Thursday, March 1, 2012


Essentially I send my kid out into the world daily hooked up to a hormone that can kill him. Yep. It is true. I don't think many people "get" that. Managing type 1 diabetes is tenuous. Balancing activity, carbohydrates, and the hormone insulin is the nuts and bolts of the matter. It is difficult at best. The balance of blood sugar numbers is not easily achieved in an active, growing child. Perhaps just as challenging is balancing "safety" while my type 1 child, Joe matures.

It was a first, the above text. Joe sent it to me from my mother-in-law's phone. She was watching him while I ran out to the store.

Times are changing.

This year the calls from school are from him, not from the School Nurse.

Each and every call to my cell phone is initiated with a whispery-question-y, subdued Joe voice "Ah... ... mom?" (who does he think is gonna answer?) "I am 72, double down ... should I do a combo bolus heading into lunch?" "I am 45, I was 42 before that ... I think we should turn down the basal..." "MOM!!!" (frustrated) "you don't understand... it is a Substitute Nurse ... she cannot help me with the Beef Taco carb count!"

Times are changing.

He asks to run across the street to play with friends. <*GASP*> Inside their homes even. He checks his blood sugar first. He lets me know where he is at "number-wise". He takes sugar according to his IOB and Dexter arrows. He consults with me, sure. I usually respond to any questions with "what do you think you should do Joe?" Many times he is spot-on. He is excellent at considering possible activity. He is getting better at recognizing the impact of IOB. Once in awhile, I will mention a combo bolus or a temp basal as a suggested action as well. He knows the implications of a bad lows and will boost, boost, boost to avoid them. He does not seem too concerned about highs and does not report them to me. He thinks he is "good-to-go" with numbers in the 200's, even in the 300's, and will head across the street care-free without a word to me.

As he becomes more independent, I notice that we tend to run him a bit higher; we run him a bit higher for "safety-sake". Times are changing. And. With the changing of times, Joe's last A1C bumped up a bit. And. With the changing of times, there are more people involved in Joe's management ... namely, Joe. As with everything else that requires balancing in diabetes care, the carbs, the activity, the insulin; the transference of care, the evolving independence demands balance and careful attention too. During Joe's last Endocrinology appointment, his doctor cautioned me about Joe's independence level with his diabetes care. A "let the reins out gradually ... and ever so slowly" approach was encouraged. Makes sense. Wish me luck.

A day-in-the-life of raising a child with type 1 diabetes.


sky0138 said...

it's a bittersweet thing to see them take the reins a bit more on managing this thing...totally in the same boat with Emma lately. and i literally spit out my coffee laughing at the "Who the fuck does he think is gonna answer?!" thing....LOL!!!

Amy@Diapeepees said...

I think the letting the reins out gradually starts when you get the's been like that around here, an education over days and days and days...for both of us...I still think it's amazing that I go to bed knowing there's insulin in my boy...that's the hard part about adding a hormone to the body that you know can be fatal if not right. But, ending on a positive note, what's not to love about Joe's d-attitude!

Becky V said...

It sounds like you are letting the reins out gradually. Joe seems to want to participate in his care - I think you'd know you'd gone too far if he is seeming overwhelmed. Which may mean that from time to time you take back a little more control.

Proud of you and Joe.

Anonymous said...

I think your instincts are correct and the endo's advice should be considered, but yours should prevail. Although they don't need to adjust the basals, they will be adjusting temp basals, particularly for low patterns. Their time away from home and out with friends will be for much longer stretches of time and when they are older they will resent checking in as much as we would wish them to. I agree with the way you are asking him what he thinks, because he needs to be acutely in tune with his body always. That training should start as early as possible. They need to be trained to always consider, never forget. Needs to become a part of their personality and second nature. So if you have a young child with D, you can mold their personality in this way, in a way that could not be done if they were diagnosed as teens. Our teen is extremely responsible, cautious and aware, but if diagnosed later in life, I do not believe that would be true. This was a personality trait not inherent, but trained. You are not letting go of the reins; you are training him to think in a certain way. Running them higher; unfortunately, we have to do that on sleepovers, if out all afternoon with friends. If she is going to be more active, we send her out at a certain number and slightly decrease basal. With such an active child as yours, I'm sure this is going to be more difficult. Yes, the A1c did go up, but only slightly. You are doing a great job, and your endo should take notes from you.

Amy said...

I love it that Joe is using proper grammar and spelling in his text messages to you. When I gave Ellie permission to text me, she already knew text lingo and tried to use it when sending me messages. I told her 'no way, Jose. Grammer errors can be dangerous'

I.e. 'Let's eat Grandma' vs. 'Let's eat, Grandma'. Two VERY different meanings!

Yeah, independence both sucks and rocks. But not sucks rocks ;)

Kelly said...

I love the team work that you and Joe have created with eachother and hope that one day me and my little guy will have the same! xoxo

shannon said...

i don't think you need the luck, but i'll wish it anyway.

we also say the same thing to L, "what do YOU think you should do?" most of the time it's exactly what we would do.

we've been having some pre-bedtime lows, so she came up with the idea to have a carb-free dinner to see if maybe her ratio was off. completely on her own. moments like that blow me away, and make me feel much better about the future.

Sarah said...

is it weird that this post made my stomach flip - I am nowhere near ready for that type of independence with Isaac, I am thankful he still has years to go and glad to hear about how awesome Joe is rockin' it, he truly helps me see a snippet of Isaac's future.
Have a fab friday :)

Kristin said...

Sounds like you're both doing the balancing act amazingly well!