For both you and your child, the trip to the doctor’s office that led to a type 1 diabetes diagnosis was likely a pretty frightening experience. Between the physical symptoms, Mom and Dad’s visible anxiety, and all the pokes and injections, your child may not be looking forward to going back to the doctor anytime soon.
But now it’s time to head back for the first three-month diabetes check-up. So what do you do? “This first appointment with your child’s diabetes care team is important, because it can set a positive precedent for future appointments and for your child’s diabetes care in general. But the unknown can be scary,” says Jenna Eisenberg, M.S., L.M.F.T., a Denver therapist who specializes in treating people with type 1 diabetes.
Is your child showing signs of nervousness? Or are you the one feeling anxious? Here are some ways to reduce the fear and even add a little fun to the proceedings.
Give yourself a break.
Letting your own anxiety about the appointment go unchecked could be sending unintended messages to your child. “Children are very sensitive to their parents’ feelings, more so than we give them credit for. If a parent is scared or anxious, the child may also feel scared and anxious about the appointment,” Eisenberg has found. Children with diabetes may also interpret their parent’s worry about the visit to mean the parent is fearful about diabetes itself, she adds.
Eisenberg encourages caregivers to cut themselves some slack. “Parents tend to think that by this first appointment, they need to be diabetes experts and perform all care tasks perfectly. But three months is simply not long enough to figure out how to fit diabetes into your family’s life. That’s why a big part of the first meeting is typically spent on continued learning of diabetes management. No member of your child’s care team is there to judge you,” she notes.
One way to start feeling more confident is through positive self-talk. “When negative thoughts come up, replace them with positive ones,” Eisenberg recommends, “like, ‘I took my child to the hospital to get diagnosed, and now I’m learning how to take care of my child’s diabetes. I am a good parent, and I AM taking good care of my child.’”
Explain what will happen.
It’s common for newly diagnosed children to associate going to the doctor for their first three-month checkup with the last time they were at the doctor or in the hospital during their diagnosis. To clear up any misunderstanding, take a direct approach. “It can be reassuring for a child to hear something along the lines of, ‘I know the last time we saw your doctor, you were sick. But you’re feeling better now, because we’re taking care of your diabetes. This appointment is to help us keep taking good care of you,’” says Eisenberg.
You can also talk through the basic steps of the appointment with your child as a way to help him or her feel more comfortable by knowing what to expect. Appointments vary according to a child’s health needs and care team policies, but in general, a three-month checkup includes:
- Checks of weight, height, and other vitals (like blood pressure)
- A blood test to measure hemoglobin A1C
- A blood sugar check (to make sure the child’s meter is working properly)
- A physical exam for signs of infection
- Review of the child’s past blood sugar readings
- Continued training in type 1 management skills
Write down questions and concerns.
As you prepare for the appointment, write down your questions about your child’s care. Having a list of concerns with you can help you stay focused during the visit. For example, still not feeling sure about emergency treatment for severe low blood sugar? Jot this down as a priority to discuss with your child’s doctor.
Next, ask (or help) your child to write down his or her own questions. Hearing what’s on your child’s mind is important for the doctor and care team—not to mention for you as a parent. To give your child a greater sense of “ownership” during the visit, you could assign your child the task of asking these questions him- or herself.
Make it special.
Giving a child a special treat on appointment day is one way to associate visits with more positive feelings. It could be a post-visit trip to a favorite restaurant, or an afternoon outing together while a sitter watches your other kids, or some other gesture that you know will mean a lot to your child. However, rather than saying, “If you go to the doctor, I will get you a present,” Eisenberg recommends taking a more low key approach: “If you don’t make a big deal about the treat until after each appointment, the child can start putting two and two together [on his or her own] and eventually look forward to the appointment.”
One way to make sure the visit ends with a treat is to call ahead to see if the endocrinologist’s office has copies of the story books by Disney and Lilly Diabetes featuring Coco, a young monkey with type 1 diabetes, along with her friends Mickey Mouse, Goofy, and the whole gang. Click here for more information (young adult novels featuring characters with type 1 are available as well).
Last but not least, trust your team.
Your child’s doctor and other diabetes caregivers want your child’s diabetes management plan to succeed, because they want your child to succeed. They’re aware that patients can be nervous, and they’ll probably have plenty of tricks up their sleeves for putting a smile on your child’s face and putting your mind at ease. Many parents find that their doctor and care team go above and beyond to make sure children feel comfortable and calm—at this and every checkup.
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.