Saturday, November 16, 2013

Middle School

Middle School.  So many new changes.  If you look at the surface, things have gone great.  Jess rocked straight A's.  She's healthy.  I think she is happy and well adjusted.

But, there are things I am so tired of.  The 504 ordeal.  I love it.  I hate it.  Getting the teachers to understand it is a fiasco in itself.  Jess is so sick of having to make up tests as she can't take them at the time as her blood sugar is not in goal.  How can a post-prandial blood sugar be in goal????  We are just not that good.  I know intellectually all the tricks.  But pre-bolusing at school for lunch isn't something done regularly.  And even with pre-bolusing and doing a low carb breakfast, she often spikes.  We've adjusted I:C ratios, we've adjusted basals. Sometimes it works.  And, often it doesn't.  And, that leads to the make up test ordeal.  Teachers staying after school is not an option we've been given.  So, Jess has flex time (study hall)  2-3 times a week in which she is to try to make up the exams (if all the stars are aligned and her blood sugar is in goal.)  That has led to exams being made up 2 weeks after the unit has been completed.  They have moved on to new material.  Is this really protecting her rights???  How many of us remember material 2 weeks after we learn it?  And, she hates it.  I honestly don't know that she doesn't hate it more than she would hate just not doing well.  There are just so many more tests and teachers in middle school.  It is so different than the amazingly supportive environment she was enveloped in during elementary school.  She might have up to 4 exams in one week or more....that is a lot to try to make up during limited time if her blood sugar is out of range.  And, I know high school is sure to be worse.  But, she is succeeding.  She has above a  97 average.  So, I guess on paper this 504 is working.  But, so many days she gets in the car and says "I hate diabetes.  I couldn't take my math test today.  Now I have to make that up too.  I have more homework as I can't get it done in flex like the other kids."  I hate that she has to deal with this.

And, the diabetes secret is new.  On this she seems so conflicted.  She doesn't want anyone to know.  She changes in the nurse's office for gym so people don't see her dexcom and pump.  But, yet, she was this years JDRF Walk Ambassador.  She texted all her friends to tell them to wear blue on World Diabetes Day, but yet she doesn't tell them the reason she is asking them to wear blue is that it is World Diabetes Day.  She tells me one day that her computer teacher was talking about how her son has Type 1.  Jess tells me she raised her hand to tell the computer teacher that he was not alone, and she had it too.  I question "I thought you didn't want anyone to know."  "I don't," she replies.  "But supporting her seemed more important than keeping it a secret."  I am so proud of her.  I know she is just exploring who she will be as a young woman with diabetes.  And, that is ok.  Up until now we have made the decision for her that it will not be a secret.  She will be an advocate.  She will be an inspiration.  She will be a source of support to others.  But, she is not a little girl anymore.  And, she must now decide who she will actually be.

There is more tension surrounding the diabetes.  Not a lot.  But the undercurrents are there.  Some days she may only check a blood sugar twice a day, rather than the 10 or more checks she has done in the past.  She has had free access to her halloween candy and has eaten many a piece although she was already high.  But, the majority of the time she makes good choices.  I will not micro-manage or try to control this part of her life as long as she is not in danger.  She has the dexcom...the data is good that it is accurate.  If she only checks to calibrate it twice a day, I am ok with that.  She boluses for the halloween candy and so I am ok with that too.  She cares about her HgbA1c.  She wears her pump and dexcom.  She boluses.  In my mind these are the big things.  During these next years, as long as she is doing these I am not going to try to control her every move.  I have seen too often what that can lead to.  I do not want her to feel so frustrated with the diabetes and how we treat her, that she rebels.  Stops wearing the pump, refuses to check at all, stops bolusing....I have seen this as a physician, I have heard many stories at CWD.  These are difficult waters to navigate.  I am not sure I am doing it right.  But, I am doing what feels right.  I know my child....she is a lot like me....and if she is forced, she will rebel.  So, I will focus on working with her.  Fighting only the big fights.  Telling her when I think she has done well.  Holding back comments when I think she has not.  Have I never eaten something unhealthy when I should not have?  Have I not had one extra margarita when I have already had too many?  I'm not perfect.  I certainly don't expect her to be.  And, luckily, we have an amazing health care provider who doesn't expect Jess to be either.  Jess respects her and listens to her.  I take comfort knowing that even if we reach a point where Jessica does not listen to me, I think she will still listen to her.

New times.  The never-ending challenges of parenting.  You master one stage, and a new one begins.  This is not unique to parenting with diabetes.  But, it does add another layer.  But, we will continue to march along.  I will continue to try to do all I can to assure that Jess becomes a healthy, happy adult.




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