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DD wants total independence, BUT...

Discussion in 'Parents of Teens' started by Helenmomofsporty13yearold, Mar 5, 2013.

  1. MomofSweetOne

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    For camp last year, we set her target at 150 and reduced her basals by 30%. They got a week without basal swings, too! (Thankfully) Her lowest low was a 72 and she had two 300s, once when the nurse for some reason dosed her different than the pump and once when a site pulled out. All in all, a good, safe week...I'm interested to see how she does without people checking with her all the time. The motivation is definitely there, but 13 is 13. I can hardly wait to get to your stage.:rolleyes:
     
  2. Sarah Maddie's Mom

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    If you haven't watched Joe's talk about teens and D you might want to. He spends considerable time talking about the nagging thing and about how parents need to help teens transition to independence
    http://www.childrenwithdiabetes.com/video/JoeS2.htm
     
  3. KatieSue

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    Mine's 17 as well. And difficult as well. "I know" is the standard response for everything.

    We don't have a cgm, and from my never ending saga with Dexcom I'm not sure we ever will, but she does all her own day to day care with her Omnipod.

    I deal with insurance, download the PDM to look for stuff, order supplies. And to be honest nag a lot none of which she pays any attention to.

    At night we've never done night checks unless something was going on. If she's had a high/low near bedtime I check. She wanted to do it herself for a while and she did, but then asked me to do it. She sleeps like the dead and half the time doesn't remember it anyway. For a while she was lying about her night number because she didn't want me wake her up. That didn't fly. She also knows that even if she tells me she thinks it's fine. I'll just say I'm not going to and do it anyway so she kind of gave up the battle with me on that one.

    We have the most trouble with remembering to test. She bolus's most of the time with no issues but I'll download her PDM and there will be days with only two tests. And her latest A1C was up I'm sure because of this. It wasn't horrible but she has definitely done much better.

    And I've had to drop her PDM off at school a few times, and lunches. Everything else she has extra supplies in the nurses office and the athletic training office so she can use those.

    I try to look at it as a team thing. We do it together. She does parts, I do parts and we cooperate on some things. Lots of times as long as she feels included in the decisions she's much more ok with it than if I make a decree. She hates to change any of her rates, especially if I say it. Just saying that I've run it by the pump nurses makes her ok with it.

    Hang in there!
     
  4. Helenmomofsporty13yearold

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    We saw Joe give this speech a few years back, and it was good to hear it again today. Thank you for reminding me of it. I have been hesitant to use discipline lately as she has been doing so much better since our last endo appt. She just got her driver's licence, so there is a new privilege to take away for say, not handing over her pump.

    I love his warning to control freaks (like me) that this will be a Spiritual Growth Experience. Amen to that. Also, what do kids say is the worst part of having D..."my mother!".
     
  5. Helenmomofsporty13yearold

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    And it is amazing how little we know after all this time on earth.
     
  6. Sarah Maddie's Mom

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    I'm a big fan of Joe's work - I don't agree 100% across the board with him but I appreciate that he's talking about things that very few diabetes educators really take seriously. Most of all I like his way of framing things. His notion of clearly stated tasks, of rules of engagement so to speak. I also appreciate that he realizes how hard it is to let them grow up and grow away - to take risks, to be independent ... it's hard.

    Honestly, overall it sounds like your daughter is doing well, that she wants privacy but she's motivated to do what needs to be done. Maybe I'd want an adjustment re attitude on her having supplies, but as a mom of a 15 year old I know that we don't always get what we want.:rolleyes:
     
  7. MomofSweetOne

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    I've enjoyed this discussion. With apologies if I'm derailing the thread, what responsibilities or how involved were your girls from my daughter's age (13) to where you're at now? My daughter leaves basal decisions to me, though she's doing temp basals on her own more and more. She makes all the phone calls to Accu-chek and maybe 1/2 to Medtronic (when she knows I just can't face the helpline questions). We take turns carb-counting, working the pump, doing finger-sticks, and doing infusion sites. She can do all of that, but there's the tired-of-diabetesness that set in at the one year mark. I tend to keep an eye on her lancet stash in her kit, but she's really good about making sure she has test strips, etc. Much better than me, to tell the truth. We tend to ask each other about carbs for lows as we leave. Sometimes I've grabbed some; sometimes she has. Occasionally we've both forgotten. She recently asked me about how to order prescriptions so that she knows how to do it. (Hey, maybe I'm about to work myself out of the Medco part!:D) Does the transition toward them feel natural at times and tough at others? Probably the biggest irritant to her was when I was feeling for the Medtronic CGM; not an issue now with G4.:D (She tells me it's mine.) I don't intend to drop out completely at any point until she's older, especially because I don't want her to reach a point of burn-out and feel like a failure to ask for help.

    Night duty is 100% mine with her very occasionally announcing "I'm taking this low, Mom" if it looks non-serious but like it will be a while before she's coming up to a comfortable sleeping number and I'm completely exhausted. The first time it happened, I was already asleep when she realized she was lower than comfortable and she kept herself up until 12:30 keeping an eye on her BG while intentionally letting me sleep. When I checked her at 2, I couldn't figure out why there was a temp basal I hadn't done.:eek:
     
    Last edited: Mar 6, 2013
  8. pianoplayer4

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    I was dx at 14 so I sort of know what your talking about with the akward transition(from the kid perspective though) Honestly, it sounds like you guys are doing great! every kid is different, and only you and your daughter know what you are ready for=) its not easy (on either side) to transition care from a parent to an adult... but it happens slowly, and it sounds like you and your daughter are doing AWESOME!
     
  9. Megnyc

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    When I was 13 my responsibilities were basically bolus for every meal, test blood sugar at set times and before eating or if I felt weird, treat lows if I was awake and that was really it. I was expected to text my bg to my parents every hour while out or before getting on the subway. I started CGMing at 14 (or 15?) and that shifted a lot of the responsibility onto me which seemed pretty natural since I was becoming more independent. My parents would download the graphs and we would go over them and bounce changes off each other and talk through our thought processes. I was doing temp basals on my own from the beginning as well as doing my own set changes. My pump was actually hand delivered my MM to the hospital and I picked it up (while in the PICU :D) and started setting it up myself. My parents tested me a minimum of 3 times a night, usually every 2 hours and managed treating all lows and highs at night. They insist on testing me at night when I am home now which is a minor source of controversy between us. My parents would rotate out test kits refilling them as needed.

    I currently handle everything with regards to day to day management, refilling prescriptions, and interacting with doctors. Currently we are basically 50-50 split dealing with insurance and Medtronic. I can probably handle 95% of interactions with our insurance company and I have no issues talking to Medtronic. I think my parents current goal is to have me doing everything by the time I am a senior in college. One thing to keep in mind is that I believe I signed a form to allow them to talk to Medtronic and my doctors so when the time comes you may need that.
     
  10. Helenmomofsporty13yearold

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    DD was extremely compliant until she hit high school. I never dreamed she would forget to test, bolus, not carry her supplies, forget her pump at the outdoor basketball court, lose meters, let her pump run out of insulin or batteries, etc. before that.
    She never hid her diabetes, so it was surprising when she went through a spell where she did not want to test at lunch. One of her former d-camp counsellors offered to text her at lunch to remind her which was sooo sweet and helped turn that around.
    I still take care of getting the supplies and insurance. She liked me doing the night checks until very recently. She started doing her own shots 4 days after being diagnosed at 8. At 11, she started pumping and has never let me do a site, sensor or reservoir change. She recently set her own patterns for her monthly and for exercise. She only used temp basals until then. She also just tweaked an afternoon basal for the first time on her own observance. I haven't let a night go by without a night check, yet.
    She has taken on all the d-mgt when she is at her Dad's since she was about 11. She never had a nurse at school, so she had to be pretty independent. I went on school trips and to all events.
     
  11. Helenmomofsporty13yearold

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    Good point. DD will probably threaten to not sign right now:rolleyes:
    Did this come up when you transitioned to an adult clinic or while you were still in peds?
     
  12. KatieSue

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    I think under HIPPA guidelines, once they turn 18 no one can talk to you, docs, prescription companies, medical companies, without their permission. I don't know in practice how this works. I'll find out in January.
     
  13. nanhsot

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    For us it has been painless, but he doesn't mind my being the contact person. When I called to order supplies he had to get on the phone and tell them "firstname lastname has my permission to discuss my medical condition and order for me". That's it.

    I still go into the endo with him, but may not this next trip. He still uses a pedi until he leaves for college and they pretty well did the same thing, asked for his permission to give me information, which he did.

    Of course this would all change if the teen in question said NO.
     
  14. Helenmomofsporty13yearold

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    Currently, our endo asks DD if she wants me there. I think they would prefer the parents aren't there so they can get the teens to talk about alcohol, driving and barriers to good BG management more freely.
     
  15. KatieSue

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    Her Endo doesn't do this but her Pediatrician always has me step out of the room for a few minutes each appointment so she can talk to her privately.
     
  16. Beach bum

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    We've started this in baby steps (daughter is 11).

    Recently the doc hasn't asked us to leave, but I noticed she's started rolling her chair in between myself and my daughter who is sitting on the exam table. I choose now to leave the room when she checks for site rotation and stuff. I find that things sink in a bit better when I'm gone. "Dr. told me I need to do this now, so you can't do it that way anymore..."

    Oh and for those who've shown their kids Joe's video, what age did you do it at?
     
  17. Megnyc

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    I switched to an adult endo from a peds clinic at a big research hospital at age 17 and I think they had me sign a bunch of forms at the appointment about a month before I turned 18.
     
  18. MomofSweetOne

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    Why did you decide to switch? I think our endo takes the kids until age 20sih?
     
  19. Megnyc

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    Honestly? I found the appointments to be a huge waste of time. My parents and I have been making all basal and carb ratio changes from the beginning. I am obviously not your typical type 1 so the endo's knowledge is generally not that applicable and it was not like the office was taking the time to research my situation. While it was a very fancy research hospital I don't qualify for any clinical trials and I didn't need the group education classes so other then the fancy waiting room with snacks I did not benefit. I have no desire to speak to a dietician and social worker at each visit, I just want to get my prescriptions refilled and get out. So I did some research and spoke to a few endos and found one that was easier to work with. I am not a big fan of the nurses at the office (I don't think they are actual CDE's) but other then that it was a seamless transition.
     
  20. MomofSweetOne

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    I find it interesting that ours changes at 20. I would think it would be better to switch before or after the college years to avoid an extra switch.

    How did you speak to endos? Did you have to schedule an appointment with each one until you found a good fit?
     

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