Going Back To School - With Type 1 Diabetes and Food Allergies
It's that time of year - the return to school. While most parents are worrying about "the right" backpack or lunch box, parents of kids with special needs like Type 1 diabetes or food allergies are generally thinking about so much more than that.
I'd be lying if I said I'm not anxious. There are a million things going through my brain about the start of school and all of the issues associated with it. It feels very much like a balancing act... and I keep wondering which piece I've forgotten or will drop. Unfortunately, the outcome of a missed piece could have severe health consequences for my son. BUT - ultimately, I feel really good about this year - mainly because we have a great team in place: a supportive principal, a teacher who has severe food allergies and understands that piece, a new 1:1 nurse who seems motivated to learn, the same school nurse I've worked with for the past two years, and a generally supportive district. Trust me when I say it didn't start that way - it's taken time and a lot of discussion for them to understand the nuances of my son's care. I'd venture to say I was among the most hated parents last year due to early miscommunication with our prior principal and a lack of understanding on the part of key players. I lost a lot of sleep, added a ton of grey hair, and stress ate my way through it. But this is different year. We are starting in a great place - and having a solid 16-page Individualized Health Plan attached to his 504 helps set the expectations too!
My overriding principle is that I want my child be safe at school, and to have as "normal" of an experience as possible given the dynamics of our situation. I thought I'd share the things that I consider as food for thought for others.
FOOD ALLERGIES:
Do you have a completed allergy emergency plan in place? Our allergist recommends the one from FARE, and we use it every year. Food Allergy Emergency Plan
Have you had your allergist complete all required paperwork for school? Often there is a medication form and/or other forms that need to be done before the start of school.
Does your child have allergies solely from ingestion, or also contact or airborne? (Ours are contact and airborne, so that changes the precautions needed.)
Will there be any activities involving food either in or outside of the classroom? If so, what?
Is your teacher(s) aware of the allergies? Are they willing to work with you? Do they know your child's specific allergic reaction symptoms (mine no longer gets hives - usually vomits and passes out)? Have they been trained on epinephrine administration?
Where will your child be eating snack and/or lunch? What precautions are in place to ensure your child is safe (e.g., how will the surface be kept clean. who will be responsible for overseeing your child if he/she is young. what signage, if any, will be put up about allergens)?
Where will your epinephrine injectors be stored? At a minimum, they should not be locked up...a delay in unlocking them could waste critical time. We have a set with my child at all times. They might be needed in the classroom, at lunch, or on the playground.
DIABETES:
Have you had your endocrinologist complete all required paperwork for school? Often there is a medication form and/or other forms that need to be done before the start of school.
Has adequate training taken place with the person(s) responsible for responding to low blood sugar? Can they differentiate hypoglycemia from an allergic reaction? Do we have a solid protocol for managing low blood sugar, including mini-Glucagon, in place? How will we handle high blood sugar?
How and when will I be communicated with? At what point(s) will the school nurse be involved? (This varies by the age and amount of responsibility taken on by your child - mine still requires assistance with all things diabetes-related, including treating lows, correcting high blood sugar, and bolusing for food).
Where will we keep emergency supplies in the classroom to be used in the event of a lockdown or natural disaster (we live in earthquake country!)? When he goes elsewhere on campus, will those supplies follow him or do we need supplies in every location?
Can I do education with his classmates? He and I usually do it together the first week of school to minimize questions and classroom disruption. Ironically, his classmates seem to like getting alcohol swabs as a "gift" to clean things with. We generally also send a letter home to parents explaining what we discussed and dispelling common myths (e.g., diabetes is contagious, he got it from eating too much sugar, he can't do things other kids can and he shouldn't be invited to parties!).
Clearly there is much more to think about at the start of school. It's not a linear process, rather an ever evolving one. It requires patience, a high level of communication, and a sense of humor...which is easier for me to find on some days than others.
Wishing you a smooth and easy start to the school year!
Lisa