Picture this: It’s rush hour on a major freeway in Los Angeles. I’m in this totally unfamiliar area and—from the looks of the graffiti and barbed wire flanking the road—it’s not-too-safe. But I HAVE to pull over. I forgot something big, something important. I forgot to give James insulin for a huge meal!
How did I find myself in that situation? Well, years ago we were on our way back from our endocrinologist’s appointment. This was James’ beloved “old” endocrinologist. We love that guy. For many years he was worth fighting traffic for, sometimes in excess of two hours each way! But it made for a really long, tiring day, and in this particular case we decided to cut bait and just hit the drive-through for dinner. Gotta love the ironic tradition of post-doctor-appointment fast food!
Anyway, my usual protocol was to pull into the back of the drive-through, lean back toward James (who conveniently sits in the middle of the rear seat), test his blood sugar, and pre-bolus for his meal. Usually the timing was perfect. He would get a little insulin in advance and then by the time we made it through the drive-through with our meal, he was ready to eat.
But this time his blood sugar was actually pretty low. Low enough, in fact, that I decided to give him a small piece of candy instead of insulin, thinking I’d bolus him when we hit the front of the line, after we’d paid and gotten the food, but still before eating. That was the plan anyway. What really happened is that between the whole money transaction, reaching through the window to get a hamburger, and passing the French fries back to James, I completely forgot to give him his insulin. Instead, I just handed back that carb-rich food and headed onto one of the biggest freeways in the world—at rush hour, of course.
And that’s how I found myself trying to cross three busy lanes of traffic to pull over into an unknown neighborhood to reach James’ pump and give him his insulin!
I was just thinking about this incident recently, because it wouldn’t have happened today. Though I still help with carb counting at places like fast food restaurants, and I still give him lots of reminders to dose himself, James is remarkably self-sufficient with his pump.
Today the scenario would have been really different. I would have still had him test his blood sugar before we entered the fast food line. I might have even still forgotten to give the bolus amid the chaos that a drive-through with kids sometimes entails. But I could have called out instructions to him (I often do), and that would have made that freeway incident A LOT less stressful. Today I would have sounded a bit like a quarterback (or maybe a bartender is more apt?) with my detailed description of what he needed to do. Especially since lately we’ve been really experimenting with some of the advanced techniques that pumping allows us to do. It would sound something like, “James, you need to dose for 45 carbs. Give it as a dual wave, 30 straight up, 15 squared over 2 hours.” And James could do it! In fact, he likes to! He loves those buttons and enjoys being capable.
And really it is SO NICE. There are some things that are actually harder now that James is getting older, and I understand that once hormones really kick into gear, managing blood sugar may become even more challenging. But there are definitely things that I love about James getting older and more responsible. Anytime I don’t have to fight against L.A. traffic at rush hour, I call it a total win.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring. Jen and Kim are real moms of kids with type 1 diabetes and have been compensated for their contributions to this site.