Wednesday, December 15, 2010

He's too smart for my own good

   Jonathan's a bright kid (and he better be if he wants to make good on his plans to become a doctor), this was no news to me.  Starting the pump just before he turned 5 I figured we wait a good four to five years before we would start teaching him how to use his pump.  Well... little man had a different plan apparently.  I guess seeing something done three or more times a day, seven days a week, for three months, he was bound to catch on to a thing or two.

   A few weeks back, Jonathan began insisting he could lock his pump himself - and promptly demonstrated the swift button presses to do it.  At first I was a little concerned that he would push any buttons, but knowing how obsessed he is about having his pump locked I thought this would be OK should an occasion arise where he was without us and noticed his pump unlocked.  Content to have him maneuver his tech to a safe place, I let it go for a while.

   Monday night, much to my horror, he unlocked the pump.  "Hmmmmm..." I thought, "this isn't good".  So we had a little talk about who unlocks and who doesn't.  He happily agreed.

   Last night, when it was time for his shower, I was disconnecting him and he proudly told me that he knew how to suspend his pump.  I paused for a moment and then decided I should know if he really could.  I handed him his unlocked pump and S#!T  Click click click - beep.  UH OH!

  While I'm impressed that he picked this up and does it without even seeming to have to think about it, I'm totally horrified that he could suspend it and go hours without insulin... or even worse yet... the unthinkable.... give himself up to 5 units without a single carb to balance it (5 is his current max bolus setting and I don't think he'll be changing that without an insane amount of bad luck).

   And so my dilemma...  Do I start teaching my five year old son how to use his pump properly or put the fear of God into him that if he so much unsnaps the case a holy hell-fire will rain down upon him?  I figure the latter will result in some sort of emotional scaring that will take reams of therapy to correct before he can ever look at the pump again, but the former just doesn't seem right for us at this time either.

   So with some serious thinking and a nice chat with a great friend (who is also a nurse, CDE, and is pretty much the go to gal in the clinic at the hospital) I think I'm going to go somewhere down the middle: there will be Jonathan jobs and Mommy-Daddy-Nurse-Grandma jobs.  Jonathan can keep his hands clean before testing, Jonathan can test and Jonathan can unlock and lock with Mommy or Daddy present.  Mommy-Daddy-Nurse-Grandma are the only ones who can push other buttons, and most importantly - Jonathan NEVER activates insulin (by the way, I know he knows how because he talks grandma through it step-by-step).

   Even giving him a little responsibility with the pump specifically is terrifying.  He could test all day long for all I care (as long as he is at least testing), but to push pump buttons.... I think this is what handing over car keys someday might feel like.  So hopefully, for my sanity, at least a few years of pump drivers ed and then we'll see where we go from there.


  1. This would freak me out too. Elise learned to check her own BG at 2 1/2 (letting me know this by grabbing the lancet and meter and saying, "I do it!"). But pressing buttons on a pump is a whole different ballgame. A very scary ballgame.

  2. Marc, Is Jonathan 5?

    That is when Joe started doing all of his pump stuff at school....he felt the school nurse was too slow - LOL. He only does it when the school nurse is looking and making sure that he boluses the correct amount...but he has done it since k-garten. He has never been irresponsible with it. He knows the ramifications of mis-steps with bolusing etc...he knows the seriousness of "d". I think Jonathan may be the same way...maybe he isn't quite ready for all of the boluses...etc...but he certainly seems interested.

    BTW, I do all the boluses (or almost all) at home...LOL. He likes to be a kid when he can afterall!

  3. Good call... I can't remember how old Adele was when she started taking more responsibility with her pump, but I'm sure we were still bolusing when she was 5. She's 10.5 now and boluses herself after being instructed by us or her teacher's aid. She also understands that she can't bolus for 'fun' without eating.

    One thing that you could do would be to set the max bolus lower and divide larger boluses into many smaller ones. It does not really fix the problem but it may make you more comfortable.

  4. This morning, my son whom is two, insisted on bolusing himself. I was there the whole time but he was definitely going to be the one holding his pump. Lucky for me the only thing he can't do yet is push two buttons at the same time to unlock it.
    I think that because he was dx at 19 months that by five he'll be bolusing himself with somebody double checking before he presses the final ACT button. I mean he's already checking his own BG and ketones, knows how to do his tegaderm and set changes. So...
    I think you know what your son is ready for and how to handle it, but it is a big question...heck I still wonder how it is that I am allowed to dose out insulin so easily when it takes two nurses to double check it at the hospital!