Backtracking

It's a quiet day in mommyhood today, at long last. Travel - even a short road trip, like we had last weekend - can throw things off a bit. I love to travel - I did a lot of it when I was younger - but now, it comes at a much bigger cost. Potty training got set back for a week. My glucose levels were, thankfully, stable. Good thing, as I spent most of the past week running up and down the stairs so many times, to get the necessary new clothes, etc., that I'd get to the top or bottom of the stairs, and forget which way I was going. I briefly considered going back to diapers (for H, not me!) - but that's a big no-no, apparently. I'm sure H's pride would have suffered, too. She may seem like a happy-go-lucky kid, and she is, but she's also hyperaware of what's going on around, and to, her. That still-forming ego of hers is fragile. Going back to diapers would have made her feel like a "bad person," as she told me once this past week after having had three "accidents" in an afternoon. Ouch!

We seem to be back on track now, so I'm glad we stuck with it. Diapering 37 pounds of wiggling and giggling is too much work! Sometimes I wonder where I get the energy to be a parent. Mostly, it comes from watching H. I get to eat a lot of extra carbs, too, I think. I snack almost as often as she does. I only hope that my regular eating isn't making her eat too often; any time she sees me eating, she wants what I'm having. I try to keep it healthy and low-fat, and limit amounts. I also try to keep H's activity level higher than mine. We go to the playground a lot, so all I have to do of fret over whether she'll fall of the high structures while she runs around like a nut.

It was maybe even harder to deal with this setback because we'd finally made it out of the woods, so to speak. (As in, does a bear...?) We'd just started coming out of a bad rut we'd fallen into because of the potty training. Not only would H want a "special treat" after using the potty - every single time - we also couldn't stray far from said potty, so trips to the playground became rare. I could tell both she and I were on the wrong track, healthwise. The treat would be a cookie or sometimes even a cupcake - that was what I had on hand, left over from what someone else brought to our house, at the beginning of training, so that's what she started demanding. Now, you may say, so what, a not-yet-three-year-old girls "demands" shouldn't be hard to handle. But then, you don't know toddler girls, and you don't know my H in particular. Sure, I could ignore the demands, or try to persuade her in another direction (here, have an m-and-m instead of a cupcake), but a full-on fit would ensure - followed by a nice puddle on the floor. See, parenting is this funny thing where your ability to control situations is always being challenged, if not out-right threatened.

But all was not lost. I switched to giving her a treat only after at least a half day of good potty use. I also made her play more in the yard, and started heading to the playground as soon as she uses the potty after arriving home from daycare. This last part isn't always easy, because once home, H settles into a routine that often involves TV. It's hard to get kids to switch gears. But she's old enough that she can hold a reward idea in her head for a decent while - so waiting a couple of hours for a cookie is usually possible, and the idea of the playground manages to lure her outside eventually, if I keep reminding her of the reward that's coming.

I'm not even sure how we got into the routine of the "special treat." When potty training started, I didn't want to use sweet rewards; I tried just praising H, and also giving her stickers and, a couple of times, bigger, non-food presents. She really liked all of this. But at one point we had those cookies and cupcakes in the house, and I let H have one and said it was a reward. I guess that was a mistake. (Ya think?!) I was partly horrified (all that sugar!), partly pleased that she could actually eat the stuff without any apparent immediately bad effects (like I would have), and partly desperate to make potty training work. But oh, the back-tracking! And yes, maybe the lure of the treat was that much greater because we hadn't allowed it before - because I just don't eat that stuff, and don't have it in the house.

Still, as I started out saying, things seem to be settling in well, we're down to one cookie a day, and I am breathing a lot easier. Motherhood is a symbiotic relationship, in that your daily routines are intimately intertwined. Anything that affects one person in this relationship deeply affects the other - and diabetes makes that even more true, or maybe just makes it more noticeable.

Weighing the evidence

My daughter is now eating all low-fat or non-fat dairy - the food group she most loves, after cupcakes! I'm still trying to get a handle on whether she's a healthy weight; she might be a little over. I certainly don't want to instill in her any obsession over her weight - more than she's going to get anyway, as a girl in our culture. But I do want to give her good habits. She loves fruits and veggies, so I encourage that. And the low-fat no-fat stuff is invisible to her.

I also try to give her "real" food for meals. This means I sometimes still feed her dinner before my husband and I eat; I've found that if I try to make her wait til dinner's ready for us all, and we're ready to eat (around 7 pm), she sometimes just snacks on junk and doesn't eat dinner at all. But sometimes, she manages to wait. I guess the difference is whether her nap is early enough that she can have a snack before 5 pm; then she can make it til family dinner time.

A couple of days ago, I searched for information about kids' body-mass index (BMI) - the real measure of whether a person is overweight. Apparently, a healthy BMI for kids is lower than it is for adults - a bit surprising, because BMI is the ratio of weight to (the square of) height. It's also different for boys and girls, whereas adult BMI ranges for healthy, overweight, and obese are the same for men and women.

So, I plugged in my daughter's digits. I used the CDC's calculator, which seems the most accurate - it asks both the kid's current age and the age at measurement, allows fractions of measurements, and considers whether the kid is a boy or a girl.

I found that if I used the numbers from her 2-year doctor's visit, she's slightly overweight, but if I use the same weight they measured, but the 1/2 inch taller height that I very carefully measured right after the visit (using a ruler, with her feet as flat as I could get them to be, and measuring twice, as opposed to the quick hand on the head the nurse used) - then, according to the CDC, she's a healthy weight.

My conclusion: I don't think these BMI figures can be very accurate for 2-year-olds. How many two-year-olds do you know who will stand still long enough to allow an accurate height measurement, especially during a busy doctor's visit? And if the difference between normal weight and overweight is only a half inch of height, then there's a huge potential for misclassification.

Have you ever wondered whether your kid was overweight? Was the pediatrician helpful? Ours was quite relaxed, just saying to go with the lower-fat milk for now - but that was at 18 months, when all the information I was reading said to stick with full-fat milk til age two, because of brain development. He said it didn't really matter by 18 months, and that too many kids already have atherosclerosis (cholesterol buildup in the arteries). I ended up switching her to 2% about a month later, to 1% a little after age 2, and now to fat-free. I still wonder whether I needed to do all that, and whether I need to worry about it now.

Too many cookies? (but not for me)

Blogging while having low blood sugar - is it like blogging while drunk? I hope not. Actually, I'm offended by such comparisons - they're dangerous, because when people think a diabetic is just acting drunk, they ignore what could be a life-threatening condition.

But enough of my soap box. Really, I'm just trying to regain normalcy (note I don't say normality) with my blood sugars. No, I did not particularly overindulge over the holidays; it's just the continuing saga of my pump sites not working right. I've gone back to using my abdomen, and really only one side of the abdomen, after a few frustrating weeks of other sites. We'll see how long this lasts. I'll be seeing a pump specialist toward the end of January, to see if she has any ideas about how to better use sites other than my abdomen, or how I might get the infusion sets to go into my abdomen better.

(Here's a bit of commentary particularly for insulin pump users: There are a lot of tricks to getting the needle in at just the right angle, and I think I've been using all those tricks, but you never know what new ideas have come out. The pump manufacturer was really helpful during my pregnancy when I had similar problems, but I reached the end of even their extensive knowledge. The one thing I've just thought of recently, that they didn't suggest, was that, when the pump seems to be in a site where it is delivering insulin, but only very slowly, I can keep it in but directly inject insulin for meals -- "bolus" in pump terms -- using a syringe, i.e., the old-fashioned way. This could be particularly useful when the pump is in the "hip," where delivery tends to be slow. My arm, I've sort of given up on - even when I could get the infusion set in right, delivery would either be too fast or stop altogether because of bleeding, perhaps because of my toddler grabbing my arms, or just from my lying on it during sleep. I just couldn't keep that up during holiday traveling.)

Meanwhile, my daughter has done really well with Christmas - no tantrums, a decent sleep schedule, and not too terrible a diet (okay, I'm not counting how many cookies she ate, but at least she ate regular food, too!). Coming back home has been a bit more challenging, of course - coming back to earth, so to speak. She slept until 8 am (unheard of normally), then had a 3 hour nap in the afternoon (1 to 1.5 hours is more typical). So she was up still and hadn't eaten much since lunch when we at dinner around 8:00, and I sat her down to eat with us. Of course, my blood sugar was high, after running low-normal all day (such swings are the norm lately), so my idea of the family dinner was, once again, interrupted while I injected (and although I used what the pump calculated I should have, I am now running low because changing out the infusion set when I've been running high often causes this sort of reversal). As it happened, my daughter didn't want to eat much anyway - she often doesn't eat much at dinner, especially if it gets delayed until after 7 pm, though she usually begs for a cookie or another "special treat" (she doesn't understand that "special treat" means you don't get to have it at every meal!).

I'm pleased that I managed to give her just one cookie today, if only to wean her from the idea that she can have cookies all day, every day (I let her wear her pjs all day instead). I don't know what's normal in that regard - that is, how many sweets a two-year-old can eat. I know that, like us, a lot of people don't give their toddlers dessert on a regular basis. But what about on special occasions - how far can one go with the cookies? How about candy (as long as it's not hard candy)? As a diabetic, I have no idea how many sweets a "normal" kid can safely eat. One or two standard cookies at once, okay. How about three or four? And how about over the course of a day? She doesn't get sick even when I think she's surely had too much - so is that okay?