Top Ten Tips to Manage Your Stress for Better Diabetes Control for Your Child

We all know that stress is a part of life. There are some good points to having stress, as stress can cause us to take action, but an overall high level of stress can cause health problems.

Having a child with diabetes is stressful. There’s “off the wall” numbers for no reason, feeding them and counting carbs, dealing with schools and playdates, leaving the house with a bag full of packed diabetes items, and of course, the worse, the 3am blood sugar checks that cause sleep deprivation!

But if you  are overstressed, your children pick up on it.  Reducing your stress can help them have better diabetes control.
Remember, when you take care of yourself, you can better take care of your child!

Tips to Relieve Stress

1. Determine what you can control and what you can’t control. We sometimes waste a lot of time worrying and trying to solve problems that we cannot control. Learning to stop and look at whether you can really change the situation or whether it is out of your control and you need to let go and change how you are dealing with a situation is important.

Learn all you can about managing diabetes so you can change what you need to, but also realize there are many other things that are out of our control that affect diabetes, such as hormones, growth spurts, and infections. And especially don’t waste time blaming yourself or trying to figure out what you did to cause diabetes, because ultimately there isn’t anything!

2. Take time for you. I frequently hear that it is selfish to take time for you and there is never enough time to do something for you. But if you think about running ragged and never having any downtime or you time, it is taking away from how you are responding to others in your life.

By being stressed, anxious, worried, etc, you may be more irritable with those you love, or may not be fully present to enjoy the moments because you are off in your mind worrying about other things. So by taking time for you, you are able to take care of others better.

It is like the airplane analogy. Put on your own air mask before putting on your child’s. So make it a priority to schedule some you time. It can be something simple like a quiet cup of coffee in the morning, a hot bath, reading a favorite book, going for a walk, or developing new hobbies. This may mean that you have to train someone to care for your child with diabetes, but in the long run, that’s better anyway in case of an emergency with you!

3. Eat healthy and limit stress increasing foods such as sugar, caffeine, and alcohol. Also eat regular meals and planned snacks. Skipping meals can increase stress. Many people are not breakfast eaters, so try lighter breakfasts such as a granola bar or smoothie. Seek out a Registered Dietitian if you need help in this area.

4. Try some guided imagery, prayer, meditation, yoga, or progressive relaxation. Guided imagery is a process where you do deep breathing and imagine yourself somewhere pleasant such as a beach. You imagine using all your senses such as feeling the sand, smelling the salt water, hearing the waves and birds, seeing the grass blades blow and waves crash, etc. Even a five minute “vacation in your head” will help relax you.

I had a client who told me “I go fishing in my head.” I love a CD available on amazon.com called Ten Minutes to Relax. It is a quick guided imagery that can help lower stress.

Progressive relaxation is a process where deep breathing is used, along with tensing and releasing muscles in order to help you see whether muscles are tense without you realizing it. It helps you relax by releasing muscles. Many audios are available that help walk you through this process. When done daily, guided imagery and progressive relaxation help lower overall stress.

5. Take 4×4 breaks each day. This means learning to take four small breaks throughout the day and do four deep belly breaths. This helps you just slow down and relax a few times during the day.  Also try this when a blood sugar number is high.   Remember that the number is a tool for managing diabetes, not a reflection on being “good” or “bad.”

6. Exercise. Yes, that is the dreaded word most people do not like. But exercise is a great stress reliever. It also can increase your energy level and help you focus better. And it improves your confidence level, which can affect how you take care of your child with diabetes.  Exercise helps lower those cortisol levels and stimulates serotonin. So build some regular exercise into your routine.

7. Be mindful with your meals. This means rather than inhaling your food while working, driving, watching t.v., or doing other activities, try focusing on your meals and enjoying each bite. Take in how your food smells and how each bite tastes. Chew slowly and try to take twenty minutes to eat.

Focusing on your senses gives your mind a much needed break, and by focusing on what you are eating, you get the benefit of being more aware of what you are eating and the amount.

8. Give yourself a mini massage. Just take a five minutes and massage your temples, face, and neck. Better yet, have a partner do it or sign up for a full massage occasionally. You will be amazed at how relaxed you will feel!

9.  Prioritize your to-do list.  This can encompass several things.  Reviewing your priorities in your life, putting yourself at the top of the list for self-care, is the first step. 
Frequently this can not be a numbered list, but several things have to be equal, such as relationships, self-care, parenting, diabetes, career, and your spiritual life. 
When you know your priorities and what matters to you in your life, it will be easier to cut things off your list that are not in line with your priorities.  Getting some help and delegating items is also essential.  It does not help your stress level to think you have to do it all!

10. Find a support person. Find someone you can trust and share your thoughts and feelings with. When thinking of a support person, discern who a healthy support person would be. This would be someone who listens and is nonjudgmental, not necessarily have to solve your problem but just being present with you, and someone who does not tell you to “get over it.”

Someone who understands diabetes is a great asset, though I know those are hard to find sometime. Having a support group with parents of children with diabetes is a great stress reliever.

Work on lowering your stress to help change your cortisol and serotonin levels and you will see the benefits in your life and your child’s. Work on adding in some of these techniques each day, as well as other stress techniques as this is not a complete list of stress reduction.

Sometimes people have to actually schedule them on their calendar or post sticky notes for reminders. And don’t be afraid to seek help from a professional if you need more individualized help.

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Catch Type 1 Diabetes Early! Know the Symptoms

We were able to catch diabetes early with both our children.  As a dietitian, I knew the symptoms, even though at first I tried to deny that was the problem. But at least I took Josh in to the doctor and the doctor was surprised we caught it so early.  By catching it early, you can prevent DKA and going to the hospital.  Here’s a great article on the symptoms of diabetes.

Type 1 Diabetes, Early Recognition, Tell-Tale Signs

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How to Decrease Pain for Children with Diabetes

Children with diabetes have to do many things that can be overwhelming and scary.  Glucose checks, shots, infusion set insertions, having blood drawn at the doctor, and many other things can be scary for children and tough to deal with as parents.  The “Wow and How” technique is a simple way to help make things easier at times.  I used this with my daughter and now I have something I can easily say to help her, by simply asking “What are you thinking about this time?”

The “Wow and How” is used by therapists more with children who are frequently hospitalized and have to undergo frequent medical interventions that can be painful, such as those on chemotherapy.  But it can also be used easily with other populations.  It is a very simple technique, yet it helps the child learn new ways of dealing with pain and fear.

Here’s how to do it.  Simply observe when your child is doing something that usually upsets him/her, then notice when it does not hurt as much.  Reflect this to your child, saying something like “Wow!  I notice that didn’t hurt as much!”  Then listen and reflect back what they say.  (Just rephrase what they say back to them, not adding any judgement to it.)

Then add the “How”.  Ask, “How did it not hurt this time” or something similar.  Listen and reflect back to them what they say.  Then help them problem solve how that can help in the future.

Here’s an example of my using this with my daughter.
Sara was putting in an infusion set one night.  Somedays this seems to hurt more than others.  We were going through a time when it seemed to hurt more.  One night, it did not hurt as much, so I said “Wow, that didn’t hurt as much.”  Then I reflected back what she said, and asked her “How did you make it not hurt as much?”  Notice that this lets her know that she has the power to help it not hurt as much.  She said “I thought about the ocean.”  So now we have an easy way for her to distract herself for a minute to help minimize the pain.

Try this today and see if it helps and let me know your stories!  Comments welcome, we all grow and learn from each other!

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Traveling with Diabetes

It’s that time of year for vacations.  A favorite for our family is the beach.  Getting a break from the day to day of life is great for recharging, but does require some planning ahead when you have a child with diabetes.  Packing all the extra things can be nerve wracking for me, as I tend to feel like I’m forgetting something. (and at times I have, such as last summer my son went off to a non-diabetes camp as a counselor, and he got there and that night called and said “I only have one test strip left!)  So I always keep a list, so as I think of things to pack, I add it to the list.  Here’s a key list of things I have to remember to pack for children with diabetes:

  • Insulin (the obvious here)  Take more than what you think you might need.  Also, I keep a prescription for an extra bottle that I can take to any pharmacy in case something happens, such as it overheats or the bottle gets dropped.
  • Syringes, even if you are on the pump, you never know if you need them for backup
  • Pump infusion sets/reservoirs, inserter if used:  an important tip here is, you can not buy these at any pharmacy, so take double what you think you might need.
  • Extra test strips, extra meter, extra batteries for pump and meter.
  • IV prep wipes, or whatever wipes for pump infusion sets you might use.
  • Carb counting books

Again I get this feeling of “I’m forgetting something!” so let me know in the comments section what else you usually take!

Here are some of my traveling tips with kids:

  • Take plenty of snacks for lows.  Keep in mind that if you are in a hotel and a child wakes up in the middle of the night with a low, you don’t want to walk out to the car, so have something with you.
  • Have a plan for what to do for activities, such as how long to stay off a pump, how the activity affects your child’s blood sugar, what supplies to carry in a bag with you for activities, what to do at the beach, such as put the pump in a ziplock bag so as not to get sand in it, etc.  Some of these need to be discussed with your doctor ahead of time.
  • Things to discuss with doctor: 
    • What to do when the pump is off for an extended time, such as at the beach.  We check our blood sugars every hour and then reconnect and bolus a correction if needed.
    • How to adjust insulin for extra activities, how to adjust insulin if something happens to the pump and you have to go back to shots, whether your child needs extra insulin such as a temporary basal rate in the car if you are traveling for 8 hours or so (we usually put ours at 110% or so since they aren’t getting any activity and there blood sugar tends to go up)
    • what to do for emergencies
  • If you are traveling by plane, get a note from the doctor saying your child has diabetes and has to carry syringes, lancets, insulin, snack, etc on board the plane.
  • If you are traveling by plane and checking bags, don’t put all the supplies into one bag, divide them up in case a bag gets lost.  And have plenty of supplies in a carry-on.  I know someone who went overseas and had all their supplies in a backpack, and it was stolen!  It was a mess getting supplies and insulin overseas.

These are just some tips off the top of my head.  If you think of others, please feel free to add them to the comments for others.  I do have that “I forgot something” feeling!
Enjoy your summers!

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Take a Break from Diabetes and Have Fun

As a parent of two children with diabetes, it seems I let diabetes stand in the way and take over my life at times.  I can be a worrier and probably at times go overboard on trying to keep it in control.  My kids with diabetes are 15 and 9, so they are at an age where they are getting more responsible with it.  I was having a bad day yesterday, as we all have sometimes, and a friend asked me “Where is the fun in your life?”  

Interestingly, my husband and I have just been in survival mode and have not been taking time for us.  In order to keep our marriage healthy, we decided we needed to do date nights more often.  Sadly, we have been so busy that we had a hard time even coming up with something to do, other than the old standby of dinner out.  So we are working on rekindling some old things to do together and have fun and get a break, not only from diabetes, but from just kids as well.

A key for parents with diabetes is a having a back up person that can care for your child.  Luckily for us, our 15 year old can manage his own.  So as bad as it can be having two kids with diabetes, it does work in our favor with him as  a babysitter.  But for those times when he’s gone, our 14 year old without diabetes knows the general rules.   We just have our routine down where our daughter knows to check before she eats and call us.  She is on an insulin pump, so it helps her be more independent and just be able to program in her carbs and blood sugar.  So we are still on call, but at least we get a break for a few hours.  When the kids were younger, we had a high school senior as a babysitter.  She had a friend with diabetes so was somewhat familiar with it.  We just went over a lot of basics with her and had written instructions. 

So I encourage parents who are on call 24/7 with diabetes, remember to take care of yourself and take care of your marriage (if you are married) and take some time to have fun and get away.  By taking care of yourself, you can better take care of  your child!

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