#Parenting a child with #diabetes #struggles & #rewards: owning your own #lifetime

This is a blog I have wanted to write for some time. As the parent of a now grown up child with diabetes, I feel a ‘special’ bond with other parents. Because of this, I am one of the moderators of the Facebook Closed group Parents of kids with diabetes. Almost every day I read & respond to heroic, wonderful, ordinary, or desperate stories of parents, ordinary people, most of them with no prior knowledge or experience of life with diabetes. Some are the parents of newly diagnosed infants. Those of us diagnosed as adults, no matter what type of diabetes, we know the emotional rollercoaster that diagnosis brings. Imagine that diagnosis being pronounced on your baby or your child.

A child's trust
A child’s trust

The journey of acceptance of the diagnosis of diabetes is often described as the journey of loss, a journey through the stages of mourning. Some people diagnosed, or some partners of people who are diagnosed, get ‘stuck’ in one of the very earliest of stages, Disbelief & or Denial. They may delay or refuse the suggested treatment or advice for management. They may hide their diagnosis from those around them. That stage is bypassed in a Blink for the parent whose child is diagnosed. From lasting perhaps years, this stage is reduced to a few moments, a few hours, a day, a couple of days. From then on, ‘Disbelief’ & ‘Denial’ do not exist. We leap straight to fear, panic, guilt; into anger, blame, shame. We also leap straight into fierce Warrior protector mode. For most of us, our fear has to be submerged into Action, Compliance, & Learning, all embedded in a fierce protective mode that overrides everything else. Our own sadness, mourning, self blame must be submerged under the need to be the responsible Parent, the one who will manage the journey of our precious child into adulthood with lifelong chronic disease. I imagine the journey is similar to that of any parent whose child is diagnosed with a chronic disease or condition.

One of the differences lies in the management. Daily, a parent must monitor & restrict or ‘manage’ the food intake of their child. When birthday parties or celebratory occasions come up, the decisions about how to manage party food become an obsession. We handle insulin, a powerful hormone with great responsibilities attached, several times a day. We check glucose levels, ketones. We must ensure that we never run out of any supplies. We make & keep appointments with a range of HCP’s. We keep records, or trust our children to. We learn jargon. We FB, we Tweet, we SoMe. We must budget to afford all this, & although thankfully in Australia parents do receive some government assistance with costs whilst their children are under 16, in some countries this is a crushing, unsustainable burden. Our sleep is interrupted, sometimes many times a night, for the duration of the time our child with diabetes lives under our roof; and in the case of our daughters, possibly again when (if) (joyfully; & scarily) pregnancy occurs. We become master mathematicians & pseudo nurses & endocrinologists, calculating complex equations several times a day, carbs, insulin, bgl ratios. measurements & the needle

Another difference between being diagnosed yourself & having your child diagnosed is the type & level of Guilt & Self Blame that occurs. For ourselves, it becomes tied up in not talking about our diabetes, in hiding it so that we check our bgl’s or inject our insulin or take our oral medication very privately. We may even not do these things at all if a social occasion comes up. When it’s your child, ‘compliance’ is not an issue. We follow our instructions to the letter, to the minute. We advocate, we speak out, we question, we seek knowledge, advice, support. We talk to teachers, schools, principals, classrooms full of children. For many parents, their Guilt & Self Blame becomes lifelong, but is submerged into supporting a search for a cure. This is absolutely normal. It gives Hope, which is so wonderful. However, for some people supporting a cause such as this can become obsessive, preventing Acceptance, & interfering with normal life, & just getting on with managing the diabetes as best as possible.

It can seem impossible to set aside time for managing to care for ourselves. We can feel as though we are too tired, too busy, too responsible to take some time out just to be ourselves, just to breathe & enjoy our lives. We feel driven to Act, to do. The younger the child, & the more young siblings there are, the more difficult this becomes. Many parents are fortunate in having the practical support of a partner, grandparents, their own siblings. Others have friends in the ‘real’ world as well as in the virtual world. You may have access to good Child Care, where people are already trained or are open to be trained in managing your child’s health condition. It is hard to accept that it is not selfish to use such practical help to simply ‘take a sanity break’. However, doing so can actually be a wise management strategy. By allowing someone else to take care of our child with diabetes for a half a day, a day, a ‘sleepover’, a weekend; we are teaching everyone concerned that if for some reason we are unavailable, they can manage, & manage well. We’re teaching our child that there are safe people & places in the world, & as they get older, that they are clever, brave, strong; and normal. They can be away from us, & we can be away from them. We will come back, & we will all be OK. And we’re teaching ourselves that our lives exist outside our Parenting role, a role which changes over time for everyone, regardless of any health condition of their child.

What activities do you currently do that are solely for yourself? Do you walk, run, climb, meet a friend, visit a library, play a sport, go to the gym, sew, go to the cinema, study, paint, garden, play with animals, swim, do yoga, ski, ride a motorbike or bicycle, box, write a diary or blog? What have you stopped doing that you would like to go back to? What have you always wanted to do or try that you have not yet tried? Do you know how to practice relaxation, controlled breathing, or any stress relief practices?

Always remember, you are a Parent of a child, & you are a Person. These roles do not exclude or preclude each other. Your life is yours, you own it. We have a short time on this earth, & our time is Now.

Remain in Light. Talking Heads

carpe diem

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling online, a Teacher, & the Parent of a person living with Type 1 diabetes since 1979. She has lived with Type 2 diabetes herself since 2001.

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It’s not easy to be me- journeying to the #self: how #melancholy is part of #happiness

Our inalienable rights are ‘Life, Liberty & the Pursuit of Happiness’- nothing in there about Health, or Wellness, right?

I was counselling someone today, someone who is actually older than I am, despite me having just had a birthday & feeling extremely ‘senior’ as a result. LOL! I had something of a ‘light bulb’ moment. I thought, it’s not depression that I live with, it’s melancholy. And is that such a bad thing? Once you realise your own mortality, which for many people is actually before the age of 10, isn’t melancholy part of the background to our lives? It’s not a word that is used or celebrated nowadays, it could even be called ‘unfashionable’ to acknowledge melancholy. It seems that you have to be always ‘happy’ to be considered ‘normal’: if you’re not obviously happy, then you must be ‘depressed’. I don’t believe that’s true.

Although melancholy gets a bad press sometimes, being equated with deep depression, it has also a more poetic & lighter side. Many poets, composers, artists, writers from various cultures have felt melancholy. ‘Melancholy is sadness that has taken on lightness’ by Italo Calvino ‘There is no such thing as happiness, only lesser shades of melancholy.’ Robert Burton. ‘Sweet bird, that shun the noise of folly, most musical, most melancholy!’ John Milton and ‘There is no coming to consciousness without pain.’ Carl Jung. When you can acknowledge that it’s actually OK to be sad, not permanently deliriously happy, to be in fact somewhat melancholy, you can accept your state of being & find that ‘happiness’ & ‘beauty’ can encompass melancholy. ‘I don’t want to get to the end of my life and find that I just lived the length of it. I want to have lived the width of it as well.’ Dianne Ackerman

taking time out in nature
taking time out in nature

Of course that melancholy can be a spiderweb, it can creep into everything, it still takes work to maintain calm in the midst of chaos: to maintain serenity, joy. The tools of mental wellness remain the same. We are all living with diabetes. Now that’s just not fair. It basically sucks. At the same time, many of us are trying so hard to ‘live our lives to the full’, whatever that may mean. Whether it’s helping others, striving for a physical ‘high’ that will reward us, striving to be successful in a career, or in love, earning more money to purchase whatever it seems we want; our time is busy busy busy. Multi tasking is a way of life. We are attached to screens for much of our waking time. We are ‘communicating’ with more people than ever before in the history of the world. We need to take ‘down time’, & to use that time to be present in the real world. This might be as simple as exchanging our gym session for exercise outdoors, appreciating the world as it passes us by. It might be turning off screens for a 2 hour waking period every day: or for an entire day a week, & focussing on the people we are with & the world around us. Or to be alone. It might be remembering we have more than 3 senses: more than our eyes, ears & fingers. It might be reminding ourselves that we are more than our diabetes, or our child’s diabetes, that we still have other interests, & other people in our lives. It might be focussing on Breathing, on silence, on music: on watching your child sleep. It might be preparing and eating a meal with pleasure, not guilt, sharing our pleasure with others, not with self judgement or self criticism. It might be that we need to give ourselves a break, to celebrate how hard we are trying, to let go of guilt or shame. We need to use that wise voice in our head to counsel ourselves as we would another, to be kind to ourselves as to another, to say, ‘It’s OK, nobody’s perfect, you’re doing OK’.

a gift for yourself
a gift for yourself

It can be hard being Superman, or Superwoman. Even Superman feels melancholy sometimes.

Helen Wilde

Helen is a Senior Counsellor with Diabetes Counselling Online, Teacher, parent of a person living with Type 1 diabetes since 1979, & living with Type 2 diabetes herself since 2002.

You may find it helpful to talk with one of our team by visiting http://www.diabetescounselling.com.au/welcome/our-team-counsellors-ambassadors/

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You Can’t Eat That!

People around us are generally helpful, caring and concerned.

But what do you say when these people make mistakes about diabetes management?

On a social media post recently Gwen commented: “Frustrated after a conversation with co-worker today who told me I didn’t need a diabetes dog I just need to take better care of myself so I don’t get highs and lows. If she knew a thing about diabetes it would be different. Also says my spouse does not need to know more it’s my responsibility. Had to walk away!!”

Diabetes is no picnic
Diabetes is no picnic

How would you manage this conversation?

Might you try saying something like:

How about you come over to dinner sometime, let sit down and eat together. We can then talk about the things I need to consider just to enjoy a meal with a friend.

Or

Hand them a copy of the

“Ten Commandments for Avoiding Negative Scenes with Diabetic Loved Ones” by Richard Rubin

  1. Thou shalt not act like a Police person.
  2. Thou shalt not ignore diabetes.
  3. Thou shalt not lead your loved one in the paths of temptation.
  4. Thou shalt not criticise when your loved one succumbs to temptation.
  5. Thou shalt not talk about your loved one’s diabetes in public unless invited to do so.
  6. Thou shalt offer support and comfort, especially when things aren’t going well with the diabetes.
  7. Thou shalt have the patience of a Saint when your loved one is acutely hypo- or hyperglycaemic.
  8. Thou shalt deal constructively with your own natural fears and resentments.
  9. Thou shalt be especially sensitive in public situations
  10. Thou shalt find out what works and do it.

Marys’ response was: “I would be frustrated too. But this would be a good time to educate your coworker a bit.”

Jane said: “this would get me mad as well because your husband needs to know about your condition. I bet she hasn’t got diabetes. It’s got my goat up just reading about it. My husband got one at his workplace. This foreign guy was drunk, went to work and got caught sleeping on he job. He says he’s got diabetes. We don’t believe him. I’ve got diabetes and people like these people who say they got it make me so mad.”

June said: “I would love to force her to go threw a day with us and let her see how it really fills…let’s see how well her day starts knowing the first thing she does as soon as she opens her eyes and before she even gets to pee is prick herself and check her bgl…. then start her day…..every day..”

A little extreme maybe, but a good point. Most people who don’t have diabetes have no idea of the reality of living each day with diabetes. They are fed media information that is often inaccurate and misleading.

Share Your Story - It May Enhance the understanding of diabetes amongst friends, family, colleagues.
Share Your Story – It May Enhance the understanding of diabetes amongst friends, family, colleagues.

Workplace Education

One strategy that could be helpful in the workplace is have the management organise on International Diabetes Day (or similar) a screening check for all staff. This cold incorporate talks from health professionals, and from people in that workplace who have diabetes.

I’m not sure of the statistics here in Australia, but according to Kaiser Family Foundation data, the American Diabetes Association’s workplace cost calculator estimates that for a company with 1,000 employees:

  • 100 employees have diabetes
  • 27 of them are undiagnosed
  • 250 have prediabetes

I suspect Australian stats are quite similar.

Friends and Family

Is dealing with this problem of misguided comments the same with friends and family?

This may be a little different, easier, to manage as you have an emotional relationship with these people. What strategies have you used in this situation? What has and hasn’t worked?

Fact Sheets

Might you share with anybody who makes ignorant comments about you and your diabetes a ‘fact sheet’ about the realties of living with diabetes?

What might you write in this ‘I Live Every Minute with Diabetes’ fact sheet?

How about people reading this blog make some comments below as to what they would write on this fact sheet. Make something that is a team effort here to be shared by all.

One reply posted said: “Never listen to ignorant people. Every one of us is different and we do what we need to in order to take care of ourselves. But just because someone hasn’t heard of it doesn’t make them ignorant, just makes them uninformed…like me!!!”

This problem of being hounded by people who do not understand diabetes has the potential to cause ‘diabetes burnout’ if heard often enough from friends, family and in the workplace.

You might like to read the book: Put the Brakes On Diabetes Burnout @

http://www.diabetescounselling.com.au/shop/put-the-brakes-on-diabetes-burnout/

“Experiencing burnout is not about being weak or being a ‘bad’ person. It is nothing to be ashamed of. Diabetes burnout can happen to any person with diabetes at any time, in particular after a period of high voltage stress, ill health or difficult diabetes control. Or it can have no obvious triggers apart from being worn down by years of self-management. What is common to all cases of diabetes burnout is that it can lead you into rough seas with no promise of calmer waters on the horizon. This is different to the experience of depression but can sometimes be related to, happen alongside, or even lead to, depression.” – See more at: http://www.diabetescounselling.com.au/shop/put-the-brakes-on-diabetes-burnout/#sthash.5CToUkM3.dpuf

 

Many Hands Makes Light Work - make a contribution to a workplace fact sheet about diabetes by commenting below.
Many Hands Makes Light Work – make a contribution to a workplace fact sheet about diabetes by commenting below.

Travel Safely my friends.

Kind Regards from

David – Diabetes Educator @ Diabetes Counselling Online

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Keeping still: scarcely breathing: & hanging on

Last weekend I was tired. I didn’t turn my computer on from Friday afternoon until Monday afternoon.

I visited Mum in the Nursing Home on Friday afternoon, & had dinner with my sister on Friday night, & we made a YouTube video for ‘Dine In’. On Saturday I had Brunch with my 4 sisters, always a lovely, laughing, chatty time: even better because we went to my lovely nephew’s cafe.. I had a Dr’s appointment Monday morning + the plumber came Monday & Tuesday, & on Wednesday morning I had fasting blood tests at the IMVS. We babysit Tuesdays & Wednesdays every week. In between I worked.

On Thursday I went back to bed after breakfast. This is something I almost never do. I usually have an obligation to someone to motivate me to get ready for the day & move into it. I was feeling really tired, almost exhausted. We have had such horrible weather events lately, & I have been as busy as I usually am, or even busier.

After I had stayed there for about 20 minutes, not sleeping, I recognised the state of almost trance that I was moving into. I call it my ‘nearly dead’ state of being. My first memory of entering this state was when I was a child. I have 4 sisters, two of them came along by the time I was 3 years old. So my life has never been solitary. When I was 10, sister 3 came along, & at 14, sister 4. By then we lived in quite a large house. But before I was 10 years old, my first 2 sisters & I always shared a room. The last of these rooms was tiny, so small that our 3 beds touched each other. Being in the days before TV & computers or the Internet, our playtime was rich with activity & imagination. We loved to play hide & seek of course, & sometimes talked our big hearty laughing Dad into playing too. There were few real hiding places in our tiny maisonette, & I remember my first very successful hiding place (to my mind) was actually under the bedcovers of my bed. The bedspring sagged, & as I was a skinny kid, if I lay extremely flat & kept very very still, scarcely breathing, it took a long time to be found. Or it seemed long. Of course the emotion of excitement had to be kept in check, & it was usually my giggles that meant I was found.

Keeping still...& giggling
Keeping still…& giggling

The next stage of experiencing this state of being ‘nearly dead’ was not nearly so much fun. I was 24 years old, & I was trying desperately hard to hang on to a pregnancy. I was admitted to the women’s ward of a country hospital, & told to ‘keep as still as you can’. This I did, for 10 days. I lay flat. I scarcely moved. I scarcely breathed. To pass the long hours I played patience, over & over again, moving only my hands.

I lost the baby. Then, I had to learn to stand, to walk, to breathe deeply, to return to my life, my work, & my 4 year old child. My body almost physically shut down over those 10 days. My muscles began to waste. My sadness seemed unbearable. I did walk. I went outside. I was dizzy. I stood in sunshine. I felt the air. I hugged a tree. It was strong, cool, detached, impersonal: it cared nothing for me, it just was. I breathed. And I cried.

hanging on means you survived
hanging on means you survived

Yesterday morning I felt this state beginning to take hold. Flatness, stillness, nothingness. I said to my husband, I might just stay here & lie flat & keep still until I die. He asked me why: & I realised I didn’t have a reason. My life is good. Sure there are some very sad things in it, there are some difficulties in it. But mostly it’s just a life, like any other. It’s up to me to Move, to Breathe, to be happy, to hang on…I got up, put my shoes on, went for a walk around the block. On the way I paused at a demolition site, where 6 burly men were pulling a house down. They had trucks, machines, skips. They were stopped, waiting for someone to come & close the huge water leak that was fountaining from the water pipe they had clearly just fractured. They were laughing & talking, enjoying their day: no guilt, no regret. I asked if I could take a cutting from the pink frangipanni tree they had already started to tear out. They gave me advice on how to strike it, & then happily broke the other half of the tree down for me. I carried it home triumphant, envisaging the flowers I might have next year.

just be..breathe in, breathe out, move..
just be..breathe in, breathe out, move..

 

Helen

Helen Wilde is a Teacher & a Senior Counsellor with Diabetes Counselling Online. She is the parent of someone with Type 1 diabetes and has been living with Type 2 diabetes herself since 2001.

If you sometimes feel you would like to talk with someone, maybe from our Team, you can do so via the Registration form here: http://www.diabetescounselling.com.au/counselling-request/

 

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Health

Is Health is the level of functional or metabolic efficiency of a living organism?

In humans, is health the general condition of a person’s mind and body, usually meaning to be free from illness, injury or pain (as in “good health” or “healthy“)?

The World Health Organization (WHO) defined health in its broader sense in 1946 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.

Although this definition has been subject to controversy, in particular as lacking operational value and because of the problem created by use of the word “complete,” it remains the most enduring. Other definitions have been proposed, among which a recent definition that correlates health and personal satisfaction.

Canguilhem

Another somewhat arguably liberating definition of health is from French physician, Georges Canguilhem, in his 1943 book, The Normal and the Pathological. Canguilhem rejected the idea that there were normal or abnormal states of health. He saw health not as something defined statistically or mechanistically. Rather, he saw health as the ability to adapt to one’s environment. Health is not a fixed entity. It varies for every individual, depending on their circumstances.

Health is defined not by the doctor, but by the person, according to his or her functional needs. The role of the doctor is to help the individual adapt to their unique prevailing conditions. This should be the meaning of “personalised medicine”.

The beauty of Canguilhem’s definition of health—of normality—is that it includes the animate and inanimate environment, as well as the physical, mental, and social dimensions of human life. It puts the individual patient, not the doctor, in a position of self-determining authority to define his or her health needs.

The doctor becomes a partner in delivering those needs.

What Do You Think?

Some of my clients – men with diabetes – who attended a focus group in 2004 defined health as:

“Sitting here. I have survived cancer. Now I have diabetes. I want to learn all I can. Knowing that I am alive still – able to walk and talk, do the things that I want to do.”

“Being able to do what I want to do, have enough energy to go for a walk, go out shopping, do things.”

“Not running out of breath.”

 

senior man bike riding

Others have defined good health as:

“Good health means participating in a daily exercise regimen and eating well. Keeping my cholesterol and sugar numbers in check is an important factor. When I’m heart-healthy, the rest follows along. Following the Best Life guidelines keeps me in good health.”

“I believe you need to address the physical, mental and spiritual aspects of your life. When you achieve balance and harmony, you attain true health.”

“Good health means being able to look at myself in the mirror and know that I’ve eaten right, I’ve been active and that I’ve been honest with myself. These are the things within my control. My best healthy life means taking care of the things over which I have power.”

“Good health is not the number on the scale, although that is a warning sign that something is wrong. What’s important are the numbers on your cholesterol report, your blood pressure, and the percentage of body fat. Healthy eating and portion control are not all that’s needed; an active lifestyle, a sense of purpose or a reason to get up in the morning and take on the world, a positive outlook on life and inspiring people to do the same are true signs of good health.”

“Good health is more than lack of disease. It is being my personal best physically, mentally, and emotionally. It is being at the ‘top of my game,’ which includes mindful eating, regular exercise, a positive mindset to overcome challenges, and pure fun and joy…and being grateful for all these things.”

“For a long time, I thought good health meant a super-strict diet, obsessive exercise and complete deprivation of anything indulgent. I now know it means mindful eating with more fresh ingredients, being as physically active as possible and allowing for the once-in-a-while treat to enjoy life!”

“To me, good health means to be fit physically and emotionally as well as being illness-free. When one thing is off, our health is out of balance. In order to have good health, we have to have proper nutrition, stay active and take the time to mentally take care of our body and emotions.”

“Good health means that I am feeling my absolute best, physically and mentally. I have found that eating well and continued exercise are the answers for me.”

“Good health is a reflection of body, mind and spirit. Through integration of moderate functional exercise, meditation and awareness, balanced nutrition, morality and peace-loving relationships (with family, at the workplace and with friends), the absence of disease can be attained”

“I define good health with one word: balance. When I eat healthfully, exercise regularly, sleep well and am social with family and friends, I am balanced. This is when I feel that my health is not just good–it’s great!”

What is YOUR definition of ‘good health’?

…. and, how does one attain good health when living with such a chronic and complex disease like diabetes?

Do you believe that using a team of experts – dietitian for meal planning; diabetes educator for interpreting BGL’s, understanding your medications and assessing if you are on the optimal medication for you, helping you understand the relevance of a good foot care plan, etc etc; the podiatrist to assess your nerves, circulation and bio-mechanics of your feet; your GP to prescribe and measure your body’s functions – to helps you to achieve good health?

Does health mean “I feel fine, therefore I must be healthy” or does it mean “ visit the doctor regularly for tests to check all of my body functions are on target to reduce my risk of future health problems?”

Or something different?

What is Your Role?

The manner in which nurses, physicians, patients, and administrators interact is crucial for the overall efficacy of a healthcare system. From the viewpoint of the patients, healthcare providers can be seen as being in a privileged position, whereby they have the power to alter the patients’ quality of life. And yet, there are strict divisions among healthcare providers that can sometimes lead to an overall decline in the quality of patient care. When nurses and physicians are not on the same page with respect to a particular patient, a compromising situation may arise.

One method of overcoming this ‘power imbalance’ could be taking a pro-active approach to your health.

As we live in an information age. By doing some research on the w.w.w, and following the trials and tribulations of people like yourselves on blogs and forums such as these, you can put yourself in the drivers seat.

 

older woman

Being prepared with a set of goals that you may wish to achieve and asking your health professional some questions relating to help you achieve these goals may be a useful strategy.

For example: a common goal is to make a healthy eating plan. By taking along to your dietitian appointment 1. a weeks food diary, 2. a set of beliefs obtained from various source, and 3. a set of 3-4 questions may not just put you in the drivers seat, but may make the appointment even more pleasurable for you both.

Another example is going to your diabetes educator with a set of questions relating to the things you are not quite sure about in your self care plan.

For example: a common comment in my practice is ‘my BGL’s are all over the place, I really don’t understand why’. You could ask something like “My health goal is to manage my diabetes well. Can you please help me understand what’s going on with my BGL’s?”

Health is a two way street. Who do you want to be the driver?

Next week lets looks at some of the ‘language of diabetes’ that may put you on that level playing field with your health professional – or teach them a thing or two.

Safe Travels,

David – Diabetes Educator @ Diabetes Counselling Online

 

 

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