If you have found this blog, saying Welcome does not really seem appropriate. I know you wish you weren't surfing the internet for diabetes. I felt the same.

A big part of me wishes I were not writing about diabetes, nor did I anticipate to become so opinionated or informed on the subject, but it happened. In 2010, my son was diagnosed with Type 1 Diabetes.

It wasn't really part of the plan… Correction - it was not part of the plan, but it happened. It is not always easy, but I think we are all doing okay, and I hope we continue to do so.

Why the Middle East? I happen to live in Dubai. I don't think that living in the Middle East makes mine or my son's diabetic experience any more unique or challenging than it does elsewhere in the developed world.

I hope you stick around, or read something you like. Feel free to comment and join the conversation, subscribe or follow this blog by liking the Facebook page Diapoint.

Please note: This blog does not give medical advice. I am opinionated, and I share my experiences, but the first rule of diabetes is to follow up with your doctor and/or nurse educator about your care, diagnosis or medication. If you do not have a medical practitioner that is helping you find your way through this crazy world, then do not give up until you find the right one.

Tuesday, August 30, 2016

Back to School with Diabetes - Directives & Supplies

When I meet with the nurses and home room teacher the week before school, I also make sure I take the first draft of my son's medical directives as well as emergency snack boxes. 

The medical directives are what the nurses will follow in regards to my child's care - daily insulin doses, what to do in extreme high and low blood sugar situations and other emergencies. At our school, only nurses are allowed to administer medications. I am fine with this. Just note that not all schools always have a school nurse available, so it is important to educate everyone that will be helping your child manage their diabetes.

I strongly suggest you have a written document with the exact protocol you want them to follow. Every diabetic is different, and every day each of those diabetics blood sugar will be different. No way is a general understanding of diabetes enough. This is not a one size fits all disease. 

You should complete this document with your child's physician. Or, if you have been around the diabetes block a few times, complete as much of it as you can and then review it with the physician to make any updates or suggestions before you take it to school.

I call it a working draft. It should be as complete as possible by the first day of school, but also know that you may find that due to your child's body's response to the schedule some things may need to be tweaked. And be sure, your child is going to grow throughout the year. So just as they will need new shoes soon, you may find one day they wake up and suddenly need more insulin.  

For the last several years, I have used the American Diabetes Association (ADA) Diabetic Medical Management Plan as a template for my child's details. It is nine pages long, but do not let the length scare you. The first time I used this five years ago, it really got me thinking about our diabetes management and things I did not consider when he was in nursery. I have actually added more information to this document  since then as I have suggestions for various blood sugar levels and activities now that I know my son's response to certain things. I am sure there are also other similar documents from other countries available on the internet. So if you find something that works for you and your child, use it!

And make sure that after you review every page of this with your child's caretakers at school that all of you sign it. Yes, this is formal, but it seals your mutual agreement about how your child will be cared for. 

Now on to emergency snack boxes. These are not the "Hey, I think I'm hungry" kind of snack boxes. I take one box of several juices and snacks to keep in each classroom where my son will be. This includes his home room and everything from the music room to PE class. In addition to these, he also has a large box of snacks and a comprehensive box of medical supplies in the nurses office. For medical supplies think daily care, and also emergencies. 

God forbid, if there were ever a lock down at his school, hopefully this would be enough. Each teacher who has one of these boxes in their classroom is trained about when to use them and how. I put a short summary on the lid of the box, and the nurses include a huge insert with their emergency phone number. 

In the US, where lock downs are more probable, many Type 1 children carry a bag of supplies with them everywhere they go. Always. Including the bathroom. But why? If there were an emergency and a Type 1 child was pulled into a random classroom, they may end up in a situation with no access to any supplies. This is a huge risk for a Type 1. If a Type 1 was running low and could not get to a fast acting sugar for several minutes, a half hour, an hour??? 

That is a scary thought as a parent. Because of what I see happening in my country, I am honestly considering that my son carry glucose tabs in his pocket always. Our children here are so innocent to the subject of such violence at school, that I cringe at the thought. But lock downs can also occur for things like routine fire drills.

Too an American an approach? Perhaps. Too much? Maybe. Unnecessary? I hope it would be unnecessary always, and if my time is ever wasted on something in my life, then let it be this.  I used to work in a hospital and dealt with risk management. There is a reason for risk management. Accidents and events do happen. Many are often out of our control, and the only thing you can do is try to prepare. In previous school years, the nurses are grateful for these boxes because it saves time. They can treat a low blood sugar on the spot, and not have to run back to the health office to get a fast acting sugar. If the supplies get low, just refill.

Below is our image of this year's boxes. My son shot this with my camera. There you see juice for severe lows, chocolate milk for mild lows, snack bars, raisins, fruit and vegetable purees among other things that will not go bad. You definitely want fast acting sugar in your boxes to treat lows. It does not have to be in the form of juice. Use what you would customarily use at home. 

With the exception of a quick fix for a mild low during a class, hopefully all these boxes return back full at the end of the year.

Have a safe, healthy year!

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