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...
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.
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.
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.