Monday, July 25, 2011

The answer/How we do school with "D"

In years past (while at school) Maddie has never carried around anything D related(except a spare meter and candy in her backpack for the bus ride home) because the Nurse’s office was so close to her classroom. The teacher would call the Nurse if Maddi felt low, and the Nurse would come to the classroom within seconds with her school meter and low treatment. If the Nurse just couldn't leave her office, Maddison would simply walk down a long hallway (with a buddy) to get to everything she needed. Quick. Easy.

We were VERY lucky to have a FT RN AND FT Aide all these years!!

Now as we change schools this year and Maddison grows older, I think she needs to be in the habit of carrying her own D stuff at school. But, ONLY if it can be disguised! (not that we hide our Diabetes, we just dont like extra attention!)

I hate to think that Maddison has to carry around a big ‘ole medical bag at school when all the other kids are so carefree. I hate to think that kids will ask questions about her D kit which may annoy her, and I hate to think she will be embarrassed, feel different or stared at because she carries a purse or “medical bag” around at the age of 10. Starting a new school is not the time to draw attention to yourself either, especially at this age when you just want to blend with the crowd! I don’t want to make Diabetes a bigger issue than it needs to be. I just CANT have Maddison carry a big ole bag everywhere she goes! So the answer is....


Thanks to the Tummietote insulin "pump pack" as we like to say, Maddison can place a meter, poker and a couple strips with glucose tabs right in the two extra pockets!! The best thing yet is that this insulin pump pack lays flat against her body unlike most insulin pump packs! You cant even tell she is wearing it under most clothes, and she wont EVER be without everything she needs! With the Tummitote Belt Diabetes is Discreet!! No big, embarrassing bag to carry around, forget or lose!

Im excited that for the first time in 6 school years Maddison can carry her own D supplies everywhere in her WEARABLE perfectly invented "TUMMIETOTE BELT!!" No Diabetes bag to carry around!!! (Thank you Tallygear!)

For us, this is the best insulin pump belt EVER, because it can carry so much more than just your insulin pump! It has 3 super Velcro secured pockets, and is made out of swim suit like, stretchy material so it lays perfectly flat against the body compared to most insulin pump packs! One of our 3 pockets on this pump pack has a clear view window so you can use the pump without having to remove it from your pocket everytime! This school year this pump pack is going to be a total blessing in DISGUISE! For us, Tummitote is the answer to keeping Diabetes discreet at school just like we want it to be!


The initial plan this year for managing D at school is just a tad different as far as lows. Instead of Maddison waiting for the school nurse to come to the classroom for lows, she will check RIGHT AWAY by herself if she feels the need (using her meter stashed in her Tummietote!!) and take the needed glucose tabs (by cheat sheet) for the low BEFORE walking to, or notifying the nurses office.

The question is, are we ready for Maddison to deal with the low recheck number herself, or do we still need the nurse to oversee what Maddison decides to do next? Bad lows can make Maddison very anxious, and she would likely recheck a low too soon and over treat, even if she has a D cheat sheet to go by. Hey, I cant blame her there! Sometimes the sense of panic (rapid heartbeat) that a low inflicts leaves you stuffing eveything you can find in your mouth! Overtreating is hard not to do sometimes! Sometimes these scary lows make you feel like you are afraid to be alone......Id hate to have Maddison feel alone and scared in class. I can picture her sitting there near tears, with everyone staring at her. Shaking. Pale. Unable to focus. So, maybe its best she does go to the nurses office for every low? I know that for myself I dont want people staring at me as I struggle to keep my composure with a terrible feeling low!

Then of course, lows always have different circumstances. Maybe Maddison ran low all night for whatever reason and needs more fast carbs for the low? Only I would know that. A cheat sheet isnt perfect, and the school nurse can only be as good as a cheat sheet is written. We can't always include all the "IF"S in a written plan! Maybe Maddi has 0.00 IOB and just needs a 4c boost? Its too hard to say if .3 is active treat with THIS, and if .8 is active treat with THAT! I dont want to confuse the nurse, or Maddison with TOO MUCH detail!

Maybe I just changed basals and its obvious something is WAY off? Maybe Maddi is just an hour after a meal and should wait a few minutes and recheck that low feeling because she is going UP, not down? 8c, 12c or 15c at different times has been confusing for Maddison to grasp when we base so much on IOB. There is always so much to take into consideration. School is not the time to be Chasing numbers and over treating lows. It is critical to get low treatment right at school, or the whole day can be a mess with headaches and fatigue being the result! Im not sure yet if the Nurse would be able to come to Maddison for low followup either, and I'm not sure how far her classroom will be from the nurses office! SO, Im still stuck on what will work for low protocol this year!

Maybe I'd like Maddison to manage lows herself by text message to me? This is probably the best answer since a new school nurse would have to learn Maddi starting all new, whereas our school nurse of 6 years pretty much KNEW what Maddi needed based on experience. What I do know is, I want Maddi carrying her own D stuff and I want that low checked by Maddison immediately as it should be. No more waiting for the Nurse!

We will have 4 T1 kids at our new school this year which includes Maddison. Two are teens, and the other little girl is Maddies age! We actually met her through a neighbor and introduced her to our local support group a couple years ago right after she was diagnosed. She attended our support group Christmas party with us that year, but we haven't really seen her since. Its nice to know Maddison is familiar with someone that has "D" at her new school!

School and Diabetes is a very tough balance. You want to limit missed class time, but also not draw attention to Diabetes care or "disrupt" the class. You also want your child to feel comfortable and safe. PE days are always tricky, and recess is BEFORE lunch this year. Hmmm.....

Typically I like Maddison to check her sugar 1.5 to 2 hours after getting to school in the morning because by then her breakfast insulin is about 80% used. Maddison goes to the Nurses's office for all scheduled checks. Morning, before lunch, before PE and 2.5 to 3 hours after lunch.

For lunch Maddi gets half her carb count bolused up front with a correction if necessary. If she is under 80 starting lunch she just gets all carbs bolused AFTER. (which I hate) But, Maddison is a VERY picky eater, and never big on the lunchtime meal, so this has been the only way we can safely do lunch at school. Maddison then has to return to the Nurses office with any eaten/uneaten food for a remainder bolus, if any. For Maddison this has always been fine because she doesn't care about missing recess either.

I think this year with recess being before lunch, I will have her check her sugar before recess. She can then treat a high or low if needed on her way to recess, without having to go to the Nurse first. Then she can just use the recess number to bolus part of her lunch (15c maybe?)and go to the nurse for the remainder bolus after eating to confirmation that she got everything taken care of just right. (Thank you bolus history!) I dont know. The plan doesn't always work the way we want it to. As always, my brain is starting to FRY just trying to plan the new school schedule! 5th grade, here we come!Just 3 weeks left of Summer vacation!


Denise aka 'Mom of Bean' said...

LOVE, LOVE, LOVE the Tummietote!!

Bean had recess before lunch last year (and we'll be requesting that happen again this year even if it means switching the schedule for her grade). Her 'rule' was if she was below 120, she would have 6g carbs of would hold her for the activity of recess. Then she would recheck before lunch and use that number for her lunch dose. She could drop anywhere from 20-90 points at recess and sometimes that was OK, especially if she started at 250!
Just our experience...

Heather said...

We love the Tummietote too! I am dreading thinking about school. Sometimes I wish that Lovebug could do some of the care herself but since she is only 5, I don't think that is realistic at all. Not to mention she really has little desire to check herself and still doesn't recoginize her lows all the time. Good luck! It sounds like you have a pretty good plan in place!