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Re: [IPp] Contact sports

I know Megan has experienced the same issues with just general rough 
playing, trampoline, rolling down grassy knolls, swings, climbing trees. 
You can tramatize the pump site if you hit it just right however we can 
usually tell because blood will show up in the tube, even just a tiny amount 
is noticable and that could certainly impact the insulin getting into the 
site.  Disconnecting for more then an hour is a fact of life for us during 
the summer months and even though she is physically active during that time 
we always seem to need to "catch up" on some of the basal she has missed. 
My endo has given me ideas to play with to see what works best, Because of 
the physical activity it is hard to pre-bolus some of the basal prior to 
disconnecting the pump.This was one of his suggestions if she was at the 
higher end of her range prior to disconnect.  The other thing is to make 
sure your tubing hasn't lost its "priming", doing a fixed prime prior to 
reconnect until insulin comes through the needle will tell you the tubing is 
full again.  If her post activity BS is reasonable then I bolus a unit or 
two to catch her back up and monitor her BS in an hour or so.  Additionally, 
depending on his BS prior to activity you may need to bring him up 
especially for the level of play you reference.  The New York State 
Department of Heath Children with Diabetes Resource Guide for Families of 
Children with Diabetes recommends the following guidelines for BS ranges 
prior to activity: (you would not bolus for these carbs)

Type of Activity            If BS prior to activity is:    then eat the 
following Carbs before activity:
Short duration                less then 100                    15 grams of 
(less than 30 minutes)    greater then 100                no carbs necessary

Moderation duration     less than 100                    25-50 grams of 
carbs plus a protein source
(1 hour)                        100-180                            15 grams 
of carbs
                                    180-240                            no 
carbs necessary

Strenuous                    Less then 100                    50 grams of 
carb plus a protein source
(1-2 hours)                  100-180                                25-50 
grams plus a protein source
                                    180-240                            15 
grams of carbs

This is in a table format so I hope it reads okay for you.  As for the site 
getting ripped out we use tegaderm patches over Megan's insertion site, we 
change it often even though we might not be changing the site.  You could 
use it for sports only for the piece of mind.  (My insurance covers the 
patches which is good because they are a bit on the pricing side).  You can 
buy a ten pack in most larger pharmacies to try it out.  I hope this helps. 

----- Original Message ----- 
From: "jackie shanahan" <email @ redacted>
To: <email @ redacted>
Sent: Thursday, April 24, 2008 9:23 AM
Subject: Re: [IPp] Contact sports
> I have a question for those of you who have children playing the VERY 
> agressive
> sport, Lacrosse. My son disconnects for every practice and game because of 
> the
> high contact and aggressiveness. What I keep worrying about, however, is 
> his
> site. He wears shoulder and elbow pads as well as a helmet and gloves, but 
> his
> site is usually around his waist area where he has no protection. For 
> anyone who
> has seen a lacrosse game, you know that the players bang into each other, 
> push
> each other, hit each other with their sticks and they end up on the ground 
> alot.
> I always worry about Brendan's site getting ripped out or pushed in too 
> far or
> something like that. Does anyone have any ideas or thoughts on this? Also, 
> my
> son has been having trouble with highs after lacrosse practices and games 
> and I
> have been blaming it on being disconnected for more than an hour at a 
> time. Has
> anyone else had this problem and what do you do?
> Jackie, mom to Brendan age 9, dx 8/06
> ----- Original Message ----
> From: Suzanne Henbest <email @ redacted>
> To: email @ redacted
> Sent: Wednesday, April 23, 2008 7:29:11 PM
> Subject: Re: [IPp] Contact sports
> Thank you very much for your very insightful comments regarding the impact
> of wearing a medical bracelet or insulin pump while playing in sports.
> Suzanne
> ----- Original Message ----- 
> From: <email @ redacted>
> To: <email @ redacted>
> Sent: Wednesday, April 23, 2008 6:17 PM
> Subject: [IPp] Contact sports
>>> I think it's more to do with the jewelry getting caught or tangled on
>>> clothing, equipment, other players, etc. and potentially hurting
>>> either the wearer or someone else.
>> That is exactly the problem. Rings, braclets, earings, etc... have
>> the potential to remove a lot of flesh , etc... when moving fast past
>> the human anatomy. Hard objects have the potential to vastly increase
>> the amount of damage to your vascular system (deep in the muscles)
>> when there is a collision. For this last case I have some personal
>> experience -- having been hit in the quad by a knee and having my leg
>> bleed out internally for several weeks. Lots of swelling, ugly purple
>> bags of blood under the skin, etc... Compounding such an incident by
>> making a hard object like a pump the concentrator of force in an
>> impact can do a LOT of damage. You might not think that, but a point
>> collision with a hard object can seriously damage an large vein or
>> artery with potentially life threatening consequences if there is a
>> bad bleed. I have seen a persons leg (shin) broken in two places by a
>> misplace kick. Both of these last accidents occurred in normal soccer
>> play, no rough stuff and without "hard" objects (like a pump) being
>> involved. In both cases is was circumstances of motion in a play and
>> being in the wrong place at the wrong time. In the case of the broken
>> leg, both players went for the ball and one got it.... the other's
>> kick at the ball caught the other fellow's leg at a bad time and
>> place. In my injury, I was kneed by my own goaly as we both rushed
>> toward an opponent that passed between us an instant before we
>> collided.
>> In 12 years of watching my daughters play soccer, I've seen kids
>> (girls) injured in soccer games because they forgot to take their
>> earrings off (coach forgot too and ref didn't check). the poor kids
>> had their earlobes torn open when the earrings were violently torn
>> away from their ears in a collision.
>> The rules that the refs and coaches put in place about jewelry,
>> pumps, and other extraneous things that hang on our bodies are not
>> whimsical, they are there to protect the players from injury that
>> WILL happen eventually if these precautions are not taken. Don't take
>> these rules lightly or blow them off as over cautious.
>> One more incident that is not sports related but similar in nature.
>> This happened to one of my fathers friends during WW2. There is/was a
>> rule for military pilots that they not where jewelery on their hands
>> or arms. The reason is that if they slip climbing into the cockpit
>> and fall... catching the ring or watch, or whatever.......
>> Friend slipped while getting into the cockpit of a fighter, caught
>> his wedding ring on the lip of the canopy and had the meat sliced
>> completely off his finger leaving only the bony skeleton. Needless to
>> say he lost his finger. Later, my dad did the same stupid thing but
>> managed to grab the ladder and pull himself back up (you think he
>> would have learned from his friend).
>> The message I'm trying to impart is that pumps and other
>> accoutraments are NOT SAFELY worn while playing contact sports. That
>> includes just about any sport where there are two opposing teams and
>> a ball. Kids and adults will both go all out to win and they WILL run
>> into each other every now and then.... enough said.
>> Michael
>> .
> .
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