At Wit's End with teenage diabetic

The longer he has diabetes, the worse his management of both his supplies and his disease get.  I cannot even try to get anything across to him about the disease until we go to the endo in a few weeks and he sees his A1C.  But the supplies!  We try and try to help him and give him all the tools he needs to keep it all organized and together, but he doesn't see any of it as important.  Earlier this week, his father made him put everything he'd been carrying supplies in on the kitchen table and clean it all out.  His school backpack was filled with used needles and test strips strewn about.  How many open bottles of test strips were there?  12. We keep the main stock of suppiies in the top of my husband's closet and the child is supposed to ask when he needs more needles/strips/whatever, but he just goes in there anytime he wants.  It's not a matter of getting what he NEEDS.   It's a matter of getting supplies because he doesn't want to bother finding where his current supply of test strips or needles is.

I guess none of this is as important as the number of times he cannot find his insulin and we have to tear up the place looking for it.  Yes, we've tried to establish one place in the house where he gives shots.  He won't do it.  The worst was just now.  He'd given humalog last night on the way home from studying at the library because he and his dad picked up food on the way home.  So where was the Humalog this morning?  In the car.  How cold is is right now?  10 degrees F. (that's -12C).

I tried so hard to keep my cool this morning and I did not succeed.  He's right in the middle of semester exams.  But his walking around the house nonchalantly whistling (to keep himself calm) when he's just ruined a bottle of humalog sent me over the edge.  And I'm supposed to send him off on ski trips the next three weekends?  And I'm supposed to send him off to dance camp for six weeks this summer?  And I'm supposed to keep all this inside without talking to anyone at the endo office about it because it might affect his chances of getting a pump?  And do I punish him because he has diabetes?  It's not about me, but then am I an "over-protective" parent because he won't act like this disease is the most important thing in the world?

If it were anything but THIS, we' d let natural consequences take over.  But the natural consequence of ruining your humalog out of total carelessness would be to do without it for the rest of the month.  When he cannot find it, the natural consequence would be for us to not help him, but then he would get to the point where he would either not eat, or more likely, start a habit of eating without insulin.

I just don't know where to turn.  And no, there are no local support groups.  I'm a total crying wreck and now must head to work.

I am mean there would be no ski trips or summer ones for that matter until he can prove he is responsible period. He isnt from what you have said its not being over protective at all. He isnt doing what he should so nope no fun. I would also add chores to do around the house to pay for the humalog he messed up.

Never had a diabetic teenager, just a teenager. LOL Don't know if this will help so here goes. Gather a bunch of pictures of the dark side of diabetes. You know bad feet, cut off parts, damage eye stuff, etc.... Start this way. Can I talk to you a moment.  >>>>>>>>>>>>HUG<<<<<<<<<<<<< I am sorry to be so hard(or whatever), But I(we) love you and care so much about you. I(we) only want nothing but your happiness and health. Here let me show what worries(insert your word) me about diabetes and why I (we) may seem so hard. After the pictures and crying(just me?), another >>>>>>>>HUG<<<<<<<<<< Tell them, I(we) love you so much that it hurts to even think any of this could happen to you!!! With my daughter, I remembered how I felt as a teenager. I didn't tell her no, I told her it's time to learn adult. Instead of no, I tried this. I explained to her how I felt about it and any fears or problems and she could make her own choice as an adult. Sounds weird but, later my daughter told me that if I had said no, she probability would have done it anyway, but because I explained how I felt and thought about it she(SHE lol) decided it make her feel bad if she did and maybe I had a good point. Good Luck with the teenager, you'll need it ROFLOL        

I was a teenage diabetic and I played with my disease much in the same manner as he.  Being fifteen, going through all the fun stuff that comes with that life stage, and having diabetes really plays with a person and can increase their rebellion.  My father and stepmother became overbearing when I was that age and I did not want to give daily reports on what I was doing with my disease.  I eventually started lying about stuff because I was sick of the pressure from them because they have no idea what it is like to live with it.  It is not fun.  I venture that there is denial on his part being less than a year into his diagnosis. 

Does he have a kit he can keep all his stuff in and carry it on his person?  My meter, 2 vials of insulin, syringe, and lancing device all fit into a small kit that I can carry with me everywhere and it fits into my back pocket.  It sounds from your description that his supplies are just haphazardly strewn about.  Also, you might want to give him access to his supplies at his discretion.  When I was that age I had all of my extra supplies readily available in my room.  It adds a great deal to the individual responsibility and managment.

We've bought 4 different types of carrying cases for his day--to-day supplies.  He cannot be bothered being that organized.  His supplies ARE haphazardly strewn about because that's the choices he makes.  He has a small sharps containor for his backpack and a large one at home.  Why do I get stabbed with used needles when picking up things in my own house?  Or going through his drawers or shelves to help him find his insulin?

What do others think?  Really turn loose 3 months of expensive supplies to a kid who in the past couple of years has lost (and replaced) a pair of glasses (we paid for the first two), an ipod, something else big --I cannot remember.  Really??  He was carrying around a full month of test strips in 12 open canisters because if he cannot find one (hard to do when you aren't organized), he just grabs another one.  I'm not arguing.  I do want advice. I don't want to lie to us (more than he probably does anyway).  If I breathe in his prescence, he's going to see that as overbearing.  How can I let him ruin his body?

CHJoe?  What exactly is the kit you have?  I don't think his back pockets are that big (lol, seriously).  He may be 15, but he's in a 28x30 jeans that hang on him.  Anyway, I know I wouldn't want to be him, being a boy (who doesn't carry a purse) and bouncing back and forth between an overstuffed school backpack (he refuses to use a locker) and needing to take stuff to the dance studio.  If that's all you're carrying, where's your glucagon (I know, you're probably way past that)?  and snacks?  and glucose tabs?  Now YOU probably think I'm overbearing.  Ha-ha-ha.

Angie,What an important post.I hope everyone speaks on this and other teen post.......Hit us with everything you have,We need to hear from you who have walked this way......Parents of teens need all the help we can get.

Wow, he sounds a lot like I was.......I didn't actually take my D seriously until September of last year.  I did the same thing......I didn't check when I was supposed to, I hated when my parents asked me what my numbers were, I wanted to pretend it would go away, I didn't want to give myself shots, I lied about my numbers, and the more my parents gave me advice, the more I didn't take it.  Finally, my parents had had it with my crappy rebelliousness.  My dad took me aside and told me that if I didn't straighten up and fly right, I wasn't going to go back to dance, or even go anywhere or do anything I wanted to.  Until I got my D under control and started taking care of myself, I wasn't going to do anything fun.  Forget about the fun stuff, the only thing I could hear was that I would lose dance.  Dance is my life; the one place I feel whole and completely un-Diabetic is the stage.  I can't live without dance.  I said, "Ok dad."  Since then, we have started a notebook.  I write in the date, every number that I took that day, every time I gave insulin, and how much I took, and anything else my parents want to know.  It was hard to get into the routine at first, but now it's just a way of making sure I'm keeping my end of the bargain.  I leave the notebook outside my door every night for them to read, and every Sunday night, I send in my numbers to my endo.  I don't know if this helps at all, but this is how I've started getting better about taking care of myself.

Angie - my son is 4, so these thoughts come with NO teenage parenting experience, but just some thoughts on how I might handle this.

Appreciate the things he IS doing - if he is not finding the current bottle of strips - at least he is finding some and TESTING. That is good. You are getting poked (OUCH!) but at least that means he is doing shots. So try to take at least some comfort from these good things he is doing in his care.

You probably know what motivates your kid. You may want to make him pay for this stuff (or work it off) but that may not matter to him. (At least if he has lost other things and is not bothered by not having them or having had to buy new ones himself.) It may pain you to do it - but will missing dance practice matter to him? Will not going out with friends matter? Find what privileges matter and take those away until the behavior changes. I know this DOES work with a 4 yr old too. :)

Really agree with Joe that all his stuff on a daily basis should fit in one SMALL case - and probably  his meter case. We used the pen vials of insulin but with syringes and so the 2 vials, 4-5 syringes, the meter and strips all fit in that case. Who cares if his glucagon is buried in his backpack or if he has a zillion fruit snacks somewhere in his backpack. He'll find those. The things I listed are the CRITICAL D care items.

If you have a 'five minute meeting' every night - you could take the case from him then (if organization is a problem) and get it ready for the next day. That way you could control that he has a full bottle of strips and new syringes, and make it habit to help with the organization part. Tell him if he does this with you that you will let some other thing go.

Our clinic has suggested that you try to keep D care discussion to this one 5 minute meeting every day with a teenager. Then you have to commit to not nagging about testing or asking about numbers, etc at other times. (I have no idea if this works or not, but it seems reasonable, if not difficult for you the parent to stop the nagging and tolerable, if unpleasant, for the teenager to talk about this with Mom and/or Dad everyday.

I would NOT find it acceptable to get poked cleaning up my house. This is NOT safe for anyone. There should be punishments for this - because it is dangerous to others. You wouldn't allow him to hit or cough without covering his mouth. This is like doing both - hurts another person and risks infections. Put sharps containers in every room of your house - remove any remaining excuse for needles, lancets not getting it into one.

Or another tact would be to push for the pump sooner. The insulin is always with him then (eliminating the freezing problem) and there are fewer sharps to risk around the house. The responsibilities are different, and just as big, but sometimes it is pretty small changes or differences that mean the difference between success and failure in any given person or situation. Good luck!

Mikaela--this sounds great,  My son has big problems with doing things for nebulous (to him) reasons.  The first three weeks after dx, he kept this awesome food log of how much of what he ate, the number of carbs, the amount of insulin given.  Made it easy to go back and figure carbs on leftovers and to see how certain foods affected his blood sugar.  At the first endo appointment, no one looked at his food log.  That was the end of that.  It's the complacency he's learned being a super smart kid.  (I blame public school----no offense to any teachers out there----I've never accepted heterogenous class grouping as the best way to teach smart kids.)  If he isn't being "graded," it's a waste of time.  Sure, one could see an A1C as a grade, but apparently that isn't often enough.  But I'm going to share all these ideas with him this weekend.  I'm staying out of his face until exam week is over.  Meanwhile, keep the ideas/thoughts/criticisms of me/ whatever coming.

My fear, if I really had to take dance away from him, because he doesn't think I'd do it, is that he would shut down on me.  One thing I've been grateful for in this is that I have an active kid.  I know another diabetic teen in town whose mother cannot get him to move at all.

I was a "rebellious" teen... and I use that term loosely because really - I just didn't care.  You can't talk about the future to a 15 year old.  Or a 20 year old for that matter.   You also can't teach an unorganized person to become organized. 

What you can do, this is my opinion, is:

  1)  Stop finding the lost supplies for him.  If he's late for school because he couldn't find his insulin, or strips or whatever... sorry, that's a tardy and I'm guessing you get enough of those, you get a detention.   Same goes for other activities:  if he can't organize himself enough to get to wherever he needs to be ontime (dance, school, ski trips) with the supplies to take care of himself, he can't go.   I really want to stress that he has to be accountable because you have less than 3 years until he's an adult and going off to college and you've lost all control.  Helping him learn to take care of himself now is the only hope he has of being successful at college/dance camp, etc.

  2) Create multiple packs of supplies - one for back-pack, one for dance bag, one for kitchen, one for bedroom, etc.   Sounds like he's always hunting for supplies because they aren't where he needs them.  Throw two bottles of strips in his backpack.  Throw two by his bed.  A couple in his dance bag.  The stuff is expensive, but you can probably work with his doctors to write the RX for slightly more than he uses on a daily basis to get a couple extra bottles of whatever for extras - and if it's on a doctors RX, most insurance companies pay for them. 

  3) The sharps thing bothers me... but you can't say "you are hurting me", because that is not going to mean much (sorry mom).  You have to put it into terms he gets... what if his girlfriend was going to get a pencil out of his bag, or his dance buddies were looking for some gum in his gym bag and got poked?  How cool would that be?  Not very and those are terms he'll get. 

  4) Does he have any friends you can bring in as co-conspirators?    Having a few friends call you out on bad behavior (i.e. throwing a needle in your bag or never knowing where your stuff is) is likely to change his behavior far faster than having mom complain (and/or yell).  "Dude - you can never find your strips - dang, it gets old" - I'm telling you - he will thick his friend is so smart even though you've been saying it for 6 months.   I know this has worked for some girls, but teenage girls perhaps talk more and are more intimately involved in each others business than boys (I don't know).

  5) Get him a counselor.  His behavior appears to be a bit of denial, a bit of anger, perhaps.  He's grieving.  He lost a huge thing recently - his freedom from responsibility and fun-loving teen years.  It's gone.  He will not get them back.    He might just need to talk to someone about it (and rightfully so and probably against his will)

  6) Hate to be the bearer of bad news but you will never win the used test strip battle.  Get over it.  ;-)  (had to put that in there... sorry)

  7) Perhaps discuss insulin pump with him and his doctors.  Gosh, it would cut down on supplies he has to have with him for sure.   Might not be great for his dance stuff, but they do make smaller tubeless models these days.  Or they can be disconnected during intense activity, etc.

At some point, you mentioned that "he won't act like this disease is the most important thing in the whole world" - and I'll tell you right now, as sure as I am that my eyes are blue - you are right.  He doesn't and he won't.  And he will spend the rest of his life trying to make it not be cause it sucks.  They aren't kidding when they say chronic.  I'm close to 33 years living with type 1 and try to forget it as often as I can (I did a "Day in the Life" a while back - November 12th - that I "tweeted" everytime diabetes reared it's head in my life - 22 times in the 15.5 hours I was awake.   It doesn't go away, it rears it's ugly head when you least want it to, and it invades all aspects of your life.   He spend the rest of his life trying to downplay it.

I do agree with whomever said: "at least he's testing" cause there are a lot of us who didn't in our teen years.  And, also with "at least he's giving insulin" cause I gave up on that in my teen years as well. 

I hope this helps.  I wish you luck.  If it's any consolation - a good portion of rebellious teens turn ok in our 20s and realize what jerks we were to our parents.

Showing him pics to scare him straight doesn't teach him what to do instead.

Here's a strategy you could try.

You could have him pre-fill up syringes with some "safe" amount of insulin (about he would usually need following a meal or even a bit less) before he goes to school. Then he can take the insulin after he eats. It requires little effort and he'd probably be likely to do it. Then, have him show you his used syringes when he gets home and REWARD him with something he likes (maybe even like lunch money for the next day).

Once he is doing this consistently, raise the stakes. Incorporate in the testing and check the #'s from his meter AND syringes. As long as he did test and take the insulin make sure to REWARD him for that. You could also incorporate more insulin in the syringes since he can choose to take it all or some of it after he has tested.

The key is to TEACH him what to do by REWARDING good behavior. If he "forgot" to do one of the previous steps, then no reward. That would just mess everything up. It's crucial to be consistent when doing things like that, whatever you choose. Starting with the easiest behavior to do first is key (the one that requires very little effort on his part).

I agree with Travis. I'm not a parent of a teenager, but as a teenager, showing me scary pictures would not have worked. Most of the stress of having D is knowing all these horrible things that can happen. When my control was bad, it was b/c this idea was so overwhelming as a 13, 14, 15 year old, I wanted to ignore it. I avoided any D related information in case I saw something that would scare me and tried to bury it in the back of my mind. As an adult, I've gotten in better control, so I still feel scared but feel more in control of my destiny.

I like the idea of only discussing D for 5 minutes a day instead of dwelling on it. It sounds like your finds organization tough overall & it's just part of his personality. Does he use any sort of system like a whiteboard, planner or cell phone for reminders, etc?

Hang in there! All us adults on here seemed to survive our teenage years. (:

Sorry you're going through this - it sounds very stressful indeed.

I do agree with Katie Clark - there's really only so much you can do.  This is his disease, not yours.  He needs to figure this out for himself, and the bigger deal you make of it, the less likely he is to comply.  He is after all a teenager and they do tend to rebel.  And keep in mind that he still has a lot to learn about diabetes management and if you turn him off of it now, the longer it will take him.  You're doing an awesome job and that is evident by the fact that he attends his doctor's visits, takes his insulin, and tests.  And that's what matters the most, despite the ugly trail he's leaving behind.

I wouldn't attempt any form of 'punishment' for his behaviour.  You want him to go on trips/dances - he needs to live a normal life.  He did not ask to get diabetes and to punish him for diabetes-related mistakes will be very counter productive.  I wouldn't even bother with a reward system because all it will do is draw more attention to diabetes, which is something a teenager wants to avoid.  Unless you're offering him a car, I doubt he will make any changes based on rewards.

If I were you, I would make sure I was leading by example.  For instance, keep your own food log (tell him you're trying to lose weight or something),  make sure you ALWAYS pick up after yourself, read books on diabetes, do things to make yourself healthier, eat right, etc.  I guess what I'm trying to say is be supportive, and refrain from yelling at him or punishing him.  And be soooo thankful that he tests!!  When I was a teen I went 3 years straight without one single test.

And FYI, I think its a Type1 diabetic right-of-passage to have used test strips all over the place. You should see my car! 

[quote user="spaghettio"]

And FYI, I think its a Type1 diabetic right-of-passage to have used test strips all over the place. You should see my car! 

[/quote]

My passenger seat also serves as a trash depository for used testing supplies. (: My whole car smells like an alcohol swab. Once every few months (okay, okay, more like once a year), I get up my motivation and go out there with a trash bag.

I hate seeing dont punish him. Really? No he didnt ask for it but as a parent WE are responsible for our kids. If I know my kid was out being reckless while driving lets say I wouldnt let him drive. To bad if he has a date or if I have to drive him around myself. To bad if they are mad at me.  Again I realize our kids didnt ask for this but destructive and irresponsible behavior is just that not taking care of yourself as you should is no different than driving recklessly. Its still a danger to yourself. If they cant or wont be responsible enough to care for themselves more at age 15 then yeah I will treat them as they are acting. If I have to follow them around school and test them for themselves so be it. No WAY is a kid going to put up with that for long. They have 2 choices be responsible and take care of themselves or have mommy follow him around for the rest of his life.

By no means am I saying that is the only way to do it showing him the pictures and discussing long term health might do it. I dont know but I do know I would have died if my parents fallowed me around school to make sure I did what I needed to do but I would also have known they were willing to fight for me even when I didnt want to.

Punishment would work far better if it were combined with something positive. That's why I suggested withholding something pleasurable (lunch money, video games, etc) if he does NOT do what he needs to do, but he DOES get access to those preferred things when he does the right things.

But punishment alone is not the best way to change behavior and it can make things much worse. Teaching what NOT to do is not the same thing as teaching what TO DO.

Obviously, finding the perfect answer might not be possible.  I VALUE the responses from the T1s who are either teens or who can really remember what it was like to be T1 and teen.  It truly helps me gain perspective on what might be going through my son's head.

But it's funny how I can tell by reading the responses who are parents and who aren't.  (Or parents of old enough kids).  It IS his disease.  But as a parent, I have certain responsibilities to raise him the best that I can in the time I have left.  Responsibility is sometimes really hard.  And that's what I'm struggling with:  how to best fulfill my responsibility and best serve my son in his time of need, when I also feel like picking up a big armload of diabetic books and whacking him over the head with them.  :-) 

That's for all the responses.  I am so, so tired from today, but your words have helped me keep my cool with him and keep it brief.  I only touched on the issue that if someone at school happen to reach in his bag and get poked by an uncapped needle, the school could seek disciplinary action and could revoke the "privilege" of carrying his supplies and require him to always go to the nurse for shots.  In typical frontal-lobe fashion, he replied that this hasn't happened so far so it won't be a problem.

Obviously I love my boy.  I think I've said on here too many times (but I repeat for emphasis) that he is a SMART kid who is mostly a GOOD kid.  In a recent 504 meeting, his honors Bio teacher said that if they couldn't trust my kid, who could they trust?  My husband and I waited until we got to the car to start laughing, but truly he's a good kid.

You might all still be here (hooray!!), but I don't know what shape your kidneys, eyes, nerves, etc. are in for the long haul.  That's why my heart aches over this stuff.  I'm not just freaking over the supplies, but the supplies as a reflection of his self medical care.  We'll see what the A1C is in 2 weeks.  And I don't mean that in a punitive way.  I just know that it's not going to be where it should be.  Thank you all.  I'm so glad you're here and so willing to devote the time.

[quote user="spaghettio"]And FYI, I think its a Type1 diabetic right-of-passage to have used test strips all over the place. You should see my car![/quote]

 

hehe Yeah! totally! Once I found a bottle in the fridge...what the heck...

Anyway, that's really a tough situation. Maybe he's burned out. I have cried in the middle of the night, feeling completly hopeless about my diabetes situation and life in genereral. And when you feel like that, you want to completly ignore your diabetes, cuz it's why you're torturing yourself emotionally. I saw that there are no support groups-I'm in the same situation here...has he talked to a school consular or teacher he really trusts? Some school consulars are really weird, but the one at my school I can actually talk to...  Anyways, I hope this random babbling helps!

 

Maria Rose

Angie,

First of all you are doing a great job with Aaron. As it was pointed out to you, be glad for the small things in life that he is doing right. I did like some of Kate's suggestions as it can hopefully make him a little more accountable. As for the pack that Joe was talking about. At one point I did have the one touch ultramini tester. It was small and the kit was just big enough for me to have the test strip bottle, the lancing device with a few lancets (i was a reuser) and zip it closed. The outside of the kit had a velcro pocket in which I kept both vials of the humalog and NPH along with the syringe. Most times when traveling I would throw in a fresh needle and go. Now I think your son is using lantus and humalog so for daily travel you could easily omit keeping the lantus in the kit to make it smaller. Granted I would never stick the kit in my back pocket I did keep it in the pockets of my cargo pants. That could help a little for the day to day stuff, and while I don't advocate it, if worse comes to worse and he leaves and forgets a fresh syringe for the humalog the old could be used. Using a not so sharp syringe might make him a little more aware of keeping track of supplies.

Not being a parent myself I can only speculate at your frustration. Being a slightly rebellious teen myself I can now listen to my friend Laurie and the troubles her 19 year old son is giving her and listen to her side of the story and see both sides. At 15 the young male is going to do what he wants. Anytime mom or dad get involved with how they do Their thing is a pain in the bum, resulting in the sigh, eye roll, or just ignoring of the parent and what they say. I mean I am 28 years old now and home on break from school. When my mom came home tonight, I had just gotten in from a road trip up to Spencer, MA. I was tired and not wanting to talk to anyone and she started asking me questions about the trip. I was not really in the socializing mood. So she decided to ask if maybe I was hungry (inferring I was low, which I wasn't). So I politely told her no, I was fine, looked at my CGM and continued my night. I did however, roll my eyes on the inside. It is what mom's do, they worry about everything and I love my mom for that even when it drives me bloody crazy. You can only keep asking the questions, try different ways though so as not to provoke him. Even if you are thinking you are not provoking him, after a while the questions will drive us crazy. Show you care but if possible try to find a way to do this without seeming like you are being over caring. I can't even come up with a suggestion for that though.

The used supply mess is just part of the game, the uncapped syringe thing bothers me, but I can honestly tell you, I find used strips all over the place. I try to be careful, but it still happens. Again, be glad that he is at least using his supplies. When I was 16, I maybe tested three times a month and just went on auto pilot, the use of supplies is a good thing.

Maybe you can reach out to your local JDRF and see if they have a mentoring program or your local hospital to see if they have something to help your son in the mentor role not in the counseling role. Just someone who can give their own tips about how they are surviving or what they do. Just to have another perspective for him and one from this side of being a person with type one diabetes.