Summer Time!
Alright, it’s not quite summertime here——but man it felt like it. The sky is blue, the pool is open, school is almost done for the year and the ice cream shops are back open. This used to be my absolute favorite time of year. And honestly, it still is—-actually it’s kind of a toss-up between summer and fall because I do LOVE pumpkin spice everything, but that’s beside the point. I just thoroughly enjoy this time of year and everything associated with it—-watching my girls swim in the pool (when they aren’t arguing, of course) is one of my favorite things to do. And it used to feel totally stress free. They’d swim for a few hours, we’d grill something up for dinner, and go out for ice cream afterwards. Come to think of it, I’m pretty sure this routine was one of the only things that kept us all sane during that first summer of Covid if you count having ice cream at home. Nowadays…it’s slightly different. At first, swimming and ice cream shops were pretty scary. As in terrifying. My daughter’s blood sugar would drop from what seemed like the minute second her big toe even skimmed the water. And it would drop fast. I’ve been known to give her skittles and starburst during the middle of her swim lessons, basically feeding her like a baby bird because her hands were all wet. She’d open her mouth and I’d pop them right in. Now that I think about it…Gatorade would’ve been such a more logical option, but live and learn I guess—-I’ve become totally comfortable looking like the crazy mom giving her kid candy while she’s swimming.
Now ice cream…that has the opposite effect. We’d count the carbs up, and prebolus on the way to the shop. Then extend out her bolus to account for the fat, and just pray that we did it correctly. And typically, we did not. Her blood sugar would skyrocket 4-5 hours after she ate ice cream, which typically ends up being at like 12am or 1am in the morning. And waiting for that high blood sugar (I’m talking 400+) to come down while you stack insulin, then waiting for it to crash down is just not fun…especially when you’re over tired. 0 out of 10 stars….do not recommend.
But heyyyyyyyyy, we’re 2 years into this. We got this! Sorta.
Swimming has become a heck of a lot easier now that she has her CGM. We bring her phone out to the pool deck, and I can watch what her blood sugar is and treat as I see it dropping. She has a pump that we disconnect when she swims, so just for a few minutes every hour, she has to hook back up so that she can catch up on her basal rate. Otherwise, she’s able to have just as much fun as she used to pre-diagnosis. She just needs to either sip on some juice,Gatorade, or have some quick acting carb to bring her blood sugar up every now and then. So as long as she’s not pretending that she can’t hear me calling her and dunking her head under water, we’re all good and it’s manageable.
Ice cream—-now that’s still a work in progress. Like with many other foods, we’re comfortable being much more aggressive with bolusing for the ice cream. She likes to get a kiddie-sized soft serve ice cream with rainbow sprinkles (pretty sure chocolate sprinkles would be the same effect, but I can’t prove this yet. Always has to be rainbow!). If I were to look up the grams of carbohydrates, I’d probably add up to about 45g. This is where I’ve learned to accept that despite what the label says, her body will react how it wants to eating different foods. What I’ve learned to do—-I double the grams of carbs. And have had much better success with it. So in this case, I’d have her bolus for 90g of carb. The issue we run into is that her pump only will extend for 2 hours, but I know that she will see a rise in about 4-5 hours. So what we’ve been trialing recently is bolusing for the 90g of carbohydrate——we’ll do 60g upfront, and extend that at about a 70/30 ratio over 2 hours. After that last bolus goes in, we’ll bolus the additional 30g and extend it at a 0/100% ratio, again over 2 hours. It’s scary——it feels like I’m just giving her way too much insulin. The biggest struggle here is getting over my fear and anxiety that I will drop her blood sugar extremely low. But what we’re noticing, is that it works——she might go up slightly, or sometimes she does dip slightly and we can treat that low easily. But we aren’t seeing her blood sugar go up to 400 mm/dL or higher for hours on end. Ice cream is no longer scary.
In hindsight, maybe she should only eat ice cream if she’s going swimming afterwards? Maybe this would solve ALL our problems. Kidding (kind of, cause it probably would help!).
It’s all a work in progress, but we’re getting there and have much better control with both swimming and ice cream than when we started. Okay summer…I think we’re ready for you!