Friday, February 14, 2014

Summer 2013: going downhill.

We knew something was wrong. Over the Summer, Max had grown apathetic. Since April, his tennis performance had only been going in one direction: down.  Harsh scores against evenly matched adversaries, unexpected losses against weaker players. Blood work had been planned in May but because of a confusion of mailing addresses and a whole lot of other family issues, it was never carried out. All the classical diabetes signs were there, polyuria and polydipsia, fatigue and weight loss. But we missed them. In retrospect, I feel a bit guilty, with my training, not to have at least suspected the diagnosis. Why did that happen? It was a mix of circumstances: heavy family issues, the difficulty in spotting a gradual change in weight in a person you see every day, the warm weather and exercise which partially explained the thirst and, Max own insistence that everything was fine... All of this is perfectly understandable. However, there's one issue about which we can only plead guilty: at the end of June, we stopped updating his growth and weight curves.

My old pediatrics teacher used to say (around 1985) something like this "We have a lot of new investigative tools which yield lots of interesting results, but always remember that simply tracking the height and weight of a growing kid or adolescent will reveal any serious chronic pathology." I still had the advice in mind, I had used it previously when Max, at the age of 3, had been diagnosed with coeliac disease. With the beginning of Max's adolescence, it had just slipped out of my mind for a couple of months... Here's Max growth and weight curve. (thanks to

The diagnosis of his coeliac disease took longer than I would have liked in 2003: at that time I knew something was deeply wrong but I was unsuccessful in convincing two successive pediatricians to take a closer look. The impact on the growth and the weight curve is clearly visible and unfortunately seems to have had a long term impact despite a strict gluten-free diet. The T1D induced weight loss was dramatic and quick. Fortunately so was the recovery once a proper treatment was in place.

Lesson learned and re-learned: keep an eye on your kids growth and weight curve.

Coming next: the day the Earth stood still: T1D diagnosis.

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