Wednesday, February 12, 2014

Oof. Diabetes education

I spent from one till almost five this evening at Sick Kids with a nutritionist, Nat's diabetes nurse, and my step-MiL, learning how to manage Nat's diabetes with a completely different method. We've been using Humulin N and Humalog, two injections total a day, and Nat's had a lot, a lot, of variability in his numbers. On Friday evening we switch over to multiple injections a day and using a peakless insulin called Lantus. We'll be giving Nat injections every time he eats more than fifteen grams of carbohydrate, probably five times a day. This should allow us to match his injections to his carb count instead of frantically trying to tailor his hunger to the injection schedule. It will probably be rocky for the first couple of weeks, but I think we're ready.

 It will mean a lot stricter carb counting, but also allowing him to eat whatever he wants (more or less), with a lot more chance to explain. Like, "You can have an extra serving, but you'll need more insulin so you don't go high." It means more chance for Nat to be directly involved in his care, which is good. I'm still absorbing the details. We'll start over the long weekend, when Geoff will be home, and revisit all the numbers with his nurse on Tuesday.

I'm really tired, but not in a sleep-deprived way, which is weird. I realized I've been away from the house and very busy three days out of the last five. Normally I go out with a couple of kids or on my own less than once every two weeks. It's strange not being here to switch over the laundry, do the meal planning, or read aloud. I feel a little discombobulated.

4 comments:

Melanie Bettinelli said...

That sounds hopeful; but a lot to get your mind around. The part about Nat being more involved in decision making sounds really good, though.

lissla lissar said...

It does. We're on the first day of it now, and so far we've explained his food choices in a much more concrete way than we usually do, i.e. "You can have more crackers, but we need to give you another injection.". Working okay. The part that is worrying me is figuring out the exact carb count for homemade foods- do you cut all your slices of bread the same thickness? Make all your cookies the same size?- it's more scary than standardized manufactured things right now. I know it will become second nature in a couple of weeks, but right now it's a little nerve-wracking because it requires more precision.

Melanie Bettinelli said...

Might a kitchen scale help with the homemade goods? Are there tables that can estimate more accurately based in weight? I'd think x grams of bread would at least be better than x slices.

lissla lissar said...

We do. We have an excellent one, I just don't use it much, but I'm starting to- okay, if fifty grams of Goldfish have twenty-two grams of carb, then thirty-one grams have...

So much of baked goods is moisture. I'll probably add up the total ingredient grams, then weigh the finished product and divide based on weight. This is really exercising my ability to do fractions. There are tables available online with the carb count for most baking ingredients, and if all else fails check the package.