# Spoke to my nurse



## MrsBoyle (Aug 9, 2010)

My husband rang her up this afternoon and she came straight round.
She has shown us how to do some ways to do the insulin and said he could be so up and down becuase i may of not been getting all the insulin in him.

Also said to try these ways for a week and see how things go.
she was really helpfull and made me feel so much better.
Im not to test his bloods alot unless i think i really need to. 

She wants us to put all his meals and snacks later ready for school and said i dont need to worry about school i have 3 weeks and so left and she will do all that for me and if i really feel the need she will train school up for blood tests.

And if in a week there is still these highs and lows she will look at changing his insulin and talk about the pump she did say she wouldnt stop us from getting it if we really wanted to just wants us to try the new ways to inject.

And told me if i ever get like i did today just ring her up and she will come straight round again.


----------



## bev (Aug 9, 2010)

Hi - I dont wish to dismiss what your nurse has told you, but I think she is wrong. The reason why levels are all over the place is almost certainly due to the mixed insulin regime he is on. There could be a tiny chance that sometimes some insulin doesnt get in - but not every single day!

Most hospitals are phasing out mixed insuliins as they just dont work - for 99% of people. 

Regarding school. Again I think your nurse is wrong. You should NOT have to make Dylan eat to suit the school timetable - ever. The only reason your nurse is saying this is because she probably doesnt want to ask them to inject him if you went onto MDI as lots of schools find this difficult to get volunteers to do the injection. It is not right that you should have to feed your child to make his life easier at school. School should be fitting in with Dylans regime - not the other way round. 

Your nurse said she will train school to do blood tests 'if you really feel the need' - this is again very wrong. School should be testing Dylan throughout the day and as required. He should be tested before and after P.E. and for any other unscheduled exercise. What if he had a hypo at school and they didnt know how to test? I am quite shocked that this has been left so late in the day to sort out with school. You need to know that from day 1 - there is someone at school who understands the need for blood testing and what to do if he is either hypo or hyper - it is absolutely essential that they know this before he sets foot in the school. 

I dont mean to burst your bubble at all - but your nurse seems very laid back about him starting school without having sorted out a care plan or whether there is anyone fully trained to be able to deal with him and make him safe whilst at school. I would not be happy to send my child to school under these circumstances as the 'plans' to keep him safe are not good enough in my opinion.

I would also want to be present at the training that your nurse gives to school as sometimes they can miss things out that seem obvious to them - but not to untrained people.

Sorry if I have misunderstood - its just that it appears that your nurse seems a bit laid back and she should not be advocating the idea that feeding your son up to make it convenient for school is acceptable. All schools are required to 'make reasonable adjustments' and this is covered in the DDA. Letting Dylan eat when he is hungry as opposed to when it fits in with school life is not making 'reasonable adjustments' at all and could be detremental to his long term health.Bev


----------



## MrsBoyle (Aug 9, 2010)

Im really happy with the things she has said and he has been in that school for a year now so its not like he is starting a brand new school.


----------



## bev (Aug 9, 2010)

MrsBoyle said:


> Im really happy with the things she has said and he has been in that school for a year now so its not like he is starting a brand new school.



I hadnt realised that he was already in school - I thought he was just starting new in September. But surely the school already know how to do a blood test?Bev


----------



## MrsBoyle (Aug 9, 2010)

They have never done a blood test. and have treated him for a few hypos.


----------



## bev (Aug 9, 2010)

MrsBoyle said:


> They have never done a blood test. and have treated him for a few hypos.



Bit confused - so who does the blood test when he is hypo? Sorry if I have misunderstood you.Bev


----------



## Adrienne (Aug 9, 2010)

Mmmmm sorry have to say I agree with Bev wholeheartedly and I think that the info the nurse is giving you is bordering on dangerous.   The worst bit is the less testing and only do it if you feel like it.    I wonder how she would be if her child had type 1.   I wonder if she has children !   Sorry but she is wrong on most points.

It is great however that she is giving you pointers on how to inject differently if it will help Dylan but that is all, in my view, that she has got right.


----------



## MrsBoyle (Aug 10, 2010)

Sorry to say but I feel like your picking on me for following the advice of a trained and experience healthcare professional. 

What training do you have? What qualifications do you have? 

No one child is the same, you can not go by what works for one, with the other as every child is different. 

We never said we won’t change anything, or no to going on the pump. The nurse explained that the reason he is doing this and that and how we can go about. And recommended we try this first before changing anything which I agree with.

So unless you are a experience health care professional, you have no right to tell me or anyone how we should treat and care for our son. 

School is 3 weeks away and how do we know that have no one trained? And if we can learn to test bloods in a few hours so can they. 

Isn’t the idea to make Dylan feel the same as the other kids? If we can get things to work around the school and times then that is BETTER for Dylan. We should not go on what is best for us but what is best for Dylan.


----------



## Copepod (Aug 10, 2010)

Mrs Boyle, I'm really glad you have a nurse you can trust and who is giving appropriate advice and support, including explaining options for possible future treatment. Bimodal insulin regime does have an advantage of not needing injections during the school day - for some children / families / schools, that's important.


----------



## SilentAssassin1642 (Aug 10, 2010)

MrsBoyle said:


> Sorry to say but I feel like your picking on me for following the advice of a trained and experience healthcare professional.
> 
> What training do you have? What qualifications do you have?
> 
> ...



Hi MrsBoyle - I'd just like to say that both Adrienne and Bev are pretty experienced at dealing with diabetes as both their kids have it, and Adrienne's little girl has been diagnosed since she was a baby. All they're doing is trying to help.

I have to say, I agree with them too. It sounds like your nurse is very laid back about it. Twice a day injections just don't work for 99.9% of people, and myself I remember being taken off them PDQ after being diagnosed because they were just...rubbish! I also have to say that the school have to make reasonable adjustments for your little boy, whether that is allowing him to eat when he is hungry, learn how to do the blood tests or the injections. If they don't do that then I hate to say it, but they could be putting your son in danger. Sorry if that seems a bit cut throat, but if your little one has a biiig hypo at school and no one does a blood test for him, what on earth could happen then?

I think you're a really brave lady for dealing with and learning about the injections and dealing with your son when he gets upset with the jabs, huuuge kudos to you with that. It just does really seem as though your nurse is a little too laid back when it comes down to it.


----------



## novorapidboi26 (Aug 10, 2010)

Stick with your nurses advice, thats all you can do........

the point that the others were trying to get accross is that if there is to be insulin changes, which there will be as you know, then there has to be lots of testing to investigate what effects its having on the blood sugars.

You will see this happen in time anyway......

Dont get worked up either, the forums are only peoples opinion on things, wether you agree or disagree......and the best qualification in these matters is actually having the condition, or like you and the others, caring for a child that cant learn these things themselves.....

Fingers crosses the new insulin calms the sugars down.....

Keep us posted.........


----------



## MrsBoyle (Aug 10, 2010)

The school will do what they have to do for Dylan and have done but if we can get his snack fitting in with school so he can eat with everyone eles then thats what i want. He did not liek having to sit and eat his snacks before all the other children and that made him hate being diabetic if we can get it so he can eat with the other kids and he doesnt feel left out then thats what we want.

The school are happy to do blood tests if needed but if they cant tell he is having a hypo how do they no wen to test in the first place.

How he has been doing it at school where if he shows signs of a hypo they treat has worked for 6 months.


----------



## novorapidboi26 (Aug 10, 2010)

I agree, he is only a small child but I dont see why he could not recognise a hypo and alert a teacher..........

Then it can be treated as normal..........

I dont understand why he cant eat at the same time as everyone else....why is that MrsBoyle.......


----------



## SilentAssassin1642 (Aug 10, 2010)

MrsBoyle said:


> The school will do what they have to do for Dylan and have done but if we can get his snack fitting in with school so he can eat with everyone eles then thats what i want. He did not liek having to sit and eat his snacks before all the other children and that made him hate being diabetic if we can get it so he can eat with the other kids and he doesnt feel left out then thats what we want.
> 
> The school are happy to do blood tests if needed but if they cant tell he is having a hypo how do they no wen to test in the first place.
> 
> How he has been doing it at school where if he shows signs of a hypo they treat has worked for 6 months.



but as adrienne and bev say, they should really be testing him both before and after pe, and before he eats too as well as if he feels "funny" either low or high. What I think we're saying though is, sometimes hypos can creep up and be a little slow to show symptoms so testing should be done pretty regularly even if he isn't feeling hypo. Also, maybe he will feel hypo but not actually be hypo, which is why it's always important for them to test - if he's not hypo but feeling funny and they treat, that could potentially send your little one hyper instead


----------



## SilentAssassin1642 (Aug 10, 2010)

novorapidboi26 said:


> I agree, he is only a small child but I dont see why he could not recognise a hypo and alert a teacher..........
> 
> Then it can be treated as normal..........
> 
> I dont understand why he cant eat at the same time as everyone else....why is that MrsBoyle.......



NRboi, I felt the same when I was first diagnosed, I didn't want to be treated as "different" - but I have to say that sometimes I HAD to. Like hypo's etc, I would just go and sit in the staff room and eat then. There are ways around it.

But as I said above, sometimes hypos can creep up and symptoms may be a little slow to kick in. This is why treating is so important.


----------



## MrsBoyle (Aug 10, 2010)

He will be eating his snacks and lunch with all the other children.


----------



## novorapidboi26 (Aug 10, 2010)

If the doses are not correct, then yes testing should be done, because of the risk of hypos........

But on paper, with mixed insulin like Mixtard 30 you are only meant to test at injection times, breakfast and dinner, its old school, and wont last much longer I think........

But thats the problem here, the doses might not be right, the insulin might not be right, he might actually need MDI due to varying sensitivity.....

Unfotunately until these questions are answered, testing is the only way to be safe..........


----------



## novorapidboi26 (Aug 10, 2010)

MrsBoyle said:


> He will be eating his snacks and lunch with all the other children.



Thats good, no reason why he shouldnt..........


----------



## MrsBoyle (Aug 10, 2010)

So your saying teh school should do blood tests about 5 times in a day.maybe more


----------



## SilentAssassin1642 (Aug 10, 2010)

MrsBoyle said:


> So your saying teh school should do blood tests about 5 times in a day.maybe more



MrsBoyle, on MDI the average testing amount is 8-10 times a day sometimes more.

But I think you're right, if your little ones doses aren't right which may be the case on twice a day jabs, then they should be testing to make sure he's not going low or high. He should be tested before meals which you should know which at school is once right? As well as before any form of snack


----------



## novorapidboi26 (Aug 10, 2010)

No no..........

If the dose it constant, which it is on your regime, and the carbohydrate intake is the same, at lunch, dont worry about snacks, then a pattern should form........

If he gets low at say an hour before finishing time then the breakfast dose needs to come down (as opposed to more food). etc etc....

Once you have spotted the patterns in his sugars then you get the dose right, there should be no need to............

Also activity, play time, PE......these might drop him down........

Its all about learning what happens to his bloods on a regular day at skool so u can plan the doses and food........

But do you know all these factors? if not then investigstion must start, so that means testing at critical times at skool, not forever, just till a pattern has been indentified......


----------



## SilentAssassin1642 (Aug 10, 2010)

novorapidboi26 said:


> No no..........
> 
> If the dose it constant, which it is on your regime, and the carbohydrate intake is the same, at lunch, dont worry about snacks, then a pattern should form........
> 
> ...



when i was diagnosed back in 96 and on twice a day i was told to test before snacking! It's important!If sugars are too high then snacks are a no go!


----------



## novorapidboi26 (Aug 10, 2010)

SilentAssassin1642 said:


> when i was diagnosed back in 96 and on twice a day i was told to test before snacking! It's important!If sugars are too high then snacks are a no go!



As I said, testing is required alot when trying to establish what going on......

But if your having a bag of crisps and an apple at playtime, thats not gonna do anythin to the old blood sugars.....
assuming the doses are correct


----------



## bev (Aug 10, 2010)

MrsBoyle said:


> Sorry to say but I feel like your picking on me for following the advice of a trained and experience healthcare professional.
> 
> MrsBoyle, no-one here is trying to pick on you - that couldnt be farther from the truth. Adrienne has 10 years experience of all sorts of regimens and I have 2 years experience. Health Professionals vary from being extremely good to extremely bad in our experiences - so we are just trying to help you to work out whether the advice your nurse has been giving you is 'good' or 'not so good' thats all. If you feel that its 'good' then thats absolutely fine as you *should* have faith in your team.
> 
> ...



I agree with you. But your post seemed to say that your nurse wanted you to change times of eating to fit in with the school times - rather than changing things for Dylan's benefit. If it was the latter - then thats great - as long as the new timings of eating benefit Dylan's levels etc.. again perhaps we misunderstood what you meant.I do hope you realise that we are just trying to help you and Dylan - not at all picking on you. It is very hard trying to communicate in black and white text and if we have upset you then I apologise. If you are happy with your nurses advice then thats great.Bev


----------



## aymes (Aug 10, 2010)

I don't think it's necessarily true to say that the mixed insulins 'don't work' or are 'rubbish'. In the same way, other insulins/systems don't work for all. They certainly are not appropriate for a lot of people but in some cases they can and do work. They worked for me for a few years until my lifestyle changed, and I know a few other people that they work very well for. The great thing on here is that we can share experiences and what works for each of us, but it's important to remember that whatever the solution for one person was, it doesn't mean that it will be the same for others as so many other factors come into play. For me the value is about sharing experiences/opinions which allows you to have informed and worthwhile discussions and make decisions with your medical team, as opposed to replacing their advice.
Mrs Boyle, it sounds to me that you do have a supportive nurse there who wants to work with you so I'm sure between you you'll come up with the solution that works for you, your family and your current situation.


----------



## SilentAssassin1642 (Aug 10, 2010)

novorapidboi26 said:


> As I said, testing is required alot when trying to establish what going on......
> 
> But if your having a bag of crisps and an apple at playtime, jesus, thats not gonna do anythin to the old blood sugars.....
> assuming the doses are correct



But what if his doses ARENT right? Mixed insulins are known to be abit naff and not work for some people! They could send levels through the roof! I was told to ALWAYS test before snacking, even when my doses were right! Because there could be TONS of other factors affecting blood sugars that day, mixed ibsulins are notorious for being rubbish and imagine if the little one is abit unwell with a cold or something? or excersise has pushed his bloods up?????


----------



## bev (Aug 10, 2010)

novorapidboi26 said:


> As I said, testing is required alot when trying to establish what going on......
> 
> But if your having a bag of crisps and an apple at playtime, jesus, thats not gonna do anythin to the old blood sugars.....
> assuming the doses are correct



If Alex had crisps and an apple without insulin - he would be up in the high 20's!Crisps are 17 carbs and apples are 15 - he is on 1 unit to 15 carbs in the morning time - so couldnt get away with no insulin.Bev


----------



## novorapidboi26 (Aug 10, 2010)

SilentAssassin1642 said:


> no need for the blaspheming there! But what if his doses ARENT right? Mixed insulins are known to be rubbish and not work! They could send levels through the roof! I was told to ALWAYS test before snacking, even when my doses were right! Because there could be TONS of other factors affecting blood sugars that day, mixed ibsulins are notorious for being rubbish and imagine if the little one is abit unwell with a cold or something? or excersise has pushed his bloods up?????



I agee with you, but I am holding back in saying get him on MDI because I dont think it is suitable for a child that young, who has problems with needles....I have no doubt in my mind a year or two down the line he will be on MDI........and I also agree that there are factors likes illness, activity which contribute, thats what my point has been, investigate, test at least for a few weeks until a pattern is established....then your on your way......

In the end there might not be any other option but to get him on MDI or a pump ASAP.......

He sould be allowed to snack even if hes not well, as this should of been indentified and insulin adjusted to compensate..........


----------



## novorapidboi26 (Aug 10, 2010)

bev said:


> If Alex had crisps and an apple without insulin - he would be up in the high 20's!Crisps are 17 carbs and apples are 15 - he is on 1 unit to 15 carbs in the morning time - so couldnt get away with no insulin.Bev



That applies for MDI.................not twice a day mixes........


----------



## bev (Aug 10, 2010)

MrsBoyle said:


> So your saying teh school should do blood tests about 5 times in a day.maybe more



Yes they should be testing as and when required. Alex tests up to 12 times a day - but he is on a pump so tests more often. If Dylan was at home - how many times a day do you test him? It should be the same at school, if not more, as doing P.E. etc can alter levels quite dramatically, as can feeling ill and not wanting to eat scheduled food etc.Bev


----------



## novorapidboi26 (Aug 10, 2010)

bev said:


> Yes they should be testing as and when required. Alex tests up to 12 times a day - but he is on a pump so tests more often. If Dylan was at home - how many times a day do you test him? It should be the same at school, if not more, as doing P.E. etc can alter levels quite dramatically, as can feeling ill and not wanting to eat scheduled food etc.Bev



12 times a day........WOW........are his sugars unpredictable, sorry for changing subject


----------



## bev (Aug 10, 2010)

novorapidboi26 said:


> That applies for MDI.................not twice a day mixes........



Yes I do understand the difference. The problem seems to be that Dylan's levels are not what they should be on mix's at the moment - so if he were 17mmols and then ate a bag of crips and an apple - he would be in the 20's too. So testing, testing, and more testing is what is required to find out ways of keeping levels at an acceptable range. MrsBoyle - have you been taught how to use a 'correction dose' of insulin to help bring levels down if they are too high? Personally I have no experience of mixed insulins - but I do know a few families who worked out ways of using fast acting insulin to bring levels down when on mixed insulins and it seemed to help a lot.Bev


----------



## novorapidboi26 (Aug 10, 2010)

bev said:


> Yes I do understand the difference. The problem seems to be that Dylan's levels are not what they should be on mix's at the moment - so if he were 17mmols and then ate a bag of crips and an apple - he would be in the 20's too. So testing, testing, and more testing is what is required to find out ways of keeping levels at an acceptable range. MrsBoyle - have you been taught how to use a 'correction dose' of insulin to help bring levels down if they are too high? Personally I have no experience of mixed insulins - but I do know a few families who worked out ways of using fast acting insulin to bring levels down when on mixed insulins and it seemed to help a lot.Bev




Thats just dodgy, if hes on QA insulin, then he may as well be on MDI....the mixture of insulin should be enough to deal with snacks and meals throughout the day, again if the dose is right.

So in theory, his sugars should be pretty much steady, aprt from wee spikes post meal, or drops post excercise...........


----------



## bev (Aug 10, 2010)

novorapidboi26 said:


> 12 times a day........WOW........are his sugars unpredictable, sorry for changing subject



His levels are no less unpredictable than any other diabetic child. The difference is that when you are on a pump, you have very tight ccontrol and if levels change dramatically then this has to be addressed extremely quickly as there is no 'long acting' insulin in the background. You only use fast acting insulin in a pump. If he takes his pump off for sport etc - then you have to test before and after to see how much basal he has missed and if he requires extra or more food and a bolus. 

The down side of pumps is that you can get into DKA a lot quicker than you can on MDI. But the upside is that you get much better control, and for children this is very important as they are growing and changing almost daily!
Sometimes we have tested up to 20 times in a day - because he has been to a 'paintball' party in extreme heat and all the adrenalin etc - but he had a great day and not 1 hypo or hyper - so worth every single test.Bev


----------



## SilentAssassin1642 (Aug 10, 2010)

novorapidboi26 said:


> That applies for MDI.................not twice a day mixes........



actually i have to say i believe you are wrong there. When I was on mixed all those years ago, random snacking would send me up into the 20's and that was even with the correct doses! And don't try to tell me that they weren't correct because they were. Carbs still affect people on twice day mixes believe it or not.


----------



## novorapidboi26 (Aug 10, 2010)

SilentAssassin1642 said:


> actually i have to say i believe you are wrong there. When I was on mixed all those years ago, random snacking would send me up into the 20's and that was even with the correct doses! And don't try to tell me that they weren't correct because they were. Carbs still affect people on twice day mixes believe it or not.



I was reffering to the ratio of QA to carbohydrate potion.....my mistake....should of edited quote.........

Donwside to 2 a day......the control just isnt as accurate........if this so called snack is regular, on a daily basis then the morning dose can deal with it.........its simple........


----------



## SilentAssassin1642 (Aug 10, 2010)

novorapidboi26 said:


> 12 times a day........WOW........are his sugars unpredictable, sorry for changing subject



i test about the same amount of times per day at the moment too, testing is required more when starting on a pump until levels get steady.


----------



## novorapidboi26 (Aug 10, 2010)

This thread has sprinted off in the wrong direction.................im bowing out................

Keep is updated MrsBoyle.............


----------



## Steff (Aug 10, 2010)

Was just about to say that boi,poor mrsboyle her thread has got awry.


----------



## Adrienne (Aug 10, 2010)

MrsBoyle said:


> Sorry to say but I feel like your picking on me for following the advice of a trained and experience healthcare professional.
> 
> What training do you have? What qualifications do you have?
> 
> ...



I apologise wholeheartedly that you believe I am picking on you (can't speak for the others here suffice to say that they aren't either) and am mortified you think I am.   I am not like that.

I spend my life helping other families with type 1 diabetes and another rare condition which is all about blood sugar levels which my daughter also has. I run a charity for this also and a support group.  She had her first insulin injection at 5 weeks old.  She has been through all the different insulins and regimes that were available.    I don't teach in hospitals as Bev said but I have held training sessions for the local support group as the local hospitals where I am are completely pants and we are all in agreement with that and are working very hard to try to get it changed.

I am also one of the main characters in the email support group and help people on a daily basis where I can.  

I don't have to actually prove to you who or what I am so will stop now.  I stand by what I say, I believe your nurse is treating your son just as a text book case (an old text book) and it breaks my heart.   I also understand why you want to believe your team which is fair enough.   There should be set care plans at school and these should have been sorted out long ago with a plan of testing ie 10.15 am (breaktime), 12.00 (lunch time), 2 pm (midafternoon break).  Plus any PE times before and after and when older probably during.   There should be snacks of the same carbs at snack times which feature into the mixed regime.    If your son's HbA1c is below 7.5 % and you know that it is due to good levels and not too many swings then mixed insulins are ok.   If however it is due to too many hypos or hypers or it is above 7.5% then the regime is not working however much you tweak it.  

I also don't agree with hardly any of the stuff Novorapidboi has said either about mixed insulins and snacks and corrections and lack of testing which again shouts out to me the damage being done if this was followed on a young child.   If you can get the right regime with the right levels now you are setting up a child to have better idea and health in the future.   If you only test twice a day what the hell is happening inbetween, very odd way of looking at mixed insulins.  There also appears to be a lack of knowledge of how children respond to mixed insulins and snacks, bizarre but do agree with him when he says this is just a forum.   We all have our own opinions and we are not medical professionals.  We have hands on experience which is different and also has its rightful place.

I have noticed that you do not reply to any of my posts where I have tried to help so I will in future refrain from entering into your threads with questions as I can see my help is not required or appreciated and taken the wrong way.   I too am now bowing out.  I am really upset that you think I am picking on you and again I apologise as that is not and never is my intention.


----------



## novorapidboi26 (Aug 10, 2010)

My thoughts on mixed insulins were reflective on my real opinions on them............whish is that they really are useless in this day and age......

You could test till your blue in the face, but you cant actually do anything about it because its only 2 a day jags........

I feel that posters are trying to say "go on MDI" and they would be right, but thats not the situation here.....

As I said, test at all the times Adrienne mentioned, so as to establish the behaviour of the sugars, then the tests can be relaxed because ultimately no action can be taken with mid injection test (apart from hypo resolve, but thats rule of thumb)


----------



## sofaraway (Aug 10, 2010)

However much I dislike mixed insulins I don't agree that any team that uses them isn't good. I know of very good pro-pump teams that uses mixes for some children. It's about assessing each child and family and finding what will work best.

It's good that you have the support of your DSN and have trust in her. If you are struggling to give the 2 injections a day, then it might not be the right time to go onto MDI. MDI is better for most people but only if they are going to be getting all the injections. 

I think it's a good idea to train someone at school to be able to test if Dylan feels low. If he needs to be tested everyday at school that is something that needes to be decided by yourself, DSN and school. Also ou need to think about how you will use that information if you are testing him more frequently.


----------



## AlisonM (Aug 11, 2010)

One of the things that really baffles me about this blasted disease is the sheer number of treatments and regimes there are. What works for one, or might seem old hat to another, works beautifully for someone else. It's absolutely maddening. Wouldn't it be great if there were a 'one size fits all' treatment that all of us could rely on?


----------



## Steff (Aug 12, 2010)

Hope MrsBoyle is ok not seen her about since this thread went awry.


----------



## Catwoman76 (Aug 13, 2010)

Dear Mrs Boyle- Hope you have a lovely weekend- try not to worry about all the different opinions- people are only trying to help. Take care and best wishes Sheenax


----------



## MrsBoyle (Aug 14, 2010)

I really do Appreciate everyones reply's  and so far everyone seems to be right about this insulin. and i cant just do his bloods twice a day. since monday he has had at least one low a day. 
Nurse is coming round again on monday afternoon.


----------



## Twitchy (Aug 14, 2010)

Dear Mrs Boyle,

I'm so sorry that you & your son even have to think about these things...  I'm trying to think back to when I was his age, but unfortunately I don't remember much except that mum used to take me home for lunch & test me before I ate - I know this isn't an option for everyone though.  Feeling different due to having to eat at different times can be an issue, so I can see why you'd want to avoid that.  I guess maybe later on, if Dylan's on mdi or a pump that won't be so difficult anyway, but if shifting things back time-wise works in the meanwhile, it makes sense! 

Does Dylan hate his blood sugar checks?  I remember hating them more than the injections, because they hurt & I couldn't see the point of them, ie a link between blood sugar level & how the injections worked.  If he's anti blood sugar testing, have you tried any different lancet devices?  I know my experience has been that some are more comfy than others...  Also, bit of a weird one (& the docs/ bean counters might shoot me for suggesting this, but if it helps...), but have you tried asking him to check yours, before you do his?  Sharing the pain might be a motivator?!  (Sorry if that's a bit random!)  Just trying to think what might help.  Maybe your DSN could let you try some different ones, or I bet if you asked the companies that make them they'd give you one free, as they make the money off hte lancets... I have a 3 1/2 yr old boy, so I really, really feel for you having to go through this with him.

I know some of the posts on this thread have maybe got a bit heated, but I think it's because people do care... I guess the other mums can remember all too clearly how the early days are and I think those of us who have had it a long while & esp as kids & maybe have a few health niggles now are just really keen to see everyone get the best solution for them so they at least are ok!    All I can say is being the parent of a diabetic kid as young as yours must be incredibly difficult and stressful & it must be very hard to know what is best to do sometimes.  I hope you know we all mean well & are routing for you both.

Thinking of you both,

Twitchy x


----------



## MrsBoyle (Aug 14, 2010)

He is really good with his sugar tests i have said a few times about him testing mine and will not let me do it, says it will hurt me and only he needs it doing.

With the ways of holding him to do his insulin is much better on him now its so much faster.


----------



## Twitchy (Aug 14, 2010)

Bless him, he sounds lovely...  I've spoken to my sister, she's a pediatric nurse... she says that they were taught to & I quote: "let them practice on teddy bears & let them do it with you, ie help to hold the pen or dial it up. Also praise & reward for being so grown up. It needs to be treated as a normal daily thing & generally only hurts if they are stressed & think it's going to be painful" ... so much for the theory at least!!  Now I think of it, I always wanted mum to do it not dad, as she seemed gentler somehow & he just seemed to be abit awkward & jab it in... not sure if that's cos she was a nurse though!  Sorry that's not much help!  I guess the thing to hold on to is that it will get easier for both of you with time... are you on the shortest needles you can get by the way?  Just desperately scratching my head for ideas...


----------



## MrsBoyle (Aug 14, 2010)

He has that rufus bear from JDRF and he does jab that.
We have tried every bribe going and it just doesnt work with Dylan. Its the same when potty training him if i bribed him with a biccy he wouldnt do it.

We use 5mm needles not sure if thats the shortest. When he first started on insulin the docs gave us the 8mm ones and he screamed the house down only new they was the wrong ones when the nurse came that afternoon and seen them in the kitchen.


----------



## Twitchy (Aug 14, 2010)

Ouch!  Can't believe the docs - such big needles for a little kid!  Bet they were the only ones they had in the cupboard or something, but how dire they didn't think about it!  My little lad's quite 'strong willed' too - he'll do something when he wants to, it's figuring out how to make him want to isn't it!   Not easy!  Are you in contact with any other diabetic kids locally?... Just wondering if he saw another kid his age who was a bit happier with injections having theirs calmly, if peer influence might help?  Might be worth asking hte nurse on monday if she could put you in touch with someone from near by?


----------



## Northerner (Aug 14, 2010)

There are 4mm needles available now, I believe. They are made by BD. Not sure if they are available on prescription yet, but nurse may be able to get hold of some to try:

http://www.bd.com/ca/diabetes/english/page.aspx?cat=14502&id=32463


----------



## Copepod (Aug 15, 2010)

Just had an idea that might work - how about letting Dylan give stickers to adults whose injections "don't hurt me too much". Might let him have an element of input into the procedure (not that no injection is an option). I have had to give many intramuscular injections into children, usually post operative painkilling ones in hospital wards, tetanus injections in A&E and various immunisations in a travel clinic and usually asked child which arm / leg / buttock they'd prefer. Occasionally, children would say "that hurt, but not as much as I was expecting" or "not as much as when X did it", which is why the scoring system might work. IM injections are almost always more painful than subcutaneous like insulin, but usually one off or just for a few days, but still worth considering as a tactic?


----------

