Tuesday, September 27, 2011

Coping with pre-teen diabetes insanity

Today is Sarah's 12th birthday. She's growing up! She's become such a unique young lady. She's fun and serious and comical and silly and determined and awesome. I am so proud of the young lady she's becoming!

Today we spent half the day traveling to Roseville for a doctors appointment. It was a group appointment, so nothing critical. Even though it was her birthday, Sarah was determined not to miss it. In this appointment, several families with children with diabetes ages 10-12 come at the same time. The kids are sent into one room, the parents to another. If I learned one thing from this appointment, it is that I have a spectacularly awesome kid and I am BEYOND thankful.

Raising a child with diabetes is hard, and it gets harder as they become teenagers and begin to want more independence. And ya know what? These pre-teens are sneaky little buggars! It's not uncommon for kids to begin to pull away and find ways to hide their blood sugar from their parents. It's extra important that we parents remain vigilant and involved.

A parent told me today that her daughter, who is the same age as Sarah, has become amazingly sneaky about hiding her blood sugars - and the kid has been in DKA (diabetic ketoacidosis) three times this year. Among other tricks, she adds water to her blood drop (which apparantly reduces the number), and she's been known to test her little sisters and show her mom their completely perfect numbers rather than test herself. Other kids simply lie about their numbers, and I've heard of some using the solution that comes with the meter and always shows a nice number.

Even Sarah is not completely immune. Just today she told me she didn't test for lunch, because she didn't think she'd have enough time to test and eat (apparently she was doing something with a teacher during lunch today). And last week she ate a few pieces of chocolate during a class (mini candy bars) and didn't bolus. I'm sure you know where that ended up!

So I thought I'd take this opportunity to at least write down how we are handing this, in the hopes that it might help someone else who has a pre-pre teen.

  1. Don't react. That is really the most important rule. No seriously. Don't react. If the number is 40, then that's what it is. Keep a smile on your face and hand over a box of juice. If the number is 400, then that's what it is. Keep a smile on your face and give/supervise a correction and a glass of water. Kids hate it when we react to their blood sugar, they take it personally. It's like getting a bad report card ten times a day!
  2. Don't immediately ask your child for their numbers after school. First ask them how their day was. What did they learn in science class? And maybe tell them a little about your day or something interesting that happened. Then, if you must ask, ask gently (refer to rule #1 above). Better yet, just have an understanding that the meter goes on the kitchen counter in the evening - then, when your child is off doing homework or playing outside, just run through it and look at the days numbers. Kids don't like to think/hear/talk about their diabetes, so the more you can reduce the need, the better.
  3. Encourage positive choices, but don't restrict. The best way to ensure a rebellion is to make something off limits. One thing we do to make things a little easier is to have dessert early, sometimes after lunch, on weekends. It's a lot easier to manage dessert bg's between lunch and dinner than close to bedtime. Also, I always tell Sarah she can have whatever she wants, as long as she takes insulin for it. So if someone brings in cupcakes to school, fine, no problem. She can have that without having to ask or feeling guilty about it later.
  4. Give 'em a break. If your child wants you to test them and make all the decisions in the evening, then do it for them. They've been managing something no kid should have to manage, all day long.
  5. Talk about it when it's appropriate. I've found that sometimes Sarah doesn't want to hear about diabetes at all, and other times she's more than happy to discuss her diabetes, how to manage it better, how we're adjusting her IC ratios, or whatever. Don't do it in front of friends, or even as a family group. Find a time when they're in a receptive good mood, like listening to music on a car ride. Just turn it down a notch and strike up a conversation. Make it conversational, not accusatory or lecturing.
  6. Meet other kids. Kids with diabetes often feel very lonely. Sarah goes to a huge school, and she's the only child with type 1 diabetes. It really helps her to get to know other kids with diabetes. Find local functions, or call JDRF. Encourage your child to go to diabetes camp and come home with some phone numbers and email addresses.
  7. Don't sweat the small stuff. I know, it all seems big sometimes. I totally get it. But look at the big picture.
These kids are expected to make medical decisions that affect their lives, all day long. It's kind of crazy when you think about how much responsibility a child with diabetes has. As parents, our job is to parent, but with a little additional understanding and compassion. It's not always easy, and every kid will make bad decisions from time to time. Help your child learn from those experiences rather than punishing them.

And I should say that this is just what's working for us right now. She's 12. I know it's going to change and get harder. I definitely don't have all the answers (wish I did!). I know there will come a time when we're feeling defeated and begging for help. So I'd love to hear from other parents too, as I know there are parents out there with amazing stories and ideas for better diabetes management.

Thanks for listening!

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