#84 Summer 2022 in Review: Travel, illness, swimming and summer camp

This episode is all about our summer of 2022. We had such a busy but FUN few months with, of course, type 1 diabetes tagging along every step of the way. Listen in as I talk about traveling with type 1, what to pack for those long trips, summers camps, swimming, keeping those devices on in the heat and during water activities and a little about our switch from the DIY Loop system to the Omnipod 5 automated system. It was a whirlwind, y'all! Enjoy and be sure to check out all the links below to the episodes and products that were mentioned throughout!

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OTHER INFO MENTIONED IN THE SHOW
Mom's Night Out hosted by Stacey Simms in Charlotte, NC
Episode #53 featuring Moira McCarthy
Episode #8 all about TSA Cares
Episode #56 with Stacey Simms
Loop Docs Website
Looped Facebook Group
T1Pal Website (they will build Nightscout for you)
Simpatch patches on Amazon
Skintac on Amazon
IV Prep on Amazon
Cavilon Barrier Cream on Amazon

Transcript

Katie: 0:00

Hey everybody. It's Katie. And this is episode 84 of the sugar mamas podcast today. I just want to unpack my summer of 2022. We had so much going on. It was so busy. You may have noticed, cause I actually took three weeks off from the podcast to. Take a break because of travel and mostly travel. I just didn't want to be editing a podcast while I was on vacation. So between the three big trips that we took, we went to flew into Nevada, did Arizona, and a little bit of Utah. To go to Zion national park. And then I spent a week at summer camp with my two oldest kids chaperoning that situation. It was a church camp. And then we went to lake lore, North Carolina for a week, which is something that we do every year with some of our friends and family. So it was a very busy summer. Sarah also did. Let's see. A week of art camp. She did a week of just kind of like a general summer camp. And she did a three day Volleyball camp during the summer. So she was a very busy lady. There wasn't a ton of downtime for her. I mean, vacations are downtime, but you know what I mean? So it was big. So I want to talk to you a little About travel. I want to talk to you about illness because we had our first major illness with type one diabetes. It was actually when we were on vacation. Since Sarah to the hospital. So I want to talk about that a little bit and what we learned. We swam a ton. We have a pool in our backyard. We also love going to the beach. We also spent a week at a lake house, so there was just tons of water activity. We went to a couple of waterparks, so it was definitely a summer of fun and the sun. And in the water. So I want to talk to you about that and about devices and keeping devices on and the best technique that we have found to do that. I want to talk to you about sending Sarah to summer camps, that weren't diabetes camps and just how I handled that. And then another huge thing that we did was we switched from the DIY loop system to the Omni Omni pod five system at the very end of the summer. That was a huge deal for us. I really wrestled with the decision of whether or not I wanted to do that. And I'll explain a little bit of that later. But first we're going to do our intro. And we will jump in by me, just talking a little bit about. My summer mindset. And how it has changed from last summer. To now. Because this is our second summer with type one diabetes. Okay. Let's get started. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. Okay. My friends, before we start the show, we have an exciting announcement from Stacy Sims

3:24

host

Katie: 3:24

of the diabetes connections podcast, Stacy has put together something very special for type one moms in her community, which is in and around Charlotte, North Carolina. Let's take a quick listen, and then get back to the show.

Stacey Simms: 3:37

What's one thing you need as a mom of a child with type one, it's time to yourself. I know, go ahead and laugh, but there really is a way to treat yourself to some time away with other moms who get it. I'm Stacy Sims and my son was diagnosed with type one almost 16 years ago, just before he turned two. Since then I have attended dozens of diabetes, conferences and meetups, and now I've taken the best stuff from those. And created something brand new. I'm calling it mom's night out and we're gonna have lots of diabetes technology for you to see and learn about stress relieving, social time, where you can meet other moms, just like us and speakers who will leave us feeling energized and ready to face the challenges of parenting a child with T one D. Katie's gonna hook you up with all the info, but head on over to diabetes. Dash connections.com to get started. Mom's night out is happening in January in Charlotte, North Carolina. I hope to see you there. I can't wait.

Katie: 4:35

Thanks so much, Stacy, if you're interested in signing up for that event, or you want to find out more information. Check out the link that I will leave in the show notes. All right, you guys let's get back to the show. All right guys, before we dive into everything that we did this summer, I just want to talk to you about my summer mindset in general. So if you remember my daughter, Sarah. She was diagnosed in the middle of August of 20, 20. She was eight years old and it was the day before she started third grade. So it was at the very tail end of the pandemic summer. So I don't count that summer as being our first summer with diabetes, even though Sarah certainly was showing signs and symptoms of having type one probably for weeks, if not months before she was actually diagnosed, but we weren't dealing with diabetes management at that time. Because we had no idea. So I do not consider that our first summer with type one diabetes. So she gets diagnosed. You know, we obviously had the deal with all the school stuff, getting her settled in school, learning how to manage diabetes. The school year, it goes by. She finishes third grade. Thank God. And the summer is upon us. And I remember thinking that very first summer with type one diabetes. So that would be the summer of 2021. I remember thinking, oh my gosh, I'm so excited to have Sarah home with me during the summer. It's going to be so great because she'll be close to me all day long. I'll be able to keep a little bit more of a tighter control on her blood sugars. And it's just going to be so much easier having her home and not having to kind of juggle the whole texting diabetes situation. And not having a nurse at the school and then interrupting her teacher's day. If there was kind of like a low blood sugar emergency. So I was just so ready for her to be home with me during the summer to have better control. What I didn't realize is that none of that Managing diabetes was not easier in the summer. In fact, I honestly think it's so much harder to manage diabetes in the summer. Now that's not to say that other parts of life aren't easier, right? It's always a give and a take and a trade off because. I would say lots, lots about life is easier in the summer. I love having a break of not having to pack school lunches, packing school lunches are the bane of my existence. And I know everybody says, have your kids pack their own lunches? And they do a lot of the time, or at least they'll help me kind of figure out what they want to have. But you know how it is, like the day gets away from you and all of a sudden it's bedtime and it's like, Aye. I don't, we don't have time for you to pack your lunch, or I don't want to deal with this at eight 30 at night. Like just go to bed. So anyway. I load packing lunches. I always love summertime to have a break from that. I just love, I just love summertime. I'm a Florida girl through and through. I love being in the pool. I love being at the beach. I just love the more relaxed. Summer vibe. I love a break from homework. Oh my gosh. Can't stand, have him to help my kids with homework. I'm really sounding like a great parent. I know, but you know, it's just always sister struggle. I mean, I'm happy to help them and I'm glad I'm available to do that, but you know how it is like Do so much better listening to their teachers and they do to their parents trying to be their teacher. And explain how to do long division. I also love just having a break from extracurriculars. You know, we don't, I don't have to shuffle people here, there, and everywhere to baseball, practice and dance. It's really wonderful. However, while all of those things are a nice break from life, I would say managing type one, diabetes is a lot harder in the summer and it's definitely because. There is no routine, you know, in school they eat lunch at the same time. Every day, they eat snack at the same time every day. You know that they're going to be sitting and doing schoolwork from this time to this time. And at this time they're going to go outside on the playground. So you know what their schedule and what their activity levels and when they're eating, when all that's going to happen during the day, well, in the summer, there's no schedule, there's no routine, unless of course they're out of summer camp. But. That was so hard for me, you know? People would wake up and they wouldn't want to eat breakfast until 10 30. And then right after they breakfast, they'd want to jump in the pool. But they had all this insulin on board. From their breakfast bolus. And then maybe at two o'clock, we'd get around to eating lunch, but it's not a real lunch because people just want to eat cheese sticks and yogurt for lunch. And then who knows when we're going to be eating snack later in the day. And there's late nights because people are staying up later. We don't have to have that tight bedtime. People are getting in and out of the pool, again, running up down the street, playing with friends. I mean, it all sounds magical and wonderful, and it is, but when it comes to managing type one diabetes in the midst of all that, it makes it pretty challenging. And I know some of you are thinking some of you type a moms out there are thinking like OKT, you could just have a routine and have a schedule during the summer. Like you could tell your kids. We're eating snacks at 10 o'clock every day. End of story. And we're eating lunch every day at 1230, blah, blah, blah. But, you know what? That's just not how I roll. That is not my personality. I have tried. Schedules like that. And I just feel like that never works for me. Like we always fail at keeping to a routine and a schedule in the summer when it comes to eating lunch and snack and things like that. I am definitely that mom, that every single summer I'm like, okay guys, we're going to do a 15 minutes of math and 15 minutes of reading every day. And I bought you these workbooks and look at these aren't they great. And then about two weeks into summer, I'm like, you know what, forget this, this was a bad idea. Let's just go to the beach instead. So that's the kind of mom I am. If you're looking to a little insight into my world But anyway, so. All that to say. Just give yourself some grace in the summertime, things are off schedule, things are off routine that makes managing type one a little bit more challenging. So just keep that in mind, go with the flow. I will say this summer was a lot with the swimming situation, cause I've kind of learned. How to manage insulin and blood sugars while Sarah is swimming. And I will talk a little bit about that later in the episode. Please always keep in mind. I am not a doctor. I am not an endocrinologist. I'm not a diabetes educator. I'm just sharing with you all what we do and what has worked for us most of the time and our experiences. And maybe that will get the ball rolling for you or give you some ideas, but I'm not telling you what to do. I'm just telling you what we do so you can kind of compare notes. All right, let's talk a little bit about traveling. Listen, if you are a newly diagnosed family. And you have travel plans coming up. And you are a little bit freaking out about those travel plans, because now you have to think about and worry about diabetes while you are on vacation. I'm here to tell you that it's going to be okay and do not let fear. Control your decisions when it comes to travel plans and vacation plans. you just keep on keeping on with the plans that you have or the dreams that you have, or the vacation bucket list that you wrote down five years Do not cancel your travel plans or your vacation plans because of type one diabetes. my favorite piece of advice that I have ever been told was by. Was from Maura McCarthy. She is the author of raising teens with diabetes. I interviewed her in a previous episode, I will leave a link to that episode in the show notes, but she said to me, Ask yourself, by the way, she has a daughter with type one who is grown and flown out of the house and doing really, really well in life. So she's a seasoned type one And she told me, ask yourself, what would the answer have been before diabetes? If the answer would've been yes. That it needs to be yes. Even after diabetes, you just have to figure out how to make it work. If the answer would have been no before diabetes, then the answer needs to be now after diabetes. I like to think of the example of, you know, I've never been the mom that's like here kids. here's a dozen donuts from Dunkin have at it. I'm like, okay, we're going to go out and get donuts, but we're going to get one donut because really, and truly, nobody needs more than one donut. We're going to continue eating donuts, even though one of our family members now has type one diabetes, but we're also going to continue with our. Rule of you make it one donut at So it's stuff like that. What I have said no to three donuts before diabetes. Yes. And am I still going to say no to three donuts after diabetes?

12:56

Uh,

Katie: 12:56

He, I, I am. I had a mom reach out to me once. And she was just in a panic because her teenage son had just gotten diagnosed with type one. It was right at the end of the school year and they had all these travel plans for summer and she just. Was. Very very concerned about what their vacation was going to look like. Now that type one diabetes was in the mix. I told her and I encouraged her. You just have to go and do it. You have to show your child that life is not going to stop. Or be put on pause because of this disease. Like I know you're scared and I know it's so incredibly intimidating, but for the sake of your child's mental wellbeing, you've got to just push through your fear and make it happen. I always remind myself that really in truly, as long as we have insulin with us in a way to get it into my daughter's body. And as long as we have enough low snacks with us, plenty of juice, boxes, candy, whatever meat you may use, we're going to be fine. crazy things could and probably will happen sometimes. But as long as you have insulin, And as long as you have enough low treatments, you're going to get through any situation. Is it always going to look pretty and amazing? No. Nothing's perfect. But you will get through So definitely don't try cancel your travel plans because of type one. One of my very good friend's daughter was diagnosed at the beginning of the summer last year. And. I think she was diagnosed on a weekend, maybe like a Friday or Saturday. And they had plans to go out of town for an entire month. The following, I think Thursday or Friday. And she spent about an hour panicking about that, but thankfully Her daughter's endocrinologist told her. Not to cancel that trip. Just take all the supplies with you. I know where you're going to be vacationing. If I need to write Extra prescriptions while you're there. it's okay. You're going to figure it out to not cancel your travel plans. And you know what they went and it was great. And they learned how to do type one diabetes while they were on vacation. I was really proud of her for not canceling those plans. I think that was a really hard decision for her, but I was really proud of her for pushing through, so it can Okay, let's talk a little bit about packing. Basically, I could just summarize this by saying you need to pack a lot of stuff. But specifically. You just need to have extra supplies. My daughter is on the Omni pod system currently on the Omnipod five system. So when we travel, we bring enough pods, honestly, for about a month, which would be about 10 pods. We usually don't travel anywhere for longer than a week. So that's kind of a ridiculous amount of pods. We absolutely have never used that many pods while we're on vacation. In fact, usually we just have to use like one extra pod, if any, at all. But I like to be prepared. You never know what's going to happen. And I also like to spread them out a little bit. Like I don't like to have them all in one place. Like I might put a couple in my purse and I might put a couple of my suitcase and I might put a couple of my daughter's diabetes go bag. And then our travel bag. Just so they're spread out in case something gets lost, we will have a few extra pods. Obviously you need insulin.

15:52

Um,

Katie: 15:52

Even if you're on a pump, I would bring lots of fast acting insulin, whether you're on NovoLog, graphy, Asper, Humalog. And then I would also bring, even if you're on a pump, I would bring a couple pins of long acting insulin. We were on Tresiba before Sarah started on the Omnipod. And I always just throw a few pins of Tresiba in our travel bag to have just in case, because you never know the pump might fail. The pump might break. You might run out of pods. Or your kid might just get sick of wearing a pump while you're on vacation and want to take a little break and that's fine too. So make sure you're prepared with both. Fast acting and long acting insulin. When you travel. Of course, we have all the normal stuff. Adhesive, remover, wipes, alcohol prep, wipes, test drips, glucometer land sets. Extra Dexcom sensors. I usually bring two or three Extra Dexcom sensors. We have lost a Dexcom sensor while on vacation. In fact, we lost two once on vacation. So I usually bring three just because I've experienced that before. And I was really glad I had And then of course, we called the company and got the other ones replaced. That was a little bit of a mess. I think that was actually our first trip after diagnosis. It was, we went to the keys. In Thanksgiving of 2020. Which I know y'all are thinking you're doing an awful lot of traveling for the year of the pandemic, but you know, you only I always bring an extra Dexcom transmitter to. The way I kind of a hack the system as far as prescriptions is I just make sure I refill my prescriptions as soon as I possibly can, which is usually earlier than when you're actually going to run out. So like Dexcom sensors, for example I can usually, after I fill that prescription and pick it up from the pharmacy, I'll get on the app that I use. We, we pick up our prescriptions at CVS pharmacy. So I'll get on the CVS app and see when is the earliest time I can refill those prescriptions. And typically it's like, A little less than three weeks, maybe 20 days out from the day that you picked up the prescription. So technically if you do that every single time, and I set a reminder in my phone, so I don't forget. To refill it when the earliest that I possibly can. But if you do that every time, whether it's Dexcom sensors or insulin or. Omni pods or whatever it may be. You will eventually have a little bit of a stockpile and that way. You'll always have a few extra on hand in case something goes wrong. So that's my little tip and trick for you today. What else do I pack? I pack scissors. I pack glucagon, of course. And I, now that we have gone through a major illness on trips, I like to pack. I'm one of those. Old school, red glucagon kits that Lilly makes, which unfortunately, I think it's being discontinued at the end of the year, which is really unfortunate, but make sure you bring your glucagon, whether you have the injectable kind or the nasal spray. I would pack a few extra of those. Bring lots of low treats that goes without saying we always have lots of juice, boxes and candy on hand. When we travel, even though I know you can stop and buy that pretty much anywhere. Oh always bring a waterproof pouch for your phone. We, when we travel, we usually end up near some sort of body of water. And I like to have waterproof pouches. In fact, I like to have it from my phone as well, even though I think my iPhone is waterproof. But I like to have my phone in a waterproof pouch and Sarah's. Phone in a waterproof pouch as well. And if you're on Omnipod, you might want to think about getting an extra waterproof pouch for the Omnipod PDM. Oh, patches bring lots of patches. Usually vacations involve either water or lots of activities. So there's a lot of sweat and your devices can fall off more easily. So bring patches for the Dexcom. Bring patches for the Omnipod Libris whatever it is you're using. Skin TAC. I'm going to describe the technique we have for keeping devices on a little later in the episode. But bring those things. Ketone strips. That's something that you want to pack. I didn't think I would need those until Sarah got super sick. But bring those ketone strips. I feel like I'm missing something that's super obvious, but for now I think that's a pretty comprehensive list of the things you need to bring. While you are traveling. Okay. I want to talk about airplanes because this was our first time flying with type one diabetes. When we went to Arizona. But honestly, it was kind of a non-issue. I thought it was going to be a big I've done an episode. I will link to this one in the show notes as well with TSA cares. If you're really, really worried about navigating the airport with your type one diabetic, you can always, if you were in the states, you can always call TSA cares. And they will help you when you get to the airport, you can. Have the meat you. At the front of the airport before you even go through security and they will walk you through the entire process, they are so sweet. They're there to help. So take advantage of that. If you're a little worried about your. Type one diabetic getting through security in the airport for us. Honestly, it wasn't even a thing. We went right through. Sarah went through the metal detector. She didn't have to go through the body scanner. I think the Dexcom and the Omnipod would have been fine in the body scanner. But had they made her go into the body scanner? I probably would've gone into my spiel about type one and what her devices did, maybe try and avoid that. And just do the metal detector instead, but that was not an issue. They did. They just let her walk on through and didn't even say anything about her devices. So. I will say flying. I didn't really notice a huge difference with Sarah's blood sugar. When we were taking off, when we were landing. They were pretty, I would say. Normal quote unquote, cause what's really normal. Throughout the whole flight. We were on the DIY loop system at the time. So I think I had said an override to give her. A little bit more insulin while we were like sitting on the plane, just cause she's inactive and we were eating snacks.

21:37

Um,

Katie: 21:37

And that worked out pretty well for us. I don't, I don't remember having any, any significant highs or lows while we were on the airplane. Once we got off the airplane in Arizona, I was very prepared for her blood sugars to be. A lot lower because of the higher altitude. but honestly, I didn't notice a huge different with that either. I mean, We had done a few things differently with the loop system to be prepared for that. We had set the target glucose level, a little higher. I think we had set an override, so it was giving her maybe 20 or 30% less insulin than what she normally gets for basal and bolus. But. Again, that didn't seem to be as big of a deal as I thought it was going to be, which is kind of true for everything with diabetes. We've got Halloween coming up and I remember the first. Halloween. I was totally freaked out thinking, oh my gosh, this is going to be awful, but it was, it was fine. It was fine. All that extra walking with Sarah, going from house to house, gathering up her candy helped keep her numbers nice and steady and stable. Okay. So what I really want to talk to you about with travel is the illness that we experienced. We landed in Las Vegas on a Saturday. We had a great afternoon. We went to red rock canyon on Sunday. We drove to the Hoover dam and did the Hoover dam tour. And then we drove to Flagstaff. And then on Monday we woke up, it was actually Memorial day that day. And we drove to the grand canyon, which is something that's on my bucket list. So I was so excited to go see the grand canyon. We got to the grand canyon. We saw the views, they were magnificent. We went and did a little hike that was highly recommended for first-timers. And ended up being only about a three mile hike, but. It was intense. It was. I think he was Angel's landing or something like that. Angel something. But we made the mistake of wearing some warmer clothes because it was pretty cool in the morning when we got there. And. You know, we could kind of strip off our shirts. We had tank tops underneath. We had, well, we had jackets first. We could take those off. Then we could take the heavier shirt off and just wear the tank top. But we wore everybody wore pants. And that was a mistake because it was. Pretty exert. It was pretty hot by the time we were done hiking. So it was a beautiful hike. We went a mile and a half down. And then we had to turn around. And come a mile and a half back And Sarah, I could just tell she was struggling a little bit like she was having, she was saying she was having trouble breathing. Like she, she was a little congested, which we probably shouldn't even have attempted a hike with her being congested. Not horrible, but still anyway, she was a little congested and on the, when we turned around to come back up, she was just. I don't know. I couldn't tell if it was cause she was panicking a little bit. Cause she felt like she couldn't breathe very well or if she truly couldn't breathe very well, by the way her blood sugars were totally fine. This whole hike. I think I had increased the target. The target glucose level on her DIY loop before we started hiking. So that held her pretty steady and stable. She only had to. Drink a juice box once and ate a few Skittles here and there. But. Anyway, long story short, the hike up was rough for Sarah. She just wasn't feeling very well and she was a really hating life coming back up that we had to end up stopping like maybe every 30 feet or so, so she could just kind of rest and catch her breath. My husband gave her a piggyback ride for some of it. I mean, it was only a mile and a half back up, but it was a struggle to get to get back up. So we get back. We get back up to the top. We're just. Refilling our waters resting. We go find some lunch. Everybody's happy. Now we check out a few gift shops. Sarah eats a full lunch and seems perfectly fine. Happy hippy Skippy. And then we get on the grand canyon trolley to go see some more of the sites. And we were on that trolley for maybe 10 minutes and Sarah just kind of went. Paleish green. And looked up at my husband and said, I think I'm going to be sick. And low and behold, as soon as we got her off that trolley. And thank God we got her off and we did, but she just got sick everywhere, like vomiting, profusely all over the loading platform of the grand canyon trolley. So if you happened to me at the grand canyon on Memorial day of 2022, And you saw a 10-year old girl throwing up right next to the trolley. That was probably my daughter. She threw up twice after that. Of course by this point in time, we are immediately walking to the car to get her set back up in the car. And it was, it was just all downhill from there. Thank goodness. Cause I was worried because she had taken all, you know, she'd taken this insulin before she ate her lunch and not even an hour later, she had vomited up her entire lunch. So I was worried that she was going to start tanking. Really quickly. I was thinking we needed to get some food in her ASAP. So luckily she was able to kind of suck on a few Smarties. She was able to get a juice box down. Thankfully, she didn't have, I had like shut her insulin off at this point in time. And thankfully she

26:33

uh,

Katie: 26:33

was able to get that down. Anyway, she fell asleep in the car on the way back to the hotel. And we get back to the hotel and probably once we get her inside and get her settled. She just started vomiting. And she got sick, probably every 45 minutes. From let's see, what time was it? Maybe four o'clock in the afternoon until the next morning she was throwing up profusely every 45 minutes. It was rough. I mean, she was. It was almost like she was barely conscious. She was kind of like, couldn't even sit up straight. I would, I was obviously trying to push fluids. Trying to get water and ice chips in her sips of Gatorade, nibble on a goldfish, whatever we could do to give her something in her system, but she just could not keep it down. I have never seen my daughter, this sick. She had to go into the hospital when she was five days old because she had RSV. so other than this time at the grand canyon that I'm telling you about right now, that was probably the sickest I've seen her, but in between. That stint in the hospital when she was a. Five days and then of course, If we're not counting the diagnosis of type one diabetes, but this illness that I'm telling you about right now is the sickest I've ever seen. My daughter. She's never had a stomach virus like this. So immediately I start thinking, oh my gosh, what am I going to do? So I, I pull out my think, like a pancreas information. That's tucked away in the back of my brain. And I know that. You want to try to be pushing fluids as much as possible because you don't want them to get you hydrated. You want to try to be pushing insulin as much as possible because you don't want those ketones to develop and you want to get them flushed out of the So I started. immediately when Sarah started throwing up her blood sugar numbers started climbing, which you kind of think it would be the opposite, right. You'd think, oh, they can't keep anything down. They're going to drop. Well, she immediately started climbing, so I start pushing insulin and I honestly was probably pushing about a unit or maybe more of insulin into her every single hour. From the time she started vomiting until the next morning at like eight o'clock in the That's a lot of insulin for somebody who's not eating any food and who weighs like 70 pounds. And let me tell you her number would not budge. I mean, she probably sat in the mid. The upper. To lower two hundreds for that entire time. I don't know that she ever got over 300. I don't remember, but even with all that insulin and her not eating a single thing, she stayed. Up there. And I just had to keep reminding myself. That we have glucagon if we need it. Right now she needs insulin and she needs fluids to get those ketones out of her system. Because at this point in time, because I had those ketone strips, I could test her ketones and they were very large. So I knew that what she needed at that moment was insulin and fluids. And I just had to keep my riding myself, you know, it's terrifying giving your child this much insulin when she can't hold anything down. But I have the glucagon, if I need it. That's what it's there for. So I just kept pushing that insulin. By the time we woke up the next morning. Because my husband and I were having the conversation of course, of what should we do? What if she doesn't get better? Should we take her to the hospital? So by the time we woke up the next morning and Sarah was still throwing up every 45 minutes or so still couldn't keep even an ice trip down. We decided, okay. It was time to go to the hospital. Her ketones were large. Her blood sugar was high. We knew that it was time to go to the hospital, which that's a scary thing to do when you're half way across the country or more, you're almost all the way across the country actually. Going from Florida to Arizona. So we took Sarah to the Flagstaff medical center. They were amazing. I wish I could remember their names and give them a shout out. But they were fantastic. I had to be pretty bold upfront, and I immediately said, You know, she has type one diabetes, she's wearing a glucose monitor and she's wearing an insulin pump. I didn't even say if it's okay with you. I just said. I want to leave those on her body and I will manage her diabetes while we're here. I'm not going to leave her side. And they were, they didn't even fight back. They were like, fine. That's great. That's awesome. We would appreciate it if you did that. Take take some of the work away from us. So I just went in bold and big and was like, look, you're not taking this stuff off of her body and they were fine with it. So definitely advocate for your kid. If they ever have to be in the hospital. Try to keep those devices on them. If you can. So luckily they did not have to admit us into the hospital. They started running an Ivy of fluids on Sarah immediately. Once we got settled in the ER and it was the craziest thing I've ever seen. I'm not even kidding you. Within five minutes of her having that Ivy in her arm, in that Ivy, drip Her blood sugar has started coming down. It is that I, the one lesson I took away. From that experience. Is how important hydration is to blood sugar numbers. Like I had no idea the effect that dehydration could have on your blood sugar until I saw. That happened. I mean, it was crazy how Sarah couldn't keep any fluids in her for over well. Not even, not even 24 hours, but the instant, she started getting fluids and getting hydrated. Her blood sugar started coming down immediately. And it leveled out pretty nicely. I, I didn't even have to have her treat a low. It just kind of gradually came down and leveled out, which was great. They pumped her full of fluids. They only gave her half a bag of fluids. And I was like, Hey, look, we are on vacation. And we would like to attempt to continue on with our vacation if possible. So considering the fact that she has been vomiting for the past, like 12 hours straight, could you maybe give her that second half of the fluid bag? They did the calculations based on her weight and everything. And they decided that it would be fine. So they gave her the second half of the bag. So just keep that in mind again, advocate for your kid, if you think they need it. They ran a bunch of tests on Sarah. They checked her for multiple viruses and stomach bugs and all that sort of stuff. And. Nothing came back positive. So. We have no idea what caused her to get so sick. I kind of think it might've been altitude sickness. But honestly, by the end of the week, I was actually had come down with a little something not nearly as bad as Sarah's, but still bad. So maybe it wasn't altitude sickness, maybe it was a contagious virus that they just didn't test for. So we didn't know about. Anyway, that's what I wanted to tell you about illness and traveling. We did our best to continue on with the vacation. Sarah, it took her the rest of the week to recover her. And I spent a lot of time. Taking naps and watching TV. My husband and I would switch off doing activities with the boys. Unfortunately Sarah missed out on quite a bit of stuff on our trip. But truth be told she was just not well enough or strong enough to even attempt it. Thankfully, she was well enough and strong enough to by the time we left on Saturday to get through the airport. And get through the plane ride home. And

33:23

uh,

Katie: 33:23

we made it home safely, but I've already told her, I was like, sweetheart, we need to have a redo maybe one day in life when you're an adult, you and I can go back and do some of the stuff, especially some of the stuff in Zion national park that we missed out on because you were so sick. So I've got that in the back of my mind. All right. I want to talk to you a little bit about swimming and insulin, because that was such a huge part of our summer. And I know it's a big part of a lot of people's summers. So, as I mentioned, you know, there was times where Sarah would eat a meal and I would give her all the insulin for the carbs in the meal. And then she, a friend would knock on the door and they would want to hop in the And I'm sorry, but I'm just not the mom. That's going to be like, sweetheart, you need to wait till hours before you couldn't go on the pole with your friend. I'm like, no, you can, you can get in the pool. We'll figure this out. So. Kind of my strategy was if Sarah was going to go swimming and she had a lot of insulin on board. I would turn her insulin off immediately or do a very significant temp basal decrease. Like as soon as I knew she was going to get in the pool and then I would all cause she's on a pump again. And then I would also give Some sort of a snack. Usually it was something with like, I don't know, anywhere from 15 to 30 carbs, depending on how much insulin she had on board. And you're just going to have to figure that out for yourself. If Sarah did not have a whole lot of insulin on board sometimes like if it had been a long time, like three or four hours before she had any bolus insulin in her, a lot of times she could just jump in the pool and swim without any intervention and she would be fine. If we were kind of in the middle of that period you know, it had been maybe an hour and a half or two hours since she had eaten. So I know she still had some insulin on board. But not as much as in the beginning. Then I might give her a little snack again, turn the insulin off or do a tent Bazell decrease way down, maybe like 80 to 90% down. As soon as she got in the pool. And just check her in about 40 to 45 I have learned that with Sarah. It's good enough for us to get her out of the pool. Every 40 to 45 minutes to have her reconnect to the Dexcom or to do a finger prick to check I don't feel like we need to get it her any sooner than that. But I feel like going a little bit longer an hour or so would be too long to maybe catch a low. That was happening. So I would just know, Hey, we've got about 45 minutes. You can enjoy yourself. And then we're going to have to hop out of the pool and check your number. I will say one of the biggest things that I learned about swimming for Sarah and insulin is that if I had to turn off her insulin, Or turn it way down. When she was swimming and then. I figured out that as soon as she got out of the pool, I would have to give her a bolus of insulin for the Bazell insulin that she missed. Like immediately or she would start to climb. Very very quickly. Which is just insane to me that she could spend, you know, two hours swimming with her insulin off or her insulin way down. And if I didn't give her a bolus for the Bazell that she had missed while she was swimming, she would immediately start to climb as soon as that activity was over. So, you know, an example of that would be Sarah's Bazell rate is one unit an hour, which it's not, but I'm just easy math. If she was getting in the pool for two hours, I would turn the insulin. Let's just say I would turn it off for that two hours. As soon as she got out of the pool, even if her blood sugar was like 80, I would have to give her a bolus of two units of insulin and turn her pump back on. Her basal insulin back on and running. Or else she would climb significantly. Her blood sugar would climb significantly. That's kind of a scary thing to do. When your kid has been swimming for two hours and they get out of the pool and their blood sugar is 80 and steady. It's like, yikes, am I really going to give her two units of insulin right now? Because her Bazell has been off for two hours. But for us, we just kept seeing this pattern over and over and over again of her blood sugar shooting up after she would get out of the pool. When our insulin was off and I just, it would just became a pattern for us. So finally, I was like, look, we're just going to give this a I'm in a bolus for the Bazell that you missed. Worst case scenario. I've got to give you a juice box or two. Okay. Or we got to eat some popsicles. I mean, that doesn't sound like a worst case scenario to me. And honestly, I don't think I ever had to utilize those popsicles or juice boxes once because. those patterns continue to happen. And when I would bowl us for the Bazell that she missed, she wouldn't spike. She wouldn't climb. She would just stay nice and steady. So maybe pay attention to that. Maybe that's not a problem for you. Just something to think about. All right. I want to talk about keeping on those devices when you're having a really a heavy water day. Maybe you're going to the beach. Maybe you're spending the day in a lake in the pool at a water park, or maybe it's just a really hot and sweaty day in the summertime. And you need something to keep those patches on. Okay. This is what we do. We have found that this is the best strategy to keep things on really, really snug and really, really securely. What I do. Let's say I'm going to put on Sarah's Omni pod. I rubbed the skin down with alcohol. Let that Then I take the liquid skin TAC and I put it on her skin and I leave a little spot where the Omnipod tube is going to be inserted. Or I had a very smart listener tell me that they. Actually put the skin TAC directly on to the Omnipod backing. So that way they can just paint around the hole where the Omnipod cannular is going to come out. But I, so I was putting skin tack on Sarah skin. And then I was putting the Omni pod on top of that. Activating the pod. And then I was putting a SIM patch patch. Over the Omnipod. Listen, if you need a patch that is going to withstand a nuclear bomb and keep your child's Omni pod on their body. It's it's going to be the SIM patch patch. These things are so super sticky, they will get the job done on those crazy water days or crazy hot and sweaty days in the In fact, they're almost too sticky. Like I love them, but I also hate them because when you go to take them off, there is so much sticky, goo left over that. I have to go through a lot of adhesive remover in order to get all that extra sticky goo off. So they get the job done, but they're a pain in the butt to take off, but just keep that in mind. I'd rather deal with the extra goo in the end. Then have pods and Dexcom's falling off left and right. We spent a week at lake Laura, North Carolina. And I mean, we, we play hard when we are on vacation. Sarah was swimming like all day long. They had one of those floating mats that you can lay on and run on and jump off of. They were wrestling We went tubing and Sarah wears her Omni pods on her thigh and she lays down on the tube on her stomach. So her thighs are like bouncing up and down on this tube. The whole time you guys, we did not lose one Omnipod, the whole trip. And we were on the water for like six straight days. It was amazing. So it will get the job done. You're just going to have to deal with a little extra sticky goo on your kid's skin, you know, that nice, that nice dirt patch that forms, when you think you got all the goo off, but you really didn't get all the goo off. And then like two days goes by and You know, see your kid's arm or leg or whatever in the mirror. And you're like, oh my gosh, who knew there was this much dirt in our life? How did that collect on your arm? Like You guys know what I'm talking about? I had a couple people, cause I actually did a post about those patches a while ago or about skin tack and just our technique. To hold things in place. And I had a couple parents comment that their children are allergic to skin TAC or that skin TAC burn their skin or the kids had sensitive skin. So there was a couple of comments that were helpful. One lady said that they used Ivy prep instead of skin TAC and that, because their child's skin was also very sensitive to skin TAC and that seemed to help really well. I also had another parent comment that Cavilon cream. Is a barrier cream. And if you put that on the skin before you put skin tack on, it creates a nice barrier between the skin and the skin TAC but still allows the skin TAC to do its job. So those might be some things that you could try. If you have a kid that is prone to irritability. With those adhesives. The other thing I wanted to mention about our summer of 2022 is that Sarah went to quite a few camps. She went to a week of art camp. She went to a week of just a regular summer camp and she did a three-day volleyball As None of these camps were diabetes camps. Again. Don't be scared to send your kids to camp. Just because they have type one diabetes. Are you going to need to find the director of that camp? And the camp counselors and make sure they are well-informed and prepared and well aware that they have a camper with T one D yes. Should you also maybe consider looking for camps that have a nurse on staff at the camp? Yes, I think that would be a good idea. One of the camps, just the general summer camp that Sarah did. I had no, I, it was at a little private school. That's around the corner from us. And I had no idea that they had a full time nurse on staff. During the week. And so like the week before camp, I emailed the camp director to let them know, Hey, My daughter's 10. She has type one diabetes. This is how we manage it. Do you think I could have the numbers of her counselors and blah, blah, blah, and just kind of getting the ball rolling for like, You know, I didn't ask for permission, like, Hey, can my daughter come to your camp? I'm telling you, my daughter is coming to your camp. And this is how this is how I would like to handle it. How can we work together to make it a successful week But the director emailed me back and was like, we actually have a full time. A nurse on staff. That's going to be here. During our summer camp. So I'm going to put you in contact with her and you all can discuss best ways to manage and keep Sarah safe next week while she's here. You guys. I was so excited. Well, actually, to be quite honest at first, I'm like, okay, that's great. But we're used to kind of managing things without a nurse. Her school doesn't have a nurse, so it's really just her and I, so I will definitely get the number and the email of the nurse, but I really don't know how much I'm going to need her or use her. Let me tell you guys, I was texting with that nurse probably like six or seven times a day. Cause there was a pool at this summer camp. And my daughter, isn't great at pre bolusing when she's not with me. So, you know, there were some things, some highs and lows to say the least during the week. And I was so grateful that that nurse was there. Could it have been done without the nurse? Yeah, probably. And also the summer camp was literally eight minutes away from our house. So in a true emergency, I could have hopped in the car and driven there. But I was so grateful that that nurse so maybe ask around, Hey, do you have a nurse that's on staff and that's going to be here during the summer. Also a good idea might be sending your kid to camp with another friend that has type one diabetes. And that way they can kind of look out for each other while they're Another really good reason to get plugged into the type one community around you. JDRF is a great place to See if there's a local chapter Next year, I really want to send Sarah to a diabetes summer camp. Like spend the nights, sleep away. There's one, that's pretty close to us. A couple hours away in our state of Florida. It looks really fun. I was following their social media page over the summer and I was kept showing Sue Sarah's picture. I kept showing Sarah the pictures of the camp and she seemed really excited about it. So I'm actually reminding myself that I need to email the camp director and see when registration starts and what weeks. They are going to have camp next year. So stay tuned on how that goes. I already have a couple of friends that I'm planning on sending her Okay. The last thing I want to talk about. With our summer of 2022 is the fact that we switched from the DIY loop system to the Omnipod five system. Very soon. I'm hoping to do an episode kind of comparing the two and just talking about how our. Experience with the Omnipod five has, is going so far. I think that would be a really interesting one for listeners. Again, I wouldn't be telling you what to do. I would just be telling you what we've done. So you can maybe. Kind of think about a few things. But I will say last may. So may of 2022. At the beginning of that month, we had a couple of weeks that were just awful. Just awful. It was, it was kind of one of those things where I was like dumping insulin into Sarah and like nothing was moving. She was very, very high for a very long time. And I just got so frustrated and so fed up. That I made a pretty rash decision to Put her on the DIY loop system. And that is a big deal for those of you that don't know, DIY loop is a non FDA approved. App. That you have to build yourself on a computer and then transfer onto your phone. To deliver your kids insulin. I actually went out and bought a Mac book air to do this. I mean, honestly, my other computer was a dinosaur and it was time for an upgrade anyway, but so I went out and I bought a Mac book air. Just so you know, it is possible to do it on other computers. Other laptops and computers, but. Like I said it was time for us to upgrade our computer anyway, because it was a dinosaur and it was working so very That whole process was extremely intimidating to me. However, I will say. There is a website. Called. Lupe docs. That will walk you through the entire process of how to do this from step one until the end. And it is amazing because I, first of all, I read the loop docs website probably two times all the way through before I even started. And then I read it through very slowly and carefully when I was going through how to build this myself. I followed each step. Exactly. And to my surprise, I actually ended up building this program successfully and putting it on my daughter's phone. I honestly was shocked. I did not think I could do it. But they're the instructions they give you on the loop docs website are phenomenal. The people that created the loop system are geniuses. I will leave a link in the show notes to the loop docs website. So you can see it. For yourself, if you're interested. Loop is an app that's only available on iPhone. There is also another DIY. System. That you can build for Android. And that is called open APS. There's information on the loop docs website about open APS. But I can also leave a link in the show notes to more about that. If you're interested. Honestly, I'm going to leave it link in the show notes to the looped Facebook group, because that was created by the people that developed the loop. System and that maintain it. And they're kind of like, Tech support and customer customer support. Like if something goes wrong with your loop system, You hop on that Facebook group and you ask your question and they will help you troubleshoot and figure it out. They are also amazing and genius level people. So if you're interested in the loop system, it really is an amazing system. It might've already come out, but pretty soon, I don't know exactly when, but loop three is going to be. Out of the dev branch and into the master branch in loop three allows you to use Omnipod dash pods. And. Your iPhone. Without the need for a Riley link. I didn't even mention the Riley link, but you also need this little device called a Riley link or an orange link. To help your pod. And your Dexcom communicate. It's a whole thing. Y'all. Honestly, I'm just not super well versed in it. So take a look at the links that I'm going to leave in the show notes. If you want to take a look and figure it out for yourself. But with loop three, if I didn't complete that thought before with loop three. it would eliminate the need for the orange link or the Riley link. You would just need your Dexcom. You're Omnipod dash and your phone. So that's one huge benefit of loop. Another huge benefit of loop without going into a lot of detail is it's very customizable. You can set the targets a lot lower than what you can on like other FDA approved automated systems, like the con tandem control IQ and the Omnipod five. So there are definitely some huge benefits to doing the DIY loop. But honestly it just, it just wasn't for us. Do I respect the people that created it. Absolutely. Do I think they're amazing in geniuses. Yes, do I think it's an awesome system. E S I do. But it just wasn't for us. And I think it was the tech, like I just found that I w I never had a whole lot of peace. About having to build this tech. You also have to rebuild it every single year. There is a chance that it could crash and then you'd have to go in and start from square one and rebuild the whole thing. So I just always had the, that in the back of my mind and it just never sat well with I never had a peace about the whole technology piece side of it. And to be quite honest. We didn't really have that much better control using the loop system. Then we did just using the Omnipod arrow system, which we were on before loop. So once the Omnipod five got approved and we finally got approval through our insurance, I was like, you know what? I really want to give this a try. There was a couple things I wasn't crazy about, but. One being, we couldn't use our phone. To control the pod because we, Sarah had an iPhone and that's not compatible with Omni FOD. Five at the moment. I didn't love the fact that there was not a view app. With the loop system, you can use Nightscout. Which is another thing that you have to build on your computer. But there are companies out there that will build it for you and maintain it for you for like$10 a month.

50:49

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Katie: 50:50

That's called T one pal. And I will put a link to that in the show notes as well. Which I had to, I had to pay for that service because honestly, after having to build the loop system, I was like, I cannot possibly build one more thing. That's going to stress me out. So I paid somebody else to do that for me. For$10 But Nightscout was amazing. I could see every single treatment decision that Sarah made on Nightscout. I could see what the system was doing, whether it was giving her more basal insulin or less basal insulin. I could see what the prediction line was like, what it was predicting. Her glucose was going to be. In a few hours. Nightscout was truly amazing. And with Omni pod five, I lost all of that. There's no view app. I have no way of seeing what Sarah's treatment decisions were when she's not with me. And I don't have the PDM to pick up with my hand and look at. So I feel a little bit more in the dark with the Omnipod five system. But the pros of Omnipod five, for me at least outweigh the cons. So I'm going to talk more about that in a separate episode. All about what our experience has been with Omnipod five so far. So stay tuned for that. But as for our summer 2022 and review that's about it. Everybody went back to school about. Three or four weeks ago. I think we just started our fourth full week of school. And I'm happy that I can now complete a full thought without interruption. I really do love having my kids home for the summer, but I am also ready for them to go back to school once it's over. All right. You guys, I hope you found that helpful. I hope you were able to glean a little bit of Information off of that, get a few nuggets of wisdom. Let me know if you have any questions or comments about that. You can always email me@sugarmamaspodcastatgmail.com. Happy to answer any of your questions or send me a DM on Instagram or Facebook. But that is it for our episode this week. As always, I'm going to link to a lot of stuff in the show notes, so be sure you check it there's three episodes that I'm going to link to the episode with Maura McCarthy. I'm the episode with TSA cares and I'll link to the episode with Stacy Sims. Remember Stacy made a little announcement at the beginning of the show. For moms in the Charlotte, North Carolina area, she's going to host a mom's night out event. But I had. I actually interviewed Stacy on a previous episode. And it was a great conversation. If you want to take a listen and learn more about her podcast. I'm going to link to the loop docs website. If you want to learn more about the DIY loop situation and the looped Facebook group, which is basically tech support. If you are going to jump into the whole DIY loop community. Those are two great resources. If you're thinking about doing loop. Or the open APS system, which is the system for Android devices. I will put a link in the show notes to the mom's night out event that Stacy Sims mentioned. So go to that link to find out more information and sign up for that. I will also put a link to the SIM patch patches. The skin TAC, the Ivy prep and the Cavilon barrier cream, which are all the products that I mentioned. We use to help keep Sarah's devices on nice and snug during the summertime. Okay. I hope you guys have a fabulous week and a relaxing weekend. I hope diabetes behaves for you, but until next time, stay calm and bolus on. Bye.