Morning food duties are typically dispersed thusly:
--Greg makes the children and himself breakfast
--Amy makes herself breakfast and packs the kids' lunches.
Greg has been traveling, which means his duties fall to me. And once again I stand in awe, in my kitchen, at the complexity type 1 diabetes brings to our lives.
Every meal, every bit of food take in requires extra layers of work, but school lunches feel to me especially difficult, as they must be prepared in advance and packed up for someone else to give the shot.
To pack Theo's lunch for school, the following considerations must be made:
What food is on hand. Of course. Though I hit the grocery store seemingly every other day, we're always out of something, or something that they like, or something packable.
A balance of reasonably healthy food products. From what's on hand, what's healthy? Unlike meals at home, during which desserts can be demanded, they have to eat whatever I pack them, so I try to make it good. For them. And a little treat, here and there.
Food that can be eaten in the short period of time called "lunch." If the kids talk at all during the 15 total minutes in the cafeteria, they won't have taken in enough food. So you can't send a whole mess of carrots to chew, for example, because it won't happen, and there they go into the trash.
Let's catch up for a moment. What food do we have? What do we have that's healthy and they'll eat? What do we have that's healthy, enjoyable, and won't take forever to chew?
All parents suffer these questions daily (or should). They present significant challenges, some days.
But now let's add diabetes.
The carbs must be counted. T1 parents must count the carbs of everything their children eat. Take a look at a nutrition label sometime. Look at the serving size, and look at the carb count. Match the food you've chosen for your child's lunch (according to the criteria above) and make sure you've gotten the correct serving size.
Sometimes you'll need to weigh the food, such as fresh fruit. Sure, you could guesstimate, but that just makes tracking these carb ratios all the more difficult.
The carb count must be coordinated with the carb ratio.
What's a carb ratio? It's the ratio of insulin needed per carb, per meal. More often than not, these vary at different times of the day. Theo currently has wildly diverse ratios for breakfast, lunch, and dinner, ranging from 6.5 carbs per unit (a lot of insulin) to 20 (not as much).
Each day, I must pack a lunch that satisfies the above requirements of what's on hand and healthy, etc, plus make sure the math is correct--that is, that the carb count divides evenly with the ratio. Too much rounding up or down and one can never get a handle on the ratios. (Parents also track blood sugar patterns in order to change the ratios when necessary. We play doctor; it's like prescribing a new dose of medicine.)
Even then, if his blood sugar is high or low, all the math is off. More insulin or food must be added.
What's not embarrassing. A little thing, but someone else sees the meals I pack. The school secretaries, sometimes the principal, uses the little slip of paper I write the math on to give Theo his shot. On it I list out each food item and the carb count, because if somehow I forgot an item or he's unable to eat it, they'll know the count of that food and be able to replace it with an equal amount of carbs. Some days I'm embarrassed to be serving PB+J again. Did they notice?
Sure, we're grateful to have a manageable disease, but sometimes the managing is overwhelming. I've run late every morning this week, and had I been able to throw food at the kids and shove them out the door, they would have made the bus. Diabetes forces you to slow down and consider what you're putting into your children. Maybe that's not the worst thing after all.