Sunday 21 October 2018

'We were mystified by her moods but the penny dropped when she told us she was always thirsty' - Molly diagnosed with lifelong condition

A few years ago, Ciara Crehan was mystified by her daughter Molly's mood swings. But then, she tells our reporter, the six-year old was diagnosed with type 1 diabetes, and that answered an awful lot of questions

Ciara Crehan with her daughter Molly. Photo: David Conachy
Ciara Crehan with her daughter Molly. Photo: David Conachy

Joy Orpen

Molly Crehan wouldn't look out of place surfing the waves in California. That's because this 10-year-old has long, shiny blonde hair, a honey-coloured complexion and a wide, sparkling smile. But she's also bright, energetic and full of personality. This girl's got charisma in spades.

But there was a time when she had so little control over her moods, it made her feel very sad. Her mother, Ciara, recalls her daughter's slide into ill-health. "It was the summer of 2014, shortly after Eli, our youngest child, had been born. Noah was three, Molly was six, and Finn was seven. Molly started having dramatic mood swings," Ciara recalls. "My mom and friends thought she might be jealous of the new baby, or of Noah, who gets extra attention because he has Down syndrome. But I doubted that was the case, because she loves them both dearly."

Back then, Molly would wake in good spirits and have breakfast. But then her mood would darken, and there'd be all sorts of issues around getting ready for school. Going to bed at night, she often complained of pains in her tummy and she always insisted on having a glass of water by her bed. Then, in November, a few days after she had run a high temperature, she woke one night and drank all her water in one go.

Then she dropped a bombshell when she told her mother that she was always thirsty at school and had to keep refilling her water bottle, while adding: "I can't stop myself losing my temper. I don't know why, but I can't stop myself."

There was clearly more going on here than mere sibling rivalry. Her mother guessed at that moment that Molly had type 1 diabetes. "I put my arms around her and told her we'd figure it out, that we'd work through the problem," Ciara says. "When I told my husband Carl that I suspected Molly had diabetes, he said he'd had the same thought."

The next day, Molly was taken to their GP, who tested her blood. She did this by analysing a tiny spot of blood. The result was high - her blood-sugar level was over 30; a normal reading is between four and eight, so Molly was actually in crisis.

"I couldn't believe this was happening," says Ciara. "Even though I'd suspected she might have diabetes, I was still shocked when it was diagnosed. But we were also relieved, because we finally understood what was going on; we felt this could be managed. Within a day of her diagnosis, we could see we already had our Molly back."

Type 1 diabetes occurs when the pancreas fails to produce a hormone called insulin, which converts glucose into energy in the cells of the body. Sugar then builds up in the bloodstream and can cause severe, life-threatening complications. Symptoms of diabetes include weight loss, increased thirst, frequent urination and fatigue.

Molly was immediately referred to Tallaght Hospital, which is fairly close to the Crehan home in Leixlip, Co Kildare.

Once she had been triaged, things began to move rapidly. Within a short space of time, she was in the paediatric high-dependency ward with a Freddie [IV line] in her hand, and hooked up to monitors.

"She was in hospital for eight nights. During that time, we learned how to care for her at home," says Ciara. "Molly didn't like what was going on. She didn't think it was fair. But she did have fun in the hospital, and even went to school there."

Taking care of Molly was complicated during the first couple of years. Her parents, who are both accountants, had to give her two insulin injections a day using a conventional syringe with a very fine needle. They also had to religiously calculate the carbohydrate content of everything she ate. Lunch and dinner contained a maximum of 40g of carbohydrate; snacks were from 10g to 15g. "It's all about matching insulin to food intake," explains Ciara.

She says Molly coped well, but one aspect worried her. "She asked if she was going to die, because the first part of the word diabetes sounds like die," Ciara remembers. "So we quickly put her mind to rest. But she could accept that this condition was for life, because she had already learned that Noah's Down syndrome would always be with him. Nonetheless, it wasn't easy explaining things to a six-year-old."

Monitoring Molly's diet meant exercising extreme caution when she went out. She remembers this aspect well. "When I went to parties, I would only get a tiny bit of cake," Molly says. "And I'd get a lot of people telling me I can't have this or that. It felt hard."

These days, things are somewhat easier for her and her parents. She now wears a continuous glucose monitor (CGM) on her arm, which measures her blood-sugar levels. She also wears a small insulin pump at waist level, which is attached to a small tube in her body.

"The pump offers her much more freedom around food, but we still need to calculate the carbohydrate content of everything she eats and feed this information into the pump," explains Ciara. "The pump, coupled with the CGM, allows us to have greater control over her blood-sugar numbers." Lots of things, besides food, affect Molly's blood-sugar levels. Being sick, exercising, a growth spurt, stress, worry, excitement, are also contributing factors.

And that's where Night Scout comes in. This is a phone app which allows Ciara and Carl to access the CGM readings day and night. If Molly's blood-sugar levels drop too low, or go too high, their phones sound an alarm and they immediately take evasive action.

They wake her if she is asleep and give her something sugary to eat (if the reading's low) or instruct the pump to deliver extra insulin (if it's high). Ciara says this system removes some of the stress. "If her blood-sugar levels are too low or too high, we can intervene at an earlier stage. We can check her when she is not with us, and at night we don't even have to get out of bed if her levels are stable."

Some time back, the Crehans joined the Sweet Pea Club at Diabetes Ireland, and have found it to be a great source of information and support. Molly and her siblings have attended many of the events organised by the club, which have included adventure holidays, which they all love.

A bonus is being with other children who understand what it is to live with type 1 diabetes. Meanwhile, Carl and Ciara are dedicated to raising funds for Diabetes Ireland.

Currently, Molly is a member of a local musical-theatre group, she's in the local under-10 girls' soccer team, she plays the keyboard and loves swimming, dancing and being with her friends and brothers. In other words, she's living a full, active, and very happy life.

For more information, contact Diabetes Ireland, see diabetes.ie

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