Friday, December 05, 2008

Head or Heart (or kidneys, or eyes, or...)

Every parent wants what’s best for their child. You want them to grow up strong and healthy. You want them to have a strong and healthy body. You also want them to be mentally strong, not just smart, but mentally healthy too. You want them to have high self-esteem. You don’t want them to feel isolated or different.

The physical part isn’t too hard with most kids. You make sure they eat healthy. You make sure they brush their teeth at least twice a day. You take them to the doctor for regular check-ups.

The mental part is a little harder. But, most kids just want to be treated like everyone else. They want to belong, fit in. They don’t want to be singled out amongst their peers.

Throw diabetes into the mix and it complicates things a bit.

What do you do when keeping your child physically healthy is a detriment to them mentally?

Or, keeping them mentally healthy is a detriment to their physical health?

Parents of kids with diabetes are faced with this dilemma on a daily basis, usually several times a day.

It’s been wearing on me as of late.

Usually if Riley’s sugar is high he will take insulin and skip snack. But, what about when there’s a birthday party at school and his sugar is 350 and the main menu items are cupcakes and ice cream with a side of potato chips?

Should I make him skip the party to keep his body healthy? Or should I let him go on and eat knowing the food is going to send his sugar soaring even higher just so he won’t feel singled out?

I’ve done both. And, I’ve felt guilty about both.

It breaks my heart to think of him sitting at his desk watching everyone else eat their treats. But, it also bothers me to think that his sugar is already that high and, before going down, will probably go higher.

9 times out of 10 if peers are involved I let him go on and eat and just deal with the high later. There are enough things he has to do that make him stand out. I don’t want to add to that.

He’s the only one in his class who pulls out a blood sugar machine before he eats. He’s the only one who sometimes has to sit out at recess because his sugar is low. He’s the only one that the teacher counts his fries before he eats.

Yes, there’s enough already to make him feel different.

Lately, he’s had a lot of highs. I’m guessing he’s going through a growth spurt. I have been increasing basals on a weekly basis for the past several weeks. Still, he sees the 300s at least once a day.

I guess that’s why this has been weighing on me so much lately. When his sugars have been pretty much in range it’s easier to let him have cake and ice cream occasionally even if his sugar is high at the time.

But, now, he’s having all these highs….

It is a horrible feeling when you know whatever decision you make is going to impact your child in a negative way somehow. I’m constantly second-guessing myself. I feel guilty if I let him eat and I feel bad if I don’t.

I don’t know how to solve the problem. A cure, maybe. That would be nice. But, until then what do I do?


type1mom said...

I am overwhelmed with this question often as well Penny. I used to be the mom that made Maddison wait for the sweet treats if she was high. At home of course, we still do.....but the peer thing just isn't black and white is it? Maddison also cried when we chose that route. When we first started to let Maddison have the treats at school regardless of blood sugar I was a mess when they would call telling me "Her blood sugar is 320 and she will have 50c of a cupcake with mile high frosting" "What do you want to do?" So, I asked them not to call, just do it and I dont even want to know about it. Of course, I still have to face it when her log comes home!

I wish they could take a time out and do the sweet treats AFTER we get in a good prebolus. I guess that just isn't realistic though. For now, we play pretend. We pretend it is just that easy to let it go. I just hope that later on in life Maddison will choose to wait out the high for her health's sake. I think that is all we can do.

Scott K. Johnson said...

This is a great post Penny, and a topic that deserves so much more attention.

While the problem is definitely amplified with kids, it exists for us adults too.

Lee Ann Thill said...

Easier said than done, but it is OK to let him indulge in a cupcake. I don't know how realistic this is since back when I would have had a similar dilemma, BG testing didn't exist, but on days when the teacher knows cupcakes are coming up, can he make a point to test an hour beforehand and correct if high? That way, at least there's a little active insulin on board, and you're already getting a jump on the high. As I said, I don't know if that's possible or not, but even if it can't be done all the time, maybe some of the time?

As Scott said, we all deal with it, and now, if I know I'm going to be eating a high carb meal or snack, I try to check beforehand to be more proactive. Does it always work? Well, no, but if it was a special occasion, I wouldn't miss out on the celebration either. If it was a sheet cake, I'd ask for a smaller piece, and maybe I wouldn't eat as much as the icing. Whether or not suggestions like that would go over well with your son, I don't know.

It's OK to be high though - just don't let the high go. As long as you're taking action to correct, that's the best you can do. I know it's hard sometimes, but we all - adults, children, parents - need to remind ourselves of this. Also, remember kids are resilient, and I wish I could remember the studies I've read about this, but they've said kids' bodies seem to have some protective mechanism that keeps those highs from really doing any permanent damage. You're right to not single him out or omit him from activities unless absolutely necessary - that type of damage is far more difficult to repair.

You're not doing anything wrong though so keep up the good work :)

Chrystal said...

Hi I just started following your blog. My son who is 6 was diagnosed on July 3, 2008. A bit of a shocker to our family. He has good days and bad days, right now I still have him on his 45 gram carb diet, and it is working, we do have his insulin pen and I'm still all new to this. I just finished my classes at our local hospital. So I may drop in from time to time. I was really looking for a site I could relate too. Now I have one. Thanks.
my email, is, if you have a really good blog or great ideas. Thanks.

Minnesota Nice said...

Absolutely great post, Penny. I think you summed it up perfectly.
As the others said, I, as an adult also wrestle with this issue of balance. Are we living to control the db, or controlling the db to live? How do we find that balance.

I went to a holiday craft show today and had some coconut Italian ice. It was delicious and I thoroughly enjoyed it. My post prandial was 220. I told myself that I have a few pp's per week over 200, but, I know this was from the treat and probably could have been avoided.....bah humbug.

You are a wise lady and a good mom, Penny. I'm sorry you have to battle the db demons. Stay the course.

carol said...

You really "get it", and that is the best thing in the world for your child. Just the fact that you understand that it is a trade off is awesome. I cringe when I read about parents who keep their kids with D in a very regimented routine all the time. My bet is that they will rebel at some point and have no emotional tools to deal with D themselves. You are teaching your son that this is a balancing act, and that if things get tipped too far one way, he can forgive himself and adjust. Now I hope you can apply the same to yourself. I think you're doing great job for him mentally and physically!

Lynnea said...

A hard dilemma....and really no right or wrong answer. Stinks that we feel so guilty about it..whichever way we decide. Stinks that the situations occur so often...I never realized how often "treats" are offered in a given week. Stinks when they're high and we have to decide....always a catch 22 situation.

Right now we often side with the "he can wait" side. Mainly because we are rarely in situations where EVERY kid is sitting down eating cake and ice cream. Usually there are kids not eating at the same time, so there's always a distraction. We usually just tell him he can have it later. He's bummed for a second, but knows the routine, and goes on playing like he was before the finger poke.

You know...I'm finding that more and more kids have some sort of "issue" with more and more parents and kids are being educated and understanding of kids that have special food needs. It's becoming a "normal" to be "different". Ha....that makes no sense does it??

I do like the idea of testing an hour ahead if possible. We might have to try that, but so often his highs come from seemingly nowhere!! UGH!!

Great thoughts from everyone here!

Anonymous said...

350 is too high to eat cake. But for us, a small portion of ice cream or potato chips are slower digesting and does not have a huge impact on blood sugars at all. If your son is the same, maybe he could skip the cake, eat half cup icecream or serving of chips and bolus 15 grams for it, along with the bolus for the high blood sugar. In our case, we would be in range later. Also, so that he doesn't feel different: There is nothing wrong with him taking a piece of the birthday cake and icecream, taking one or two bites out of each, and pushing the rest around on his plate. If someone asks why he doesn't finish it (doubt they would notice) then he could say that his stomach is bothering him, sorry, he can't finish it but he tasted it and it was delicious. Or you could tell the parents hosting the party that you would like your son to have very small servings (tiny sliver of cake, I would let him have the ice cream). I know this does not address the fact that he wants to finish the cake but with a BS of 350, he may very well feel sick. With four celebrations a weekend, he needs to decide what he is going to eat if his sugars are that high. He does not have to eat everything served to him. But he should be able to eat a little of everything and be able to participate. Sure this is only temporary as you will get his BS down, honeymoon, no honeymoon, regardless.