Sick w/ worry as school starts

[kel4han]

I am literally making myself sick to my stomache, and High from stressing over my daughter returning to school next Monday She will be repeating 1st grade as she was diagnosed just 4months into the year last year. Thats worry number one of course. Guilt. That doesnt help either. We kinda just let the year slide by, we knew she wasnt ready for 1st grade when she started anyway....and then with the diagnosis and her being emotional, sick, high, low we just kinda gave no pressure for the year. Anyway.....

I have the 504 meeting tomorrow. This year I had to insists since she is already repeating her grade! We meet the teacher and train the nurse (who we love) on the pump today. I have all the supplies ready for her drawer in the nurses office. I have a detailed treatment plan for the nurse. I have print outs from JDRF for all the teachers that come in contact with her so they know all about this F'ing disease. I am going to speak to her teacher in detail, the importance that she understands this. I am scared to death that Maddison wont catch her lows. With the tighter control of the pump, a crazy summer that we just figured out the basals......she has endured alot of LOWS and has lost awareness until around the low 50's. I am afraid that she wont stand up for herself to get to the nurse NOW if she needs to. She is very timid, and soft spoken, and never wants attention drawn to her. I have lectured and pleaded with her to be certain she is aware that she MUST interupt, MUST get to the nurse, no matter what.

Then, there is the glucogan. The nurse has one, but I feel I need to train her classroom teacher. Is this my place to ask her? I literally feel I am having panic attacks becuase of the worry each school year brings! She is only six and only diagnosed 8months ago. Last year was good, becuase she was feeling lows at 100 when making the transition back to being right and healthy again. Yikes! Please give your input as to if I can do anything more! Anything that was helpful for you as a child in school? Thanks for listening to all my worries!! I need you guys more than you know! :o

[rzrbks]

As a former Classroom teacher---

do you really need for her teacher to have glucagon emergency kit or would just having glucose tabs be enough?

or maybe squeeze tube of glucose gel?

Is she passing out and/or going to ER ?

[palefacegirl03]

I dont have a child with diabetes in school, I was not diagnosed till I was 21, so my mother did not have to deal with it for school.

I know that on the parents board on the American Diabetes site, there is alot of threads dealing with it.

My niece is 11, she was diagnosed type 2, last year, so my sis ter has to do all of that though,my niece tests at school, but is not on any meds yet.

[Funnygrl]

If the nurse is in the building all the time, I see no reason for the teacher to need to know how to give glucagon. If she passes out, then they'll be calling 911 anyway.

I would suggest not overwhelming the teachers with information. Seriously, that will just put them into lockdown mode and they won't end up knowing anything about how to handle diabetes.

Teach the nurse how to operate the basic functions on the pump, test, treat lows, give glucagon.

Teach the teachers how to recognize symptoms of lows and suggest she test if she is low. That's it. Teachers don't need to know anything past that, but they do need to know that, so just teach them that.

Instead of handing them lots of generic sheets printed off from the internet, I recommend you use the information in those sheets to make one personalized sheet to give the teacher specific to your daughter. Make it have her symptoms of a low, and her target bgs on it, and how you want her to treat a low.

Make a sheet for the nurse with her parameters for bgs, info on how to use her pump, when you want her tested, how you want these logs, and how you want to treat lows and highs on it. Make sure you haveyour contact info on it and guidelines for when you want her to call.

Make a meeting to talk with the nurse and her main teacher. Meeting them will help you calm down.

Overall, it may not go perfectly smoothly, but things will work out.

[kel4han]

I have to say, I am quite offended. I noticed rzrbks that you are type 1.5, so this to me, means you have no idea how different it is to have a child with diabetes. I am myself type 1 as an adult onset, and thought no big deal of lows for myself, until my daughter was diagnosed and I am now constantly worried, even more so since she is a bit unaware of lows. Has she ever had a seizure, NO. Could she at any point? Of course. Would I want to risk the nurse not being available to run to her classroom if needed? If she has a seizure in class, I dont want the teacher without Glucogan while they track down the nurse. I am a big participant in the Childrenwithdiabetes forums, however, I thought maybe someone here in the adult forums could give some info about when they were in school with Diabetes. You just made me feel entirely over paranoid, and that doesn't help my stress about all this. :mad:

And yes, I wanted to know if you guys thought the whole Glucogan thing would overwhelm the teacher. I would think it would, but I am still unsure of what should be expected if there is no school nurse there.

[LancetChick]

I don't have kids, but I totally get the too-shy-to-speak-up thing, since I was always like that too. As a kid (before my diagnosis), I know I would much rather have kept lifesavers or glucotabs in my pencil case than have to raise my hand and have everyone stare at me. If she's going to be eating them all day, though, that would be a problem, but I really think someone as shy as I was needs a discreet way to treat lows, because I doubt I would have raised my hand.

[Funnygrl]

Does your daughter test herself? I would push for her keeping her meter and sugar with her if yes. I did that in school. I find packs of fruit snacks easy to carry around.

[kel4han]

She does test herself, but she is 6 and not really aware of what certain lows mean, such as 80 or 60 compared to 40 etc. She knows her lowest was a 29 and that was URGENT but she still hardly counts to 100. She is not a math girl, so she couldnt really be trusted to gage a low. I am planning to have her keep tabs in her pockets. Its so dang hard to know what is right at this age in school......and sorry rzrbks....I am a bit over snappy today......I re-read your reply and apologize I took you as being sarcastic. I didnt mean to bite your head off!:eek:

[BrendaK]

Hi Kel4han -- thanks for showing me this forum!! Last year, we showed the both the teacher and the office staff how to use glucagon (we don't have a nurse and the office staff does Carson's care). It wasn't overwhelming at all. They understood they would probably never have to use it, but it's a life saving thing, like an epipen. I went in with an expired glucagon kit and had them practice mixing it up.

If she is ever on a field trip with just the teacher, someone really should be trained. The training on it took about 5 minutes -- if child is unconscious, this is what you do... It's much faster than calling 911.

[kel4han]

Hi Brenda! I was hoping you would find us. Glad you made it here. -Kelly-

[rzrbks]

I'm sorry if I didn't present my questions well.

All too often, the classroom teacher is so busy just trying to keep disicipline and on task going that something as "small" as child going low is overlooked.

If you have a good school nurse, she'd be the one I'd deal with first, then get her opinion as to how much to put on the teacher.

Some teachers are great at being aware of all their students, others are on the edge of being overwhelmed. The nurse would probably have a good idea which your daughter's teacher is.

A second issue is legal in nature:

Many tecahers are now taught to leave any Health issues to the nurse or administration as lawsuits are rampant.

[poper77]

I was diagnosed a few months before I started kitergarden. I know my mom must have been worried, but i never knew...which i think is good, otherwise I would have been stressed out. I ALWAYS had a purse with candy and those darn peanut butter crackers (to this day I can't stand the thought of eating them) My teachers were informed that I had diabetes and that there were times that I needed to either go to the nurse or eat in class. They were pretty good about it. Back then they only had the NPH and R so I had to even leave class to eat lunch before the rest of my grade. Back then we didn't even test every day....I think only the nurse had the glucagon kit. I only had 1 time that my bloodsugar dropped and I didn't realize. The lunch ladies thought I wasn't acting normally and brought me to the nurse who fed me soda - I don't remember this at all....but everyone reacted properly and they didn't need to use the glucagon..
Good Luck!

[JediSkipdogg]

I didn't read everythingin this thread but here's my thoughts....

How tight are you controlling her? Personally, I think children need looser control than adults. I would keep her target at 150 and have her aim for that all the time but not to worry if she hits 200 or 100. That will give her more of a buffer so you don't have to worry about lows as much as with a kid they can go from sitting all day running 100 to doing a 5 mile run on the playground in under 10 minutes. And that can cause problems.

I would encourage her to test and eat in class if she can. I use to do that all the time. Well, not the testing but the eating as back then we didn't test that much. So it was all based on how I felt then.

All of my teachers were aware of the main symptons of a low and if needed they called the nurse and I'd sit there for 30 minutes or so and snack away with some OJ (Sunny D or those small cans (not cartons) of OJ are great to keep in a nurses office as they can last all year without going bad.)

I would find out in your state if teachers can even give glucagon. Here in Ohio as far as I'm aware, only nurses are allowed to administer that so the teacher having it would do no good anyways. Also, be aware, that in those cases they will call for an ambulance and transport is generally mandatory for a child at school. Again, state/local laws may vary there.

Good luck and let me know if you have anything else specific and I'll try to remember back into my childhood.

[dekockc]

I agree with Jediskipdogg and that is to not have too tight control with the little ones. Obviously this is not your aim for life, but it takes a lot of stress and dangerous low situations out of the mix if you aim for 150 - 200 during school hours. My son, now 7, was diagnosed a month before starting 1st grade , what a year that was! We battled through the first year with lots of concentration problems because of BS going up and down etc, but we slugged on. He is now almost at the end of Grade 2 and doing great. We have found it really helps if you are not controlling it to the optimum the way you would do for say - a child of 10 years and older who can take some more resonsibility. Anyway, each person is different, but this works very well for us. Also, where we live, in South Africa, there is no law for school care like your 504 plan, therefore you have to take responsibility and for the rest rely on the goodwill of the teachers to assist. I have made sure that they are well educated. The school secretary keeps the Glucagon injection in her office and I have written clear instructions on a sheet and tied it with a rubber band around it. They let him test if he is not feeling well and they always phone me. If he is low, they have glucose tablets and biscuits to give him. He is also allowed to eat his snack any time in the morning when he wants. If bs is high, I drive to school and administer insulin. This happened a lot in grade 1, but since he has matured a bit and since we have better control than the first year, it hardly ever happens any more. I also go to school every 2nd break - about 12H00, test, give food and insulin (He is on MDI, not a pump yet). In the beginning I gave him a roll of glucose tablets to put in his bag to eat if he feels low, but he ate the whole roll, regardless! I now put two tablets in his pocket, which he also eats regardless, but being only 2 tablets, it raises bs only a few points.

It is never easy with small children and school, and you have to do what it takes to make things work. My personal opinion is again, that the very tight control with small children only creates even more problematic situations at school. My son has only had 1 very bad low in the 20 months since diagnosis, right in the first month. Obviously, you should not let the bs go too high , out of control, and you should do what you feel is best for your child in conjunction with your doctor, but this is my 2 cent's worth of advice. Sorry for the long story, but it is difficult to explain in a few words!

[Erin]

I am a 1st grade teacher, I am also a type 1 and was diagnosed in the 3rd grade.

I would have to agree that the classroom teacher just can't have the responsibility of administering glucagon. I don't think I would feel comfortable giving one of my students glucagon if we were in the school building with a nurse on site. It's a legal nightmare to have sharps in the classroom. I keep mine under lock and key. It's also a legal nightmare for a teacher to administer meds.

If we were on a field trip and I was the only person with half of a clue about diabetes, I'd give a kid glucagon in a second, and deal with the legal stuff later. But in school with a nurse and administrators on site, my hand would be forced to let them administer the glucagon. (you can request that the principal be trained to give glucagon, incase the nurse can not be reached in an emergency... but unfortunately you can't have the teacher be that go-to person.)

I would give the teacher glucose gel, and teach her what a low looks like, and how to treat it with glucose. I would also be hesitant to have your daughter walk to the nurse alone or with another first grader if she is low. I always had the "treat first... check later" attitude when I was in primary school. The teacher should be more than willing to allow your daughter to treat the low with glucose tabs or juice in the classroom, and then go to the nurse.

The teacher can help you in these ways:
1) keep extra "low food" in a safe place in the classroom that is easily accessible to your child.
2) keep an eye out for strange behavior that might indicate a low.
3) Allow your daughter to eat, test, use the restroom (in the case of high bgs) and go to the nurse without restriction.
4) Know that she should contact you (not yell at or question your child) if she feels your daughter is abusing these accommodations.

[Alice]

I can understand your worries...someday you'll be worrying about a teenager all too quickly. So enjoy these young school years like any other parent. Just with a different "twist". Another parent will have another issue as well, trust me.

I was diagnosed in second grade, so I can speak from some experience although I have to say, so long ago, we didn't have meters, pumps...really no tools whatsover we have today. I had too learn on my instincts which gave me many skills I still use today. (41 years later)

Keep in mind some teachers are more knowledgeable (or willing to learn) than others. If you have to find the right teacher, then that's ok, but don't be an over demanding parent, unnecessarily. (I don't think that you are)

I did just fine. I am very proud today (and can still remember) of how much info I learned at age 7 about my own disease. So, don't discount the age too much and the ability to learn. My parents never were the hovering types, or let me know that they were hovering (I'm sure there were many discussions with the teachers)

The main thing is to to let her enter her education experience as any normal child would do...sports, sleepovers & such. From what I've read today, tight control is not suggested, but that doesn't mean poor overall control, which I know you will never let happen.

The teachers will be very helpful. Keep in mind they hear all the "out-of-date" info about diabetes that we hear. Let them know that it is ok for your daughter to have cookies and whatever, if you are comfortable with in her diet. I find I am more frustrated today by explaining boluses to non-diabetics, than I am being diabetic...that will never go away.

This is also a great age to teach your daughter that just as it is ok to say yes to birthday treats (think how many birthday treats appear in a second grade class), it is also ok to say no. It is her choice, not someone else telling her that "diabetics can't eat sugar"...that simply isn't true and can be downright dangerous to tell a Type I child that...I heard it some many times and still do, I get angry, not shy, now that I'm older. Teach her to stand up for herself...that is what educates the public, at any age.

Training teachers on the pump, I don't know about...but the main urgency would be letting her keep her meter with her. I've heard that some schools insist on keeping them in the nurses office, that makes no sense and I'd go to the school board if that happens. Kept with her, at least the teacher would know the numbers. I personally wouldn't want too many adults "trained" on my pump...at any age.

(I pretty much partied in second grade like any other second grader...maybe started skipping the Kool-Aid by then...that much I had already learned at age 7! LOL! Kids burn so many calories, the goal is too keep them on their feet.

Even back in the days of "no meters" and one injection of Lente/Regular a day (very old memory!)...I've never passed out or been in a bad situation out of control. (Knocking on keyboard right now!) I've never been in the ER...I'm not saying I'm better than any other Diabetic, Lord knows it's a day-by-day disease. But, those life skills learned early have definitely helped today.

I loved second grade. That was the year I was diagnosed...and still my favorite year of school. It was the year that Mary Poppins, the movie came out and we sang by the piano all those songs. My teacher just happened to love playing the sheet music for Mary Poppins...we sang all year!

[CaptainMike]

Advice bit #1...
RELAX!!!

You are not doing yourself OR your daughter any good whatsoever by making yourself sick with worry and stress.

If she is anything like most 6 year olds she is VERY attuned to your emotional state and the fact that you are maximally stressing to the point of physical symptoms is not going to help either of you with the situation. She may even be wondering what it is that she is doing wrong to make you so unhappy.
You will also want to make things as easy and pleasant as possible for the people at school you are trying to get willingly aboard your treatment train, and being in a near panic will not help you or them in any way.

I understand your worries and the serious nature of the potential downsides, just try to be mindful of the fact that 80% of face to face communication is nonverbal, so the more calm and relaxed you can get yourself, the better it will be for you, and for your daughter in dealing with what is already a very stressful situation for her.

Best of luck to you and your family, I'm sure your daughter will do great!

Mike

[georgepds]

I am literally making myself sick to my stomache, and High from stressing over my daughter returning to school next Monday

Then, there is the glucogan. The nurse has one, but I feel I need to train her classroom teacher. Is this my place to ask her?

Hi

I would make my concerns known to the teacher and administration. I notice you are in the US. My understanding is that the school is responsible for providing education, preferably in the 'normal' classroom environment, to all children. If this means they have to keep the nurse nearby then maybe they have to adjust

Good luck

--g

[56sushi]

Hi kel4han,
I just wanted to add a further thought. I substitute teach and on a few occassions teachers neglected to tell me about a student's special needs. One parent had made a sheet up with her daughter's picture and relevant information about her condition (needs to have a snack at 2:00 pm etc.) to be placed in the sub folder. It was on colorful, full sized paper which made it stand out among the other instructions and was really helpful to have. Nothing too intricate but let me know that I needed to be mindful that this little girl might have a few needs to be attended to during the day.
I tend to be a stickler for the rules and might have rolled right over a shy child who was eating in class. (Sorry, but even first graders try to pull one over on the sub these days. I once had a second grader insist that her doctor told her she needs to have a brownie every day "for the protein") and this in a school with a 'healthy snack' policy))
Try not to worry too much. I know several diabetic children in the system where I teach and they are growing and learning along with the rest of 'em.