It's weird how having a child with a chronic illness can creep not just into your lives and habits, but also into the lives and habits of those around you.
Case in point: birthdays.
I have blogged in the past about cake. I hate it. It seems to be cake, above all, that M's body and insulin together cannot handle.
And yet it is everywhere.
But not in our family.
In our family, we have a new tradition: ice cream cake.
This tradition began with M's birthday.
Since she cannot eat cake without having uncontrollable bg numbers for 24 hours, we began looking for other fun options. We tried ice cream cake. While it still has huge numbers of calories and carbs, the carbs seem to seep into M's system at a more steady rate than regular cake, and are therefore easier to manage over the 24 hour span that follows.
When we first figured out M's cake issues, she simply ate the ice cream
at birthday parties, with no complaint from her, nor from me or Bill.
It wasn't until my father's birthday that I realized that ice cream cake was the new family tradition. Grandparents, aunts, uncles, nieces and nephews all shared ice cream cake at Papa's birthday without even a question. No reference to regular cake was made. It was as if we had eaten ice cream cake at birthday parties all along.
Which leaves me with a few thoughts. A) I have a very cool, thoughtful, and supportive family, B) Everything changes when you have a kid with diabetes, C) Diabetes can't stop you from having fun unless you let it. and D) Change, while sometimes annoying and unwelcome, can be good.
Showing posts with label stupid cake. Show all posts
Showing posts with label stupid cake. Show all posts
Sunday, December 16, 2012
Monday, April 30, 2012
Left out
It happens.
I try to understand that it happens.
I tell myself that I would rather have a person tell me that they are not ready for the responsibility of watching my daughter during a sleepover party, or on a trip to the beach. I tell myself that if they are not able to deal with my daughter having Type 1 diabetes, then I do not want them to be in charge of her care in a situation when I might be out of contact for even a few minutes.
But it hurts.
It hurts me to even ask them.
And even though I understand it, it upsets me that some people are unwilling to take the risk.
She has not been hospitalized, lost consciousness, or flipped out since she was diagnosed. She knows to call me when her bg hits certain levels, just so that I can be part of her action plan for the day. And realistically, she can handle it all herself for a few hours. Odds are, nothing will go wrong.
But you never know.
If she loses consciousness, if she grows unreasonably angry, and the person in charge doesn't know what to do, it's a problem.
M's bg levels had been crazy. All over the place crazy. 595! 33! 578! 41! It didn't stop for days!
And when we finally had two days of it more or less under control, M was to go to a friend's house overnight and then join the family at Anime Boston to honor her friend's birthday.
The plans had been in place for weeks.
M was the only person that her friend invited.
Everyone wanted M to be able to go: M, her friend, me, the friend's mother.
This friend's mother is fantastic. She has traditionally been unafraid to take M for days at a time. But this was unusual. M's bg has only been back under control for a day or two.
I knew I had to make the call, and I hated it.
I explained the situation to the mom. She listened carefully, and asked several good questions.
I told her how much I hated asking her to take M under these circumstances, but I thought it was only fair that she fully understand what she was getting into.
After a few more questions, the mom stated that she would take M. She asked for contact numbers for the entire time she had M, as well as permission to treat letter in case of an emergency. Then she told me that the girls would refrain from the birthday cupcakes that she had planned to share.
I started to protest that M shouldn't be any more of a burden to her than necessary. She said, "No. It is not all right for my daughters to pig out in front of M when she can't enjoy it. We will save the cupcakes for later."
I have a friend who once told me that I can juggle a million things, and I am always in control: until my kids are sick. It unnerves me.
So, at this point I snapped: not in a bad way, but I could feel tears of relief stinging my eyes. My voice was trembling as I thanked her for her kindness, and told her how much I appreciated that she was willing to accommodate my daughter.
And I really did.
I try to understand that it happens.
I tell myself that I would rather have a person tell me that they are not ready for the responsibility of watching my daughter during a sleepover party, or on a trip to the beach. I tell myself that if they are not able to deal with my daughter having Type 1 diabetes, then I do not want them to be in charge of her care in a situation when I might be out of contact for even a few minutes.
But it hurts.
It hurts me to even ask them.
And even though I understand it, it upsets me that some people are unwilling to take the risk.
She has not been hospitalized, lost consciousness, or flipped out since she was diagnosed. She knows to call me when her bg hits certain levels, just so that I can be part of her action plan for the day. And realistically, she can handle it all herself for a few hours. Odds are, nothing will go wrong.
But you never know.
If she loses consciousness, if she grows unreasonably angry, and the person in charge doesn't know what to do, it's a problem.
M's bg levels had been crazy. All over the place crazy. 595! 33! 578! 41! It didn't stop for days!
And when we finally had two days of it more or less under control, M was to go to a friend's house overnight and then join the family at Anime Boston to honor her friend's birthday.
The plans had been in place for weeks.
M was the only person that her friend invited.
Everyone wanted M to be able to go: M, her friend, me, the friend's mother.
This friend's mother is fantastic. She has traditionally been unafraid to take M for days at a time. But this was unusual. M's bg has only been back under control for a day or two.
I knew I had to make the call, and I hated it.
I explained the situation to the mom. She listened carefully, and asked several good questions.
I told her how much I hated asking her to take M under these circumstances, but I thought it was only fair that she fully understand what she was getting into.
After a few more questions, the mom stated that she would take M. She asked for contact numbers for the entire time she had M, as well as permission to treat letter in case of an emergency. Then she told me that the girls would refrain from the birthday cupcakes that she had planned to share.
I started to protest that M shouldn't be any more of a burden to her than necessary. She said, "No. It is not all right for my daughters to pig out in front of M when she can't enjoy it. We will save the cupcakes for later."
I have a friend who once told me that I can juggle a million things, and I am always in control: until my kids are sick. It unnerves me.
So, at this point I snapped: not in a bad way, but I could feel tears of relief stinging my eyes. My voice was trembling as I thanked her for her kindness, and told her how much I appreciated that she was willing to accommodate my daughter.
And I really did.
 |
| Anime peeps. Long story short, a good time was had by all. |
Tuesday, December 6, 2011
The rule of small numbers
When M was diagnosed, her teacher gave her a very useful gift.
It is a book entitled Dr. Bernestein's Diabetes Solution, which was written by a doctor who is, himself, a diabetic. In the book are many interesting anecdotal stories regarding growing up as a diabetic over the years. Some of the stories involve boiling syringes, using daily urine tests, and general health inconveniences. The man became a doctor in order to learn more about managing diabetes well, and having the authority to teach people to manage their diabetes well. He claims that he has patients whose myopathy, retinopathy, etc, have actually REVERSED after learning to manage their diabetes using his methods.
One item that he brought up in his book is the "rule of small numbers". I am not sure if Dr. Bernstein is the first to call it such, but it seems to make sense, and it taught me a lot.
First of all, did you know that the FDA labels need to meet a certain accuracy level? I am sure you assumed that was the case. I know I did. What I didn't know, is that nutrition labels are permitted to be off by up to 20% and still meet FDA standards.
I really don't have that big a problem with this: food is a messy business. However, for people who rely on accurate nutritional information, labels can be disappointingly inaccurate.
Diabetics who are dependent on insulin use what they call a "carb ratio" to calculate how many units of insulin to give themselves when they eat. M's current carb ratio is 7. That means that for every 7 carbs M eats, she must give herself a unit of insulin. If M gives herself a unit of insulin without eating, it generally brings her bg down about 20 points (mg/dl).
The good doctor, therefore, recommends that diabetics stick to low carb food for accuracy purposes. Since the margin of error in food is 20%, a food whose label claims that it has 10 carbs in it may actually have somewhere between 8 to 12 carbs. The amount of insulin that covers 8 to 12 carbs does not vary that much; in M's case, it's about a half unit of insulin. If she gives herself 20% too much, her bg will be about 5 mg/dl less than the ideal. If doesn't give herself enough, her bg will be about 5 mg/dl higher than ideal. 5 mg/dl off is no big deal at all.
However, if a food claims to have 60 carbs in it, then the actual number of carbs in the food can range from 48 to 72 carbs, which can make a big difference in the amount of insulin you give yourself to cover it. Let's see: If she gives herself 20% too much insulin, her bg will be 40 mg/dl lower than ideal, which brings her into dangerous territory. If she gives herself 20% less than she needs her bg will be 40 mg/dl higher than ideal.
M's target bg - the one we shoot for every day- is 120.
In reality, we are very happy if it's between 85-145. Because she is a teen, and because some foods don't have labels, or portions are over estimated, underestimated, and because of other factors like exercise or lack thereof, most days it goes over 200 at least once. Nearly every day it drops below 70 at one point.
We notice that when M eats steak and salad, and minimizes bread, her bgs are much better under control. During the holidays, when the house is full of carb-loaded sugar-filled nutritionless crap, her bgs need to be monitored much more closely.
While many low-carb foods are delicious, sometimes a kid just wants a bagel, which we then pay for in extra test-strip usage and monitoring, or, alternately, higher bgs.
The argument in the DOC has been that, while "the rule of small numbers" seems to make logical sense, it doesn't always work.
I think it is true, but brittle diabetics and diabetics with other factors such as unrelated illness, medications, etc. might not be able to rely even on something as seemingly straightforward as the rule.
Currently, we use the rule as a guideline in determining a balance in food. For example, M is smart enough to realize that eating a large Blizzard from Dairy Queen (at a labeled 160-190 carbs, depending on flavor) or a slice of cake is not only not worth it to her, but it can also be dangerous. But she knows that if she wants a big slice of Italian bread, she best eat it with a steak and salad so that her total meal is less than 70 carbs.
Verdict: I like the rule of small numbers, but while M is off at school, with high carb quick lunches and hot lunches, sticking to the rule can be a challenge. Let's hope she makes good food choices when she is out of sight.
It is a book entitled Dr. Bernestein's Diabetes Solution, which was written by a doctor who is, himself, a diabetic. In the book are many interesting anecdotal stories regarding growing up as a diabetic over the years. Some of the stories involve boiling syringes, using daily urine tests, and general health inconveniences. The man became a doctor in order to learn more about managing diabetes well, and having the authority to teach people to manage their diabetes well. He claims that he has patients whose myopathy, retinopathy, etc, have actually REVERSED after learning to manage their diabetes using his methods.
One item that he brought up in his book is the "rule of small numbers". I am not sure if Dr. Bernstein is the first to call it such, but it seems to make sense, and it taught me a lot.
First of all, did you know that the FDA labels need to meet a certain accuracy level? I am sure you assumed that was the case. I know I did. What I didn't know, is that nutrition labels are permitted to be off by up to 20% and still meet FDA standards.
I really don't have that big a problem with this: food is a messy business. However, for people who rely on accurate nutritional information, labels can be disappointingly inaccurate.
Diabetics who are dependent on insulin use what they call a "carb ratio" to calculate how many units of insulin to give themselves when they eat. M's current carb ratio is 7. That means that for every 7 carbs M eats, she must give herself a unit of insulin. If M gives herself a unit of insulin without eating, it generally brings her bg down about 20 points (mg/dl).
The good doctor, therefore, recommends that diabetics stick to low carb food for accuracy purposes. Since the margin of error in food is 20%, a food whose label claims that it has 10 carbs in it may actually have somewhere between 8 to 12 carbs. The amount of insulin that covers 8 to 12 carbs does not vary that much; in M's case, it's about a half unit of insulin. If she gives herself 20% too much, her bg will be about 5 mg/dl less than the ideal. If doesn't give herself enough, her bg will be about 5 mg/dl higher than ideal. 5 mg/dl off is no big deal at all.
However, if a food claims to have 60 carbs in it, then the actual number of carbs in the food can range from 48 to 72 carbs, which can make a big difference in the amount of insulin you give yourself to cover it. Let's see: If she gives herself 20% too much insulin, her bg will be 40 mg/dl lower than ideal, which brings her into dangerous territory. If she gives herself 20% less than she needs her bg will be 40 mg/dl higher than ideal.
M's target bg - the one we shoot for every day- is 120.
In reality, we are very happy if it's between 85-145. Because she is a teen, and because some foods don't have labels, or portions are over estimated, underestimated, and because of other factors like exercise or lack thereof, most days it goes over 200 at least once. Nearly every day it drops below 70 at one point.
We notice that when M eats steak and salad, and minimizes bread, her bgs are much better under control. During the holidays, when the house is full of carb-loaded sugar-filled nutritionless crap, her bgs need to be monitored much more closely.
While many low-carb foods are delicious, sometimes a kid just wants a bagel, which we then pay for in extra test-strip usage and monitoring, or, alternately, higher bgs.
The argument in the DOC has been that, while "the rule of small numbers" seems to make logical sense, it doesn't always work.
I think it is true, but brittle diabetics and diabetics with other factors such as unrelated illness, medications, etc. might not be able to rely even on something as seemingly straightforward as the rule.
Currently, we use the rule as a guideline in determining a balance in food. For example, M is smart enough to realize that eating a large Blizzard from Dairy Queen (at a labeled 160-190 carbs, depending on flavor) or a slice of cake is not only not worth it to her, but it can also be dangerous. But she knows that if she wants a big slice of Italian bread, she best eat it with a steak and salad so that her total meal is less than 70 carbs.
Verdict: I like the rule of small numbers, but while M is off at school, with high carb quick lunches and hot lunches, sticking to the rule can be a challenge. Let's hope she makes good food choices when she is out of sight.
 |
| Here's a small number. I'm pretty sure I can cover for that. |
Tuesday, October 26, 2010
Cake
Cake makes me mad.
Why? Because it frustrates M. She always loved cake. But when her new lifetime pal diabetes came along we discovered, practically right away, that cake gave her problems.
I have other diabetic friends and acquaintances who have shared with me their own freaky food sensitivities. I know people who can eat cake with no problem; no significant change to their blood glucose levels. But they can't eat carrots. Or maybe potatoes. Cherries. Bread. Peanut butter. For some weird reason, not all diabetics react to the same foods the same way.
I have tried to rationalize the cake problem. I have thought about the glycemic index, the inability of the FDA to properly estimate the amount of carbs in bakery items and various other random thoughts. But I think that it's "just one of those things".
I found myself in a conversation with a parent of a non-diabetic sufferer of celiac disease. She was talking about how challenging it is for her child to attend social functions filled with gluten. I could sympathize. I explained M's cake problem. Despite her knowledge about gluten and foods in general, this piece of information flummoxed my new friend.
New Friend: How could carbs from cake be any different than carbs from anything else?
Me: I don't know.
New Friend: Did you try lots of different kinds of cakes?
Me: Oh, yes. She can eat ice cream cake.
New Friend: But why can't she eat cake? That's weird.
Me: I don't know. Yes it is.
Sure, technically M could eat cake. She did. Several times. Each time, we gave her an irrationally large dose of insulin to cover the intake of carbohydrates. Each time, her blood glucose readings were through the roof.
M decided that giving up cake was easier than feeling the swoon of high blood sugar afterwards.
We have adapted. Ice cream cake it is.
I am sorry it is weird. Too bad.
Stupid cake.
Why? Because it frustrates M. She always loved cake. But when her new lifetime pal diabetes came along we discovered, practically right away, that cake gave her problems.
I have other diabetic friends and acquaintances who have shared with me their own freaky food sensitivities. I know people who can eat cake with no problem; no significant change to their blood glucose levels. But they can't eat carrots. Or maybe potatoes. Cherries. Bread. Peanut butter. For some weird reason, not all diabetics react to the same foods the same way.
I have tried to rationalize the cake problem. I have thought about the glycemic index, the inability of the FDA to properly estimate the amount of carbs in bakery items and various other random thoughts. But I think that it's "just one of those things".
I found myself in a conversation with a parent of a non-diabetic sufferer of celiac disease. She was talking about how challenging it is for her child to attend social functions filled with gluten. I could sympathize. I explained M's cake problem. Despite her knowledge about gluten and foods in general, this piece of information flummoxed my new friend.
New Friend: How could carbs from cake be any different than carbs from anything else?
Me: I don't know.
New Friend: Did you try lots of different kinds of cakes?
Me: Oh, yes. She can eat ice cream cake.
New Friend: But why can't she eat cake? That's weird.
Me: I don't know. Yes it is.
Sure, technically M could eat cake. She did. Several times. Each time, we gave her an irrationally large dose of insulin to cover the intake of carbohydrates. Each time, her blood glucose readings were through the roof.
M decided that giving up cake was easier than feeling the swoon of high blood sugar afterwards.
We have adapted. Ice cream cake it is.
I am sorry it is weird. Too bad.
Stupid cake.
 |
| Sometimes the cake makers are stupid, too! |
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