{"id":34387,"date":"2012-11-08T13:11:47","date_gmt":"2012-11-08T18:11:47","guid":{"rendered":"http:\/\/asweetlife.org\/?p=34387"},"modified":"2015-12-27T15:42:47","modified_gmt":"2015-12-27T20:42:47","slug":"hospital-food","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=34387","title":{"rendered":"Hospital Food"},"content":{"rendered":"
Bisi had to be admitted to Children\u2019s Hospital in Boston to get her blood sugar down\u2014but also so we could learn about type 1 diabetes and the glucose testing\/carbohydrate counting\/injection regimen that now needs to happen at least three times a day (with every meal and sometimes snacks).<\/div>\n
\u00a0<\/div>\n
Before this, most of what I knew about type 1 diabetes had come from a friend of Bisi\u2019s who was over at our house for a playdate last year. She had a relative who had died of undiagnosed type 1 diabetes. (One of the dangers of diabetes is that if your blood sugar is too high for too long, acids build up in your blood and you can go into something called diabetic ketoacidosis, which can cause kidney failure and heart attacks, among other potentially fatal complications. Once you\u2019ve been diagnosed, you are much less likely to go into DKA, though diabetics have to be especially careful when they get things like the stomach flu or pneumonia.\u00a0Here’s\u00a0<\/a>a more scientific and complete description than mine.) Somehow diabetes came up while I was serving them snack and I said something that in retrospect sounds to me both inane and ironic, like, well it\u2019s important that everyone eat healthily to lessen the risk of getting diabetes. This little girl told me that getting type 1 diabetes has nothing to do with what you eat or how much you weigh\u2014it just happens, it can happen suddenly, and we don\u2019t really know why.<\/div>\n
\u00a0<\/div>\n
Now, a year later in the hospital, Mark and I heard a more complicated version of what Bisi\u2019s friend had told us. Type 1 diabetes, unlike type 2, is\u00a0an autoimmune disorder<\/a>. For some people, there may be a genetic predisposition, and then some sort of environmental factor, or combination of factors, triggers the body to attack the pancreas, eventually shutting down its ability to produce insulin. While some people with type 2 diabetes can control the condition with diet and exercise, people with type 1 diabetes are dependent on insulin injections (but\u2014and this may sound confusing\u2014the type of food they eat and how much exercise they get affects how much outside insulin they need).<\/div>\n
\u00a0<\/div>\n
Our three days in the hospital were a crash course about the disease and the steps that we needed to take for Bisi before each meal. The torrent of information was overwhelming\u2014it felt a bit like when you have your first child, and you\u2019re learning so much in those early days that you can almost feel your brain stretching and expanding. Yet while that learning was joyful, this education at Children\u2019s was upsetting but essential. Our minds were (and are still) raw from the new knowledge that our daughter has a chronic disease, yet we were asking our minds to work harder than they ever had to lock in this new information.<\/div>\n
\u00a0<\/div>\n
So here is an (extremely) distilled version of the routine they taught us we would now be going through before each meal:<\/div>\n
\u00a0<\/div>\n
1.\u00a0\u00a0\u00a0\u00a0\u00a0Test Bisi\u2019s blood sugar. (Prick her finger with a little needle called a lancet, use a test strip to suck the drop of blood up through the test strip and into the meter, wait five seconds for the result.)<\/div>\n
2.\u00a0\u00a0\u00a0\u00a0\u00a0Figure out how many carbohydrates she\u2019s going to eat in her meal.<\/div>\n
3.\u00a0\u00a0\u00a0\u00a0\u00a0Plug these two numbers into a mathematical formula involving Bisi\u2019s target blood glucose level (right now it\u2019s 150, which is 70 or so points higher than what someone\u2019s without diabetes would be); her correction factor (for her, one unit of insulin would bring down her BG level by 250 points); and her carbohydrate ratio (these days, she needs one unit of insulin to eat 55 carbs).<\/div>\n
4.\u00a0\u00a0\u00a0\u00a0\u00a0Draw up the dose of insulin based on your calculation. (Calculating this on the Children\u2019s Hospital worksheet took us about five minutes; but Mark quickly found an\u00a0iPhone app<\/a>\u00a0that calculates it for us\u2014thank God for apps.)<\/div>\n
5.\u00a0\u00a0\u00a0\u00a0\u00a0Inject the insulin and wait at least five minutes for it to take effect before Bisi starts eating.<\/div>\n
6.\u00a0\u00a0\u00a0\u00a0\u00a0Make sure Bisi eats pretty much exactly the number of carbs she said she was going to when you calculated the dose, and that she eats it within 45 minutes or so of when you gave her the dose.<\/div>\n
\u00a0<\/div>\n
Anyone who has a child knows how difficult it is to get them to wait five minutes or longer when they\u2019re really really hungry, or to eat exactly what they say they\u2019re going to eat (except if that food is, say, ice cream with sprinkles).\u00a0 So there\u2019s a lot that goes on between the lines to make sure these six steps happen.<\/div>\n
\u00a0<\/div>\n
Luckily, so far (I\u2019m knocking on wood as I type), Bisi has been fabulous about eating pretty much exactly what she says she\u2019s going to. In fact, she\u2019s been pretty great about the whole thing; maybe most six year olds would be? I\u2019ve been surprised by how quickly she\u2019s adapted to and how well she adheres to this whole routine. But I do think that three days in the hospital (the last time she was a patient was when she was born) have a way of making a child take things seriously.<\/div>\n
\u00a0<\/div>\n
At Children\u2019s, the process I described above was made slightly easier by the fact that the menu they gave us had nutrition information printed on it, so it was easy to count up a meal for her of, say, 4 chicken fingers (25 grams of carbs), \u00bd cup of broccoli (3 grams), \u00bd cup of milk (7 grams), and a \u00bd cup of vanilla ice cream (16 grams). But, even with our nascent understanding of diabetes, there was a lot on that menu that we didn\u2019t think we\u2019d be serving to Bisi once she got home. Why would we give her the empty carbs of a hamburger bun\u201427 carbs, for which she\u2019d need a half unit of insulin\u2014or Teddy Grahams (27 too), or French fries (18 grams for a measly 3 ounces)? Or what about the sugar jolt from a regular-sized yogurt with 42 carbs? (In yogurt almost all the carbs come from added sugar.)<\/div>\n
\u00a0<\/div>\n
Also, there were the mysterious sugar-free items that started showing up by her bedside, even though we hadn\u2019t requested them. Bottles of Crystal Lite lemonade and containers of Jello made with Nutrasweet. We didn\u2019t serve Bisi much juice or jello before she was diagnosed; why would we start now? Her endocrinologist, who happened to stop by when her tray was piled with unasked-for sugar free treats, clearly felt the same way we did. I told him that we ate pretty healthily at home, and I didn\u2019t imagine that Nutrasweet was going to become a big part of Bisi\u2019s diet just because of this new diagnosis. (This is not to say that I don\u2019t give her some sugar free gum now and then when other people are having treats that she no longer can\u2014but sugar-free treats are a small, back up weapon in our arsenal rather than something we rely on often. Perhaps our feeling on this will change as our understanding of the disease\u2014and how Bisi does with the disease\u2014evolves.) He quietly slipped the Crystal Lite bottles and Jello containers into his lab coat pockets, and continued on with his rounds, probably with a stop by the nearest trash can.<\/div>\n
\u00a0<\/div>\n
There was a lot we didn\u2019t (and still don\u2019t) understand about diabetes. But we now knew that Bisi would be insulin-dependent for the rest of her life (barring some yet-to-be discovered medical miracle). We knew the basic steps of how to take care of her. And we also knew that we would address this disease by trying to feed Bisi (and the rest of us) the healthiest food we could.<\/div>\n","protected":false},"excerpt":{"rendered":"

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