Transitioning

Last week we experienced something new in the world of diabetes management. On Monday, after my class, my throat was really sore but I figured I was pretty chatty for 2 hours and thought nothing more of it. I sucked down some wine and cheeze its and figured that nutritional powerhouse would work its magic. Tuesday I woke up with a full blown headache and swollen glands. I don't really care when I get sick. I've never been one of those people to shut everything down for a day or two while I recover. The thing that scared me, was Grace going to get this?

When diabetics get sick, all kinds of wacky things can happen. Sugars can go high and low and it's very unpredictable. Diabetics can also produce something called ketones which are bad, bad news. Ketones are what your body produces when it can't access carbohydrates and your body starts burning fat. Ketones are detected by a urine test and come in all kinds of fabulous sizes: trace, small, medium, large. You can consult your handy dandy color chart to see what you've got.

Grace never got sick but she did fight it off. Even when diabetics fight off an infection, blood sugars can be whacked and ketones can show up even if your blood sugar is where it's supposed to be. So we spent the week checking urine pretty much every 2 hours and keeping a close eye on Grace's numbers. I exchanged a ridiculous amount of phone calls with the school nurse and our CHOP people to keep things in check. All things considered, we survived unscathed and it seems like this may have been a good warm up for when Grace actually gets nailed with something. I've committed my sick day insulin and fluid rules to memory and feel like I can handle it (kind of).

But I think all the flurry of worry last week left a mark on Grace who was really sad last night. She told me she was scared diabetes was going to change who she is. When I hear stuff like this, I feel like I've been sucker punched. But we're working on something new in her therapy--moving on from mourning. For kids Grace's age, who have a memory of life before diabetes, the process of acceptance is particularly challenging. Essentially Grace is in mourning--experiencing a sadness for the loss of her previous self. To help Grace move on from mourning, we have to help her focus on acceptance.

I find this part particularly difficult. I just want to sweep her into my arms and squeeze her tight and we can have a big cry fest together. But this doesn't move us forward. So, instead, I nonchalantly said, "Asthma has never changed who I am." Grace balked at the comparison but I moved on casually putting plates away and talking about my life with asthma. I compared her pancreas to my lungs-both don't work the way we want them to. I take medicine every day, she takes medicine every day. Sometimes diabetes and asthma can be scary. I wish I never had asthma as much as Grace wishes she never had diabetes.

I didn't want to draw too close of a line between the two because, in many ways, we're talking about apples and oranges. Yes, I do use an inhaler every day and carry a rescue inhaler with me. Yes, I totally wish I never had asthma (especially in allergy season). Yes, sometimes asthma really does scare me. But, I emphasized to her, it has never, ever changed who I am. I spoke about a few athletes who have diabetes and how it never slowed them down-professional hockey players, baseball players, and swimmers. As much as I wanted to scoop her up and squeeze her pain away, I didn't. I looked her right in the eyes and said "This will never, ever change who you are."

But of course, the great unsaid in all of this, is it will change Grace. Grace has already changed. She has demonstrated a courage that few adults could channel. She is stronger than who she used to be. She just doesn't realize that but she will some day. I think there are parents out there who try to do everything in their power to protect their children from their hurts. And I respect that. When I know Grace's sugar has gone low in a soccer game, it's my first instinct to pluck her out of there. But I don't. I want to give Grace the tools to handle the frustrations of this thing and to rise above it.

Initially I felt bad speaking to her in a way that was firm and unyielding. But at the end of the conversation she had stopped crying and was listening carefully. I refused to give any ground on her "buts" and eventually she was quiet--annoyed--but quiet. After we talked, I realized how important it is to have these conversations and to not go back to the comforting place of mourning. It's time we all moved on and a little discomfort is probably a good thing.