Monday, August 22, 2011

The Beach

I love going to the beach, and so does my daughter.  Floating on the waves, picking up shells, building sand castles, playing with hermit crabs, and taking long walks are among our favorite beach activities. 

Our constant traveling companion, diabetes, is not as fond of the beach.

We try to leave the pump plugged in as much as possible, when walking or digging in the sand for example, but there are long periods of being unplugged in the water.  The pump we have is waterproof, but given a choice, I choose not to put a multi-thousand dollar piece of electronic equipment in the ocean.  We try to compensate as possible with quick bursts of insulin to make up for the missed basal.  But it doesn't work quite the same, and there are often exercise-induced lows after these boluses and/or insulin deprivation highs which appear later in the evening.

None of our diabetes supplies like the beach.  Insulin becomes less effective when it gets hot.  Keeping the pump covered and the tubing enclosed is the best defense but sometimes sand castle building becomes a higher priority and we forget.  We've had the meter cease to function because it got too hot (which begs the question why they put them in black cases).  A few minutes in the cooler and it was back to normal, but even the temporary lack of information was a bit nerve-wracking.  The afternoon I spent picking sand out of our old pump grain by grain after my daughter had buried herself in a hole while wearing it was a long one. 

Nevertheless, we take diabetes with us wherever we go.  If it doesn't like the beach, tough luck.  It's not always easy, but it's much more important to dig the toes (and some days even the pump) into the sand.  If only we could set diabetes off on a nice sail into the sunset while we were there.

Friday, August 19, 2011

The Vacation Mystery

After several years of taking our annual beach vacation with diabetes in tow, I still haven't solved the mystery.

The first time we brought diabetes on vacation with us, I made a decision which I've stuck to in all subsequent years.  Before we left home, I decided the diabetes goal for vacation was to stay close enough in range to be able to enjoy the trip. Each year, I take a solemn  vow that 3 numbers in a row above 200 won't aggravate me like they did this morning, and that we'll be flexible about food.  There's no such thing as a complete vacation from diabetes.  But with some willpower, I'm able to step back from the obsessive nit-picking which I firmly believe makes diabetes management successful on a day-to-day basis.

Then, each year without fail, the most amazing thing happens.  Strings of numbers appear which are really quite good!  Actually, they're often stunning.  Like an essentially uncountable fried seafood plate for lunch with a 150 an hour and a half later.  'All that fat will surely catch up to her ,' I thought(unobsessively, of course).  She never got above 200.  She eats ice cream, pizza, clam chowder (creamy, buttery, potatoey New England, of course), and even candy!  She unplugs her pump for an hour or two at a time to swim in the ocean.  And rarely does it catch up with her like it does after every birthday party, restaurant meal, pool visit, and ice cream outing at home.

So, my fellow diabetes detectives, what is the difference?  My money's on exercise as the primary one.  We walk, swim, visit playgrounds, shop our way through town, make up silly games before dinner, and tour new places.  Looking carefully at the whole picture, though, there are other things going on.  There's absolutely no stress on this vacation.  Stress can result in high blood sugar, and even at 9, there's stress of schoolwork, friendships, sports, and more which can come into play at home.  I also find that in a new environment, and when we're trying new foods, I count carbs more carefully than I sometimes do at home.  I have my Calorie King book handy in the car to look up restaurant foods.  I measure the new variety of rice pilaf I've prepared and count it exactly instead of my relying on my memory. 

Whatever the reasons, the lesson to be learned is clearly that vacations are really, really good for my daughter and that we should defninitely be spending more time enjoying them!

Tuesday, August 2, 2011

Packing

Summer includes a couple of annual trips for our family.  They're simple road trips compared to our international adventure last year.  But there's really nothing simple about traveling with diabetes.

When I stop to think logically about the 250 test strips I've packed for a 14 day trip, I have a hard time envisioning a situation in which we'd consistently need 17 test strips every day for 2 weeks. 

I can't remember the last time we had a glucometer die, yet I've packed 3 "just in case."

While the most it could take is 3 days for the pump company to ship us a new one in case of failure, I've got enough syringes to last a week.

Theoretically, we'd plan on 5 site changes during the trip.  We're prepared for 12.


Contact info for our endocrinologist,  pediatrician, pump company and pharmacy are plugged into my cell phone.  But I also know where the closest branch of our home pharmacy and the local hospital are.  I have printouts of all of our current basal rates, and ratios.

My daughter is just hoping there's still room in the car for her beach toys and her trusty stuffed rabbit!