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Tight Control, free will, CMG's and Parenting

Discussion in 'Continuous Glucose Sensing' started by MoiraMcC, Jun 24, 2009.

  1. Darryl

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    Sarah,

    I don't know what you mean by that, but I assume it is directed at me.

    If you read my posts, you will see what I told Moira was that I thought she did the right thing, and she should not blame herself for her daughter's DKA experience. I still believe that to be true, and sorry if that offends you, or her.
     
  2. StillMamamia

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    Moira,

    Thank you for your post. It is very insightful and it's always good to have the perspective of someone who's been there/done that.
    It's like telling a kid to look both ways before crossing the road, isn't it? The intention is a caring, well-intended one. But the intention is sometimes doubted or relativized. Just like everything in life, I guess. Good thing is some kids will listen and actually look both ways before crossing.
    Again thanks.
     
  3. Lauren

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    margins of error

    For what it's worth... A1C numbers are not as precise as we like to think. We had two A1Cs in one day once, one was 6 something so I said, do that again, there is no way that is right (she was about 7 and we had just moved, adjusting to high altitude, new school... her numbers had been crazy), after a lot of begging, they redid it. It was 8.0

    Recently at the ADA meeting, a friend walked around and got an A1C done at a bunch of different booths over 2 days. I think she had a .5 difference in them all.

    Agreed, the 2 point difference is not the norm, but I *try* not to beat myself up over the small differences. There are margins of error for those machines. My rule of thumb has been if it is within .5 of the last, it is essentially the same :) (it keeps me mentally happy, so don't argue with me :)

    LLL
     
  4. Lauren

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    Of course all kids go through some type of rebellion. No one said they didn't. What we are saying is that the pressure of tight control and not getting the "winning" numbers, can cause some kids to lie and fool cgms and meters just to keep their parents happy. Or just give up. Making them the teen on the forums with "poor control".

    ... take this for what it's worth... Another opinion here. "poor control" in a teen... hmmmm... Even with CGM, we find lower numbers very hard to achieve at times. Hormones do crazy things. I sit up many a night, answering alarms every hour, with a 300 that won't come down for anything. (this is why I love Navigator, I can sleep with it next to me in the room next door and she never has to wake to the night alarms) I pump/inject what seems like gallons of insulin trying to get them down. It doesn't work. Hours later, something gives, and, wahlah, they go back to normal. Some days Monica's nav will alarm, I ask her why, she will tell me she is high and won't come down. She tells me she can't even say the number. I have to respect that. Probably similar to what I see at night. It really has to be demoralizing to a kid who is trying so hard, trying to gain independence from Mom and Dad, trying to be "successful", a "winner" ...and in their eyes, failing. In my eyes, she is trying. She is reacting to highs and treating. To me, that is success. Please don't label it "poor control"

    Sorry if I sound defensive on this. Teen bgs are hard. Just at a time when kids need independence, they hit the hardest bg time of their life. It is hard for them to not feel like failures and give up. It is a fine line for parents to walk. We are fortunate to have cgm, and I am fortunate that M hasn't burned out. Her overall control is great. I know all of this can change in a heartbeat. And it scares me.

    Lauren
     
  5. ecs1516

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    Yeah, I may have missed it , but how do you trick a CGM???
     
  6. Diana

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    I've always wondered about margin of error with the A1c. I asked about it once at our clinic, and they said 0.1 - but I got the impression they were guessing!

    I don't even shoot for an A1c with my son. I think it is way too hard to shoot for a 3-month number. I have daily parameters that I look at on the CGM to see generally how we are doing. If we have a good run and meet those "goals" for a good stretch of time, then the A1c should be pretty darn good.

    My son was commenting the other day that his numbers had been crazy lately and wondered why things were so wacky. I told him that it was because he has diabetes. He rolled his eyes at me (!!) and said, "That's DUMB. I have diabetes even when I have good numbers."

    I lowered my son's high alarm yesterday because I wanted to get some information at certain times. At the end of the day he said, "What are you THINKING??!!! This is driving me CRAZY!!!" Given the conversation around here lately, I had to laugh. At least I know that for now, he will tell me. I changed the alarm back to where it was.
     
  7. StillMamamia

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    This is the BEST comment I've read in a long time!!!!:) Simple wisdom!!
     
  8. hawkeyegirl

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    I've (obviously) never done it, but I guess if you were having a string of highs, you could "tell" the CGM that you were in the 100s. You'd have to be consistent about it, or you'd get Cal Errors, and I don't know how you'd do it very well with the Navigator and its built-in meter, but that's what occurs to me off the top of my head.
     
  9. jcanolson

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    Thanks for posting!! It's so easy to become obsessive. A good reminder that T1D is more than the numbers!
     
  10. Darryl

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    Lauren,

    Many people seem to mistake what we do (tight control) with "winning" or "losing" with regard to a BG number. In fact, for us, the BG number is of any importance to anyone. If BG is 100, we don't care, and if it is 120, we don't care, and if it is the occaisional 200+ we don't care. Leah just enters the # into her pump, presses a button, and goes back to her business. There is no sense of "winning" when BG is good, and certainly no sense of "losing" or "failing" if BG is high.

    Let's say she tested her BG tonight, and it was 400. No one would care, she'd just press a button on her pump, and go back to her business. Since she'd know it was just some strange anomoly, it would not matter.

    I'm not sure why people jump to this conclusion that tight control is some kind of "pressure". Tight control is simplly looking a number and putting the number into the pump. That's all it is. BG is going to go out of range no matter what you do, so the only difference between a tight range and a loose range is that in the loose range, the corrections are larger and more prone to error than with a tight range.

    I am so confused by people's assumptions...
     
  11. Darryl

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    You'd also have to trick the meter into reading a low # since the BG cal history reflects the BG meter. If both were faked, the ISIG (at least in the MM) would easily disclose that.

    I think it's like anything else with kids. You have to be aware of who their friends are, when they hang out, how they drive, whether they are using drugs or smoking. You have to "trust but verify" until adulthood. With D, there's just one more thing you have to check, and it's logged right there in the meter and CGM. If a child refused to wear their CGM and/or not check their BG, it would be akin to not wearing their seatbelt, in which case similar parental approaches would be needed.
     
  12. MelStan

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    Darryl I think that one of your earlier comments may be the reason that people are reading it this way..?


    Quote:
    We have a rule, BG can never be over 240
     
  13. Darryl

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    OK... I have no idea why that rule would be interpreted as "winning". If there is a rule
    that a child can't drive over 55 and has to release the gas pedal if speed gets over 55,
    does that mean that the child is "winning"? Or would that be a "pressure" that would
    cause rebellion?

    As I explained earlier, the consequence of BG heading towards 200 is that she takes out
    her PDM and programs a 1u bolus, then puts the PDM back in her handbag. :confused:

    Good thing I didn't mention our OTHER rule... when she's low, she eats carbs!
     
  14. Darryl

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    I think we'd better start a new thread to fight this one out, Dave...;)


    Moira, if you are still checking in - I know this thread got off topic and it's probably my fault. Sorry for that. Just want to say that I appreaciate your post, and will keep all of it in mind in the next few years. What we do now might not work then, and if not, we will adjust.
     
  15. Jacob'sDad

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    Actually I think I will delete it Darryl because I don't want to downplay the good points that Moira made.
     
  16. MelStan

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    Too late Dave and Darryl..you already have
     
  17. Darryl

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    Mel,

    In the spirit of quipping which is apparantly not limited to the Parent's forum, I am compelled to point out that the quote you attributed to me above was not from this thread, it was from another thread, and even that thread was quoting something I posted in a different and much older thread, in response to a specific question that had nothing to do with this thread. Perhaps you should also acknowlege your hijacking of this thread rather than trying to pile criticism on me and Dave.
     
  18. Sarah Maddie's Mom

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    Oh Please!

    Darryl, it's something you say all the time. It's part of your mantra. You can't have it both ways - you can't be the authority on something and not expect to have your previous declarative statements be remembered by others.
     
  19. MelStan

    MelStan Member

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    No hijack intended Darryl :( I apologise to anyone I've offended.
    I originally responded to your post :confused: That was all..
     
  20. Jim

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    Are we having fun yet? :eek:
     

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