Pasta Fazool

The wonder child of Lorraine, Elizabeth and Karen!

I am happy to be participating in the First (Weekly?) D-Feast Friday!!  It's a day for us to come together and share a recipe, diabetes-friendly or not, and walk away with a slew of new recipes to try!  So, without further adieu...

Pasta Fazool

Now, this is a staple meal in our home and has been, long before diabetes entered the picture.  But what's so great about it is that it really works great with C's blood sugars.  And, as anyone who deals with a faulty pancreas can tell you, usually pasta is one of those foods that misbehaves.  Because this recipe is balanced with beans, the fiber can actually be subtracted out of the total carb count.  Hence, making it a more manageable meal, bloodsugar-wise.

Some of you might be more familiar with it's other name:  Pasta Fagioli.  It's kind of like a pasta/bean soup.  My dear mother-in-law taught me how to make it.  In fact, when each of the grandkids were old enough (11-12), she taught each of them how to make it too.  Unfortunately, she is no longer with us to teach our kids.  I have already taught my oldest and now middle C is next in line.

When I was still a newlywed, she brought a bag full of groceries to our little apartment and showed me exactly what to do.  It's a challenge for me to write it down because it really does help to see it done.  But, I'll try!

Ingredients:

2 (15 oz.) cans of Great Northern or white beans
+ 2 cans of water
1/2 can (4 oz.) of tomato sauce
+ 1 can of water
3 T. olive oil
2-3 cloves garlic, crushed
1 heaping T. oregano, crushed between palms
1 t. salt
1/8 t. pepper
1 c. ditalini pasta
1/2 c. spaghetti, broken into 1 " pieces
chopped onion for garnish (optional)

*Keep a couple cans of water near stove in case you need to add to pot when pasta is boiling.

Heat all ingredients (except pastas) in large pot to a gentle boil.  Turn down to low and simmer for 30 minutes, stirring occasionally.  Turn heat up to boiling again and add pastas...stirring every few minutes so that the pasta does not stick.  Gently boil for 10-12 minutes.  At 10 minutes, check the ditalini for done-ness.  If, during boiling, mixture becomes too thick, add water.  It should stay at a thick, soupy, consistency.  (I like it thinner and usually add water when it's done.  This cools it down a bit too.)

That's it!  My kids love it and ask for it regularly.  I wish I had a picture of it to share.  But it's been so hot that I haven't made it recently.

It serves 6-8.

After much trial and error, I have finally found that counting a 1/2 cup serving as 10 grams of carbohydrates works well for C.  But, please do your own calculations from the bean label and pasta packages.  The great thing is...you can subtract out the 7 grams of fiber per serving from the carbs!

Enjoy!  And, Happy D-Feast Friday!!

"LO GLUCOSE"

So, whenever we change any type of setting on C's pump (basals, carb ratios, etc.), I'm not sure why, but it always takes a good 4-5 days until the true result is seen and felt.  So, this time was no different.  Slowly and ever surely, her numbers were calming down.
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Usually when we go to an appointment, her endo knows not to overwhelm us (me) with too many changes at once.  But this time, C had been so high for so long, around the clock, that I knew I had to throw some of my caution to the wind and trust that it was for the best.  Also, her doc was out on vacation, so I was working over the phone and the CareLink website with one of the nurses.

We increased every single basal setting and even added a couple new ones.  We changed several carb ratios during the times of day when she would really shoot up high.  And, lo and behold, this sweet nurse recognized that C's active insulin time was set at 3 hours, not the normal 2 hours...meaning the pump would calculate corrections knowing that any insulin coverage would last 3 full hours.  Sweetly, and calmly, she told me that the 3 hour setting is "really only used for babies and toddlers."

"If we change it to the normal 2 hours, that will really help with her correction doses."

"Huh.  Well, I guess it's still at the 3 hour setting because, huh, she started on the pump when she was still a toddler!  Thanks for noticing that!...I was never told to change it once she got older."  I had been enlightened. : )

"Now, be sure to do a few nights of 12 and 3 checks," she said as we were just about finishing up.

"Oh yes, yes we will.  I'll email her doc in about a week so she can go over the new numbers.  Thanks so much!"
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Days passed.  And, like I mentioned before, C's numbers gradually started dropping back into range.  Then a sneaky little low popped up of 60...and honestly, I was kind of glad. Numbers in range...ahhh!  But then one low turned into 2 in a row.  And then, there were more lows than highs.  I backed off corrections.  I began second-guessing my high-level carb-counting skills.  The midnight and 3 am checks were continuing.  And the "ZING" of anxiety shot through my body as I woke early in the morning.  I lowered a couple of the basals again...

...and then, it was America's birthday!

We were busy with pancake breakfasts, parades, bounce houses, friends and family all weekend long.  And C kept experiencing lows all weekend long.  And, when we were standing in line to go into the local high school football stadium to await the glorious fireworks show, it happened. 

I looked down at C, who was sitting on the sidewalk since the line wasn't moving.  She looked pale.  I tossed her meter to her and told her to check.  And, then intuition kicked in.  Slightly panicked, I shoved everything I was holding into my husband's arms.  I dropped down and took over testing her finger.  And, this is what the meter spewed back at us:

LO GLUCOSE

Okay, my heart did a swan dive into my stomach.  I tore through her bag and ripped open a juice box.  She downed it in seconds.  I held the meter up to show the husband.  I couldn't really even speak at this time.  I shoved another test strip in the meter:  58.  **Gigantic sigh**  58?  We can deal with that!  But what in the world was that LO GLUCOSE reading???!!!

I had never seen that before.  In all the 6 1/2 years we've been doing this thing called diabetes...not once.  I wonder, Has anyone else ever experience this nasty message?

Now, if you look closely (at my poorly photographed image), you'll notice that C tested at 58 only one minute after the LO reading.  So, maybe that means, she really wasn't too much lower that one minute before.  So, I'm still not understanding that message.  Oh well. 

To say the least, it was unnerving.

And, after contacting her endo the next morning, we gladly followed her advice to back off on some of those changes we had made the week prior.  I asked her about the LO reading, but in her email, she didn't make mention of it.  I'm sure it will be a topic at C's visit next month!

(Still uttering big sighs around here.)

Insulin Gone Bad?

Just when I think Gee, C's numbers have been really great lately...boom!  Relentless highs.  I mean blood glucose readings in the 200s, 300s, and yes, even 400s. Gobs of insulin corrections weren't making them even budge at times.

These highs began happening as soon as the kids were out of school last month.  But I couldn't figure it out.  It didn't make sense.  We were even more busy, with lots of activities...swimming included.  And swimming always makes C go low.  It was so frustrating.

What was totally insane was that it wasn't just at one or two different times during the day.  It was round-the-clock.  I'd get her down to the mid 100s with jumbo corrections, only to have her test in the 200s or 300s before her next meal.  This continued throughout the nighttime.  I did a couple of our famous middle-of-the-night-site-changes to no avail.

I began changing the site daily...opening another insulin vial, and then another.  Maybe it's gone bad, I thought.  Maybe it's a bad lot.  I just kept pushing forward, checking and correcting overnight, feeling overly exhausted.  You know this kind of tired...when the first thing you think of upon wakening is the bottle of Advil.

And then one day, I B-lined it for the pharmacy.  The insulin must have gone bad, I kept thinking.  Maybe they'll replace these vials that are barely used...I know, wishful thinking.  But, I was tired.  So off I went with C to the pharmacy.  I asked to speak with the guy who's been there the longest, as long as we've been getting insulin for C.  There are really only 2 employees left at our particular pharmacy who  remember me from the beginning...the haggard, emotional mom who needed, yes, 300 test strips a month for her baby.  He's one of them, so I thought for sure he'd see things my way!

"My daughter," I said, "her numbers have been crazy high.  I've opened like 3 new vials of insulin in the last week.  Could the insulin have gone bad?"  I asked.

"Uh, no," Mr. Pharmacist said.  "Let me see the cartons...Hmmm...no, they should be good.  Our shipments go directly in refrigeration.  She's possibly having a growth spurt."

A growth spurt?  That really didn't cross my mind.  Why hadn't it?  I thought for sure the insulin had gone bad.  Her numbers were high across the board.  Usually when we make adjustments and tweek basals in the pump, it's because numbers are creeping up, sneekily...not all at once.

So, with blurry, sleep-deprived eyes, I nodded, "Hmmm," I said.  "thanks."  We headed back home...determined to make adjustments and figure this out.  Over the course of the next few days, with some nurse help over the phone and internet, we adjusted every single basal setting and even added 2 more.  We changed so many things!  It made me nervous.  I'm very much a fan of the scientific method of changing one variable at a time.  But I knew we had to wrangle these numbers in a bigger way.  So, that's what we did.

It seems to always take several days for any type of setting change to really work itself out and show results.  We dug in for the long haul.  I knew this meant lots more testing and lots less sleeping but...oh well.  That's life with diabetes.

And, did the basal changes help?  Boy, did they?! But that's to be continued in another post...
Insulin gone bad?  Well, I know it can.  But not this time.  Now we have 3 newly-opened vials...ug. 
 

Sometimes insulin can go bad.