When I was little I obsessed over the Little House on the Prairie series. Not the TV show, the books (I’m old). Not only did I love the adventures going west, I loved reading about the old school way of doing things like making puffy birthday cakes out of three ingredients; or curling hair with tied up rags. I will admit it: I tried them all.
I learned a lot from doing things the old way. My now grown daughters will attest that before special events, their hair was washed and then tied in rags – it looked great and didn’t cost me a cent.
Which brings me to the olden days of diabetes. Back when we had to walk barefoot both ways uphill in snow to get our NPH and Regular. Back when pumps clicked and meters took a lot of blood and a good long time to count down. Back when we had to work with numbers from set points in the day, not 24/7. It was hard. It was rugged.
And yet, sometimes I think newer folks to the diabetes world, particularly parents, could learn a lot from knowing some of the “old school” ways of doing things. With all the amazing new tools we have, we still must be sure that our medical providers are reminding patients and parents of the basics.
Because here’s a secret: Things break. Wifi stops working. Tubing and pods mess up. I hate seeing folks in a crisis because of any of those things. After all, it wasn’t that long ago I was lumbering across the prairie in a covered wagon with my daughter with diabetes, praying the crops would come in so we can get a bolt of calico. Oh, wait. That was just my imagination. What I mean is: it wasn’t that long ago we had only the old way. And we all got by.
With that, I’m going to make some suggestions all people with diabetes and parents should consider and then discuss with their medical team to see if they are good practices to adopt.
Unexplained highs may best be corrected via syringe or pen, and then the infusion site changed. In the old days, healthcare professionals drilled this into our heads. Even if you just changed the site. Even if you just changed it for the second time. Here’s why: sites don’t always work perfectly. If you keep trying to correct an unexplained high via a not-working site, you’re going to go down a road toward highs and ketones that may lead you to a bad situation (DKA). When you change the site you remove the possibility of the situation being the site until blood sugars have come down.
Don’t rely completely on cell phones. They break. And get lost. And lose signals. When you send kids off to play or to a friend’s house, find out if there is a land line available. Also make sure your child knows your phone number, and not just how to autodial you.
Along this line, practice being unafraid while Share is down. I know, I know… only the Pilgrims did that. But again, things break. No one doubt that CGMs are amazing, but we need to be able to embrace life with diabetes without them too. Just in case, you know?
Even if you exclusively pump, it’s a good idea to keep long acting insulin in your home. (Pumps break, remember?) Ask your medical provider to write out instructions on how to use the insulin. You will probably still going to need to call your CDE or endo for input, but having it on hand and knowing the basics may help avoid a crisis.
Write things down. Like, in long hand. On a piece of paper. In a notebook. I’m talking here about basal patterns, doctors’ phone numbers, carb ratios and more. Sure, it is all stored in the pump, phone, or iPad. But in case of problems or lost phone/pump, you are going to want all that information. You might even ask your medical team to keep a copy on paper.
Be prepared for sick days. Have a plan in writing and the supplies you need in your cabinet. This used to be a diabetes 101 thing, but lately I hear more parents wondering what to do on a sick day. Ask your CDE to talk you through it and to give you some basic tips in writing to keep on hand. It’s never going to be simple, but sick days can be less stressful if you are prepared and knowledgable ahead of time.
I’d love to have more old school tips shared in the comments here, and I’d love those newer to this D-life to consider embracing them as back ups they know and understand.
I’d also love to cook flapjacks made from wheat that we had to grind using a coffee mill over an open fire while Pa played the fiddle. You know, so I know how to eat and entertain if the power goes out forever.