Raising Teens with Diabetes...Book Review

"Raising Teens with Diabetes. A survival guide for parents" by Moira McCarthy arrived at just the right time for me. I had heard that she was writing a book and it had been published. Thanks to the interwoven world of Facebook, I had seen her posts in groups that I belonged to as well as comments from mutual friends. I was therefore really excited when the folks at Spry Publishing asked me if I would like to read an advance copy of the book.  My son with diabetes is just a few months shy of 16.  We are knee-deep into the teen years and tips for handling drinking, driving, and letting go are definitely all things that I welcome with open arms!

Each chapter of this book opens with Moira's own personal stories.  In chapter one she gets us started by introducing us to the world of "Hurricane Hormone" and advises us of the horror ride that both parents and teens are about to embark on.

Moira's daughter was young when she was diagnosed with diabetes, so much of the book looks at burnout of both parent and teen after years of dealing with this disease.  As a parent of a child diagnosed at two, this was definitely a welcomed perspective.  She does not exclude those diagnosed at a later age though or even those who were diagnosed in their teen years or later. Chapter three is dedicated to those children struggling with their adolescence as well as a new diagnosis.  Short asides, from people like Moira's own daughter as well as well-known bloggers and the JDRF's own Aaron Kowalski give a wide perspective on this topic.

"Raising Teens with Diabetes" looks at family dynamics, the role of siblings, and the role of friendships--old and new with some great tips and pitfalls that many parents fall into. Moira warns of making your child's friends the "diabetes police" and suggests ways to use friendships to help your child without going overboard.  She further touches on the more quiet or shy teen and how to ensure that they tell their friends at least the basics in diabetes management and care.

As the book nears the halfway point, you are now beginning to learn how to set the stage for adulthood.  Moira looks at school and letting go--allowing your child to be more responsible for their care in a safe setting, setting limits and having consequences that fit the action.  She talks about the rules for driving and how vital it is to stick to them.  Since my son will be legally able to begin this process in a matter of months, I read keenly wondering if we can both stick to these guidelines and knowing how important they truly are.

This book even talks about sex! I instantly was hooked when Moira's first suggestion when handling dating and then sex was "...go on every single date with them, forever and ever...and this will not be a worry."  I loved it! My sons would definitely not agree however.

By Chapter 10, we are faced with another teen challenge--Drinking! It terrifies me.  My son is very private. He does not talk about diabetes.  He does not hide his testing or bolusing but he does not advertise it or talk about it either.  A few of his closest friends know about it.  His best friend has a good idea of what to do but who will help him when he and his friends decide to drink?

This book offers a great chance to talk to your teen about these subjects as you read.  I would often bring up topics as they were covered.  "Did you know..." or "Wow! This book says..." were great conversation starters. We were even able to talk about erectile dysfunction! In the early chapters, Moira's warns that teen males exposed to tv commercials may quietly be concerned about this complication. My son shook his head and swore this was not something that he had remotely considered or knew about.  One problem overcome already!

Drug use was something that I had somehow not considered until it was brought up in the book. It is something that I have thought of and talked to my oldest son about but drugs and diabetes? It was not a topic I had ever considered...how naive was that! I was therefore really grateful to have the topic mentioned.  In modern society, it is definitely something that needs to be discussed and prepared for as much as all of the other topics.

I also had my eyes opened to a new view with the section on rebellion. Moira writes about the first time her daughter lied to her about a bg level and how things spiralled out of control until she ended up in ICU.  Her daughter said she got a test of "the drug she's struggled with for years.  That drug is called freedom.  That day,(when she lied about a reading) she realized that I trusted her so much, she could pretty much do or not do whatever she wanted.  The idea of not checking was so delicious, she still says today she thinks she must know what drug addicts feel like when they try to detox.  She skipped testing more and more...And she told me after she landed in the ICU and almost died, as sick as it made her feel physically, the emotional high of DENYING diabetes any power in her life...made that horrid feeling all worth the while."  Even rereading this passage still makes me want to cry.  I "get it". It hurts me but I "get it".  I understand a bit more why my son "forgets" when he goes away from me. It's not just about feeling so great that you forget you need to bolus/test, it's about denying diabetes.  I wish that they could.

I appreciated Moira's honesty when she noted that she had once thought that her daughter would never rebel.  That that sort of thing was something that happened to "other families".  I have always known that this could happen to us.  I have also looked on to some of my friends and wondered, "how did they get such perfect kids? They never seemed to have any issues."  I have also watched some parents struggle to do everything that they could with non-compliant teens and somehow manage to come out into adulthood with amazing young people.  I know that "this too shall pass" and "Raising Teens with Diabetes"  gives some wonderful tips on how to handle the rough ride until it does.

If you have a teen with diabetes this book is for you.  If you have a child who will grow up to be a teen with diabetes, keep this book around for later years. It will come in handy! Thank you Moira for giving new things to think about and a wonderful tool to refer back to.

Think About it Staller

Yes, I admit it. I am a "Think About it Staller".  I have blamed my son for many of the diabetes messes we have landed in but if I was a much more conscientious Mom and a bit less of a "think about it staller" we may not be in the current predicament. 

Last night, we went for an evening walk.  My phone was running on fumes so I plugged it in to charge and left it behind for a change. Imagine my surprise when I walked back into the house and saw two missed calls from my youngest son.  There had to be trouble. He had left a message but I simply called him instead. 

"My pump won't let me bolus.  When I need to bolus it screams at me instead."  

A lot of not so nice words went through my head as I realized that my son was at his father's, not coming home for another week, and had no spare pump with him. I asked him if he had tried to take out the batteries, restart it and bolus.  He had tried everything.  Super crap! I asked him for the serial number off of his pump and the support line telephone number.  I told him I would get on the phone and we would go from there. In the meantime, he had told me before he left that he had syringes at his father's house so he could inject. 

I called the Cozmo support line and was shocked to no longer even hear, "Press 3 to deal with warranty issues".  There was just dial the extension or press 2 for clinical support.  Eek!! The client list must be getting smaller.  I finally spoke to the on-call answering service. I knew she was not a pump person.  It took five spellings for her to type out "bolus".  It was frustrating but not her fault. I waited to get my call back from the clinical staff (last time I called there was only two of them left). 

A woman called me within a few minutes.  She quickly said that she would replace the pump.  They only have one color--slate grey.  They can only ship during office hours.  The pump most likely would not go out until late tomorrow afternoon due to many downsizing issues.  What can you do when they don't make your pump anymore? 

In the meantime, my son had called two more times.  He had finally got his pump to bolus...oh and correct that high that had happened because he was eating cinnamon buns.  Yes, I screamed.  Yes, I reminded him to inject! Yes, I suggested that foods that were not high in fat and a carb counting nightmare would be the best to use until he had a fully functional pump.  I then began the search for his old Cozmo 1700.

This was the pump that usually travels with him. This was the pump that I had thought about sending along (and normally do) "just in case".  This was the pump that was instead hidden somewhere in the depths of his room.  When I finally found the lifesaving pump, I set about the task of reprogramming.  

And here would be where further proof of me being a "think about it staller" came in.  What were his basal rates? What were his carb to insulin rates? Heck, what was his insulin sensitivity these days? I had no idea! I searched for the log sheets from his last endo appointment. I tried to boot up my old computer that had his Cozmo program running.  Neither would have the latest results but after numerous calls and texts, my son was no longer answering his phone or his messages.  I had no way of getting the actual, recent rates.  Before he left to go away I had thought, "I should write down all of his rates just in case. I should actually keep a book that has the latest changes in it at all times."  Of course, that is where it ended...as a thought. 

The old pump is in the mail.  Because of where my son is staying, the only courier service that has a slight chance of getting to him within 24 hours is through Canada Post.  I am crossing my fingers that he gets it tomorrow, if not it will take until Monday. I am kicking myself for not sending it to someone at an address with higher odds of it arriving on Friday but you only think of these things once it is too late.  

Lesson learned.  This "think about it staller" will never let her son go anywhere without the spare pump.  Said pump will have the latest rates programmed in before leaving the house.  An updated list of basal, bolus and correction rates will be kept near to me...Hopefully!

The old standby and one of the old Lean Green Pumping Machines

   

Waking up is a good thing

My son got off of the plane, stumbled towards me and yawned. He had to be up at 6am and for a teen who likes to sleep until noon, this was just way too early!

After our initial chatter he turned to me and said "You will be happy to know that I now wake up from my lows."  


"You mean you woke up more than once?"


"Yeah, I wake up feeling starved. I hate it. It messes with my sleep."

"Waking up is a good thing. The alternative is not waking up!" 


"I know but it wrecks my sleep. I would rather have uninterrupted sleep." 


"That is not an option.  Waking up is a great thing. I hope you continue it!" 


"Sleep is a good thing. I would really rather just keep sleeping. That would be great."


I shook my head and attempted to explain that an eternal sleep was not an ideal. My son grumbled some more. He is not nearly as enthused as his mother is.  He understands my relief but yet another glitch in his life thanks to Diabetes is not at all welcome.  


Oh well! Hopefully we are onto something that lasts! 

High Urine...A D-Momma Rant

"Your A1c is good.  Your thyroid is fine. Your urine is high. Are you supposed to have a 24 hour urine collection done?" Our nurse asked us and both of us were unsure. 


I was still trying to process.  Did she say "your urine is high"?  High in what? That isn't good. Nothing is supposed to be high. Why was she asking about the 24 hour test? She did say high urine didn't she? 


My mind was reeling but I tried not to overly concern my son. He was less than worried. I was sure that there was not a problem but why did she say high? 


What was high? Isn't that protein levels? Isn't that bad.  Doesn't that indicate kidney issues? 


We have been dealing with diabetes for over 12 years but my son is only 14.  There could not be a problem. I had to be over-reacting.


His A1c's have always been great. There is no problem. It was just a fluke. 


My son said "Didn't Grandma die of kidney failure?" 


Yes, but I explained that his previous doctor did not feel it was something for us to be concerned about. 


Crap! I have tweeted. I have gone to my trusty CWD parents list and I have chatted with my peeps on Facebook. I am doing my best to go, "yep, it showed up but that doesn't mean anything." (and people are telling me that it does not mean a lot. Even the worse case it is still very treatable with modern medication).


But...Crap I hate this disease! I hate the stress. I hate the fact that I even have to consider that this could be a problem. My son is not yet 15 years old. His kidneys should be lovely, not constantly warding off potential danger because of Type 1 diabetes. 


Okay, that is vented. I will get it out of my head and pray that they don't call back looking for more urine either way. No matter what, at least we live in a time when doctors are able to be proactive about these things. 

The Full Meal Deal

"Isn't today the day that you need to change your site?"

"I don't think so."

"Let me see your pump. I am sure that you are due for a site change. If not today then you are overdue."

Begrudgingly, my son handed me over his pump. The first thing I noticed was that his battery was stating that it was dying and almost dead. "You need to change your battery...like now. Its on its last legs and I was right! Your site change is today.  Get the stuff out and get the site changed."

My son grumbles and heads out of his room. 

"What are you doing?"

"I need to get some insulin."

"Holy cow, you are going for the full meal deal tonight! You have a dead battery, no insulin and a dead site!"

I"ts not a dead site. The site is fine."

"Its due to be changed its a dead site.  Time for a clean slate!"

Soon we had everything new but sadly he was still high during the night. Can't win them all with Diabetes in the house!

Fears of a D-Momma

I was talking to my mother the other day about my youngest son's lapses in memory concerning his diabetes care.  She told me that I was just worried because he will soon be an adult and I will lose all control. He will be on his own.

I laughed at her. I am not worried, I am downright terrified! I am not sure if the terror is magnified because my oldest son is now days away from being 18 and is currently planning his future with little input from Mom.  Knowing that the first child has reached this stage means that the second one is only a few years behind in doing the same thing but the second child has a bit more baggage to consider. 

I know in my head how much my youngest son has learned over the past few years. I see some small changes.  I know that he will learn at his own pace and he will surprise me when need be.  I also know that he will be a young man one day. He will drink. He will most likely do his best to ignore his diabetes.  He has already stated that he would rather go back on injections than have to continue to visit a doctor on a regular basis to have prescriptions refilled. (I told him that he still had to go back once a year either way.  He was not happy.)

He will most likely move to an area where I am not two minutes away.  He sleeps through his lows.  He answers his phone only when he feels like it.  He has no interest in a CGM and I am not sure if I will be able to convince him of its benefits before he goes off on his own.

Its not just about control...being able to tell him to test or to bolus.  Its also about complications.  Its about not waking from a low. Its about not telling people around you about your diabetes and getting into trouble with no one to know the difference. Its the fact that he doesn't wear his Medic Alert bracelet or necklace unless I tie it to him.  The list goes on and my terror grows.

I can't dwell on any of it.  It is still a number of years away.  I can only hope for the best. I must prepare myself to accept a happy medium and teach, teach, teach without coming across as preach, preach, preach.  Let's hope that there is enough wine and hair dye in the world to get me through! Why do I want a cure? To save myself from myself and this list of fears!

Slides are not always fun

I have been trying to give my son space.  My boys are growing up and I have to step back and allow them to fall on their own at times.  I think that is the hardest part of being a parent thus far.  The older they get, the less I can stop them from doing things that could harm them. I have to sit back and be ready to wipe their knees and help them back up again.  Diabetes is no exception.

For almost 12 years, I have preached about testing, bolusing, counting carbs, carrying meters, carrying glucose and the list goes on. Now that my son is a teen, its important that he start doing many of these things on his own. It is also important that I don't drone on and on so that he completely tunes me out. Finding that balance is hell!

Now that he is more self-sufficient, I don't think as much about two hour after tests. I go to bed knowing that he will test and if he is not in what we have established as a "good" range, he will either get me up or handle it himself.  I know that he always has his kit with him. I know that he usually has glucose somewhere in a pocket. 

Being a teen, he can take advantage of that trust...and does.  Last night I went through his meter. I knew that we were having a few issues with lows so I had let things go for a few days to see if there was a pattern or if it was human error.  As I sat down with meter and paper, I found huge lapses in readings. I really didn't know what to do.

The lapses were during the day.  They were sometimes while he was with me. More often, they were while he was at school or with friends. My son is terribly private.  I think he is dangerously private when it comes to diabetes. He doesn't want his friends to really "see" his diabetes.  He carries his meter but he leaves it in his pocket. He is great at detecting when he is out of range so he uses his internal compass to keep him out of trouble. At night, when he knows he will not wake up from a low, he makes sure that all tests are done.

I was proud of myself. I didn't yell when I saw blank spaces of up to 10 hours with no readings. I wanted to scream but I also wanted to cry. I was failing. I was being too lax. I laid out some new ground rules for the next little while. He will do all of his tests at school. No exceptions. No excuses. He will text me those readings for the next week. I will text him to remind him (in case his pump is not enough of a reminder).  If he fails to do this, he will lose all online privileges including his xBox. 

I then told him that testing takes about 10 seconds total.  It can be done quietly by heading into the washroom or sliding it out at his desk. He does not need to draw attention to himself. He can stay private but he MUST test. He is putting himself in danger. I told him that quietly testing himself will not draw nearly the attention that throwing up from being high or passing out from being low will. Those are big time attention getter's. If he wants to avoid them happening in front of his friends then he must test.

I left it at that. I was sad. I was ashamed. How could I let him go so long with no tests? Because I believed him when he said he tested. I trusted that testing when he got up was routine. 

I give him breaks in his care. I test for him. I bolus for him. I help him with carbs. I remind him.  I back off and let him remember. I do not ask a reading before asking him how his day went.

Its a struggle.  I know we are moving forward. I acknowledged how much I appreciate that he is bolusing. I told him that remembering to test before bed was super important and I was so glad that he was doing that. 

He is now in class for the day. I have texted him asking for his reading. He hasn't replied.  I am hoping it will happen by their first break. I hate one step forward and then sliding back. I know...its called parenthood. I have to be glad that there is forward movement but... AAAAAAHHHHHHH!! Okay I feel better! Today is a fresh new day.

I Googled "fear of slides" and this image popped up!

That's a lot of insulin!

"Twenty-nine units! Wow! That's a lot of insulin."

"Its what your body needs for what you ate.  If you are worried that its too much, you will find out when you test in a few hours."

This was our conversation after breakfast the other morning. My son had had his usual stack of pancakes. His carb to insulin ratio in the early morning hours is something like one unit of insulin for every 5 grams of carbohydrates, so 100 grams of pancakes equals a LOT of insulin.

I never heard any complaints when he came home later that day suggesting that there was an error or he was low.  I think he just realized that he uses way more insulin than he once did. He also eats WAY more food than he once did!

He is a teen. He began this journey when he was a toddler.  Way back in time, he would not use 29 units of insulin in a day.  When we first began pumping, I would fill his pump to about 150 units and still throw out insulin after a week. 

I remember when his basal rates moved from .1 unit per hour to .5 and then 1.0 units.  I was terrified. I had to keep reminding myself that this is what his body needs. If he had an internal pancreas, it would be pumping out gallons of insulin as well, its just that I would not have the visual to go with it.

As he grew, his carb to insulin ratios were no longer 1:40 or even 1:20.  He now sees ratios of 1:5 to 1:15.  Insulin sensitivity is not even a consideration any more but thankfully insulin resistance has not become as much of a problem as it could have been either.

When my son first began to see major changes in his insulin needs, I spoke up to friends and said I was concerned.  A wonderful woman who lives with diabetes laughed at me and reminded me that my son was no longer two.  He was becoming a man and that journey would be filled with many more empty insulin vials before we were through!

I should have run over a meter

Last week was a bit of a muddle. I injured my foot and spent most of the week sitting on the couch going crazy. I hate being laid up but my foot was not happy if I used it.  As I sat, self-absorbed and frustrated, I really did not pay a lot of attention to diabetes.

I yelled out the normal "Did you test?".  I asked what he bolused and helped to calculate meals. I hobbled out of bed each night to test. I failed at Reading Review Thursday and swore we would do it the next night, and the next night, and so on.  I didn't keep track of when the next site change was due and sadly trusted my 14 year old to actually pay attention to the alert on his pump. Yes, I majorly failed as a parent of a child with diabetes and diabetes got its revenge.

I finally looked at my son's pump after a bolus and decided to check when the next site change was due.  My son quickly grabbed his pump back and attempted to escape my limited grasp.  I somehow hauled him back and reviewed the screens.  The site change was FOUR days over due! I could not breathe. I wanted to beat him with his tubing. What was he thinking? Or not thinking? What the heck was I going to do to get him to remember?? 

I told him to change his site NOW! No games, no chats, no text. March his butt in his room and change that site before I put one in his tush! I was doing my best to breathe and allow him to live another day.  He had been high for the past few nights...now I knew why.  

I kicked myself.  I should not have allowed things to slide.  I should have been on top of things. I have been slack on a lot lately.  I had to pull myself together! The next thing was to review the readings. 

I had him bring out his meters and a sheet of paper. We were going to get down to brass tacks and review things. 

"Mom, we really can't make a lot of changes.  My site was really old so the readings won't be accurate."

Thanks! I needed to be reminded of how we failed! I told him that I wanted to check things anyway. I looked at the first meter. It was his USB one.  This meter is still so neat but I couldn't remember how we reviewed readings without sticking it into a computer. Finally we figured it out and I began my review.  I loved the highlighted highs and lows.  The readings were everywhere but the display was so cool that I was oblivious to much else. 

Next I moved onto the school meter. There were no readings. None. Nothing. Was he using a different meter? He brought out a second one. It had a few readings but something was seriously wrong. He swore he tested. I checked the dates on the meters.  We have a real issue with One touch Mini's changing the date and time.  I know that they are supposed to be the most accurate meter on the market but this problem drives me insane. 

The meter was off...like by years! It had the time as two hours later than it should be, the year was 2010 and the dates was October.  How the heck was I supposed to go back and figure out what he really was and when? He had missed tests so I could not really even take three tests each day and guesstimate.  I was frustrated. 

We made a small change and I told him we were going to have to be way more on top of this. He had to test at school.  We had a problem but I couldn't solve it without the data of those tests.  

As he left, I wanted to scream at myself. How could I be so slack? He is only 14 and he is a teen. He forgets. He gets lazy.  If I was on top of this days ago, I would have information and would have known that the meters were off.  I wanted to cry.  I wanted to yell. I should have run over a meter. That just may have helped. 

Instead, I promised myself that today will be better. I have circled his next site change on the calendar. I will try to be more proactive. I will work harder to be a better pancreas guide.  I have to. We aren't allowed to quit.  

"Good" is not a number

Does this happen in your house?

"What was your reading?"

"Good"

"No, what was your reading?"

"I don't know but it was good."

Arggghhhh!! "Good is not a number. Good is a four letter word.  Yes, "four" is a number but good does not necessarily mean "four". "

At this point, my son usually looks at me like I am completely insane.  If I am lucky he has figured out that I would like to hear a real blood glucose reading and not his generalization of his take on his reading. 

"10.0" (180)

"That is not good.  That is actually a bit high since you just woke up and should technically be under 7." 

"I like it. Its good for me. I think 10 is a good number."

"And that is why good is not a number. What you define as good and what I define as good are not the same."

The teen years can be trying enough, but a teen with diabetes? Well he may well tip my sanity scale! Time to buy some more hair dye to cope with the dozen new grey hairs he just caused me.  

Update after...Hating Five

I was driving in the car with my youngest son. He yawned and I asked if he was tired. 

"Why?"

"Well, I thought you might be tired since I was up all night wondering when you were going to go low.  You hovered between 4 and 5 all night. I wasn't sure what to do and didn't want to send you high so I ended up awake for most of the night. You finally did go low, I gave you a juice and things eventually worked out."

"Next time give me a sandwich."

"What???"

"Next time I'm low.  Don't worry about the juice, I would rather have a sandwich."

Oh my! Teen boys and food! Its not like I haven't fed him a sandwich while he slept before but that was back in the days of injections and NPH. Nowadays its juice, gel or tablets and some sleep. 

After this nightmare night, as I mentioned, I had to decide if I should decrease the basal rate or give it one more shot.  We had a huge dumping of snow that day and my son had been out shoveling for a few hours. When the evening came, I had to decide what to do. I went with the wait and see approach. In hindsight, it wasn't my most brilliant decision but this time he was over 7 (130ish) before going to bed so I thought I had a lot more wiggle room.

Wrong! Two o'clock in the morning saw him dropping again. There was no sandwich.  I found some regular pop and decreased his basal rate.  I also changed the previous rate back down to where it was to begin with. I was not taking any more chances!

Diabetes Burnout

This morning I read a post about an adult who was suffering with depression and struggling to keep his diabetes in check. He knew what to do but just could not always bring himself to do it. The post really struck a chord with me.

As a parent of a teen with diabetes, I don't have to remember to test before and after every meal or intensive activity.  I don't have to remember to bolus for every meal. I don't have to watch my pump for reminders of site changes, low cartridges and low insulin. I do not have to carry around constant reminders of my diabetes.

My son leaves the house and takes diabetes with him.  When he sleeps elsewhere, he is in charge of his own care.  I technically get a break.  I still think about it. I still count the carbs in a meal out of habit. I will still keep an eye on dates and ask about site changes. I will look at trends and deal with adjustments. I get tired and yet I am not the one living with diabetes 24/7. This scares me.

My son came home a few days ago after spending time with his father and other family members.  He didn't change his site.  I avoided looking at his meter until later that evening. He had come home alive.  I did not want to ruin our reunion if things were not as they should be...and they weren't.  When I finally scrolled through the meter that he used, I found times that he went over 12 hours without testing! The readings that were all "in range for the most part", included a 28 (504). 

I was too tired to scream despite having just had five days away from diabetes. I was too tired to fight about it. I read through the readings aloud.  I asked him if he had used another meter because there were a LOT of missing readings.  He gave me his usual look of "of course I must have used another meter because I would never do something like totally neglect myself just because you were not there to remind me." I knew otherwise. He knew I knew. I walked out of his room.

If I can get this tired, this frustrated, this worn out after 11+ years and its not my disease, how do those living with it handle it? How can we not expect depression? How can we not expect burnout? We can't.

We can only offer help and be there to lean on.  My son has been able to bolus on his own for many years but there are still times when he hands me his pump after a meal.  He has been doing his own site changes since he was at least 11 or 12 but he still calls me in now and then to do them.  I am okay with those breaks. He knows what to do but some days its just nice to let someone else deal with it. I hope I can continue to do this for him...not forever but whenever we are together.  Hopefully it will help when he has to battle his own diabetes demons.

Another Reason to Test at Night

We all know the many reasons that people like myself test their children's blood glucose levels at night.  There is the fear of dead in bed, the desire to "know" what is going on in their bodies, checking basal rates, making sure an infusion site is working, checking on the result of so much activity during the day and many, many more.

This Christmas I discovered yet another reason to test at night...the turkey!

Yes, the turkey.  In this part of the country, a large holiday meal is usually served at noon rather than in the evening.  This means that if you are having a turkey of any size, it needs to be put into the oven long before normal people get out of bed for the day. 

We were having all of our children over to eat.  This bird was going to have to see the oven long before daylight would be arriving.  As I thought about having to crawl out of bed during the wee hours I was less than thrilled but then I remembered that it was okay.  I had to be up anyway! I would kill two birds with one stone, in more ways than one!

With both of my boys home, I knew that they would have been up late so I did not have to be up too early to test. Four in the morning would be fine...and it was! I got up, tested my son and he was perfect.  You know that perfect that makes you wonder if he will drop or be okay? Lucky for me, I had a bird to stuff and get in the oven.  I did just that and then went back to retest him. He was fine.  I could sleep for a few more hours before the Christmas mayhem began.

You have to take the benefits of diabetes where you can. This holiday season that one worked for me!

Growing up, independence and Mother's fears.

Time moves so quickly. It can feel so slow when you ask your son for the twentieth time if he has changed his site and he hasn't.  You wonder if it will ever change. Will he ever get it? Will he remember to test? He will not live with me forever no matter what.  How will he continue? Will any of it sink in? How will he handle things? What will he do when he needs a break?

I am a worrier and the thoughts going through my head lately will soon drive me over the edge if I am not careful.  Preparing for my oldest son's graduation from high school and realizing that he is on the verge of manhood, is sending my mind reeling.  My children are growing up! Have I prepared them well enough? What else can I do for my youngest? How will I handle their independence? It will not be easy but I suppose I will adjust.

When I look at my son's log book I wonder. When I see how well he pays attention to site change reminders...five days later, fear takes over.  How will he handle this for the rest of his life?

I then listen to him react as I ask "Where are the tests? Why did you not test for this food? Why did you not check after that low?".  My questions are no longer asked in panic mode.  I no longer ask in that hysterical, meltdown voice.  I simply ask the questions and wait. 

His answers are now more interesting. "Mom, my new year's resolution is to test more. I can't believe that I am missing these tests. I can't do that. I have to do better. I will definitely be working on this."

I know, you are thinking, yes he is saying everything he feels that I want to hear. You may be right but I have also watched the actions. I no longer "freak out" as often over his care mistakes.  I think a lot. I wonder what else I can do but I give him facts. We look at trends together and decide what needs to be done.

"Why where you high? Oh you made a bolus mistake. No problem. Now you know for next time." 
"Where did that low come from? Right! Exercise, okay we will work on that one but where is the retest? Oh there it is."

He is learning. The process is so painfully slow that I still fear him leaving my house.  The rational part of me says that I allow him to do a lot of his care without my hovering now.  He is left to go places and must face the world on his own.  He comes back alive and well. We still have another three plus years at least to learn, stumble, fall and brush off his knees. He has learned a lot in the past few years, he will continue to learn. We will be okay...I pray!

More noises from Charlie Brown's Teacher

When my son came home from school, I reminded him that I wanted to look at his pump and meter later that evening.  I asked him if he knew of any trouble spots that I should be concerned with. He said that he had been high after breakfast but felt that that was probably because of a bolus error. Everything sounded good...until I checked the meter and the pump.

I looked at the meter first. There was a 5pm test and a 1pm test.  Okay, what happened to the 2:30-3pm test? There was the high from breakfast, and the tests from the previous day but wait, we were missing a few more tests.  There were almost as many missing readings as there were readings. This was not good.

As I thought about the after breakfast high, I began to wonder..."Let me see your pump."

"Are you going to make some changes?"

"Just let me see your pump.  Yeah, I thought so."

"What?"

"Well, you came home after school went straight to the fridge.  I asked you if you had tested and you said that of course you had but your meter says that you didn't. I see that you didn't bolus your lunch until 1:30pm. Since you are in class at that point and a missed meal bolus alarm went off, I am guessing that you forgot to bolus your lunch.  When I checked for a breakfast bolus, which I remember asking you not once but twice this morning if you had done it, guess what I saw? No bolus again!!! You seem to be forgetting an awful lot lately.  Are we going to have to go back to you testing and bolusing in front of me as well as texting me all of your readings from school? Will I have to demand your meter the second you walk in the door from school?"

"I can't believe this.  I must have remembered to bolus. I can't believe I forgot to test.  Let me see. There has to be some mistake!"

I handed him the pump and told him the only mistake was his in forgetting most of his care. He had only bolused for one meal that day and that was the meal that I bolused. Things would change I reminded him as I walked out of his room.

Outside, I wanted to bang my head against a wall. Oy!! We really do make one leap forward and six shuffles back.  Teens really do have minds of sieves.  Its back to observing and not just reminding. Its hoping that one day some of what I say will sink in and mean something. One day I hope my voice will be more than the squawking sound of Charlie Brown's teacher.

Mom I did a bit of tweaking

"Can you bring me your meters please?"
My son came out of his room with three glucometers for me to review.

"Mom, I have made a few tweaks of my own."

"Oh really? What did you change?" I asked rather intrigued.

"Well I have been coming home low the past few days so I figured I should make some small changes and see how it goes.  I adjusted my basal rate."

Basal rates?  Those can be tricky.  "When were you low and what time did you set the adjustment for?"

"I am low at about 3pm so I brought the noon rate down a bit."

Holy cow! I am impressed. He had been listening and learning after all! "Are you sure its not a carb to insulin adjustment? How long after you eat does this happen?"

"I am not positive but this seems to be working. I was in the twos (low 40s) for a few days and today I was 3.8 (64) when I got home."

"Okay, keep an eye on it and if you are still low try the lunchtime carb ratio."

With that my son headed downstairs to have his shower. I was still in shocked and very impressed. He was taking charge of his diabetes care! He was making the changes as they needed to be made without my help and doing a great job of it.  My little boy was growing up!

I turned to the meters to see what else was going on that I didn't know about.
Ugh! Missed tests at school! One morning test out of four.  I was not happy. I reminded myself that he was making strides in one area. Baby steps, baby steps. 

It would be a miracle if he was actually doing everything he was supposed to.  I did not freak out completely. I did not take away privileges. I did suggest what could happen if he forgot again but for the most part I just tried to bask in the glow of the "Mom I did a bit of tweaking on my own".

Eating your young or life as a harp seal?

Last night I woke up later than I should to test my son.  I cursed at myself as I stumbled in his room and was grateful to hear the soft sound of snoring coming from his bed. The test showed that he was high. Did he change his site like I asked him? I checked the history and yes he finally had.  While I was up I checked his meter history.  The meter I was using had my tests only.  Hmmm...I found a second meter. It was still seriously lacking some readings but it appeared to be his meter of choice for the weekend.

I silently fumed. He had missed more tests than he had done. I had specifically told him at points during the day to test and nothing was done! I knew he ate a bowl of popcorn at around 10pm and no test before.  I once again felt a kinship to those animals that ate their young.  They had it right I was certain!

I headed back to bed trying to put my frustrations out of my mind so that I could fall back to sleep.  It took a bit of work. This weekend we had been focusing on school not diabetes. I had believed my son when he told me he was studying. I trusted him when he swore he knew the concepts for the upcoming exams.  I had allowed him to read his novel at his own pace not realizing that there was a book report that would soon be due.

Freedom was short lived as my son came home with low marks and a novel with three chapters read that was to be finished and have a book report completed on it in less than five days time.  I was so not impressed but tried to appease myself with the fact that he hadn't lied about the horrible marks.  With a math test looming and a book report that had to be completed in short order, his weekend plans of Xbox and Beverley Hillbillies was derailed by his mother. It was time for him to be put back on a short leash. Homework first, play when Mom says its okay.

All of this now played on my mind. I had been harping about school work, now I would complain about diabetes care. Do I ever stop? I must be sounding like Charlie Brown's teacher by now.  There is no way he will pay attention to anything I say.  How will I get it to sink in? Yes, eating my children when they were young could have saved me these problems.

I finally wound down and went to sleep. The next morning I calmly discussed the issue of testing with my son. Will he change? Did he hear me? Will he pay more attention to testing? Will I harp on his a little less? Probably not to most or all of the above.  I will try not to nag but will continue to remind him and provide consequences for his actions--or lack of them.  Oh the joys of parenting!

The lancet is thrown back

As you may recall, my son was going to have to do his own night testing this past weekend. I had to have day surgery on Friday and was worried about how well I could handle testing him. My son was less than impressed with the new arrangement but agreed.

Friday night came and I was literally up every hour.  He stayed up until 1:00am. I tested around 2:30am (because I was up) and found him low.  Thankfully the anesthetic wasn't impairing me too badly so I stayed up, read, and waited for him to come back up.  I eventually checked his alarm clock and noticed that he hadn't set it to wake up at three either way! He had felt that the 1am test would cover his night testing duty.  Wrong! I woke him up and told him that he was on the 7am test because I needed to get some sleep.  He reluctantly agreed.

Saturday night arrived and I again reminded my son to test. I was terribly sore and tired. I could really use the sleep. He looked at me with a pained expression and said "How much more of this do I have to do?"

I tried not to laugh. I reminded him that he hadn't tested Friday night because I had and I would make sure to do it on Sunday night so he had a decent sleep before school. I could visibly see the relief on his face.

Saturday night, he tested himself before he went to sleep. I woke up at about 2:45am and tested him. He was a little bit low.  Not seriously low, but not where I would feel comfortable. I gave him some glucose gel and went back to sleep.  He should have been up in 15 minutes to test.  Thankfully he was. I tested him again when I woke at 6 and all was fine.

Sunday night he went to bed with a look of joy in his eyes.  Mom was back on duty! He could sleep. There would no longer be the issue of setting an alarm.  He was safe for a few more months at least!

The Water park

After finally figuring out how to bolus for food in the US, we headed north once again.  The final stop on our journey was my mom's to pick up our dogs and visit with family.  My parents were back from their trip to Alberta and my brother and his family had dropped in during their own cross-Canada adventure.

As we got closer to my mom's, my brother began texting me...
"I am at the grocery store.  Will you be here for supper?"
Unfortunately we still had eight hours to travel so I had to tell him no.  A few hours later I received another text....
"I am at the grocery store.  Will you be here for bedtime snack?"
Bedtime snack? Does he live in the grocery store? No snacks for us.  We were still too far away and would have to get a hotel one last time before we arrived.  Because I was driving at this point, my son began texting my brother back. We decided to meet for breakfast the next morning.  My brother then asked my son if he wanted to go to the water park with them the next day.

I really wanted him to go.  My brother lives on the other side of the country and we don't get to see each other very often. He is my son's namesake and it would be great for him to spend the day with his young cousins.

I was terrified of him going.  Who would watch his pump? Who would remind him to test? My brother really hasn't been around him enough to know a lot about diabetes.  He knows its a big deal but...my mind continued along this track with the "let your son be a kid first" blaring over top of the insanity.

My son was going. They would head out after breakfast. I had an hour to prep my brother between bites of food. I had a night to prep my son.  They had to remember to test.  The pump had to be put in a locker if everyone was in the water (its water-proof but with all of the cracks that he has in it, I knew it would not be able to handle water anymore).  He had to use the "disconnect" feature. He had to bolus for the missed insulin.  He had to have fun but he had to test. 

The next day arrived. I ran over things with my son. I gave him money for a locker. I talked to my brother. His girlfriend didn't plan on being in the water. She would watch the pump and the meter.  I tried to breathe. I let my son head off and tried to remember that he was going to be a kid with his uncle. He was going to be fine and any errors could be corrected when they returned.

A few hours later I received a text from my brother...
"Just finished at the water park, getting pizza, L### took his insulin an hour or so ago.  I think it said 11.9?"

I laughed a little. I breathed a lot easier.  First, my son was testing.  Second my brother got it.  He may not have the terms right but he had confidence in his nephew and was still keeping on top of things. I could relax and deal with the rest of my day knowing that they had everything under control. 

We all met up a few hours later.  They had enjoyed water slides, pizza and even chocolate.  The only problem that my son had all day was that I missed his shoulders with the sunscreen and he was burnt.  I will try to do better next time!

He's only thirteen, he's only thirteen...

He's only thirteen.
He's only thirteen.
He's only thirteen.

That is the mantra I was saying to myself on my drive to deliver insulin to my son at school first thing this morning. After recently bragging about his A1c, after talking to other parents about what was working to get my kid to take care of himself and be responsible, I am now back to the point of knowing why animals eat their young.

Today's drama began last night.  At 4am, I stumbled into my young son's room to test him. He was high.  I checked his pump.  He had 10 units of insulin left and was supposed to have changed his site earlier that day.  Gee, I guess I knew why he was high!  I grumbled and left the cartridge for him to fill up when he had his breakfast in the morning.

Breakfast arrived with its usual chaos.  I was cooking bread dough (toutons).  It is not the healthiest breakfast on the planet but a treat loved by our household. As I cooked, there were also dogs to be fed and my son's lunch to be made for the next day. When my own tea and toutons were done, long after my child had left for school, I remembered, "He didn't bolus his breakfast!"

Larry asked how I could know that.  I told him that with that breakfast he would have had to verify the carb count with me and he didn't.  I texted him and asked if he bolused.  No answer.  I called him.  This time I did hear from him. Nope, he had forgotten.  Ugh! I gave him a quick total and told him to bolus NOW!

A few minutes later I got a text from my son.  "I only have 2 units of insulin"
(Insert a lot of cussing under my breath) "I guess you didn't change your cartridge this morning before you went to school."
"I forgot"

(More swearing to myself as I headed to the shower).  What would he do if I were not able to just hop in the shower and run him up a full cartridge of insulin? He had two units and his breakfast required close to 12!! For petes sake! You would think after a day of alarms he would notice something like this! (insert a lot more cursing to myself and then add in the fighting back tears of frustration) When will he learn? Will he ever learn? Larry had said that I will still be asking him if he bolused when he is 35. I agreed and now wondered if he would still be forgetting everything like he does now?  We have been at this for over 11 years! When does it sink in?

And so the internal conversation continued as I got ready and drove to my child's school.  The closer I got to the school, the more I began saying "he is only 13.  He is only 13."  It was interupted by the "when will he ever learn? I brag about how much he has changed and how great he is doing and then this? He constantly forgets site changes and now no insulin despite repeated alarms??...He is only 13.  He is only 13. The mantra continued.

By the time I met him at the school I was a lot calmer than I had been but he was still very skiddish. I was waiting for him in the foyer. I could tell that he wanted to take the insulin and run.  No such luck! I sat him down and asked for his pump.  We were doing a site change right then and there as well as putting in the new cartridge and correcting.  He could not get away fast enough when I was done!

This evening when I picked him up after ball hockey, he immediately told me that he was "getting better at this diabetes stuff." 
How do you figure that one?
"Well last year I forgot insulin a lot of times, but its only been twice this year!"
And that makes things better how? You had 12 hours of alarms that you missed!

He continued to quietly stay in the backseat for fear that I may yet choose to eat my young.
Ah the joys of life with a teen with diabetes!