Well, we had K's appointment with the D-nurse and dietician on Tuesday.
First of all the nurse we met was the one who had made the comment to me last week about convulsions . I think I unfairly misjudged her intentions last week. We had a good discussion about recent trends and she put last weeks comments into context (altho' i'm still not fully convinced about same). Her main wish is to avoid lows that may lead to hypo unawareness.
She had also discussed K's case with the consultant and K has moved from twice daily injections to 3 times - 1 in the morning of both fast & slow acting insulin, 1 at dinner time (5:30pm) of Novorapid and 1 of slow acting at 9p.m.
We're on to the hospital every morning to review how its going. K is still getting the highs and we arent changing the new dose yet as the hospital wants to see a 3 day trend before amending dosages.
I asked her to check Ks HBA1C, it came back at 7.7, which wasnt as bad as i expected; we've a month before Ks quarterly appointment to see how it will change with the new regime and we us watching those carbs a bit closer.
We also had a very good chat with the dietician......
When K was diagnosed we got a list of 20g Carb snacks from (a different) dietician for mid morning and mid afternoon, and guidelines on food intake.
We reduced the amount of fruit K would have traditionally eaten from fear of highs, I dont think anyone advised us to do this, it just seemed like common sense (we were so flummoxed with new information at the time i dont know if we even asked about same).
In the pursuit of measurable carb snacks we've also increased the number of snacks such as crisps and pop-corn, neither of which ever really came into the house pre-D. We weren't really comfortable with this but they were on the list...
Well fruit is back on the menu, and crisps are kicked to touch.
The dietician explained that the natural sugars in fruit are okay due to the combination of fibre, even fruit like pineapple & mango (both of which K LOVES). We may just need to do some trial and error to see if any send her high.
She suggested a number of ways of presenting them, e.g. cubed with cheese, so K will have some snack variety (she's mightily bored of the same snacks)
She also mailed us on a recipe for flapjacks - we'll do a test run & put up the recipe.
It was naivety on our part regarding the fruit but we followed the set lists too rigidly and prob didnt question enough - we'll know in future.
Great news!
ReplyDeleteTrial runs with the fruit are the way to go. I'm amazed that some send kiddos sky high while not really effecting others. Just have to see what works for K.
We tend to stick to the three day rule, too. Sometimes it's really hard but it's good to establish a trend before making any other changes.
We're on day three of a daytime basal (would be like adjusting K's long acting insulin) and I will be making changes for tomorrow!
Totally hear you on the following the rules rigidly. That was me when Bean was first dx'ed. It takes a little while to start bending the rules to see what works best for your family. :)
oh yeah for sure there's still a learning curve. always will be probably. sounds like you're taking it all in stride, as it should be.
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