Ski

Skiing with kids is already a difficult undertaking.  There are coats and snow pants and helmets and mittens.  There's sunscreen and lunches and making sure the right long johns and layers are being worn.  It's already hard to ensure a healthy breakfast is eaten to stave off meltdowns mid-chairlift ride.  There's the time when your 7 year old can't carry her skis AND poles AND not side swipe every car from here to the lodge.  There's the 10 year old who wants to take on the moguls, but still fights the request to "just TRY a hockey stop, because really it's safer than blowing out your knees with a wedge stop".  Granted, it's a TON easier now that the kids are such good skiers and old enough to roll with things a bit more.  We're actually at the point where it's more "fun" and less "work".  We're skiing black diamonds, and the kids are itching to get in the terrain park and bumps and glades.  At the end of the day my legs are sore because of all the steep skiing and quick turns, instead of burning quads from a constant slow speed snow plow.  

It's becoming hard to keep up with them, especially now that their diabetes is riding along.  Because, in addition to all the other things we need to make sure we do to have a successful day on the mountain, we also need to prepare ourselves for the day-to-day, hour-to-hour, minute-to-minute care of their diabetes.  Exercise, altitude, cold weather, and Type 1 are an interesting combination to say the least.  

This is what a day on the mountain looks like for us.

We wake up early enough to have a breakfast full of protein, fat, fiber, and a moderate amount of carbohydrate.  We've found homemade breakfast burritos or egg sandwiches with some fruit to fit the bill.  Marshall and I have a cup (or two or three as is the case for me) of coffee.  Murphy's law usually dictates a pump site needs to be changed, and at least 1 of the 3 T1Ds of the family will inevitably also need a CGM sensor change.   Lunches need to be made, because French fries and soft pretzels from the cafeteria don't work for us.  Again, a delicate balance of protein, fiber, fat, and carb needs to be achieved, while still being something fun and worthy of a day on the mountain.  I load a small backpack with emergency supplies: Glucagon in case someone's blood sugar drops so dangerously low they need a lifesaving shot, snacks of various carb amounts (to either maintain a target number or lift someone from a falling one), glucometers to check blood sugars, and phones to track CGMs.  Once our bellies are full, slope pack is stocked, our insulin vials are topped off, and all batteries for various technologies are charged and ready we make our way to the car.  We need to leave with enough time to allow a few minutes in the lodge to once again finish our prep for the morning. This means a snack if blood sugar is too low, or a bolus of insulin to correct a high blood sugar (because, really, it's very rare for anyone's blood sugar to be EXACTLY where we'd like it.  That would just be too easy!). We also have a mandatory bathroom break (because high blood sugar leads to increased urine production, and dropping trou and popping a squat trailside is never a fun experience).  So here we are, doing our best to set ourselves up for success, and controlling that which we have in our control.  Diabetes may throw us a curve ball, but at least we can try our best to be prepared to strike back.

This is our routine.  This is our third year bringing diabetes along with us on our ski days for the kids.  Marshall has been doing it much longer (he's coming up on 28 years!).  All these elements take place with hardly a second thought.  It's just what we do.  But each day on the slopes brings its own challenges, or excitements as we like to call them.  Typically Marshall and the kids run high while skiing, not because we keep them there, but because it just always happens that way.  There are bursts of activity, coupled with long breaks on the chairlift.  Energy output is never quite enough to drop blood sugar, and the happy excitement of skiing tends to elevate their sugars.  Altitude also seems to keep them a bit high (and I've heard some T1Ds experience the opposite).  Maybe the 10,000ft elevation affects the way the pump processes the insulin or introduces air into the system?  Or maybe it's due to hydration?  Cold weather also plays a role in blood sugar.  We've never seemed to pinpoint the cause, and just the moment we think we've got it under control it changes again.    

Last weekend was our first day on the mountain this season; the snow pack is low throughout Colorado and the mountain we ski doesn't make snow.  The kids were beyond excited, and going into the day their blood sugars were in target (or close enough).  Our morning went really well.  Spirits were great, skiing was good, and the kids were open to instruction.  We have always stopped early for lunch, it just works better to eat when everyone else is skiing and ski while everyone is eating.  Everything seemed to be falling into place to make for an ideal ski day.  Then we headed back out.  A few trips down the slope and Walker started getting a little cranky.  That's the giveaway, even before a glance at their CGM, that they're running high: cranky attitude.  We were at the top of the mountain, and I figured we'd get down and on the next chairlift ride I'd check and dose some insulin.  We were taking a black trail, one that we'd already done earlier in the day, and I figured things would work just fine.  Walker was skiing fast and making quick turns, and then the trail got a little icy and she got out of control.  She corrected herself, but only after my heart skipped a beat and visions of a dangerous crash flashed through my head.  We got to the lift line and with a single look I knew it shook her just as much as it shook me.  She started to tremble and tears welled behind her tiny goggles.  On the lift ride we decided it would be best if we sit out the next run, get some insulin and water, take a quick pee, and wait for her blood sugar to come down.  More tears were shed, because now she's missing out on skiing, but those quickly passed.  She knows that high blood sugar plays a part in her mood and ability to focus and manipulate her muscles, and when she's not focusing well then accidents are more likely to happen.  We're not on the bunny slope anymore, and when we're going as fast as we are and on the trails we ski, little issues can have greater consequences.  She knows this.  

So we sat in the mountain top yurt and had our own fun while Marshall and Ollie had their time alone.  We people watched (which Walker may love even more than me!) and talked about what we would do with the rest of our day.  I watched as her CGM arrow shifted down, and listened as her ire softened.  Ollie and Marshall returned and Walker got her chance to take a solo run with her dad while Ollie and I had our chance to spend some time together too.  One more run as a family and we called it a day.

Skiing is never a simple undertaking when we go as a family.  But the lessons the kids learn about themselves are beyond measure.