A family living well with type 1 diabetes.

Archive for the ‘School and Diabetes’ Category

Happy Little Free Food

I can’t be the only D-parent that makes happy faces out of the zero when writing out the carb counts for school snacks, can I?

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Enabling Independence.

Jenna is almost half way through her first year of school. She loves school! Kindergarten has been fun, exciting and full of growth and learning, not just for Jenna but for me as well. I’ve come quite a way from the worried and nervous mom I was at the start of the school year.

We have a routine now and it seems to be working quite nicely. We have found ways of doing things to ensure that Jenna has virtually the same opportunities as any child does while attending kindergarten and still remains safe. I can, in part, credit her student support worker (SSW), her teacher and the school for this success.

Oh sure, we’ve had a couple of hiccups along the way. We are, after all, blazing a bit of a trail here. There aren’t many children with diabetes as young as Jenna and on an insulin pump in the school system here. And every family has their different ways of managing their child’s diabetes. But with good communication and the setting aside of some egos, we (myself and the staff) have managed to maintain respect for one another’s perspectives while achieving our common goal of ensuring Jenna is safe and happy while at school.

At the start of the school year we set a goal for Jenna to start doing some of her own bolusing by Christmas while she is at school with the supervision of her SSW and with my telephone guidance. Presently, I go to the school twice a day, for morning snack and lunch to administer her insulin doses as no staff members at the school are permitted to do so. However, Christmas time is never a good time to initiate a new plan. So we all agreed to hold off until the new year when the dust of the holidays has settled and we are back into the groove at school.

So here we are, well over three weeks into the new year and back into our routine. Jenna is no stranger to bolusing herself with either my or her dad’s supervision. We have handed her her pump and walked her through the process on many occasions. But her motivation is lacking because, well, she’s a kid and she doesn’t want to have to take the time to engage in such tedious matters as inputting carb info and blood sugar results into a mini computer to receive an insulin dose recommendation then input that number and press GO prior to eating a yummy snack — not when Mommy can do it in a third of the time while Jenna can dig in and enjoy social time with her friends.

What kid would want to do that?

But, of course, she has to do that. This is the next small step in Jenna’s slow journey toward independence. So we’ve developed a little incentive program for her at school with the help of her teacher. Jenna is expected to give herself her snack bolus three times a week, on Mondays, Wednesdays and Fridays, with supervision from her SSW and my counsel via mobile phone. She will receive a check mark on a special chart that her teacher has devised and at the end of the week, provided she has met her three-check goal, she gets special play time privileges and she gets to chose a friend to join her for this reward.

Sounds great, right? Well, we shall see. This plan is to be implemented today. In fact, I am going to park outside the school in about a half an hour to do our first phone bolus and still be close enough in case any unforeseen issues should arise. I slid the little, bare-bones cell phone we purchased last week into Jenna’s lunch kit this morning, ready for that first call. I will keep you posted.

The other little dilemma was, how do I provide a mobile phone for Jenna to use at the school to communicate with me for bolusing without it seeming to my 8 year old daughter –who is already asking, and has been for some time now, when she will get her own cell phone– like I am giving my 5 year old her own cell phone? I have had to be careful of language; I don’t refer to the cell phone as “Jenna’s cell phone”. That would give the wrong message to both girls. I explain that it is Mommy and Daddy’s cell phone. Of course, it was a bit of a hard sell for Jaz. But she does understand. Incidentally, Jaz has been bolusing Jenna lately on some occasions as well, and she is a pro at it. Yes, things are progressing nicely. My little girls are growing up.

It’s bittersweet, really.

Update: SHE DID IT! She just gave herself her first bolus without J or I present! I heard her little voice over the phone and I distinctly heard pride as she input the info and pressed GO, giving herself her insulin dose without me there. And I find myself oddly emotional about this rather huge step toward her independence. It reminds me of the first time either of my girls tried solid food after being strictly breastfed. Ah, but it’s all good. She’s taking the reigns. Slowly but surely, she is taking charge. :)

Letting Go

There are a few significant events in every parent’s journey that mark a time of pride and excitement; first words spoken, first steps, the first time you say goodbye to your child at the babysitter, preschool, kindergarten… These are events worth documenting, photographing and celebrating.

But some of these events are also pretty darn anxiety laden. It isn’t easy for parents — often (but not always) moms — to say goodbye to our babies and trust their care to someone else. But we must, and we do. Sometimes it doesn’t feel natural, but it’s a part of life, right? …to say goodbye and help our children make that slow journey toward ever increasing independence.

Jenna has begun her school journey. She is attending full time kindergarten and, in all honesty, she is absolutely loving it. She no longer has to feel left behind watching her big sister walk into the school every morning. She is a big kid now, in real school. She is ready.

Sure, she had some anxiety at first. She was shy, withdrawn and a little lost. But her teacher, Ms. C, handled it beautifully and in no time Jenna warmed up to her.

Of course, the big pink elephant standing right smack-dab in the middle of the room is…

DIABETES.

Without question Jenna’s diabetes has been a tricky one to juggle. There are a few factors that make it so:

  • Jenna is far from completely independent with her diabetes management. (Of course she is, she’s five.)
  • Jenna is often unaware of her lows until she is well below what constitutes a low.
  • Jenna is stoic. This scares the ever-loving stuffing out of me as she is not apt to speak up if she is having a problem, preferring to avoid the spotlight and be “just like all the other kids.”
  • No staff member at the school is legally allowed to administer either insulin OR glucagon to a child with type 1 diabetes in our province.
  • A single teacher in a busy kindergarten class of 20 young children, all equally deserving of attention, cannot possibly be expected to do her job AND watch a child with type 1 diabetes for the often subtle signs and symptoms of hypo or hyperglycemia, let alone react to a low or high in the appropriate way. (I have two children and trust me – this is no easy task at the best of times.)
  • Since no staff are able to give glucagon, it is absolutely vital that Jenna receive timely intervention in the event of a low to avoid a dire situation.

Given these obstacles, it was crucial that we obtain government funding for an additional support staff in the classroom to assist Jenna with her care.

The trouble was, we had to actually prove that she really does need this assistance.

Jenna’s pediatrician likely anticipated this because I received a letter from him this summer stating that her medical condition placed her in the special category that makes her eligible for this added support. That letter turned out to be the means to a fabulous end and the way it played out was beautiful poetry to this D-Mom who felt all kinds of panic wondering why I actually had to prove my daughter’s need for help to ensure her safety while in school. To me it was as clear as the nose on my face. But this is the system we have and this is the way things are done.

This summer I met twice with the public health nurse who gathered all the pertinent data regarding Jenna’s medical needs and her care. She drafted a care plan outlining, to the utmost specificity, how Jenna’s diabetes management is to be conducted in school: If A, then B. Then follow up with C fifteen minutes later. However, if D, then E…

It is clear, precise and to be followed to the nth.

This care plan was presented at a meeting we — members of the school staff, the public health nurse and I — had last week in preparation for Jenna’s school start this past Monday. This meeting was to provide diabetes training to the staff and give a chance for the concerns of everyone involved to be voiced. The vice principle was also present. She is the lady with pull. She, along with the letter from Jenna’s pediatrician, was key in achieving the ideal outcome.

When the meeting was winding down, I noticed her eyes were wide as she digested the full scope of what she had learned. She realized that this was a life and death situation which would require constant diligence and monitoring beyond what one teacher would be capable of. She promptly excused herself from the meeting stating she had some phone calls to make in her office, assuring us that she would be back.

Staff members who had been pulling for us since last spring when this whole process got started gave me subtle, reassuring pats on the back. They knew her and knew that this reaction bode well for us.

I whispered to Jenna’s teacher “What does this mean?”

“It’s a very good sign. She realizes now what we are dealing with. She can make this happen for us” she whispered back then gave me a wink.

It was all I could do to maintain my composure. All the anxiety and fears I had been living with regarding Jenna’s start in the public school system that dated all the way back to her diagnosis were daring to subside.

The vice principle returned not 15 minutes later and announced that Jenna would have an assistant assigned to her in the class room for four hours everyday.

And it was like  letting go of something I had been clutching with a death grip for three and a half years.

It was validation. They understood how precarious my child’s health is — the fine line we walk.

So now Jenna is attending classes everyday and looking every inch the big girl, school kid that she is in her new school clothes with her giant backpack on her back. I still go in to the school to give her boluses for her snack and her lunch — that won’t change until Jenna is old enough to do so on her own with supervision — and, until today, I had been spending my days in that little room off her class room to be available in case there were any questions. But my presence there has become less necessary as her worker, who is so awesome, has become more confident and capable. I must remain in town (we live rurally, almost a twenty minute drive from the school) to bolus and in case there is a problem — a stubborn high, a dislodged infusion site, etc. — but I am quickly phasing out my constant presence there.

And now it’s my turn to feel lost — proud and relieved, but lost, nonetheless. Suddenly I am struggling to fill some free time and it’s a foreign feeling. I am trusting others to ensure my child’s safety, as capable as they are. I won’t deny it, I’ve had some moments of anxiety sneak up and put me in a head-lock. But I’ll be okay. If there is one thing I am, it’s tough. That is undeniable. I’ve been able to wrestle free from the anxiety when it does ambush me. I just remember that there are good people at that school who really care about my daughter and her wellbeing. They want her to be safe too.

Another milestone, complicated by diabetes, has been reached. Now there’s just the dreaded teen years and college to worry about.

Just keep blogging, Sherry — just keep blogging…

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