Let me just start by saying…
Diabetes sucks. Hard.
Now that’s out of the way.
Princess Punk is 20. She is still struggling with her compliance and is not doing well. Her numbers are high most of the time and as a result, she feels like crap most of the time. Also, because her numbers are so high most of the time, when she’s in a normal range, she starts to feel low. Normal blood sugar for her is between 70 and 150. Below 70 is a low that she needs to treat, above 150 is a high that she needs to treat. When she’s low, she gets shaky, loses any color in her skin, gets dizzy and cognitively she slows down a bit. She’s kind of spacy? When she’s high, she’s grouchy, nauseous, thirsty and has to pee all the time. If she gets too low she could pass out or even go into a coma. If she gets too high, she could go into what’s called diabetic ketoacidosis (DKA).
I try not to talk about work on my blog. But I will say that one of the aspects of my job is to read medical records of people with serious health issues. Like the 32yo poorly-controlled diabetic that has to be on dialysis due to kidney failure. Or the 23yo who is in the ER several times a month due to DKA and gastroparesis (persistent vomiting due to the stomach being unable to empty completely – also a potential consequence of high blood sugar). So I frequently see the end-result of poorly controlled type I diabetes.
It is terrifying. Especially since The Princess’s numbers are just as bad, if not WORSE than some of the records I read.
Her endocrinologist is flummoxed. As I mentioned in my last D-Monster post, there are a number of things besides in addition to poor compliance that could result in numbers like hers. Problem is, there’s no way to figure out what that might be until she can provide the doctor with some data so he can check out her actual response to insulin at different times of the day. The amount of insulin The Princess needs over the course of a day varies wildly, but since she hasn’t been testing or bolusing (when she gives herself insulin for a high blood sugar or for the carbs she eats) reliably, there’s no real way to figure out what she needs and when.
Here’s the thing… Princess Punk doesn’t want any help. Or at least, not from me. And I know why. I use most of my breath while harassing her about testing her blood sugar and covering her carbs talking about all the horrible things that are going to happen to her if she doesn’t get her shit together.
I’m doing it wrong.
She had a couple of pieces of pizza the other night. When I asked her if she covered it, she said yeah and then I asked her how much she was counting (she takes a certain amount of insulin for every carbohydrate she eats). She said, “I dunno, I think 40.” She had eaten 2 1/2 pieces of an 18″ pizza. I spluttered and told her I was going to look it up. She was in fact, incorrect and 40 grams of carbs was about half the amount she ate and therefore she administered only half the amount of insulin she was supposed to get. When I told her this she got huffy with me and went into My Mom’s room. I stood in the kitchen and cried for a minute. Then I got my bag, walked into My Mom’s room and announced,
“I’m going to bed because I can’t sit here and watch you kill yourself anymore.”
And I went upstairs. Several minutes later, I hear The Princess downstairs sobbing to My Mom about how she couldn’t believe I said that and that she was trying.
And I came downstairs. The ensuing screaming match can not be repeated, only to say that I said some really horrible things that came down to me blaming her (or at least sounding like I was blaming her) for her diabetes. I believe the words, “I’m not going to outlive my child!” were expelled from my mouth more than once. After the screaming came a furious text message argument in which The Princess maintained that she needed to deal with this herself and she didn’t want my help.
She was right.
A little later, My Mom says, “You know, she is absolutely terrified.”
I didn’t.
I got so caught up in my own fears that I completely neglected to think that Princess Punk, the one who has to deal with this disease face-to-face, every single day, might be a little scared too. And I told her she’s killing herself. I told my daughter, my 20-year-old daughter that she was going to die and it was her fault.
She’s still a kid. But she’s also an adult. And I can’t do this for her. I have to trust that she will get it together and do it for herself. And I shouldn’t butt in. Because she doesn’t need me telling her what to do and that if she doesn’t she’s going to die. I’ve been doing that for ten years, that’s obviously not the way to go. What she needs me to be is a mom she can go to and tell she’s scared without me making it worse. She needs support. She needs love. She needs understanding. She needs me to be there for her not do it for her. A co-worker likened it to being the parent of an addict. Your child is in a life-threatening situation and only they can get themselves out of it. While you stand by helplessly and hope they will. To me, that’s the worst feeling in the world.
Despite how I’m feeling, she is objectively not in immediate danger. Dr. Gruff did not freak out. He did not advise her to check herself in to the hospital. He did not advise her what the signs of kidney failure are. He didn’t even think lab work was necessary at this visit. While it’s likely she HAS experienced some damage to her body (eyes, kidneys, heart, nerves, etc.), if she can deal with this and, with the help of trained medical professionals (i.e. not me), start getting it under control, any damage is reversible.
I still dream about going to her funeral.
This is HER disease. I need to let HER deal with it.
As much as that is killing ME.