I'm a Checker, but not a Mice Checker...Yo

A few days ago..

 

Pre-post note:  We are currently besieged by mice.  Traps are set in the basement and the main level of our home. 

The words "GI BUG" scare the BeJeezus outta even the most resilient, calm, cool, and collected of d' rents.  Joe currently has one.  I was up at 3 am ... checking a blood glucose, ketones, and then bolusing insulin.

As Dave woke, I updated him on the night care provided.

Me:  "I checked his BG...high 200s, ketones were OK...I've bolused twice over the last three hours."

Him:  "What about the mice?"

Me:  "What?"

A sick Joe with Oscar.  Miniature Schnauzers are supposed to be mousers! 

Him:  "Did you check the mice?" (referring to our traps)

Me:  "I'm the ketone checker; you're the mice checker."

Checking in on the day-in-the-life, but not on the mice. 😱

Maturi-D'

Over the years, I've tried to teach him the proper way to do things.  A healthy diet was discussed and modeled.  But... he did his own thing, choosing to eat from the "Brown and Beige Club" for years - chips, bread, mac and cheese, chips, crackers.  Now, lean meats and vegetables are consumed regularly.  Blood glucose checks were encouraged multiple times daily.  This has been his routine for the most part, but with some nagging.  Rotating pump sites, took years; like 9 to be exact.

The lumps and bumps are persistent in one arm; his right.  Until this last year, he used the backs of his arms exclusively for pump sites and CGM sites.  He was reluctant to try a new area.  Reluctant should be translated as "refused".  

Several months ago, Joe first found these lumps.  I explained it was most likely due to lack of site rotation - lipohypertrophy. I encouraged rotation, but didn't say much more.  A few weeks later...

 

A little more maturity in the day-in-the-life.

Growin' Up D'

Just like when you questioned their ability to one day pee and poo on the potty, to feed themselves using a utensil, or to tie a shoelace, a parent of a child with t1d questions the ability of their child to perform the tasks involved in managing t1d, independently.  The tasks are one thing.  They are fairly straight forward.  First do "this", then "this", and then "this".  This approach can be used to teach checking a blood glucose, carb counting, and delivering a bolus of insulin.  There is a whole other level to managing t1d; the critical thinking aspect.  If "this", then "this", but if "this", then think of "this" and then try "this", but do "this" if "this" is happening.  This is much more difficult and challenging to impart.

About a week ago...

In an early morning hour, I entered the kitchen.  The blood ketone monitor and a scrumpled strip wrapper was laying on the island.  When Dave woke, I asked him about it.  He didn't use it.  Eventually, Joe woke.  He explained it.  He decided to check ketones before going to bed the night before.  He had been in the 300's all day (due to a cold) and was in the 400's prior to going to bed.  He thought it would be a good idea.

When he was diagnosed at three, the thought of teaching him how to check a blood glucose seemed unattainable.  It happened...when he was four.

The thought of him learning to bolus was overwhelming.  Again, it happened...when he was five.

Carb counting seemed out of the question.  It, too, occurred ... I think it was when he was 7-ish or 8-ish.

Pump site changes... yup...he started those when he was 9.

The previously mentioned tasks are just that.  They are tasks.  They are the foundation of managing t1d.  The next level is where the critical thinking skills come in: managing activity,  managing illness, managing pump settings.  We are at this point now.  He's doing it.  

Independence and it's progression in the day-in-the-life.