Many Schools Failing on Type 1 Diabetes Care

[Tanaqui]

I don't know why I'm surprised by how bad it is, but I am. And it's not reasonable to expect every parent to be all "Okay, the public schools are awful, guess we'll homeschool!" even if that's a perfectly valid option. We're all supposed to have the choice of a decent public school that won't kill our kids. That's just not that much to ask. I thought that a friend's kid getting excluded from computer class (because that's the time she visited the nurse) was bad enough, but some of this...!

 

There's a related follow-up here.

[DesertBlossom]

That's really disappointing. The school that DD went to before homeschooling was really great. I think I took them by surprise though will all my handouts and paperwork and asking for a meeting with every single teacher she would have. The nurse was kind of shocked when I insisted that in first grade DD be able to have a blood sugar meter in the classroom and that she be able to test herself there and then be able to treat her lows (and then call the nurse), as opposed to walking down to the nurse first.  She said she'd never had a child that young be able to take care of herself that way. I insisted and it was fine.  But I learned to just insist on things my way. :)

 

DD goes once a week to an enrichment program, also part of our public schools, and her experience there has been great as well.

[mommybee]

This makes me so mad!

 

My oldest has Type 1. He was homeschooled so I didn't deal with this but I really wish I could help these schools understand better.

 

The stuff I had to put up with was people monitoring what he ate and constantly cornering me and telling me all about it. I even once wrote a letter to our entire boy scout troop trying to explain that he can eat what he wants and it only takes insulin to cover it. And that when he is low on camp outs that yes he will be eating sugar of some kind to bring his number up and that he eats a regular healthy diet. It was incredible annoying.

[magnificent_baby]

On the other hand....if I was a parent of a type 1 diabetic, I wouldn't want my child attended a school where they were uncomfortable handling it. I'm a school nurse, and we have had students transfer from other schools to our district because we provide very good diabetic care. I can't say that about all schools. We do not have a registered nurse at every building either, they are unlicensed associates handling the diabetics. They do a phenomenal job. It can be very, very scary to have a student come in with levels in the 30's or so high the meter doesn't register it. We are very used to taking care of diabetics of all ages, but I can certainly understand a school especially one without a nurse being uncomfortable with the care required. School systems do need to work with parents to train their staff, however, I wouldn't want to send my child to one that wasn't completely comfortable with handling this. 

[JumpyTheFrog]

Why doesn't every school have a nurse these days? Who is handing out the medication to all the students? I know there are budgeting issues, but really, a nurse in every school seems like a no-brainer to me.

 

I'm guessing all the push back from the schools is because they are afraid of lawsuits if a non-nurse treats a diabetic student improperly.

[magnificent_baby]

Why doesn't every school have a nurse these days? Who is handing out the medication to all the students? I know there are budgeting issues, but really, a nurse in every school seems like a no-brainer to me.

 

I'm guessing all the push back from the schools is because they are afraid of lawsuits if a non-nurse treats a diabetic student improperly.

 

Unfortunately because of very tight budgets. In my district, unlicensed health associates run the offices. They train them in medication administration among a few other required classes. Our associates do a fantastic job. My job (as the RN) is to oversee all district buildings and make final decisions for complex or emergency situations. My pay is incredibly small for my experience and education, but I love my job. We went through our budge already so we have to use each supply with caution to have enough for the end of the year.  :mellow: We only get so much from the state and have to work with what we have. 

[bolt.]

None of our public schools have nurses. Any child needing medication just gets it on a schedule (parents' instructions) from the office staff. If there's an emergency they call the public help line (nurse staffed) or EMS -- as they do first aid, just like anyone else would.

 

I don't know why a school would need a nurse.

Edited March 2, 2016 by bolt.

[prairiewindmomma]

Our previous state did away with requiring school nurses to be in every school building several years ago.  They do not even have unlicensed health associates in every building. One nurse covers several schools, and is there primarily only to handle medication distribution and scheduled things (like feeding tube feeds).  The schools are easily 20-30 min apart in traffic, so in an emergency 911 is dialed as the ambulance is faster than the nurse. (And still not fast enough for us--hence why we homeschooled from the start.)

[magnificent_baby]

None of our public schools have nurses. Any child needing medication just gets it on a schedule (parents' instructions) from the office staff. If there's an emergency they call the public help line (nurse staffed) or EMS -- as they do first aid, just like anyone else would.

 

I don't know why a school would need a nurse.

 

I imagine it has to do with the size of the school. One of our buildings has nearly 1,000 kids in it. At any given time it is full of kids needing their psychiatric medications, inhalers, nebulizers, insulin, treating wounds and an occasional broken bone, taking temperatures, sending home sick kids, dealing with vomiting, nosebleeds, lice, emergency seizure medications, epi-pens...you name it! The high school office on the other hand....very slow. 

[bolt.]

I imagine it has to do with the size of the school. One of our buildings has nearly 1,000 kids in it. At any given time it is full of kids needing their psychiatric medications, inhalers, nebulizers, insulin, treating wounds and an occasional broken bone, taking temperatures, sending home sick kids, dealing with vomiting, nosebleeds, lice, emergency seizure medications, epi-pens...you name it! The high school office on the other hand....very slow.

That does seem big enough to be distracting to the office staff just by volume... But I don't understand the need for an 'actual' nurse for most of those situations. Lots of them are first aid, and others are simply 'lie down while we call your parents'. Only insulin and seizure emergencies seems to call for training, and I'm not sure a whole nursing degree is required. Edited March 2, 2016 by bolt.

[Ali in OR]

We have a district nurse--one nurse for the whole district. My daughter has seizures (as do several of her classmates) and all of the life skills class aides are trained by the district nurse to administer emergency meds to stop seizures. If you think about it, parents have to be trained to handle these things and we don't have any nursing credentials. I'm okay with no nurses as long as someone is trained to do what I would do in an emergency situation. And they have called 911 and taken dd to the ER once. I'm confident in their ability to handle the situation. Not sure what they do with diabetics in elementary schools--I would guess each school probably has at least one kid? (not sure how prevalent it is)

[magnificent_baby]

That does seem big enough to be distracting to the office staff just by volume... But I don't understand the need for an 'actual' nurse for most of those situations. Lots of them are first aid, and others are simply 'lie down while we call your parents'. Only insulin and seizure emergencies seems to call for training, and I'm not sure a whole nursing degree is required.

 

Ours are staffed by unlicensed, but trained personnel. The district RN's make decisions in complex or non-straightforward decision making, attend and participate in IEP/504 meetings, vaccine paperwork/audits, teach health and development courses to students, teach CPR and AED for staff, work comp injuries, etc. Things that would require higher education/license.There are so many aspects to school health, especially with large districts. 

[Sara in AZ]

I have heard many horror stories, even from schools with full time nurses. When DD was diagnosed with type 1 at age 6, I was so grateful we were homeschooling. Later, she attended a once a week homeschool enrichment program on the campus of a public school. The nurse split her time at many schools, but the health aide was well trained and did a fantastic job handling things and keeping me informed.

 

Most recently, DD started full time at a small charter school (6th-12th grade). There is no nurse at all. The kids with diabetes are allowed to store their supplies in the office and manage their blood sugar independently as needed. BUT, I know no one on that campus has any clue how to use that glucagon kit we have stored in the office. I offered to have our diabetes educator come do some training, but the receptionist said they have some nurse come in periodically to review various health related issues with the staff. I don't have any confidence in that, though.

[JumpyTheFrog]

When I was in elementary school, besides handing out medication, the nurse did lice checks as needed, and annual vision and hearing screenings. They also checked for scoliosis annually as well.

[Dmmetler]

In my experience, the urban schools with low income populations actually handle health issues better, maybe because their parents aren't going to be able to shuffle their schedules, hire a nanny, move the child to a private school, transport their child to a school across town, or homeschool, so the school tends to find a way to make it work. Usually in my school, the PE/art/music teachers, guidance counselor, assistant principal and secretary all had epipen, CPR, first aid,blood sugar monitoring, and glucagon training, and any other health issues in the school, every year. Usually we had at least one type 1 diabetic, at least one or two kids with seizure disorders, and several kids with athsma and/or severe allergies, so it made sense. We had a nurse a couple of days a week, too. The feeling was that the office folks were the most likely to be called, and that the specialist teachers saw and knew all the kids in the school, so would be best able to handle it. It also gave us something to do during In-service week when none of the workshops were applicable to our subject areas each year, which I suspect was one reason why specialist teachers and guidance counselors were selected for such training over classroom teachers.

 

Honestly, when I started homeschooling and hearing what parents from suburban schools said, I was surprised-in my urban school, I never got the idea that being unwilling to give a kid an epipen or administer glucagon was an option. It simply fell under my job description as a music teacher.

[TechWife]

Wait - a kid who can manage their own blood sugar in a non-school environment can't push the button on their own insulin pumps, test their own blood and treat themselves accordingly while they are at school?  We have taken so much autonomy away from our kids and then "they" complain that kids are weak in critical thinking, don't think independently and that parents are over-involved. This doesn't even make sense to me. 

[Sara in AZ]

Sure, a middle schooler on up is probably capable of checking their own blood sugar and using their pump. But will they? Adolescence is the prime age when kids might be wanting to fit in, not take the time to bolus, not track carbs carefully, etc, etc. Making sure there is oversight is important to me as a parent. Plus, a kid that's passed out from low blood sugar can't administer their own glucagon.

 

The article specifically mentioned Kindergarteners. Kids in elementary school for sure need monitoring.

 

Do you have a child with diabetes? I don't understand your confusion or your expectations of what every child with diabetes may or may not be capable of.

 

Edited for spelling.

Edited March 3, 2016 by Sara in AZ

[magnificent_baby]

Wait - a kid who can manage their own blood sugar in a non-school environment can't push the button on their own insulin pumps, test their own blood and treat themselves accordingly while they are at school?  We have taken so much autonomy away from our kids and then "they" complain that kids are weak in critical thinking, don't think independently and that parents are over-involved. This doesn't even make sense to me. 

 

It is SO much more complex than that. Especially for those with extremely little parental involvement. In some cases, WE are the ones who teach them how to manage their diabetes and eventually teach them give their own insulin because their parents are too busy to do it. Very few in our district have pumps until the middle school/high school age. Not to mention when they go through the phase of wanting to be like their peers and lying about how much lunch they ate or if they gave themselves insulin. Yes, some are very autonomous, but those are the minority in my large district. Blood sugars can become so extreme, so fast in children. It's not as simple as it may seem. 

[NoPlaceLikeHome]

I have heard many horror stories, even from schools with full time nurses. When DD was diagnosed with type 1 at age 6, I was so grateful we were homeschooling. Later, she attended a once a week homeschool enrichment program on the campus of a public school. The nurse split her time at many schools, but the health aide was well trained and did a fantastic job handling things and keeping me informed.

 

Most recently, DD started full time at a small charter school (6th-12th grade). There is no nurse at all. The kids with diabetes are allowed to store their supplies in the office and manage their blood sugar independently as needed. BUT, I know no one on that campus has any clue how to use that glucagon kit we have stored in the office. I offered to have our diabetes educator come do some training, but the receptionist said they have some nurse come in periodically to review various health related issues with the staff. I don't have any confidence in that, though.

I would insist your daughter be allowed to carry her diabetic supplies at all times on her person especially glucagon since keeping meds locked in an office may delay proper care for too long IMHO. What if staff member is not present in office or they cannot find the key? I would also insist in all staff members being trained and having an emergency action plan. They should all know how to give glucagon and when to give it as well as first aide and CPR.

 

MY ds carries his epi-pen and benadryl and has done so since 5th grade. Prior to that I had teachers carry his supplies in a fanny pack and have his meds in the same location (room) as he was at all times with someone trained how to give them.

[Sara in AZ]

This is how it worked for my daughter in 3rd-6th grade at her homeschool enrichment program: At the beginning of the school year, I met with the nurse/health aid and completed the appropriate forms including her plan if treatment. We made a schedule for when she would test each day. She would test herself in her own classroom and call the numbers into the aid. If they were outside the acceptable range she would take care of it, but always called me to let me know and sometimes ask what I'd like her to do. She'd let me know if DD forgot to check.

 

Now that she's in this new charter school, DD has near zero oversite. She checks herself when it's convenient (generally just at lunch). I'd prefer she check 2 hours after breakfast, but I'm not there to remind her and no one else will. She's generally really responsible and knows what she's doing, but it worries me that there is really no layer of oversight. There are some situations where you have to make a judgement call and she doesn't always have the experience/wisdom to make the right call. We live close by, so I can be quickly on hand if necessary, but I think I will be pushing for more education of the staff.

 

But I'm really new to middle school. What are the experiences/expectations of those of you with middle to high schoolers?

Edited March 3, 2016 by Sara in AZ

[Sara in AZ]

I would insist your daughter be allowed to carry her diabetic supplies at all times on her person especially glucagon since keeping meds locked in an office may delay proper care for too long IMHO. What if staff member is not present in office or they cannot find the key? I would also insist in all staff members being trained and having an emergency action plan. They should all know how to give glucagon and when to give it as well as first aide and CPR.

.

[catz]

In my experience, the urban schools with low income populations actually handle health issues better, maybe because their parents aren't going to be able to shuffle their schedules, hire a nanny, move the child to a private school, transport their child to a school across town, or homeschool, so the school tends to find a way to make it work.

 

I'm in an urban district and we have some higher income and lower income schools.  My son went to 2 years at a relatively higher income school for an urban school.  That school had no nurse and there were 500-600+ kids.  There was a traveling nurse.  I attended district school board and PTA meetings and our school really was bare bones on the budget.  We didn't have a librarian either.  Without of a bunch of extremely involved parents, our school would have looked not so appealing.  Schools with high numbers of low income students got a higher dollar amount per student and definitely provided more of these types of services.  Just an observation I made in our district.

 

It's sad and difficult.  I feel bad for families who have kids with unique needs in the classroom right now.  If schools can't get the education of individual kids right, I can't imagine how they can manage serious medical issues. 

 

I'm grateful we were able to homeschool through those elementary years at least.  My kid had a somewhat serious medical issue in kindergarten.  I went to school every day for a month to administer meds. 

Edited March 3, 2016 by WoolySocks

[Sara in AZ]

Just saw this reply. Yes, I will strongly encourage the staff to consider better training. They are allowed to carry their supplies with them, although we have an extra stash in the office. I've gotten out of the habit of taking glucagon everywhere as we have never needed it in 7 years (knock on wood). I actually need to give myself a refresher on his to use it...tha's probabky where I should start here.

[Sara in AZ]

DP technical difficulties!

Edited March 3, 2016 by Sara in AZ

[TechWife]

Sure, a middle schooler on up is probably capable of checking their own blood sugar and using their pump. But will they? Adolescence is the prime age when kids might be wanting to fit in, not take the time to bolus, not track carbs carefully, etc, etc. Making sure there is oversight is important to me as a parent. Plus, a kid that's passed out from low blood sugar can't administer their own glucagon.

 

The article specifically mentioned Kindergarteners. Kids in elementary school for sure need monitoring.

 

Do you have a child with diabetes? I don't understand your confusion or your expectations of what every child with diabetes may or may not be capable of.

 

Edited for spelling.

No, I don't have a child with diabetes. One of the articles mentioned a high school football player, a junior, in fact. I'm surprised he was unable or not allowed to manage his own needs at his age. A friend if mine had diabetes and she checked her blood sugar and adjusted her insulin as needed, carrying everything with her by the time she was 12. This was back when they used needles, syringes and she had to draw up her own insulin. I had a six year old in one of my homeschool co-op classes that tested herself (we called her mom if her level as at a specific point, although I never had to do that).

 

I'm simply surprised that these kids aren't able (or allowed) to be a bit more independent by the time they reach upper elementary years and beyond. At what age is independence encouraged? Do I just know unususal people?

 

What is the logic behind keeping their supplies in the nurses office or school office instead of their desks, lockers or even the teacher's desk? A 15 year old can decide to get an abortion but can't decide if she needs insulin? Why is that logical? What does that say about our culture in regards to respect for people and their abilities? Are the schools afraid of lawsuits? Theft? What?

 

I certainly don't think kids should be expected to self-manage before they are developmentally ready, that's not what I'm driving at. There seems to be a systemic problem with managing children with this disease in schools, that was the point of the article. It blows my mind that schools, run by adults, intentionally put barriers in place that risk the well being of the very children under their care and deprive children of the dignity of caring for themselves as much as possible. The system doesn't make any sense at all.

[mommybee]

Just saw this reply. Yes, I will strongly encourage the staff to consider better training. They are allowed to carry their supplies with them, although we have an extra stash in the office. I've gotten out of the habit of taking glucagon everywhere as we have never needed it in 7 years (knock on wood). I actually need to give myself a refresher on his to use it...tha's probabky where I should start here.

The day may come......we never needed it in nine years either and then one day my son set his loaner pump wrong and boy was I glad I had it. But I had no clue how to use it either.

[OnMyOwn]

I don't know why I'm surprised by how bad it is, but I am. And it's not reasonable to expect every parent to be all "Okay, the public schools are awful, guess we'll homeschool!" even if that's a perfectly valid option. We're all supposed to have the choice of a decent public school that won't kill our kids. That's just not that much to ask. I thought that a friend's kid getting excluded from computer class (because that's the time she visited the nurse) was bad enough, but some of this...!

 

There's a related follow-up here.

Wow, that's awful. But, I would never feel comfortable sending my child to a school like that if they weren't prepared to care for them, even though I had a right to. I'd be too afraid of what might happen. What a horrible psoition to be put in.

[magnificent_baby]

No, I don't have a child with diabetes. One of the articles mentioned a high school football player, a junior, in fact. I'm surprised he was unable or not allowed to manage his own needs at his age. A friend if mine had diabetes and she checked her blood sugar and adjusted her insulin as needed, carrying everything with her by the time she was 12. This was back when they used needles, syringes and she had to draw up her own insulin. I had a six year old in one of my homeschool co-op classes that tested herself (we called her mom if her level as at a specific point, although I never had to do that).

 

I'm simply surprised that these kids aren't able (or allowed) to be a bit more independent by the time they reach upper elementary years and beyond. At what age is independence encouraged? Do I just know unususal people?

 

What is the logic behind keeping their supplies in the nurses office or school office instead of their desks, lockers or even the teacher's desk? A 15 year old can decide to get an abortion but can't decide if she needs insulin? Why is that logical? What does that say about our culture in regards to respect for people and their abilities? Are the schools afraid of lawsuits? Theft? What?

 

I certainly don't think kids should be expected to self-manage before they are developmentally ready, that's not what I'm driving at. There seems to be a systemic problem with managing children with this disease in schools, that was the point of the article. It blows my mind that schools, run by adults, intentionally put barriers in place that risk the well being of the very children under their care and deprive children of the dignity of caring for themselves as much as possible. The system doesn't make any sense at all.

 

By high school, most of the kids manage themselves and don't come into the health office. We have extra/emergency supplies but if they are able to manage themselves independently, then they do. If they aren't comfortable, the associates are there to help. By then we absolutely want them comfortable since they will soon be adults. 

 

Middle school depends on their level of responsibility. They usually do all their own cares independently in the office, but the health associate charts their levels and how much they gave themselves. Upper elementary even those very responsible needed guidance. If they are really high or low they may not have the cognition to think straight to the next step. Not to mention the dangers of accidentally administering too much. They also need to accurately add up their carbs to figure the next dose of insulin. We absolutely want them to be independent, but still have to account for normal developmental stages. 

 

I don't think anyone was putting barriers in place to be jerks about it...they simply were not comfortable. It's very complex when dealing with pediatric diabetics and every student has unique needs in regards to safely managing their disease. 

[TechWife]

By high school, most of the kids manage themselves and don't come into the health office. We have extra/emergency supplies but if they are able to manage themselves independently, then they do. If they aren't comfortable, the associates are there to help. By then we absolutely want them comfortable since they will soon be adults. 

 

Middle school depends on their level of responsibility. They usually do all their own cares independently in the office, but the health associate charts their levels and how much they gave themselves. Upper elementary even those very responsible needed guidance. If they are really high or low they may not have the cognition to think straight to the next step. Not to mention the dangers of accidentally administering too much. They also need to accurately add up their carbs to figure the next dose of insulin. We absolutely want them to be independent, but still have to account for normal developmental stages. 

 

I don't think anyone was putting barriers in place to be jerks about it...they simply were not comfortable. It's very complex when dealing with pediatric diabetics and every student has unique needs in regards to safely managing their disease. 

 

Thank you for this explanation. It's helping me understand the issues involved. I appreciate it! 

[Um_2_4]

I am not in the least bit surprised.

In 2nd grade (7yo), I was diagnosed with a condition that affects my blood sugar. As a result one thing I needed was to have those glucose tablets (or lemon drops was the Drs suggestion) readily available in case I felt a plummet in my #s (I tested occasionally at home, but I knew the signs before I was about to pass out). The school nurse and admin (we had a school nurse then) argued with my parents about my having this available to me despite a Drs written orders and it's NOT EVEN a perscription.  :huh:  You know, the other kids will want to keep candy in their desk/backpack or will bug the teacher for the "candy" in her desk. The nurse wouldn't "deal with it" as it was not a perscription. :glare: 

After a while, my parents noticed a pattern that all my issues happened after PE class (exercise sent me in a spin and I wasn't allowed to eat before or after, my parents asked that 1st) and my Dr wrote a letter that was I not to participate in PE. Well the Principal cussed my parents out. Yep that's right, I was waiting just outside his office and heard everything. So after that my teacher lined everyone up for PE, put me in the back of the line, stopped at the office, announced to class that I had to sit in the office because my parents did not like PE and then took the rest of the class to the gym. No wonder I despised elementary  :laugh: .

 

[TechWife]

 

I don't think anyone was putting barriers in place to be jerks about it...they simply were not comfortable. It's very complex when dealing with pediatric diabetics and every student has unique needs in regards to safely managing their disease. 

 

I can understand this. I had quite the gulp and some fear when I learned there would be a child with Type 1 diabetes in my co-op class. Just knowing if I messed up, a child could die, was a responsibility I didn't think I'd encounter in co-op. Meeting with her mom ahead of time, seeing the glucose monitor, learning how it worked and getting both oral and written instructions with clear guidelines for what to do when was very helpful and I felt equipped me to help in the way that the child and her family needed/wanted me to help. 

[RebeccaS]

By high school, most of the kids manage themselves and don't come into the health office. We have extra/emergency supplies but if they are able to manage themselves independently, then they do. If they aren't comfortable, the associates are there to help. By then we absolutely want them comfortable since they will soon be adults. 

 

Middle school depends on their level of responsibility. They usually do all their own cares independently in the office, but the health associate charts their levels and how much they gave themselves. Upper elementary even those very responsible needed guidance. If they are really high or low they may not have the cognition to think straight to the next step. Not to mention the dangers of accidentally administering too much. They also need to accurately add up their carbs to figure the next dose of insulin. We absolutely want them to be independent, but still have to account for normal developmental stages. 

 

I don't think anyone was putting barriers in place to be jerks about it...they simply were not comfortable. It's very complex when dealing with pediatric diabetics and every student has unique needs in regards to safely managing their disease. 

 

One time, my dd was having a pretty bad low.  Dh went up to her room to deal with it and he's talking her through it and she says, ok, ok, she's got this, pulls out her pump, enters a random number and boluses herself some more insulin.   :lol: She was that out of it with her low.  I'm so glad dh was there and she wasn't trying to treat it herself. Once she hits the 50's she's pretty much toast and any rational decision making goes out the window.  

[MomtoCandJ]

At dd1's small catholic school (70ish kids total grades pre-k-7th), the one diabetic student has her supplies with her at all times and all the staff that she has regular interaction with are trained to deal with any issues. There are also a few with allergies and epipens are available in every class room, the office and kitchen. Also one of the staff has an epipen with them at recesses.

Though it may help that there are quite a few nurses as parents.

[Sara in AZ]

And here's an example from the opposite end. DD13 was recently at a party and texted to tell me that her infusion set pulled out of her tummy. Ok, it's important to replace that pretty quick, but I gave her about half an hour to enjoy the end of the party before I went over to pick her up (she was very close by). Well, it turns out she forgot to tell me that she had ALREADY eaten cake and ice cream before she texted me, but after the site fell out, so no bolus. And of course by that time she was hi and feeling awful. What wouldn't have necessarily been a big deal became a big deal because we didn't communicate well and she wanted to stay at the party.

[magnificent_baby]

Thank you for this explanation. It's helping me understand the issues involved. I appreciate it!

Glad I could help!

Edited March 3, 2016 by magnificent_baby

[Dmmetler]

What I've seen with type 1 elementary age kids is that their behavior is the first sign that they need more insulin or more sugar in their system, and that even if they pick up on it, they don't always verbalize that this is what they need before they get into the level where they can't. I could see the same thing happening to middle school age kids, especially when they're excited about something and want to just be a kid.  

 

I ended up chaperoning a lot of field trips for one particular student because of this. He was basically one of those "you're not yourself when you're hungry" snickers ads when his blood sugar started to dip, and needed someone to prompt him and say "Hey, L, are you feeling alright?" Even at age 7-8, once he was prompted, he could accurately judge what he needed to do (as long as he wasn't really, super low)-but he needed that prompt, and he was too busy being a kid to notice. And while the classroom teacher did pretty well in the classroom, when the schedule was stable, on a field trip a LOT of kids aren't acting like they do in the classroom, so it was easy for her to miss it if there wasn't a dedicated adult who was keeping a closer eye on that particular child. By 5th grade, he'd gotten better, and perhaps more importantly, his peers had also started taking on that role, but we made sure "Extra adult chaperone on field trips to help monitor behavior and blood sugar" was in his 504 plan before sending him to middle school.

 

 

 

 

 

 

 

[fairfarmhand]

I have a question, just out of curiousity.

 

How does this disease play out in Middle/High School when kids are dealing with growth spurts and hormones? Is it trickier to manage given these issues?

[Murphy101]

That's really disappointing. The school that DD went to before homeschooling was really great. I think I took them by surprise though will all my handouts and paperwork and asking for a meeting with every single teacher she would have. The nurse was kind of shocked when I insisted that in first grade DD be able to have a blood sugar meter in the classroom and that she be able to test herself there and then be able to treat her lows (and then call the nurse), as opposed to walking down to the nurse first. She said she'd never had a child that young be able to take care of herself that way. I insisted and it was fine. But I learned to just insist on things my way. :)

 

DD goes once a week to an enrichment program, also part of our public schools, and her experience there has been great as well.

My dh has been in this bandwagon bc of his friends whose children have type 1. (When someone's kid gets dx, they seem to remember dh has it and come asking questions, kwim?)

 

He was dx in kindergarten and from that time on, he always had his glucometer and insulin injecting supplies and sugar elevation snacks or tablets in his backpack at all times.

 

He is horrified that diabetic children in most schools are now required to keep it all with the nurse and go to the nurse every time. Even in high school.

[Murphy101]

I have a question, just out of curiousity.

 

How does this disease play out in Middle/High School when kids are dealing with growth spurts and hormones? Is it trickier to manage given these issues?

It can be.

 

It's a hormone based chronic disease.

 

Think of all the things that affect hormones.

 

Physical activity

Diet

Stress/anxiety

Depression

Monthly cycles

Aging

Weight

Any other health issues, even good ones

[RebeccaS]

I have a question, just out of curiousity.

 

How does this disease play out in Middle/High School when kids are dealing with growth spurts and hormones? Is it trickier to manage given these issues?

 

It has been a nightmare for us.  I know that it affects everyone differently, so I don't expect that everyone struggles as much as we have.  Dd was 10 at diagnosis.  The first two years were fine.  The last year+ has been a roller coaster and it's so hard to keep her in a normal range.  She spends a large chunk of her time too high and we are going crazy trying to keep her below 200.  Her endo isn't a whole lot of help either, so that's another part of the equation.  :P 

[DesertBlossom]

My dh has been in this bandwagon bc of his friends whose children have type 1. (When someone's kid gets dx, they seem to remember dh has it and come asking questions, kwim?)

 

He was dx in kindergarten and from that time on, he always had his glucometer and insulin injecting supplies and sugar elevation snacks or tablets in his backpack at all times.

 

He is horrified that diabetic children in most schools are now required to keep it all with the nurse and go to the nurse every time. Even in high school.

Yeah, even in K she had supplies in her class, but the nurse often came to her for checks. It was only 1/2 day. In first grade I insisted she be able to test herself at her desk if she felt low. I think the nurse was a little concerned she'd test herself too often or for the attention. (She never did) If we're trying to teach kids how to take over the management of their disease, they ought to do what they are capable of. Obviously really young kids need to be monitored. But I also wanted her to get used to the idea that she can and should test her bg anywhere and anytime she felt it was necessary. She needs to be able to trust her instincts and take care of herself.

 

In 3rd grade at her enrichment program once a week they switch classes hourly. She carries all her supplies with her and only goes to the nurse to bolus for lunch. Even though she could do that all by herself because I provide her the carb count in her lunchbox. I gave each of her teachers a handout on symptoms of low or high blood sugar. If I freak them out sufficiently at the beginning of the year about her passing out in class, they take it pretty seriously.

[DesertBlossom]

It has been a nightmare for us. I know that it affects everyone differently, so I don't expect that everyone struggles as much as we have. Dd was 10 at diagnosis. The first two years were fine. The last year+ has been a roller coaster and it's so hard to keep her in a normal range. She spends a large chunk of her time too high and we are going crazy trying to keep her below 200. Her endo isn't a whole lot of help either, so that's another part of the equation. :P

I have heard that toddlers and teenagers are the hardest to manage. Dd was dxd before she was 2, so we get to go through both. Blech. We've got a couple years before puberty but I am already bracing myself.