Monday, March 8, 2010

The highs and lows of skiing

Sleep. If there is one thing aside from a cure that I could change in the Type 1 games rules, it would be that "real" sleep would be allowed. Being able to just go to sleep, uninterrupted with peace of mind would be the the first ammendement that I would make... if only it worked this way...

For non-gamers out there, a popular analogy of what night time is like for a Type 1 gamer is the nighttime feedings that you go through with a young baby that persist beyond the baby years. I like to compare it to those nights when you're caring for a child sick with the flu. Times when you're planning to go to bed and you notice that your child is burning up. The last Tylenol dose isn't working anymore. You give some more but can't sleep until the fever goes down a bit. After all, such a high fever like this is dangerous and needs to be watched closely. You're worried that the symptoms will get worse and that the fever medication will be enough to keep the temperature down. If it does get worse, you know that it surely means a trip to the emergency room. You finally fall asleep exhausted, but quite uneasy because of the uncertainty in not knowing how your child's body will react to this flu virus and medication. You end up waking up a few hours later in a panic and can't get back to sleep without checking on the child to see if the fever has broken. You wake up the next morning very tired and go through the motions of starting your day...

I remember feeling an overwhelming relief when Adele would get over a flu like this before we started playing the Type 1 game. "She's finally over it, we can finally stop worrying and get some much needed quality sleep tonight" is what I'd say. Type 1 gamers never get this relief. They never experience this closure. They never get to move on. Type 1 players never get over their Diabetes. It's chronic. Life is spent walking on thin ice and you never know if or when you're going to fall through...

Adele has been asking to go snowboarding for a long while now. This desire of hers gained momentum during the Olympic games. An opportunity came up last Saturday so we headed out to our local ski hill. Adele opted for skis but I gave the snowboard a try. Adele had never skied and I had never snowboarded. As the saying goes "Snow = Low", so we were anticipating less insulin and extra snacks to keep low blood sugar at bay. Adele was high before lunch (12.0 or 216). Since we were still home and had a 1.5 hour drive to the hill, I gave her full lunch bolus. I wanted to bring her sugar down and we'd have a snack before heading out to the ski lift. We tested again when we arrived at the hill and her sugar was even higher (18.0 or 324). Crap ! Was it the excitement? Was it a bad pump site? Who knows? I gave her 1.0 units of insulin and no snack and we proceeded to burning off this excess sugar on the ski hill. Two hours later she had gone down to 8.3 (149) and was hungry so she ate a Fruit to Go bar and gave herself 0.4 units of insulin. At 5:45 pm her sugar had slowly dropped to a very good 6.5 (117). The Type 1 gods were finally cooperating. We ate, bolused and got another hour in out on the hill. We tested just before leaving for home at 7:30 pm and her blood glucose was 17.2 (310). Crap ! I guess skiing doesn't affect her blood sugar as much as other winter outdoor activities? Maybe "Snow <> Low"?

We got home late at around 9 pm. Adele's sugar was coming down (9.0 or 162). She ate a small bedtime snack - some crackers and fruit. We didn't bolus and she went to bed. At 10 pm she had dropped to 3.6 (65). We had never experienced a delayed sensitivity to insulin like this before. Her sugar was dropping and we were having a hard time getting it back up. About 60 to 70g of carbs later, 2 hours pump suspended and 5 or 6 blood glucose checks through the night with a lowest low of 1.9 (34), she pretty much slept through the whole thing (she barely remembers drinking the juice just before midnight). She woke up at 8:15 am the next morning at 6.5 (117) and I threw myself out of bed and started going through the motions of the day...

5 comments:

Keeley's mom & dad said...

To sleep a whole night with no worries,,,it's like dreaming about winning the lottery. Sean does her night testing throughout the week and I do her day testing. But on one night a week (Friday), I do her testing and let Sean sleep in on Saturday morning. So he has an entire night of sleep. If it's a "sick" week, where any of the kids are sick, we will take turns so that one of us doesn't have to get up at all. We each need those nights to recharge a little. I'm glad you guys got to go skiing! We're thinking of getting season's passes next year at Poley. Hope all is well with your family! Take care :0) Nat

Lora said...

I don't really remember what it feels like to get a "good nights sleep". At this point I feel like I'm in "zombie mode". I guess I should consider myself lucky though... I only have to check once MOST of the time. It could always be worse~ right?

Sorry you guys had a long night after skiing. We chase lows several hours later sometimes too. No fun!

Great post. You always have a great way to express how the rest of us feel.

Meri said...

This happens to us ALL THE TIME. Soccer season is the worst. When the boys have a lot of exercise, they usually don't go low during the day...it is always at night when they are sleeping. Happens every time.

I'm so glad she got to have her day of fun without Diabetes stopping her!

And sleep? What is this thing you call, "sleep?" I am fortunate, now that I have Lawton I can go back to sleep after our 1am checks (Most of the time) and know if there is a problem Lawton will wake me. It is a huge relief. but for a good 10 years before we got him, I was pretty much a zombie.

kim hobbs said...

hi mike
i just wanted to share our ski experience after reading your post. we live in florida and ski out west each year for spring break. our first year on the mountain was very stressful and exhausting. at that point, i didn't realize just how much altitude affects insulin requirements. we live at sea level and usually stay at a condo around 7,000 feet. during the day, we are anywhere from 7,000-10,000 feet above sea level. i need to increase garrett's basals by about 1 unit per day, distributed evenly through the day and night. if i don't do this on the plane a few hours before arrival, his blood sugar will be nearing 400 when we arrive at our condo. it is amazing how these small adjustments pulled him right into line; his numbers were beautiful last year. i don't even pull back on his carb ratios much at lunch while he is on the mountain. he does get the long "afterburn" at night, but not nearly as severe as what you have described with adele. this is probably because she returned home to her normal altitude, while garrett's sleep is still on the mountain. l learned about these changing requirments by reading a blog from another person with type 1 who moved from sea level to about 6500 feet and experienced horrible blood sugar problems.
i don't know what type of altitude change you had during your day of skiing. you were only there for the afternoon, so this change might not be the only reason for her crazy levels. it could have been a contributing factor, though. i just thought i would pass along this info...it may be useful if you ever spend a lot of time on the slopes and have significant altitude changes. Stay well!
kim

Illona said...

Hi Mike,
Thanks for your thoughts ... helps to feel connected to fellow Type 1 troopers. SLEEP ... what sleep? Even as we go through our nighttime routines, we 'sleep' on the edge ... any sound, any movement. We react quickly relying on our ability to assess a medical 'situation' with the efficiency of a doctor in the home-stretch of their second shift. Over time, we wear thin and as caregivers we can develop chronic insomnia and even worse, our own medical 'issues'. The stress of always trying to 'control' a situation / an outcome that can't be controlled ... just managed. It is now 22 years for my husband (a late 'bloomer' at 26) and 15 years for my daughter (diagnosed at 4) who is a university student now. Two different personalities managing this disease, now, in their own way with their caregiver as a safety net. Countless nighttime lows, seisures and glucagon needles take their toll on all concerned and 'sleep' ... is just a pretty word. Working and praying together for the cure ...