Category: Uncategorized

Parents (or at least this parent) of a child with Type 1 Diabetes fear school for many reasons. Sure homework, tests, and attendance give all parents the jitters. Add in the concern about high sugars, low sugars, and mistreatment of your child’s health and it’s a wonder how any parent of a child with T1 makes it past the first week.

We are new to full day school. In our school district there is 1/2 day Kindergarten, so as we embark on 1st grade, we are also getting ready for our first full day of school. That means there are bus rides to and from school that I need to worry about my son’s blood sugar levels. That also means lunch, snack, recess and gym are more specific times that I need to worry about my son’s blood sugar levels.

More importantly I need to be concerned if my son is being treated as if he were at home. No I don’t mean treating him like he is the king of the household, what I mean by this is I have to wonder if there is any way his diabetes management can come close to his diabetes management when he is with me, his mom.

While I understand that this is public school and there are literally hundreds (over 800) of other children in the school, there are some things that need to be done to keep my son safe at school that go above and beyond how the other children are kept safe.

Since some awful school shooting tragedies in recent history many public schools have instituted ‘lockdown’ procedures that would protect the students if there were to be a shooter in the building or on campus. During these ‘lockdown’ drills I also have to be concerned that someone that is locked down with my son also knows how to work his blood glucose meter, identify and treat a low blood sugar, identify and treat a high blood glucose, administer glucagon in case of severe low blood glucose.

May not seem like a big deal, as lockdown drills are not often, but what if it’s the real thing? Yes, protect the children from the shooter, but please don’t forget my son in the meantime. I know as his mom, I would protect him from the shooter and manage his diabetes. It’s what I do.

That may be too extreme for some people. Let’s bring it down a little closer to home. Every child has to use the bathroom in school. In our home we have an open door policy. I have two little children at home, all doors have an open door policy. But really because of diabetes, I will always have to have this policy. I cannot let my son shower, even when he is 16, with the door locked because if his sugar goes dangerously low while showering I will have to get in there somehow. Sure I can break the door down, but just seems easier to keep the door unlocked.

Schools don’t have an open door policy for their bathrooms, and believe me as a former teacher I am grateful for that. But what about the one time my son goes into the stall and his teacher forgets that she excused him to go to the bathroom? What if that is the one time that he goes dangerously low while in the bathroom stall?

It’s the ‘what ifs’ that worry me about the upcoming school year. There is no way any staff member can run through these ‘what ifs’ unless they live it like me. They will snicker behind my back (probably like you are) when I bring these ‘what ifs’ to their attention.

But I am a mom of a child with T1, bringing up the ‘what ifs’ and trying to catch them before they become a teachable moment is my job.

Much of parenting is about making judgement calls. You assess the situation and make the best decision you can at that time. It is the same with Type 1 diabetes. With Type 1 diabetes you assess, treat and hope it was the right decision.

While much of dealing with Type 1 diabetes is pretty cut and dry like giving insulin for carbs eaten, there are times when you have to make a decision based on the situation at hand and things are not so easy.

When my son has a low number while he is awake I know to treat with sugar and retest in 15 minutes. The problem arises when he is low and sound asleep. I can treat the low number and make him eat while he is sleeping, and then retest in 15 minutes.Then if the number is still too low, I can make him eat again while he is sleeping and then retest again in 15 minutes.

OR I can treat the number with more carbs then I usually do because if I got him eating while he is sleeping it may be easier to get it all in at once, and then retest in 15 minutes and possibly correct the number down a bit later.

OR I can treat the number with a normal amount of carbs used to treat a low, and put a temporary basal on him pump for an hour or so. What this means is I would stop the amount of insulin that is normally being put out from his pump at this particular time a day to give the sugar a chance to raise the low number. Of course, then test again in 15 minutes to see if I have turned the low around.

It seems like it shouldn’t be too difficult, as I have only laid out three different scenarios for treating a low while my son is sleeping. And choosing which plan of action is not the part that causes the most stress. The part that causes the most stress is after you have chosen a way to go, and the results are not at all what you expected.

After 15 carbs a person’s sugar is supposed to go up. Sometimes it doesn’t and sometimes it even goes lower. So when that happens to you one time it makes you question the next time. The one time when you check your child and his number is 65, treat with carbs, and then test 15 minutes later to see a 57 on the meter definitely changes your opinion about that plan of action. It is way harder to get a child to eat more carbs after you had already fed them not 15 minutes before all while they slept.

Diabetes is so unpredictable, that unpredictability is the only measurable factor. What works one day is not sure to work the next. It definitely makes judgement calls more difficult because there is no distinct pattern of when you’ve made the right call.

Experience helps you make the right decision, but even experience can not really tell whether you are making the right decision or not, that answer lies only in the next meter reading.

Dealing with Type 1 diabetes is a challenge, and one of the greatest obstacles is ensuring that the equipment that acts as life support is working properly.

My son’s life relies on his proper dosage of insulin based on his carb intake and his blood glucose values. Yet, how he determines his blood glucose numbers and how he doses his insulin all relies on properly working equipment.

The equipment that my son uses 10 times a day to check his sugar is a blood glucose meter, test strips, multi-clix lancing device and lancets. We rely on the meter and the strips so much that we determine how much insulin he receives based on one particular number. If there is a hidden malfunction, a glitch somewhere inside the meter, the number may be wrong. Wrong number means wrong insulin dose, which could have dire consequences.

It is faith in our meter company that we trust the numbers that we see. Yet, they are a piece of equipment, and just as your remote for your television, they are not perfect and can malfunction within a moments notice. We just hope we catch the malfunction before it’s too late.

Then there is the insulin pump. The equipment that my son uses with regard to his insulin pump is what causes us the most stress. His pump is life support that is just like any other piece of electronics. It runs on batteries and it can break, but if your remote breaks there is no chance of anyone dying. At least not literally.

Along with the insulin pump there is the cartridge that holds the insulin on the inside. There is the tubing that connects the cartridge from inside the pump to the site that is inserted into my son’s body. The tubing is just plastic. It can crack, snag, pull, snap or spring a leak like any other plastic tube out there. Sure there are certain quality control standards that it must pass before it gets out there on the market to my son, but still, it is just a piece of plastic.

Then there is the actual cannula that gets inserted into my son’s body every 3 days by me that allows insulin into his body that is flowing from the tubing. The cannula is a hard plastic tube about 6mm long that rests just under his skin under sticky paper that we call a site. So the site sticks on the outside of his body (usually his butt) and the site is connected the cannula in his body and clips to  the tubing that brings insulin from the pump.

It is these sites that are going to be the death of me. For the life of me, I cannot imagine how a tiny piece of hard plastic that is only 6mm long can actually bend in 3 separate spots inside of my son’s body to prohibit the flow of insulin. How can something so small cause so many problems? If the cannula kinks inside of my son’s body I am unable to see it with my eye. The only way I can guess if  something is wrong with the cannula is when another piece of equipment, the blood glucose meter, shows a very high number. A high number such as 575 for those of you following along.

Then it is with a leap of faith that we get more pump equipment to change the site to try to get the blood glucose number back into range.

So, if Type 1 diabetes weren’t hard enough to manage with all the carb counting, high numbers, low numbers, stress numbers, exercise numbers, growing numbers and sick numbers, throw in the variables of all the equipment we use to keep my son alive it’s a wonder how we see any numbers in range at all.

I would love a cure for this rotten disease, but in the meantime I’ll take a cannula that doesn’t kink. Is that too much to ask for 2009, a piece of plastic that doesn’t kink? I surely don’t think so.