Dear pizza, not today!
Ok, today stunk. Pizza for Rocco is the devil. The main problem is that the fat in the pizza causes the carbs to kick in more slowly. So the pre-meal insulin can cause low blood sugar early on. Then, when the carbs finally kick in later, the insulin has already stopped working (high blood sugar). When there is a family gathering, pizza is often the main course. This was the case last Sunday, when we spent a belated Christmas with my aunt and cousins at my mom’s house.
So here is how it went. As a side note, our target blood sugar level for Rocco is 150, although a range from 90 to 120 is better for him long-term. My plan for the pizza was first to research the carb count per piece exactly. I use an app on my phone called Calorie Counter.
Then I was going to start him on the insulin 15 minutes before the pizza comes. This is a trick my doctor swears by, but, thinking back, this was a mistake with pizza, since pizza carbs are delayed due to the fat content. I was also going to count every carb of the treats and desserts he chose. Finally, I decided to bite the bullet and check his blood sugar ALOT throughout the day.
Before we left the house at noon, he was at 103. Awesome!
Got to mom’s and I checked him again at 1:30. He was at 163. My mommy guess was that he was going up because his body was finally now processing the protein from a zero carb meat stick I gave him a while ago. Although the snack was zero carbs, protein eventually can release some carbs into the body. Or, maybe he was going up due to the excitement of a fun day.
I gave him some pre-meal insulin at 2:15, around 45 minutes before I expected the pizza to arrive. Here is where I went wrong. I thought he would eat some chips or crackers that were out until the pizza arrived, but it seemed he was focused on playing rather than eating. I let it ride, thinking maybe it would help his rising blood sugar. I knew I should have given him some food, but he was having so much fun reconnecting with his cousins, fun mommy told diabetes mommy to let him be.
At 2:30, he said he felt low. I checked him and he was at 75, too low. We had 30 minutes before the pizza would arrive, so I gave him a CapriSun at 17 carbs.
At 3:00, the pizza arrived. He ate two pieces, for 60 carbs. Including the juice, the total was 77 carbs. Ugh!!! At home, we usually try to limit meals to 40 or 50 carbs.
To top it off, there were five different desserts. I told Rocco and Zeke before we left for my mom's house that they could each have two desserts. My mom usually cuts things up in bite-sized pieces, so I thought each dessert would amount to only a few carbs.
For dessert, Rocco chose an 8 carb pastry (not too bad) and a 17 carb pumpkin square (darn it). At this point he was up to 102 carbs! But, being the scardy cat I am, I told the pump he had only 90 carbs, so that it would recommend less insulin. Like most moms of diabetics, I tend to guard against the immediate bad effect of too much insulin, even though the long-term impact of high blood sugar (i.e., not enough insulin)is also very bad. His pump recommended 2.4 units. I decided to do a dual wave of 1.7 units now and .7 units over an hour and half. I gave him the insulin and locked his pump. I guessed that some exercise would help the insulin battle all of those carbs, so I said a little prayer and sent him off to play with his cousins.
An hour and forty five minutes later, I was just about to check him when Zeke came downstairs and said,
"Mom, Rocco is low, really low."
Wow! This is one of the few times that Zeke has actually told me this - kind of a big moment for me.
On the way up the stairs, I asked Zeke "How did you know he is low?"
"He was just really, really mad and he yelled at the girls". Crap!
I kissed him on the head and thanked him for letting me know.
I checked Rocco and he was actually at 228, not low at all! That number is, of course, too high but for 102 carbs, I will take it! At this point, the pump did not recommend any additional insulin but I knew I had shorted him earlier. If I would have just given him the full amount, his reading would probably have been perfect. Lesson learned.
So I gave him 0.4 units.
An hour later he was 177, still not bad. He wanted another Capri Sun and a piece of a brownie. Ok, so here is where I know I should have said "Stop! no more carbs for you tonight", but I didn't. His numbers weren't terrible and the other kids were eating, and to tell you the truth, I just didn't have the heart to tell him no.
I hate singling Rocco out at social functions. He already has to get checked, and he already has a lot of restrictions put on him when he is around a group of kids, I almost always cave into his demands. One time we were at his pre-school Valentine's Day party and I said no to something super sugary and he cried. Everyone looked at me and him. The teachers, the parents and most importantly ALL the kids! I was mortified and he was mortified! One little kid kept asking me "Why is Rocco crying? Why is Rocco crying?" Zeke came over and answered for me, "because he can't have a rice crispy treat!" This made Rocco cry harder. Thanks anyway, Zeke.
After this experience, I swore that I would mostly let him eat what the other kids were eating at social events and just load him up with insulin. I don’t necessarily recommend this, but this is how I get through it. Rocco’s doctor told us to remember that Rocco still is a normal kid. Let him eat carbs. He can have sugar. Don't single him out. Just give him the insulin to match the carbs. He will be fine. I silently chant these words to myself at parties and family gatherings. Having a pump to do frequent insulin adjustments, rather than doing multiple injections with a syringe, is what makes this easier.
However, I still look like a freak at these parties. I hover over him like a neurotic bird. Counting carbs and trying to smile and nod at the other parents. Forget talking to them or getting to know them. My head is swimming with numbers as I watch him eat rice crispy treats, frosting-covered cookies, and while slurping down Capri Suns. The other parents must think I am a totally anti-social, because when they try to make small talk, I give them a half-interested smile while looking past them toward Rocco and counting every time he takes a bite.
Oh and don't forget, I also have another son in another classroom wondering if his mom will show her presence at his party... Ugh!
The hour and a half at these parties is exhausting! Truly just a hot mess. Total disclosure: I almost always leave in tears. It's just too much. I cry because usually it is only 10:30 am he just had 97 carbs and has 3.2 units in his 50 pound body. "Good luck trying to concentrate on Math groups Rocco. Mommy loves you..." Crap!
So, back to my mom's house. Now it was 8pm and I just wanted to check him before we went home, in case he fell asleep on the way. To my surprise the number was 147!! Seriously, I wanted to "jump the couch" like Tom Cruise! Wow! What a day!!
Then it was midnight, and we checked him again. He was at 326.
Dear pizza, you win. Again...