Sugar - free cherry limeade excellent low-carb way to cool off on a hot summer afternoon!
Love companies that make nutrition info easy to find online.
And love friends who introduce us to fun diabetes-friendly treats.

Best Laid Plans

In September, my daughter transitions to the middle school. (A sentence which in and of itself causes alarm.)  In June, our previous school nurse was kind enough to facilitate connecting us with the middle school nurse.  We spoke a few times by phone, and at the end of the school year, my daughter and I stopped by for a reassuring visit to the nurse's office and a guided tour of the 5th grade wing of the school.  We learned that the nurse was a former pump trainer, and that there was an older girl in the school with diabetes.  We left feeling comfortable with this nurse's diabetes knowledge and, as a bonus, having enjoyed spending the hour with her.

Therefore, today's letter including the fall schedule and some other details about the 2012-13 school year literally brought tears to my daughter's eyes.  "We're pleased to welcome our new school nurse, Mrs. Not-the-one-you-met-in-june." 

Primarily, of course,  I hope all is well with the original nurse, and wish her well wherever life has taken her.

But oh, how I wish it hadn't taken her anywhere.  Selfishly, I'm upset that the time and energy I spent with her in June is lost.  More importantly, much of my child's comfort about starting this new school came from knowing the nurse understood the whole 'diabetes thing,' and that she could then focus on the rest of the new experiences of middle school.

For all we know, nurse #2 is fantastic.  For all we know, she's a Certified Diabetes Educator, or has gracefully assisted dozens of kids with diabetes through middle school, or is the kindest, smartest person in the world, just waiting to learn all there is to know about type 1 diabetes. 

My daughter's diabetes skills in terms of checking, bolusing, treating lows are good.  Professional support is important, but with the emphasis is on support.  She needs someone she's comfortable sitting with for 5 or 10 minutes after the juice box.  Someone who gets that her greatest wish is to be in and out of the nurse's office in a flash at lunchtime so she can eat with her friends.  Someone who can calmly guide her through troubleshooting a weird high or a pump alarm. Someone who she can confide in if a teacher or student gives her a hard time about diabetes stuff, and who she trusts to handle that information well.

Until my Monday phone calls are returned, though, the new nurse is an unknown.  Pit in the stomach, tears in the eyes unknown.  As with many things diabetes, just when you think you have everything figured out, it's time to start all over again.


It gets us every summer, this swimming thing.  The afternoon goes like this:

Arrive at pool (or if on vacation - beach) around 2.  Immediately disconnect and run into water.

Become hungry around 3:30.  Test, reconnect, snack on crackers and/or fruit.

Disconnect to swim again by 4.

Reconnect between 5 and 6.

What I have learned is that, for my child trying to give the missing basal insulin before-hand can and usually does backfire.  Two thirds of the time, she'll come out low by 3:30.  Deciding this is dangerous anytime, but particularly when waves or water slides are in the picture, we've abandoned that tactic.

We do bolus snack, tacking on any needed correction and just a smidge more to that bolus.

That combination yields an acceptable number by the time she reconnects. 

It's after that when  the whole thing begins to catch up with her.  Unless there's a brisk after-dinner walk or some other unusual evening activity, there's an inevitable high by 9:00.

Yes, a tubeless pump or the 'untethered regimen' could help with this problem, but neither option is on our table at the moment, so we continue our quest for the next best answer.

If only I were a more 'scientific-method' type of thinker.  I'd make some charts and create a well-planned experiment.

In reality, though, using the scientific method requires accounting for all possible variables before you can claim you've proven a hypothesis. I can see us at the pool with a stopwatch, timing the connecting and disconnecting windows. She'd also have to engage in the same types of pool activities each day. Practicing her swimming strokes for an hour is different from repeatedly jumping off the edge. Eating the same dinner every night would get old too. That impromptu after dinner walk could skew a whole day's results.

Instead I hapahazardly try a variety of tactics, figuratively closing my eyes and hoping one of them will work (and that I remember what I did so I can do it again tomorrow).  If I figure it out, I'll be sure to blog about it here so I can refer back to it next summer.