In light of my daughter's Bat Mitzvah this past weekend (!), I've been thinking a lot about setting our children "afloat" — out on their own, responsible for their own actions and the consequences thereof. It's scary, and mine don't even have diabetes. Today my good friend Allison Blass joins us again to discuss some of these issues, and share some of the wisdom she's gained from personal experience.
A Guest Post by Allison Blass
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Kids sure are growing up fast these days, aren't they? Nowadays, they have cell phones, hang out at the mall, and with after school activities like sports, band and volunteering, teens and tweens are spending less and less time with their parents.
When I was diagnosed with type 1 diabetes at age 8, the most important things to me was that I could still attend Girl Scouts and hang out with my two best friends. Diabetes was, to put it mildly, just a couple of routine items that I had to make sure I did, which was test my blood sugar and take my injections.
But as I got older, and entered middle school and high school, there was more and more responsibility placed on my shoulders because I was spending more and more time away from my parents. These days, I get a lot of questions from parents that I meet about how they should handle things like away games for sports or when their kids want to eat pizza with their friends.
Here are a few pieces of advice that I give:
Kids will be kids, but more importantly, they want to be like the other kids without diabetes. They want to be like their friends, and it's important for their developmental growth not to isolate them from their peers. These days, I have found a lot of socialization revolves around food, whether at the food court or a friend's house. I have found it more realistic to teach your child about carbohydrate counting and how to read nutrition labels. If McDonald's is their go-to restaurant, help them identify things on the menu they like to eat, and figure out the carbohydrate count together. This way, they are prepared to take the right amount of insulin. Or if Oreo cookies are the after school snack of choice, teach them how much each cookie is so they can calculate based on how many cookies they actually ate. Requiring your child to eat differently than his friends may encourage your child to eventually lie about what he is really doing, because he doesn't want to be punished.
Understand the frustration your child faces and encourage problem solving. Most of the time when I hear of kids rebelling against diabetes, there is usually a reason behind it. They don't like testing in front of their friends or they don't want anyone to know they have diabetes or they feel isolated and alone. Sometimes they have actually been given to much responsibility and don't have the emotional strength to handle it like adults do. These are emotions we have all felt at one time or another, and the awkwardness of being a teenager can heighten these emotions. It's important to understand the emotional challenges that your child may already be facing at a young age, and working on these together, by providing solutions such as allowing your child to carry his meter with him so he can find a secluded place to test (like the bathroom) or brainstorming who their "safety buddy" could be without needing to tell every friend. Or simply being more understanding when your child "forgets to test" at a sleepover because she didn't want to cause a scene. Sometimes this may require getting a third-party involved, like a family therapist or psychologist (you could also try an art therapist — I know a really great one!)
Start diabetes responsibility early, but slowly. But when is a good time to give responsibility to a child? That, my friends, is the million dollar question. Some children are remarkably mature at an early age, while others progress a little slower. But overall, it's important to stay close to your child's diabetes. I often liken diabetes to driving, where you need parental supervision even when in the driver's seat already. Allowing your child to test his blood sugar and figure out his insulin intake throughout the day could be an excellent way to see how he does — but then you need to follow up at night to see what happened. Some kids might be ready for this at 11, but others may not show an interest until they are 14 or 15. Or you could allow them independence at certain times, like at lunch or right after school, but follow up either that day or a couple days later. I encourage kids to get their "diabetes permit" as early as possible, but not so early that their health is put at risk. It is all too easy for kids to forget, and then lie in order to avoid scolding. Once the habit of lying begins, it is very difficult to stop.
When I was around 14 years old, my parents started quizzing me at dinnertime. I would check my blood sugar, my dad would show me what we were eating, and I would tell them what I thought I should do. Sometimes I was right, and other times they would work with me to figure it out, especially if it was something tricky like pizza or Chinese food. These days it is a little easier with the advent of the bolus wizard calculator, but it's still important to learn how to critically analyze diabetes. This isn't in order to make you feel bad about what you did, but to understand your body. It's why logging and reviewing graphs are so important. I was never felt alone with my diabetes, and I had two parents who gave me the freedom to try on my own, but the forethought to realize I was probably going to mess up a few times before I got it right (though to be honest, I still mess up sometimes, and I'm almost 25!).
The last piece of advice I have is for families to get involved with the diabetes community as early and as often as possible. One of the reasons why I think I'm as "well-adjusted" as a person can be with diabetes is because I have grown up with a lot of perspective about it. From going to diabetes camp my very first summer after diagnosis (I had only had diabetes for six months), to participating in diabetes walks, to volunteering at the Oregon JDRF Chapter office, to diabetes chats and blogging and message boards, every little bit has helped focus my energy on my health and how actively participating in your health will make your life better. It has also, in a way, made diabetes more fun.
Obviously you don't need to do everything, but the friendships I have made have lasted a lifetime and I am continuously encouraged by the accomplishments of my friends. I never feel alone, even when I am the only person in the room being asked "Are you sure you can eat that?"
We hear you, Allison, many thanks!