In Which I Realize That I Actually CAN Let Kittygirl Out of My Sight

Kittygirl was diagnosed with T1D just a few weeks after her 6th birthday. She had quite recently reached the age at which I was beginning to regularly leave her at playdates and birthday parties, and she had even begun to ask about sleepovers. When I was told that she would need to have a shot every time she ate anything and her blood sugar would need to be checked regularly, especially when she was playing actively, I was afraid I'd never be able to leave her alone again.

I was terrified to send her back to school (which happened just three days after diagnosis) because something might go horribly wrong. Despite the fact that, at that point in time, her teachers had had almost as much diabetes education as I had, I presumed I was better because I was her mom.

She survived the her first day of school after diagnosis, of course, and her care at school has always been great. Until she got an insulin pump, however, I still attended every playdate and birthday party. I wasn't comfortable asking other parents to give Kittygirl a shot. 

After Kittygirl got her pump, a mom at soccer asked if I was comfortable having her come to their house for a playdate. I nervously agreed, and proceeded to give the mom a 15 minute mini training session when she picked up Kittygirl. Everything went fine.

That winter, Kittygirl was invited to a birthday party. I had still been staying at every party, but, in the second semester of 1st grade, I had become unusual. First graders are normally dropped off at parties, at least around here. Kittygirl begged to be dropped off. I nervously asked the mom of the the birthday girl if she was comfortable texting me a picture of the food before Kittygirl ate and entering the number of carbs I gave her into the pump. I gave her a demonstration of how to use the pump. She was happy to help, and I walked out the door.

I was nervous enough that I didn't choose to go far. I parked myself at public library branch just 10 minutes from the birthday girl's house. I looked at Kittygirl's Dexcom graph about every 10 minutes to make sure she wasn't going low, despite the fact that I had alarms set to notify me earlier than the alarm on her phone would beep. Everything worked out fine, and I realized that, with friends with parents willing to learn, it really was acceptable to leave my T1D child at a party.

As time has gone on, I've gotten more and more confident leaving Kittygirl at playdates and parties. All the parents of her friends have been incredibly helpful and willing to learn. I realized we're blessed in that way. I've heard plenty of stories of kids who are excluded from parties and playdates because of their T1D.

We've entered new territory this year. The day camp Kittygirl has attended for two summers now is held at a local private school. I was nervous approaching them about accepting a child with T1D the first year, but they were totally open to it and willing to let me and Mr. Engineer train their staff. The school encourages kids to be independent in their own care (normally this is things like putting on their coats and tying their shoes) and they encouraged us to push Kittygirl into the first steps of independence in diabetes care. That camp was the first time (the summer after first grade) that Kittygirl tested her own blood sugar. This past summer (after second grade) we agreed we'd test out the idea of Kittygirl using her pump there with adult supervision. Since that worked well, we continued the practice this school year.

Kittygirl asked for even more independence when she begged to sign up for the Girls on the Run afterschool program. It's run by college age volunteers. I met with her main coach half an hour before the first session and gave her a brief rundown on diabetes, but Kittygirl has mostly been on her own dosing insulin for snacks and treating lows. It has not always gone well. You can read the post in which I reduce Kittygirl to tears to learn more. However, overall I've seen Kittygirl take some big steps.

Yesterday was the last session of Girls on the Run before the 5k this weekend. Unbeknownst to me, they had a Christmas party, and most of the food was not labeled for carb count. Instead of asking a coach to text me, Kittygirl looked at her plate and estimated the carbs on it. She nailed it. Her blood sugar never went above 124. I was amazed and proud when I found out.

Mind you, Kittygirl, who will turn nine in 2 months and 2 days, is far from fully independent in her diabetes care. She uses her pump and treats low on her own when we're not with her, but we do everything (and I do mean everything, including taking the pump out of the pouch) when she's with us. She is not ready to help change her pump sites or CGM sensors. In fact, she currently has no interest in learning. 

She's also quite a ways away from nighttime independence. It's a rare night that her blood sugar doesn't go low or high, and I still have never let her have a sleepover away from us. I've reached the point where I might consider it with a parent I know well who was willing to keep their phone on and all night and possibly get a call or a text. In fact, there was even a sleepover planned this summer but Kittygirl backed out at the last minute. Slumber parties, on the other hand, are a bridge I'm not yet willing to cross. I'm sure I'll get there, given how far I've come from the day Kittygirl was diagnosed, but I'm nervous about putting another parent on the spot to treat overnight highs or lows while dealing with all the other chaos that a slumber party entails.

The one thing I've never been really nervous about letting Kittygirl do, with or without diabetes, is climbing up to high places. She's an excellent climber, and she's also good at knowing how high she can climb and still get down safely. She has often gone so high in trees and on playground equipment that she makes other parents nervous.

I think this is a good analogy to giving your T1D child gradual independence. Of course you're not going to leave your newly diagnosed 3 year old at a party, just like you're not going to let any 3 year old climb to the top of a tree. However, as your child gets older, it's appropriate to give them more independence as they show readiness for it. 

Just like with climbing, this will look different for different kids. Some kids are giving themselves shots with adult supervision at 6. Others are still asking for help at 14. Some kids are climbing to the top of the monkey bars at 5, while others are having a hard time just crossing them at 8. 

I'm in favor of following the child's lead for the most part when it comes to independence in diabetes care. I think it's fine (and sometimes even advisable) to suggest the child try a new task (testing blood sugar, giving a shot, using their pump, etc), but I don't think it's a good idea to push. Even if you see 50 posts today on that diabetes parent Facebook group of 4 year olds testing their own blood sugar, it's really okay if you still do it for your 8 year old. 

My one caution (based on the experiences of others, not my own) is to avoid pushing all diabetes tasks on your child from an early age, even if they seem ready. This is likely to produce diabetes burnout sometime during adolescence. So far, I really like the balance we have of a lot of independence when Kittygirl is away from us and us totally taking over when we're together. Only time will tell if the balance we've achieved now will work out well long term.