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we are losing him

Discussion in 'Parents of Teens' started by gardnergirl, Aug 20, 2010.

  1. gardnergirl

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    Last night my 14 yr old burst out with " why do you think I go to my friends house all day.... to get away from all the nagging!!"
    this summer has been really hard for all of us as we are seeing some members grow up and fly the coop- our 14 yr old is the youngest. We have lost alot of control with his D because he refuses to cooperate. He takes his insulin and checks his bs but not when gone with friends- he has breakfast but not until around 1030 and then no lunch because he is not hungry. Even one question from me such as " do you have all your supplies?" freaks him out. He does not understand the reasoning behind testing frequently when being active- he just drinks gatorade as he was told by the dietician to have 15gms /30 min of activity and he thinks that is enough. He doesn't log any numbers but will agree to sit down reluctantly with us to fill in his log every few days. His numbers are frequently high. One of the biggest sources of his anger is that he feels he has one set of rules and his brother has another. this is true because at this moment we don't trust that he is being responsible. We cannot get it through to him that if he watched his diabetes carefully he would be allowed more freedom. He refuses to tell people such as coaches that he is diabetic hence I do and then I get an earful about how it is ALWAYS ABOUT DIABETES. His anger is simmering right below the surface and we know he needs to see the social worker. I do not have alot of confidence in the D clinic as they have not been helpful teaching him D basics from the start ( 2 years ago)- looking back we realize he has never actually been told how to manage things on a day to day basis in language he can understand. He is not a child you can " ground" - he works best with being completely honest and setting guidelines. We just cannot get him to sit long enough to listen- he just slumps in a chair and closes down. Sometimes when he is mad enough he is struggling not to cry- my heart aches for him - I wish he would cry and scream and let it all out. I am so scared for him.
     
  2. kiwiliz

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    I really feel for you. You are trying your best - and he doesn't understand. One thing I am sure of is that you won't be losing him. When you love your children they eventually swing back to you. He is mad at having diabetes, fair enough, and he is taking it out on you. We recently had a visiting endo who was absolutely fantastic with out dd, 13. We have not talked in depth about "things that can go wrong later" and she alluded to this in her conversation with him. He was very sensitive - but laid one thing out for her. He said that one thing that can go wrong is with people who have had really high blood sugar levels for a long time - they have problems like people with alzheimers. Their brains, on autopsy, look the same. He said if you want to stay smart - you have to look after you b/s levels. That really got through. You will know what you sons passions are - if it is sport, academic.... get someone outside - like an endo - to have a frank talk about WHY they have to comply in order to succeed in those areas.

    I must also add that dieticians have been the bane of my life. Usually they are people who OBVIOUSLY don't take their own advice. They are often really really unhealthy looking and often state stupid things like "do you like milo - you can have milo (a very sweet chocolatey milk drink) that makes dd go sky high. We never had milo before D but because this stupid woman insisted that it was an acceptable treat we bought some. They do this with all sorts of things - and it is the bm reading that we should be taking note of. As one of our lovely posters here says "always always trust your gut" (and you bs meter). (Rant over..)
     
    Last edited: Aug 20, 2010
  3. Mrs. Russman

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    well, if it helps any to know you are not the only one....
    Ben's a1c is regularly over 9!
    One thing our Endo recommended was a diabetes care contract. Spelling out exactly what Ben would do, and exactly what his dad and I would do. What would happen if he didn't do what he was supposed to and what reward he would get if he did. It works if I am diligent in enforcing consequences.
    Hang in there1
     
  4. TheFormerLantusFiend

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    Just my advise

    Diabetic adults hate diabetes police; diabetic teens do too. It sounds like he's feeling pretty judged about his blood sugars and that's a bad recipe.

    Unless he is in short term danger (Has he passed out from a low? By high do you mean over 500? Does he go more than 24 hours without testing his blood sugar? Does he skip more than one shot in a row?), I suggest plain old backing off. Tell him that you trust him. Tell him you are not going to do anything he doesn't ask for diabeteswise for a month, because you are listening to his need for freedom, except for providing carb counts. Tell him you are available for help, and that you would love to look at his numbers sometime. Let him know that you do not expect that it will be perfect in that month- this is not pass/fail.

    After a month, ask him what he learned and if he changed anything and how he feels and take it from there.
     
  5. blessed

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    I really understand.....

    I hear the hurt in your post...I am so sorry. 1 thing I have always done, even when they are mad and really angry is that I tell them I love them, I txt them that I love them "to the moon and back" no matter what, and I leave notes on their bed telling them I love them. If they feel loved they will come back. Sometimes no matter what we do as parents, they still smack us in the face with anger and hate...but usually it is short lived. 14 is a hard age. They aren't little and they aren't big....I would ask as little as possible about his D. As hard as it maybe, you are probably better off. Make sure you have supplies available to him and beyond that it kinda needs to be his disease.(I hate referring to it as that...but I guess it is) I am really sorry it is so tough right now....Prayer is all that saved my heart sometimes.
     
  6. PatriciaMidwest

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    I'm sorry you are dealing with this. It is so hard. I think you and your DH need to establish some ground rules to keep your son safe. If he doesn't want to take insulin when he's with friends, then he needs to stay home, etc. Just like you wouldn't let him smoke cigarettes or drive in a car without a seatbelt, his D habits are not safe.

    I would pick and choose my battles, though. If it's summer and he wants to sleep in until 10:30 and not eat lunch, I'd probably let that go.
     
  7. nanhsot

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    Teenagers are definitely a slippery slope, and it's hard, so hard not to be overprotective. What I tell my teen is that as long as he manages things well, then he will be trusted to do so. When his numbers are off, then we'll have to step in. So my challenge to my son is to do it right on his own, and trust will be given.

    The other day a relative with a T1 daughter heard me teasing my son because his BG was 200 and he had shoved cake in his mouth an hour earlier. I truly was just messing with him and I heard her mumble under her breath "he's going to resent you". Wow, that was hurtful, particularly since her daughter does resent her and her A1C is in the double digits all the time and she admits she never tests, ever. So, yeepers, who am I to give advice. I went off on my own and just sobbed a while.

    Will my kid resent me? I really don't know.

    What I do know is that my job as a parent is to usher him into adulthood with all the tools and skills to be healthy and productive. Happiness is for him to find, but hopefully I'm able to show him the path to that, and able to model it. Some days I fail, other days I hope I inspire.

    This is pretty rambly but it hits home to me right now. Your son is teetering on the edge of a crash, IMO, by not taking insulin, by not testing. Someone already pointed out nicely that there are MANY rules we set down for our children that they dislike...wearing a seatbelt, not smoking, not doing drugs, no drinking and driving, no texting while driving, etc, etc. Teens are prime to push the envelope and this is no different. If you found out that your kid was doing drugs you'd limit his freedom, you'd look into his friends, you'd do something to keep him safe. This is no different. He is being just as dangerous to himself right now as if he were doing drugs.

    My stance is that trust is earned, not assumed. My son (knock wood) has my trust. Until that is known to be misplaced, I will allow him the freedom he desires. There have been a few times recently that he did break that trust and there were consequences, kids we avoid, situations we monitor. Trust is being re-earned and freedom will return. And the cycle repeats.

    Our kids are not meant to be our friends, I think many parents make the mistake of worrying about their kids liking them. To me, my kids liking me is a side benefit but not a goal or a priority. I do think my kids like me and I'm grateful for that. But more important to me is that they enter adulthood as responsible, healthy, productive, spiritual beings. The rest is icing.

    Our son went through a very difficult phase this summer, where he was shutting down and shutting us out. We ended up sending him to a diabetes camp and it was a lifesaver. We took away his violent video game at the same time. He started sports again. The change in him has been so heartening, he is back to being the positive, optimistic kid we've always known. This is a tough tough sentence for any kid. It really is NOT fair, and yeah, his brother really does have it easier. It stinks, any way you look at it.

    I honestly think you should consider private counseling for your son. I've looked into counseling and am ready to start that process if I see the shutting out creep back into our lives.

    I really do understand where you are, and feel for you. Feel free to PM me if you need to talk more.
     
  8. gardnergirl

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    thankyou for all the suggestions, i truly appreciate them - we are going on holidays tomorrow and I hope some down time will help us reconnect in a fun,relaxing way.
     
  9. quiltinmom

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    I may not be much help, since my D kid is only 8...but there are a few things that I think help him not resent all the D care. 1) he got really sick right before DX. He's not excited to relive that, which he knows will happen if he doesn't take care of it. 2) He knows that his body parts will quit working. Did you see the Oprah show about D? It was mostly about type 2, but at the beginning they had a lady with type 1 who had one leg partially amputated, some fingers, and toes on the other foot. She was in pretty bad shape. I let him watch it, and talked with him about it, so he would understand. I'm sure your DS has been told everything that will happen if he doesn't take care of his D, but sometimes seeing an actual person's experiences makes it more real. Plus it's coming from someone other than mom and dad, someone who has lived D life.

    I think what Jonah (lantusfiend) suggested is a good idea. I know my kids are young, but I've realized they do what I want them to do when I can trick them into thinking it was their idea. When I push them harder, they push back just as hard. (I assume it's the same for teenagers.) I can't imagine how hard it would be to step back and make yourself not say anything, but it's his body, and you'll eventually have to give him control. You may find that he does much better once you give him some space. (ironic, isn't it?)

    The contract idea might work. Let him help set the terms. Give him a certain amt of time, and if he does everything he's supposed to, give him another span of time. I wouldn't tie it to his BG's, but instead to his testing/dosing correctly. So often we have unexplained highs, and there's no reason to punish him for it, but there should be consequences for not doing something about it. I might even attach some kind of reward, if I thought the backing off wasn't enough.

    And give him all sorts of sincere praise when he does take care of it. A little praise will go a LONG way. We give out high fives for testing 7 times a day (regardless of the numbers) or for being in the 100's all day, etc.

    I try not to get uppity about high BG's. If he's high, I just say, 'okay, we'll give you a little more insulin.' I don't want to downplay the importance of good numbers (but don't they already know?) but I also don't want him to feel punished for highs he didn't purposely cause. It's a fine line.


    Good luck! If nothing else, I want you to know I really feel for you. It breaks my heart just reading your post. I hope you find a solution quickly.
     
  10. joan

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    I understand your pain and frustration dealing with your son. While I agree with the others comments you may the help of a counselor if this doesn't get better. He may need someone to talk to about how he feels. Just a thought. As another parent said d camp can be a great way for your son not to feel alone. Good Luck. I always think its better when they are in school and on a schedule. The summer is very stressful for me with my son out constantly with a his friends.
     
  11. wilf

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    You don't mention what sort of insulin regimen he is on, or if pumping. It could be that things could be changed in order to achieve a minimum of insulin coverage and testing to keep him safe. This would require an honest and open discussion, in which you ask him to buy in and sign on in return for trying to find a way of minimizing the intrusion of D into his day.

    An example of what could be negotiated might be (if he's on MDI) you could be testing blood sugars and then giving him two shots first thing in the morning (Lantus, and a big mixed injection of NPH and Apidra and/or Novolog) and then turn him loose for the day.

    The Lantus would cover all basal needs, the Apidra/Novolog shot would cover breakfast, the NPH would cover lunch and snacks of a set amount of carbs, and as long as he can feel his lows he wouldn't even need to test through the day. At supper time a second test and bolus, and then another test at bedtime to make sure he's good for the night.

    An advantage is that all of the critical tests and injections are at breakfast and supper, while you're around and can log them, while the rest of the day he can run with his friends.

    I would not normally advocate such a minimalist regimen (which certainly won't offer perfect control), but it's better than the current alternative.
     
  12. 2type1s

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    Just wanted to say "been there, done that" with my teenager. She almost 16 now, and it's been a huge difference. 13 was the worst, 14 still pretty bad, but slowly I've been able to turn over the apron strings. There really is no "book" knowledge that Morgan doesn't know. She just didn't have the emotional maturity to deal with it. We had the teary battles, the contracts, the yelling, the promising, the talks with the doctor, etc. Really, what it took was time and maturity. I've done from micro-managing her D, to really being the backseat (silent, mostly) driver. And, in the year I've back off...her A1c had dropped from low 9'2 to 7.5. From her Dexcom, it will be even lower next time we go. I really think (especially for teens who have been D all their lives like Morgan) they just get sick of it. They totally go through the autonomy process of becoming their own person. That means rebellion is part of it. The past month has been so different for me...I've had to be Morgan's advocate on the other side...getting the school to BACK OFF and let Morgan handle her own care at school. She knows what she's doing.
    So...my advice is only to tell you what I did
    1. we had rules: when she was out with friends, she had to text me her numbers. No negotiating. If she forgot, I went and picked her up. That happened once in a year...she never forgot again.
    2. I looked at her meter twice a week. That's it. No logging, just looking.
    3. I looked at her pump twice a week to look for missed boluses.
    4. We talked about the numbers and the bolusing then and that's it.
    5. I only asked about checking sugar at meals we ate together (like if we sat down to dinner together I'd ask Zoe and Morgan what their numbers were)
    This went on for about a year. Now I really don't do anything except night checks. I will do this for her until she goes to college. Mainly because she has the rest of her life to deal with this. And I'm getting up anyway to check her littly sister!
     
  13. PatriciaMidwest

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    This is some really great insight. I can totally relate.
     
  14. gardnergirl

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    Wilf, I was wondering how we would go about figuring out how much nph to give as you suggested to cover him over the day. he takes 38 u of lantus at bedtime and uses humalog to cover meals, snacks etc. he uses a 1:8 ratio for carbs. at the moment- I am unsure of the total amt of humalog he is using as he does this himself and writing it down is not happening at the moment. He was taking this while at school but not over the summer - in looking back through his logs he was taking 30-32 u nph back around Feb.. to cover him at school. He is about 5"6 1/2 and about 145 lbs if this helps- very active
    thanks
     
  15. wilf

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    He is actually getting a whole lot of Lantus for a guy who's very active..

    What are his waking numbers like? Do you ever test him at night? Where does he take the Lantus?

    Anyhow, in answer to your question we find that about half of every unit of NPH acts like an extended bolus and can be used to cover lunch and a bit of snacking and the other half has a basal function.

    So say for example he typically has 40 carbs for lunch and another 40 in snacks during the afternoon - if the NPH works for him the way it does for DD then I'd be giving 20 units NPH (10 of the NPH covering 80 carbs at the 1:8 ratio, and the other 10 NPH providing increased basal coverage)..

    To accommodate the extra basal from the NPH I'd be reducing the Lantus to 25 or so for starters.

    So this is kind of what a regimen using NPH could look like:

    Breakfast (I'm assuming 40 carbs) - 5 Novolog/Humalog mixed with 20 NPH

    Lunch (40 carbs) and snacks (another 40 carbs) - covered by the NPH given at breakfast

    Supper (60 carbs) - 7.5 Novolog/HUmalog

    Evening - 25 Lantus

    I had DD on something like this at her camps this summer, though all the dosages were much smaller and she got her Lantus in the morning. So she would get her breakfast shots and then be good till supper.. :cwds:
     
  16. gardnergirl

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    thanks for the info- he eats a lot of food so I will adjust accordingly. Is there an advantage to taking lantus in the am or pm? also, someone suggested to inject in the derriere rather than the abdomen ( where he does)- we were advised to use the abd. but is there a difference? Interesting that we just had an appt with the endo and they never suggested that the lantus dosage was high. He does have lows sometimes in the night ( maybe 2-3 times a week) but I was thinking it was due to too much humalog to cover a snack esp. if he has been playing football or basketball in the evening. I have suggested to him to use a higher ratio in the evening ie. 1:10
    I was even wondering if he should divide up his lantus into 2 doses.
    He is usually pretty good in the am with numbers except if he has overcorrected a low because he is starving.
     
  17. wilf

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    Best spot for Lantus is derriere, next best is thigh. If it were me I'd be giving the Lantus in the morning. With him so active, his exercise will be pulling him down anyways in the evenings and I wouldn't want a Lantus peak complicating things further at night.

    Splitting the Lantus gives smoother coverage, but it's an extra shot and if he's feel overwhelmed by the intrusion of D into his life I'd leave that for now.
     
  18. KHM

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    WORD. I often remind myself, my daughters, my husband AND my parents that my job is to deliver these children into adulthood with the skills and health they require to lead a productive, healthy happy life. That's the job I've taken on and everything else comes secondarily or not at all.

    Of course, I don't have a teen-aged diabetic, I don't even have a teen. I do think that ideas such as contracts or trying a month of hands off followed by an assessment of how things done can be a relief and enlightening for all of you. We had a rough summer, many periods of not being able to get Lindsay's blood glucose in range and another period of about a week when she was eating treats on the sly. I was sure our A1c was going to be rotten. But it wasn't: it was 7.0. That really put things in perspective for me. I don't like it when she chooses to have a snack without checking in with me regarding her bg, but we have a general household rule against any snacking without permission except for a few all-access items. So eating on the sly is something we take on with everyone and that's how we deal with it: as an infraction of our family rules, not a diabetes cheat.

    I surely wish you well. I'm sure you and your son will work toward each other's perspectives and maybe things will be even better than you anticipate. Best wishes!
     
  19. celiac_mom

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    What stands out to me is the phrase "always about diabetes". It is important to remember that your child has diabetes, not the diabetes has your child.
    Remember that being a normal teen is very hard, and a teen with "issues" is even harder. He just wants to fit in with his peers.
    Forget about the Diabetes for a minute when you talk to him about his day, or when you talk to teachers and coaches. Yes, they need to know he is Diabetic... but your son's rant may be frustration that the diabetes is getting more attention than he is, or the manner or location in which it is brought up.
    Talk to him when he's not upset. Listen to what he's saying, not just the attitude he says it with. You may be able to get to the bottom of things without taking him to a social worker or counselor.
    I got my daughter a cell phone enabled with texting, as a condition that she would text me her BG levels, carbs, and bolus amount or ask me any questions without her friends knowing. We also set up a bribe... when she could prove that she could test 4 times a day and calculate and inject boluses, and keep logs on her own, we invested in an insulin pump.
    I hope that things get better soon!
     
  20. ecs1516

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    My son is 13 and says things just like that. He knows he should check for lows etc. but still considers it naging when I ask him what his number is or does he have his kit packed. He says It's fine mine, I have done it. I need to back off a little but I also need to make sure he doesn't forget things. Because he does. We got him a cell phone with texting and that does help.

    My son wants to be so independent at this age. He even said let him get up at night to check himself instead of me. I said I really don't want you tired for school. He has been at school retreat the last three days and his dad is also there working with other parents in the kitchen. He has really had good numbers on this trip but on the low side like 100 or 80. Last night about 10pm he was 70. My son ate some skittles. My husband didn't know how many. So , he told my son he would call the cell phone later so my son could check. They are staying in building about 5 minutes apart. He called the cell phone twice and my son never answered. So he had to go over there. My son was fast asleep and never heard it ring. My husband just checked him. It is very hard to know how much to let go and be safe.
    My son also went to Diabetes camp this summer and that helped his indepence more I guess.
     

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