In Which I Reduce My Child to Tears Because She Didn't Do the Job Her Pancreas Should Have Done

Spoiler alert: I am not  a perfect parent, in the realm of diabetes or otherwise. My goal is to parent my children well and to address any problems or hiccups brought on by their challenges or just by being kids calmly and rationally. However, that is not in my nature, and all too often I crash and burn in that area. I experienced a crash yesterday that I'd like to share about.

Kittygirl is 8.5 years old, and closing in on 3 years with diabetes. Because she was diagnosed at a fairly young age (just weeks after her 6th birthday), in the beginning we kept a pretty tight rein when it came to managing her diabetes. We did everything for her for over a year, then we slowly started to introduce more independence. The summer before second grade she started testing her own blood sugar. The summer before 3rd grade she started using her insulin pump with adult supervision.

The ability to use her insulin pump with an adult looking on has opened up a lot of opportunities to Kittygirl this year. First of all, she no longer has to go to the nurse's office before lunch at school. Her teacher just quickly supervises her in the cafeteria before lunch. We've also given her more leeway to attend events with adults who have no real training in diabetes care. Two examples are an after school activity called Girls on the Run and a Parents Survival Night where she takes gymnastics. Both of these have had mixed results, diabetes-wise.

The Parent Survival Night includes dinner. Pizza is provided. We would allow Kittygirl to eat pizza if she wanted to, but she hates pizza (remember, she's extremely picky), so she brought her own packed dinner, including a sheet with a carb count for everything she packed. The only "training" the workers received was being told that they needed to doublecheck that Kittygirl entered the number on her sheet into the right place on her pump. They did that, but Kittygirl forgot to eat 10 carbs of her dinner and her blood sugar went a little low.

On the bright side, I reacted quite calmly when I found out what happened that time. I reminded her that it's important to eat everything she boluses for, even if she's at a fun activity. I told her that we'd give her another chance to do better, but that she could lose the privilege of going to such events if she repeatedly forgot to eat her whole dinner.

Yesterday's incident was worse - both in the degree of what Kittygirl forgot to do and in the degree of how I reacted to it. Twice a week after school, Kittygirl participates in Girls on the Run. This is a great program that teaches girls to be healthy and confident. Every lesson includes both some learning time and some running time, as well as a snack provided by the program. I met with one of the volunteer leaders before the first lesson and went over some basics of diabetes. I told her that she or another adult should doublecheck that Kittygirl entered the right number of carbs in her pump before eating the snack, and that she should text me with a picture of the snack if there was any question as to how many carbs it had. They've ended up bringing packaged snacks with an easy to find carb count, so I haven't needed to step in in that realm.

Up until yesterday, Kittygirl has been able to find the nutrition information on the packages easily and bolused the correct amount. For that reason, I had no idea that the coach had completely forgotten that she was supposed to be doublechecking the pump and Kittygirl had never reminded her but rather just gone ahead and bolused on her own. This fell apart yesterday, when she ate a snack and somehow completely forgot to bolus for it.

Usually, when I pick her up at 4pm, Kittygirl's blood sugar is in range or even low, because she spends the last 20-30 minutes of the lesson running. However, yesterday at pickup her blood sugar was 225. Our goal is to keep her blood sugar under 180 at this point, and we intend to lower that goal once we are consistent at reaching it close to 100% of the time. Normal blood sugar generally runs between 70-120, so even 180 is kind of high, and 225 is about twice as high as a nondiabetic's blood sugar is likely to be.

When I looked at Kittygirl's pump (she still prefers to have me bolus her when we're together) to see if she might need more insulin. I saw that there was no insulin on board. What this means is that she had not given herself any insulin through her pump in 3+ hours (this doesn't include her basal, which is constantly running). Well, that solved the mystery of why her blood sugar was high.

First I calmly asked her if she had eaten a snack. There was always a chance that she didn't bolus because she didn't eat a snack, and the high was caused by some other factor. She replied that she did eat a snack. I then asked her if she had bolused for the snack, and she replied, somewhat nervously, "I thought I did." I told her loudly that she, in fact, had not bolused for the snack, and that's when things started to fall apart.

She asked me what I had brought for her to eat on the way to dance class, and I told her that I had brought a banana and a granola bar, but that I was considering not giving them to her because her blood sugar was already high and I didn't want it to go higher. She started to cry, and, instead of taking that as my cue to calm down, I ramped up and told her that, if she couldn't remember to bolus or to eat all of her food (yes, I brought up an incident from nearly a month earlier) we would have to take away the freedoms we'd given her this year.

She continued to cry and said she just forgot this one time and really didn't want to lose her privileges. She said she'd do better. At this point, we'd arrived at the van and she climbed into her booster seat and curled up in a ball.

It should have hit me earlier, but it was then that I realized just how wrong my reaction had been. Yes, Kittygirl is a very responsible 8 year old, but she's still an 8 year old. None of her friends at gymnastics need to remember to eat all the carbs they bolused for. Their pancreases just makes insulin for however many bites or pieces of pizza they eat. Her friends at school don't need to remember to look up the carbs in the snack and bolus for them. Their bodies just make insulin for whatever they eat. It's not fair that Kittygirl has this responsibility, and it's not unusual that, at 8, she might forget about it occasionally.

I calmed myself down and apologized to Kittygirl. I told her that I got angry because I didn't want her to get hurt because she forgot to do something to take care of her diabetes, but that it was wrong of me to yell at her. I bolused her for the snack I'd brought and gave it to her (it didn't even raise her blood sugar, and she was back in range just a few minutes into dance class). She stopped crying, buckled herself into her seat, and asked me to start the audiobook we're listening to.

Thankfully, Kittygirl is very forgiving and recovers quickly when I apologize for yelling at her. However, as she gets older, this may not always remain true. We've been doing diabetes long enough now that I'm able to forget just how much responsibility it is to stand in for your own or your child's pancreas. It's just part of our lives. However, it's not a responsibility that the average 8 year old has, and I need to do better at keeping that a the forefront of my mind.