So confused

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jen1229 replied on Tue, Mar 24 2009 6:58 AM

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Generally when a low is treated with glucose tabs, it is SOP to wait 15 miutes, test again and then if the BS has gone up, then give the insulin to cover his lunch, or if preferred, she can test again after the glucose tabs and give the inslin AFTER he eats his lunch. 

Too Bad Mary does not post here anymore.  She would be a wealth of knowledge.

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vet2@comcast.net replied on Tue, Mar 24 2009 6:36 PM

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Dear Kerryann,   I am a 49 year old type one diabetic who was diagnosed when I was 10.  You have a very brave son.  Being a diabetic as a child is challenging.  I had kids who wouldn't play with me but times have changed.  I'm on a medtronic pump and I love it.  It may be a challenge but you sound like a parent who would be involved and I think it would be great.  Your school nurse sounds like she should learn a little more about his issues and forget her fears.  Hang in there.  I have late night and early morning lows.  You have to be vigilent and it takes time to get it right, then you find out you have to change things again.  Good luck and best wishes to your family.

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kerryc1998 replied on Fri, Mar 27 2009 11:31 AM

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Hello everyone. Thank you all so much for your respones. I can't tell you how much they helped and made me feel like we are not alone. It has been 2 weeks and one day now since my son was diagnosed. Just like several of you have said..just when it seems we have it down to a science..it all changes. He went from being High more often than not..to now having more lows. All with the same foods. But he is doing amazingly well. We gave the school nurse more literature and had another meeting with her. Things are going much better on the school side of things. He was pretty low yesterday (57) she gave him 15 and waited 15 and checked him and it brought him right up. Every day it is getting easier and a little less scary. I truly believe that god gives us what we can handle and we are doing ok with it. We have decided to make up his lunches for him. That way we know for sure how much he is getting and what he is getting for food every day. Which in turn makes dosing so much easier. Soccer and Baseball have started so we are now learning to adjust for the practices and games. He is a little jock..football will start before you know it. He plays QB, Linebacker, and special teams....I am a bit nervous for dosing during these games but I am sure we will figure it out.

Ooh...and good news!! We are going for his insulin pump consult in April!! :) Looking forward to learning all about it!!

Take care everyone! Happy Spring!! TGIF!

Kerryann

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Ron AKA replied on Fri, Mar 27 2009 1:03 PM

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Kerryann, I hope all goes well with the pump. It really is the best way to go. You should discuss what strategy will be used when your son is playing in contact sports. They can go under water, but not sure how they would handle a run in with a heavy duty linebacker!

On the highs and lows, it is a hard thing to get perfect, although the pump should do a better job. You may want to discuss a switch in insulin with your doctor, unless you are going to the pump right away. Levemir can offer some advantages over Lantus. The effect tends to be more repeatable from day to day. It does usually require two shots per day rather than one. The end result can be better control of BG between meals and overnight. Some also find there is a slight advantage in Novolog instead of Humalog. It tends to work a bit quicker and many find they use about 10% less of it. I believe most that are pumping use Novolog as well due to the quicker action.

On lows, I believe the correct way is to use the 15-15 rule. Take 15 grams of glucose, wait 15 minutes and then test again. Repeat if still low. If you discover a low right before a meal the conservative approach is to take the glucose, wait 15 minutes and test again. In other words delay the meal until the BG is tested to be normal, and then take just enough insulin to cover the meal.

While it may be best to do pre-made meals until things are under control, sooner or later you son will have to learn to deal with restaurant meals, which means becoming very well educated on how to estimate the carbs in the meal. The hot lunch program would seem like an ideal way to learn that in a controlled manner. I suspect there is not a huge variety of carb containing foods to learn.

Hope that helps some. Your son has a great attitude and I'm sure he's going to be just fine.

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Speristere@comcast.net replied on Fri, Mar 27 2009 3:38 PM

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Hi Kerry,

I am the school nurse with Type 1 diabetes and a pump who posted previously. I have much personal experience with children who live with diabetes. I think you are getting great advice from many sources and will continue to learn just as your son and his school nurse will continue to do. Diabetes is never stagnant and responses to insulin, activity and food vary in individuals with many factors including stress and illness, and the learning takes time. You will get it and so will your son.

I would suggest that you encourage him to verbalize how he is feeling any time he is "out of sorts" for any reason. Children should not hesitate to speak up to a teacher if they are feeling low, funny, shaky or any way other than normal. BG checks should be done anytime that occurs and if they are in the habit of describing how they feel their awareness of early symptoms becomes easier to treat before it becomes an emergency. Glucotabs should always be on his person and a buddy assigned to accompany him to the urses office if feeling low, or the nurse should come to him.

These are just random thoughts. Keep working with your school nurse and consider her and the teacher as your school team.

Sue P. RN

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Spirit replied on Fri, Mar 27 2009 4:16 PM

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Sue P's suggestion about a "buddy system" for your son is an excellent one.  I used to work in a school and diabetic students had buddies.  It worked out very well.  When experiencing a low you can sometimes get confused, have memory problems or lose your focus.  For example, your son might start out to the nurses' office, find himself in the corridor to the rest room and just sort of go there on automatic pilot.  Without a buddy, no one would really know where he was for a time and that time could be crucial if he is continuing to go low.  Glocotabs or juice boxes (whatever he finds works the best)should be supplied by you to the school and kept track of so that they never run too low.

One parent I know of a T1 child has developed a system of reporting how her child feels based on numbers.  So, if she asks "One to ten?" (10 being just fine) and he replies "Seven", she has a pretty good idea what that means.  They find this easier than trying to deal with descriptive vocabulary, sort of a quick shorthand.  It is also handy when they are in social situations and don't want to get into a big diabetic dialogue. I also agree with Sue P. that learning to report his feelings will hone his awareness of them and help him learn to treat before it becomes a greater problem.  Kids can get so caught up in their own things that they can ignore early warning signs.  This way, he can train himself to recognize what he is feeling, deal with it and then get on with his "real life" as a kid that much more quickly.

Spirit

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RobertIA replied on Wed, Apr 1 2009 6:57 PM

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Speristere@comcast.net:

Hi Kerry,

I am the school nurse with Type 1 diabetes and a pump who posted previously. I have much personal experience with children who live with diabetes. I think you are getting great advice from many sources and will continue to learn just as your son and his school nurse will continue to do. Diabetes is never stagnant and responses to insulin, activity and food vary in individuals with many factors including stress and illness, and the learning takes time. You will get it and so will your son.

I would suggest that you encourage him to verbalize how he is feeling any time he is "out of sorts" for any reason. Children should not hesitate to speak up to a teacher if they are feeling low, funny, shaky or any way other than normal. BG checks should be done anytime that occurs and if they are in the habit of describing how they feel their awareness of early symptoms becomes easier to treat before it becomes an emergency. Glucotabs should always be on his person and a buddy assigned to accompany him to the nurse's office if feeling low, or the nurse should come to him.

These are just random thoughts. Keep working with your school nurse and consider her and the teacher as your school team.

Sue P. RN  

Kerry,  What Sue says x2.  I highlighted something that in my opinion is also very important.  I would also refer you to the following link which also is a factor in BG control - the mood of the child - whether happy or sad.  The link is: http://www.healthcentral.com/diabetes/c/17/62380/emotional-diabetes .  This is also being backed up by studies.  I would also remind you to keep the positive attitude for the entire family as I believe this can help your son deal with type 1.

Like the two previous posts about the buddy system, our local school system has very quietly instituted the buddy system for several areas and has had teacher education for them.  In addition to diabetes; epilepsy (only certain children who are not having major attacks) has been very successful in the initial months of the program.

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Melissata replied on Fri, Apr 3 2009 12:31 PM

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Hi Jen, I haven't figured this site out yet, but did decide to read here today and saw that you mentioned me. I decided to join and see how it goes. I do feel like this mom is going to have a hard time with this school nurse, and would advise her to go to the ADA parent's board for ideas and to get a 504 in place asap. There is a sticky at the top of the boards that tells all about it and how to get one in place. When Melissa is low, she takes a glucose tablet and eats lunch, taking the insulin after lunch. She now has the Navigator CGM, and that has been a huge help to both her and Michael. Nice to see a picture of you, so I thought that I would post one of Melissa and I from vacation last year on Lake Huron. Hope everyone here is well and I will try to catch up. I have missed all of you, but the last time I checked here it didn't seem like anyone was posting much! I don't know if I have a signature yet, so I will sign this, mary

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Tina replied on Mon, Jul 13 2009 2:58 PM

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Kerry

I was diagnosed in High school and  i am currently a junior in college. I definitly recommend a pump (it has been a life saver for me!), as for the school nurse- she has no right to say things like that to your son! I was lucky to have a wonderful nurse, however i have heard some terrible stories from other people. JDRF has a wonderful outreach program which can put you in contact with other Type 1 families in your area, and they might have personal experience with the nurse at your sons school. Also, if you let JDRF know the problems you are facing, they can put you in contact with someone who has had similar experiences. I hope this helps!

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PumperB replied on Mon, Jul 20 2009 3:35 PM

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I believe that you can request the carbohydrates for the hot lunches from the board of education. They can give you a list of carbs for 'typical' meals and you can plan for that. There is also a great carb counting book, put out by Calorie King: 2009 CalorieKing Calorie, Fat and Carbohydrate Counter. This is really a great -small book that has lots of fast food as well as normal carbs listed that you can calculate your own carbs.

Good luck!

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JoanR replied on Mon, Jul 20 2009 4:30 PM

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Hello "PumperB" - Yes, I know about the many carb counting web sites and the books.  However, they do not provide me the list of foods that I prefer; if they did I would use them. 

I dislike fast foods, gravies, cold cereal, white potatoes, heavy root veggies (hard to digest for anyone); I do not use wraps, f/fries, hamburgers, ice cream, popcorn but on on very few occasions.  I prefer wholesome food choices made from scratch so that I know what the ingredients are.  I believe that most of the pre-packaged foods bought in super markets today are just not good for anyone, but especially a person living with diabetes.  I have a wonderful Health Food store in my community and purchase many wholesome basic foods by internet from the U.S. and Canada.

For Carbohydrate Counting I use the U.S. Department of Agriculture's Nutrition Site List of carbs.  It is very extensive, and has all types of foods, fast and slow! :-))  I believe that most CDE and Nutrionist use this resource most of the time when initially prepping us for meal content and how to figure the carbs.

Thanks anyway,

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c03pringle replied on Tue, Oct 6 2009 3:06 PM

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Dear Kerry,  my daughter was dx with type I, 5 years ago.  My how the years have flown!!

She is now 12yo.  We have had a minimed since she was dx at 5 months.  As far as the school lunch thing goes, I went in to see the school dietitian. we went over the menu, it repeats.  We figured out the carbs for everything on the menu.  It didn't take long.  then we published the list.  As the kids get older, the portion sizes increase. something to think about. 

The school nurse had a copy of the menu with all of the carb counts.  when Sarah went to the nurse just before lunch, she checks her BG, then lets the nurse know what she will eat, and tells Sarah how many carbs her lunch will be.  We had her write the carb count on a piece of paper, so she boluses while she is eating.  If there is recess after lunch, you might want to decrease the # of carbs for the activity.  For gym, sarah usually has a snack, or if after lunch, only has half of the carbs from lunch. 

have to go pick her up from school.  have lots of ideas, will ing to share.  you need to look into joslin/clara barton camp.

they are having wacky weekend in nov.  look up on the barton center for diabetes.  Your son could take a friend.

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kurtsieg replied on Tue, Oct 20 2009 11:20 PM

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well i could fill a dozen boards with all kinds of advice but i will try to be breif and give you the best advice that i can. you and your son will and should always be aware of trends in his blood sugars, but dont be afraid of them. You will have lows, you will at some point have to take care of insulin shock (reactions). I do not say this to scare you , but to get you to be calm and able to quickly and safely help your child through it. If you keep him under good control these will be rare but they do happen and the best thing for him will be calm, decicive,and responsive people around him who know what to do and get it done fast. Talk to your schools superintedant tomorrow and demand that your son be placed on a 504 plan. it is a plan that basically protects your son from being singled out or held back in any way becuase of his diabetes. if he fails a test that he was prepared for or misses a class becuase he was low and had to spend time with the nurse he will be allowed to retake or make up or get one on one tutering to get him caught up. Get the 504 in place. why would he not be allowed to eat a hot lunch?? my daughters school has provided a complete list of carbs for every item on the menu to both me and the nurse so that no matter what she eats we just add the carbs up and calculate her dose. pumps are fantastic if you give them all of the real info that they need and insuranse is now starting to cover the continuos monitering, they are not perfect but they make life a lot easier than just being on a pump. every doctor and every hospital seem to have a different view of pumps and whether they like to put kids on them. if you have a good doctor, you feel good about them and they came highly recommended, they should not keep your child from being on a pump, but as with any serios medical desicion they should st up pump training and get you in touch with others who have a pump so that you can get some real input on the ins and outs of pump therapy. One of the most important things to come to terms with is that YOUR FAMILY NOW HAS DIABETES!!!!!!!! What i mean by this is that your house and grandmas house and any other house that your son spends alot of time at needs to have supplys on hand and  appropriate snacks and foods , this is where it gets tough... you need to change the entire households diet to a good diabetic diet. do not think that if grAndma has a lot of sweets and snacks that your diabetic will be able to resist those temptations. you can still have a birthday cake and icew cream but you need to eat a salad with as little carbs as possible for dinner to make room for the cake . it is a constant balancing act but the better you get at it the healthier your son will be. I could just go on for days but how about this my name is kurt i am both insulin dependant and the father of a daughter who is also, she was diagnosed at 18 months and is now 13 years. If you want to you can call me 724)269-1244. If it is long distance for you just call and I'll call you back. This is a new life that can be real smooth and uncomplicated at times and at others make you wonder how you will ever get through another day. GOD, family,friends, will make your burden lighter. God Bless you and your son and your family. if you need anything call.  Sincerely, Kurt    

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iris replied on Fri, Jan 8 2010 6:45 PM

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Hi Kerry,

As a parent of a Type I diabetic I am aware of the frustration you are facing.  I am also an educator, and I know that there is a lot of misinformation about diabetes in the school system.  You are not being overprotective, but are trying to help your child live as normal a life as possible.  Many school nurses are not current on what diabetics should eat and how to figure out their insulin.  It is important that you maintain open communication with the nurse, and help her help your son.  Explain to her that on a day where the menu changes your son should call you and together you will figure out the amount of insulin he needs to take for that meal.  Also, stress for him that if he isn't sure he should always contact you or his father to help him make decisions.   He can not put the control of his insulin in the hands of someone who may not really understand the relationship between carbs and insulin.  As he gets older he will be able to figure this out himself, but at this point he needs the support of his parents.  You cannot allow other people to put a stigma on your son.  If the nurse will not work with you, go to the administration.  Your son has rights that are very specific under federal law and you only want what is best for him.

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Andrew replied on Sat, Mar 6 2010 5:30 PM

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I was diagnosed with Type 1 diabetes when I was 6. My mother took me to the Doctor and when we left I asked her if I had to have a shot. You can imagine how that made her feel. I have had diabetes for over 50 years and my brother and son are both type 1 diabetics.

I don't think that you will ever be able to stop worrying about low blood sugars whether at night or during the day. Just like raising any kid the hardest part is letting go. Your son will learn to be able to tell when his blood sugar is low one feels pretty funky. What you can encourage your son to do is have food readily available when he is outside away from the house.

One of the best things that I ever did about being diabetic was to not regiment myself according to the condition. If I am hungry I will test my blood and if necessary have a shot, wait and eat. There is no magic bullet about meal times, meal types or anything else. Your son needs to learn to manage his diabetes, you can not do it for him. You can encourage him to learn what foods work for him (for me a low fat diet works best.). I have learned to forgive myself for both high and low blood sugars, they are not a reflection of my lack of commitment to taking care of myself. To forgive myself when I just have to have some food that is clearly bad for me; I love milk shakes and most of all forgive myself for the affects that the difficulty of having diabetes causes in my life.

Hope you and your son thrive in spite of a very difficult constraint.