Counting Down Until Christmas

Today is the last day of school for 2017.  In a matter of hours, my house will resume a family energy.  While mornings will be excessively quiet due to the need to sleep-in, the rest of the day will be full of kids bustling in and out, demands for food and snacks and certainly any intent of a clean home will be long gone. I wouldn't trade it for anything!  It's a special time of year and I hope to keep this tradition for years yet to come.

It is also a good time to take stock in what we are doing within the T1D realm.  Having the girls home, even for short bursts during the day, allows me to see how care is really going.  I can take a few moments to download insulin pumps and CGMs and I can make changes more easily to their daily insulin:carb ratios.  It's a lot easier to do this during break week than when they are at school, work or extracurricular activities.

To help streamline our to-do list, I created a simple list of activities for all of us, including other families, to do at home:

1.)  Reorder supplies.  
This is the end of the year and for many, the out-of-pocket and deductibles have been met.  From now through December 31st, you can take advantage of ordering DME and pharmacy supplies and for most, this is at no additional cost!

2.)  Spend the last of your FSA.  
Have money hanging around?  Many plans allow over-the-counter pharmacy items to be reimbursed.  Check with your employer to see if your plan qualifies to save money on things like alcohol wipes, band aids, contact lens solution, Tylenol, ketone strips and more.

3.)  Review the emergency bag.
Everyone should have an emergency diabetes bag that is ready for instances such as natural disasters or on a positive note, impromptu vacations.  This is a great time to check on the bag and toss expired, out-of-date, or to replace items that no longer are used.  After the bag check is complete, take a moment to remind your family on where and why the bag is available.  It's a great time to review a fire safety plan too. 

4.)  Give a second look at the 504 plan. 
Anyone with school aged children should know that the 504 is a living, breathing document.  It is not a one time make it and forget it.  In fact, December is a great month to review what worked well, what needs improving and what can be added.  Schedule your school meeting for January and start the second half of the year implementing your strategies.  It's a win-win for all, especially your student.

5.) De-stress. 
This is the time of the year where there are many other events, parties and other demands.  As a mom of two with T1D, I urge all of us to practice compassion and kindness to ourselves.  Say no to anything that is not mandatory.  Use your time to spend it with the people that you love the most.  Savor and reflect on far you have come in your T1D journey and most of all, celebrate those victories - big and small! 

Happy holidays from all of us at NaturallySweetSisters.com!  

We need your EXPERTISE!!! Please JOIN US in Helping to Improve Our T1D Community

STILL TIME TO ENROLL!!!!!!!  SIGN UP TODAY!!!!!!

Click this link to enroll!!!   http://bit.ly/TCT1D

Sometimes, you may wonder if there is a way to help others, to make small improvements that lead to better changes.  As you may know, this is what I consider to be one of the key 'silver linings' within T1D... when we are able to use our personal knowledge and expertise within the T1D community, we then receive the satisfaction of knowing that we aren't just waiting, but that we are actively working together to change the face of T1D.  

Today, we have the perfect opportunity for families with children ages 11 to 16 years old  (AND PARENTS TOO!!!) around the country.

Teens and Parents will also earn $ for answering questions about T1D within a set period.  

This is an excellent opportunity to share that T1D knowledge is VALUABLE!  

⏩⏩⏩⏩    HELP US DESIGN A NEW APPROACH TO CLINIC VISITS    ⏪⏪⏪⏪

WHAT CAN I DO TO HELP? 

Many adolescents struggle with managing type 1 diabetes (T1D) and about 75% of them have A1Cs greater than target recommendations. This often goes hand in hand with coping difficulties, lower quality of life and high risk of complications. Psychosocial factors are major influences on T1D outcomes, but regular T1D care often does not address these issues. In this 3-year, NIH-funded study, Dr. Tim Wysocki will coordinate the development and testing of a Transdisciplinary Care (TC) model in which T1D is co-managed by an Advanced Practice Nurse, Dietitian, and Psychologist who will see adolescents together. The project will use “crowdsourcing” to obtain input from separate crowds of teens with T1D, parents, and healthcare providers to gradually develop this new model of healthcare delivery. Once the TC model has been developed and team members are trained, the team will complete a randomized controlled trial to evaluate effects of the TC model on health and psychosocial outcomes. We are currently recruiting for the TC Model Development Phase. 

WHO CAN HELP? 

If you are a teen with T1D between ages 11 and 16 or a parent (or legal caregiver)of one, follow this link to learn more: http://bit.ly/TCT1D

WHERE DO I SIGN UP OR GO TO LEARN MORE?

Click HERE!

Working T1D In - On Their Time

Part of my success strategy in taking care of the T1D monster is to find the easiest, least burdensome way to manage the myriad of 'extra' tentacles like blood work, eye exams, allergists, paperwork and even supplies. I do this by focusing what works for us and when.... NOT by robotically following the alloted plan of action. For instance, I try to schedule A1C appointments at three and six months to guarantee we get a time that works, and I often order supplies at night while everyone is asleep, using email to our DME - something that I didn't even know was an option until I asked.  For eye appointments, we schedule the girls together, pick up the scripts and then, I order online at home at night.  This often involves a slight bit of extra time to work the appointment into our schedules, but the ease of which it is accomplished, far outweighs the calendar dates.  

After last week's multiple clinic appointments, we still needed to obtain labwork.  Through the years, I have found that our walk in neighborhood lab is more accessible as there is never a wait time.  Conversely, the pediatric lab at our local hospital always has a long line and while the process is geared exclusively to children, it takes extra time to do the exact same procedure.  This wasn't a big deal when my girls were in preschool but today, with a fear of missing homework, tests and exams, we try to avoid any extra time spent in the hospital. In turn, this relaxes my girls and helps them to not look at blood draws as both a literal and figurative pain. 

So from last Thursday's GI appointment, we looked at times where we could make it work.  Friday was out as there were already too many things going on after school and to be honest, I wanted to give the girls some time off from anything medically related.  The weekend is always a bust as the lab is closed and so, we geared our blood draw time towards Monday afterschool.  Together, we strategized to make a plan to pick up the girls at dismissal and to head directly over to the lab.  I went ahead and gave our endo team a head's up of the plan so that they would know when to roughly check for completed labs.  

All should have been well.  Except that this is real life and with real life comes this messy, unplanned series of interruptions. The girls learned that one of their service organizations called an inpromptu meeting after class to discuss the preparations for a holiday celebration at the local senior center. 

That's right, the girls and several of their classmates are volunteering at their local senior center during the holiday and they wanted to meet and discuss the evenings' events. (Side note:  TEENAGERS VOLUNTEERING!!!!)

Vs. a blood draw.

If you read my post last week, you will know that I am struggling with the notion of placing T1D at the top of the mountain of life. Sure, we could spend extra, anxiety riddled time at the end of our second day of missed school in waiting for a blood draw.  Then, we would have been done with a blood draw as a need.  However, we would have had two very unhappy kids, feeling overwhelmed by the entire process and then, ultimately feeling even more negative towards an autoimmune disease that has no cure. We do NOT need negative feelings. 

- OR -

We wait.  We live life as kids first, T1D second and we recognize that this health journey is a marathon, not a sprint.  That the needed blood draw will still happen.  That the results may or may not require changes to medication, and/or T1D maintenance.  Life will continue and my girls will feel whole, centered and balanced as they continue to achieve everything that is important to them, while managing T1D.  Most importantly, we will fulfill the need to have positive outcomes/outlooks. 

So yesterday, on our own terms, we finally made it to the lab.  Confidently, my youngest daughter walked up to the check-in desk and recited her first and last name plus her birthdate.  She then walked back to me to the waiting couches and sat down.  Sixty seconds later and she was called back.  I asked her if she wanted me to go with her.  Now too big to sit on my lap, I usually stand next to her and hold her hand while the tech draws up the samples.  Without hesitation, she shook her head no and said she was going to be fine.  A few moments more and she returned with a freshly neon pink taped cotton ball and a smile. We immediately headed out and back to the budding independent teenaged life that is rightfully, very important to her.  

In that moment, it is easy to see that the decisions we make are the best decisions.  Maybe it was the ease of the clinic, maybe it was waiting a bit longer, maybe it was just getting a good night's sleep.  Whatever it was, in that moment, it was the best possible outcome for our daughter.  

Our goal is to have the most positive outcome and overall outlook towards one of the most intensive self-managed autoimmune diseases in the world.  

I think we are on the right track. 

Parenting High Achieving Kids with T1D

We just wrapped up what felt like a world tour at our clinic.  Four appointments in two days, with two daughters and a half dozen providers that have become part of our team.  When we are done, it is a mixture of relief, exhaustion and gratitude.  I love our 'people' but the reality is that in times of T1D need, this is a huge burden.

In the eyes of my girls, it can be summed up into a negative knot of things like: missing school, missing important academic tests, skipping practices, missing club meetings, rescheduling work dates, not getting perfect grades, not getting paid, feeling like you let your friends down.... 

This is the real burden of T1D for many.  It isn't the steps needed to monitor blood sugar, dose insulin or change infusion sites, but it is the imbalance of prioritizing what is most important to the patient.

To our provider that said T1D needs to be at the top of the list, I understand that but the risk is that shifting something to the top may result in the breakdown of everything else and that may lead to depression, avoidance and non compliance.  For a mom that watches closely to ensure that her kids are free to not let T1D hold them back from anything they want to achieve, I think we need to be ultra careful in our language that depicts T1D as the most important part of a teenagers day.  It is important and I agree that we need to find a way to fit it in.  However, if we make T1D the domineering influence of everything our kids accomplish, we will in turn be sending the message that if their care or A1C is not perfect, than they will have failed.  I don't know about you, but I am pretty certain that there is no way to get an 'A' on how you take care of your T1D.  The best we can do, is truly the best that we can do.

Which brings me to the this thought and something that I want to start a conversation on... how do we balance 'Kids First, Diabetes Second' with our high achieving older children?  I am slowly transitioning care to the girls (age appropriate steps toward independence) and am not necessarily the main caregiver that I used to be.  I am more a support system for the steps/tasks that they do not want to do (insurance, night-time blood sugar checks, supplies, other med reminders, etc) and that leaves more on their shoulders. 

How do we teach the understanding that it is still a balance to manage T1D while living a full, wonderful life?  And for our children with T1D, how do we express the need to understand that there is 'perfect' YET STILL, the understanding that there is a need to manage daily blood sugar tasks.  In other words, this is a marathon, not a sprint.  We can't give up on taking care of everything if one thing like A1C is not perfect. 

I would love to hear your ideas and thoughts on successfully raising high achievers that seek perfection in life.  Can we help them find their balance?