How to Decrease Pain for Children with Diabetes

Children with diabetes have to do many things that can be overwhelming and scary.  Glucose checks, shots, infusion set insertions, having blood drawn at the doctor, and many other things can be scary for children and tough to deal with as parents.  The "Wow and How" technique is a simple way to help make things easier at times.  I used this with my daughter and now I have something I can easily say to help her, by simply asking "What are you thinking about this time?"

The "Wow and How" is used by therapists more with children who are frequently hospitalized and have to undergo frequent medical interventions that can be painful, such as those on chemotherapy.  But it can also be used easily with other populations.  It is a very simple technique, yet it helps the child learn new ways of dealing with pain and fear.

Here's how to do it.  Simply observe when your child is doing something that usually upsets him/her, then notice when it does not hurt as much.  Reflect this to your child, saying something like "Wow!  I notice that didn't hurt as much!"  Then listen and reflect back what they say.  (Just rephrase what they say back to them, not adding any judgement to it.)

Then add the "How".  Ask, "How did it not hurt this time" or something similar.  Listen and reflect back to them what they say.  Then help them problem solve how that can help in the future.

Here's an example of my using this with my daughter.
Sara was putting in an infusion set one night.  Somedays this seems to hurt more than others.  We were going through a time when it seemed to hurt more.  One night, it did not hurt as much, so I said "Wow, that didn't hurt as much."  Then I reflected back what she said, and asked her "How did you make it not hurt as much?"  Notice that this lets her know that she has the power to help it not hurt as much.  She said "I thought about the ocean."  So now we have an easy way for her to distract herself for a minute to help minimize the pain.

Try this today and see if it helps and let me know your stories!  Comments welcome, we all grow and learn from each other!

Traveling with Diabetes

It's that time of year for vacations.  A favorite for our family is the beach.  Getting a break from the day to day of life is great for recharging, but does require some planning ahead when you have a child with diabetes.  Packing all the extra things can be nerve wracking for me, as I tend to feel like I'm forgetting something. (and at times I have, such as last summer my son went off to a non-diabetes camp as a counselor, and he got there and that night called and said "I only have one test strip left!)  So I always keep a list, so as I think of things to pack, I add it to the list.  Here's a key list of things I have to remember to pack for children with diabetes:

• Insulin (the obvious here)  Take more than what you think you might need.  Also, I keep a prescription for an extra bottle that I can take to any pharmacy in case something happens, such as it overheats or the bottle gets dropped.
• Syringes, even if you are on the pump, you never know if you need them for backup
• Pump infusion sets/reservoirs, inserter if used:  an important tip here is, you can not buy these at any pharmacy, so take double what you think you might need.
• Extra test strips, extra meter, extra batteries for pump and meter.
• IV prep wipes, or whatever wipes for pump infusion sets you might use.
• Carb counting books

Again I get this feeling of "I'm forgetting something!" so let me know in the comments section what else you usually take!

Here are some of my traveling tips with kids:

• Take plenty of snacks for lows.  Keep in mind that if you are in a hotel and a child wakes up in the middle of the night with a low, you don't want to walk out to the car, so have something with you.
• Have a plan for what to do for activities, such as how long to stay off a pump, how the activity affects your child's blood sugar, what supplies to carry in a bag with you for activities, what to do at the beach, such as put the pump in a ziplock bag so as not to get sand in it, etc.  Some of these need to be discussed with your doctor ahead of time.
• Things to discuss with doctor: 
• What to do when the pump is off for an extended time, such as at the beach.  We check our blood sugars every hour and then reconnect and bolus a correction if needed.
• How to adjust insulin for extra activities, how to adjust insulin if something happens to the pump and you have to go back to shots, whether your child needs extra insulin such as a temporary basal rate in the car if you are traveling for 8 hours or so (we usually put ours at 110% or so since they aren't getting any activity and there blood sugar tends to go up)
• what to do for emergencies
• If you are traveling by plane, get a note from the doctor saying your child has diabetes and has to carry syringes, lancets, insulin, snack, etc on board the plane.
• If you are traveling by plane and checking bags, don't put all the supplies into one bag, divide them up in case a bag gets lost.  And have plenty of supplies in a carry-on.  I know someone who went overseas and had all their supplies in a backpack, and it was stolen!  It was a mess getting supplies and insulin overseas.

These are just some tips off the top of my head.  If you think of others, please feel free to add them to the comments for others.  I do have that "I forgot something" feeling!
Enjoy your summers!

Take a Break from Diabetes and Have Fun

As a parent of two children with diabetes, it seems I let diabetes stand in the way and take over my life at times.  I can be a worrier and probably at times go overboard on trying to keep it in control.  My kids with diabetes are 15 and 9, so they are at an age where they are getting more responsible with it.  I was having a bad day yesterday, as we all have sometimes, and a friend asked me "Where is the fun in your life?"  Interestingly, my husband and I have just been in survival mode and have not been taking time for us.  In order to keep our marriage healthy, we decided we needed to do date nights more often.  Sadly, we have been so busy that we had a hard time even coming up with something to do, other than the old standby of dinner out.  So we are working on rekindling some old things to do together and have fun and get a break, not only from diabetes, but from just kids as well.

A key for parents with diabetes is a having a back up person that can care for your child.  Luckily for us, our 15 year old can manage his own.  So as bad as it can be having two kids with diabetes, it does work in our favor with him as  a babysitter.  But for those times when he's gone, our 14 year old without diabetes knows the general rules.   We just have our routine down where our daughter knows to check before she eats and call us.  She is on an insulin pump, so it helps her be more independent and just be able to program in her carbs and blood sugar.  So we are still on call, but at least we get a break for a few hours.  When the kids were younger, we had a high school senior as a babysitter.  She had a friend with diabetes so was somewhat familiar with it.  We just went over a lot of basics with her and had written instructions. 

So I encourage parents who are on call 24/7 with diabetes, remember to take care of yourself and take care of your marriage (if you are married) and take some time to have fun and get away.  By taking care of yourself, you can better take care of  your child!