Thursday, August 18, 2011

Back to School

School starts next week.  I seem to have blocked this from my mind and all of a sudden here it is!  So, today I have been making lists.  School supplies, D supplies for school, Gluten free snacks for TJ, touch base with school nurse, forms to dietitian, update health get the picture. 

We have been pretty lucky, I think, with our school experiences.  Thinking back to Tylie, her daycare provider  and preschool teachers were right at the hospital with us learning to count carbs and treat highs and lows.  When she started kindergarten, there was no school nurse, but we met with school staff and created a health plan that worked.  At that time we were still mixing "cloudy" and "clear" and she did not get a shot at lunch time.  Wow- we have come a long way!  We did have some struggles with Taya.  She told me- way after the fact- that the teachers at the daycare she went to before kindergarten would make her eat all by herself.  They said she ate too slow and they couldn't keep track of it in the big group.  She hated going to this center.  But, we always thought it was because she went there alone, without any of her siblings.  It wasn't until recently that she even told me about this memory!  If I had known I would have pulled her out of there so fast.  I still drive by there and want to march in and ask what they were thinking!  She told me of teachers that made her walk up and down the hall in an effort to lower her blood sugar.  She has always been so secretive about having diabetes and these two stories showed me why.  She is slowly working her way through this and having an insulin pump has really helped her to be more compliant.  This is not to say she doesn't struggle but we see progress.  While Taya likes to pretend she doesn't have diabetes, Tylie has been known to use it to her advantage.  Her 5th grade teacher told me once that Tylie was always low at music time.  Well, after some investigation it seems she didn't really like music.  But she really liked spending time in the classroom with her teacher!  But, overall, their experience was good, particularly in elementary school.  The teachers were open and willing to meet.  I came into the classrooms and talked with the kids.  It still breaks my heart when I hear the bad experiences that others have had. 

When TJ was diagnosed he was still at the daycare the girls had attended and T was more than willing to learn how to give shots and get a refresher on fingerpokes.  He also attended a preschool.  There they had not previously had any children with diabetes but the director had gestational diabetes with her last pregnancy and agreed to give him his shot at lunch time.  For kindergarten he attended the same school the girls had but now there was a nurse!  Wow- is she amazing!  She is as irritatingly organized as I am so she double checks everything.  I love it!  When he was also diagnosed with Celiac she contacted the school district dietitian and helped us create a plan so he could eat lunch at school most days of the week.  This year she is as excited as I am about no shots but I have no doubt she will monitor him with his pump just as stringently. 

They have all had their back to school appointments so basals and bolus' have been tweaked.  Now I will work on updating health plans and packing tubs of snacks to take to the class open houses next week. I still will worry if their blood sugar got checked before lunch or if they remembered to bolus or if the teacher remembered to grab TJ's juice boxes for the field trip.  But, I am thankful for the support we have and the plans in place.   The big girls are lucky enough to have their parents teach in the buildings they go to school in so we will go shopping for a stash of snacks for there as well.  Actually, I kind of enjoy the times they have to come to my room because their blood sugar is low.  They usually bring a friend and you can learn a lot about them they don't normally share! 

My goal for this school year are for the big girls to consistently remember to check at lunch time and in the busy mornings.  It is difficult with teenagers because if I remind them, they are annoyed that I am treating them like babies. However, if I don't they "forget."  I don't think that battle will really end, but my hope is that they get to a point where they don't need me to remind them.  Taya actually has a pretty cool plan.  She has a spare meter she put at the end of her bed with a note to herself saying, "Check!" with an arrow pointing down.  It will be the first thing she sees when she wakes up and the last thing she sees when she goes to bed.  Tylie also makes lists.  They have both made huge gains in this area so I am really hoping for the best A1c's ever at their next appointment.  As for TJ, my biggest worry is actually school parties and snacks and more related to gluten than to insulin.  And I will write more about that later!

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