So I decided one day several months ago to spend one week living like my daughter. Well, every day I live with my daughter IS living like her… essentially… but, I don’t have Type 1 diabetes – she does. So, even when they say that when a child is diagnosed with diabetes that the whole family (figuratively speaking) has diabetes, the rest of us don’t have to stick our fingers upwards of 15 times a day and actually think about every morsel of food that touches our lips. My daughter is seven years old, and she doesn’t live a single day without these considerations. And she’s happy, healthy and (mostly) well-adjusted, but some days she is angry and frustrated by the need to wait 15 minutes for the insulin to start working, by the lows that make her feel shaky and anxious, and by the fact that “No. Mom is not buying donuts for breakfast today.”
So, I did this thing – and journaled it. Unfortunately life - as it always does - intervened with my plans and I only followed this plan for two days. The stuff I wrote below remained unfinished for months, but I decided to share it anyway, incomplete though it is.
DAY 1: Monday
I tested my blood sugar this morning, after re-setting a vial of test strips on my own meter (which involves a test strip and a drop of control solution – shaken for 5 seconds – to calibrate the strips to the meter). Blood sugar was 81. I’m not accustomed to using a lancet on myself, so I used the same depth setting I use for Ava; it didn’t hurt, but my finger is still tingling from the stick. I am having a cup of coffee, with a little sugar (I’m cutting back on how much I use – and thankfully the coffee Todd buys tastes great black) and a little Coffeemate.
Diabetes trivia: one vial of test strips for a blood glucose meter costs about $25. One vial contains 25 strips, which equals $1 per test strip; however, one of those strips is used to calibrate the meter. We use about 15 strips per day.
Breakfast today: 9:30am
Chobani yogurt = 20g carbohydrates, 0 fat, 14g protein
½ grapefruit = 9g carbs (usually I add a little sugar to sweeten it up – today I didn’t)
Total carbs = 29g (incidentally, if I’m using sugar in my coffee –or even Splenda – I need to count those carbs. So, that was my first cheat on this journey – and only one day in. However, Ava often “cheats” with little things – and my philosophy has always been not to be so anal about every little carb going in. For example, she might want 3 or 4 almonds. She gets them, I don’t count them.)
Usually I skip breakfast. This is a new development with the big change I went through last Sept. and I have known this has to change. So, on my first day of this journal I decided to show off and act like I am super healthy and making wonderful food choices – by eating calcium-rich yogurt and fresh fruit (guess how long this lasted?) Everybody knows that good health and nutrition begins with breakfast. Skipping breakfast – so common for so many people – according to Dr. Arthur Agatston, architect of The South Beach Diet, actually makes the body hold onto the carbs you eat later in the day because it doesn’t know when the next meal is coming. Result? Weight gain, NOT loss.
Ok, Lunchtime. About 1pm.
Blood sugar is 86. I am eating this wonderful strawberry salad, courtesy of my dear friend Chris who is a Pampered Chef. Now this is something I ate A LOT of a year ago before my life went temporarily to hell in a handbasket.
2 cups romaine lettuce = approx 3g carb
2.5 oz of strawberries (about 3 large) = 8g carb
¼ cup chopped walnuts = 3g carb
Dressing (a la Pampered Chef) = approx. 10 g (I was guesstimating this one – I was generous on the carb count due to the sugar content in this homemade dressing.)
Grand total carbohydrates = 24g
Diabetes trivia: everything Ava eats is counted, measured, and/or weighed. It’s the best way to get the most accurate carbohydrate count on the food she eats. And by the same token, we count CARBS, not calories, or sugar. The insulin she takes is for the number of carbs she eats; sugar HAS carbs – and she does eat sugar-containing foods, so we count the carbs in those foods and bolus insulin accordingly. Those well-meaning folks who offer her sugar-free treats are just wrong. Sugar-free does NOT equal ZERO carbs. And, incidentally, sugar-free usually means artificial sugar, which is far worse for the human body than white cane sugar.
I drank water. It’s about all I drink on most days, besides coffee. I am trying to again drink the equivalent of 8 eight-ounce glasses per day, since I was slacking for a long long time and it showed on my skin (in the form of dry patches). I also finished off Ava’s leftover Chicken Ascona, sans the pasta – just chicken breast and French green beans. Generally speaking, where Ava is concerned the chicken and green beans have no carbs.
No run for me today. Behind on school work and have laundry and some housecleaning to do before the kids get home. Food shopping too. Plus, it’s raining. Don’t feel like getting drenched and going to pick up the kids at school looking like a drowned rat.
6:30pm dinner – my blood sugar was 91. May have been somewhat affected by the Dogfish 60 Minute IPA I couldn’t resist while I was cooking dinner.
We had Salmon, simply broiled with a little olive oil and sprinkled with garlic and grated romano. No carbs.
Roasted new potatoes, in olive oil, Italian seasoning and sea salt = 21g carbs for three very small potatoes.
French green beans, roasted in same pan with potatoes = 0 carbs.
Big glass of water. Ava and I had dessert tonight – a Skinny Cow ice cream sandwich = 30g carbs, 3 grams of fiber.
Total carbohydrate count for dinner: 51 grams.
DAY 2: Tuesday
Breakfast 9:00am – my blood sugar was 91. I think this number is higher today than yesterday because I started coffee earlier due to the rain and my foggy head wanting to stay in bed and forget school. Coffee today had only Coffeemate in it, no sugar.
A bowl of whole grain cereal (from Trader Joe’s) = 24g carbs. I measured the ¾ cup serving for accuracy, just as I do for Ava. 3 grams of fiber.
½ grapefruit = 9 g carbs
1 slice raisin toast = 15g carbs. I used light butter with canola oil, with half the calories and fat of regular butter.
Total carbs = 48g
I was in the middle of an important phone call when I got hungry and was just distracted enough to grab a banana and eat it (hey – at least I made a healthy choice!)…. not realizing it was 12:35pm and I hadn’t checked my blood sugar! So by 1:00pm I was starving and needed to eat lunch. Dad dropped in to hang out a bit between appointments, so I waited another 15 minutes and decided to test my blood sugar. It was 143. This is considered elevated for a person without diabetes, and would – under normal circumstances – require a closer look at what’s going on on the inside. However, I just ate that banana and so… my blood sugar remained elevated. For Ava, this is a happy number. The banana, incidentally, was about 6 oz and therefore 22.5 g carbs. Soluble fiber found in fruits slows down the digestive process.
When we were in the hospital as Ava was recovering from DKA and we were fully immersed in Diabetes Crash Course 101, one of the first things we had to do was practice testing blood sugars – on each other. Mine at that time was 136 – which momentarily startled the nurse instructing us before she asked if I had just eaten lunch (I had).
A fasting blood glucose of under 100 is considered normal. A fasting blood glucose that measures between 100 and 125 indicates impaired glucose tolerance, otherwise known as pre-diabetes. A fasting blood glucose over 125 is considered diabetes. These stats refer to routine blood tests that might indicate the presence of Type 2 diabetes. Nearly all cases of Type 1 are impossible to miss given the symptoms and a monstrously elevated blood glucose level. My daughter's blood glucose was 416 at diagnosis. I have heard other parents tell of blood glucose levels as high as 1600!
Lunch, approx. 1:25pm – ham and cheese on a club roll = 31g carbs (with horseradish Dijon mustard = 0g carbs)
A handful of carrot sticks = approx. 4g carbs. (these I call “free” food for Ava, since she doesn’t eat many when she snacks on them; however, carrots do have a carb count that is higher than most vegetables.)
I drank some club soda (0g carb) and then water. Later, a glass of milk, approx. 10 oz = 17g carbs.
I did slip in some salt and vinegar potato chips – what little Todd left in the bag for me – maybe an ounce – so that was worth 14g. But there’s FAT in those!!
More diabetes trivia: There is no single way to treat diabetes. Every BODY is different, and therefore there are many ways to manage an individual’s diabetes. What works for one Type 1, may not work for another Type 1. That said, the ongoing battle with fats in foods seems to be a common thread among us D- parents. Fat in certain foods slows down the absorption of the food so that the process often takes way longer than the two hours it takes for insulin to peak. When my daughter eats pizza, for example, we are guaranteed a very very long night of blood sugar checking and correcting. So while my daughter can happily attend birthday parties, the usual fare of pizza, ice cream, and birthday cake – all carbs we will count and give insulin for – will keep us alert and constantly checking/correcting for the next 4 to 6 hours. As previously stated, a blood sugar of 135 is decent for her – but 5 hours after pizza it will look more like 320.
That's where I left off. I did test and eat dinner later that day, but the results were never recorded. Ava is not so fortunate - she doesn't get to "forget" diabetes, or have life "get in the way" of managing it well. She accepts her lifestyle for the most part, but it is so difficult to go places where other kids her age are grazing on cookies, cupcakes, potato chips and candy. She doesn't see it the way I do - that those kids are unhealthy, and the parents irresponsible in a nation with an obesity epidemic and Type 2 diabetes on a high-speed Concorde flight to a house near you. To her it's unfair that they get to eat whatever they want, whenever they want. She's only 7, and I haven't told her everything yet. She knows what to eat and how to test and what's good for her and what's not; she doesn't know why her life depends on good diabetes management. She asked me recently what would happen if she didn't get insulin. It so caught me off guard, that I stuttered off a quick response about getting really sick because her blood sugars would get really high. And then what? Then nothing, because you need insulin and so you take it, to keep you from getting sick. But what if I don't get insulin? Then you would get really sick, really fast and we'd have to give you insulin to make you better. Would I have to go to the hospital? Yes, you would. But you're not going to because you're going to take your insulin to keep you healthy. (Undeterred by my sidestepping, she continued.) Would I die? She knows, I think. While I didn't exactly say no or yes, the tears in my eyes that I tried to hide told her more than I could.
She wanted to ride the school bus this year, which required me to have a very important conversation with the bus driver - who told me she has had kids on her bus before with diabetes and that she has kept juice boxes on board for emergencies and such, and oh - she can make sure to give Ava some sugar-free candy when she hands out treats on holidays.
Okay folks - here it is - one more time:
Type 1 diabetes refers to individuals whose bodies cannot/do not produce insulin, and so they must replace that insulin - whether by syringe, insulin pen, or insulin pump. Type 1 diabetics count CARBS, and therefore can eat anything that anyone else eats. Anything. (It is wiser to consume healthy food over junk - but that fact is true for us all.)
Type 2 diabetes refers to individuals whose bodies cannot effectively use the insulin produced by their pancreas, and so must control/treat their diabetes with medication (and in more advanced cases - insulin injections), exercise and diet.
So, repeat after me,
"Ava can have anything that I eat." A carb count on those oversized chocolate chip cookies from the grocery store would be really appreciated, though.