Becoming Dr. Mom
In a world of medical professionals, the real expert is you.
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
January 2007 — When you are the parent of a child with diabetes, your life is transformed. Your formerly healthy child now has a chronic, life-threatening condition. You also find that you go from being a completely non-medical person one day, to (upon your child being diagnosed with diabetes) being thrust into the world of medicine, like it or not.
I can still remember very clearly the day when my son was diagnosed. His diabetes nurse Kathy told me, "Believe it or not, in a few months, I am going to be asking YOU what changes to make with Joel's insulin, diet, etc." I didn't believe her. Before diabetes, our pediatrician never asked me what dose of antibiotic to give my child. At the time, I didn't think she understood just how non-medically oriented I was. But what hadn't sunk in for me yet was that I really didn't have a choice. One way or another, I was going to BECOME a medical person, or Joel was going to suffer because of it. That change in me really did take place, and it happened much more quickly than I had expected. Kathy was right. Within just a few months she was consulting me to determine what changes needed to be made with Joel's insulin doses. I had assumed a huge role in establishing Joel's sliding scale correction chart, his doses of insulin at different times of day, adjusting his dose for certain kinds of carbs that burn up more quickly or slowly than others, and his basal and bolus rates. I was playing this role pretty well for a formerly non-medical person.
What I wasn't really prepared for, even after this major shift in responsibility for Joel's medical care, was that this responsibility would carry over into all other major medical situations. Last fall, Joel broke his arm. This was the first broken bone in our family, so everything about the trip to the ER was unfamiliar. During the long process of being at the ER to get his X-rays and cast, I knew I would have to closely monitor Joel's blood sugar because of the stress from the trauma, the pain, and the adrenaline that were going to effect him. I felt like I was doing OK. I was staying calm. I had made sure all the nurses caring for Joel were aware of his diabetes. We even remembered to take his pump off before doing the X-rays. Then the nurse was giving him his pain medication and she casually said to me, as she was inserting the syringe into his IV, "Oh, can he have morphine?" It had not occurred to me that the medical staff would be asking me about the safety of pain medications that Joel had never taken before. Wasn't it HER job to know this? After all, she was the one who had the medical training as well as a limitless number of resources at her disposal. Did I mention that we were at the hospital that is affiliated with our local Joslin Center and the only one in our area with a pediatric Emergency Room? At first this enraged me. Why was I expected to know this? And why didn't she? But then, I remembered that at one point, I had asked Kathy if there were any medications he absolutely could not take. She had said no. So I gave the OK for the nurse to give the morphine, and continued to test his blood sugar every half hour, giving him tiny corrections each time so as not to correct him too much, too quickly knowing he could drop way too quickly if the pain or adrenaline suddenly wore off. The next day when I spoke to Kathy, it was confirmed that I had handled the situation correctly.
As a parent, you are almost always going to be the person responsible for your child's medical care when it comes to diabetes. Even when surrounded by doctors and nurses, you may be the one who knows the most about what is best for your child. It may take some time to become comfortable with the role of diabetes expert. Just remember that you are always the most qualified expert when it comes to your child.
Karen is the author of My Child Has Diabetes: A Parent's Guide to A Normal Life After Diagnosis, available on www.barnesandnoble.com.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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