Monday, August 8, 2011

Another paranoid (but more specific) school question

So...

We switched over to the school schedule today to get ready for kindergarten in TWO WEEKS. He's been getting up at 7:30 and eating around 8, so I wanted some time to figure things out since he will be getting up at 6:30 and eating at 7. Breakfast has always been pretty tricky for us, but we've been having some consistent and satisfying results over the last couple months, so I wanted to make sure that a schedule change wouldn't affect that. (HA! HA HA!).

So he spikes up to freaking 384, double arrows up. Out the window goes the plan for morning snack- which he usually needs to keep him from crashing post breakfast (just no other way around it). Lunch was supposed to be at 11, but since he got his correction at 9:30, two hours after breakfast (did I say breakfast was supposed to be at 7? Yeah, he was still in bed. Oops.) he wasn't ready to eat lunch until closer to 11:30, because he was still uncomfortably far above target.

So the question is: what happens if it is lunch time at school, and he's high? Like, too high to let him eat high?

At home, we have the luxury of waiting until he comes down. I have the luxury of substituting low or no carb options until he's in range. At school, 30 minutes later means lunch is over. At school, lunch is whatever is already in his lunchbox.

In preschool, we didn't have lunch, but if he was too high at snack time, we'd give him the option of:

a) Hunt's Sugar Free "Snack Pack" (which means Jell-o)

I do not love this option for many reasons, first of all being that I firmly (ha ha) believe that jello-like products need to be cold. There is something scientifically confusing about how this does NOT have to be refrigerated. Which at pre-school was essential, since they would not allow us to use their refrigerator due to licensing restrictions. That isn't the kind of thing we'd normally have a problem with. Just ask my sweet five year old boy who almost spit out his Juicy Juice when he was low last week because it was COLD!! However, that did rule out meat, cheese, raw veggies... so there went our usual arsenal of low carb stuff.

Secondly, because I really hate to give Liam artificial sweeteners (check) and artificial dyes (unless that stuff is red from CHERRIES- no- check). I figure it sucks enough when he has to watch his classmates all eat the same carb loaded snack while he gets something else, so when he said he liked it, I decided to just call it a compromise.

b) Mt. Olive Pickle Pak
No brainer. Tiny, cute carb-free pickles individually packed and sealed so they don't have to be refrigerated. Now, I am totally repulsed by pickles and my husband is a strict Claussen-from-the-refrigerated-section-only SNOB, but these are so convenient that we are going to put our parental issues aside and let the kid eat them.

c) Jerky
We were getting desperate. We won't talk about the bag of fried pork rinds that made their way into my house. As a former vegetarian, the jerky offends me enough.

All is well and good with those, but a lunch they do not make.

We do have a Dexcom that we can monitor to make sure he's close to range as we come in to lunch, but remember he has to eat a snack two hours after breakfast to prevent a crash from the tail on his breakfast bolus. So if breakfast is at 6:45, snack is at 8:45, and lunch is just over two hours later at 11, we don't have much time to see where he is going to land before lunch. It makes me nervous.

How are we supposed to handle this? Any ideas?







10 comments:

  1. Ugh how frustrating!

    As far as the high bg from breakfast he may need a different ic for eating earlier. For example if J wakes up at 11am (today it happened! Lol) he has to use his IC from 8am bfast not 11am lunch. Did that make sense?

    As far as carb free options, id stock the school frig with everything you can. Cheese, pickles, turkey and anything else you can.

    Have you found out the schools protocal on highs? For us if J was 384 id have to come and correct him or do a site change.

    Sorry if confused you more! Good luck!.

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  2. We have the same issues - with certain breakfasts. And we will be on a similar schedule, since our school starts at 7:45am (yes, I'm still in total denial about that). I am going to try to have him eat lower carb breakfasts - like a smoothie or something instead of cereal. Cereal is just a nightmare for us. I'll let you know what we find out at our meeting with the nurse tomorrow!

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  3. Same with Lex...if Joe eats breakfast later...I still use his breakfast ratio (1:14) and not his am snack ratio (1:28).

    Now...as far as eating...as long as his site is good and he doesn't have ketones etc...I let him eat whatever I packed him (Usually 70grams worth of carbs). Does Liam get pre-bolused? Joe gets pre-bolused... honestly, we haven't had any issues in this department. I like Lexi's idea of having some low carb options in the fridge. I used to keep some string cheese in there for Joe...that would help him stave off hunger...but I never have utilized it as a substitution.

    Good luck...you are gonna do fantastic!!! xo

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  4. We used to do double arrows up every breakfast, until I totally turned up the basal on the pump. Which means he definitely needs a snack at about 10, but he is also ready to eat at lunch. Our breakfast basal is about .5, compared to .25 for normal basal. It's hard, though, because whenever you're playing with big insulin amounts (for little ones at least), you want to be monitor and get ready when numbers start to come down fast. I don't know if you even use a pump, but maybe you could just try turning up basal modestly -- so it's not as severe but also doesn't turn into a crash?

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  5. Since they won't let you use the fridge... can you pack a cooler bag with the carb free stuff? Sorry I don't have anything else for you.

    See you tomorrow!!!

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  6. You correct the hell out of him and let him eat. Then recheck and make sure hes coming down. I agree that you may have to adjust the ratio and double check to make sure its set for the correct time.

    You will figure it out. The unknown can be a scary thing, but you will be a rockstar within a week :)

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  7. I'm with Lora...I have them correct and let her eat. This was something that was especially hard for me because snack is always less than 3 hours since her last meal, so I always feel like we are stacking insulin. (May require some trial and error days to get it all worked out to your comfort level.)

    As for the breakfast spike, UGH! I've been so there with you!

    Good luck with Kindergarten, you both will do great!

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  8. Just now reading this --- I got nothing but I do crank up the AM basal to avoid the spike and then feed the insulin later. Our basal jumps from .10 to .30 for breakfast.

    I agree with the others --- you will be rocking this in no time!!

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  9. For my DD (going into 3rd grade next week) she eats lunch no matter what. She would go to the clinic, poke her finger, and then was supposed to bolus before going to eat if high. (This didn't always happen according to plan, but that's another issue!) I don't have any options but to let her eat then and whatever she has in her lunchbox. It worked out ok.

    For snack time, we usually kept a pepperoni stick or prepackaged mini-pepperonis in her backpack. If she was high at snack time, she could substitute the "free" snack for whatever else I'd sent her that day. Not the very best option, but one that we could work with.

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    ReplyDelete