Jean-Paul's stay at the hospital was fairly undramatic.  He hung out in his room or the playroom.  Nurses popped in and out as well as the mass of attending physicians, fellows, senior residents, residents and medical students that are part of the day to day of teaching hospital. 

 

The drill with diabetes type 1 patients is that you need to stay in the hospital for 4 days give or take so that the care team can establish that the patient (if they are old enough) and the parent/care giver understand the principles of nutrition for diabetics, can give an insulin shot, test the blood and know what to do in case of an emergency.  CHOP has a training program in place... a handful of training modules that are taught by nurses as well as a meeting with a nutritionist and some support by a social worker.  It is a lot to learn in short period of time. 

 

The simplest way to describe the whole diabetes management concept is well 'Weight Watchers with Needles'.  It isn't that the diet is restrictive... it just requires that you measure/understand how many carbohydrates are consumed and keep that within a range. The insulin is dosed based on the carbs.  Jean-Paul immediately started calling the carb grams 'points'.  The focus is on counting carbs as they are most readily turned to sugars and require the insulin to be absorbed by the body. It is easiest to create a routine for eating... fixed times and fixed amounts of carbs.  As we get more proficient in managing the diabetes, it is possible to make more adhoc adjustments to the insulin dosages.  That's why lots of diabetics end up with insulin pumps... it makes it easier to eat what you want when you want and not have to give yourself a shot everytime you eat. For now though, we follow a routine.

 

Jean-Paul did well with the routine...he always likes routines and schedules.  :-)  Lucky for us.  Right off the bat he understood no food without a blood sugar test.  He also understood that he got a certain number of 'points' for his meal or snack and only certain foods got points.  Since he is a big carb eater...he was motivated to understand how the system worked.