Tuesday, June 14, 2011

Just Swimming

Swimming is by far the most difficult activity for me to manage when it comes to Maddison’s blood sugars. Here we are in the month of June. Things are about to get crazy. I’m sure I complain about this every Summer, but it still ain't getting easier and I’m still complaining!! I think a big part of the swim season difficulty is likely the fact that our insulin pump isn’t water proof, therefore you have to disconnect and remove it for swimming. If Maddison will be swimming for many hours, she will have to reattach the pump every hour or so, to dose some of the missed basal insulin that was automatically given .....but how much? All of it? Or what percentage? It just never seems to work out right.

Is Maddi splashing around on the steps? Is she swimming crazy laps in a challenging race? Is she lazing on a raft or is she jumping in and out of the pool playing a game of “Fish out of water?” This Summer is going to be a major challenge, because if I am not pool side with Maddi, there is no way I can judge what her needs are. The hard truth is, Maddison isn’t little anymore, which means she just goes off on her own to swim at friends houses now. Its stressful. Its scary, and can be down right dangerous if we dont stay on top of Diabetes! I hate having to give “the talk” to other parents every time my kid comes over to swim. But, I have to. With Diabetes, you just have to. We pack at least 4 juice boxes, glucose tabs, candy, glucose gel, a protein bar, and Glucagon. You know what I say to that? Screw you Diabetes!!! Can’t my kid just swim like all the other kids!!??

Diabetes was hard enough to manage when I was always with Maddison at the pool....but now? Im just not sure where to start!

We certainly want to avoid “TURBOCHARGED” insulin while swimming, but entering the pool with zero active insulin isn’t always going to happen. So, we give a snack. A HUGE snack, at least 30c with some good protein power. (no bolus of course) Sometimes it works to keep the lows away, and sometimes it doesn’t. Lows strike within the hour. Sometime it’s the worst ones, the straight arrow down ones. The result is usually an upset tummy from having to ingest a bazillion sugary carbs to fight off danger! Or, maybe Maddison will end up WAY TO HIGH, then you are left trying to decide how much to correct that crazy high!

How am I supposed to keep Maddison safe while she is swimming away from home if I am not there to judge her activity level? What if she drops so fast, she needs help and the parent on watch doesn’t notice? What if she is confused and unable to treat her low herself? Will the parents understand the emergency at hand? Ohhh the “what if’s” of Diabetes!

So, last night Maddison was on her own managing D for the first time this season while swimming at a friends house. BS= 268 with .4 active. (I reduced dinner insulin by 15c) I had Maddi set her cell phone alarm for an hour after swimming started so she could check her sugar and call me. She was 198. Just where I hoped she would be, but I still hate the fact we have to run our kids high to keep them safe from lows when they are active!!

So now what? Re-attach the pump and give the basal insulin she missed in that hour? Its only a matter of time until her sugar “could” start to rise, but who the hell knows what will happen today? Today isnt the same as yesterday and wont be the same as tomorrow! Lets think....initially when exercise starts, your muscles suck up any excess glucose in the blood for fuel, which means if you have insulin still working in the body your blood sugar will go too low, because there isn’t any sugar left that needs all that insulin to enter the cells right? (Something like that) But, at the same time the Liver will start to put out extra glucose to keep the body fueled, and if there isn’t enough insulin in the body that means her cells are starved of the energy they need! Blood sugar rises. It is such a tricky balance! Im just a MOM, not an scientist!! I keep thinking, without enough insulin going through her body, her sugar will start to creep up, (and DKA can set in!) but yet at the same time if there is too much insulin she will go to low.....

Damn! What do you do? After much contemplating in my mind, I made the decision to have her do nothing with the 198 since she had a tad insulin still working from dinner, and I’m still kinda (a lot) worried that Maddison may give the wrong tiny dose if I have her give the missed basal without my watchful eye. My decision to not dose back the basal insulin missed in that hour slapped us in the face an hour later. 298. UGH.

And, of course it isnt enough just to make it through the time of swimming itself. No,no,that would be too easy. After the swim we may need to reduce basal rates (again, an educated guess of how much) give snacks, change pump sites (because water logged sites fall off or sometimes fail to work properly) and wake up to check numbers multiple times overnight to make sure our child is safe from delayed lows while sleeping. Just swimming? Not really. The is no such thing as "just swimming" with Diabetes. It is a hard fact that lows and highs trying to get swimming right is gonna happen. And they can be scary. And dangerous. And make you want to cry. Or scream. Or give up. But we can never give up. Diabetes can never win.

How do we make it through another season of swimming while keeping our kids healthy and safe? Even harder yet, how do I manage this by phone, miles away!?


Reyna said...

Oy..Maddi's swimming sounds like Joe's hockey. Joe doesn't really have issues with swimming to-date. I am thankful. And you are right...it would be so wonderful to have a crystal ball or something so we would know how much basal to make up for or how much to reduce after the swimming is over. It is a crap shoot...no two times are alike...or...so it seems.

Kerry said...

Swimming is so hard for us also, my son isnt pumping yet so I know you have tonnes of extra factors involved there and it really sucks :( Here comes summer and here we go again. Best of luck to us all lol.

Heidi / D-Tales said...

Acckk! It's such a challenge! We're still on shots. So swimming is easier for us, but I'm imagining what you're going through and I really feel for you.