Friday, January 31, 2020

Our First Class Party

We didn't get much time to get accustomed to diabetes management before we had to face one of a T1D mom's worst days - classroom party day.  My son went back to school for five days before winter break.  Just in time for all the hot chocolate, sugar cookie making, handing out candy canes, and xmas class parties.  I seriously thought about keeping him home from school that last day before break because I had NO IDEA WHAT I WAS DOING with the diabetes management and his class was having a party where parents were providing: hot chocolate, cookies, brownies, cupcakes, candy, sugar cookies with a decorating station and a movie.

I met with the teacher and the nurse about a week before the party because we were establishing his health plan for school.  What to do for parties was part of the plan we developed.  The school nurse told me that there are usually three ways kids with T1D handled class parties:

  1. they were opted out (parent would keep them home or they would go to a buddy class that wasn't having a party)
  2. parents send in alternate "treats" that are diabetes friendly
  3. child participates in the party and covers the carbs with an extra insulin injection  (calculates carbs and covers before the party or calculates and covers after eating the treats)
Since we'd been home from the hospital for only two days when I met with the school; I had no clue what to choose.  I wasn't going to opt him out because that seemed like it was only in my best interest.  I didn't believe I would be any good at baking alternate treats that would be friendly but figured I could try some recipes while he was at school and if they worked out then great.  So we decided he would just be a part of the party.  We'd been told that dosing fifteen minutes before eating was the best for N's management but it was going to be a challenge since it was parents providing the treats and we wouldn't know what was available until just before the party.  I talked it over with N and he understood that he should make a few choices at the party of things he REALLY REALLY WANTED instead of having some of everything.  The day of the party came and the nurse and I had come up with a list of carb counts for common treats.  N was going to choose his items then go get his insulin for those then return to the party and have the treats.  We were ready!

That's not how it went though.  At the party, parent volunteers were in charge of the treats.  They walked around to each student and offered them a cupcake/cookie/brownie/candy and then they put it on their plate.  N had to wait for six different parents to come around 1 at a time before he got the three items he wanted.  Then he went to the nurse.  There was a sick child in the nurses office so he waited.  Then he went in and one of the things he had picked was a brownie with frosting but it was definitely bigger than 1inch square which is how the carbs are factored so they decided together what they estimated the brownie would be.  The cookie had sprinkles and stuff, so again, an estimate.  He got his insulin and waited ten minutes then went back to the party.  Once he was back at he party he ate a cookie and then a parent volunteer told him it was time to put any snack he hadn't eaten into a plastic bag and put it in his backpack to take home; so he put his other two items away.  So he had insulin for three treats of carbs but only ate one.  He wasn't ready/able to advocate for his diabetes and couldn't try to explain to an unfamiliar adult that there could be serious consequences for him not eating these treats.  About half an hour later he felt sick and went to the nurse with low blood sugar (no surprise - he hadn't eaten 2/3 of the carbs he dosed for).  The nurse didn't know he hadn't been given time/opportunity to eat the treats so she was concerned that his blood sugar was so low.  She gave him a 15g juice and glucose tabs to bring him back up.  He then had to stay in the nurses office until she could check him again after fifteen minutes.  She wondered if he'd be able to ride the bus because she couldn't figure why he was low after eating so many carbs.

My poor kid.  He didn't enjoy the party much.  He didn't really get to eat the treats.  He had a scary low blood sugar that made him shaky and sick.  He had to sit in the nurses office for 30 minutes drinking juice and eating sugar tabs and rechecking his sugars every fifteen minutes worrying that he would be too low to ride the bus home.  When he got off the bus I asked how his day went and how the party was and he said it wasn't very good then he told me the whole story.  I felt terrible.  It hadn't worked out well for him at all and he hadn't had fun only extra worry and stress and nerves.  

We made a plan that next time he could eat what he wanted at the party then go to the nurse and tell her what he had to get insulin.  His blood sugar will spike with this plan and the insulin will come in later than we'd like to cover those carbs but the stress and fear will be removed from what should be an average childhood experience.  Valentine's Day is right around the corner so we'll get to try the whole stressful situation again in just a few weeks.  

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