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How to get a 9 year old to accept a CGM

Discussion in 'Parents of Children with Type 1' started by Nicole N, Apr 2, 2013.

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  1. Nicole N

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    Hi all,

    My son just turned 9. He has had Type 1 since May. This year has been so life changing and so tramatic for him (and all of us). He really wanted to get a pump because he hated the shots. We use the Medtronic Revel (since October).
    I really want to get a CGM but he HATES the finger sticks and site changes (especially the finger sticks). I see many children his age or younger using a CGM. How can I get him to agree to getting one? Any ideas?

    Thanks!
    Nicole
     
  2. Sarah Maddie's Mom

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    My dd found the mm cgm much more intimidating that she does the G4. Which are you looking to try?

    I think this sort of thing really depends on the kid's temperament and the parenting style. Generally speaking one hears of three common approaches
    1. Go slow - get the cgm, let him warm up to the idea. Practice inserting the sensor on yourself/spouse. Explain the benefits and ease your child into it.
    2. Explain that it's a medical necessity and that while you appreciate that he may not want to try it, that he must try it nonetheless, or
    3. A reward

    We blend them when dealing with our 15 year old. '-)
     
  3. MomofSweetOne

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    Until Enlite is released, I wouldn't try Medtronic's CGM for a reluctant child. My daughter either doesn't feel or barely feels the Dexcom G4 insertion, and it has eliminated the most dreaded D-moment of our weeks.

    I used a bribe to get my child to try an CGM arm site. She was pretty mad at me for three days after agreeing to it, and before the week was up, she liked arm sites and we've used nothing else since. Sometimes it's worth pushing them to try something new.

    Honestly, if your son has many low or highs, he may really like CGM once he experiences the benefits of avoiding the worst highs and lows. You may also be able to avoid some fingersticks, so maybe present it to him as one poke that saves others, not eliminates but lessens the number.
     
  4. denise3099

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    Tell him he has to at least try it for a whole month and that since this is a difficult thing you will give him a reward for being cooperative. After a month you can discuss the pros and cons. he can also use it for 2 weeks at a time to make sure everything is set well. If you get it, he doesn't have to wear it every minute. Although most ppl even kids learn to really like the data. Like if you're in range and want to eat you may not have to test just dose for the food.
     
  5. Nicole N

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    Thank you. I don't know when the Elite will be available. Does anyone? I believe the Metronic has the Guardian CGM. It seems that the general opinion is that the DexCom is better. Can I use another CGM with the Medtronic? If so, we lose the wireless ability though.
     
  6. Sarah Maddie's Mom

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    Yes, you most certainly can use the G4 with a medtronic pump. The CGM will still be wireless, but it will send the signal from the sensor to an independent receiver, not the pump (as would the minimed).

    We initially thought the free standing receiver, and not having the data on the pump screen would be a problem, but we were wrong. My dd found it really annoying to have to dig out her pump every time I wanted to see what the cgm data looked like. The new dex is small, and attractive and really, for us, a far better device. Not to mention the smaller introducer needle of the G4 sensors when compared to the mm. ;)
     
  7. MomofSweetOne

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    The Medtronic pump works as a CGM as well; that's its benefit. You can also buy a separate Guardian unit. We did, but it had to be within 5 feet of her or it wouldn't read her, so it's main benefit was in the car and increasing volume at night (but it also increased the awakenings for Lost Sensor.:mad:) All the records and one device to carry are attached to your child. It's also one of its downfalls. The kids don't always like pat-downs for Mom to see the #. The BIGGEST downfalls of Medtronic are the 1) size of the insertion needle and 2) the quiet volumes (it can't always be heard with blankets over it:mad:). You can buy the MySentry to have louder bedside volume, but the cost of the MySentry is twice a Dexcom system that comes with volume control and a large range.

    I wore the Medtronic for a week after my daughter switched to G4. I could feel the sensor needle almost all the time; it felt like stitches post-surgery and I felt like I was recovering from surgery between that and the tape. My daughter said the G4 is very different, that she could the Medtronic but doesn't feel the G4, even at insertion most of the time. I hadn't realized what she was dealing with with such a good attitude until I wore it. (She told me yesterday, "Mom, you would make such a lame diabetic. I was so ready for you to remove the Medtronic because of how much you whined.":rolleyes:)
     
  8. nebby3

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    My dd pumped for 5 years and then didn't want to anymore. She has also briefly worn a CGM for a research study. She wants neither. I think it is her decision so I ask occasionally but I don't push it. Her A1Cs are good for her she (low 7s). I might be more inclined to push if our control was worse.
     
  9. Nicole N

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    Thanks everyone for your help.
     
  10. Mish

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    This was our experience as well.

    We first started CGM'ing with MM because that was really the only way I was going to get my very reluctant son to get a CGM. He did not want another device and I was ok with that, though the decision to CGM was mine, not his. We also had an agreement on how often it would be worn, since the accuracy was never great for us, I had no beef about working out a schedule of a few weeks on/ a few weeks off.

    With the G4 we've not only had no issue with the 2nd device, he feels it's much less intrusive since I'm not asking for it all the time. At school he either puts it in his backpack or wears it on his belt - that was his choice to do.

    Insertion of the MM vs G4 is night and day. Half the time he doesn't even feel the G4 go in and will insist that it didn't insert at all. ;) MM was a struggle every time and emla was really needed (though most of the time he just opted out of the emla because he hated waiting for it.)
     
  11. StacyMM

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    Mine are 11 and 9 and we've never pushed the CGM issue before. We tried the Medtronic one when DD was on their pump and it was horrible. She was absolutely positively not wearing it. So she didn't. Everything in it's own time...and it wasn't the time for that.

    Years later, I have her pumping again (but only because DS was switching to a pump and she didn't want him to have anything cooler than she had! She is quite content on MDI.) and I've started the paperwork for the Dexcom for both kids.

    For DS, it was an easy sell. Less checking, fewer visits to the office, less intrusion into his school day, reduced hovering at sports practice and games. He has no issue with it and is actually looking forward to it. He's old enough to see the benefits and it makes it worth it.

    DD, who is 9, is not. She sees the extra site, the extra tape, the extra insertion, the extra gear...and she was not interested. The benefits are there for US, but not for HER, at least to her 9 year old mind. We're actually pushing the issue now, though, because of social issues. She and her friends want to do parties and sleepovers and their summer daycare is doing lots of field trips. I've told her that the extra freedom is a big deal, but that the CGM was the price. With that, the CGM suddenly seemed worth it. She wants to do those things and recognizes that the CGM will get her there and make it easier for other people to keep her safe.

    So for us, freedom was the ticket for both. Not sure if it would work with you, or if you have a different situation and these aren't even issues for you because he already has more freedom, but I wanted to put it out there.
     
  12. Nicole N

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    Oh no, my son does not have any freedom at all. :(
    Since diagnosis, he's only been to a friend's one time for 1 hour and 15 minutes, then I got the call that he was low.
    Once on the Dexcom G4, how will it change the school day? Does it mean less BG checks at the clinic? Right now my son goes down once in am, lunch and once in pm typically - but often it is more often if it's gym day, he feels low, etc.
    Thanks!
     
  13. Sarah Maddie's Mom

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    It really depends on how willing he is to interact with it ( or a supporting adult is willing). If it's having an accurate run then he should be able to use the graph and the arrows up and down to feel more confident about things, and you may decide to reduce the scheduled checks, BUT if it's silenced and in his backpack it will just be gathering data for you to look at later and not really doing much to change his daily routine.
     
  14. hawkeyegirl

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    My 9 year old wears a CGM, and I would say that it doesn't really change his routine much at school. But it does alert us to problems faster so that you don't have a surprise 350 right before a birthday treat or a 40 out of nowhere. Honestly, most 9 year olds are not going to see the benefit from a CGM. The benefits are HUGE, but it will be hard to impress a 9 year old with them. My 9 year old does have more freedom because of his CGM, which is a good thing.
     
  15. kim5798

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    I feel there is nothing wrong with a bribe for something like this. When we needed to have our daughter try different pump sites that she was unwilling to try, we offered $5. My son, who is 2 years older, and non-d said "no fair". We said, no problem. You put a site there to try it too. You also will get the $5. I have photos of the two of them with tummy sites. Crazy childhood memories! Best $10 we ever spent. She realized it was no big deal & we gained real estate for pump application.
     
  16. Nicole N

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    Thanks to everyone for responding to me. :)
     
  17. KatieSue

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    Can your Endo's office arrange for a trial of one? So he could actually see what it would be like? Other thought is if you know someone who's using one, if they could talk to him about how it feels/works. Maybe he'd be more inclined?

    And hey I'm always up for bribery if it means getting them to do something and feeling like they're getting something out of it.
     
  18. skimom

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    I am curious - why is it so important to get the CGM? Is there a problem with numbers and determining rates for the pump? Does he hate the testing several times a day? I don't mean to come across harsh here, so forgive me if I don't word this right but I am basing this next part on a comment my son has made to me several times when I have tried to get him to change his diabetes management ( note he is 22 now)- it is your son's diabetes, not yours therefore it is important that he participates in the management. At this point in time, if he does not want a CGM, I would personally not push the issue. He may come around later - or never..LOTS of kids with diabetes never use a CGM for a variety of reasons and manage really well. Maybe you can do a trial run for a few days and see how that goes? ( our clinic has a cgm that they lend out for a week for families to test drive) However, if he doesn't want a CGM I think you have to respect that for now but bring up the subject periodically as his thoughts may change , especially as he learns more about this condition. He has only had diabetes for a relatively short period of time and has already had to learn so much - please take your time on this as unless he buys in ( and honestly buys in - not because of being "bribed" or agreeing under pressure ) he will have more success.
     
  19. Megnyc

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    I basically agree with you but just wanted to offer another perspective...

    At least given my experience I think a lot can be said for starting a cgm earlier rather then trying to introduce it during the teen years when things start getting crazy blood sugar wise. I started pumping at age 9 and my pump feels like a part of my body, it is just there and I don't notice it. However, I started the cgm at the age of 13 (a somewhat awkward age to begin with) and the sensor, while I am grateful to have it, still feels like an awkward attachment rather then a part of my body. I would guess had I started them both around age 9 both sensor and pump would feel like a part of me.
     
  20. Beach bum

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    I wanted the CGM more than my daughter, and she had no desire for it...at all. So, we didn't push it. At the time, the technology was OK, I had heard grumblings about the reliability and accuracy. Then she went to camp and her good friend had the new DexG4, she went to a ski event for D kids and a bunch had it there and she saw how it worked and really liked the idea. I saw it and was really excited about what I heard and knew I really wanted one now, especially since she was starting puberty. We were offered a spot on a study because someone jumped ship, we had to decide asap, and she was all for it.
    We have had our ups and downs. She doesn't necessarily want to wear it all the time, she gets anxious for the sensor changes (though she says they don't hurt) because we are using spots we haven't used before. But, she likes the fact that she can eliminate some of the finger sticks certain times of the day, she likes to know how her body is reacting to exercise in dance class, skiing and soon track.
    Bribery has worked. We give her $2 for trying new spots and she gets paid for participating in the study...that really motivated her:D I think you need to let your son feel he has a say in this, get him involved in the research, listen to his feelings, fears etc. I looked at it this way, we had done OK for 7 years prior, we'd still be OK if she was adamant she didn't want it. It would be just as much work as there always had been.
     

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