Murky


My twitter feed has been weird for the past couple of weeks.

I use Twitter to follow diabetes-related accounts and current events.

The tweets from the news accounts and politicians are usually easily distinguishable from those from diabetes organizations and bloggers. 'Earthquake rocks Italy' and 'Mayor jailed' fall into an obviously different bucket from 'Drowsy from a 3 juicebox night' and 'Just passed the 30 minute mark on hold with insurance co.'

I now have to take a closer look. Was the tweet about the cost of insulin a Bernie Sanders quote or was it from the American Diabetes Association? Will the link to the article on repealing the affordable care act take me to the New York Times or to a Blogger site? Is the anxious political tweet from a political commentator or from a person with diabetes afraid of losing her health insurance ?

It's getting very murky.

Just Another Morning


6:15     Teen crawls out of bed later than is ideal. Finds nondairy yogurt, granola, berries.

6:18      Checks blood sugar. Programs breakfast bolus.

6:19      Discovers pump's insulin cartridge is almost empty after bolus. Implores mother to fill
             a new one.

6:20      Mother inhales cheerios, chugs coffee, gets dressed, packs lunch.

6:40      Mother listens to stream of consciousness commentary on teen's outfit, hair, and tonight's
             potential homework while filling an insulin cartridge and priming the pump.

6:59      Teen is delivered to school.

7:26      Text: 'I forgot Dexi.'

7:27      Text: 'Unless you put it in my bag?'

7:45      Mother (belatedly) texts back:  'Nope. It's here on the kitchen counter.'

7:47      Text: 'Oh well.'

7:55      Text: 'You wouldn't drop it off for me would you?'

7:56      Mother takes deep breath and decides that, yes, she would (and should) drop it off.

7:57      Text: 'I'll drop it off by 8:15.'

8:13      Mother arrives at school. Mother who is usually happy that school is secured as tightly as
             Fort Knox is not happy today. Mother is buzzed into vestibule with table on which to leave
             forgotten items for kids to pick up. Mother is uncomfortably holding Dexcom thinking, 'I'm
             not so sure about leaving this here' a when kind secretary appears behind large (bulletproof?)
             window in vestibule.

8:15      Mother says, 'Hi. This is a medical device- I'm not sure I want to just leave it here. My
             daughter knows it's coming and will pick it up between periods.'

8:16      Kind secretary says, 'Here- let me take it. I'll give it to the nurse.' Secretary jimmies open
             a pass-through slot like one might find at a shady check-cashing joint, and takes Dexi.

8:17      Mother thanks secretary and leaves.

8:18      Text: 'Gave Dexi to secretary who will give to the nurse.'

8:50      Text: 'Ok I will go grab it now.'

9:29      Proof arrives, in form of blaring cell phone alarm, that teen is in possession of Dexcom: 

 
9:42     Text: 'I'm low so I'm not playing gym.'
 
And so on and so forth...
 



Muffin Chronicles Part 4: Applesauce Theme Week Edition




 




Applesauce Mini Muffins

Since too much applesauce is never enough, here's the latest batch of muffins for the lunchbox:

1 c. whole wheat flour
3/4 c. white flour
1 tsp. baking soda
1/2 tsp. salt
1 tsp. cinnamon
1/4 tsp. nutmeg
(you could also add 1/4 tsp. clove if you like it but we don't)

1/2 c. shortening or softened butter
1/2 c. sugar
1 egg

1 c. applesauce

Mix flour, soda, salt and spices in a small bowl or in a glass measuring cup with spout. If you use a spouted measuring cup (which makes a later step easier) it's still best to measure your flour first with a standard measure for dry ingredients (you know- a metal or plastic one that'll let you level the flour off across the top). Set this mixture aside.

In a large bowl, cream the shortening and then add the sugar gradually until the mixture is light and fluffy. Then add the egg.


The shortening/sugar/egg mixture will look like this.
Also of note, these single-serve applesauce packs are
1/2 cup each which is convenient.





















Add the dry ingredients, alternating with the applesauce, to the bowl containing the shortening mixture. Stir between each addition. I usually add about a quarter of each at a time. This is the part my daughter has always loved to help with!



 


How much dough? I just used a teaspoon from my silverware drawer-
one heaping spoonful per muffin cup.



Spoon into mini-muffin tins and bake at 350° for about 18 minutes until a toothpick inserted in the center comes out clean. I made 33 mini muffins for about 8.5 g. each.


The recipe is adapted from my husband's Nana's applesauce cake recipe. To adapt it back for a great dessert, use all white flour and a full cup of sugar. Bake it in a standard sized loaf pan for an hour (which sounds like it would be too long but trust me, it isn't).

We love this recipe because - yum - but also because we almost always have the ingredients we need for them in the pantry.
 
Hope you'll enjoy it too.



Gym Win


Out of all the anticipated diabetes challenges of high school, gym has been the biggest thus far.

Marching band's 14 hour days, including an outdoor week in the August heat? We handled it.

New nurse? She's great.

An intense and stressful academic schedule? Intense and stressful, but managed.

Gym? A disaster since day one.

I wrote about it in the fall. Gym is always in the morning but that's where the predictability ends.

Gym class happens three out of every four days. At 8 or 9 or 10 a.m. Some days are 'fitness days' with sprinting or other heavy cardio. Some days they play volleyball which my kid enjoys playing at a moderate pace. Some days feature floor hockey, during which the senior boys apparently dominate the puck and give nobody else a chance to play. Some days gym is preempted by 'peer leadership,' which can involve either active or sedentary group bonding activities. All we can be certain of is that the whole thing is totally unpredictable. Therefore, adjusting basal rates didn't help. And changing the breakfast bolus was useless. Our next best hope was this:


Squeezy Applesauce!
Toddler applesauce has greatly reduced trips to the high school nurse's office. It's fifteen carbs provide slightly more nutritional value than a straight juice box. It's easier to consume while changing into one's gym clothes than a clementine or a handful of grapes. It's even sort-of fun? And, most importantly, it's working.

She makes the decision whether to consume a pouch before gym based on three factors: what her blood sugar currently is (usually based on the Dexcom, inclusive of arrows), what the day's anticipated activity is, and what time it is (she's more likely to drop fast if there's still a bunch of breakfast insulin on board). There are occasional problems, like when an anticipated floor hockey day becomes an unannounced outdoor running day due to good weather, or when she's had an unusual breakfast and the 'insulin on board' factor is harder to predict. But overall, this tactic is (thus far...knock on wood...fingers crossed) a winner.

Also a plus? We won't be running out of squeezy-sauce anytime soon due to today's 5/$9 sale at the grocery store. She's not sure about the new 'applegrape' flavor, but if you're sucking it down in three gulps, how much does flavor really matter?






Advocacy


I've shared with you my first New Years plan: spending more time with my fellow 'diabetes people.'  The second plan is much less fun, but in my opinion, unavoidable. I plan to spend more time advocating for people with diabetes. Phone calls, emails, tweets and more appear to be a necessary evil for the coming year.

I started today, thanking my representatives who support the parts of the Affordable Care Act which are important to me, and contacting some who do not. The ACA is not a perfect law, but eliminating it without a reasoned replacement would be a setback not just for people with diabetes but for those with all kinds of chronic and expensive diagnoses. Repeal of the ACA will not only impact people who've been able to buy insurance because of it, but also the greater majority of us with employer-sponsored insurance who've seen new benefits and protections through the law. This article explains those parts of the law in greater detail, including coverage regardless of preexisting conditions, coverage for preventative care and the elimination of annual and lifetime maximums.

My daughter is at the age where she's considering career choices. The existence of protections for her as someone with a pre-existing condition and who has high annual healthcare costs is important to us. We'd rather she not have to choose a career, and a job within that career, based primarily on whether she can obtain quality health insurance and be assured that her coverage will never lapse.

Are you concerned too? Here's an easy way to get in touch with your representatives:

http://diabetespac.org/

I'm certain this is only the beginning of my advocacy this year. At the rate insurance companies and prescription benefit managers are picking and choosing what's covered, it's likely I'll be in touch with them. We're fortunate to be in a great school district, but small conversations still need to be had from time to time.  Other political issues may arise locally or nationally which I feel require my voice- not just for my own child's benefit but for that of the whole diabetes community and beyond.

Diabetes People

We were very fortunate to find a parent support group shortly after my daughter's diabetes diagnosis. People in that group were also involved with the local JDRF chapter and I got involved there too. Once we got our heads above water with the help and support of both of those organizations I found myself able to turn around and help others. I encouraged the next round of newly-diagnosed families at the support group meetings. I got involved in planning and running a local JDRF walk. In the three years after diagnosis, personal contact with other 'diabetes people' was a big part of my life.

Then, because of a lay-off and a subsequent job opportunity, we moved back to the area where I grew up. We continued to participate in JDRF walks, and I did help with walks at the elementary school, but my contact with our local chapter was minimal. There was not a parent support group in the area. We were fortunate to know a couple of nearby families with T1D and so had, and continue to have, an informal network of information and support. I found the diabetes online community, and there found both personal support and a way to be supportive of others by starting this blog. For a while that was enough.

Now, though, I'm feeling a pull.

I'm still incredibly grateful for those moms and dads I met during the first months after diagnosis. Having those conversations provided a framework for how we still live with diabetes today. There's nothing like sharing stories, laughs, information or tears with people who have faced the same challenges.

In lieu of New Years Resolutions, I tend to think of something I'd like give some extra energy to over the course of the year.  Some years it's practical, like learning new recipes or starting a vegetable garden. Some years it's more social, like sending thank-you notes for even the littlest of gestures. This year?

I'll be looking for ways to spend more time with other 'diabetes people.'