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Licking the Bowl [and Other Food Rituals]

Discussion in 'Parents of Children with Type 1' started by SandiT, May 7, 2013.

  1. SandiT

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    So as a kid on NPH, this is something Kira doesn't get to do anymore. And for me today, since we had such a hard time this morning, it's kind of being representative of so much.

    This morning Kira got some craisins, and started eating them right in front of me, giggling away. Craisins are very, very high carb; so this was a rather big deal.

    I had to sit her down and talk to her again about eating when she hasn't had insulin to cover it. About how it's not okay for her to just go around picking things up and eating. It was a hard morning with tears and upset.

    One thing that we did before this whole diabetes thing was that she got to lick the bowl when we made things. I'd rather not argue about the egg thing. I want to talk about the issues of not being able to spontaneously eat food.

    And about measuring the immeasurable... like how DO you measure or insulin for that little bit of stuff she has licked out of the bowl?

    How do you measure a little handful of super-carby craisins?

    What new and special routines around food have you created to help your CWD feel good about food again? Have you created any? What would this look like, these food rituals that, by definition, are forced to include "how many carbs in that?"?

    What do you say to your child when he or she cries, saying, "I just wish I was normal!"?

    Do you take the coward's way out like I did today, too? I'm making the cake while she's gone so I don't have to face her sadness about not getting to lick the bowl--a time honored family ritual for my family since... well, practically forever. Sadly, one of the extremely, extremely few that I even have to pass down since my family was the penultimate "dysfunctional" group.

    I feel sad, defeated, and cowardly today. Any thoughts on new happy food rituals would be really, really appreciated.
     
  2. HBMom

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    Have you considered changing to MDI? It would make things SO much easier.
     
  3. SandiT

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    We're in the process of getting the pump. Another couple of weeks, we hope.

    But I still don't know how you'd measure "licking the bowl" even then. :(
     
  4. liasmommy2000

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    Well, not on NPH though she was in the beginning. It was hard and while I appreciate it for the first few weeks while she adjusted to shots (that was AWFUL), after that it was just a huge pitb that I'd like to forget. I think sometimes she would just end up higher than we would have liked so as to be normal. Definitely for school parties etc.

    Now on the pump (and while on MDI) for things like licking the bowl, I just guesstimate, have her bolus for that and check often so we can correct highs/lows if needed.

    Trust me, as you go on you will get accustomed to just guessing and doing the best you can and rolling with it at times.

    And ITA. Switch to MDI/pump as soon as you can. Keep insisting if the doctor resists. Switch doctors if you have to.
     
  5. HBMom

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    That will be great! I think we pretty much guesstimated as far as "licking" goes. Once you have the opportunity to try it, you will get pretty good at it!
     
  6. liasmommy2000

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    You don't. You just guess (you'll get better at that) and then check often and correct/treat. I usually tell dd to put in 10-15 grams and we check in a bit.
     
  7. 3kidlets

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    In all honesty, I think this is mostly unique to the insulin she is taking. My father in law who is T1, has a very strict routine and does not deviate. He has always been on NPH. Therefore, he does not understand how Hana can eat anything whenever she wants.
    In all honesty,there are no special routines or rules. Just that Hana checks her BS and tries to per bolus as much as possible. We do a lot of guesstimating, which works most of the time. If she wants to lick the bowl, she licks the bowl.

    I agree with others. MDI or a pump will make this much more bearable.
     
  8. nanhsot

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    Well, you know how many carbs in a cookie or piece of cake, dough is simply unbaked cookie/cake. So a spoonful would be the equivalent of maybe a small cookie or a big bite of cake (depends on the size of the spoon).

    This is one of those things that doesn't happen daily so you simply can't sweat it. So she goes high, you correct. Totally worth it. Big dough eaters here in our home!

    Pumping makes this type thing sooo much easier.
     
  9. Nicole N

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    I look forward to these posts as well. We are almost at our one year anniversary and honestly I still am not good at guestimmating.
    I love to bake...and in our house as well we always licked the bowl (and lots of it)! Sadly, I just "sneak" bake now. I do it when my DS is not around. :(
    There have been a couple occassions when he asked to bake sugar cookies for the holidays like we always have. I refused to not allow him to eat the dough/lick the bowl...he didn't eat a lot...just a little...and I didn't give him any insulin...because I just didn't have a clue as to how much I should. Also, we can't check extra because my son HATES sticking his finger and we've had so many tears over this I just can't do it any more times than we already do. Not easily being able to "lick the bowl" is just another ridiculous aspect of this disease...and not a normal way of living (IMO). Sorry to not be encouraging.
     
  10. SandiT

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    Thank you all so much. It's a huge relief to know that there's an end in sight. I hate feeling like she can't just spontaneously lick a bowl or have a few freaking craisins. She loves those things. And I do let her have some, just with meals, not standing around waiting for her BG test while I write down all her foods. Her ratios are smaller now, but still so extremely tight. One bloody craisin miscalculation and she's at 296 (oh, you had 5, not 4? oops!).

    Her sensitivity to insulin is the hardest part for us right now, but today with her not wanting to go to school and her crying about not being like other kids... it was really hard.

    She got cheered up and off to school... but I'm still a train wreck, lol.
     
  11. hawkeyegirl

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    You will become very good at bolusing for licking the bowl. ;) Seriously, pumping will change your life and hers for the better. My son eats normally, and has since we started pumping 5 years ago.
     
  12. SandiT

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    It's really hard, and it's really depressing. Cooking together and letting her lick the bowl is very bonding and sweet.

    I wonder on the finger pokies, what kind of lancet do you use? With Kira at least, she has begun to choose the finger pokies and an extra shot sometimes when the time is right that she can have a little extra, desired treat.

    Maybe, "I'd like to bake a cake tonight, though I'm not sure we'll have enough time. Besides, if I bake a cake, it would mean an extra finger pokie if you wanted to lick the bowl. Maybe I'll make it tomorrow instead." See if he says, "I'll let you do a finger pokie if I can lick the bowl!" Make sure that he knows he'll get a bit of the cake after you make it, though.

    I was really shocked when Kira started bargaining "I'll get an extra shot for it!" when she wanted some ice cream, lol. But that kind of has to happen in conjunction with a meal for us at least.

    You never know, you might find him willing to accept the extra finger pokie if he knows he's getting something out of it. If done well, where he knows that otherwise he can just wait until lunch tomorrow and get a piece of the cake itself, so he's not really "losing out" if he doesn't want a finger pokie... but he would be gaining if he decided to risk it.
     
  13. Sarah Maddie's Mom

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    You might want to look into alternate site testing. My dd uses her forearms with the freestyle lite kit lancer and the clear cap. For her it's painless and (cleaner) and when compared to finger sticks, no discernible difference in the numbers.
     
  14. Anyelday

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    I feel the same. Every time I spontaneously pop something in my mouth I think about how she can't and it makes me sad.:(
     
  15. mamattorney

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    I know things are different with NPH, and I know my daughter is strongly honeymooning (in the span of less than 2 months has gone from a 1:10 ratio to a 1:30 ratio), and maybe I'm a horrible parent/diabetes caretaker, but sometimes I just let her eat a little something and we correct for it later if we have to.

    For example, we were at a coach's house for a season end party for one of her activities on Sunday and I took her aside to the bathroom and she bolused herself for the main meal, and after dinner the kids were all running around in the backyard playing and having a great time. Then about 30 minutes later someone brought out ice cream sandwiches.

    The correct thing to do would be to pull her out of the backyard, take her back into the bathroom and bolus for the ice cream sandwich, but I didn't. I let her eat one without a shot and told her we'd correct her later if we had to. It turned out we didn't even have to - probably all the running around after dinner (incl. trampoline) took care of it.

    I know her honeymoon will end and we will have to be more careful with things like this, but I don't think I'll ever be beyond doing it under circumstances like this for so long as she is on MDI. With a pump, I think it would be less of an issue. But, especially being so new into diagnosis, we're doing our best to make diabetes fit into her life, not the other way around.
     
  16. SandiT

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    Well, the difference is that, at a party, we're there with her. I can correct her BG later with a little novolog, and it's no problem. I can also frequently test her.

    However, on a school day, it's all a different story. She gets tested twice at school, no more. And she doesn't notice highs or lows AT ALL.

    So I agree that at parties and things like that, it's okay to just correct for it. We do that, this Saturday she had a friend's party. It was a lot of fun for her, and we let her have extra stuff and gave novolog over and above her typical NPH coverage.

    But I was there to keep track of her testing and to watch her behavior and sense lows or highs.

    School days aren't like that. I can't just correct for those craisins later--well, I can, but I have to go over to school and do it since there's no school nurse. It's a different day weekend versus school days. :(
     
  17. mmgirls

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    First I think you need to get a food scale, with a scale you can weigh 5 crasens and know how many carbs, and then you will come up with little things that you will remember after having that same thing a few times. Like medium grapes, after awhile I realised that each medium grape is about a carb each, so when she asks to have some at the spur of the moment I say sure get 10 or 20. or that 4 medium strawberries is about 6carbs.

    You need to work with the school so that you have a system that works for both of you. If the difference from school and home is what is making her the most upset then this is something that you will have to work on now and not wait till you are pumping, this is the time to get things worked out so that there is not a difference in school and home.

    Of course my dd was just a toddler (13months) when dx'ed and not yet weened and the dr's insisted that it would be best to ween because we could not carb count for breast milk. So I did, and that was the worst choice to make for everyone. It lasted for 2 months the weening, and then I could not do it anymore, so I decided that it was in the best interest of everyone involved that I give her the comfort that one I could give and make it work.

    I had no flipping idea how much milk she was getting from me it literally was me deciding either by how full/empty I felt or how long she was at it before she fell asleep in my arms. Sometimes I would bolus her and other times I would not, you have to go with your gut sometimes.

    Even with pumping and CGMing and using a scale 90% of the time we get numbers in the 300's and numbers in the 50-60 often enough, it is hard being a pancreus beause as much as we think we can control for a few variables like insulin and food, we can not for all the other variables that are just as much if not more involved in what shows up on the meter.

    I remeber a day when my dd was running high, in the 300's no matter what I did. increasing insulin, changing her site, changing the insulin, "rage bolusing" to no avail, still stuck in the 300's like the insulin was water.

    We went to Sonic and got a milk shake for the first time with whip cream and cherries on top. I did not weight it like I normally would have done, did not bolus her since she had never had one, and just waited. Sat in the car and enjoyed watching her have her first whipcream and cherry topped choclate milk shake. she only ate about 1/3 of it and I then looked it up and bolused her. You can do everything right and it still might not work out, and you can do everything against what you would normally do and end up in the same place. With the same number on the meter either way.
     
  18. Nicole N

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    Food is everywhere - treats are everywhere - my DS does eat all of these goodies - it's just very hard to give the correct amount of insulin for them when the item is homemade or a lick of the bowl, etc.

    To SandiT:
    Thank you for the suggestions. We have tried 3 meters/lancets and currently use the FastClix. Based on all the research I've done this is supposedly one of the least painful. Our dr. suggested we try the thumb and palm as additional sites but they just don't work as well (it is difficult to get enough blood out).
    My son said the same when he was on MDI - "I'll get an extra shot for it" - completely broke my heart. We have been pumping for 6 months. It does make it easier to eat/snack but knowing carbs for everything - like licking bowls - is so tough.
    To Sarah:
    Thank you. Based on all that I've read and learned, alternate sites just aren't as accurate as fingertips. Do you happen to know of research studies where this is not the case - where these alternate sites are accurate and easy to use?
    Nicole
     
  19. SandiT

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    Perhaps having him warm up his hands as much as possible will help with that. Kira washes her hands in as warm water as she can for as long as she can til they're warm in order to get get enough blood.


    We have a scale and we use it for everything. The issue this morning was 1. how much did she eat? she "didn't know". She's so sensitive to insulin that, if she ate 6, and I gave insulin for 5, she'd be very high BG. If I gave her enough for 6 but she only ate 5, she'll plummet to below 70.

    The endo was all "omg, you have her on a carb restricted diet, that's why you have to count each raisin", but that's very simply not true at all. She is just extremely, extremely sensitive to the insulin to the point where being off in carb counting on anything like craisins that's she's quite responsive to begin with, can throw her very high or very low... and she's still only on a 1:28 ratio, so trying to be accurate for ONE craisin is insanely difficult. Mind-blowingly difficult.

    That's why this "strange" obsession with how much bowl licking comes to... there isn't ANY wiggle room AT ALL in Kira's doses. She has to eat within a carb or two--tops!--of how much insulin I gave her, because being off just a bit shoots her sky high or plunges her below her range. It's like an insane pendulum.

    My daughter's school year is nearly over. And it's all about to change when she gets the pump, too. I just want to get it over with, with the least difficulties. She'll be in a different school next year, so I don't want to bother getting into all of this with this school right now.

    We're struggling enough just trying to get her diabetes to resemble "controlled" in any way... every time I turn around, the rules change. Higher NPH... oh no, wait, lower NPH, raise novolog... nope, that didn't work, let's make her eat more carbs... no more carbs, too high at lunch now... It's crazy-making as is.

    I know that it's always a wild ride. However, Kira is SO sensitive to the carbs and the insulin that it's literally obvious when it's because I didn't get the dosage JUST right or didn't measure something extra.

    The only thing predictable about Kira's diabetes is that she WILL have a reaction to too little or too much insulin based on just a TINY miscalculation.

    So I meticulously weigh everything and obsessively track everything. Many days now, I just get tired of it and give her something that's EXACTLY the right amount and hasn't ever been a problem. Which is in its own way rather heartbreaking sometimes. "Here, just have a granola bar because I'm afraid you'll drop to 45 if I'm off by 1/8 of a unit" sucks. It's not fair to her.

    Honeymoon... well... isn't. :rolleyes:
     
  20. Sarah Maddie's Mom

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    Personally, I think to get all worked up about the "accuracy" issue between a finger stick and a forearm poke one needs to 1. believe that their meter is always 100% accurate, 2. That fingers are never dirty or damp, 3. that test strips and meter have been kept at ideal temperature and 4. that bg is moving so rapidly that the finger stick will catch the 325 that the arm simply sees as a 300. Oh, and too that your I:C ratio and your correction factor are spot on as to make that 25 pt difference matter.

    I don't believe any of the above so she tests on her forearm, has an A1c under 7 and has never cried about finger sticks.

    I gave up believing in the perfect science of managing type one years ago. It's an art, it's a life and it's inherently imperfect. JMHO
     

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