Marching Band

Our meeting a couple of weeks ago with the new school nurse also included the band director. Marching band is a serious endeavor in our district. There have been weekly 3 hour rehearsals since June. Band camp week in August consists of twelve hour days at the high school. Our fall weekends are spoken for.  There will be weeks when my daughter spends more time with the band and its staff than she does with us, her beloved (and diabetes-familiar) family.

She's the first kid with diabetes to be in the band, so this is new territory. Both the director and assistant director agreed to be glucagon trained, which is great.  More important to me, though, was to teach and then strategize so that they will never have to use that training.  So we talked about diabetes.  We talked about how steady exercise (like walking and presumably marching) can lead to low blood sugar. We talked about the importance of treating a low blood sugar as soon as it's noticed.  We talked about the importance of checking blood sugar obsessively on days of important events (like band competitions) so that my daughter can use every tool at hand to aim for a in-range number at show-time.  We talked about the importance of keeping diabetes supplies accessible at all times.

The last time we had to explain and discuss diabetes in this kind of detail was at our initial 504 plan meeting at the middle school . The goal of both meetings was, of course, to get the staff to agree to allow my daughter to do what she needed to do to take care of her diabetes.  The tactic we used both time was conversation and education.  More effective than making a list of demands, I think, is to talk about life with diabetes: what a low blood sugar feels like, how it's treated, how we use the tools we have at hand to prevent diabetes emergencies, how good my kid is at taking care of her diabetes with a minimum of disruption, and how much bigger a disruption it would be if an oncoming low turned into a medical emergency.  This information, presented with a healthy dose of 'we've been doing this forever, and we know what we're doing,' seems to slowly but effectively shuffle people's preconceptions about how things should be done and lead to building consensus on a mutually agreeable plan.

The conversation with the band director led to a game plan, to be fine-tuned as events start to unfold.  She will have her meter kit on the sidelines of all rehearsals.  While the director is strict about nobody leaving the lines for any reason during practice, my daughter has permission to slip away to check if the Dexcom alarms or she's feeling low. The band director will carry glucagon and a spare meter in the first aid bag which accompanies him onto the field. At performances she will check her blood sugar during the time just before they enter the field and then hand her kit to the director or a parent volunteer as they line up. The uniform jacket has a pocket in which she can keep a roll of glucose tabs to use in an on-field emergency. The lines of communication remain open and if we have any concerns, we'll bring them up. Ditto for the band director. We left feeling comfortable with the plan.

Next up, how wear the pump and dexcom with the uniform, how to survive a week of band camp in the August sun and how to balance the busy fall band season with the first semester of freshman year of high school...

Little Things

Some years, the 504 meeting has been formal and dedicated to big-ticket issues like being allowed to use a glucometer in the classroom or the procedures for standardized testing accommodations. 

This years issues are more trivial:

When a nurse is assigned to be present at an extra-curricular activity, could someone let my daughter know who it is?  Somehow this seemingly important step is being missed. My daughter usually takes care of her diabetes stuff on her own at after-school events and texts me if there's an issue, but if someone's being paid to help her, why not at least let her know who it is and where to go for help?

And, in what may seem to be a counter-intuitive follow-up question, could we please just put in the 504 that she is allowed to use her cell phone for diabetes purposes at extra-curricular activities?  The reality is that she does, and that the staff in charge of these programs know she does and are perfectly okay with it.  The school cell phone policy is that kids can use their phones at after school activities with permission from the person running them.  All I'm really asking is that that permission be granted through the 504 instead of her potentially getting caught texting me by an unfamiliar teacher involved in the play practice.

I'm incredibly grateful that things are going well and that there's nothing major to discuss.  But with an opportunity to sit down and advocate for my daughter to have a school experience as unencumbered by diabetes as possible, I figure it doesn't hurt to bring up little things.

 

Missing Class

Low blood sugars have been frequent around here lately.  My daughter seems to go through a streak of them every fall, but the implications are getting harder to manage.  Missing class time in 7th grade is much different than it is in 3rd.

Our current in-school low blood sugar protocol is this:  She checks in the classroom to confirm she's low and is escorted to the nurse by a classmate.  She has a juice box and waits 10 minutes.  She rechecks and if she's back in range she heads back to class. Usually, one juice box perks her back up, but she's had a few 2 box lows lately.

Nobody's comfortable with her wandering back up to class at 53, hoping that second juice will kick in. So there she sits with the nurse.  The nurse, as we all know, is lovely.  But she's not accredited to teach geometry, or geography, or grammar.

So when 4:00 homework time rolls around, I'm called upon for help.  I'm able to help with English. Geography is easy enough with the textbook at hand, and it's interesting.  Geometry?  Forget it.  Helping with math homework consists of me sitting near her, muttering encouraging words while she reads the textbook out loud until she figures it out.

Fortunately she's a smart kid, and can catch up pretty quickly.  But it's frustrating for both of us.  The question is, can we make it so she doesn't have to?

Obviously we're tackling the low blood sugar issue.  No matter when they happen, sticky low blood sugars shouldn't happen on a regular basis.  Adjustments are underway.

But I'm also wondering about our low-at-school game plan.  What could we do so that she misses less class time when this does happen?

As usual, sitting here writing has brought ideas to mind, some of them pretty obvious.  Like when she tests in class and she's 58, she should drink the juice she has with her on her way to the nurse, not wait until she gets there.  And maybe we need to talk with the nurse about whether any lows could be treated by my daughter in the classroom.  For her, some lows are very functional lows at which she can drink juice and keep doing what she's doing.  During others, she feels much safer taking a time-out in the company of a caregiver.  How to quantify or describe this on a 504 plan, I'm not sure.

Any other ideas or suggestions which will keep me from (re?)learning more geometry or algebra are most welcome.