News flash: 8 year olds and 14 year olds aren't adults. You would think I would know this, and I do of course in theory, but sometimes I still find myself expecting my kids to act like adults when it comes to their decision-making ability. That came up in different ways for both kids this week.
Though I've gotten better about not compulsively checking my Dexcom share app, I do still often take a peak shortly before her lunchtime and sometime in the afternoon (her lunch period, for some unfathomable reason, falls at 10:35am). When I checked before lunch her bg was coasting in the 80's, which is a totally awesome number to be at right before a meal. I figured she might actually stay in range for the whole school day, which isn't super common and would be totally awesome.
When I looked again shortly after noon, her bg was nearly 300 and still climbing. I could not for the life of me figure out how that could have happened. I'd allowed her to switch from greek yogurt tubes to gogurt tubes, which have a little more sugar. Could that have made such a big difference? We'd had an issue with a bad pump site a few days earlier. Could it have been happening again?
There was nothing I could do until I picked her up at 2:45. I checked her pump as soon as we left the building, intending to look through the history and try to figure out what happened before giving a correction. I didn't need to go that far, however, her pump was still on the "confirm bolus" screen from lunch, which means that she did not deliver any insulin for the lunch she ate.
To my credit, I learned a lesson after I reduced her to tears for not bolusing for her snack at Girls on the Run in the fall. I didn't get angry. I told her what I saw, explained that I was relieved there was such a simple explanation for her high blood sugar, then gave her a correction and sent her on her way.
Internally, however, I was pretty annoyed both that a) she forgot to complete a process she does EVERY.SINGLE.DAY. and b) the teacher didn't notice. When I reflected on it, though, I realized that it's actually expecting a lot to give my still relatively young child responsibility (even very part time) to take over for one of her organs that stopped doing part of its job. Under normal circumstances, kids without allergies can just eat without thinking about it. It's not as if she willfully sat down and ate her lunch without pulling out her insulin pump. She entered the information. She just forgot to deliver the insulin.
Diabetes, as much as I hate this fact, is a marathon, not a sprint. Barring a cure (which I don't think will happen until Kittygirl is a young adult, best case scenario), Kittygirl will have to deal with this disease her entire life, long after I'm done raising her and having at least some responsibility for her actions. My job is to teach her to manage her diabetes as well as I can, and to try to do so gently so as to either make burnout as a teen or young adult unlikely or something she has the tools to overcome.
In another venue altogether, Squirrelboy reminded us this week that he's still not completely responsible. Monday night he was caught using his phone in an unapproved way later at night than he's allowed to use his phone for anything other than listening to books before falling asleep. He wasn't accessing anything objectionable, but he was breaking hard and fast rules nonetheless, and the phone history showed it wasn't the first time.
Understandably, Mr. Engineer was pretty upset when he caught him. I was already in bed when it happened, but I heard about it in the morning. Squirrelboy had lost his phone for the day, and he came into the living room in the morning crying. I thought he was crying about losing the phone, but it turns out that what really upset him was that he had disappointed his dad and he was afraid Mr. Engineer would never trust him again.
I assured him that that wasn't the case, but he didn't stop being stressed and nervous until he and Mr. Engineer had had a talk about the incident after dinner. This reaction actually made me happy, because it shows we're doing a pretty good job as parents. If our teenager breaks a rule and his main cause of distress is having possibly lost his dad's trust, I call that a parenting win.
New rules have been set, including the phone charger being moved to our bedroom and the phone being plugged in to charge before bedtime and not moving until the morning. Perhaps we should have done this to begin with, but, as a general rule, we prefer to let our kids have a good amount of responsibility unless and until they show they aren't ready for it.
That applies to both diabetes responsibilities and general life responsibilities. Sometimes it turns out well. Other times it doesn't, but the way we react to those times (like, say, not freaking out about a high blood sugar caused by user error but rather using it as a teaching moment) has the potential to teach our kids a lot.
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I did not realize the tandem would fail to alarm in one of two ways or both. First, the Blood sugar climbed at a large rate I would expect the pump to alarm and or, once it got a predetermined point it should alarm. I hate mine when it buzzes at 170 but it also has saved me more than I care to mention.
ReplyDeleteSecond, I am surprised that the pump does not go crazy with alarms when you enter but fail to deliver a bolus. Wow I would be in serious trouble if my pump were not reminding me constantly of the things i fail to do.
Interesting questions. I would say it was only the pump's fault in one mannner. I was surprised that the pump didn't alarm for a missed bolus. It does alarm when we enter the carbs for a bolus and then for whatever reason (most often we get distracted) don't deliver them. However, the pump has never before been left on the "confirm bolus" screen. Unfortunately, this seems to take it past the "missed bolus" alarm point. We don't have CGM alarms set up on the pump, so it should not have alarmed for a blood sugar rise. It could, but we haven't enabled that capability. Instead, we depend on the phone Kittygirl uses for Dexcom. That DID alarm, but Kittygirl keeps it in her supply bag and doesn't always keep her supply bag right next to her (even though she's supposed to). She has also been known to tune out alarms when she's involved in something. Sometimes the teachers hear them and call her attention to them in that case, but I'm guessing the classroom was relatively loud that afternoon and noone heard the alarms.
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