Wednesday, September 26, 2007

School Update

I haven't written anything about Riley and school lately. Mainly because things have been going fine.

He hasn't had a low at school in a while. His last one was one day last week and it was only a 73 that appeared at lunchtime. He's been in the lower 200s a few times and it is always at morning snack. That number has always been the hardest for us to reign in anyway.

We haven't had anymore problems with administration. In fact, they seem to have just left us alone to do our own thing. I like it that way.

His teacher continues to amaze me. She is doing really well with Riley. She's doing so well, in fact, that I told her she could stop calling me every time she gives Riley insulin. The first few weeks she would have Riley test and after he had eaten she would call and say, " His sugar is __, he ate ___ carbs, he has ___ units on board, and the pump says to give him___ units." Then, I would tell her how many to give. Sometimes I gave what the pump suggested and other times I did not.

But, after a while I noticed I was telling her to give what the pump suggested every time. So, I wrote her a note and told her that she didn't have to call anymore if she doesn't want to. But, I did ask that she call me if his sugar is <80>200 at his meals. Why? I don't know, because I want to know, I guess. I can't quite let go of the reigns completely. I don't know if I ever will.

After the pump fiasco yesterday, I wasn't very happy sending Riley to school. What if his pump failed?

First off, I realized around 9:00 that when I changed his pump battery it cancelled the temp basal I had set. If I don't decrease Riley's basal by 60% for 3.5 hours after a site change he has severe lows. So, I called Holden and had him go decrease Riley's basal for me. OK, one crisis adverted.

Then, about 30 minutes later, his teacher called. His snack time sugar was 304. The pump suggested to give him 1.10 units for that and his snack. I told her to give him 1.00. Then, a couple of minutes later I remembered that because I had changed the battery after his breakfast bolus that the insulin on board had been erased. I calculated that Riley had probably received about .4 or .5 more units of insulin than he probably needed. That's a lot of extra insulin for his little body.

So, I called the teacher again and asked that she check Riley's sugar again in an hour because I was afraid he had gotten too much insulin and his sugar might crash.

An hour later, I was at a patient's house. This particular patient I have been seeing every week for over 9 years. My kids have been to see him. He's like a part of the family. One of the first things he asks every week is : "How are my boys doing?"

The phone rang in the middle of his dressing change. I excused myself and answered it. "Hi, Penny. This is P." I could hear the panic in her voice. "Riley's sugar is 384. What do I do?"

I was silent for a minute. I couldn't think. I was afraid to tell her to give him more insulin because he had just gotten insulin an hour earlier. But, I didn't want his sugar to go up any more. And, I was very afraid that either his pump wasn't working properly or the site change I had done earlier that morning was bad.

I told her that I would call my mom to come pick Riley up. She said, "I'm sorry. I wish I knew what to do." I told her that was OK, I didn't even know what to do myself.

Then, I called my mom and asked that she go get Riley. As I explained that his sugar was 384, my voice caught in my throat and I began to cry. I couldn't help it. I didn't want to. But, I did it anyway.

My patient just lay there silently. I felt so bad for crying, but my emotions just got the best of me. I sucked it up and finished his dressing change. All the while I kept thinking, "I can't take this anymore." over and over.

I was about 45 minutes away from home. I left my patient's and went to my mom's. An hour had passed since he had last checked his sugar.

I found him in the back yard with my mom. He ran up to me with his pirate's sword in his hand and ,while grinning from ear to ear ,invited me into his castle. My mom had built him a little fort in the back yard to play in.

She said he wasn't upset about leaving school. He was just upset that he wouldn't get to "play pirates" on the playground. So, my mom made it so he could play pirates at her house.

I ushered him into my mom's house with a bottle of ketone strips in my hand. It was lunchtime now, so I checked his sugar. It was 166.

I felt like such a fool. He would have been fine at school. All I could think when his teacher said his sugar was 384 was that I wanted him with me.

Everyone who deals with this disease knows that it's kind of a learn as you go disease. This school thing is new and I'm still learning.

His teacher just called and his snack sugar is 292. Ugh. I hate this disease. Really, really hate it.

I'm not panicing now. Now, I'm just mad.


Scott K. Johnson said...

Hey Penny,

It is really a "learn as you go" thing. That is probably the most frustrating part about it.

You are really doing very well at all of this.

Penny Ratzlaff said...


The most frustrating part is that just when I thought I had learned something, diabetes changes the rules. It just doesn't play fair.

Paige said...


I dread the whole "school thing" and Olivia is only two. Such a challenge...letting non-family members take on some of the responsibility for Riley's care. I know that it is probably hard for all parents when putting their children in school - adding diabetes to the mix increases things thousands of times over. It is such a blessing that Riley's teacher is doing so well and seems to care so much. Even so, I think that is completely normal at this stage to want to pull Riley to your side when things get wonky. I want to tell you to hang in there and that things will get better, but I am also conscious of the fact that diabetes is always changing things up, always zigging to your zag. We have to keep on keeping on. And it sounds like Riley is really doing well and enjoying school. That is the big picture.

Donna said...

The whole school thing has got to be frustrating for you. Luckily, though, Riley seems to have a teacher that is right on top of things & that's good. Hang in there; he'll be fine (oh and so will you - even though it may not seem like it right now.) Scott's right - it's definitely a learn as you go process.