Thursday, November 10, 2016

November is National Diabetes Awareness Month: Lessons Learned About Feeding Your Baby

The most common question that I have been asked is about the diagnosis of Type 1 Diabetes in both of my daughters.  The question is usually blanketed in the concern of whether I breast-feed or bottle feed or if I think my early feeding days caused a diagnosis.  To answer the question, I usually share that I raised my children with two different ways of feeding early through infancy, yet both had ultimately been diagnosed with Type 1 Diabetes.  Sometimes that answer provides enough relief, but sometimes, parents walk away with continuing concern over what they did or did not do.  With November is National Diabetes Awareness Month, I wanted to help families by eliminating any concerns they may continue to harbor by sharing our personal feeding journey.

Thinking long ago to when my oldest daughter was born, I remember having so many well-intentioned people sharing advice, thoughts and opinions about the best ways to raise a child.  I was grateful as having the multitudes of advice sharers on hand, as somehow it made for a kind of newborn insurance policy.  I knew that even if I didn't know what to do, I could call any number of friends that had 'been there, done that' and get the answer that I needed.

Those early feelings of insecurity that manifested in collecting my advice sharing friends intensified after delivery.  As a first time mom, I had a difficult labor that required a lengthy recovery after our precious little girl was born.  Without going into major details, there was a bit of trauma in the way that my daughter entered into the world and that trauma fed into my own worries and anxiety of carrying for a baby.

Not knowing how I would be feeling, I had asked for a close family member to stay at our home for the first two weeks.  My husband and I had taken multiple birthing classes, read a million childcare books on modern parenting and prepared to try to recreate everything we had learned for our nursery.  Not surprisingly, there was an immediate clash between the family member, praised for her sage advice before our little girl's arrival and our freshly graduated parenting class ideals.  If you could see and hear friction, it would be a closed wooden bedroom door with the sounds of many, many tears on both sides of the partition.

The biggest and boldest issue causing the most tears was the way that we had decided to feed our little girl.  Leading up to the arrival of our child, we had planned and prepared for exclusive breast-feeding.  Meaning, there weren't even bottles on stand-by within our home.  We were well decided on the breast-feeding route and so there was no need for pumps, bottles or even pacifiers.  Trouble arose immediately with this plan as our little girl displayed difficulty with latching during our long hospital stay.  The nurse asked if we would like to clip her frenum (simple surgery for tongue-tie) or supplement with bottle feeding.  Horrified that our sweet baby might endure any pain after such an exhausting delivery, I declined and agreed to the first bottle of formula.  The nurse assured me that it was common for newborns and would not present future feeding struggles.  The advice that I was given was a reminder to keep trying and eventually our baby would easily latch.  After a few more bottles and another two nights, we were discharged and sent home with a well stocked cooler of prepared formula.

At home, despite our efforts including middle of the night calls to La Leche League, continued offering of breast only and then, frantically calling the on-call doctor every hour on the hour proved to no avail.   Flashback back to the closed bedroom door, and on that particular day, our visitor, feeling anguish over hearing baby and mama cry, had realized two sad truths.  First, no one likes to see a mother and baby struggle over feedings and secondly, there is no feeding and holding a baby that is breastfed.  Both of those were thoughts that never crossed our guests mind before agreeing to stay with us.  Her old-fashioned skilled thinking included the time she had spent as a mother, which were during 'pro-bottle-fed only' days.  So by the second day, she decided enough was enough and happily prepared bottles with an offer (and pressure) to feed the baby.

This led to more mothering tears and also, more worries and more nerves.  The easy answer was to accept the bottle (and I did) but with a hefty dose of anxiety, guilt and shame for not feeding my sweet baby in the way that I had tried and wanted to achieve.

By the third day, our guest left (more tears) and I was able to try to reconcile my different feedings by offering more and more bottle feedings.  Visually, our baby was gaining weight, sleeping better and even giving those adorable 'too young to smile' smiles. By the end of the second week, with my milk drying up, I recognized that bottle feeding was doing 99.9% of the overall job.  I also recognized that it was doing a wonderful job.  Dare I say that I had the sweetest, happiest baby on earth? Clearly this was the best for our baby.

Time marched on and just a bit over a year later, I was pregnant again.  This time, we took a very fun and silly parenting class that catered to more seasoned parents as 'A night away from toddlers'.  The overall tone from the instruction circled around the thought that just feeding your child was best (still makes me laugh) and that regardless of how you chose to handle breast-feeding, bottle feeding or some sort of combination, parents are doing a great job. Not surprisingly, even after my first delivery, for the second, I felt relaxed and ready.

Perhaps some of that positive energy helped.  Immediately, I was able to breast feed without any issues.  In fact, feeding went so smoothly, that I spent about 1.5 years doing it.  When it came time to wean, we were both ready and the end felt natural and complete.  While completely different than our first experience, this was also best for our baby,

I shared my story after diagnosis and now with the parenting community because all too often, we look at ourselves to blame when what we originally envisioned in feeding our babies doesn't work out according to our plan.  When unimaginable news like the diagnosis of Type 1 Diabetes, an autoimmune disease with no known origin or cure, came into our lives, once again we looked for what, we as parents, might have done wrong.  We blame ourselves for what we did, or didn't do, as that may have somehow caused our child's diagnosis.  That's not only unfair but defeating to our future recovery.  The honest truth is all parents are trying to do the best that they can for their babies, families, and world.  However you choose to feed your child, will always be the best thing that you can do for your baby,

If there is proof in doing our best, all I have to do is to look for it in the eyes of my daughters; both are successful, well-rounded, accomplished and most of all, loving, sweet and kind.

Our sweet girls are our 'best' part of life.

To learn more about feeding your baby,

#ndam #kids #natsweetsisters #diabetes #kidsfirstdiabetessecond

Tuesday, November 8, 2016

November is National Diabetes Awareness Month: Lessons Learned About Sleepovers

October was a big month for our youngest.  Not only did she officially turn 13, but she also had several friends that celebrated birthdays during the same time frame.  Since all of the girls are wonderful friends (about a dozen teenaged besties in total), large, fun sleepovers were held to celebrate the big days of each individual girl.  To our youngest daughter, this was easily the most exciting time of year.

Our 'rules' for sleepovers are fairly straightforward.  I have posted stories about it here and here.  As the girls have grown, plus with the addition of new technology, we as a family have adapted the game plan to better suit all of our needs.  Mostly, I need to know that they have caught the low before it gets to a ridiculous number that would require mom to drive like a maniac to bring them juice and glucagon.  On their side, they need to bring a charger for their cell phone because nothing is worse than not being able to snap chat and yes of course, read those Dexcom Share numbers.

For the first sleepover, the girls were invited to a local movie as part of the activities.  The family borrowed a large mini-bus and impressively had all of the girls safely riding together to and from the theater.  Our youngest daughter followed her 'mom sleepover instructions' to text me just as she began to treat a 90mg/dl blood sugar (knowing that a drop was headed her way) and then called me right before bed time to review her bg, any IOB and to confirm that next to her sleeping bag were safely stored juice boxes (just in case) and her cell phone both plugged in and charging.  The next morning, she happily came home and promptly took a nap as the girls were well awake past 3:00 a.m..

During the second sleepover, our youngest daughter planned a night-time scavenger hunt throughout the neighborhood with her large group of friends.  Returning back home after running around, the girls sang karaoke, danced and played air hockey.  Activity stayed high throughout the evening and the girls had trouble settling down.  Somewhere around 4:00 a.m., the last one finally went to bed.  However, since it was at our house, it was easy for me to help discreetly guide extra snacks for pesky lows and to give not so subtle reminders to the girls TO GO TO BED.

By the time the third sleepover in a row rolled around, our youngest was a bit short on sleep and attitude.  Various hormonal factors played into the not-so-sweet attitude and her blood sugar was already in a whirlwind before the evening and before leaving our home.  I should also mention that the day prior was spent at our quarterly endocrine appointment and while I can't say exactly why this is, the attitude towards T1D is always more upset than what would be typical.  With the perfect storm already brewing, we sent our youngest daughter on her way with extra snacks, juices and a birthday present for the party.

This is where I am going to share what I did to further contribute to the forthcoming mayhem...

  • I did not check her blood sugar infusion site to see if it looked good or needed to be changed.
  • I did not check her insulin cartridge levels within her pump.
  • I did not send her with extra insulin.  
  • I did not spell out a specific consequence for not communicating with me.

From those missing items, if you are parenting a child that lives with T1D, you can probably imagine what happened but I will share the full story.  As a parent, I needed a reminder to myself that no matter how adult she may act most of the day, that I am still her reminder for many things - the above list is probably the most important and well, I blew it.  

First, our youngest started to go low, treated on her own and thought that we as her parents would figure it out on our own.  However, her Dexcom Share CGM was in the 'sudden drop' mode of two arrows pointed downward and despite my effort to not call her, when the number flickered at 41 mg/dl, I started dialing like a mad woman.  First our daughter, than the sweet hosting mom and finally, friends and friend's parents.  True story.  I actually texted the mom of her friend in hopes of getting daughter to respond.  While that was happening, my husband was roaring out of the driveway on his way to the house to get her.  Fear.Makes.Parents.CRAZY!

And then the text that I received, "Calm down.  I am fine."


At that point, an angry call led to an unhappy daughter that promised us she would communicate throughout the rest of the night and a grumbling, upset parent duo that are arguing over what to do with the child causing the chaos.  No fun at all.

However, close to midnight (and for a change all of the girls were feeling exhausted), our youngest suddenly realized that she was in trouble.  On her bedtime call to me, in listening her to ramble about various things, the tone in her voice was worried.  Finally, a bit of questioning prompted an admittance that her cartridge beeped a low-reservoir warning.  Adding to that, her blood sugar started to spike as she had made a decision to not dose when correcting the low with goodies and she had silenced her CGM by accidently restarting it (requiring a two-hour warm-up).  With the pressing need for insulin looming combined with her worry about how much insulin to correct with, she broke down on her cell phone and agreed to return home, missing out of the rest of the fun party.  

The kicker?  Before she went to sleep in her own bed, I checked her BG and it was mid 500s, about 250 points higher than what she thought or even what her CGM had been reading just a half hour before that.  We know that her thinking was impaired as was her ability to sense futher highs and lows.  We quickly changed the infusion site and saw it was red, irritated and bent at the tip.  I gave her an injection to bring down the high quickly and stayed up through the night to watch for ketones, extra boluses and crashes.  By morning she was in perfect range, feeling a bit of a diabetes hang-over and also very sorry for her attitude and actions.

As a result, the punishment for the situation was resolved before we even woke.  Leaving the party had been pure torture to our daughter and a reminder to all of us that we need to be more clear on expectations, increase our communication to one another and utilize a checklist of what should occur for future sleepovers - including check on insulin needs and infusion sites.  

I'm sharing my learning with you as it does take a village with T1D.  I am so happy that my daughters have friends that are willing to have our girls over to spend the night, despite the worries that come along with T1D.  This past weekend, our daughter was invited again to another friend's house and the night went just as it should... kids first, diabetes second.  <3 

#NDAM #Sleepover #Natsweetsisters

Monday, November 7, 2016

November is National Diabetes Month: Lesson Learned of Keeping Perserverance

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Tired of talking T1D? Check out the Diabetes Emoticon App by HealthDesignBy.Us

Here is a true confession:  Sometimes, I really hate talking about T1D.  

I confess this because over the matter of days into weeks, leading to months, I have been dragging my little fingers over to the keyboard and feeling the worst case of writer's block ever imaginable.  At the same time, I have been scrambling to keep up with my growing teens as they embark on new and greater independent adventures.  

All of this has felt completely overwhelming.  So much so, that I have struggled to find the words to share the massive highs and lows they have experienced while continuing to remain upbeat and positive for the girls.  Sometimes, I can't even think about what happened because I am already moving on to the next big, more adult-ish topic.  All of their learning seems to be come fast and furious.  This is just so different than grade school or preschool or even toddlerhood.  It's hard to even explain.  

And they are really good kids.  That's the kicker.  Great kids that have been dealt this extra card of 'DIABETES' on top of everything else.  Their life game is achieving amazing grades, scoring well on the SAT, playing the best golf that they can, joining community service organizations, managing the social connections and above all; staying in control of their diabetes.  

It's not much to handle, right?  

So sometimes, the scales tip more towards one direction over another.  Sometimes it is an innocent, "I forgot to bolus" or other times, it is "I needed to take the test and couldn't pull out my phone to check my CGM."  There are decisions made on "It worked last time" or "My sister does it that way."  There are understanding supporters and once in a while, a unsympathetic adult that blocks their route.  All of these things lead to learning and often, mom or dad to help intervene.  

What I have come to realize is this new phase of life is the final push of learning before I set them (mostly) free.  I once read a quote about why teens struggle to deal with so many new situations that create conflicts and demands during ages 13-18.  The quote (paraphrasing here) shared something about the reality that if they were good all of the time, parents would never let them willingly go off onto their own.  I suspect that this is true.  There are days when I am so tired that I secretly wish for college to come that much sooner just to give us some space.  Then, I shudder because with that experience will bring an entirely new set of challenges including the one I dread the most, "THE NEVER ENDING SLEEPOVER."  The other sharp reality is that none of us are quite ready for that.

But we will be.

As I have watched all of the good and the very discouraging unfold around the girls, I now understand that this kind of learning that brings about both failures and success is the most important lesson that I can teach them.  Most of all I learned that my perseverance to try yet again, is the best teacher yet.  

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As November is National Diabetes Month, I want to share some of our newly discovered lessons.  Tune in tomorrow, November 8th for lessons learned on sleepovers. 

#ndam #T1D #november #natsweetsisters