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More "Grand" Parenting a Diabetic Child – A Southern Site Change
By Franklin and Karen King (Kari’s Oma and Grandy)

Published:
5-September-2005

Three years ago we anticipated the first visit of granddaughters, Kari & Kristin (then 8 & 6 respectively), without their parents. It was to be two weeks of summer fun 1000 miles away from home, with the beach, tennis, boating, cousins, and lots of special family time. Then, one month before the visit Kari was diagnosed with type 1 juvenile diabetes. Following counseling and training, her parents Kara and Russ, decided to go ahead with the visit.

We met at great-grandmother Nana's house in Michigan; We had anticipated three days of "training", learning to give shots, planning meals, recognizing highs and lows, and generally reaching somewhat of a comfort level. We had prepared by surfing the net, talking to friends, and assuring each other that yes, we were grown-ups (and older than their parents) and certainly we could handle it.

We had not taken into consideration that 20 visiting relatives and their never ending need for food precluded the training we had envisioned. As a result our learning period lasted about a half hour and consisted of steps to fill the syringe with the correct dosage of Humolog and Humulin and transferring same to Kari. From the beginning, she was brave and wonderfully patient with all the amateurs nervously poking and prodding. Armed with her kit, extra supplies, the log book, and a list of appropriate foods and phone numbers, we set out for the 1000 mile drive home to South Carolina, comforted by the fact that our doctor was on speed-dial and the hospital only 5 minutes from home.

Since Kari had been so recently diagnosed, her numbers hadn't stabilized; there were many calls to her parents and to her diabetic counselor as we faithfully recorded her blood count and carefully controlled her food. Kari has always been an active child, and her dosage had taken that into account, but nobody had factored in Charleston summer temperatures often hovering near 100 degrees. One Sunday morning, after breakfast and a normal count, we left for church and Sunday school. Two hours later, Kari walked in front of a moving car in the parking lot, decidedly woozy. We raced home, gave her orange juice, and breathed a sigh of relief and gratitude that Methodists tend to move slowly on warm Sunday mornings unless there’s a covered dish luncheon following the service.

We had scheduled the girls for tennis lessons with their cousins and were concerned the heat Kari wasn’t acclimated to and exercise might be a problem. Kari, ever the joiner, bounced around the court and had a wonderful relationship with her tennis camp counselor who was well versed on the problems of Diabetic children. Kari acclimates well.

A challenge of equal importance was balancing the attention that Kari's illness demanded with the attention that Kristin needed and deserved. We gave each girl "alone" time with Oma & Grandy and with Aunt Kiki. And we allowed Kristin more freedom in choosing her foods, theorizing that chocolate chips for breakfast were a good thing if you also served milk.

Although the vacation was not as carefree as we had initially envisioned, we made every effort to follow through with our original plans. An overnight road trip to the zoo with five children under 10 proved to be a wonderful experience for all of us. We chose a suite hotel with small kitchen, large pool and full breakfast. To avoid panic among the cleaning and serving staff, we made them aware of the situation and asked how they would like us to dispose of the needles. All the restaurant and hotel personnel were helpful and accommodating, but we were particularly open about what we were doing and what we needed.

At the end of the two short weeks, we kissed the girls goodbye - and got a real night's sleep, comforted by the thought that next year would be easier since we now knew what we were doing.

The next year the regime changed. Kari was now on Lantus and Novalog. Now we counted carbs (easy, we’d been on the Atkins diet and could recite chapter and verse) and adjusted her insulin dosage according to what she planned to eat. This made food less of an issue for both girls. However, we discovered that we had to re-learn what we hadn’t done for a year.

This summer our confidence level received another blow when Kari switched to an insulin pump. What we thought would be easier proved to be just as challenging. We learned new words like "bolus” and "basal” and how to do site and cartridge changes without getting any more gray hairs. Now she could adjust her insulin according to what she ate. Nutrition not diabetes became the focus. Although we still do most things as a family group, individual attention from additional aunts and uncles made sure that everyone had special time.

Throughout this experience we have learned several things:

It helps to have a resilient child. Kari has been incredible throughout, upbeat, positive, and accepting of her situation.

It helps to have resilient parents. Their attitude, expectations and support have encouraged Kari to take appropriate responsibility for managing her diabetes. They also give Kristin the attention she needed to manage the changes in their family and allow her to shine in her own right. Resiliency in siblings is a must.

Old dogs can learn new tricks. Despite Oma’s near hysteria at the thought of doing permanent damage to her grandchild, she ultimately gave the best shots and did painless site changes. Grandy remained (outwardly) calm, quietly diffusing uproarious situations when the wrong dose was given or a bubble appeared in the tube. It took awhile to convince him that a site change did not mean figuring bolus amounts in a different room each time. ( he spends a lot of time in the hot sun)

Best of all, the girl’s visits have become everything we had initially hoped for. An opportunity to know them as individuals apart from their parents, to share special experiences, and to make memories. Now, if we could only get them to move here… the ultimate site change.