Birthday Day and Other Heavy Eating Occasions

My daughter's friend had a birthday last week.  It was on the same day as mine.  The kids have found a way to skirt the school nutrition policy of 'no outside food for celebrations' by bringing in treats to share at lunch. So lunch that day included oreos, hershey kisses, doritos and munchkins.  To her credit, she ate the sandwich and grapes I packed first, but she sampled the rest as well.

For dinner we went to a Thai restaurant and she had an uncountable portion of pineapple fried rice. We came home and had mini cupcakes and cannolis for dessert.

Our household diabetes philosophy (yours may vary) allows sweets, and even junk food.  Birthdays include cake.  S'mores over the fire pit or a trip for italian ice are part of summer fun.  A little bag of chips for the walk home is o.k.  Most days include cookies or a non-dairy frozen treat before bed. Taken one at a time, or even two in one day, we're o.k. with both the questionable nutrition of it and with the diabetes challenges.

'Everything in moderation' is the general idea. But on days when moderation goes out the window, I'm left feeling torn.  Should we ever let her eat this way?

"Yes!  You can eat anything except poison...or cookies made with poison..." is one side of the coin. But she really can't eat anything and maintain the same kind of blood sugar numbers she does when she eats healthy, countable things.  Twenty carbs of oreos and doritos is not the same as twenty grapes. Half a restaurant portion of pineapple fried rice and a bakery cupcake simply can't be counted and dosed for as accurately as portions prepared, weighed and measured at home. Add the 'one more dorito because everyone else is still eating,' or the picking all the pineapple out of the fried rice despite bringing home 'half,' and the challenge increases.

Still, I lean towards letting her learn from her mistakes over outright forbidding her from eating like this. She'll encounter days with heavy eating potential for the rest of her life, so perhaps helping her develop a healthy sense of how to handle them is the answer.  Last week's birthday day was an example of how not to handle it.  And she knew it.  She was upset that her blood sugar was high for hours.  Between that lengthy high and the general junk food overload, she had some lingering indigestion into the next day.

Sometimes she makes better choices.  Last weekend, she said no to lunch out with a friend before an evening birthday party because it would consist of too much uncountable food in one day.  She's come home from parties and told us she was the only one who ate the proffered grapes or salad to balance out the junk. She will report with alarm how many cookies or cupcakes some kids consume in one sitting.

I guess it's like all things diabetes, really.  We do our best.  We try to fit the diabetes stuff into what we consider a normal, healthy lifestyle.  We try not to let it ruin our fun.  We learn from our mistakes.  And we're never quite sure we're doing it right.

Time Suck

A sampling of annoying events from the past few summer days:

I received a lunchtime phone call from the beloved nurse-free music program.  "I'm 72.  How should I bolus?"  The question took several minutes to sort out.

While at the pool, she had to stop to disconnect or reconnect her pump while her friends were already running for the diving boards/ping-pong table/snack bar.  This scene repeats several times daily.

She had to leave her friends in the pool to treat a low blood sugar.

We delayed leaving for the pool to replace the tape on the Dexcom.

We delayed leaving for music to add tape to the Dexcom.

I spent half an hour online searching for tips to keep the Dexcom stuck when frequently submerged in a swimming pool, lake or ocean.  (Suggestions are still welcome...).

We expected to do a quick site change, only to find that the pump battery needed to be replaced and the supply of wipes needed to be replenished from the downstairs closet.

A desire for a summer peach turned into an ordeal involving the food scale and the calorie king app since it was the first peach of the season and we couldn't remember the carbs.

A group of friends descended on the kitchen for a snack break.  She was the last to eat, as usual, since she had to stop to check her blood sugar, read the nutrition label, and bolus for her food.

A cure and/or a bionic pancreas will some day dramatically improve my daughter's health.  That, in the big picture, is the reason we want these things.

The other benefits are indisputable though.  When the day comes, we'll go through every day without any of these kinds of stops and detours.  She'll stop being the one lagging behind at the pool.  She'll dive into her friend's pantry right along with everyone else.  Diabetes won't delay the fun.  We can't wait.

Information?

'Oooh...great.  I don't have to weigh them,' I thought at first glance when I noticed the familiar chart on the back of my sandwich rolls. Then I looked closer.

 

 

 

 

 

 

Per the FDA Guidelines a baked good does not need to be labeled with nutrition information if it's made and sold on premises.  This label is within the letter of the law. 

 

It's just very disappointing.

 

 

Math or Guess? Some of Each.

Thanksgiving is fast approaching and a string of celebrations will follow.  It's time to dust off those carb counting books, or reacquaint yourself with your favorite nutrition info website, or download a new app.  Or probably all of the above.

While it's particularly true for this time of year, each season brings a unique set of foods which must be counted.  Every summer, I brush up on popsicles, ice cream cones and the crusty bread I like to serve with salads.  Late spring brings the start of picnic season, with its hamburger buns, pasta salads, and watermelon slices. This week, I'll be refreshing my memory on stuffing, winter squash, pumpkin pie, and cranberry bread.

I'll turn to my trusted resources - mostly Calorie King - in paper and electronic forms.  I'll read the labels on packaged items, and review the backs of my recipe cards with their penciled-in math problems from previous years.  That homework will provide the base of knowledge needed for the weeks to come.

Yet once faced with a plate of food which includes a 'spoonful' of this and a 'slice' of that, it gets complicated.  Unless the pie slices are measured with a protractor, variables have been introduced.  Unless I know what my hostess means by the 'splash of maple syrup' she added to the butternut squash, I'll need to improvise.  The unforeseen appearance of cornbread could have me suspected of inappropriate phone etiquette at the holiday table.

About a year after my daughter's diagnosis, I met with the nutritionist at our endocrinology office.  I explained that I had gotten pretty good at reading labels and was learning to do the math on favorite family recipes.  "But how will I ever figure out how many carbs are in the scoop of mashed potatoes Grandma serves her, or in the dish of ice cream that comes with her kids' meal?"

The nutritionist gave me a sheet which had to do with eyeballing portion sizes.  Specific measurements were equated with 'half a baseball' or a 'deck of cards.'  She then explained that while this might be sort of helpful, eventually I would just know.  By consistently using measuring cups and food scales at home, I would come to be able imagine how a pile of rice would fit into a measuring cup, or how the size of the diner's french fries compared to the frozen ones at home.

I have to say I doubted her,  But she was right.  Granted, sometimes the 'splash' of maple syrup turns out to be a half a cup.  Sometimes I misjudge the amount of frosting on the cupcake.  Usually, though, a combination of scientific knowledge about carbohydrates, practice with portion sizes, and intuition gives me enough information.

It allows me to make a pretty good guess.

Hungry

The phone rang at 10:45 a.m., flashing the school's number on the caller i.d.  It's always with a sense of dread that I answer calls from school.  But, of course, I do.

"Mommy?"

"Yes...hi."  (Who else would be answering?)

"I finished my whole lunch."  (Brunch?)

"O.k.  Good?"  (I was struggling to get the tone.  Was this good news or bad?)

"I'm still hungry.  And the nurse has some pretzels I can have.  But I'm not sure I can finish the whole bag.  And I don't know whether to eat the sticks or the twists. But I'm really hungry.  And I have art club after school that I want to stay for. And then I'll be really, really hungry."

I cut her off before she got too worked up, "O.k.  Look at the label for the twists...they're probably easier to count than the sticks.  How many carbs in a bag?"

"23."

"How many pretzels are in there...open it up and count as best as you can."

"Looks like about 20."

"Ok...well take them and eat what you can and come back and bolus 1 for every pretzel. That should be close enough."

"Ok."

"I'm glad you're hungry!  And make sure you say thank you for the pretzels."

"Ok."

At 11:20, the phone rang again.  School.  "Mrs. Osborne, everything's ok. In fact, I thought I'd call with good news for a change...she finished the pretzels.  I'm so glad she's getting her appetite back."

Me too.  And thankful for the nurse's support, and for how nice her friends have been keeping her company on her many treks to the nurse's office during these first weeks of school.

My wish to provide a balanced brunch snack-like meal which can fill her up is complicated by her aversion to 'cold cheese,' and her wanting to lunch with three friends who are allergic to peanuts. This week we're trying yogurt tube + grapes + crackers or pretzels.  I still contend the cafeteria should serve eggs and toast. 

 

Slurpee

Sugar - free cherry limeade slurpee...an 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.

Counting

Don't forget to count as you eat those goldfish crackers.

There were 20 pretzel sticks in there.  How many are left?

If you eat more than 12 cherries, come back.

People on diets count their calories and track how much of everything they consume.

Children, generally, do not.

It must stink to be sitting at the pool with friends, chatting about important things (or about nothing at all) while simultaneously having to keep a running tally of one's wheat thin consumption.

Where we lunched on Wednesday has the best thin, crispy french fries anywhere, and a generous portion came with my daughter's grilled cheese.  I have no idea how many I picked off of her plate.  I do know she ate 26 of them.

It takes a bit of the joy out of eating, this counting does.  Especially in the summer when there's nothing nicer than sitting in the shade eating cold grapes or berries.  Or sitting on the beach grabbing handfuls of goldfish crackers between hermit crab races.  Or sitting on a pier with a fresh-from-the-water basket of clam strips and fries.

It's part and parcel of this whole diabetes thing though.  And the glass-half-full part of me says 'well at least she can eat what she wants as long as she keeps track of it...it wasn't long ago when there were tons of restrictions on what people with diabetes were allowed to eat to begin with.'

And that's true.

But wouldn't it be fun to dive into that tray of chips and salsa at the next cookout without enumerating each one?