Wash with care

I may have mentioned it before, but diabetes is a tricky disease. You can follow all the rules, but it still has a mind of its own.

Some diabetes management tasks are clearly visible -- spend more than a couple hours with us, and you'll see Mark check his blood, correct a high or low, and count carbs before he boluses. But other tasks -- tasks you and I take for granted -- are much trickier.

Such as bathing. Chances are, you jump in the shower without a second thought. Not so for Mark.

The first time bathing became an issue was when Mark got his insulin pump. Suddenly he had this extremely expensive device that was waterproof, but not heat-proof. He can wear the pump in pools, but hot water cooks the insulin, making it a bad idea in the bath.

Then there were the sites. The pump is connected to Mark through a tiny cannula (plastic tube) stuck into his skin with a needle. It has an adhesive that keeps the site on Mark, and if we're lucky, it sticks for about three days.

Except when you submerge it in water. Then it peels off, and Mark gets another opportunity to shoot a needle into his body. As you can imagine, he declines this opportunity every chance he gets.

The temporary solution to losing sites was to eliminate baths. Instead of a nightly bath, Mark took a bath every three days -- that way, if the site fell off, it was time to change it anyway.

I mention this was a temporary solution because any of you who have or know little boys also know that a bath every three days is...well, not optimal. Turns out these little critters are excellent at attracting dirt, and the..."aromatic"...smells that accompany dirt infused with little boy sweat.

So I embarked on a mission to keep Mark's sites on in water. I tried numerous clear adhesive products with wonderful names like IV3000 or Tegaderm, which didn't work. I cemented the tapes using a liquid adhesive called Skin-Tac, and that worked better, but Mark still lost sites with alarming regularity. (Oh, and did I mention the sites run about $40 a pop to replace?)

And so I went to the boards...the www.childrenwithdiabetes.com boards. Where the parents suggested another product, called OpSite Flex-Fit tape. It worked like a charm! Suddenly, Mark's sites stayed on. He showered one, then two, then THREE days in a row, and we didn't lose the site! He got out, I gave him the insulin he missed while disconnected from the pump, and life was good.

It was a miracle, and I celebrated it as such. Until...I tried removing the tape. Which refused to come off. And sent Mark into a screaming fit as I doused it in Uni-Solve three times, and then finally ripped it with all my might. Mark was in tears, but the site finally came off. I couldn't believe it -- first I couldn't get the sites to stay on, now I couldn't get them OFF!

I went back to the boards, and this time the parents recommended a product called Medi-Sol. That did the trick -- Mark's sites peeled off easily, and we were back in business. He started a new nightly bath regimen, and was thrilled. (He really likes baths!)

Except...now the daily bath has sent his little body into a series of low blood sugars. Apparently, hot water opens up your arteries, which causes the insulin to rush through and burn out much faster than it's usual 2-hour time frame. Which means I can't give him the insulin he missed while in the bath (it sends him even lower), and around 11 p.m., he shoots waaaaay up to the 300s.

So nw we're on a new schedule. I give Mark his insulin as soon as he gets home, around 6 p.m. We eat, wait 90 minutes, then I give him a small, uncovered snack (to keep him from going low), and put him in the shower. When he gets out, I give him the missing insulin, cover the snack, and cross my fingers. So far, my success rate is hovering near 50%.

I'm certainly not complaining, and I'm not whining about how hard diabetes is. It's just fascinating to me how much work and thought diabetes requires for things as simple as bath time, and how dire the consequences can be for Mark if I judge incorrectly, or bathe him too soon after dinner.

To you and I, it's just a shower. To Mark, it's a whole science experiment, and another chance to outwit diabetes. Unfortunately, as is often the case, diabetes is a formidable opponent.