In the past few weeks, the diabetes community has suffered several tragedies in losing young people to diabetes. It is shocking and upsetting when diabetes takes the life of anyone, but somehow more so when it cuts a young life so short. Moira McCarthy Stanford is a journalist, a long-time JDRF volunteer and mom to Leigh, 22, and Lauren, 18 — who was diagnosed with type 1 at age 5. Today, Lauren is one of many teens who may look ‘perfect’ on the outside, but under the surface, she struggles terribly with day-to-day D-management. In light of recent events, Moira volunteered to open her heart about raising a teen with diabetes — in hopes that her words can help others.
A Guest Post by Moira McCarthy Stanford
Walking into my kitchen to do one of the billion chores it seems I have to do every day of my life, I was stopped short by the emotion that overtook me when I noticed what was on the counter.
Used test strips. Three of them. Not in the trash; not put away. Now before you think I’m a neat freak, consider this: the surge of emotion I felt was pure, undiluted joy. Because the test strips littering my granite countertop were evidence of the most beautiful kind I could ever imagine.
They were evidence that my daughter was checking her blood sugar.
Moira & daughter Lauren (photo: 2006)
Why, you ask, would this send me so over the moon when she’s had diabetes for 13 of her 18 years on this earth? When the total finger pricks she’s done definitely number in the 40-thousands? Because, you see, she’s that truly puzzling soul: a teen-aged girl who has had diabetes for more than a decade. And while I struggle to get my head around it, that has meant — more times than not in the past five years — periods of checking seldom if ever, ignoring blood sugars until they skyrocket to stomach-retching highs, “forgetting” to bolus for snacks (and even meals sometimes) for her and a constant state of combined worry, anger and sadness for me.
I tell you this because I think it’s time that we all just stood up and admitted what is true in many homes: our teens — even the brightest, smartest, funniest and most driven of them all — have a hard time dealing with the day-to-day demands of diabetes. I know first-hand. My daughter was the “model patient” for oh-so-many years. She started giving herself shots just weeks after her kindergarten diagnosis. She understood the math of bolusing before she knew how to spell “algebra.” She went on the pump as the youngest kid in the Boston area to do so at the time, and figured it out like a trooper. She was seven then, and I can honestly tell you I’ve never done a site change myself. She willingly strapped on a CGM when they were big and ugly (it didn’t last long, sadly), and understood its function. She is her high school student council president. She was on homecoming court. She was voted Most School Spirit by her fellow students. She’s a four-year varsity tennis player. She’s anchor of her school news and its nominated for an Emmy this year. She’s spoken before Congress twice and spoke as part of the Democratic National Convention in 2008. When he was alive, she had Senator Ted Kennedy’s private cell phone on speed dial. So far she has been accepted to every college she applied to. Yeah, she’s quite a gal.
So, one would think, the idea of pricking her finger to check her blood sugar six or so times a day and then counting her carbs and pushing some buttons on her pump must not be such a big deal, right? It’s just something one has to do and that’s that, correct?
Think again. Because diabetes is the one thing that trips my daughter up. Constantly. It started the summer before she turned 13. I’d yelled across our club pool for her to check her blood sugar and she just was not in the mood to do it. Instead, she tried something “new.” She fiddled with her meter for a bit and then yelled back across the pool to me, “I’m 173!” I nodded, reminded her to correct, jotted it down in her color-coded log book and went on with my day.
She told me months later that was her turning point; the moment she tasted the “drug” she’d struggled with for years. That drug is called freedom. That day, she realized that I trusted her so much, she could pretty much do or not do whatever she wanted. The idea of not checking was so delicious, she still says today she thinks she must know what drug addicts feel like when they try to detox. She skipped testing more and more. By fall, she started skipping insulin doses too. And as she told me after she landed in the ICU and almost died, as sick as it made her feel physically, the emotional high of DENYING diabetes any power in her life (and yes, I do see the irony here) made that horrid feeling all worth the while.
Lauren (center) with friends at the 2009 Walk to Cure Diabetes
So the ICU trip was my wake up call. It call came clear; she fessed up. I worked at being more in her face and actually looking at the meter and the pump. Her A1C came down. And by the next summer, I was back to being the trusting mom again. She never did land in the ICU again, but her blood sugars have suffered. She seemed to have two good weeks of doing what she should, and then she’d fall apart again. As she grew older and was not with me often, it became easier and easier for her to hide her secret. And as much as she intellectually knew what she was doing was wrong, the addiction held tight. After a particularly jarring A1C one year, she tried to explain her struggle to me.
“It’s like I go to bed at night and I say, ‘Tomorrow morning I’m going to wake up and start new and do what I am supposed to do. I’m going to check regularly and take my insulin. I’m going to bolus every time I eat. And starting tomorrow, it will be fine.’ But then I wake up and I just cannot do it, Mom. Does that make any sense?”
Ummmm. That explains the success of the Weight Watchers Program. We mere humans want to do right and start fresh. We know well what we have to do, and yet… we stumble. Of course I understood. But the thing was: it’s her life she’s messing with. Each time she stumbled again, my heart hurt more.
I could never admit any of this to just about anyone, either. My non-diabetes-world friends would say something like, “Well, isn’t it just a matter of discipline?” Or, “Well, you need to just take control!” And even my diabetes-world friends would judge. Everyone’s kids seem to have an A1Cof 6.3. None of them mind checking, and they all fully understand why they should change out their site every three days even if it still seems pretty good (or so they all say). I’m the only bad mom. My daughter is the only bad diabetic. That’s what I thought.
Until I started to be honest about it. Lauren spoke before Congress about her struggles and the line of people waiting to talk to her afterwards stretched out seemingly forever. There were either kids who had done the same thing and not admitted it, parents who feared their children were doing the same, parents who wanted to figure out how to keep their kids from doing it, or kids saying “OMG. You totally told my tale.” Then I started to hint to D-world friends that all was not ducky in our house. A few brave souls reached out to me and told me — privately — that they, too, were struggling with their teen. Still, I sit here today a bit shamed as I write this.
After all, I am my daughter’s protector. I am her defensive linebacker. How could I let anything bad come her way? I mean, diabetes? I could not block that. But complications? That’s on my watch. Good Lord.
But here is the thing: I really believe that by addressing this openly, we are going to help millions of people and even save billions of dollars. What if there was no shame attached to your teen with diabetes rebelling? What if it was no different than, say, admitting your kid skipped their homework and got a zero on something (what kid hasn’t done that once?) What if instead of hiding in shame, teens — and parents of teens — had an open forum to discuss their situation and find ways to make things better? It’s time for the non-compliant teen and his or her parent to come out of the closet.
I believe this will bring us closer to a cure. How? Because, first, the sad coincidence is that the adolescent years are years the body is ripe to start on the path to complications. Tight control is vital. And yet, teen hormones make it tough enough to do when you try hard, and hard to want to try at all. Talk about some mixed up stuff. So what if we could find a way to help teens stay in tighter control? That would save hundreds of millions of dollars in health care for hospitalizations now, and perhaps billions of dollars in healthcare cost for complications down the road. Of course the real “Cure” is the answer, but wouldn’t a good, smart, small, easy-to-use artificial pancreas help bridge this horrid gap?
I mean, what if the first people the APP would benefit are those who studies showed did the worst on the CGM trials? Because the reason they did the worst is simple: THEY ARE TEENS. Like my daughter, their chemistry is messing with them physically and emotionally. They grasp onto this crazy idea that the terrible feeling of constant high blood sugars is a fair trade for losing the feeling of obligation to their disease. So, give the obligation to a cool little tool. Heck, take it away when they are 23 if you want. If all we do is create a world where teens and their parents can cry “uncle” and a good tool will be handed to them, won’t we already have changed the diabetes world dramatically?
The sad thing is this: some mom (or dad) out there with an eight-year-old with diabetes is going to read this and cluck her (or his) tongue and say, “I’m glad I didn’t raise my kid that way. I’m glad my child doesn’t do that.” She’s going to be smug; she’s not going to agree. I know this because I was that mom. I had it all figured out. And look where that smugness landed us. So if that person is you, I don’t want to hear it. But should you ever need support and understanding if you face this, I’ll be here for you.
My daughter is doing better this week: thus the test strips littering my countertop. Her last endo appointment was a nightmare. Her A1C came up high and her endo told her, in no uncertain terms, something that had been in the back of my head: if she does not change her ways and prove herself, she will not be heading off to the amazing college so far away that we’ve put a deposit on for her.
I hate that while other kids are stressing over roommates, she is figuring out how to break years of difficult diabetes struggles. I despise that she really does have to take this on the right way once and for all. But, as I smile through tears at the litter on the counter, I feel overwhelming hope. I adore my daughter. She’s strong, smart, funny and good at heart. She can do it. And the best thing I can do for her is admit that it’s hard, help her try, understand when she slips up, and work hard for that elusive better way of life for her down the road.
Moira, my daughter doesn’t have diabetes, but she’s a burgeoning teen, and I cried when I read this. Pure, unadulterated honesty is always the best policy in my book.
I felt like I was reading a story about my stepdaughter who now is taking better control after he ICU admission and a BS of 1080 and almost dying. No that was not a typo. Watching your child walk around weighing 78lbs at 20 years old with an A1C of 16 is heartbreaking. As a parent you want to do something but at this point she is an adult what can you do. Thank you for sharing your story its so great to know we are not alone. I also have a son who is wonderful, most of the time with managing his diabetes and we are heading into his teen years and I know its going to be hard. The best advice someone gave me is, make him own his disease, he has to live with it his whole life not you. As a parent we take on the role of being diabetic and we are not. I do thank god that my childrens disease is managable while others are losing their children to life threating illnesses. Don’t give up hope our kids will continue to thrive. I will not complain about those used test strips on my counter any more my eyes are open to that at least he is checking his blood.
Thanks you!
Thank You for sharing!! Unfortunately I know exactly how you feel…my now 11 year old daughter was diagnosed @ 6 & recently hospitalized twice w/in 30 days due to “highs”. All because she “just wanted to be like all the other kids & not deal with it!” Thankfully she’s doing much better now….but as you know that doesn’t necessarily lessen the worry or heartbreak I feel every time I have to say “What was your sugar?!?!” or “Let me see your checker!”
Thank You Again,
Praying for the CURE!
Trina
Thank you for this! I was diagnosed at 18mos and am now almost 21. This is my story. I’m told that when I was little I was the “perfect” diabetic, but the only memories I have of my diabetes are horrible endo appointments where I was yelled at because my A1C wasn’t a perfect 6, and my parents were berrated for not taking better control. (when infact it is not their disease at all! It’s mine!)
From preschool-8th grade, I was the ONLY student with T1D in our school system. Teachers were not happy to have a diabetic student, and my parents had to fight tooth and nail to allow me to be in regular classes and not special needs. Imagine that! Special needs classes for an A/B student because she has diabetes!
In high school I realized I had more freedom, and started skipping breakfast blood sugar checks. And by my freshman year in college I was hardly checking at all (or bolusing). As I write this now ( finishing my Junior year in college as an Occupational Therapy major with a minor in Psychology) I know that I have not checked my blood sugar in probably close to a week or two. <– Oh I know how dangerous this is, and all the horror stories that should come with that statement, but like your daughter I get the energy to be great with my diabetes for a week or two then I'm back to not caring.
I feel horribly for my parents, who know that I do not take care of myself, but I don't want to disappoint them anymore by not being the perfect diabetic, where I am near perfect/stride for perfection in all other aspects of my life.
I am tired of being the only T1D (even in college) I know, and feeling like I am the only T1D that doesn't have her D-life under control.
This was an amazing story to read, I am so glad to know that I am in fact NOT the only person in this situation! Thank you
Hope for a cure!
Thank you for this wonderful. I know exactly how you feel. My daughter is only 11 and we had to make two trips within 11month for the same reason. I blamed myself for not double checking each time she tests. I think she just wants to be like everyone else. I will more understanding of her now that I have read your story. Thanks you so much and lets all pray for the cure.
I met you at the JDRF Children’s Congress when my son was a representative. I want to thank you for being so honest about your experiences. I suspect more often than not teens and college students struggle with wanting to be free from diabetes. I think I am also not alone in feeling that I didn’t measure up to the other perfect parents with perfect kids, even though we tried to do everything “right”. My son is now 17 and through counseling we are working on getting him ready to be on his own in college…walking the fine line of being a support without being a hindrance. Just today an old high school friend of mine related that his college age niece had just spent her second time in the ICU in 3 months, having been found unconscious by her roommates. These are the realities and fears we live with, and it helps to know we are not alone.
I’m a type 1 diabetic, am now 26, and was diagnosed at age 11. I also went through the stage of just not caring about my diabetes, especially when I left home and went to university. From my experience, I had my parents and doctors telling me that I needed to be keeping better control, but I just didn’t care.
I’m not sure whats changed but in the last 6 months I’ve started testing more and am learning about carbohydrate counting (I’m from NZ, from the sounds of things we are lot more behind in Diabetes care than America! My doctor basically told me the other day that pumps aren’t a good idea because they are so much work, she didn’t even mention all the benefits!) I’ve reduced my HBA1C from 9.2 to 7.5. I’m not sure that anything would have changed my attitude when I was younger although I do think knowing other type 1 teenagers and being able to discuss how much of a pain having diabetes was might have helped. It might be because I recently got married and we’ll want to have kids in the future, so my diabetes isn’t just affecting me, its affecting my husband and potential children.
I’m sorry I don’t have any helpful advice, but from the few other diabetics I know, they have all gotten over this period in their mid 20′s, so maybe its just a phase that most of us go through. I do know though, that its not lazyness, and I’m sure that most of you don’t accuse your diabetic kids of that, and if you do tell them that they’re lazy, I can tell you right now that that will not work at all! Maybe try rewarding good HBA1Cs, or ones that are better than they previously were. Even though I’m not a parent I know that your childrens diabetes must cause you so much stress, but just remember that your children can’t take a day off from diabetes, so if there is the occasional slip up, its not the end of the world. In the end its their decision how they deal with things, and you don’t want to ruin your relationship with them by alientating them by always going on about their diabetes.
Thank you Moira for your brave story. My youngest sister, Maria, has T1D and she is 26. My mother calls me continuously about her ups and downs. My sister has blackmailed my mother with the threats of not take her insultin for whatever she wants… rent for her new apartment… food money… you name it. I want to be kind and understanding but my heart is resentful and angry. Maria boozes it up with alcohol every chance she gets… and about three month ago, she landed in the emergency room with TKD … and an $11,000 hospital bill that she can’t pay. Death did NOT scare her at all. And she looks to mom to pay it all. I tried to talk to her … and she kicked me off her facebook page and refuses to take my calls. It is depressing because I think that she may be the first of us kids to be put in the grave. My mother lost her husband in November … she should enjoying herself… travelling the world … visiting her other children … but no … she has to babysit a 26 year old. Then, I feel guilty for not being nice to Maria … and I get very depressed about the whole situation. It is a constant DRAMA… I often think if it is this bad for me… it must terrible for my mom. If I had a wish, it would be that my sister would take care of herself.
Thank you Moira, and all the rest of you for your comments. THIS was exactly what I needed to read today, as we wait for blood test results to confirm (or not!) if my 16 year old T1D daughter has an abcess that needs to be surgically removed, caused by high blood sugars. The emotions of her diabetes are what we all seem to struggle with the most. I so appreciate your honesty. It is truly nice to know that as we struggle day to day, we are not alone in our battles with this disease, and with our children! As we drove to the endocrinologist the other day, and she raged, mostly in fear, I came to realize that she really has not accepted diabetes as a part of her life. She was diagnosed 5 years ago. But I am still left wondering…what can I do to help her facilitate that acceptance? Counseling? Support groups? I have suggested these over the years, but she tells me she will refuse to go. Her A1C has been consistently high the past year or more. The docs say she could go blind before she gets to college. Once to the hospital for DKA. But none of these things have been a wake up call for her to take on the responsibility and acceptance. And then, it becomes an emotional struggle for all who live in our house. As many of you know, we’ve tried to set limits, but she breaks them. Sometimes she lies…my sweet girl who I know knows that lying is wrong…will lie to get what she wants without having to test, or correct. I need some advice on where to go next…..
Hi Kristin,
First you can feel free to find me on facebook if you want. Second, DO NOT panic too much. I got so tired of threats — and the endo saying she will go blind before college is a threat . . . she won’t. You take her for eye exams, right? I mean, yes, we want our kids to have tight control and high a1cs are horrid . . . . but how about a little empathy? We are moving to a new endo (well my daughter is) and the first thing he wrote was “Listen, not knowing details yet I do know you’ve been a teen. I have MANY patients who struggled in teen years and have now had diabetes and few if any complications for decades. It’s not too late. Don’t worry. We can make it work.” OMG – I almost screamed I was so relieved to get some CARE in our “care.”
Anyway, I do have some ideas. Find me on facebook — Moira McCarthy Stanford — and we can chat.
Great article… its good to know that we are not alone. And there’s hope for no complications as a result of this time of constant turmoil.
It makes me think of the time when a family member (sister in law) said after a stay in the ICU for my t1 daughter in DKA, “God, how could you not know what was going on?” She was 17 at the time and not being truthful about her testing and bolusing. I took that to heart and have been beating myself up for not catching the lies. I feel like I’ve been judged the last 7 years trying to deal with this. Feeling inadequate, feeling like I didn’t instill good self esteem or coping mechanisms. My daugher is 20 now and still not caring for herself properly but I”m hoping for the day it ‘clicks’ and I hope its not too late.
Thanks for the Honesty!! Its helps.
Moira,
Its the first time I got to read this letter you wrote about teen and diabetes I am not a teen but I was diagnosed with T1 just before my 21st birthday but I can relate to your daughter I am turning 30 this year and I am still struggling now and then it is like an permanent struggle but you get through it with the support that we get from our loved ones like you give like your daughters its difficult if you get judged by everyone but lucky for me I have a father that could give me guidance even though we stay far from another but we speak on the phone regulary. but it helps to see that there is others that relate to what I’m struggling with. Thank you for this letter.
Thanks for the info. I struggle with the exact same issue with my son who is a high school jr, diagnosed about 3 years ago. The biggest obstacle is my ex-husband (who he spends every other week with) has not been supportive or involved in the medical treatment from the beginning. He was didn’t spend any time with my son when he was hospitalized initially and was resistant to the mandatory education courses. He still does not attend ANY endo appointments so probably (not that he cares) is unaware of how poorly my son is managing his diabetes. It’s unfortunate his initial hospital stay was so luxurious because I wish I had some sort of tangible threat that would get him to “step it up”. He doesn’t want to drive and has a very limited social life. Today was actually the first day I refused to take him to his appointment and told him his dad had to since he was at his house this week. He treats me disrespectfully so in a way I feel as though I’m enabling him by being the one to take him to his appointment. We have to go to see the endo about every 2 months because he’s not managing it and his A1c is still well over 8.5. So frustrated, he is a bright kid with aspirations to become a pharmacist. At this rate if he keeps taking tests with his blood sugar high (I’m guessing because he doesn’t test) he won’t get anywhere and things will become worse. I know he’s depressed but my ex has put such a stigma on the “depression” diagnosis that he won’t go to counseling or take anything.
[...] good friend of mine, Moira McCarthy Stanford, who is known widely in the JDRF community for her diabetes advocacy and has made appearances on TV [...]
I am so glad you shared! We are really going through a rough spot and I feel so alone. My son has been diagnosed since he was 4, and these past 2 years it’s like he could care less if he goes into DKA. I am at my witts end. I cried seeing my feeling written in your article, especially about the complications on your watch. That’s me to a T! Thanks for being honest.
Hi Moira,
This is Anne Chaffin. We met several years ago when at a JDRF national conference. I was just sent this link by a friend who read it. Thought it was a near perfect description of my life. As you know being in the ‘spotlight’ and one of those very active and proactive moms with a T1 child should mean we and our child have it all together!! Ha! Being on the JDRF BOD and involved in its activities seemed to add pressure to be ‘in control’ (both of us), but we just were not and have not been for several years. My daughter, diagnosed at age 8, and now just about to hit 21 has pretty much struggled since 14 (as have I) in all the ways you describe. It was good for me to read about the addition to freedom as an apt reason why a teen or anyone would want to go on with their life this way. But it does make total sense and and is not just doing it to be self destructive. One thing that I am sure must be of some help to a person that is feeling this way is 1.) Honesty ( as you have put forth here and I have tried to do in the last couple of years 2.) Acceptance of them as they are and not putting them in a perfect mold 3.) Hope…Giving them hope that they can do this and that we will give (or will back off) to help them and try whatever approach is best for that individual person.
I admire your courage and honesty and hope all is well with both of you.
Fondly,
anne
Thank you so much for sharing your story. My family has also had a really hard time dealing with our 12 yrs. diabetes. She was great until the middle of last year. Now not so much. Her dad and I are divorced and had a great relationship up until a month ago. He has not stop speaking to his daughter over this and has said all sorts of awful things to me about it. I refuse to punish her for her numbers but work to be caring and understanding that she just wants to be normal and not have diabetes anymore. I hope he comes around since it is hurting her very much. I am so worried for her and hate to see her hurting her self. but I don’t know what else to do but care for her best I can.
Hi,
My name is Jordan Bennett,
I am 14 yrs old and I am a type 1 diabteic
I am in Year 9, but i was diagnosed in yr 7 when i was just hitting my prime years of being a teenager.
I was diagnosed with a blood sugar of 89mmol, I was almost in a coma.
I am really glad to have found your story moira because it helped me realise i wasnt the only person NOT DOING all my bsl and insulin injections.
It really is horrbible and life threatening for your body, but i kept saying, ….. i will start fresh tomorrow!!!!I
I have just recently been put on the pump, AND LOVING IT!!!!
It is really helping me control my bsl levels!!
I used to test my blood sugar once a day if that and make up blood sugars everyday. And when i did test it once in a day….. my blood sugar would read HIGH!!!
(IM NOT TALKING A NUMBER I AM TALAKING hi SO hi IT COULDNT READ ON MY METRE, AND MY METRE READ UP TO 35MMOL)
just a slight tip for those parents that have irritable or aggresive, angry kids when they are high:
i am just wanting to tell any parent with a child my age, that if you think your child is acting out, or beeing more agressive or angry than their usual self, they know their blod sugar is high, and if you tell hem to test their blood sugar it really will tick them off!!! trust me i know. of course they will tell you “no its not” even though it really is, that just casue they dont want to say it. and if it is high…. when they test it dont say “told you ” or “knew it”, cause that tends to make me really upset and emotional.
i hope this helped parents or teens!!!!
p.s i strongly recomend the pump!!!
p,s thanx moiraxxx
Jordan I LOVE your comments and input! Thank you so much.
BTW Lauren made it through her first year of college. First half was a charm — a1c dropped quite a bit. Second not so much but she did well and came home healthy and LOVES college.
Thanks for posting this Jordan! It’s really helpful to hear honest emotions from the ‘patient’. As most teens are usually not commucative or in touch with what’s going on, it’s nice to have a glimmer inside the diabetic teen brain. Keep the advice coming!!
Was so glad to find this forum. I am the mom of a 16 yr old son, who was diagnosed with type 1 10 years ago. He is a great kid, mature for his age, does very well in high school, involved in marching band and guitar playing. However, his A1C has been averaging 10 for the past year and before that pretty much in the 9′s. He’s been “forgetting” to test his BS, fudging BS’s when he does test (and gets high #s), and forgets to bolus with his insulin pump (either to correct a high BS or for food). In addition, he is overweight and has signs of type 2 (he also takes metformin). Being a retired RN, I am on his case regularly, reminding him to test (I sound like a minah bird sometimes). I’ll admit to trying to “scare” him into testing (telling him that his kidneys and eyesight could worsen if he keeps going like he is), without success. From reading these posts, this is obviously not the answer. His endo nurse just told us that he may need to go back to shots, since he’s not being compliant with testing and that he is not being responsible enough for the pump. I realize that I cannot “control” him like when he was young, but I get so frustrated when I try to allow him more responsibility (and less for me) and he then does not test. He’s gone days here and there without testing at all. All I can do is keep supporting him, and like many of the teen T1′s who posted, not freak out too much at the high #s. I just want him to take care of himself so that he can attend the college of his choice in 2 years, but unless he does a big about-face, am starting to doubt that this will happen.
I have read this before and it really describes what we are going through with my 17 year old daughter. The comment before the blog where she looks perfect on the outside hits home too. One of my coworkers has seen my daughter and has said you would never know my daughter has these problems by looking at her- she looks so healthy! Only a fellow parent of a diabetic would understand what our lives have been like!
You just told my life story…wow. I really did think I was the only one…Im only 15 and all I get is nagging. But this…This helped me. Thank you so much ma’am. Im so grateful.
My daughter is T1D and is 13 years old. She was dx at 2. I can see this beginning to happen and thank you so much for sharing. Does your daughter have any advice for my daughter as she moves into her teens? She is the only T1D in her school but is burned out on Diabetes Camps. We’ve had some bad experiences with the school around her bs and pump. She is pretty frustrated.
Thank you.