Wednesday, July 30, 2008

School is coming.....

Stress, chaos, relief and worry. Returning to school means alot of additional stress for parents with Type 1 kids. The stress is an entire different scope than the typical parent worry. It isn't just being concerned about your child's new class lacking familiar friends. It is a concern of staying safe. Oh how I wish we could go back to life without all these complicated new concerns for a new school year.

Diabetes manifests every single aspect of our lives, and going back to school is guaranteed to bring many changes in insulin needs. For Maddison, going to bed earlier in the night means we will need to adjust basal rates since her growth hormones kick in almost immediately when she falls asleep. Hormones cause resistance to insulin, so sleeping actually brings about her highest basal rates all day for her growing little body. We have to adjust each hour by hour with a pump to time the doses just right or we will battle highs or the dreaded lows at all random times through the night.(Talk about feeling like crap when you wake up) I have to get Maddison's nightime adjusted better so she feels her best and can perform well and learn to her potential while at school. That is alot to carry on your shoulders. Summer has been so unpredictable (and carefree) that we haven't gotten many stable nights. I hear a ticking clock in my mind telling me that I am running out of time....I have got to get Maddison's insulin better adjusted to "assure" a smooth transition to school days. For now I am the "mean mom" with the much earlier bedtime rule and no eating after 6pm to better chance a good look at basal adjusting over night. Maddison is not liking this transition already and is complaining I cut her summer short by a few weeks.

All the extra work and concern us "D" parents manage this time of year can really bring back the exhaustion of "D" management. We always have to factor in so many things just to keep blood sugar well controlled, and just when you may get there, it changes all over again, especially with school vacations. I am emotionally exhausted just thinking about getting ready for school! I don't want to wonder every minute of the school day if Maddison is high or low. I am never too sure if Maddison will speak up if she is low in class when she is amongst a new group of peers. She doesn't want attention drawn to her, and she has always been "shy" around new settings. We have been working on her feeling comfortable and being able to speak up immediately in a discreet way so that she doesn't feel so "different" in having to rush off to treat a low blood sugar. I just have to trust that I have given her the proper knowledge on how to handle these times.

Worry can consume me if I don't feel confident in the way blood sugars have been trending, I am not confident. In fact, I know her daytime basal needs to be reduced, but in doing so I will then also have to increase her breakfast and lunch ratios. That can take a long time to "perfect" and during school the highs especially can cause a decrease in mental performance that will equal poor grades. What a bunch of crap Diabetes is. What happened to this just being about food like everyone thinks in the beginning? That I could handle, no problem! I'm hoping by some miracle things will even themselves out so I don't have to go with the complete change approach. I have alot of logging and analyzing to do so we can get back on track. Maddison's meter average is at 167, the highest it has been in many, many months. But with that 167 I see many, many random numbers in the high 250's to 300's. Alot of rapid drops and spikes. Not too many lows, so that is good. I can already see myself freaking out over the next A1c report in August.

There is nothing I want more to avoid than Maddison sitting in the nurse's office all day, and the kids in her class again wondering why. They begin to question her and she feels uncomfortable. I would too if I were 7! I hate that she has to miss class time to treat a high, especially a low. I expect a good month or so to get settled into a new routine. Each day is like torture for me carrying my cell phone attached to my hip those first few weeks waiting for a call from the nurse reporting a nasty low or persistent high blood sugar. This year sending Maddison back to school is a hundred times easier than last year, I'll admit that. I'm not as freaked out over all the little details though they are still there nagging at me on occasion. I believe this new school year stress will be with me until Maddison hits around grade 5 and is able to do most care in the classroom herself. Yikes, that's still a long time away.

And I worry about the normal social aspects.... Will she have familiar friends? Will she meet others well? She still insists that she doesn't have any friends, though I believe that is her perception. "Everyone likes me" she will say, "but no one wants to play with me"......that's a heart breaker that the school counselor assures me is exaggerated. We also worry about lunchtime. We pray Maddison goes into lunch at a good number to avoid eating when already high. Going higher after lunch will only make her tired and irritable, less able to concentrate and learn. It is hot outside. Our insulin in the pump can go bad in the heat. How will playing outside at lunch recess at 110 degrees make the insulin react? I hope she is drinking enough water.....

PE days are initially a worry too. Test before? Test after? What time of day does she go? Why does it seem to always be right AFTER lunch!?? Are they just sitting around because the heat or are they running laps inside? Recess......ugh. Some days you just can't get right depending on what kids decide to play for the day. Chase boys or play in the sand? What a difference a little bit of outdoor fun can do, makes me wonder if the duty teacher really DOES carry the "care pack" that holds Maddison's picture and quick sugar? Would they realize if she passed out from a low among the 200 other kids on the playground? Would they recognize her from her picture? Would they have any idea..... really?

Bus rides. Ahhhh. Maddison loves to ride the bus. It is 110 outside, I can't wait for the heat to not be a factor in my decision. Should she ride the bus home this year? or is it better to avoid that last blood sugar check before school gets out? After all, it is just another absence of time from learning. Will the bus driver notice if she goes low? Should I give her a meter and glucose tabs in her backpack even though she still doesn't interpret well what a number needs? And if the bus is late we have other worries......

Field trips....class parties......oh the things us parents can no longer just enjoy without the extra work and concern.

Finally, I called the school to request a meeting to revise our 504 plan. They assured me it was not necessary, the plan is still in effect unless otherwise dismissed by me. Ahhhh, NO. It needs to be revised every year, are they denying me a revision meeting? Yes, I think so. I put in a call (thanks Robyann!) to the district Special Education Superintendent this morning. We are scheduled with the school nurse (who I love) Maddison's new teacher, the Principal and school Psychologist for next week. One thing down, now I have to change some things for Maddison's care plan that the nurse goes by. Did you know many schools don't even have an RN to care for kids? I think I would just die if that were our case. We are lucky to have such a great school nurse, she learns Maddison's patterns well and she is always talking Maddison through the days she uses her Diabetes as an excuse to get out of class. That, is another story for another day.

Maybe this year will be a smooth transition? Maybe I will amaze myself and "let go" of all my worries early on. Are they unrealistic, or do all Type 1 parents experience these same concerns? We shall see what the year brings.....

1 comment:

Minnesota Nice said...

Hi. I saw you on Scott Johnson's blogroll.
I don't have any kids so I'm not much help re the upcoming schoolyear. But there are a lot of experienced and wise parents on the OC who will definitely be able to help you.
Good luck and best wishes.