Category Archives: transition years

THE doctor for every teen with diabetes

A great doctor means everything in diabetes care.
Last week my son went to his first diabetes appointment without Mom.  As I said before, I had emailed the clinic. I had given them a heads up about a lot of things but I was not at the appointment. I was both surprised and impressed when a little while after the appointment I text my son, asked him how it went and he said “I will call you after.”  He was going to call and share the appointment with me? I was very pleased that he wanted to do this.
Later that evening we did talk. He told me that they had a lot to say, most of it he didn’t remember.  Again, my son is 16 and forgetting what adults say is a teen brain specialty. The nurse made a few changes.  His doctor commented on how much he had grown…and then his doctor talked, and talked, and talked to him for a full hour.  That was not unusual.  This doctor takes a lot of time with his patients and their families.  He gets to know you, shares with you and advises you.  He is wonderful.
My son was a little shocked by his high A1c (personally I was shocked that it wasn’t higher).  His doctor quickly told him that he didn’t care about that. It was just a number. (Yes you read that right! His DOCTOR said he wasn’t concerned about a high A1c!)  The doctor’s concern was with my son learning to handle HIS disease.  He wanted my child to know how to troubleshoot the issues himself.  He needed to know how much insulin to give himself, how to adjust a basal or bolus setting.  This was on him.  Now was his time to step up and learn.
I was beaming on the other end of the phone! This was what I had been aiming for as well but coming from his doctor was different from the “momma yammer”.  We do sit down and discuss strategies.  For the past few years, when making changes I would first ask him if he thought it was a bolus or basal issue.  He now had to develop the confidence to do it all on his own.  I was thrilled and reminded him that he was already doing a great job learning.
No one was suggesting that this complete transformation would happen overnight. This was his two-year plan and his doctor had told him that messing up and having a high A1c while he found his way was okay. This was a good reminder for Mom and a great message for my son.  Learn! Learn! and then when you have it figured out, go back and fix that A1c but for now learn about you, your body and your disease.
I still love this doctor and would gladly clone him for everyone else with diabetes to have as well.
d health

Psychic Connection?

The other night was night two of tossing and turning which in itself is not entirely unusual. This night was different though.  I was completely tired and ready to drop.
I had read a few pages of my book, done some relaxation exercises but sleep would not come.  After awhile anxiety began to creep in. I tossed and turned some more.  My mind began to take off on its own. There was no way to reel it back in.
I thought of my oldest son living up in Alberta.  Had he been injured at work? I would have heard if he had. I tried to shut my mind down again. I tossed and turned some more.  I thought of my youngest son. Was he testing at night? Was he in trouble? Had something happened? I again worked to calm myself down. Both boys, or someone around them, would have contacted me if there was a problem.  I was being foolish.  I was overtired. I had too much on the go. I had too much time on my hands.  There were a million reasons for me to be tossing and turning. Driving myself insane was in no way helping the situation. By 2am I finally fell asleep.
When I got up the next morning, I wondered if this had just been a reaction to so many years of interrupted sleep.  Was my body going through some sort of withdrawal? It has not slept through the night for any extended period in 20 years.  There was bound to be some issues at some point. I decided that I would try herbal tea with my book the next night.  All would be fine. My kids were still alive. No friends or family had been injured during the night. Obviously my anxiety was unwarranted. It was probably just my body being strange….and then I talked to my youngest son.
After a bit of chatter, I asked him how his readings were.  “Good except for last night. I was up all night because of a bad site.  I got it fixed though and was perfect during the day.” BINGO! There was the source of my anxiety!  He was in trouble the night before.  Well not trouble, but you know what I mean.
I have spent almost 14 years somehow waking to most diabetes related events. I would wake at unexplained times when he was low or high.  Something would bring me out of a deep sleep and make me test him.  We have no CGM.  I just somehow often “knew“.  Perhaps this knowing did not know distance?  I am not sure. Some people would say that I was crazy and this was just a coincidence.  It could be. I am not sure but I do know that I slept a little easier the next night.  Any tossing and turning  I experienced that night didn’t have a higher level of anxiety attached.  As long as my son is also waking and dealing with things…well I will probably always worry and be concerned but hopefully I will find a level of calm. If I don’t, I will text! psychic


A Mile in His Shoes

When my son wakes up in the morning, the first thing he does is check his iPhone.  He eventually gets out of bed, does what needs doing in the washroom and then begins to scrounge through the cupboards in search of food. Once all of this is done and he is ready to eat, he pulls his meter out of his pocket and tests.
I constantly ask why he doesn’t test as soon as he wakes up? When I wake up in the morning, and it’s not a school day, my first stop is his room to test him.  After that I do the rest of my morning routine but testing is first on the list before all else and it’s not my body.  Why can’t he do that, I often wonder.
Today I thought about it a little bit more. For years I have questioned things like forgetting to bolus.  He has had to have insulin with his food for as long as he can remember and long before that. How can he forget to bolus?  How can he go for days and days without changing an infusion set? Doesn’t the adhesive begin to annoy him? And the list of questions go on.
But what if I was the person living with diabetes? Would I still be as diligent? I have a hard time sticking to a diet.  I can do a new exercise routine for three weeks and when it is supposed to become habit, for me it becomes annoying and I usually come up with a thousand excuses and eventually stop. How would I then handle a routine that had to last me for the rest of my natural life?
I could count the carbs at every meal. That is habit. I do that all the time now.  In fact, recently a friend and I were out to dinner. I was ready to tell him how many carbs in his supper when I realized that it wasn’t necessary.  We didn’t need to count the carbs.  My son wasn’t there.
What about site changes? The other day, my son said that he should get to do one on me in exchange for all of the infusion sets that I have put in him over the years. I declined. Would I be like him and put off changing them for as long as possible? I would probably need to use numbing cream ( he hasn’t used it in years).  The noise of the insertion launching device would freak me out. I would probably also be looking for someone else to do it for me so I didn’t pull away.
Testing? Would I test as often as I should? Possibly. I might be okay here because I would have to use AST.  I have tested on my arm before. It was completely painless. That amazed me! Lancing my fingers?? Well that would take a lot more effort and my son makes it look like no big deal.  Once again, what’s with the big bang of the lancet? That noise scares the begeebees out of me! I wouldn’t be worried about drawing attention to myself in public because…well I just don’t really care about stuff like that most of the time.
If I walked in my son’s shoes, would I be better at my care? Perhaps but I am a bit older than him.  If I walked in my son’s shoes when I was 15, would I be better at my care than he is? I remember what I was doing at 15 and 16 years old.  Diabetes would not have been a welcomed addition to my awkward new life.  I’ll have to try to remember that a little more. I am trying but when your child’s life depends on something like insulin injections and blood glucose testing, it can be hard to remain relaxed and easy going. I will work on focusing how ill-fitting his shoes are when I try them on. They are his shoes. I can lace them for him but he will one day have to walk in them alone…and as a mother, that still remains scary.
shoes
His dirty running shoes, my pasty legs

She Kicked Me Out!

Yesterday we had our regular clinic appointment…a day dreaded by mother and son for none of the obvious reasons.  We simply find it rather boring.  Because Mom is a bit obsessed, learns a lot, and surrounds herself with diabetes experts, diabetes clinics rarely have much new information to offer us. I also make it my job to educate my son so again, he is not often shown anything that he hasn’t already heard about. I will say that the people at the clinic are pretty respectful of this but we still must wait to see the required list of people…and we are easily bored. 

Yesterday was no exception…except when the doctor came in.  She asked my son his age and then asked me to leave the room! Wow! I have never been kicked out before! Well from kindergarten but not a doctor’s appointment!  

I know that he needs to learn to speak for himself and to communicate with his diabetes team.  He needs to know his rates and we are working to get him to understand where to make changes and how….BUT my son is super quiet! Don’t get me wrong, once he knows you and is comfortable it is impossible to keep him quiet but for the most part he is very reserved and mumbles one word answers. How was this going to work? 

I paced the floor outside of the examining room.  The support staff looked at me and said “Kicked out, huh?”  I smiled and nodded.  This was obviously a common practice.  As I paced, and worried that she would get no information out of him. I realized how important this was.  He needed to speak up on his own now before he reaches 18 and sees a new doctor.  I try to make him answer questions when we see his team but often he defers to me.  This one on one session would make him answer the questions. 

It seemed like I was wearing a hole in the floor. What were they talking about? Were they getting to talks of sex, drugs, alcohol and diabetes? That would be good…not that I want my son engaging in any of those activities, especially at his young age, but I don’t know enough about them to talk to them from a diabetes angle. 

Finally he came to door and beckoned me back in.  I tried not to be too obvious in my relief.  As I sat down, she turned to me for all of the basic information that my son could not provide…basal rates, carb to insulin rates, etc.  For some reason under the pressure of having to do it with a relatively new doctor in his presence, he had forgotten where to find the relevant details. 

I gave her the information she wanted.  She signed our DTC form without a second glance and refilled a prescription she had given my son during his last visit.  After she left, while waiting to see the other members of the team, my son expressed his approval of this doctor. Not only was she a nice person (and she is a nice looking lady which I am sure is not lost on a 15 year old male), she also told him that since he had great control he could forgo having his annual blood work.  She was a star in his eyes! I hope he realized that it was the hard work of maintaining good blood glucose control that allowed her to give him that reprieve. Either way…my little boy is growing up! Where has the time gone? I am guessing I will be kicked out on a regular basis now….