Just Around the Next Bend

As Steve mentioned a few weeks ago, we packed up the gear and the kids and headed off to the mountains of Southwest Virginia for some much needed back-to-nature time. No cell phones, no computers, no television or Red Box. A chance to detox from the connections that keep us firmly rooted in our busy lives. And also the opportunity to remember that there is a great, big, beautiful world out there and the best entertainment is often the sharing of stories with those with whom we share it.

This was our second foray into the wild with diabetes and to be honest we felt like pros. Meals were planned to the nth detail, the food pre-measured, pre-packaged and pre-labeled, and in some cases even pre-cooked. The load divvied up amongst us. Supplies checked and re-checked. Our plan for managing all things diabetes researched, discussed and settled. All that was left was the leaving.

In terms of blood sugar control, we opted to try something new: dose 100% for the food Lia ate, and use negative temp basals to reflect the increase in activity. This turned out to be a better plan than last year’s and easier to manage. The first half-day, we only put the temp on for four hours and then forgot to renew it, so she battled some lows later in the day. For the rest of our trip, we put on temps for twelve hours before we left for the day and this worked out perfectly for the most part:

By the Numbers (Data from Diasend)

Average Blood Sugars While on Trail: 153
BGs within range: 67%
BGs above range: 16%
BGs below range: 5%
Average daily basal insulin: 8.2 U (a full 2.3 units less than at home)
Average daily bolus insulin: 11.5 U
Average BG correction: 8%

The Hike

We hiked a total of 22 miles: 8 miles the first day to the top of Mount Rogers; 8 miles the second day to the Scales; and 7 miles the third day back to our car (two miles on VA 603).  Both girls did a great job keeping up and staying in high spirits, even when feet and backs hurt from the rocky terrain and from the climbs and descents.

On the first day, Lia hiked all day with her pants on backwards and didn’t even notice until lunch. She also fell over once when having to get over a fallen tree and needed help getting up from her overturned turtle position. Our hike was mostly uphill, and rocky only in places. The night was cold but not unbearable and it took us longer to get up and going on the second day than on the first. We lost time and had to adjust our route by cutting across the park on a horse trail, which in hindsight was a bad idea.

Horse trails, designed for horses, are filled with large loose rocks that are difficult to walk on. The horse trail was four miles long and muddy. At one point, Steve was out front and saw a copperhead snake. He turned around just in time to see Lia nearly step on it! Their quick reaction saved her from a snakebite and a disastrous end to our trip

(and possibly an upcoming plot line for a novel). We were all shaken so much after this that we just wanted to get to our destination and take a load off. The four miles felt like eight and Steve’s near-constant assurances that Scales was “just around the bend,” made Krista and I want to scream.

Change in Plans

We love Southwest Virginia. The beautiful vistas we saw during our three days were some of the most breathtaking views we’ve seen as a family. We saw our favorite friends, the feral ponies of the park. At Scales we encountered 50-60 heads of long-horned cattle, and continued to hear their lowing long into the night when a mama and her young were separated at dusk. Unfortunately, on the second day, our memory card malfunctioned and all the pictures from the first two days were mistakenly erased! We did manage to take a few on the last day.

On our last morning, we awoke to frost and a temperature of 25 degrees! Before the girls woke, Steve and I decided not to spend our final night at the campground as originally planned, but to head to West Jefferson, NC for a night at a hotel.  We ate breakfast and everyone was ready in record time. On our way down the mountain, we encountered a young man who was through-hiking the Appalachian Trail with his beautiful black German shepherd, as well as several other

campers who were short-term hikers like us. The last two miles on the road were brutal. We were once again subject to Steve’s continued assurances that the end was “just around the bend.” We were happy to finally see a sign designating the Grindstone Campground.

For all the preparation and work that we put into going on our trip, nothing compares to going to the great outdoors. It sounds like a cliché, but the clean air of the countryside, the reduction of noise and light pollution, allowed us to see things we would ordinarily miss. We noticed each other, our idiosyncrasies and habits, manner of speaking, and things we say. We listen.

And yes, diabetes, our unwanted companion, is always along for the ride. But the planning, preparation and organizing we do in advance allow us to put diabetes second, and Lia and Krista time first.

To say that we enjoyed our trip is an understatement. For three days the girls didn’t bicker, they rarely complained, and we, the parents, did not need to scold. We were surely tired when it was over, but this is the one time a year that we truly reconnect, without electronic intrusions of any kind. We are connected through our disconnectedness. We live simply and purely for these days, and we are better for it. We feel confident that we can plan for even longer trips, even if diabetes has to come along for the ride. It is Lia’s favorite activity that we do as a family and this year it has made me think of the old Steve Winwood song. It is true that life goes on too fast with these trips we hope to slow it down.

“We’ll be back in the high life again
All the doors I closed one time will open up again
We’ll be back in the high life again
All the eyes that watched us once will smile and take us in
And we’ll drink and dance with one hand free
And have the world so easily
And oh we’ll be a sight to see
Back in the high life again”

Metaphorically, that is.

 

For those interested in our supply lists and menus, here they are:

Supplies

  • Glucose meter w/ test strips, lancet device, extra lancets
  • 2 spare infusion sets 2 syringes
  • 2 vials of 50ct test strips 1 vial of insulin
  • spare meter extra batteries for meter and pump
  • glucagon kit spare battery cap, spare cartridge cap
  • Emergency info, copy health insurance card, and prescriptions
  • glucose tabs

The Menu

  • Dinner on Friday:  Fried chicken, potato chips
  • Saturday
  • Breakfast: Whole Wheat Bagels with cream cheese (with chives, bacon, and sundried tomatoes)
  • Lunch: Veggie Burgers, dried apples
  • Dinner: Gnocchi with sage butter, bacon, and sundried tomatoes
  • Sunday
  • Breakfast: Apple Almond Couscous
  • Lunch: Ollalie Wrap (spinach and whole-wheat tortillas, cream cheese, roasted pepper pesto, and Israeli couscous, with bacon)
  • Dinner:  Manly Man Orzo
  • Monday
  • Breakfast: Strawberry Almond Couscous
  • Lunch: Esmeralda wrap (spinach and whole wheat tortillas with cream cheese, avocado, sundried tomatoes and bacon)

Snacks

The Kitchen

  • 2 stoves
  • 2 pots with lids (1 small, 1 large)
  • 1 serving/stirring spoon
  • 4 sporks
  • 4 bowls
  • 4 cups
  • 1 cutting board
  • ½ sponge
  • camp dish soap
  • 4 small cloth placemats
  • 1 wiping cloth (for drying dishes)

 

Into D-Wild

Steve and I love the outdoors. As parents, we try very hard to instill that love in our children.  When not on a His-and-Her-only retreat (for you other outdoor enthusiasts check out Mount Le Conte, a “primitive” lodge in the Smokies reachable only by hiking. You will not regret it!), we’ve had the kids join us for a wide variety of outdoor recreation in the hopes that our love and respect for nature will rub off on them: camping in the Appalachian mountains; a four-day canoe trip down the Buffalo River in Arkansas; and once to the beach (heat + sand + tent = Sad Franca, so we didn’t do that again).

Three summers ago, just months before Lia’s diagnosis, Steve and I took three days to hike 42 miles of the Appalachian Trail. It was an awesome time together and afterwards we talked of bringing the girls with us on the next one. Diabetes derailed those plans and other than visiting a couple of park-managed campgrounds, it kept us from venturing too deeply into the wild. But only for a while.

This year, we decided we would give it a try with diabetes as our fifth traveling companion. After careful planning–thanks to Mike at Rainforest Treks, a website about hiking with Type 1, as well as Melissa at meewah*betic, for all of their hints about food, insulin, and what to bring; and also to OnePanWonders’ “Dicentra,” for what to cook–we settled on a 12 mile section of trails winding through the beautiful Mount Rogers National Recreation Area of southwest Virginia.

 The Pack List

Our pack list consisted of the usual backpacking fare: tent (a four-person four-pounder, thank you very much Tarptent), sleeping bags, extra clothes and kitchen gear, but also had to include whatever diabetes supply needs and emergencies we might encounter in the woods for the two full days we expected to be “away from civilization”. Steve whittled the list down–with help from those mentioned above–to the following:

  •  Glucose meter kit w/ test strips, lancet device, extra lancets
  • 2 spare infusion sets, plus tubing
  • 2 spare cartridges
  • 2 syringes
  • 2 vials of 50ct test strips
  • 1 vial of insulin
  • spare meter
  • extra batteries for meter and pump
  • spare battery cap, spare cartridge cap (really channeling Murphy’s Law here, thank goodness these things are light)
  • 2 individually wrapped ketone strips with color chart (again, Murphy’s Law)
  • glucagon kit (Murphy again, damn you!)
  • Emergency contact info, health insurance card (we didn’t take along prescriptions, but next time we might. With Walgreens on every town block, who knows)

The Food

As you know, I love cooking and food. Being outdoors is no excuse to leave this passion at home, otherwise it’s just a walk in the woods, not a journey toward some fabulous dish prepared in a single pot on a little camp stove we toted for miles on our back. Things have come along way since the days of some fat man named Cookie serving cowboys beans around a wagon. Still wanting to keep things simple though, I had only three requirements: It had to taste good, it had to be light enough to carry, and it had to help in the control of Lia’s blood sugars. I settled on the following:

  •  Lunch at the Trailhead:  Ham and Cheese, or PB&J Sandwiches
  • Day #1 Dinner:  Gnocchi with saged butter and parmesan cheese
  • Day #2 Breakfast:  Crepes with Nutella, Peanut Butter
  • Day #2 Lunch: Modified Esmeralda wrap (whole wheat burritos with crème cheese, black beans, avocado, and bacon)
  • Day #2 Dinner:  Manly Man Orzo
  • Day #3 Breakfast: Oatmeal with dried fruit, hard boiled eggs, bacon (pre-cooked at home)
  • Day #3 Lunch: Dilly Tuna Salad Wrap

For on the go snacking, each of us carried some variety of homemade granola or trail mix, crackers with Justin’s Nut Butter, and beef jerky. For the likelihood that Lia might suffer a low, she carried glucose tabs, a bottle of juice, and sucked on Werther’s Original Hard Candies whenever she felt the need.

To get all this food where it was needed, our camp, the girls divvied it up by meal, so in addition to each of them carrying her own pack things, they carried a breakfast, lunch or dinner. Steve carried the stove and cook stuff.

 Blood Sugars

For the two days we were hiking, Lia’s BGs averaged 161 and 135, respectfully. She suffered no lows and the highest it climbed was the middle of the first night at 263 (ah, gnocchi…. and here we were worried about carry-over from all that outdoor exertion!). Helping these numbers was a +30% temp basal set for the four hour car ride, a 50% reduction during the hike, and a return to normal once we set up camp (These worked for Lia, please don’t assume they will work for you).

In fact, we noticed that as long as we kept her well-fed with proteins and whole grains, her BG was cooperating just fine. She snacked on the granola, dried fruit and nuts, and relied on the  Werther’s when needed along the trail. The Friday morning breakfast of crepes with Nutella was probably not a good choice. She was headed for a low by lunch–which we successfully avoided–a situation not helped by the empty calories of Nutella (even though it is just so yummy).

We took breaks often. Each time we stopped, we checked BGs and had a snack. We had comic relief when the girls and I put our packs back on:  it was not an easy feat and it sometimes required assistance. Lia ended up in the upside down turtle position many times and Krista took a most unflattering picture of me that I won’t share with you. We all had a hiking stick to help us get up (and down) those sometimes very steep and rocky hills.

 The Hike

When we arrived at the trailhead parking lot at Grayson Highlands State Park around noon, it was a chilly 54 degrees. The foliage in Southwest VA at that elevation is nearing its peak: bright reds, yellows, and oranges already carpets the entire landscape.

What I love most about hiking is the quiet and noticing the details of the forest floor. No one I know cares very much about moss (except my friend, Jenny), but I just love to see all the different and beautiful varieties of moss. During one of our breaks, I asked Steve if he was pointing out the flora we saw along the way. He told me that no, in fact, he was not because Lia was talking about scat and boogers. In terms of quiet well, Lia wanted to tell us all that she knew, and with Lia, a story often takes twice as long to tell.

When we arrived at our campsite on Friday night, we couldn’t believe our luck. The Scales, as they call it, is an old corral where they used to weigh livestock back in the old days, but now, it is an open field surrounded by a wooden fence, a nice, mostly-clean privy, and even tapped spring water. After a long climb to end the day, we felt like we’d won the lottery! It was getting very cold and windy so we set up the tent and the girls began arranging our beds, Steve worked building a fire, and I started on dinner. After the gnocchi, which was hot and delicious, we stood around the fire a little while and gazed at the billions of stars that aren’t normally visible from our “city” street at home. This, I feel safe in saying, was everyone’s favorite and most memorable moment, gazing up at all that dark sky.

That night, the wind howled. The sleeping quarters were cramped, what with the four of us and a big dog to occupy that four pound tent, but we managed. The next morning, we had breakfast, broke camp and set out. It wasn’t long until we ran into a few of the feral ponies that live in the park, one of which allowed the girls to get close enough to pet. The area also sports a vast horse trail network and we encountered a number of people on horseback, one man and his granddaughter stopped and spoke with us for a while at our lunch spot and even gave Lia her first riding lesson! Not long after, we had a big laugh at Krista’s expense right when her retainers (which we told her to put away in the carrying case) were blown off the rock we were sitting on and fell onto a big cow paddy. She won’t allow that to happen again! In the end, it turned out that we out-hiked ourselves and were done with the 12 miles about a half day ahead of schedule.

Our trip was a total success. We had a great time, laughed a lot and spent time together in the great outdoors. We know the girls are willing to go out into the wilderness again to do longer hikes. Lia has an appetite for roughing it. Krista likes it, too, as long as she can be fashionable.  We’d like to take them to LeConte someday soon. We feel confident enough with this experience under our belts to take on something a little more challenging.

 Steve and I would love to venture out again as a couple, too. But that will be more difficult. It’s not Lia being outdoors that worries us; it is us not being there with her. We don’t want to be out there, where we can’t be reached—just in case. Our level of comfort for that isn’t there yet, but it will be one day, we’re confident, when she is older. For now, we take comfort in the fact that she loves being outside and enjoys the small wonders of nature that surround us every day.

Homemade Bread
(So Easy, Even I Can Do It)

I was born with no sense of smell, a fact I hardly notice (other than to regret having passed it on to one of my kids). Without fail though I am reminded of it when someone enters the house and if a loaf of bread is baking or just come out of the oven they comment on the wonderful aroma. While I may have no olfactory inkling of what they are talking about, I know joy when I hear and see it and that is enough to clue me in on just what I am missing.

To be sure, I’ve had plenty of time to get the picture. For fifteen years or more we have been baking our own bread at home. It began with disdain for the taste and nutrition lacking in store bought bread and blossomed into a full on and eventually successful war against sugar and especially High Fructose Corn Syrup. The bread, hands down, was the easiest of the many battles we waged in that fight to put good healthy food on our table. And the nicest part about it? Other than the cost and obvious health benefits, making homemade bread takes about as much time as it takes for a pot of coffee to brew. It’s so easy, Franca even taught me how to do it, and in a moment she’ll teach you, too.

But first, let’s talk about why you should be making your own bread. Like almost everything that is good for you, most of you will already know why, so I’ll just keep things simple and visual.

Here’s just a partial list of the “extras” that go into making that loaf of industrial bread:

soybean oil, sweet dairy whey, butter, maltodextrin, honey, high fructose corn syrup, calcium sulfate, soy flur, dough conditioners, such as: dicalcium phosphate, calcium dioxide, sodium stearoyl lactylate, ethoxylated mono and diglycerides, mono and diglycerides, and/or datem, yeast nutrients: ammonium sulfate, ammonium chloride, calcium carbonate, monocalcium phosphate, and/or ammonium phosphate, cornstarch, wheat starch, vinegar, natural flavor, beta carotene (color), enzymes, calcium propionate, soy lecithin.

In comparison, here’s what goes into our simple homemade bread:

oil, honey, flour, salt, yeast, water.

If you want to go the extra step–and we usually do–we add:

flax seeds, sunflower seeds, pepitas, and chia seeds, all usually ground but not necessary

‘Nuff said? Let’s move on.

How to Make a Loaf of Bread

The tools

the tools
We use a kitchen aid mixer, but it’s just as easy to mix it in bowl. Other than that all it takes is a couple of measuring cups and spoons, and a kitchen towel.

 

 

the ingredients

The ingredients

2 tbsp honey

2 tbsp olive oil

3 cups flour

3 tsp yeast

1½ tsp salt

1-1½ cups water

** if making wheat bread add 4 tbsp gluten
*** if desired, 2 tbsp each of ground sunflower seed, flaxseed, chia, pepitas

Now for the rest, here’s Franca–

(We had a good chuckle from the inferior audio our cheap, little camera provided — what’s with those S’s anyway–as  well as Franca’s double fist pump at the start. In the interest of full disclosure, she had to make three loaves to get this video so by the final cut she was ready to have this over with).

So that’s it. Baking bread at home. Stress free. And, if you’re lucky, scented.

A Birthday Wish

Steve suggested that I write Lia’s birthday entry for Without Envy.  I am nervous, as I don’t usually share my writings with anyone.  But, as Steve has told me, sharing your writing is what helps you heal. So here is my earnest attempt.

The other day, Lia was running high so I walked from the High School where I teach and went to the building where the 4th grade is housed to make sure she didn’t need to change her infusion set.  I had the bottle of Humalog in my pocket to try to bring it to room temperature. Her blood sugar was within normal range, so I returned to my school. In the office, a friend of mine asked me if her glucose levels would stable out after being on insulin for a while.  I told her that it would not, that this would be a lifetime struggle for her and that the insulin I was carrying was to keep her alive.  As I said these words, I quickly had to leave the room to compose myself. Although I know very well what the insulin does, it was sobering to say those words aloud to someone else.

Since Lia’s diagnosis, I have not spent a lot of time thinking about how I feel about diabetes. With all the carb counting, figuring of boluses, night time blood tests, and everything else that comes in the day of a parent of a child with diabetes, I don’t allow myself the time to think about it.  I’ve done a lot of reading, mostly about how to manage diabetes, but also some about the long term effects of the disease.  I prefer not to think about the latter because if I do, I can’t function. I don’t want to read about what can happen if her kidneys fail, or her eyesight worsens, or anything else that might result in complications from diabetes.  What I focus on, is how we get her through another day as safely as we can.

I am not angry about the diabetes.  We will probably never know what caused it, though I am confused, since of the three kids, Lia is the one who was breastfed the longest, had the most natural foods given to her from the first days, and was home—unexposed to whatever her two siblings were exposed to in the daycares of their early days. I try to approach the whys in the way that I approach everything else:  it doesn’t really matter why—it just is—so learn to deal with it the best you can. When I get angry, it is at myself for making an error with a bolus or some other asinine thing, and it’s difficult for me to let it go.  But mostly, I feel tired: from all the things mentioned already, but really just tired of not knowing if I am managing things correctly—ever. Despite all our efforts, we never really know whether we’re doing things right, and more often than not, it is Lia who gives us the correct advice.  As a parent, that is frustrating to me.

Lia’s upcoming birthday is bittersweet for me.  I should not be feeling sad for the marking of another year in my little girl’s life, but this will be her first birthday with diabetes.  There is a part of me that wants to give her everything she wants—no matter what it is.  Mostly, I wish so much that she didn’t have diabetes, and of course I can’t deliver.

As I prepared to write this entry, I reread a journal that I kept when Lia was a baby. It is a sporadic account of her early days until February 2004 when she was 2 years and 5 months old.  I wish now that I had kept better records, but time is a precious commodity and I am sure I squandered it doing things like mopping my floors or doing the laundry.  Krista and I got a good laugh reading about when Lia dumped a roll of toilet paper into the commode and then proceeded to give herself a “spa” treatment. Or how when she first began drawing, she would make little swirls with her crayon and then look at it and exclaim, “Whoa!” The recurring theme in those entries is that even as a baby she was strong and independent and that she was, and still is, our comic relief at the house.

Last year, Steve planned her a dinosaur dig party.  He built a pit that looked like a real archeological dig site —complete with “fossilized” bones.  I enlisted one of my students (who is now at Johnson Wales Culinary Arts Institute) to make her a dinosaur cake.  She loved it all and was so very happy that day.

This year, she wanted a sleep over with her friends, so she wrote out the invitations on ruled notebook paper (I had given her some very nice card stock, which she politely refused) and gave them to the little girls at school.  On the morning of her party, I took her to get her ears pierced—something she has wanted to do but has been afraid to go through with. Our dear friend, Jessie, artist extraordinaire, made Lia the greatest looking Harry Potter cake we’ve ever seen.  Her excitement was a beautiful thing and, lucky for me, Steve captured it in a video so that I can relive that moment over and over.

What I want to do is to make this birthday as memorable as possible.  She’s been counting the days to her birthday for the last six weeks, and while I am not certain that what we’ve gotten for her is exactly what she wants, I know that our little girl will react in the way one might react to winning the lottery—as if she couldn’t imagine anything better.  That’s just Lia.

Happy Birthday, Lia.

Love, Mommy.