Kindergarten.

Preschool Graduation: All the Feels

The preschool our son attends is wonderful. His primary teachers have Dexcom Share on their phones, and we usually text several times a day about carbs or insulin dosing. Here’s a text we got a few days ago.

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Yes, his teacher picked out a dried blueberry, raisin, cherry, craisin, and part of an apricot, weighed them, took a picture, sent a text, waited for an answer, and delivered insulin to our kid. In a preschool classroom. This is to say nothing of the Bakery Unit they had last month, which was also handled with care and attention.

This morning, Henry graduated from preschool. I have all the normal parent feelings of time passing too quickly, pride, and fear as my child grows bigger into a much bigger world. But, I also have caregiver-parent feelings, which are messier, more full of fear and dread. I try not to let those caregiver-parent feelings invade these happy milestone moments, like leaving preschool and starting kindergarten. However, milestone moments are inherently reflective. So, the thoughts of my son’s short, but complicated history, coupled with a future inextricably linked to a chronic disease, sometimes share space with joy. If I’m not saying this clearly, Pixar did: think of Sadness and Joy from Inside Out.

He’s five and has lived a life of more medical intervention than me, and most other people my age. His medical history (not all related to diabetes) is a long list of specialists: pediatric neurologist, neonatologist, ENT, immunologist, pediatric endocrinologist, infectious disease specialist, E.R. physicians, multiple anesthesiologists, and several primary care physicians. I stood beside his isolette in the NICU for weeks after his birth and climbed into five separate hospital beds with him over the past five years, and I know I’ll need to be prepared to climb in again. 

I’ve seen my son, and he’s seen me, in really scary basins and valleys, so we’ve learned the value of looking at something else: a tenacious mountain goat climbing a rock face, a cool cat handing a diploma to a kid who is going to rock kindergarten.

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Henry with his preschool teachers, a preschool diploma, and TC!