Good News

[keanna's momma]

We went yesterday for our 5 month post diagnosis check up and she has brought her a1c from off the charts to 7.5!!! I told the nurse can we check that again :D.

We have been struggling with her numbers, medicine changes and puberty for weeks. We were running in the 300's etc. I am so impressed with her number.

I also requested the digital pen yesterday after advice from my co worker. So now I won't get the yes mom I did my shot while at the football game or the yes mom while I was at band practice I did everything. Now I can see the time and how much she gave herself. I hate to be the parent that does not trust her child but she has been sneaking food with no shots and the numbers are reflecting it.

The nurse said 14 is too young to show them the bad things that can happen if they do not take care of themselves but I am really thinking that might be what she needs. Any thoughts or input on this? She is in the burn out stage of I will do my shot later or yeah I did it and I can tell by her numbers later that she did not.

[nanhsot]

We went yesterday for our 5 month post diagnosis check up and she has brought her a1c from off the charts to 7.5!!! I told the nurse can we check that again :D.

We have been struggling with her numbers, medicine changes and puberty for weeks. We were running in the 300's etc. I am so impressed with her number.

I also requested the digital pen yesterday after advice from my co worker. So now I won't get the yes mom I did my shot while at the football game or the yes mom while I was at band practice I did everything. Now I can see the time and how much she gave herself. I hate to be the parent that does not trust her child but she has been sneaking food with no shots and the numbers are reflecting it.

The nurse said 14 is too young to show them the bad things that can happen if they do not take care of themselves but I am really thinking that might be what she needs. Any thoughts or input on this? She is in the burn out stage of I will do my shot later or yeah I did it and I can tell by her numbers later that she did not.

First of all CONGRATS! That's wonderful.

We've always had followed the philosophy of "trust but verify" with our teens, not only in D management but in life. I trust but I will always verify that the trust is earned, and when it's not, then the leash is shortened as needed. That's all your doing now, shortening her leash a bit, she still is out there doing what needs to be doing but you are keeping her near so you can watch out for her health. You definitely are doing the right thing and have my support.

As far as telling of the dangers, well, only you know your teen. Some kids would hear this type of news better than others. My kids have grown up (literally) hearing all my horror stories from work, "today I had a guy that jumped off a bridge into the water and a log was floating by and he broke his neck" (true story!). They actually make fun of any sentence that begins with "I had a patient once..." cause they hear it so often. So, because of what I do for a living and because of how I've raised them (they are tough kids), the complications of D have just sort of been woven into conversation, you know? It's not like I one time sat him down and terrorized him with the facts, but more sprinkled them into conversation.

He knows he goes to the dentist regularly now, and the eye dr too, when we didn't before...and he knows it is because of his disease. He hears me talk about work about the guy who denied he had diabetes (with regular blood sugars of 300+, all day long) who lost his leg...had a stroke....was on dialysis...I see them every day so I have a VERY different perspective on this subject (and before I freak anyone out, these are ALL type 2 folks).

I know my teen and I know how smart and logical he is. I have told him that as long as he keeps his A1C below 7 that he can live a long and healthy life, that the LOWER he keeps that number, the less the chance of complications. He scoffs when people tell him he has to wear shoes and avoid being barefoot because he knows that those type problems don't happen to those who manage well. That's the attitude we've adopted, "you CAN go barefoot because you are doing so well." So that's the approach I guess I take.

I think the key is to do it in a non threatening way, instead of "you'll lose a kidney", it's "your kidneys will stay healthy forever if you do xyz....". These are smart and amazing kids. They can read between the lines, they can hear that "your eyesight will remain good if you manage your BG" and they will know that if they don't, they can lose their eyesight.

Anyway, if I had a child who wasn't taking diabetes seriously you can bet I would be having a conversation with them about why it's so important. Again, not to terrorize or frighten, simply to empower.

[Christopher]

I don't believe 14 is too young to know about the potential future problems, but I think the key is the timing and presentation. I would not discuss this after she has not taken insulin when she should have and you are arguing about it. I would do it when things are calm and not focused on compliance.

I don't believe that fear of future consequences motivates most teens to be compliant. So I think presenting it in a matter of fact, medical way is better than trying to scare them with horror stories.

Just my 2 cents. Good luck.

[KatieSue]

My daughter was diagnosed at 13. They didn't really mention any of the long term consequences in the hospital. Last year she did a report for her health class on Diabetes so she researched and found out all of the possible long term health effects. She's very mad that no one had told her about these before. She's brought it up a few times since then that she doesn't understand why they didn't tell her all that in the hospital.

Every kid is different. Mine has always wanted people to be straight with her. I'd have to tell her when she was little, yes it's a shot and it will hurt for a minute, but then you'll be fine. She'd get very upset with the nurses who'd tell her it wouldn't hurt, and then it did.

If you think it would help your child understand more why she needs to do all these things now then I'd certainly have that conversation with her.

[emm142]

I firmly believe that teenagers who self manage should be aware in a matter of fact way that there are complications from high BGs. The reason for this is that otherwise for many people there is simply NO motivation to keep BGs down. For many (maybe even most) people, highs just don't feel that bad, and are nothing compared to lows (I think I'm the exception to this rule :p). For people who are aware of hypos, after running high for several weeks, being high feels fine and being normal feels awful.

So, if you were one of these people, and had no idea that high BGs caused long term complications, would you be motivated to get your BGs down? I don't think I would be. Without all the facts, there certainly isn't much motivation for those who are asymptomatic with highs.

That said, I definitely do not believe in scaring into action. I have heard people say "I took my child to look around a hospital ward where people had just had amputations because of D, to try to shock him into looking after himself" and I would never do that. There is a fine line between "this is why we're trying to avoid highs" and "HIGH BGs WILL KILL YOU". (Okay, the line isn't that fine. :p) I think the ideal is for her to have an awareness that there is a good reason to avoid high BGs, without scaring her into thinking that because she can't help having high BGs sometimes she is destined to get long term complications, KWIM? My BG goes above 300 a few times a week, and if I thought that that was enough to seriously harm me long term, I'd probably lose motivation to take care of myself entirely.

[keanna's momma]

I wouldn't say that I want to scare her but really don't know how to get through to her. Her grandmother is losing her eye sight from diabetes and my uncle is blind, but it does not see to hit home to her for some odd reason.

Every day I have to tell her to put her shoes on because I catch her outside twirling her saber and rifle for color guard with no shoes on. I always tell her Keanna your feet are extra sensitive to being injured and not healing properly and that would affect your marching in band. But she sneaks outside the next day. I know that a lot of this is typical teenage behavior but URGH.:confused:

I know that in time she will get it but I just as her parent worry that bad things will happen before she does. It?s like she asks me to let her be self managing in her care and only have me jump in when she asks me to. But then I go through her meter and find days where she tested 2 times or one day that she only tested 1 time.

I have been talking with her father and we are thinking that one way to get through is tell her that she is required to do the 4 tests a day and if we find that she is not then she will lose her iPod or cell phone. I know that sounds harsh but she has to be responsible. She has been talking with the doctor about the pump and the doctor and myself have told her it?s a minimum of 4 tests a day with the pump.

[obtainedmist]

I have been talking with her father and we are thinking that one way to get through is tell her that she is required to do the 4 tests a day and if we find that she is not then she will lose her iPod or cell phone. I know that sounds harsh but she has to be responsible. She has been talking with the doctor about the pump and the doctor and myself have told her it?s a minimum of 4 tests a day with the pump.

I think giving consequences for not testing/dosing enough are totally appropriate for this age group. Not harsh at all in my opinion! If you caught her doing something risky outside of D care, there would certainly be consequences. I would treat it the same way. When she knows the expectations and complies...good things happen as far as priviledges (of course...good things happen to her health as well but that doesn't motivate her at this age). Hope she gets with the program!

[keanna's momma]

I think giving consequences for not testing/dosing enough are totally appropriate for this age group. Not harsh at all in my opinion! If you caught her doing something risky outside of D care, there would certainly be consequences. I would treat it the same way. When she knows the expectations and complies...good things happen as far as priviledges (of course...good things happen to her health as well but that doesn't motivate her at this age). Hope she gets with the program!

Excellent way of putting it. I really think this is something that might get her attention.

[emm142]

I think giving consequences for not testing/dosing enough are totally appropriate for this age group. Not harsh at all in my opinion! If you caught her doing something risky outside of D care, there would certainly be consequences. I would treat it the same way. When she knows the expectations and complies...good things happen as far as priviledges (of course...good things happen to her health as well but that doesn't motivate her at this age). Hope she gets with the program!

I agree. Punishment is appropriate for testing less than 4 times per day. If all the other motivation (feeling better, complications, etc.) is not enough for now then it's your job to do whatever you can to keep her healthy.

Of course, she'll have to develop some other motivation at some point, because when she moves out and lives alone you won't be there to dish out punishments if she doesn't test enough... I guess you just have to hope that she's in a different place by then.

[Christopher]

Every day I have to tell her to put her shoes on because I catch her outside twirling her saber and rifle for color guard with no shoes on. I always tell her Keanna your feet are extra sensitive to being injured and not healing properly and that would affect your marching in band. But she sneaks outside the next day. I know that a lot of this is typical teenage behavior but URGH.:confused:

Not sure where you got that information, but you might want to do more research on it. There is no reason why your daughter can't walk around in bare feet.

You may be confusing information you heard about people who have diabetic neuropathy and lose sensation in their feet, can't tell when they are cut, don't check their feet for injury, and then get an infection.

After being dx for 5 months, I would not expect your daughter to have signs of neuropathy, but if she does, then she needs to take precautions. If not, then let her enjoy the great sensation of cool grass on bare feet. :cwds:

[timsma]

I agree with Chris about going barefoot. My son was diagnosed at age 2 and is 17 now, and has always gone barefoot with no problems. I think this is one battle you may want to drop. There really is no reason she can't go barefoot at this point. Sometimes you have to pick your battles, kwim? As for not testing a minimum of 4 times per day, I also agree that she should have consequences for not doing so. Taking away things she loves and telling her she will get to keep them when she starts testing and treating appropriately.

[emm142]

I agree with Chris about going barefoot. My son was diagnosed at age 2 and is 17 now, and has always gone barefoot with no problems. I think this is one battle you may want to drop. There really is no reason she can't go barefoot at this point. Sometimes you have to pick your battles, kwim? As for not testing a minimum of 4 times per day, I also agree that she should have consequences for not doing so. Taking away things she loves and telling her she will get to keep them when she starts testing and treating appropriately.

I agree with this (and Chris). If you fight her on too many little and unimportant things, she might just feel overwhelmed by ALL the things which she has to change, and feel like she is unable to do it all and therefore not bother with any of it. You're best to introduce the bare minimum that she has to do, and then she should at least manage to do that.

On the subject of feet, mine heal just as fast as they ever did and I have plenty of feeling. Unless your daughter actually has slow healing or neuropathy, I assume that she's fine with bare feet.

[keanna's momma]

Not sure where you got that information, but you might want to do more research on it. There is no reason why your daughter can't walk around in bare feet.

You may be confusing information you heard about people who have diabetic neuropathy and lose sensation in their feet, can't tell when they are cut, don't check their feet for injury, and then get an infection.

After being dx for 5 months, I would not expect your daughter to have signs of neuropathy, but if she does, then she needs to take precautions. If not, then let her enjoy the great sensation of cool grass on bare feet. :cwds:

She currently has necrobiosis lipodica diabectorium all over her lower legs and the top of her feet. Her doctors have told her with this skin condition and her diabetes it is not a good idea for her to take any chances of ulcerating her skin condition or damaging her feet.

[Christopher]

She currently has necrobiosis lipodica diabectorium all over her lower legs and the top of her feet.

OK, you did not mention that part of it. In that case I guess she has to take precautions. But normally, people with diabetes who don't have neuropathy (or other issues) can go barefoot. Sorry she is dealing with NLD.