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[IP] pumping kids who take gymnastics


Sara's swim practices require the removal of her pump also. First advice, your
daughters reaction to exercise will be completely unique to her and you will
have to find her response patterns to the longer workout.

Our method was establishing a snack routine that we followed exactly before
practices, adjusting as we needed to based on her BG reactions, and then do
BG's checks frequently for a about a week or two. You will find how Jenny's
body reacts during each part of the practice and the best timing for food and

As an example Sara cannot bolus for the pump being disconnected for 3 hours
right at the beginning of a practice as recommended in Walsh's book. When we
tried this her BG's drop dramatically in the first 30-45 minutes. But, if we
do not give her something her BG's begin to rise dramatically. We must give
her a snack and bolus 30-45 minutes before the workout. This gets her through
the first hour. Then at that point she needs to take a bolus of insulin. If
she does not take that bolus by one hour in she will end up going high later
on (this is due mostly to the extreme intensity of the workouts) and it is
difficult to bring down. The pre-workout snack also varies depending on the
length of workout, the intensity and time of day (AM versus PM).

The point is Jenny can do this but it will take detective work and time by the
family. It is time consuming at first but will decrease as you become very
familiar with Jenny's BG reaction to the long practices.

I would avoid asking the coach or other kids to remind Jenny to check her BG
and to bolus. The kids are just as busy and intent on the practice as she is.
All the kids were very serious about the sport to get this far and are at the
practice to focus and improve.
The same with the coach. He/she is there to coach several kids at once and is
responsible for their safety in a sport where safety is a very big issue. To
ask the coach to remember to stop whatever he/she is doing every hour to
remind Jenny about her BG and boluses will become very annoying quickly, even
if the coach says he /she is willing to do this up front.
There is only so much a coach can accomplish and with their attention going
several directions for those four hours, even a small thing such as hourly
reminders will become tiresome and easily forgettable.

One if the things that has earned Sara the respect of teammates and coaches
alike is that she just deals with her diabetes during practices and meets and
does not make an issue or disruption out of her checks and boluses. She waits
until the end of a set to do routine BG checks (the key to getting through
long workouts with good BG's and good productive workouts). She only stops in
the middle of a set if she is feeling "off." She gets herself out of the pool
and out of the other swimmers way so they can continue their workout without
interruption. All her equipment is right next to the coach so if her "score",
as he and she jokingly refer to it, is off he knows she will be out of the
water for a few minutes to get everything under control. As soon as she feels
ok she waits for a moment when she will not disrupt the other swimmers in her
lane, reenters and hits the water. There is very little interruption. The
other bonus to this is that when Sara does have a bigger problem that requires
disruption her teammates and coach know it is the real thing and Sara really
needs a hand, not just a drama queen thing, and you should see how they all
pitch in to help her.

A trick we discovered is to pack a syringe and bottle of insulin in a Frio and
send this to the pool with Sara for long practices. When she needs a bit of
insulin it is tough to reconnect on the pool deck with two-three drag suits
on. Dignity goes right down the drain. The syringe is much easier.

Good Luck to Jenny,
Pam, mom to Sara, 16 and an All American Swimmer
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