Friday, May 15, 2009

Highs and Lows

I've posted a lot on diabetes recently and with good reason: having Mary Hannah's condition in the mix is a big change. Overall, her blood sugar readings have been more consistent and predictably reactive to insulin. For instance, if we give her 1 unit of insulin, her blood sugar levels respond pretty consistently by lowering her BG by about 100 points, or covering 25 carbs eaten. Ethan, on the other hand, continues to be an unpredictable roller coaster ride. 1 unit of insulin may have no immediate discernible affect on his BG or it could, who knows. We're looking forward to seeing how he responds to a new pump in a few weeks.

On the behavioral side of things, MH is still adjusting to being diabetic. Not long ago, when her after-school BG reading was really high, she admitted to having a snack at school, but instead of choosing candy, she made a healthy choice: an orange. (For those of you who are confused at this point, oranges and grapes are the two fruits with the highest natural sugar content. A 6 oz orange has about 2o carbs worth of sugar in it, versus a candy like a Jolly Rancher, which has 5 carbs).

Anyhow, I was a little concerned after learning that a few days ago. MH had a cookie at school. She'd figured out how many carbs it had and gave herself a shot to cover it. While I am glad that she is taking the initiative to learn how to do all of this for herself, I'm still not comfortable that she is attentive enough to all the complexities (how much active insulin she has in her system, whether she's been exercising, if she is ill, etc) to be able to do it all without a knowledgeable adult to oversee the procedure. So, I told her that I was proud of her for taking care of herself and that her mommy and I want her to do that, but we still want to be 100% sure that everything is exact, so in the future, if she has the opportunity to have an extra snack at school, to call one of us and verify things before she goes through with it. She agreed to do that.

Fast forward a few days: MH calls me and says, "Daddy, they had some candy at school and I wanted to have some, too. It is a Jolly Rancher and I looked it up, it has 70 carbs. Can I have it?" Now, I remember these types:
but the ones I see most often are a little smaller:

So I said, "Mary Hannah, 70 carbs is a lot of candy, are you sure?"
MH: "Yes, I looked it up."
Me: "Baby, I believe you looked it up, but 70 carbs is a lot for a snack, how about if you save it for lunch time and I'll double check it when I come to give you insulin for your lunch?"
MH: "Dadddddyyyy... please? Everyone else got one. Please? I want it."
Me: "Baby, I know you do, and I'm very glad that you called me to check, but now I need you to trust me and obey, even when you really, really want it. I think that is too much and I am not saying you can't have it, just that you can't have it right now. You need to obey me and wait for just a while."
MH: "I have to get off the phone now, daddy. Please can I have it?"
Me: "No, I'm sorry, but you really need to wait for me. I promise we'll look it up and it can be part of your dessert for lunch."
MH: (sighing) "Okay. Bye."

As it turns out, when I got to lunch, I looked it up in her Calorieking guidebook, she'd been looking at the calories, not the carbs. It was 70 calories and about 5 carbs (the small, assorted kind). If she had given herself 3 units of insulin to cover 70 carbs, her BG would have dropped 300 points. That would probably have put her into seizures or worse. >shudder< I praised her for calling me to check in, as instructed. I told her how I was proud of her for obeying me even when she REALLY wanted the candy and for trusting that I just wanted her to stay healthy. She had a good lunch and got her Jolly Rancher for dessert.

Now, for MY feelings. First, I was was a little bit afraid when she called because I was 99% certain that she'd misread the information. I was glad that we'd had the talk a few days ago about calling to verify things. My heart is both joyful and pained about the situation, though. I am so proud that she was able to obey instead of giving in to the temptation to indulge. It may not sound like a big thing to those of us who can process sugar with no side-effects (spare tires and assorted flab notwithstanding). But I am reminded of a friend who told me about a time when her adolescent son was at a camp one time and all the boys were segregated for talk about "girls and temptation". They passed out slips of paper and asked the boys to write down the thing that tempts them most. Other boys mentioned different female body parts, or flirtations. Her son wrote: "Sugar". So I'm proud that she resisted the temptation to have unauthorized sugar, the temptation to disobey her daddy. However, my heart breaks again when this stuff happens and I am reminded that my baby has to worry about something like this. I hate diabetes.

Thank you, Lord, for the abundant blessings. You surround me all day long with your love and keep my cup full to overflowing. I am assaulted by bitterness when I think about the ways that you want to bless me with diabetes. You give me an everpresent sense of reliance on you for strength. You give me empathy to reach out to other families who are stricken with chronic illness and to comfort them and strengthen them. You help me to overlook obstacles that would weigh down other families because they have not walked where you have caused us to walk. But Lord, oh, Lord... when will you take this disease away from my babies? When will you heal them of their infirmaties? I am aware of both blessing and curses, suffering and healing, but I admit, I don't always understand what I am supposed to feel about these things. Be with my children, your children, and help them grow strong in you, oh God.

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