School Ignorance

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1

I just wanted to post here my recent experience with an Elementary school, their handling of my daughter's diabetes, and see if this strikes a cord with anyone else.

Last week I got a pretty scary call from her school at about 2:00pm, or about two hours after her lunch. They informed me that my daughter was found wandering the hallways, confused and weak (oh, did I mention, she is only 6 years old). When approached, she fell on the floor, yet not passed out. So, they test her and she is 32 (!), give her snack, then call me.

My first question is, what happened at lunch, because that would certainly explain a lot? I am told that she had ~90+ gr of carbs, pump suggested 4.9 units, so they accepted it. That just doesn't sound right! The most insulin she ever had prior to that day, is around 4 units, and her lunches usually average 40-50 gr... That night I locked up her pump to not allow any more than 4.5 units and thought that was the end of it, not!..

Yesterday I got another call at noon. This time they complain that her pump wouldn't allow then to give her insulin and it gives them an error message, something about "exceeding maximum allowed insulin"! Again, I ask them exactly what they are trying to input into her pump. Here is what they tell me:
her glucose reading was 275;
she ate 130 gr of carbs (WHAT?!! No way! Right there I challenge their calculations)
based on that, pump suggests 6.9 units of insulin.

WTF? How quickly they forget what happened last week with 4.9 units!!!

I insist that they only give her 4.5 units, retest in two hours and correct then, if needed.

At 2:00pm her glucose reading was 146 and at 3:30pm it was 96. Can you imagine what would've happened, had they followed their calculations?..

2

Based on my own ratios, that would mean I would have to bolus for 12.2 units!!

Does she pack a lunch? Maybe it would help if you put a note in her lunch with the carb count and the bolus units for the carbs? I don’t have a child with diabetes but based on recent experience it seems you can’t rely on others to properly count her carbs and/or ratios.

3

I know that if that were my child, I would have gone ballistic. How hard is it to follow directions? And 130g of carbs? what did they give her a bowl of pasta, a regular soda and a couple of candy bars!? I know if I were in their shoes, I would be a lot more sensitive to your directions unless they wanted a raving lunatic going postal on them. Most important thing is that she is ok now.

like Terry said, brown bagging it may be the key.

4

This sounds terrible. I think you need to label foods if you’re packing lunch, or provide a cheat sheet of likely carb amounts based on the school lunch. Heck if the lunch is being cooked by any service organization, they should be able to provide you (and the school) with an analysis of the meals.

In our work we have a food service organization and when I asked about a particular soup they gave me a copy of both the recipe and the carb, calorie, fat, etc. breakdown for it. Maybe you can get these for the following week from the company that does the meals.

Best of luck.

5

Actually, school cafeteria has a complete list with all the carbs for every food they serve and that’s what the office is using. I prefer to pack her lunches, but because it’s a new experience, she really wants to eat “school lunch”. I just emaile the food service requesting a copy of that list, so I can check.
I guess the second incident was more alarming to me because person who called me said that my daughter had French Toast Sticks and she said that she had “quite a bit of syrup”. I asked what is “quite a bit”? Her answer was that her estimate is about 2 oz, which is about 40 gr, which is what her list said is a serving size! I seriously doubt she had that much! That still doesn’t explain the other 90 gr…

6

Incredibly dangerous! You are going to have to take matters into your own hands. Firstly, I pack my niece’s lunch with food, carb count for each item, and the total bolus. I also calculate the insulin for the carbs and write it on the sheet, i.e., 45 grams with insulin to carb ratio of 1:10 equals 4.5 units of insulin. In addition, because there are two school nurses and one sub, I have her call me at lunch, she reads me the numbers and we bolus over the phone. The nurse looks at her pump and my sheet and verifies that she has input the numbers correctly on the pump. As for cafeteria food, I would not allow French Toast Strips if they did not supply sugar free syrup. Four tablespoons of regular syrup, which really isn’t all that much, is 55 grams. You may have to monitor very carefully the carb count of the cafeteria food as it is often extremely high. You might mention to them not to go over a certain carb count so they don’t end up giving huge doses of insulin. I know from experience that a larger dose has a stronger effect even if the carbs are accounted for. Packs more of a whallop. Good luck with the school. Sounds as if they are not watching her anyway. How does a six year old go about “wandering the halls.” Isn’t anybody looking out for her? I would ask for a personal school aide under a 504 Plan if the teachers are this lax.