Change is the only constant - or words to that effect

I can't remember who said that, and I can't find the exact quote on Google. I'm sure it was some old Greek chap like Plato or Heraclitus - one day I'll check it out. For now, though, it's the concept that I want to write about. Now, I could go on and on and write a big philosophical essay on that, but that's not what this post is about....it's about Isabel and one of the key points about managing her diabetes: eating properly, and the routine and responsibility that goes along with that.

It was a difficult, tantrum-filled, drama-queen breakfast-time yesterday, trying to get Isabel to eat a bowl of yoghurt and cereal before the camp bus arrived at 8.00 to pick the kids up. It resulted in a looooooooong discussion with Bob in the car on the way to work, about how we can a) reduce stress levels about breakfast in the mornings when she has to be out of the house at a certain time; b) teach her some table manners (!!) and c) generally get the message across to her that she has a responsibility to start learning to look after herself and think about what she is eating, and when she eats it. She's only 5, so it's early days, but not too early to get her starting to think about it, we reckon.

The thing about Isabel is that she is not a huge routine junkie, like Josh and me. She is more like Bob (who is the most spontaneous, 'wing-it', 'fly-by-the-seat-of-yer-pants' guy on the planet!) And she's not a big eater - particularly in the mornings. Her ideal morning 'routine' would be to get up when she wakes up, read a book, watch a bit of TV, maybe have a Yakult, maybe a nibble on a fruit bar, maybe nothing at all for the first hour, maybe a big breakfast fairly quickly if she'd not had much dinner the night before or if she wakes up slightly on the low-BG side. Bob is the same - but he can quite happily go without breakfast, reduce his own basal slightly or correct a high depending on how he feels and what his meter says, and grab a coffee and/or a sandwich when he gets to work - or eat breakfast at home if he feels like it. He's an adult, so he's able to be more flexible.

So we talked about flexibility with regard to Isabel and her breakfast. I was insistent. "She needs to eat breakfast. Ok, it's fine in school holidays, when she can get up as and when she likes, eat when she feels like it and not worry about it, but what about when they go back to school in August? She has to be out of the house at 7.40am and we can't expect her teacher to treat hypos or give extra insulin or not when she gets to school, depending on whether or not she decided she wanted breakfast that day. It's not fair on the teacher. She has to learn to eat breakfast and have a bolus and it must be the same thing every day. That's what works for her BG in the mornings."

To cut a long story short, we ended up agreeing that although this approach does indeed work well for her BG, it's like forcing a square peg into a round hole, for Isabel, and could result in long-term issues such as eating disorders if we force the issue too much now.  We need to find a way to be more flexible, letting her feel empowered about her morning routine (such as it is), while STILL understanding that there has to be a degree of routine because of her diabetes, and that she has a responsibility, to herself and to others, to stick to it! What a conundrum.

After much discussion, we came to a decision - we will test her when she gets up, bolus her up front for any correction and the bits of her breakfast that she always eats (Yakult and a spoonful of Manuka honey) and then let her choose a nibbly something (an oat biscuit, a fruit bar, a digestive biscuit, 2 Ritz biscuits) that doesn't involve more than about 12g-15g of carbs and that she can take in the car to school with her if necessary, and a piece of cheese or ham for protein. Then we see what she eats of that and top up her bolus right before we leave for school.

We talked it through with her yesterday evening and then tried it this morning.  It worked better - she had her breakfast out on the deck and, true to form, chugged her Yakult and spoonful of honey right off....then ran about, trampolined, checked out her 'jewellery box', read a book.....all the while nibbling on a piece of Parmesan cheese and a fruit strip worth 12g. Finally it was all gone without really very much nagging on my part - just the odd reminder.  Much less stress all round!

But one thing that Bob said really stuck in my mind. "The only constant is change....so you know what'll happen? This will work for a while and then it'll all change again." Yes, that's exactly what will happen with Isabel. Before long, this will start to look like a 'routine' to her - and she can't deal with that. She will want to change it - on her terms! What then? I guess we will see. I have something to learn here, too. I have to roll with her and let her be flexible, and learn to be more flexible myself. When she wants to change, instead of battling with her and it becoming a case of the irresistible force (her) meets the immovable object (me), I have to find a way to move out of the way (while insisting that her irresistible force still says "excuse me, please" before barrelling through, and "thank you" when I move!)

The other "change" quote that springs to mind as I write this is something Grandma taught me when I was little and which I have always loved, although I struggle with it.....being a control freak AND a routine junkie who really can't deal with 'winging it'!  It's the Serenity Prayer: "Grant me the serenity to accept the things I cannot change; courage to change the things I can; and the wisdom to know the difference." 

I always think there should be another line after "....to accept the things I cannot change" - it should go : "....accept the things I cannot change and the things that change whether I want them to or not...." or words to that effect.

Well, serenity has never been one of my strong points but neither is it one of Isabel's, so I suspect the battles of wills will continue, at least for a while - hopefully they will become fewer as she grows up and learns to accept some degree of routine, and I keep on learning to accept change. Let's hope we meet in the middle one day!