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?

Pump Problems

I've had insulin pump problems of a new sort ever since pregnancy. During pregnancy, the extra blood vessels in the abdomen that every woman gets became a problem, so I tried other infusion sites. (The pump pushes insulin through catheter tubing into a tiny canula, about a half-inch long, that gets introduced under the skin via a needle that then gets pulled out, leaving the canula in for a couple of days, before it has to be changed to avoid infection, and also because healing of the tissue stops the insulin flow. The abdomen is a great site because it's surprisingly painless and allows insulin to flow faster and more reliably than in any other site on the body. A pregnant belly actually isn't supposed to be a problem in itself - the canula doesn't go in that far! - but accidentally hitting a blood vessel clogs the canula and stops insulin delivery.)

First I tried the thighs: too uncomfortable (too much muscle, though I'm not all that fit), and still too many blood vessels. Then the "hip" (really, a bit further back than that!) - okay, but hard to reach, hard to get the canula to stay in, and a literal pain in the butt. Then the back of my upper arm: surprise! That worked and actually wasn't too uncomfortable or too in the way, ven though I had tubing running down my sleeve to where I keep the pump, usually in my pants pocket.

After pregnancy, though, I eventually went back to the abdomen. It's just easier, less painful (really!), and more reliable. But now, every time I hold my squirming two-year-old, I can feel the infusion set pushing in, and it often just stops working - gets clogged with blood or, I guess, kinked. I may well also have scar tissue built up over the years of injections and then the pump. I rotate all around the abdomen, but it still seems like certain sites are useless, for the first time (I've used the pump for about 10 years). Perhaps pregnancy, or the C-section, did something to the tissue there.

So now, I await new infusion sets to go in my arm again (it takes several weeks to get them), and change out the current infusion sets two or three times a day, and try to keep my blood sugar from going hopelessly out of control (what's the definition of hopelessly out of control? Hard to say, I'm probably already there). I'm just not sure the arm will be enough out of the way of my daughter's sweet, grabbing hugs. But I'm not about to hold her at arm's length, so I'll have to find a technical solution.

Would I ever go back to injections, though? I hope never to have to. Even with all these problems, I have better control overall than I ever did with shots, and I can push a meal later if I want (up to a point), where I couldn't with injections. Sometimes, being able to wait until I put the baby (big girl!) to bed is the only way to get a proper dinner, where I can program my insulin and then eat all the food, instead of jumping up and down and keeping track of her meal. I wouldn't go back to having lows overnight several times a week, either.