Presentation on theme: "Living with/adherence and PKU"— Presentation transcript:
1Living with/adherence and PKU Dr Kathryn Bondx 0500
2Emotional Development Psychological Functioning and PKU BehaviourSocial DevelopmentAdherenceChronic IllnessEmotional DevelopmentPsychological Functioning and PKUQuality of LifeDietary DemandsMedical Factors e.g. Phe. levelsCognitive & Neuropsychological DevelopmentFamily Functioning
3Aims for presentation today Think from a psychological perspectiveStrategiesTime for discussion and reflection
4Becoming more independent DietFeeling DifferentNon-adherenceSupplementsBlood testsPKU….the tricky bits!!Becoming more independentCognitive Development (for some children)Difficulties for parents: e.g. anxiety, keeping control v promoting independence, guilt/feeling sorry, coping with difficult stages e.g. toddlers and teenagers!
5Cognitive Development Increased risk with non-adherence and consistently high blood levelsIn comparison to siblings slightly lower IQExecutive Functioning: working memory, maths, attention & concentration, executive functioning
6The meaning of PKUWhat is the meaning of PKU in your family, in your lifestyle, in your cultural system??….acknowledge those difficult feelings, where do they come from…are there people undermining PKU management?Involve all your networks in managing PKU so it fits with your lifestyle
7Parenting and PKUSome parents can struggle with guilt, feeling ‘sorry’ for their child, wanting to compensate for PKU…Anxiety: diagnosis was probably the most frightening experience of your life as a parent. It can feel as though you are no longer in control and you worry about being able to keep your child safe. Anxiety is transmitted to children.Overprotection: common, normal reaction (can be reinforced by the medical regime). How will your child achieve their best potential in life without becoming more independent and making some mistakes along the way?
8Family Functioning and PKU Chronic health problems like PKU results in extra demands for familiesIf there are pre-existing difficulties (like relationship problems, parenting difficulties, addiction, abuse, cultural expectations) it can be hard to keep pace with PKUTalk to your clinic and GP about accessing extra support e.g. social services, CAMHS or AMHS
9Control and Chronic Illness If you have a chronic health condition, like PKU, life can be different at times, sometimes it is not fair, there are things you have to do that sometimes you just don’t want to e.g. diet, supplements, medicines, blood tests, weighed and measured, hospital appointments……: FACTHow can you give control back? Give choices (but stay in control). Can you work around some expressions of wanting to be in control? Rewards should be based on 75-85% success: do we always achieve 100% success?
10Feeling DifferentNot PKU per se but feeling different to everyone elseMore difficult at secondary school/college…(how do I tell friends, girlfriends/boyfriends)Set realistic strategies…remember what it was like to be a teenagerPromote well rounded self-esteemInclude good friends, girlfriends/boyfriends….they can be your best allies!!Sensitive arrangements at school e.g. use of sink to brush teethPractice responses together to questions/comments about the diet, supplements, having PKUAcknowledge, model and talk about how feeling different can be…and can be coped withAcknowledge, model and talk about how the same issues exist for adults too – e.g. bullying/feeling anxious doesn’t end when you leave school
11Becoming more independent Start as early as possibleAim: PKU is part of their life not part of parentingExpect some setbacks & don’t highlight errorsBreakdown every task (e.g. diet, cooking, blood tests, supplements) into tasks and always be working on a stepWhat will it be like to lose control after so long!!....What long-term outcome do you want??
12Blood Tests What are you transmitting to your child? How many steps of the blood test can your child do on their own?Who gets the feedback from the blood tests at home?Does your child know what the blood test is for and what it is measuring? Can they explain it to a friend?
13BREATHING TO HELP RELAXATION Obviously we all know how to breathe… we do it all the time!!There are some ways though, of changing your breathing slightly to help you to be more relaxed.Try to breathe through your nose, using your stomach muscles. When you place your hands on your stomach you will feel the movement if you are breathing properly. Try this out to make sure that you are used to this feeling!Try to breathe slowly and regularly.It is important that you do not take a lot of quick, deep breaths as this can make you feel dizzy or faint and make your anxiety worse. Blowing out slowly when you are breathing out stops this.
14SLOW MUSCLE RELAXATION Sit or lie down in a comfortable position. Try to relax as much as you possibly can. Think about your different muscle groups one at a time, and try to learn the difference between tight and relaxed muscles.Try to concentrate on the feeling in the muscle as it goes from tight to loose.Hands and armsClench your fists and tense your arms.Feel the tightness in your hands and arms and then slowly relax them.See how far them. See how far theywill go, but do not push too hard. Do not hold on at all, let everything go!
15YOUR FAVOURITE PLACEAnother good way of relaxing/ distracting yourself is try to is to imagine your favourite place. It can beanywhere in the world or Universe, a place whereyou would most like to be and would be thehappiest you have ever been. It could be a beachon a desert island, on a rollercoaster, or anywhere.Now close your eyes and imagine what it’s like…What is there? sounds, smells, noises, feelings, who is there with you? What are you doing?
16Yes no How worried are you 3 minutes before the blood test? How worried are you 3 minutes after?Did you remember to breathe from your stomach?YesnoWrite down the things you did to help yourself. How much did they help?I did my breathing from my stomach. I also used my special place and blocked everything out from my mind.
17Everyone will laugh at me How anxiety works: a “Worry Cycle”You wake up on a Monday morning and have a job interview……ThoughtsIt is going to be awfulEveryone will laugh at mePeople will think I’m rubbishBehaviouryou might avoid the interview, pace up anddown, go to thetoilet..FeelingsFeeling scaredHeart pounding Breathing faster Sweating
20Thinking about change… What worries you about your current situation?How would you like things to be different?What do you think you might do/be willing to try?What are the advantages of change?What makes you think that if you did decide to make a change, you could do it?What encourages you that you can change if you want to? Who could offer you helpful support in making this change?What do you think would work for you, if you decided to change?
21Protective FactorsParents/family can take on the diet but without too much anxiety/controlLearning about your medical condition and understanding the diet early in childhoodSteadily increasing independence and control …especially before teenage years