{Diabetes at School} Elementary School

by Leighann on August 8, 2011

D-Mom Blog Guest PostEach day this week I have the privilege of sharing guests posts from terrific D-Moms, D-Dads, and D-Kids, who are talking back-to-school. Up first is Alexis of Justice’s Misbehaving Pancreas. What I love about Alexis is she doesn’t “sugar” coat it. She tells it like it is. She’s such a strong voice not only on her blog, but also Twitter and Facebook. Alexis shares what it’s like to have a son in elementary school in Las Vegas, where staff are not allowed to administer insulin!

I have the pleasure today of guest blogging over here at D-Mom Blog. Awesome! This blog is a source of great information, and D humor. Today we address school.

Can you say OY?!

Justice was diagnosed just 4 days after turning six. He was on break from school when he was in kindergarten. Here in Vegas, Kinder is done as half days. Only 2.5 hours a day. We were very blessed to have an awesome teacher who trained himself on lows, and a nurse and nurse’s assistant (nurses in Vegas switch between schools all week) who knew how to treat lows, and well that’s it.

It wasn’t a big deal. I was 5 minutes away and if ever he was high, or there was a party with food, or a field day I would come and handle it.

Not much has changed. Yes, he’s going into 3rd grade now but let me explain.

Obviously 1st and 2nd grade were not half days. The nurse and nurse’s assistant do a little more than just handle lows, but when they do,  it’s with my guidance over the phone or with Justice’s help.

But I still have to go to the school everyday and bolus Justice for lunch. If there’s a party or field day I’m there too.

Here’s why and how I do it:

In Las Vegas school staff are not allowed to administer insulin unless there is a lockdown or it’s an emergency. Me, being an OCD control freak, I am actually am okay with this.

It does present many challenges. Someone must always be accessible to Justice, which means we are a one income household right now.

Justice’s school nurse is only in two times a week, so it’s really the nurse’s assistant who cares for him daily. SHE’S AMAZING. She can spot a low, even when he can’t, she knows he CAN eat anything as long as carbs are counted and bolused for, she has always been eager to learn more and accustom herself to his new devices such as Dex. She never allows him to walk to the office if he’s low. Nope. Not even with a buddy. She goes and gets him! She honestly loves him, and we love her. If he’s high she will allow him to bolus himself while I listen over the speaker phone to ensure it is done correctly.

Now you may be wondering…if he can do that why can’t he just bolus for lunch? Technically he can. BUT if we say he can bolus himself for lunch, his 504 will say “self-dependent” diabetic. Meaning he needs NO help. Ever. Yeah, I am not okay with that. So instead his school management goes like this:

Firstly Justice carries with him at all times (in his Tummietote) his pump, Dex, meter (with strips and lancing device of course), candy, and cake icing gel.

The nurses office has: a meter, candy, juice, snacks, glucagon, sites, cartridges, iv preps, iv 3000, batteries, cake icing gel, ketone meter, extra strips (glucose and ketone), and I’m sure I’m forgetting something.

Each class he attends has: a bag with juice, candy, and a snack just in case.

The nurse, nurse’s assistant, and office staff are all trained on Glucagon.

The teachers cannot train but know how to handle a low either with candy, juice or frosting. And know when to call 911 and not give anything by mouth.

Justice is allowed to treat a low, check his sugar or do anything D-related anywhere, everywhere and anytime.

He is allowed to skip the lunch line if he’s showing he’s trending down, or if he was just low.

A Typical School Day

8:45 am School starts.

Justice usually has some IOB (insulin on board) from breakfast. But he knows when he’s running low, or if he’s too high (thanks to Dex). So we don’t really stress it. UNLESS it’s a gym day. If he has gym I bolus less at home and give some free carbs.

10:30 am Gym is over. He reports to the nurse with a buddy (unless low, then she comes to him). He checks his bg, treats accordingly all while calling me to confirm.

Back to class.

Now he has recess.

11:45 am Justice reports to nurse’s office to check bg before recess. He is very sensitive to activity so they call me and we decide if he needs a small snack or boost. I won’t go into how we handle all the numbers, cause well we will be here all day! Lots of variables.

After recess/before lunch 12:15 pm Justice reports back to office where I am already waiting for him. We check bg, and head to the lunchroom where I count carbs for lunch and bolus. (Of course if he’s low or unusually high we handle that before eating.) I would also like to add Justice is able to eat school lunch. We were sent a full list of all foods served with the carb counts. We get a menu on the first of every month. Which sometimes changes with no notice which is another reason I like to be there to bolus for lunch.

2:00 pm Scheduled bg check. Since its 2 hours post lunch and bolus I like to see where he’s at. Usually he likes a small snack of protein and then heads back to class. If low nurse and him treat, if high he may bolus himself or I have him wait it out since there’s enough IOB.

3:00 pm Home!

* If there’s food to be eaten (usually), I’m there.
* If there’s a party, I’m there.
* If over 250 or there are ketones, I’m there.
* If there is extreme activity, I’m there.
* I am called with EVERY bg. In range or not.

We have it written in the 504 that if Justice feels low, he may test if he feels he needs to OR just treat the low with some Smarties, while he’s treating the nurse is called, and she comes to him. She then rechecks him and gives additional carbs if needed. She has come up with a way to get him to the office (that he loves) she wheels him on a teachers chair. So that he doesn’t have to walk. I told you, she’s awesome!

By allowing him to treat while she’s coming to him, he caught a 32. Actually he was 32 AFTER the candy! I can only imagine how low he actually was.

I’m not a doctor by any means, but allowing him to do this works for us.

The Dexcom has really helped in this aspect. Justice feels his lows and Dex confirms them. So he doesn’t feel the need to check his bg right away. I am ok with that. A low is more dangerous than a high in the immediate. And so far he’s never been wrong.

I honestly believe this works for our family because I’ve made it work. I’ve enforced our 504 to the T, I’ve allowed Justice to assist in his decisions, and I’ve let the school know I mean business! 🙂

We have had some issues (last year’s teacher), but thanks to a wonderful principal and nurse’s assistant we got through it. Justice feels safe when at school and has been accommodated.

If he’s absent or leaves early due to D, he is allowed to make up all work and tests. This is very important. He made honor roll! Insert proud mama smile here!

Everyone’s child, their diabetes, their school, their schedule and 504 plans are all different. But the desired result is the same:

A safe child, who is learning and having fun at school!
Diabetes and all!

Further Reading

{Meet a D-Mom} Alexis of Justice’s Misbehaving Pancreas

Posts mentioning Alexis

Read more guest posts

Posts about diabetes at school

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{ 5 comments… read them below or add one }

1 Lisa August 8, 2011 at 4:49 pm

I have an odd question, but if the Vegas state law is that no one in the school can administor insulin unless lockdown etc, then what do full time working parents do?? My son was dx 7 mos ago at 3 and is in a preschool/daycare and his daycare has no issues administering it and they do great at it. When he starts school later – we’ll have to figure a new system out, but I do know that my husband and I have to work full time, so I’m just curious how parents in states where its not allowed who have to work full time handle it??

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2 Alexis August 8, 2011 at 6:10 pm

Leigh Ann thank you for featuring Justice and I , I feel people really have no idea how complicated school with D can be and I’m happy to help shed some light!

Lisa as you see I mentioned we have no choice. That is why we are a one income household. Sad but true we have had to make changes because of Diabetes and school.

I heard that a family last year had their child eat lunch, and didn’t bolus him till he got home! I also know many families have their kids bolus themselves, if they are comfortable with saying their child is completely self dependent than its a personal decision.

I’m sure not all schools in Vegas are like this, but so far he has been to two and they have the same rules.

We have to adapt to what we are given and for us it means someone must always be accessible to go to the school. There isn’t a choice. We are a one income family now because of it.

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3 Sara August 8, 2011 at 8:42 pm

My niece and nephews go to school in the Vegas ‘burbs. Thankfully they don’t have diabetes – just auntie does. I bet all it would take is a good lawsuit for those school rules to change!

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4 Reyna August 9, 2011 at 5:43 am

Wonderful post Lex and you should be donning a cape girl friend!!! You are AMAZING. ‘Nuf said. xo

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5 Kristin August 9, 2011 at 9:45 am

We’re in the same position as Lisa (and same state) – I agree: very eye-opening to hear about those 504 rules. Great post & interview – thanks! Someone should make a bumper sticker that says “Not OCD, it’s T1D.” 🙂

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