Thanksgiving Dinner (Skip if you read Snuffleupabolus)
Thursday, November 21, 2013 at 8:00AM Here’s a little tidbit that I’ve literally never told anyone, ever. When I see a turkey, I hear the Sesame Street character Snuffleupagus in my head. He says, “Buuurrrd.” Not a huge revelation perhaps, but it’s weird enough that it shouldn’t be shared. In the past, as the father of a child with type I diabetes, I’ve conjured other words while preparing Thanksgiving dinner. Those words were R rated and not appropriate for this blog post. These inappropriate words would pop into my head as I tried to imagine how many carbohydrates were in a scoop of mashed potatoes, homemade stuffing, dinner rolls, fruit, gravy and all the rest of the seemingly unquantifiable holiday treats that cover every inch of counter top in my kitchen.
I say in the past because I was finally able to get out of my own head last year and find a way to give my daughter Arden insulin on those long, food-heavy holidays without making myself crazy or causing Arden to feel like a science experiment.
I think I will call the result of my revelation, Snuffleupabolus.
Could I measure everything that Arden eats on Thanksgiving? I could. But I’m cooking and cleaning, while socializing with family, trying to sneak a look at a football score and balancing the preparation times of more dishes than I normally prepare in a week. I’ve tried unsuccessfully in the past to count each morsel, but too often the results were uneven. I found that putting in so much effort and care without achieving the desired result to be defeating, and the end of the day brought blood glucose results that made me wish that we skipped Thanksgiving.
All of the day’s tasks are secondary to keeping my daughter’s blood glucose in range. Too low, too high, too inconstant. Each possibility comes with its own physical punishment for my sweet girl. I bet that you know what I want more than a golden brown buuurrrd, perfect stuffing or a well placed table. I want Arden to enjoy her holiday with minimal diabetes interaction or the unpleasant feelings that come with riding the diabetes roller coaster. The enemy of that desire, especially on Thanksgiving, is the difficult to count mixture of complex and simple carbs that tempt at every turn.
During the day we employ a cadre of slick diabetes moves. Increased temp basal rates to combat snacking, pre boluses to help get ahead of carb-heavy meals, and we lean heavily on Arden’s DexCom CGM for guidance (If you don’t have a CGM, frequent testing can produce similar data). But when that meal plate comes with its potatoes steaming and stuffing so plentiful that covers Arden’s slice of buuurrrd - I Snuffleupabolus. I do my best to guess at the carbs, but honesty, Arden’s belly only holds so much food. So if my estimate doesn't match the insulin amount of the largest meal that I’ve seen her eat in recent history, I increase the bolus to match that number. Likewise, if the suggested amount of insulin is greater than the largest recent meal, I decrease the insulin. The odds that Arden won’t eat much more than on a normal day are pretty good. Thanksgiving or not, that little kid can only eat so much food and I’ve found that historically most of her large meals need a similar amount of insulin. There is nothing scientific about this method and I only whip it out on days like Thanksgiving… but I’m getting good results.
After the malay, I watch Arden’s CGM closely and test, we aggressively tend to high numbers and treat lows with pie and other desserts. The only real time-sensitive planning that I do around food? I like to pre bolus the main course 15-20 minutes before it’s served (DexCom admittedly makes that easier) and I make sure that dessert is finished and the eating frenzy is over, three hours before bedtime. I want Arden’s active insulin to be finished before bed so that decisions can be made about overnight care from a fresh perspective. This is something that I strive for everyday but is extra important on days that contained high amounts of exercise, stress or eating. Thanksgiving day contains all three of those variables in our house, as I’m sure it does in yours.
I hope that your family has a wonderful Thanksgiving, that your home is warm and full of good friends, loving family and one Snuffleupabolus that allows you to enjoy it all with a light heart.
buuurrrd
This post originally ran as part of a Lauren's Hope/Life Is Short, Laundry Is Eternal giveaway. I liked it so much that I wanted to run it in it's entirety, here on Arden's Day. Thanks to Lauren's Hope for not being weird about reposting! They're good people, please check out thier blog if when you get a chance... blog.laurenshope.com
BGnow, DexCom, Insulin, Pre-Bolus, diabetes in Daddy's Blog, Guest Posts 
