Mr T wanted to take part in his field hockey-team, team building activity, a day long hockey clinic.
This would involve lots of excitement, running and hitting the ball from 8am till 3pm. Longer than a school day and certainly more activity.
The food would be provided by others for the entire team and of course, no moms or dads would be allowed to stay for the day.
In one word - a challenge. A scary challenge.
without being the only mom hovering over the field?
Feeling sorry that the invisibility cloak has not been perfected yet,
I just had to go with the tools I had at hand on the day:
I changed the pump settings to deliver lower doses of insulin
Activity makes insulin more effective. Mr T will therefore need less insulin on the day, but how much less? Pure guesswork here since he has never before had such a day: basal reduced by 30% for the duration of activity and beyond. For this purpose I have set up a separate basal program called “exercise”. I could have used the temporary basal feature with a setting of -30% for XX hours BUT if he needed to prime the line (in the unlikely event that……say he found a bubble), temporary basal would have been cleared and the pump would automatically revert to full basal after the prime. This would result in too much insulin, potentially dangerous.
I also changed the insulin to carbs sensitivity factor, from 1:17 to 1:22 guaranteeing that he would get less insulin for the same amount of carbs compared to an ordinary day. Why 1:22? I do not know, I took a guess.
I found out about the break and eating times
That was easy. I can always phone in during the break to see how is it going.
I found out about the food they were going to eat
I was told that they will have a selection of fruit for morning tea break and sandwich rolls with ham and salads for lunch. I was shown a bun and guessed they were about 40-45 g of carbs each. Playing it double safe, I advised the coach to tell Tomas to bolus for 35g each.
I asked the coach to remind Mr T about his routine and insulin
I explained quickly that Mr T needs to test before each meal and give insulin through the pump for any food with carbs that he may eat. A crash course for the coach. Mr T needs a reminder only, he’ll do the rest, I hoped.
I informed the coach and staff about what to do in case of a low or loss of consciousness
Another crash course, but they already knew that Mr T needs to eat his sweets or drink his juice if feeling low. In addition, I briefed them about use of Glucagone in case of an emergency. I was very relieved when they accepted the responsibility of administering it if it came to that. Two people staying with the kids had First Aid certificates. A relief for me.
I left extra sweets and extra food for Mr T
Always good to have a back up, which you only realize if you do not have one. This was just in case Mr T was extra hungry or going low after the provided food was eaten.
I left my phone number with the coach /staff
Thank goodness for mobile phones!
I trusted Mr T to do the right thing
I hope he has learnt something along the way. At least some of my nagging must have got stuck between those ears.
And I hoped he will be OK
Looking back on the day and considering that Mr T DID NOT test his BG before morning tea; and considering that he bolussed for 40g carbs for fruit (a bit high unless he actually ate half
a watermelon) and that he bolussed 105g of carbs for lunch (having only eaten 2 buns, 70g carbs in total) it was a miracle that his BG profile for the day was like this:
6:00am 10:00am 12:30pm 2:00pm 4:00pm 6:30pm
5.3 ?.? 5.0 5.0 4.1 5.3
I am grateful for that, but one thing is certain – I need to share more on carbs counting with Mr T so he can build his confidence in it and get the better feel for unlabeled / unmeasured foods.