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Giving your kids control...

Discussion in 'Parents of Children with Type 1' started by MichS, Feb 23, 2009.

  1. MichS

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    I've read many different views over the past few months. Everybody's DMV, I know that. AS much as every child is different. Some of you give a lot of control to your 6 year olds, some of you are extremely involved in your 14yo D child's care. (just picking numbers really - I've read it all). I'm wondering in 600 words or less (haha) how you decide to give up some control? Do you let your child do carb counting? Calculate bolus? Give themselves needles - or in the case of a pump, enter the bolus? Obviously this is a totally loaded question.
    My 6 yo D son has only be dx for 4 months. But since day 1 he's poked himself and now starting to manage the meter on his own. He understands completely what to do when he is low - and though we are there to supervise and advise, we let him "treat" himself. He also understand correction factors and again - under supervision he will give himself his insulin and correct when necessary. It is the same at school. The protocols are crystal clear. But the teachers and I feel he wants control and so we let him, WITH SUPERVISION at all times. (I want that to be clear.) I also realize my son is maybe an anomoly in that he hasn't reached the "I HATE DIABETES" part yet. He likes it when people think he's brave for giving himself needles. The only time he fights it is when he doesn't want to be torn away from something he is doing and enjoying. So we wait until he's ready.
    Our endo would like to see us understand mdi and carb counting better before we pump. He would also like to know that our son can manage his own care. (No nurses in our school). I've read many different viewpoints about age and involvment, and wondering if it depends on maturing, or your own comfort levels, or what?
     
  2. sam1nat2

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    Your son sounds a lot like mine. Sam was 7 at dx and always very responsible. We got on the pump in less than a year and he has always been great with it. I'm confident in his ability to count carbs now too.
    He has also not had the I hate diabetes point, probably since he was not sick with dx and he hasn't had to miss stuff as a result.
     
  3. Caldercup

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    We're still practically "newbies," but we have made sure our son (who turns 13 next week) understands the science, the math, and the importance of his D care. He memorizes carb counts, helps determine what each meal will be in terms of carbs and, together, we calculate the dose with his I:C ratio.

    I've gotten him some books geared towards kids (he especially likes the books by Bo and Spike Loy -- and I like the book by their mom) and he devoured them.

    He wanted an insulin pump right away and requested all the brochures, which -- as soon as they arrived in the mail -- he grabbed and put in his room to read until he could spout facts better than any pump rep. :D He's the one who chose the pump we'll be getting (the Animas Ping.)

    All that said, he does not give himself his shots -- he tests his blood sugars and preps the insulin, but just can't bring himself to administer the shot itself. My husband and I do the shots at home and we have a great school nurse. (DS swears he'll do the site insertion once he's pumping, but.... <<shrug>>) I'm okay with this and haven't pressed him yet. I figure, he'll have to deal with this his whole life or until there's a cure, and I'll save him some of the stress in the meantime if I can.

    I don't know if that helps, but that's our experience so far.
    Eileen
     
  4. heamwdevine

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    My daughter just turned 7 last Monday and was just DX 3 weeks ago. She can already test her own BS but I am with her the whole time. She really wants to try to fill the needle too, so this morning I let her get it out of the bag, take the bottom off (not the needle cover though) and I let her fill it up with the necessary air and put it in the vials. Oh and she also wiped them off with alcohol. I try to let her do as much as she can but not unsupervised. I don't think physically they have the dexterity to do the needles until a little older (I have read) so I don't really feel comfortable with her doing that yet. I guess we could let her practice filling the needles with some water or something but we'll just take it day by day and let her do as much as possible.
     
  5. sammysmom

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    There is nothing wrong with giving your child control as long as they know that YOU are the real boss when it comes to diabetes. There has to be a line that the child knows they can not cross. As long as you keep that line then all should be fine. Not wanting to be torn away from something can be frustrating but at times it is necessary. I would just keep a watchfull eye on that and just remember that YOU are ultimately in charge.

    Your son may be in the honeymoon stage right now and following the instructions are a bit easier. When things (bg) starts to go wonky, and it will, your son will have to understand that changes will have to be made and new schedules drawn up. It may be hard for a 6 yr old to understand that. As long as you are always around to step in though, it should not be a big problem.
     
  6. Reese'sMom

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    My son is 6 also and was just dx in January. He insists on doing his own bg checks...and holds the meter so that only he can see it and then he tells me the number (I also get to look at the meter after he has told me). He does not give himself injections...but he asks which insulin, and how many units before each dose. He also counts carbs with us, and reads labels to see how many carbs. He especially likes doing this with the dessert section of restauarant nutritional guides....like "oh this has 125 carbs, how many units would that one be!!"

    We went straight to MDI at dx and our pump has been ordered. Reese is very excited about the pump and I am sure he will insist on learning all about it too.

    Like you, we supervise everything...and would do everything for him if he would let us! I think it's the age, they enjoy being brave, and independent, and we don't discourage it. It's also "fun" for him because he knows it really is not his responsibility at this point. Although we have almost forgotten to give him his Lantus a couple of times, and he is the one who reminded us :eek:.
     
  7. Tigerlilly's mom

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    My son Tyler was six when he was diagnosed, and has never complained about diabetes, or said "why me?" etc., I think alot of that has to do with that although I do the majority of his care when he is at home, he is totally aware of why and how decisions are made so that he is capable of making decisions and taking care of himself when is away from home.

    Tyler was never able to give himself a shot with a syringe, since he can only he use arms or bum for shots, it was too akward for him, but after he was on the pen for a few months, then he was willing and able to give himself injections with the pen.

    He does have a school nurse and many wonderful parents of his friends were willing to learn how to give him shots so that he wouldn't miss out on any activities due to me not being there and him needing a shot. So the need for him to learn to give injections was never there.

    He does his own carb counting when out and about, and is better at guesstimating than me;), knows how to treat lows, etc. He tested himself from the start and would also know what the numbers meant and what type of action, if any needed to be taken based on that number.

    I think that nobody knows your child better than you, if you feel confident and comfortable in his abilities, then allow him to do it.
     
  8. Sarah Maddie's Mom

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    I think there are two issues.

    1. The mechanics of D management and 2. the cognitive development needed to manage D.

    Lots of younger kids can do the mechanics of D but most can't, especially at the critical times of highs and lows, really do the cognitive stuff. I think it's great for D kids to do a lot of their self management but I think it's up to us parents to provide the bulk of the care. I also think our kids run a great risk of burning out if they shoulder too much, too young.

    Only you know your child and what he can manage. I just suggest keeping an open mind and a watchful eye and stay willing to be flexible and change if the current plan isn't working.
     
  9. MichelleDeGoede

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    My son just turned 6, dx in July. He did his finger poke from the beg. We got the pump in Oct.

    He likes to see his number first, before anyone else. He has recently begun looking at lable and trying to figure out the carbs, but I always tell him the exact amount for a meal or a snack. He like to enter the info. himself and the shows me before pushing the go button. Same @ school, we do not have a school nurse, so the secretaries tell him the carbs and oversee everything he does on his pump. It will be a few years b/f he is on his own. Sorry for the run on and Good luck.
     
  10. Tweety8

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    Michelle, I just read this and am so curious to know how you manage your son's diabetes in school? My daughter's only 3, but we thought we wanted to homeschool for a while but now I really want to see how I can be involved in her school care. I am just really curious who monitors your son and how you feel during the day not being there? This is such a huge issue for me and I am trying to educate myself. I am so scared, but she is only 3, so I have time.

    But your email gave me so much hope because at only 3 years away, my daughter could be doing what your son is doing.
     
  11. LizinTX

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    Jacob was five when dx'd, he did his own finger sticks from the get go, also I did his shots, but within the first two months he was also giving himself his shots, with me drawing up the insulin. We all learned how to carb count together, and since we did this at every meal he caught on rather quickly.

    I really think it was both my comfort level and his maturity, as to how things progressed from there. Like when I noticed he had the carb count faster than I did, and was accurate--then it was like o.k. you can do that.

    We got on the pump after MDI for a year, and since he was already proficient with video games, he mastered the pump waaaay faster than I did, and I couldn't very well hold him back because "I" was too slow.

    Now I feel like I just kind of guide him, and over see that he is doing what needs to be done; and he is managing it. I still do the rate changes, because he isn't showing any interest in that yet.
     
  12. hawkeyegirl

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    Jack is almost 5 and has no interest in taking over any part of his care yet. At the beginning he liked to put the strips in the meter and prime the lancet, but now he doesn't even care about that.

    I'm fine with that. I'm sure he'll want to be more independent when he starts getting invited over to friends' houses and the like.
     
  13. MichS

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    Thank you for all of your replies. I hope everyone did read that he is supervised. And, yes, I do have ultimate control. WE use the injector pens, and he is very comfortable. He is even allowed to dial up the insulin, but we check to make sure he did it right. He does belly and leg injections, but we have to do arm.
    Kristen,
    We live in a very small community - our school has 150 kids kindergarten-grade 9. The teachers are not required by law to give injections (or medications) but the school division is required to provide someone to offer care to my son. The teachers and staff have been extremly helpful to us from the beginning. Starting with checking BG and supervising meals, understanding how to treat a low. Then we phased in the noon time rapid shot to cover lunch. (Previous to this we were using NPH. We were never taught how to use it properly and couldn't get it to work right. I think now, after reading so many posts on here, we could give it another try and make it work, but we've come this far with MDI I think we'll stick with it now)
    When we started the noon shot 9 teachers and staff came to the training session. There are no less than 5 who are a part of his daily care. So we are very lucky. I would attribute this to a few things: 1. small school, 2. I've been very involved in the school and activites since my older ds started 4 years ago, 3. my D son's outgoing and goofy personality, 4. amazing, caring and wonderful staff!
    I am lucky. And we are lucky that D son is so willing to participate in his care. We are honeymooning quite strong, so I think of this as training mode for the real thing ;)
     
  14. Mimi

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    Amanda was dx'd Nov. 29/08, a week after her 7th birthday. About a week after we came home from hospital she started doing bg checks. She was curious about how we prepared the syringes, so I showed her and she would help. Now that we're on pens she prepares the pens (under supervision and we always double check) but she is not willing to inject herself yet. I'm okay with that.

    She does her bg checks at school under supervision of a nurse. At home, there are times she will ask us to do the bg check and we never refuse. I feel she has a lot of responsibility at school for a 7 year old, so at home if she want mom & dad to do it...no problem. Time will come soon enough when she will be 100% responsible.

    We talk about carbs and she asks how many units she's getting but she's not at the point of being able to grasp the math yet. (heck, I'm barely there!! ;))

    As you and other posters have said, I think it really is up to the parents comfort level and the child's desire/ability to manage whatever portion of their care they feel is appropriate.
     
  15. tiffanie1717

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    This is interesting. My DD was dx at 4 years old so we obviously did all of her care. She slowly transitioned to wanting to be the one to poke herself for bg checks. She could do the whole bg check but often wanted us to do the rest, so we did.

    Then Trav was dx just last week. He's 7 and totally into being in charge as much as we allow him to be. He is already doing his own bg checks, with our help only a small bit of the time. He has also measured some of his foods - again with us supervising. He has inquired about giving himself the shot, but hasn't really wanted to do it.

    It was a nice surprise and a relief to see him taking on some of his care. I don't expect him to do much but even the small things he does helps us get it all done. And now Kylie wants to be like her big brother so she's doing bg checks more on her own too. :)
     
  16. Shirley and Jamie V.

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    My daughter, who is nearly 10, does a lot of the management herself. When I send her to school, she knows the carb count for the individual items in her lunch and boluses according to what she eats. It she goes to a party, I will usually ask to see the cake or whatever else and help her estimate her carbs. I do ask that she be given a serving of snacks (ie. chips) in her own bowl to be certain of the servings. She has only lied about a bg once in the two-and-a half years with D.

    She is a unique kid. We always said she was born older. If it were my younger daughter, who knows? Give the freedom in small doses and you'll know when you've crossed the line.
     
  17. juliesmom

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    Wow MichS I am so impressed with how far your son has come in such a short time! Julie, who was/is 6 at dx started to do her own BG checks the day she came home from the hospital-I think she wanted some control over her body. We try to have fun with it and have a guessing game of what is the #, kinda fun:) I encourage her to do as much of her own care as she wishes. She doesnt seem ready for much more. I want her to be knowledgable and responsible for her health, but at the same time I know that she will be managing her diabetes much longer than I will:( A few nights ago she was so sweet and said "thank you for taking care of my diabetes" it broke my heart and at the same time it gave me joy that I can take care of my baby.
    But yesterday was the first time that she ever tested with out being directed to do so, I was so proud-so of course I told her like three times:p
     
  18. MichS

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    Nice story Julie. What an intuitive child to thank you for such a big job!
     
  19. Jake'sMama

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    Jake is 6 and is very interested in his care. We let him choose fingers/toes early on, he does BG checks alot and has given himself the shot after we draw it. We involve him in figuring the carbs but it's still early. He still looks to us before he eats anything.

    DH asks him what his dose should be etc. but I'm usually doing 17 things at once...

    The school counselor wants him to feel like he doesn't have to "worry" about his care, that the adults are capable. But Jake is a kid who likes to feel control of himself so we honestly have gone by his cues. He's a little frustrated that the health aid does things differently than we do at home, but I explained she has different rules to follow. He gets that.

    Sounds like you've got a good thing going...
     
  20. Boo

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    I think this is good advice.

    MichS--congratulations on your very responsible young man! It sounds like you are doing a wonderful job as a parent. My son was diagnosed at age 8, and is now 13. We spent 3 years on shots, the past 2 on a pump. (I would have gone to a pump earlier...he wasn't ready). Andy has generally been very responsible with his diabetes, and I am thankful that he was diagnosed at an age where this was possible. It is so much easier to talk directly with hm about his numbers, his activity, his food intake, etc. rather than having to have an intermediary (such as the school nurse) interpret...though we always keep them in the loop of our mutually made decisions.

    Things look great for the two of you right now. Just be aware that things may change over time, and there may be stages during which you will need to shoulder a bit more of his burden. This is normal and try not to be resentful or think it's a setback if it happens.

    It sounds like he has a great attitude about his diabetes. It's your job to help that continue over the years in whatever way necessary.

    Keep up the good work, and don't let his maturity fool you into thinking that you can let up on the monitoring side of things!
     

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