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Re: [IPp] Contact sports--a postscript

 The idea of the Lantus on game days seems like a good one. Your son's problems
definetely mirror my son's. I am curious, though, how would you work the Lantus?
I am guessing you would give the Lantus in the amount of his basal insulin and
then just keep his pump disconnected or suspended and just use it whenever he
eats? When would you give the Lantus because if my memory serves me, it works
for 24 hours and does not peak right?

Jackie, mom to Brendan, age 9, dx 8/06

----- Original Message ----
From: Mary Donovan <email @ redacted>
To: email @ redacted
Sent: Thursday, April 24, 2008 9:02:36 AM
Subject: Re: [IPp] Contact sports--a postscript


I should have mentioned bolusing for at least part of
the missed basal.  The new cozmo has a disconnect
feature that computes how much insulin you should give
to compensate for disconnection, but you can figure it
manually as well.  

We did not have  a lot of luck bolusing ahead of time
for missed basal.  With all the running in lacrosse,
it would tend to cause lows unless Dan went into the
game on the high end.  Your mileage may vary, and
hopefully this will work better for you than it did
for us.


--- Mary Donovan <email @ redacted> wrote:

> Jackie,
> Dan played lacrosse his first two years in high
> school.  He quit this year because practice went to
> every day, in addition to at least two weekend
> double-header games, and he just doesn't have time
> for
> that kind of commitment.
> While I loved the regular exercise Dan got from
> lacrosse, we did have exactly the same concerns you
> mention.  His sites (butt or love-handle area) got
> messed up occasionally, but it was usually pretty
> obvious if it was damaged. I didn't worry about the
> canula being pushed in so much as the site just
> loosening up.  If the site looked loose or weird, we
> would change it after the game or practice. On away
> games, he always had an insulin pen with him, in
> case
> he needed to correct and had a bad site.
> The long disconnects were a huge problem.  Sometimes
> he would go three or four hours disconnected,
> despite
> my frequent reminders that that was verboten!  For
> other sports, Dan had been able to reconnect, test
> and
> bolus at some point, but in lacrosse it's hard to do
> because the kids are subbed in and out so fast it's
> hard to find time to do it, in addition to the fact
> that his hands were often cold and therefore hard to
> get blood out of, he had bulky gloves on, and he was
> covered with mud.  This was more of a problem on
> game
> days than on practice days, since games tended to be
> doubled up or come in tournaments.  
> Some of the post-game highs can be
> adrenaline-induced
> as well.  Dan used to get those in basketball, and
> we
> found they were helped somewhat by a small snack
> (with
> some protein and some carb) about an hour before
> game
> time.  He would bolus for it (sometimes at a reduced
> rate in anticipation of exercise), but just getting
> a
> little additional insulin in there seemed to help
> the
> post-game highs.  For lacrosse, though, I feel the
> extended disconnects were usually the cause of the
> highs.
> Had he stayed in the sport, this year we were going
> to
> try Lantus for game days, to get some background
> insulin, bolusing with the pump for meals and
> corrections as needed.  I think that is the best bet
> for this situation, unless someone else has come up
> with a pump-based solution that works.
> Dan also had pretty significant delayed lows after
> games (like eight hours later, during the night).  
> Best of luck -- let us know what is working and what
> isn't!
> Mary
>  Mom of Chris, 24, Carrie, 20, Dan, 16 dx 01 pumping
> cozmo 03, aunt and guardian
> of Mike, 20, and wife of Jim
> .
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