Wordless Wednesday ~ NHBPM!

National Health Blog Post Month starts tomorrow. 30 days, 30 health posts. I'm in, are you? Click the image above to sign up!

...and Happy Halloween!

Sending Relief to Storm Victims

We have all witnessed the devastation brought by Hurricane Sandy, though most of us via television or internet. For those who live in the areas hit by the storm, who have lost power, homes, or experienced injury as a result of the storm or its damage, I offer my deepest sympathies and pray that you find the strength and supoort to pick up the pieces and rebuild your lives.

Numerous organizations have offered, or will be offering, relief to victims of Sandy, be it in the form of food, temporary shelter, warm clothing and blankets, or medical treatment. ViSalus is one of those organizations. Between now and 11:59pm PST Friday, November 2nd, ViSalus will be directing all of their Community Challenge donations to Hurricane Sandy relief efforts. These donations are in the form of meal-replacement shakes. Each shake provides complete nutrition and is a balanced meal suitable for adults and/or children. To date, the ViSalus Community Challenge has donated over a million meals to people in need, including food banks, to after-school programs, to natural disaster relief.

Challenge yourself to make a difference. For a $24 donation, ViSalus will donate 30 meals on your behalf, and match your donation with an additional 30 meals. That means $24 will get 60 meals to those affected by Hurricane Sandy. Visit the ViSalus Community Giving page for further information, and to donate.

Thank you for your support.

Blogroll Updates

After completing a thorough review of my blogroll, I've decided to do some updating. I removed a few blogs that are no longer active or haven't been updated in the past 6 months or more. I've also been reading other bloggers lists to get ideas for new diabetes blogs to include on my roll.

That being said, I know there are tons of worthwhile diabetes blogs out there, so if you wish for me to include yours, or notice there's a great blog out there that's mysteriously absent from my list, please post a quick comment with a link to the site I should check out and I'd be happy to add it to my blogroll!

Pumpkin Bundt Cake

Just in time for Halloween and the holiday season, this festive bundt cake was a huge hit with my family. Personally, pumpkin flavored foods are not my cup of tea, but I found myself drawn to idea of doing some pumpkin baking and giving the gourd another try. I'm so glad I did! I used the recipe below, which I adapted slightly from a recipe that appeared in Epicurious in October 2007. I also added a light glaze consisting of icing sugar, lemon juice, vanilla, and milk, to the cooled cake.

Ingredients

3 1/3 cups sifted all-purpose flour

1 1/2 teaspoons baking powder

1/4 teaspoon baking soda

3/4 teaspoon salt

2 teaspoons ground cinnamon

1 1/2 teaspoons ground nutmeg

3/4 teaspoon ground ginger

1/2 teaspoon ground allspice or mace

1/8 teaspoon ground cloves

1 1/2 cups granulated sugar

1 1/4 cups dark brown sugar, packed

1 cup canola or light olive oil

5 large eggs, at room temperature

2 cups canned unsweetened pumpkin

2/3 cup orange juice, milk, or buttermilk (I used milk)

Procedure

Position rack in lower third of oven. Preheat oven to 350°F. Prepare the pan as directed. In a medium bowl, whisk together the sifted flour, baking powder (if using), baking soda, salt and spices. Set aside.

Add the granulated sugar to the large bowl of an electric mixer and crumble in the dark brown sugar, breaking up any clumps with your fingers. Add the oil and 2 eggs and beat until blended, then beat in the remaining eggs and the pumpkin. Scrape down the bowl and beater. With the mixer on the lowest speed, alternately add the juice or milk (or buttermilk if using) and the dry ingredients. When everything is blended, scrape down the bowl, then beat a few seconds longer until the batter is smooth and creamy.

Scoop the batter into the prepared pan. Bake for 65 to 70 minutes (or for the time indicated for your altitude in the chart) or until the cake has risen, is springy to the touch and is cracked on top, and a cake tester inserted in the center comes out dry. Cool the cake in its pan on a rack for 20 to 25 minutes. Slide a knife around the pan sides and the top of the tube to release the cake. Top the cake with a foil-covered cardboard cake disk or a flat plate, invert, and lift off the pan. Cool the cake completely. Makes approximately 16 servings.

Nutritional Information (Approximate, Per Serving)

Calories 383, Fat 19.5g, Sodium 380mg, Cholesterol 26.4mg, Carbohydrates 50.2g, Dietary Fiber 2.1g, Protein 3.9g

Maze of Fear

Throw this into the mix to add a bit more fuel to a d-mom's fear. Dylan is going on a corn maze trip tonight with his class. 25 kids, ages 11 and 12, are headed out to a corn maze located about an hour from where we live. They'll enter it at dusk, and proceed to find their way out using their wits, sense of direction, and flashlights. This is a BIG maze. We went last year and it look us about an hour and a half, of steady fast walking, to get through it. The kids will start all together, but will quickly split into smaller groups. And while there are a few parents going, I am not one of them (I have to work), and my 2 "go-to" parents, that are very familiar with Dyl's diabetes and recognize his low symptoms, are not going either.

So let's put this all together: type 1 child on a pump with newly increased basal settings + excitement of 24 other kids and a nighttime adventure + 3.5 acres of corn maze to get through, aka major exercise + dark + no diabetes-knowledgeable adult supervision + a maze (potential to get lost). Am I insane letting him go? What if he has a low and he can't find anyone? There are so many "what ifs" running through my head.

I have to keep forcing myself to remember that he is almost 12. He's not a little boy anymore, and he's lived with diabetes for almost 7 years now. He recognizes his lows early on, and is very good at treating them effectively. This is one of those times when I can hold on, or let go. And I need to let go, so that he can continue to grow and take on more and more responsibility. So I'm permitting him to go and have fun with his friends, knowing that he's armed with a tester, a juice box, a bottle of dextrose tabs, and his cell phone.

An example of a local corn maze

Tweak, tweak

Last week I wrote about the problem we were having with Dyl constantly running slightly high (Trends Don't Lie). As a result, we upped a couple of basal rates in the hopes that it would at least curb the 2 daily spikes he was experiencing. And we were right, it did combat the spikes. However, it still left him elevated throughout the day, all day.

Fast forward to today, when we were back at the diabetes education center for a check-up. In addition to doing Dyl's quarterly A1c, weighing and measuring him, and talking about changes and updates in diet and exercise routine, the endocrinologist took a really hard look at Dyl's pump data and decided to make some pretty substantial changes. In fact, she increased every single basal rate. Background note: Dylan has six different basal rates which vary considerably at different times of day. For example, because he is prone to hypoglycemic seizures in his sleep, he takes less insulin at night. For some reason, which we really have no idea, he requires more than twice the amount of insulin between 2:30pm and 6:00pm than he does at any other time of day. The other 4 rates fall somewhere in between. (This ability to vary insulin delivery over a 24 hour period is one of the MANY reasons I love pumping over MDI.)

I've said this before, and I'll say it again and again: I love our endo and I trust her explicitly. So when she says increase all the basal rates, I do it. And I did, but not without fear. This is, by far, the most drastically we have ever altered Dylan's settings, and a couple of the settings were increased by as much as 0.2 units per hour. In an MDI user that injects insulin two or three times a day, 0.2 units may not seem like much, but in an 11 year old pumper, who boluses additional insulin for food, it's a lot. Fingers crossed that these changes get his bg levels back into ideal range, at least most of the time.

Wordless Wednesday ~ Signs of...

Driving to work yesterday, I was struck by the stunning color of the leaves on this tree. So much so, that I stopped and took a picture. Fall has definitely arrived. And while fall is perhaps my least favorite season (because in Vancouver it rains pretty much every day in fall), fall means Diabetes Awareness Month in November!!

Big Blue Test!

It's back! Once again, the Diabetes Hands Foundation is running the Big Blue Test, from Oct 14th to Nov 14th. Participate and help those around the world with diabetes in need.

How Does it Work? Simply test your blood sugar, exercise for 14-20 minutes, test again, and fill out the super-simple form on the Big Blue Test website. It's that easy! Don't have diabetes? No problems, simply track your exercise only!

Why? The average person participating in the Big Blue Test sees a reduction in their blood glucose level of 20% after 14-20 minutes of exercise. And if that's not enough reason to get you motivated, how about this? Every test gets the Diabetes Hands Foundation one step closer to their goal of 20,000 entries.And if they achieve 20,000 entries, Roche Diabetes Care will donate $100,000 to organizations that provide supplies and services for people with diabetes in need.

Quick, easy, and effective. This is a no-brainer. Test today. Test every day between now and November 14th.

Trends Don't Lie

Up and down, up and down. Just when I think I have pump rates set so that "in range" is a reasonable goal for the immediate future, diabetes goes and changes everything again. Call it Murphy's Law, call it karma, call it whatever you want, I call it living with diabetes. At it's best, it's manageable; at it's worst, it's a roller coaster, but it's always uncontrollable. And the more we try to control it, the more elusive that control becomes.

After some pretty decent bg readings for most of September, we have seen some consistent highs for the first half of October. And not "high" highs, which are so much easier to correct, in my opinion, with a nice, big, well-measured bolus. No, we've been dealing with what we call "low" highs in our house - those pesky high blood sugar levels that don't appear to be have an obvious cause. The ones that hover just a little above the "ideal" range; too low to continually correct, to high to ignore. The 11's were our battle for Thanksgiving. Not just one, not two, not even three, but a solid 48 hours of blood glucose readings ranging from 11.0 mmol/l (198 mg/dl) to 11.5 mmol/l (207 mg/dl). Furthermore, Dylan felt fine. He didn't feel high and wasn't showing any symptoms of hyperglycemia. It didn't seem to matter what he ate, or how many times we corrected the highs, the next reading was another 11. We changed infusion sets, tried a new vial of insulin, double checked against multiple meters and the result was still the same...11s. It became a bit of joke with Dyl after a while, as he'd test and then say to himself, while waiting for the number to appear on the meter screen, "anything but 11."

What does one do in that situation? Personally, I am always hesitant to adjust basal rates because so many things can cause a temporary increase in blood glucose levels. Maybe Dylan was under a bit of stress, or fighting the early stages of a virus. Perhaps he had a decreased amount of exercise for that 48 hour period. Or maybe it's the beginning of puberty - something I've been dreading, from a diabetes standpoint, for a while now. The point is, it's so hard to determine what causes a rise in bg, that basal adjustments are not always the best answer.

So I did what I usually do in this situation, after I've tried the obvious solutions (bolus, increased water, bout of exercise, infusion set change, new insulin, different meter) and haven't seen success - I look to the numbers to tell me. After all, numbers don't lie. And while a single number, or even a day's worth of data, can't always provide a clear picture, trends over time can reveal a lot. So I sat down at the computer, uploaded the last two weeks of pump data, and stared long and hard at the information, looking for trends, patterns, or anything that would shed light on the situation. Sure enough, I quickly discovered a number of problems. Twice during the day, for the past 2 weeks, Dylan's bg levels had been quite elevated (prior to the 2 days of 11's). It was always at the same time each day, and always a similar level of elevation. So I increased the basal rates for the few hours prior to those 2 times, in the hopes that it would help to curb the spike.

I then texted the endocrinologist to let her know that I had uploaded new data, and increased two of Dylan's six basal rates. I also asked if could she please let me know if any other changes were required. Yup, after almost 7 years of parenting a child with diabetes, I still ask the endo about every change to pump settings. And I probably always will.

Happy Thanksgiving!

Wishing all of my Canadian readers and their families a wonderful thanksgiving!!

BSC Wins Award!

KwikMed, a leading health care provider with a profession, modern approach to healthcare, is one of just two fully licensed online pharmacies in the USA.

Last week, KwikMed recognized 20 diabetes related website/blogs for their excellence in contributing editorial content to the diabetes community. After reviewing hundreds of sites, the specialist panel of judges selected Blood, Sweat & Carbs as one of the 20 diabetes sites to receive this award!

I am so flattered to be included on KwikMed's list! For a full list of recipients, visit: http://www.kwikmed.org/20-star-quality-diabetes-information-sites/

What if it All Came Crashing Down?

I keep envisioning this image of myself as a juggler, trying to simultaneously spin multiple plates on his hands, feet, elbows, knees, hips, head, and any other body part one could possibly balance a plate. I've been spinning them pretty darn well for a long time, balancing a child with diabetes, a struggling and rebellious teenager, a stubbornly demanding nine year old, three jobs - one of which is on call and very unpredictable, a range of familial problems, a husband who has changed jobs four times in sixteen months, financial struggles, my own personal health and exercise goals, and a marriage that has been suffering as a result of me being on overload for too long. It's been a precarious experience and I've been feeling like if I took a moment to breathe, all of the plates wold come crashing down. And broken plates is simply not an option.

So I checked out. On blogging, on life, and on myself. I've stretched myself too thin for too long, so I forced myself to step back and really evaluate my life. I asked questions, about what I want, what's important to me, and what things are not worth my time. Where do I want to be in six months, in a year, in five years? What do I truly want for my family, and for myself? Asking questions like these can be hard, because the answers are not always what we want to hear. But if I'm to get to where I want to be, I need to make some sacrifices, and focus on the things that will help me achieve my goals.

So more negativity. No more living in the past. No more worrying about, or even thinking about, trivial things. It's time to focus on what matters. On the positive, on the meaningful, and on making the most of each and every day.