tag:blogger.com,1999:blog-7558528804236989500.post7622414512951219014..comments2024-01-12T06:12:35.838-05:00Comments on StorytellERdoc: The BossStorytellERdochttp://www.blogger.com/profile/14371229500424449124noreply@blogger.comBlogger27125tag:blogger.com,1999:blog-7558528804236989500.post-32537210783541883142010-09-05T14:45:10.137-04:002010-09-05T14:45:10.137-04:00Very Nice Post, I'm not sure if this hold tru...Very Nice Post, I'm not sure if this hold true for teenage girls ( perhaps the opposite in my experience) but this might explain why my husband is such a crybaby. Well, I did have three children without so much as a tylenol, so I expect that as women our life experience pulls affects the ways we experience pain. Nice to read such a lighthearted post. <br /><br />Natalie Hodge MD FAAP <br />Chief Health Officer<br />www.personalmedicine.comNatalie Hodge MD FAAPhttp://www.personalmedicine.comnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-59981663516030482762010-09-05T14:29:33.578-04:002010-09-05T14:29:33.578-04:00After reading some of the comments and seeing pati...After reading some of the comments and seeing patients first-hand in the ED, it's amazing how parenting style figures into the equation. I learned not to fault the kids, but rather the parenting. I was glad to see you approach the parent as the root of the problem, rather than complain about the kid (which a lot of healthcare workers do).<br /><br />Obviously, that Mom (and Dad, if he's in the picture) needs to help her kid learn how to be disciplined, especially given his diagnosis.Stop smoking informationnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-50423452044147912742010-09-02T07:20:27.888-04:002010-09-02T07:20:27.888-04:00Oh my heck, this is so much like the situation fri...Oh my heck, this is so much like the situation friends of my parents' were in when their daughter was diagnosed with juvenile diabetes. Everything she wanted, she got, and believe me she didn't ask nicely. This kid was nice enough to be around when she got her way, but she was manipulative from birth and it only got worse once she was diagnosed. And her brother was completely neglected, turning him into a complete terror. The father finally checked out and just tried to ignore everything, and the mother was as shrill and shrieking and unpleasant as the daughter.<br /><br />The boy grew up okay - which shocked me, I honestly thought he'd be in jail by now - but the girl is still manipulative and spoiled. She got into law school by being mistakenly admitted due to error and threatening to sue the school if they didn't let her attend. They caved. <br /><br />I gotta say I don't miss these people.coulrophobic agnostichttps://www.blogger.com/profile/13529243280844103232noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-54028225682252548132010-09-01T14:53:43.059-04:002010-09-01T14:53:43.059-04:00My heart breaks a little for this family. I had to...My heart breaks a little for this family. I had to take a daily shot for awhile in order to maintain a much-desired pregnancy. Even as an adult, this really sucked and I pampered myself to get through it. One shot a day, for nine short months. This poor kid is looking at multiple shots a day for the rest of his life. He's only five and it's actually sort of the job of kids to test some boundaries.<br /><br />And that poor mom. If *my* child had been diagnosed with a lifelong, life-threatening illness, I would find it really hard to deny them a simple cheeseburger, even though I know that is not the healthiest choice. <br /><br />It sounds like they need an alternative treatment plan. A shot after the meal, maybe? Someone besides mom to deliver the shot? The families I know of with critically ill children often have someone besides mom do anything painful. That way mom remains absolutely safe, not the person who delivers the pain. Doesn't every kid deserve that?<br /><br />Getting this family connected with other families in the same situation is a great idea. This is not the first clever kid with diabetes to come along.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-89361566615451227862010-08-31T04:49:17.608-04:002010-08-31T04:49:17.608-04:00good swift smack......
some children just need to...good swift smack......<br /><br />some children just need to be spanked. Works well, works fast...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-12196541778720660452010-08-30T06:50:30.726-04:002010-08-30T06:50:30.726-04:00Technical question....are we SURE that lil' Sc...Technical question....are we SURE that lil' Scotty had type I DM? You mention him being chubby and a bit of a chowhound. I ask because a patient of mine (in Home Health) was a seven year old obese Hispanic child with Type II diabetes. <br /><br />The mother was cluless and not interested in learning how to manage his diet and disease, even after we sent out a bilingual RD to help her learn how to cook ethnic food for her son.<br /><br />I don't know if he is still alive, as he would be 20 now. Last we saw of him at age 13, he had already had one BKA and vision loss.<br /><br />Pattie, RNAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-31606800623803728272010-08-29T12:44:59.196-04:002010-08-29T12:44:59.196-04:00I have been type 1 for over 16 yrs and my parents ...I have been type 1 for over 16 yrs and my parents always dosed my insulin after a meal to ensure I would get the correct dose for the food and BG number. My never tod me I could not have something she just made sure that when I did have something that could possibly mess with my BG it was in moderation. It breaks my heart to see little ones having to deal with this but they are so strong and usually go through the anger phase and then we move on to accepting our life and making it great.type1medichttps://www.blogger.com/profile/13048383983756732838noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-80498416470055440512010-08-29T02:35:34.157-04:002010-08-29T02:35:34.157-04:00Hi doc,
I agree with the observations of some abo...Hi doc,<br /><br />I agree with the observations of some above that the kid already had control over his mother way before the diagnosis.<br /><br />From my observations at an acute paeds ward, kids who behave like that already do so at home. It is unlikely to change over the duration of their stay in the hospital. Usually in such situations, parents, grandparents, maids, and other caregivers, look to the nurse to take control of the kid. That is, the nurse has to be the bad guy. Some parents even use the nurses to threaten the child if they don't behave.<br /><br />In the hypoglycaemic case, the child would have been put on IV stat at my previous workplace. Both arms will be splint to prevent him from pulling out the IV. And the child will be told that we will poke him again if he does so. At acute situations, managing his survival is our priority.<br /><br />Thankfully, the majority of the children are still well behaved, if not under their parents, then at least under their alternative caregivers. I have seen "weekend" parents who has zero control over their child but the child obeys their alternative caregiver.<br /><br />That said, I was a tantrum throwing kid who refused food intake too. My mother used to bribe me with additional pocket money because I was significantly underweight/under-height while growing up. IMHO, the power dynamics didn't changed much over the years. Thus, IMHO, it's going to be a long and hard road for the mother in your story.<br /><br />One option may be for the mother to temporary let a firmer relative take over the daily care of her child. The power dynamics is not as yet established with the alternative care-giver. Coupled with frequent blood sugar tests pre-meals and post-meal insulin jabs, the 6 year old would soon realise that the faster he complies with food intake, the fewer pokes he gets at each meal. That may change his behaviour over time.Winking Dollhttps://www.blogger.com/profile/14045187430930181570noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-71072876338795148512010-08-29T00:31:02.175-04:002010-08-29T00:31:02.175-04:00Jim another touching story. As much as we sometime...Jim another touching story. As much as we sometimes feel sad for sick children, its true we are not doing them any favor letting them control everything. Thanks for the good lesson and reminder, as I do those things even with a healthy child. Thanks again, and hope all is well. Anna :)myonlyphotohttps://www.blogger.com/profile/07324578791902437827noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-29182154146025704912010-08-28T19:07:43.512-04:002010-08-28T19:07:43.512-04:00hi doc, we are back from the wonderful cruise and ...hi doc, we are back from the wonderful cruise and i am catching up on my reads while the washer washes and the dryer dries. ha ha<br /><br />this child sounds so unhappy and it seems to me he is acting out for attention, not for the certain food. i certainly could be wrong but i think i'd try a different route. like putting dinner in front of him before the shot like others have said. he'll get hungry. lots of attention during good behavior and not much for the bad. <br /><br />just my 2 cents though.<br /><br />smiles, bee<br />xoxoxoxoxoxooxEmpress Bee (of the high sea)https://www.blogger.com/profile/08300140506585000934noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-6335402910690021072010-08-28T10:41:17.501-04:002010-08-28T10:41:17.501-04:00Like others have said, my pediatrician friend said...Like others have said, my pediatrician friend said no insulin until after he eats.<br /><br />And lots of blood sugar checks until he eats too - practical, and maybe not so fun.<br /><br />He certainly sounds like a brat - but poor kid too, juvenile diabetes (well any diabetes really) certainly does not sound fun.Tracy2noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-88219771440561605392010-08-28T10:04:11.708-04:002010-08-28T10:04:11.708-04:00ER Murse beat me to the punch. I'm sure as th...ER Murse beat me to the punch. I'm sure as the parents of a newly diagnosed child they're still in the rut of doing things by what seems to be the "right way", but there's no reason he has to have a shot before eating.<br /><br />Today's modern insulins [humalog/novolog] start working within 15 minutes, so there's no longer an absolute requirement to take it before eating. The older R (regular) insulin doesn't start working for at least a half an hour [usually closer to an hour].<br /><br />Hopefully the endo is smart enough to encourage the parents to do just this. That way if the kid starts going on hunger strikes because he's not getting his favorite junk food he won't fall over from hypoglycemia.Moosehttps://www.blogger.com/profile/10397412122635951126noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-78749491328640179652010-08-28T05:40:00.548-04:002010-08-28T05:40:00.548-04:00I'd think they could check his sugar, wait unt...I'd think they could check his sugar, wait until he eats, then give him his insulin. Gives the parents a chance to count carbs too, and adjust the insulin dose if needed. Can't go on letting the kid live on cheeseburgers, and calling the shots with temper tantrums.ER Mursenoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-69959307017494111842010-08-27T21:05:07.911-04:002010-08-27T21:05:07.911-04:00I think it sounds like Scottie has been the boss f...I think it sounds like Scottie has been the boss for a long time..<br /><br />sorry Doc, but he would have had an IV on arrival to our ER. desperate times call for desperate measures. ;-)Tonjiahttps://www.blogger.com/profile/00355425625416597121noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-3456155560001689762010-08-27T16:31:18.981-04:002010-08-27T16:31:18.981-04:00you know, in the big scheme of things... (I could ...you know, in the big scheme of things... (I could be totally off base, and you can tell me so later!)...<br /><br />The kid is newly diagnosed. Kids don't deal well with medical crises anyway. Especially little ones who need to take shots three times a day. The kid knows he has no control and is exerting control over the one thing that he can: food. It will get better. He is too little to understand abstract thought anyway. A little reward chart with stickers, and Mom is good to go. No more Happy Meals. (She needs to hang out with some other moms who have chronic kids too!) ;)The Hopeful Elephanthttps://www.blogger.com/profile/00004038685351656184noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-39623025501927287642010-08-27T13:54:54.834-04:002010-08-27T13:54:54.834-04:00In response to seeming barbaric to stick a child b...In response to seeming barbaric to stick a child because he won't eat. My grandson is a hemophiliac and we all have learned to set up the IV. It can be done. Realistically though, I was reading this and trying to figure out how I'd rangle control from this child. I think this mother needs Super Nanny or something.Lisa https://www.blogger.com/profile/09324961653370110887noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-20226082189626073782010-08-27T13:44:15.290-04:002010-08-27T13:44:15.290-04:00Yuck. Stories like this make me crabby. I pray I...Yuck. Stories like this make me crabby. I pray I am never this kind of mother. Although, I can see how it happened. <br /><br />I'm a picky eater, and I remember a fight with my father in the upstairs bathroom (how we got from the kitchen, up the stairs, and into the bathroom I may never know) involving a piece of cheese I declared pink and refused to eat no matter how long I sat at the table. But that's about as bad as our food defiance ever became. Well, until our dog refused to eat this summer. She might never eat dog food again. It's all boiled hamburger for the rest of her life (yucky).<br /><br />Have a good weekend,<br /><>< KatieKatie Axelsonhttps://www.blogger.com/profile/09361471654719262744noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-36370591222455454182010-08-27T13:17:07.427-04:002010-08-27T13:17:07.427-04:00It is hard for everyone involved to deal with a se...It is hard for everyone involved to deal with a serious chronic condition. The kid rebels, the mother feel bad for her son. It is not in the best interest of the kid to live off Happy Meals, but I can see how it happened. Hopefully they can sort it out soon enough.Calhttps://www.blogger.com/profile/17204635978443190089noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-68638094803719172212010-08-27T13:03:37.614-04:002010-08-27T13:03:37.614-04:00I hope she listens to you.I hope she listens to you.Chrysalis https://www.blogger.com/profile/00757696627388704079noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-41987143679833608152010-08-27T12:41:01.691-04:002010-08-27T12:41:01.691-04:00I have been type 1 since i was 6 and my twin as we...I have been type 1 since i was 6 and my twin as well and now my neice and we all did this my mom was great though she did not let us run the show. we received our shots after our meals and neither of us have bad A1C's now we are on pumps and my neice who was dx'ed 6 months ago is on the pump and we bolus after meals to ensure correct carb coverage. this mom bless her heart has got to find something that works because the alternetive is not good.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-27661504024029481402010-08-27T11:31:30.501-04:002010-08-27T11:31:30.501-04:00Wow, that sounds like a really tough problem. Mom ...Wow, that sounds like a really tough problem. Mom should never have let him rule the roost in the first place, but now he's got her over a barrel--if he refuses to eat and she doesn't get him the Happy Meal, he could suffer serious medical consequences. There's no way she can allow this to continue, so she's got to find a way to outsmart him.Amyhttps://www.blogger.com/profile/12714078352001622357noreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-1761021954710444942010-08-27T10:56:03.162-04:002010-08-27T10:56:03.162-04:00There is a fairly obvious way for the mother to re...There is a fairly obvious way for the mother to regain control: don't give the insulin until after the meal. They will have to give a little less insulin, and the control won't be quite as good, but it would sure be better than it is with all the games he is playing now.leslienoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-37008866761463825232010-08-27T10:29:48.767-04:002010-08-27T10:29:48.767-04:00I agree with R.May about the IV stick. The kid see...I agree with R.May about the IV stick. The kid seemed to listen up when an IV was threatened. <br /><br />Sounds barbaric to threaten children with an IV if they don't comply, but the reality is that a heck of lot more than an IV is in his future if he doesn't get with the program. <br /><br />I think they could benefit from some counseling. I'm sure there are other families out there dealing with the exact same thing. She needs some support.Gennoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-44499986999316917812010-08-27T09:15:15.568-04:002010-08-27T09:15:15.568-04:00I thought the same thing Tracy...
I can't ima...I thought the same thing Tracy...<br /><br />I can't imagine! So many kids go through the refusal to eat phase. My solution was of course you get nothing until you eat your dinner, which if not eaten is offered again for breakfast, lunch, dinner again, etc. And I only had to do that once. But what do you do when the child will die without eating? <br /><br />Don't know, maybe the iv would have been better - if not eating what is offered results in a slightly painful stick....<br /><br />And myabe a referral to a nutritionist specializing in diabetes....R.Maynoreply@blogger.comtag:blogger.com,1999:blog-7558528804236989500.post-75877111671110726252010-08-27T08:42:15.770-04:002010-08-27T08:42:15.770-04:00Wow, I wonder what you do in that case. You can&#...Wow, I wonder what you do in that case. You can't force feed a kid - and he seems to have figured out the perfect method to get his way.<br /><br />A non-diabetic kid, you could just refuse the McD's and figure they'll eat when they get hungry enough. But a diabetic kid...Tracy2noreply@blogger.com