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Monday, November 8, 2010

Getting Naked

My beta buddy Reyna started the latest meme with her Naked Pancreas post. Never one to pass up a good meme, I'm getting naked, too! :)

1. What kind of insulin management mode do you use?

Jack is still on MDI, which means multiple daily injections for those who don't speak D.

2. How often do you inject/change pump sites? 

Every day, Jack gets a shot of fast-acting insulin for breakfast, lunch, dinner and snacks in addition to correction doses of insulin used to lower his blood sugar, if it's too high. 

He also gets one shot of fast-acting insulin daily at 7pm.

That's at least 5 shots per day.

3. What type(s) of insulin do you use? 

Humalog (fast-acting) and Lantus (long-acting)

4. What are your basal settings? 

No pump basal settings for Jack since he's on MDI, but his Lantus dose is 10 units.

5. What are your correction factors? 


6. What are your meal ratios? 

Breakfast 1:20
Morning Snack 1:20
Lunch 1:20
Afternoon Snack 1:20
Dinner 1:15

7. What do you do for activity and/or PE?

It all depends on his BG. If he's trending low at school before PE or recess, he may boost with juice, fruit snacks or glucose tabs, depending on how low he's been.

Our school nurse is wonderful. On PE days, she takes into account Jack's pre-lunch BG, his lunch carb count, the type of food he's eating (i.e., pizza vs. turkey sandwich), and whether we've seen any recent BG trends, and she'll adjust his insulin dose, if necessary. She usually calls me, before doing so, and I appreciate the way she defers to my judgment, but I totally trust her judgment. She's *that* good. 

Outside of school, Gregg and I take all factors (BG, foods consumed, trends, particular activity, etc.) into account, and give him some quick-acting carbs of choice, if needed. Last Thursday afternoon, before his tennis lesson, Jack was 95, which would ordinarily be a really nice number. But since he plays hard, running around the court like Roger Federer on speed, I knew he'd crash without a little sugar in his system. Two glucose tabs did the trick.

8. How do you manage pizza, macaroni and cheese, or any other "difficult to manage" foods?

We manage by dropping a number of F bombs. We f-ing hate the way foods like pizza and ice cream wreak havoc on Jack's BG. Lately, we have been dividing his insulin dose and giving him two shots, instead of one, separated by about 1 hour. It seems to be much more effective than giving all of his insulin upfront. 

We also test his blood sugar more often than usual, after he enjoys a slice or a scoop, and then we correct if necessary.

Seems easy, eh? Not so. When he eats those foods at night, we usually have to stay awake... or, ehum, Gregg has to stay awake...until at least 1:30 a.m., stabilizing his sugars.

Last night, we ate Chinese food for dinner, and that freaking fried rice and chicken lo mein screwed with his sugars for hours. HOURS!

Have I mentioned we f-ing hate foods like that? We're at the point where we don't eat them often for dinner. It's just not worth it.

9. How do you prefer to manage your logs/data?

I created an Excel spreadsheet that we use. The spreadsheet has space to log BGs, carbs, ketones and insulin doses. It also includes room for notes. Unless, Jack is ill and starts presenting ketones, or unless he's experiencing wonky numbers and needs new ratios, we usually just track his BG readings.  

If anyone wants a copy of the spread sheet, let me know. I'd be happy to share. It holds a week's worth of data.


Reyna said...

Oh Heidi, you guys are BRAVE. Chinese food? I haven't dared go there in 4 years since Joe was diagnoses LOL. I cannot even imagine managing pizza, etc. with injections. Sounds like you have come up with a good way to help you muddle through. Those hard-to-manage foods during the night are difficult to manage at best.

Thanks for stripping you sweet gal!!! Love you...

shannon said...

LOL @ F bombs! They're dropped all over our house too! :)