[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

[IP] Family Fun Day March 2, 2002..diabetes focus

Family Fun Day March 2, 2002..diabetes focus

Hello everyone

I tried hard to take good notes for those not able to attend theFamily Fun Day
event in Dartmouth,Nova Scotia . This event was hosted by Minimed and Roche
Diagostics. A sincere thank you should be given to them for the great day we
all took part in.

Dr. Michael Vallis was the first speaker for the adults while the kids went to
see magic shows and clowns. Dr.Vallis is a Psychologist with the Diabetes
Management Centre at the QE2.

Dr. Vallis spoke on " Learning to Adapt"
This was for the short term and the long term for families living with

1. Psychological Factors
- highlight challenges of parents with children
- identify common psychological traps that impede self care

Diabetes is ....purely a biomedical disease
                     ....purely  Behavioral (impact involves
                   how, what, when, where, in managing)
"The more we(medical world ) know, the more the work  load for the parent and
child with diabetes.

The kids were introduced to Intensive treatments...4 injections a day...often
the kids hated this as well as the school systems and others. Often needing
insulin at noon time made it harder for parents.

It's Not Your Disease!!!!! Most distressing as you cannot be in charge

Diabetes is also not the Only Issue in your lives or theirs.

Bottom Line: Individual Behaviors , personal beliefs, feelings, and intentions
(self regulation )

When Doe The Child Develop Self Control?

Their behavior is not based on our recommendations (the medical model)
-Tight control is a good thing they say...To Whom??

As parents, how do you and your child develop the same beliefs? How do these
beliefs match the medical people involved (HCPS)?

The tighter the control, the more chances of hypos.

What is it all about ???

- self care
1. Monitar
2. empowerment
3. respect

Quality of Life
- meaningful, dignity
- wellness  (are you having fun yet is very important) ....The physical,
emotional and psychological.

What determines Self Care?

*Reaching  Acceptance
- must be viewed as serious but not a death sentence
-must be viewed controllable but not pin point control

We cannot always know what will affect our blood sugars but we do know the
liver releases glucose often in relation to stress, sicknesses.

- Must Take Personal Responsibility

Coping With The Burden:

- Don't let anyone tell you it does not produce positives things.
1. It produces good perspectives on life
Don't Sweat The Small Stuff
2. Diabetics make very good friends
...as we know what it means to be sick and have problems so we are often
better listeners and can understand more.

Burden - Emotional (sadness, grief, anxiety, frustrations)
             - Social
             - Financial / Time Management

Develop Motivation
- Readiness to change / deal with things.

Parents of Child

Emotional Well Being
- take good care of yourself before the child
-you cannot help the child if you are sick
dysphoria (sadness)
Facing The Guilt (especially the Moms)
Hope***The Cure is right around the corner***

Staying Calm
- marriages are affected and conflicts are common under these stresses
Uncertainy- How will you deal with it
How do you help the child ......stay Calm

Determining the Responsibility
- Self Care

Knowing when to back off

- How much control do you give a child and for how long...
Allow for Trial and Error. (1-2 MONTHS) to evaluate & see how they are doing.

How do you deal with the Choices the child makes?

The Child
- can have excessive distress(anxiety,anger, depression)

Mom and Dad affected by this as well
Family Adjustment
-How are other kids feeling in the family?
- Don't turn your house into a clinic...

Don't expect things to be normal!! it cannot be so find what works to make
your own normal.....

Diabetes is hard to adjust to
Social issues are ever present.

People with Chronic illnesses have fewer friends alot of the time but they
have deeper friendships that last usually.

Kids may be at risk for Emotional Problems.
- Don't let this frighten you.
- Develop buffers to help with coping.
EXAMPLE: if you have family history of high cholesterol  and Heart Disease,
live with a low fat, healthy diet and exercise is one buffer to help prevent)


Tasks of Adolescents are inconsistent with he principles of diabetes
**Individuation** need own sense of self worth
-Defying rules / regulations
-Identifying with the opposite of parent's beliefs.

**Social Integration**
-unique ( I want to be just like my friends, peers, TV stars, fashions)
- fitting in with peers of Paramount importance


- when they were little, you played with them and made life fun, interesting.
Often by age 12, this has stopped. You need to make family life living more
fun.Play games, do things together, go places and enjoy things together.

Being Cool is far more important to them than being Healthy!!!

Forget long term goals as adolescents just don't see that far ahead.

The Medical world sets us up for failure.
- For too long, the medical worlds forgot, ignored or expected us too much to
follow through on their demands and expectations. Things are changing now for
the better.

Psychological Traps:
1.Psychological Reactions.   The tendency to act the opposite to what you are
asked to do.
Related to the issue of control and self determination. If a person feels you
are taking away controls or limiting their free will,It is very normal to see
that person to resist.

What Can We Do...
See the world through the individual's eyes.
Give them choices
Be Non Defensive
Watch your Own Expectations

- Have good sugar controls
-How long should it last
-If it doesn't last, how do you feel.How do the doctors feel, parents feel...
- degree of Adherence---it will not last forever.
Too many things affect how your blood sugars stay
Everything Affects Controls!

They do their best, try, fail, try harder, fail, Give up.

Repeated behavior is learned behavior.Feelings of failure build up.

Be careful when they cannot achieve


Avoid  Be Careful

Abstinence: I vow to abstain
Violation: despite my vow, I gave in
(Like a diet... you need to lose weight but you eat one thing you should not
often leads to eating more things)
What we see before our faces and surrounds us has this effect. We blow it/ get
out of control/ say get it out of our system/ will start again tomorrow with
clean slate but often don't.

No Behavior lasts Forever
But the problem takes too long to get back on.

The real problem is How much and How Long

What Happened...What can we do about it...

We limit behavior to 100% compared to 0%.

Be constant/ expect cycling to happen
Work with it and don't give up.

Accuchek display was presented.

Next Speaker:
Dr Beth Cummings

Good Glycemic Control
What is it? Why is it important?

Diabetes complications
Avoiding complications
Intensive Controls

This is a Balancing Act.
Food..demands of life..stressors...insulin activity....

Avoid Acute
Hypos - low blood sugars and DKA- High Sugar controls
Promote Normal growth and development

A1C's are markers on the red blood cells. They usually stay around 120 days /
2-3 months so checkups every 3 months help determine the A1Cs UNLESS you were
recently sick.

The A1CS have a variable to the average Blood sugars.

Example A1CS             Average Sugars
                 12                        17
                 11                        15

Sugars stick to everyone' hemaglobin. The glucose sticks to the protein in the
red blood cells. Everyone has some , controlled diabetics have more and
uncontrolled diabetics have alot more.

Changes happen...complications  start to happen
- eyes
- kidneys
- nerve damage in blood vessels relating to Feet/ limbs
- Blood damage to the heart in later years (heart attacks and strokes)

Eye exams for Retinopathy
- Should be yearly and with dilated pupil examation

Kidney ( nephropathy)
- Blood vessels thicken
Filtering is blocked or slowed down

Normal bumimuria- 60%

Microalbuminura- 30% (300 mg /d)
 can get better or worse

Macrolbumimuria (7300 mg/d)

End Stage renal disease.

Foot Care
50% OF Long term diabetics had lower limb amputations

By Age 15, annual foot examinations should start


Test sense of touch

Atherosclerosis- Heart disease
- most common causes of deaths in both women and men, especially when
-happens in much younger ages of diabetics 20's to 30's
-if family history, more care is needed.
Coronary Arteries become narrow.
Cholesterol accumulates
Blood flow slows

Watch the healing of any sores.

Can affect your Sexual ability
This is a good one to talk to teens about they suggested...

Lower the RISKS
- Try for good controls
- Don't smoke
- watch for High Blood Pressure
- watch for High Cholesterol

Modifiable                            Non Modifiable

glycemic control                   family genetic factors
hypertension                         duration of diabetes
smoking                                 hormonal factors
diet and fat

Diabetes Control & Complication Trial 1993
-adults had better controls than teens
- risk prevented by 75% with intensive management
- Kids under 13 not in these tests

Look for patterns
Test often
Respond and adjust insulin as needed
Exercise more
More or Less Food

1. Multiple Daily injections- humalog before each meal and at bed time
2. Wear the pump.

Overall goals
Maintain good A1CS
-beware of more risks of Hypoglemcemia
- Can be associated with weight gains
-   Goals A1CS = 8.4
Target for kids in puberty 4-8
under age 6. target for 8-12


-Tell them what to do
-You make the rules

Should not drive when under 6.0 mmol/l
Before driving Test and eat.Test alot while driving if gone a long time

Many diabetics drive and appear as bad as a drunk driver.

Hard work but reasonable goals
Any improvement is Good
Keep in touch with he diabetic Team as they are there for you.

Then we had 6 teens talk on a panel about being diabetic. 2 were pumpers, 2
were never on a pump, 1 was a former pumper and 1 wanted to pump as soon as
she could get one maybe. They did an excelelnt job discussing their ways of
dealing with peer pressures, diabetic problems, school work and living life
full. All of these kids are really active in many things from hockey to drama
and dance, sports, horses etc.
I end here saying that I might have made some errors here but this was the
best I could do for writing long hand at the event. This was a good event and
we appreciated all we learned today.
I hope this is something you can read and get more help from.

The most important thing to remember is each child is different and so are
each family so keep in good contact with your doctors and diabetes Teams.

Warm wishes to all
Jana Church
R.R.2 Falmouth, NS, B0P 1L0

To Laugh often and much;  to win the respect of intelligent people and the
affection of children....to leave the world a better place..
.to know even one life has breathed easier because of you.This is to have
- Ralph Waldo Emerson.
for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml