Wednesday, September 9, 2009

Back to school

Its that time of the year again....time to head back to school. Many parents love this time of year. I hate it. Its not just getting back into a routine and not being able to pack up and go when you want. Its not just the thought of cold weather coming. Its new teachers, new people to educate, new worries, new growth to deal with, new issues from other families.

Liam was to have a new teacher this year. I was nervous. He goes to a French school. The teacher's English skills were minimal. My French skills are worse. I had already organized a meeting that would involve the principal and the teacher. I wanted a translator and someone on my side.

As school opening neared I had to bite the bullet and prepare documents for school. The teacher had to know when Liam needed to test, what diabetes was about, what his pump was, his need to use the washroom, what to do in case of exams, etc. I was really not looking forward to all of this but I got it done. I had a two page sheet on basic care. Liam is doing so much more of his own care, I just basically needed someone to watch out for him when high or low and to allow him the freedom to look after his disease. I was praying it would happen.

My prayers were answered! The teacher Liam was to have quit! The teacher replacing him for now was someone that I knew and knew Liam. I was relieved! The sheets will still go to school with him but they will be read and followed. I can breathe again!!!!

Type 1 -Insulin Dependent Diabetes Mellitus
(Grade 7)


If there is an emergency or questions regarding Liam’s care please contact
Barb at 6xx-xxx6 (home) OR 6xx-xxx0 (cell)

Liam has type I diabetes. Diabetes is a chronic, debilitating disease that can affect every organ system in the body. Type 1 diabetes occurs when the body’s immune system is triggered to react against and destroy the insulin-producing cells in the pancreas. Without the hormone insulin, the body cannot use glucose (sugar to fuel the cells of the body). As a result, the level of glucose in the blood will rise, causing symptoms. To compensate for the lack of natural insulin, Liam is currently using an insulin pump, which is attached to his body 24/7. He must never remove it. This pump does not regulate his blood glucose levels; it’s just another way to deliver insulin into his body. His Blood glucose levels can still go high or low.
Low Blood Glucose…This is an emergency situation and must be treated immediately!!!
Low Blood Glucose Symptoms
Grouchiness, shakiness, sweating, fast heart rate, pale skin, dizziness, tired or falling asleep, sudden moodiness or behavior changes, difficulty paying attention, or confusion.
If Liam exhibits any of these symptoms he may not be able to care for himself. He MUST be monitored and CANNOT be left alone. His thinking will be impaired as the brain is being robbed of vital fuel to function. He has too much insulin in his system and is in need of glucose right away! Liam has glucose tablets with him and will also have a supply of sugar in his red emergency kit. If he runs out of any of these supplies please ensure that I know to replenish them. If you run out and he needs glucose any sugar or sugar product can be used—spoonfuls of sugar, or hard candies for example.
What to do?
If Liam tests and he is below 4mmol, he must immediately have 3 glucose tablets and retest in 15 minutes. He CANNOT be left alone during this time. If his blood glucose level does not go up in 15 minutes he must have more glucose and retest again in 15 minutes. Repeat until he is over 4mmol. IF HE IS BELOW 4 mmol BEFORE GYM OR GOING OUTSIDE HE CANNOT TAKE PART IN THE ACTIVITY UNTIL HIS LEVELS REACH A SAFE LEVEL. A “safe level” before physical activity would be defined as any reading over 6mmol.
If he is under 4mmol before any exam, he is not physically able to take this test and it must be rescheduled when his blood glucose levels are above 4mmol. When he is “low”, his brain is starved of fuel and he will not be able to think or function properly.

High Blood Glucose…this can be a serious situation that can quickly become an emergency.
High Blood Glucose Symptoms

Tired, grouchiness, difficulty in paying attention, thirsty, frequent need to use the washroom, sore stomach, headache, blurred vision, confusion.
If Liam exhibits these symptoms, have him test to ensure the proper method of treatment. If he is “high” (a blood glucose level over 10mmol), he will give himself more insulin through his insulin pump. He should retest within an hour. If his blood glucose level has continued to rise, he should contact me for further instructions. His pump may not be working and this can quickly lead to vomiting and much more serious conditions.
If Liam’s blood glucose level is over 16mmol before an exam he is not physically able to take this test and it must be rescheduled for a time when he is healthier. A high blood glucose level impairs the thinking, processing and vision. He is not able to function properly at this time.

Accommodations that are necessary:
*Liam shall be permitted to use the bathroom without restriction.
*Liam needs to have immediate access to water.
*Liam will have an emergency kit containing glucose and spare supplies in the classroom as well as glucose in his school bag at all times.
*Liam will have access to the phone to call home regarding instruction on his care when running “high” or “low”.
*During a fire drill, Liam’s kit (blood glucose meter and treatment for hypoglycemia) MUST accompany him from the building.
*Liam will be allowed to leave the classroom to wash his hands before all testing times. Liam must test and record his blood glucose levels at the following times:
Before morning snack/recess (approximately 10am)
Before lunch (12pm)
2:20pm…If Liam is low at this time, ensure that he is over 6mmol BEFORE he leaves the school grounds. If this is not possible, have him call home to be picked up as it is not safe for him to ride the bus or walk home.
Before and after returning from gym class.

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