FUDiabetes

Children, diabetes and routine


#1

Samson is a champ when it comes to sensor and site changes. He doesn’t flinch and is totally fine with them. He sometimes even asks for them because he knows he can watch a video through them.

BUT we’re realizing that his totally nonchalant response has some very definite limits. The doctors, Dexcom, and everyone else have recommended we change his sensor location from his arm to his upper butt or his tummy since we’re having such terrible problems on the arm.

HE HATES THIS IDEA. He’s absolutely thinking and fretting about it, is super nervous, and really, really really doesn’t want to change where his sensor goes. He says it will hurt and the needle will “go into the wrong part.” I don’t know what to say to alleviate his fear.

Same with needles. His site came out recently at a birthday party and he went without ice cream and cake rather than get an injection. And we don’t rotate his infusion sites beyond his upper back because whenever we try he flips out.

Anyways, I am realizing that clinging to the known is one of his coping mechanisms for what is likely a pretty stressful process. It’s made me remember that even though he’s so tough and wise for his age, he’s also just a little boy, and he has a little boy’s response to these stressful things.

But we still have a problem – we really need to be trying a new sensor position as the current one simply doesn’t work well for us. Does anyone have any tips or suggestions for how to alleviate Samson’s nervousness?

I told him we could do a “practice” sensor on his belly where we don’t insert anything…but obviously we can’t afford to burn through a perfectly good sensor, so it may not be that convincing or prepare him for the feeling.

Any other tips? We can offer incentives but he’s not motivated much by candy or treats or video games. He’s very self-motivated by his own things, and they’re not really things we want to tweak (getting to wear his bear shirt, drawing in his sketch pad, etc…)


#2

Could it be a visual thing? He can see it on his arm, as can others. If it’s on his belly or butt, it won’t be seen by him or anyone else.

I find the belly a perfect location, off to the side really, but I don’t know how to convince a child (I can’t recall Samson’s age) to allow for such.

What about his calf? I know a lot of people use their calf and he could see it easily. I’ve place an OmniPod there before, but not Dex.

Have you asked Samson where else he would put Dex, explaining that the arm just isn’t working out as well as it had in the past and a new location (home for Dex) has to be found?

I wish you the best of luck and am sending good thoughts and prayers your way.


#3

This is what would have worked with my sons. Work with him for a few days until he can explain (in kid terms) why the current site is bad, and then give him the flexibility to pick which site to go to next (within a construct of your choice of possible good sites to try)

BTW if you are still on the G5 the G6 insertion is sooooooo much easier and less painful.


#4

he has the G6, i think it’s more something conceptual than discomfort.


#5

Yeah the psychological parts of this disease are really evil. Poor guy. I really feel for you.


#6

I think the best thing to do is make site rotation part of the routine. Get a site chart with little check boxes or dates he can write in. And he has to write different dates in different places. And also with different colors.

You can show him how when he fills in the different sites with different colors over the course of months and the whole year it looks much nicer than just filling in the same section.

This is not a great one, but just an example:
image



From what you have said about him before, I understand his personality is task-oriented and how he wants routine and consistency.



  1. He has to develop the mindset that rotation is part of the routine. Try these concepts:
  • It is not fair to the tummy, if the arms get all of the sensors!

  • It is not fair to the left arm, if the right arm got it last time!

  • It is not fair to the legs, they need to be treated the same as the other parts!



  1. Also, have him understand about balance between left and right. Try this as a demonstration:
  • Have him try to carry 2 containers of milk, a gallon each, but both of them in his right hand. Now have him do it with 1 gallon in the right hand and 1 in the left hand.

  • Left and right balance is better. It is much easier than everything on the same side!


#7

@Eric this is great advice. I framed it that way and when I asked today and told him next time sensor has to be rotated and that we’ll ask each time where. So I asked him where, he said upper back. Not sure that’s an ideal spot but it’s not the arm so we’ll go from there. By the way, the sensors came today — and we immediately had one sensor failure that didn’t even make it through the 2-hour calibration period.