Monday, July 22, 2013

The balance of managing and letting HER manage

I can't believe my girl is going to be 11 years old in about a month. I can't believe she has lived with diabetes now for almost 2 years. While there are many joys to watching her grow and become more independent, there are many bumps and moments of frustration for me. One of them is carb counting.

I don't think Alex left our sight for at least 6 months after she was diagnosed. And it took me quite a while to allow her to go somewhere without family or very close friends. In the past year, we have loosened up quite a bit and for a while it worked decently enough. She would take her phone and supplies. We would make sure the adult in charge was aware of her diabetes and how to treat a low. Alex would call or text when she was eating something or if she had a number out of range for advice.

As time as gone on, she has become less willing to communicate with us. Case in point this weekend...she went with a friend on Saturday to a local mini-amusement park. She left around 10 AM. By 2 PM I hadn't heard a word out of her. I tried texting her. I tried calling her. Her dad did the same thing. I tried texting her friend. That finally got a response out of her. She said she was 197 and she hadn't eaten anything or had any lows. They were headed to eat now but she wasn't sure she wanted to eat or come home. Fast forward to 4 PM and I try calling and texting her again. She texts back that I ask too many questions and she is on her way home anyway. Wrong answer!

She comes in all huffy and says she is getting her bathing suit and swimming at her friend's house. I ask if she ate and she says she had a small burger and nothing else. Her dex shows 279 and double arrows up. I ask for her pump while she changes. Now up to this point I haven't lectured or judged that I can tell anyway. I've asked for information and made no comments about her management or choices.

Her pump shows she had an 82 around 1 PM. It is the ONLY time she tested the entire day. It shows she bolused 3.1 units for about 25 carbs around 3 PM. She did NOT test first. 

Her friend is in the living room with me while Alex changes and I ask her what they had for lunch. Her friend says they had burgers and fries. I decide because her friend is there I'm going to table the conversation until after swimming. Part of me wanted to say your staying home but I chose not to make a scene in front of her friend about Alex's diabetes care (or lack thereof). Plus, she is high and swimming will help anyway!

She comes home about an hour later and asks about having a sleepover. At this point her dad and I decide it's time for a talk. We explain that being independent is a privilege. Yes, it sucks to have diabetes (as she vents to us). But you have to take care of it. I ask her why she didn't tell me she had an 82 when I asked her if she had any lows. She said that wasn't low. I asked if she did anything when she was 82. She said she had 4 tablets. I asked her why. She said she "felt low". That was a reason to text or call then! I asked if she had a burger or burger and fries. She said she had both. I asked her how she came up with 25 carbs. She said she "guessed" because "you always guess". I explain there is a difference between guessing wildly and guessing because you've eaten for example pizza once a week and have an idea of the carb values when they are not available for a given restaurant. And the fact of the matter was she ate at a chain restaurant and the carb count for burger and fries was 70g. She could have texted me to check the carb count (and is supposed to). She said texting "takes too long". She could have looked on her iPod touch with has the Calorie King app. Again, "that takes too long". 

We explain a sleepover is not happening this weekend. She starts crying and screaming that we are unfair and that it's only because she has diabetes. I try to explain that it is more a matter of trust and responsibility. You have these rules to follow. If you can't follow them, you don't get privileges. She's 355 by the way at this point and not being reasonable. Finally we send her to her room because the conversation is going nowhere fast.

Later that evening, we talk some more and she says she is sorry for not checking the carbs. I hug her and try to explain to her that it does indeed stink that she has to do these things but that she FEELS better when she stays in range. She enjoys her friends more when she stays in range. She agrees.

I guess all I can do is keep focused on the path and try to encourage her to take the time to do what she needs to do and enforce the rules set forth for independence. I don't know what else to do. Sometimes I want to get down on the floor with her and kick and scream that it isn't fair and that I hate diabetes too.

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