The NPH Days or Why We Got A Pump
After her diagnosis with diabetes, my daughter was on injections of NPH and Humalog insulins. NPH, combined with a small child who didn’t want to eat, was disastrous. For those of you who’ve never had the pleasure, NPH is a long-lasting insulin which peaks. I can still remember the endocrinologist and educator drawing the curves for us, showing the action of NPH and reinforcing for us the importance of sticking to our “meal plan.” Humalog was given with the NPH at breakfast and dinner to cover those meals, but the NPH covered a morning snack, lunch, and afternoon snack. Whether my daughter wanted them or not.
I could probably count on one hand the days between the ages of 14 months and 18 months when my child (who’s subsequently been known to sneak lobster off of my plate) actually wanted lunch. That was when her independent spirit surfaced, and she decided to she’d manifest it at lunchtime. Every day.
I spent the first two months of 2003 trying, religiously, to stick to the “meal plan” sent home with us by our medical team. Starch, protein, fruit, milk. Every day at 1 p.m. There was screaming and crying. Yelling and throwing of stuff. Sometimes she would throw stuff and I would cry. Sometimes we’d trade.
It was reminiscent of Green Eggs and Ham, without the happy ending. Would she eat it in her chair? Would she eat it over there? Would she eat it if I sing? No…she won’t eat ANYthing. We’d inevitably end up sitting on the kitchen floor, covered in yogurt or peanut butter, in an exhausted stalemate. And then there was a low blood sugar at 2 p.m., for which I’d have to squirt cake decorating gel into her mouth because she’d refuse to drink juice.
By the time month 3 of this circus rolled around, I was coming to my senses (or desperate in my insanity) and began to ask questions of the medical team. “I understand what I’m supposed to be feeding her at 1 p.m, but is there a plan B?” The answer was, of course, yes. We should try for the ideal balanced meal, the carbs combined with protein for steady bg, the healthy fruit and milk. But the carbs, of course, were the most crucial.
And so it was that our kitchen cabinets began to resemble those of Jerry Seinfeld. Because the one meal my daughter would always eat was dry cereal and a little fruit. With a wide variety of healthy cereals all to her liking, we stocked up and relaxed a bit. I’d still offer her a pb&j, or a piece of string cheese, but learned that she survived without them.
The moral of this story is that there’s a learning curve to diabetes. When I think back, I wonder how I went so long assuming that I HAD to feed her these things and accept the psychological damage to both of us. But upon further reflection, I realize it was really the first of many “aha” moments we’ve had since then…getting her an insulin pump, writing up a 504 plan for school, tucking a roll of glucose tabs in the pocket of every coat I could possibly leave the house in. Why didn’t we think of it earlier? At least we firgured it out eventually.