Just Keep Swimming. And Swimming. And Swimming.

Sugar moves.

All.  of.  the.  time.  I'm not kidding.  When she's sitting still, her toes are still moving.  Mr. Rose and I have joked about it for her entire life.

She also likes to ride her bike.  And swim.  And take walks runs around the block.  And swim. And chase the dog.  And swim.  And climb the tallest play structures. And swim.  And play tag.

And did I mention that Sugar likes to swim?

Summer has arrived in the desert, and that equates to swimming.

Is she going to swim hard or just splash around?

Huh?  Huh?  

Tell me.  Because it makes a HUGE difference.  If she's hanging out with the swim toys in the shallow end, that's one thing.  But, if she's treading water like a maniac and swimming all over the deep end...that's an entirely different story, my friends.

Using the same psychic powers that predict how hungry she'll be at lunch every day at school, I must pre-determine how active she's going to be in the water.  As a rule, I generally plan for a lot of activity and hope I haven't screwed up.  Like I said before...Sugar moves...so, in my mind, she won't be hanging with the boring toys for too long.  Soon enough, she'll be pretending to be a mermaid in an underwater sea adventure.

We're embarking on our 7th summer with diabetes.  After a few years of ATTEMPTING to be her pancreas, there's a few things I've learned that works for Sugar throughout swim season. (And keep in mind that this IS NOT medical advice.  This is one tired mother reminding herself of the swimming plan that worked last summer, because the pools are officially open again, and said tired mother isn't exactly sure how that happened so fast since last year, and "hello" run on sentence.  This plan is subject to change, because.  That's all.  Just because.)

1)  The pump MUST come off for swimming.  Since her pump is waterproof, she could wear it **with a ZERO TEMP BASAL**, but her history dictates an equation that never fails:

swimming + basal insulin = LOWS.

We bring a cooler of drinks to the pool, stick the pump in a ziplock bag, and toss it in there to keep the insulin from overheating -- which, by the way, is REALLY important when the weather tops 110 every day for a few weeks.  Overheated insulin DOES NOT WORK. (DISCLAIMER:  Sugar's Animas pump is waterproof.  Before choosing to allow your pump to stay on while swimming, or putting it in a cooler, please make sure you understand the manufacturer's recommendations.)

2)  She needs a snack AND a bolus within the hour before starting to swim.  Once she's splashing, a few random sips of Gatorade here and there definitely helps to keep things stable. Sometimes it seems like we're replacing her basal insulin infusion with micro-carb basal sips instead.

I've tried a few variations of decreasing her basal 1-2 hours before swimming, but

• A)  We don't always know 1-2 hours ahead of time that swimming is on the agenda; and
• B)  Stubborn highs seem like a consistent challenge after the fact.

3)  Blood sugar checks every hour.  Period.  More often, if she feels "off".  She needs snacks with boluses about every hour as well.  The insulin on board (IOB) feature of her pump considers the number of carbs being entered along with her current BG (yes, even if the last bolus was only an hour ago), and balances it with the active insulin still circulating to help prevent an insulin overdose (which is bad).

I have the ultimate authority to administer the dose I feel is appropriate (hands on hips, sticks out chest) based on the pump's recommendation and variables the pump cannot take into consideration (i.e. types of carbs being eaten, true level of activity, anticipated total disconnect time, etc.)  We simply reconnect to bolus as needed -- easy peasy lemon squeezy.

She needs bursts of insulin to convert glucose into energy for all those crazy mermaid moves. This means she also needs glucose available in her system to be converted.  The whole thing is a delicate artistic balance with one goal:  Make sure those crazy mermaid moves don't leave her helpless at the bottom of the pool.

4)  Beware of post-activity lows.  They can occur for about 24 hours after the activity, and may strike without warning, seemingly out of nowhere.  If the next day (and the next, and the next, and the...) is full of swimming, keep carbing  (and swimming) and realize that, eventually, it's going to catch up.  Be on alert, and armed with plenty of fast acting carbs at all times.

School is out.  

Our community waterslides are open.  

Players, take your positions...

Let the games begin!

The Induction

It just kind of snuck up on me, ya know?

It was a normal Thursday afternoon.  I didn't expect anything unusual.  I work on Thursday evenings, so Thursdays tend to be slow paced around here.  I don't schedule much -- in fact, if anything, I try to take a little nap and come up with an easy dinner (you know...cereal, oatmeal, pancakes -- or tacos, like tonight).  The girls generally have a quiet day after school (HA HA HA HA!!!), often just hanging out in their rooms or watching a movie....with a few little arguments thrown into the mix. 

Well, Sugar has been asking to play with a new classmate off and on for a couple weeks.  Today I was finally able to cross paths with her mom at pick up, and it turned out that this afternoon would work for everyone.  This other little girl had a couple other friends coming to play which meant Sugar would get to hang out with a gaggle of pals!

I shuffled the two extra kiddos I usually pick up home to their abode, followed by my 3 girls who were all talking at once trying to tell me about their day.  I can't say that I was paying attention as my brain had already moved to the next step...preparing Sugar for a playdate at a new friend's house -- WITHOUT ME THERE.   I promised myself that I'd regroup and ask each of them individually about their days once I jumped the hurdle in front of me.

Once home, we checked her blood sugar (147, after a cupcake at school 2 hours earlier, thankyouverymuch), made sure the bag was stocked, and ran through a few scenarios: 

"What will you do if your blood sugar is less than 100?"  
"What will you do if your blood sugar is over 300?"  
"Recite our phone number."  

**RING RING**

We got the phone call, I wrote down directions, and then....you know....mentioned that Sugar has diabetes.

Because you can just throw something like that into a conversation, right?

Forget the fact that we've been playing this game for 5 years and *I* still don't understand all the rules.  Or the fact that Sugar is only 7.  Or the fact that this little drop is such a powerful thing.  Or the fact that she has celiac on top of it.  I mean....it's all arbitrary, right?

Worried that I'd scare my new mom friend away, I quickly followed with an explanation that Sugar can check her own sugar, knows how to operate her insulin pump, should keep her bag in a safe place, will bring along her own gluten free snack, and knows to call me for any reason at all.

With that, we packed up and headed over.

It just happened so fast.  I tried to focus on how well she did the other night with a new babysitter.  I tried to tell myself that she can do this -- and I'll only be 2 minutes away --and it's just going to be okay....

About 20 minutes later, the phone rang.

**EEK** PANIC -- RUN -- JUMP OVER THE DOG -- FLY TO THE PHONE!!!!!!

"Mom, we're going to go swimming."

Ummmm...say again?

Let's pause for a moment here.  Seriously.  Go find the D Mama nearest to you 

and mention these three words:

"SWIMMING.  BOUNCE HOUSE."

Watch what happens.  I guarantee you'll get the same universal response. Those words will send shivers down a D Mamas spine so fast it could turn the desert heat into Antartica.

"But you don't have your swimming suit"  (YEAH RIGHT!  Like that's going to work when she's playing with TWO other girls the same size!!!)

Think.  Think fast, Wendy.  THINK THINK THINK!!!!!!

"Okay.  Well....check your sugar first....and take off your pump..." (I figured losing the basal would be best for this scenario)

After a little chat with her mom (I hope I didn't sound nervous), she offered to set the kitchen timer and have Sugar test every 30 minutes.

God love that woman!

And that was that.

I proceeded to pretend everything was normal....you know....I'm just a normal mom with a normal kid who is enjoying a normal afternoon in a normal backyard pool with normal friends.  Yup.  It's all normal.

Normal.  Normal.  Normal.

This image kept flashing into my brain from yesterday...

TARGET BLOOD SUGAR 90 - 150

But, you know....it's all normal.

Ho Hum....HO HUM....HO HUM!!!!

The next 90 minutes went like this....

180
120
80 -- Phone call while I was getting ready to pick her up to let me know that she was eating her snack.

Ya know, I think this newfound friendship is going to work out quite nicely.

(And everyone had a great day at school, by the way!)