One of the hardest lessons I’ve learned as a parent is that doctors don’t always know what to do.
I’m quite sure that they do know what course of action to follow much of the time — and it’s clear that they know a lot more than I do about medicine — but over the past 10 years of visits to the pediatrician’s office, as well as a number of hospitals, I’ve come to understand that sometimes treating a child is a good amount of guesswork.
The first time this happened was when Mitzi was just a few months’ shy of her third birthday. We were living in Connecticut at the time, though Ray had already started a position in Boston and was there during the week as we prepared for the move north. Mitzi had developed a sudden, high fever, but had no other symptoms. By this time I knew that she’d inherited my tendency for high fevers (there’s no in between with us!), and agreed with the doctor that she probably just had a virus. Without symptoms, there was nothing to do but treat with ibuprofen and Tylenol, and wait.
After a few days, nothing had changed. Another trip to the pediatrician earned us a prescription for antibiotics. They didn’t help. This went on for a week, until one of the doctors in the practice suggested a chest x-ray was in order. The x-ray revealed pneumonia so severe she was hospitalized in order to receive IV antibiotics. After a few days, this didn’t help, and she was transferred to a hospital in New York City, where she had surgery to drain the fluid that had been building up in her chest cavity all that time. She was there for 10 days.
All along, we wondered why it had gotten so extreme, when she had been sick for so long. But the doctors did what they had to do — start with the evidence and proceed from there. They had no idea why she had a fever, and experience taught them that more often than not, tests, such as x-rays, are not called for, when the most likely cause was a virus.
The same thing happened with Cooper over the years, as he struggled with winter colds and coughs that left him struggling to breathe. But no one really officially said why — symptoms were just treated, relieved, colds came and went. Despite a weekend in the hospital when he was a toddler, no one gave us an exact diagnosis for what was going on. Until this fall, that is, when he was diagnosed with allergies (seasonal, dust) as well as asthma.
So when Mitzi became diabetic, we were not entirely unprepared for the world of medicine and its try-and-see approach to treatment. However, this being a pretty well-researched and defined disease, we were a bit surprised that it too was not an exact science.
Managing diabetes really means regulating one’s blood sugar, all the time, every minute of every day. Because 1+1=2, you’d think this would be easy, make sense. Give the right amount of insulin, eat the appropriate amount and types of food, throw in a bit of exercise, water and a good night’s sleep, and you’d think that all would be regulated. Easy peasy.
But it’s not like that. With diabetes, 1+1=3 or 10 or four-fifths. Blood sugar can be influenced by any number of factors. A virus, for instance, a common cold, can make you insulin-resistant. So can the human growth hormone and puberty. Stress, adrenaline, exercise can also raise blood sugar inexplicably and unpredictably. But exercise can also lower blood sugar.
The balancing act is a hard one. It’s a mystery. Mitzi has had consistently high blood sugar over the last week — not excessively so, but higher than normal and higher where she out to be. We don’t know why. Could it be another growth spurt? Is she starting to go through puberty? Is she sneaking a snack here and there and not ‘fessing up? All we can do is give her insulin after the fact and hope it works. At some point we’ll probably have to increase her basal rates too, and hope that helps a bit.
This might be the hardest part of it all for me, the parent. I’m not afraid of a challenge, a problem, so long as I know the solution. The guesswork and the uncertainty are what undo me on so many days.
All I can do is have faith in the mystery of medicine and the doctors who seem to be guides rather than all-knowing wizards (which might be an unfair description but what we often think of doctors as, carbon copies of the Great and Powerful Oz).
That, and, when deciding on the right thing to do, hope like hell my heart and gut know what that right thing is.