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Old 10-21-2003, 10:02 PM   #19
wendyrowe
Dojo: Aikidog Aikikai
Location: Massachusetts
Join Date: Jun 2003
Posts: 199
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Before they let my son have a pump, his Joslin team had us talk in depth with the doctor, nurse, dietician and a psychologist -- and this is when they already thought he'd be a good candidate!

It's important to be realistic about what you expect, and you have to be good about testing your blood and counting your carbohydrates and remembering to give yourself insulin etc etc -- once you're feeling "normal," it's easy to get lazy and start ignoring things and then your control get worse instead of better.

Pre-pump, his control was OK: A1C 6.8 - 7.5 (6.8 was more recent), but with big swings from around 23 mg/dl (not all that often, but he felt horrible then) or more often 45 and up to 350 and the occasional 400 (that was whenever he went swimming in REALLY COLD water, or sometimes for no reason at all that we could find -- maybe the shot went into a calcified spot or somesuch).

He now has to carry pump supplies with him instead of just his meter and glucose. Now his belt pouch also contains batteries, spare infusion set and skin prep stuff. And we have insulin handy as well as syringes in case something ever goes wrong with the pump. And of course he still has glucagon nearby, just in case.

He tests his blood 5-8 times/day.

Always -- well, usually -- before and
after exercise, then before bed if he's
exercised (actually, he usually tests
just before bed anyway, since if he's lowish then he eats something) and of course before meals.

Benefits of the pump:

He doesn't have any severe low bs anymore

He can eat whatever he wants, whenever he wants -- he just has to remember to

find out how many grams of carbohydrates he's eaten and must push the button to give himself enough insulin

He doesn't have to eat unless he's hungry -- used to have to eat snacks every 2 hours, more or less, since he had long-acting insulin working

It's more convenient when he's eating out, since he can eat anything and then can just push the button to dose himself with insulin.

He thinks it's cool that he's a cyborg.

***

He disconnects the pump when doing something very active that might break it (it's rugged, BUT ...). That means while he's doing the activity he's not getting the basal drip of insulin the pump give him between meals. When he's done, he decides whether to dose himself

with as much insulin as he missed while disconnected or whether he thinks the exercise will make that insulin unneccessary. (Remember, exercise not only uses more blood sugar, it also makes you use insulin more efficiently.)

***

I'd said earlier that adrenalin makes his blood sugars go up -- maybe that's why yours go up in class. Your liver dumps stored sugar to make sure you've got the fuel for your "fight or flight," but you need insulin to get it into your cells where it belongs. We've seen his go WAY up if he gets a real adrenalin rush. (Then it seems he goes low later, when we think it must be that his liver gets refilled with more stored sugar.)

He's 14 now, and has had diabetes since he was 3. So it's probably easier for him, since it's all he remembers.

I don't know how much detail everyone on this thread's interested in. Feel free to email me if you've got questions you think are too detailed for the forum.

***

Interestingly, a different young teen with diabetes just joined the weekly jujitsu class my aikido Sensei teaches.
The first class he came to, he didn't bring any sugar source with him and didn't test his blood. He was OK, but is more careful now. We'd had it drilled into us at our training at Joslin right from the start that it's important to test before and after exercise and that you'll probably need to eat an extra 15 grams of carbohydrates for every 30 minutes of hard exercise (and that seems true for my son), so it was a big surprise to see a diabetic who didn't seem to know anything about that. I put glucose in the dojo's first aid kit, just in case.

Last edited by wendyrowe : 10-21-2003 at 10:04 PM.
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