The school - Home away from home

The school - Home away from home

When I was growing up in India, my school was always a home away from home for me.  This is not only because of the fact that we spent a huge share of the day at school every day.  But also because, I can unarguably claim  that I had the some of the most qualified and caring teachers for most of my school and college life.  My teachers played a huge role in my life. Sriram's teachers are playing a similar if not a more pertinent role in his world now.

We had moved to Sriram's new school barely 3 months before his diagnosis.  So, we really didn't know what to expect from his school soon after the diagnosis.  The day after the diagnosis, Raghav had mild temperature when he woke up.  We knew that we can't have him home that day as Sriram needs us more that day than Raghav.  We gave Tylenol to him and waited for an hour.  Senthil dropped him off Raghav at the day care and then we all headed off to Sriram's school.

Thinking about that day, I wonder why it didn't occur to me even once that we should let Sriram stay home that day to make sure we digest the situation ourselves first before thrusting a whole lot of people into it.  Sriram was diagnosed with Type 1 diabetes in an office visit after routine blood work.  Type 1 Diabetes diagnosis happens in the emergency room for a vast majority of patients.  Luckily, that was not the case with Sriram.  He was a healthy child in every other way.  Therefore, it never occurred for us to let him be at home the day after the diagnosis.

The secretaries at the school office said that they have no idea about Type 1 diabetes care and they have never dealt with a kid with this condition in the past.  It was a huge shock to me as the school had almost 650 kids at that time and hundreds of kids would have passed out of the school just in the past few years.  I knew that T1D is a rare condition.  But, I couldn't fathom that the secretaries of such a large school has never seen a type 1 diabetic child.  But, they were ready to listen to us and learn.  I ended up going  back and forth to school couple of times that day.  But, in the end it was as close as it could be to a normal school day.  Of course, the word normal has a new meaning now.

Sriram's class was an integrated class.  This means kids with special needs were also with him in the same class.  I was volunteering in the class couple of times a week that year.  Therefore, I was familiar with most kids including the special kid in his class.  I knew how well his teacher handles the kid with special needs. Of course, I didn't realize that this would be a blessing in disguise for us.  His teacher was very open to learn about Sriram's condition as he has also never handled a kid with Type 1 diabetes.  I told him frankly that we are as new to this situation as him and we need a lot of help from him.  And he did help out a lot.  He was very accommodating to us for the rest of the school year and was supportive of Sriram by engaging him in a lot small conversations about Diabetes.

I knew that usually teachers get a choice of the kids they have in the class and hoped that his teacher for the following year would be more prepared.  His principal assured me that it would be the case.  Sriram's second academic year was very different from his previous year of diagnosis as he has started using the omnipod insulin pump over the summer.  We were getting more comfortable with giving corrections and actively managing his blood glucose levels by that time.Senthil, Sriram and I were listening to the juice box podcast regularly.  The podcast's host Scott Benner manages his daughter's blood sugar levels almost exclusively through texts while she is at school.  I checked with Sriram's teacher if she was ok with us sending texts to Sriram while he was at class.  She was fine with it.

But, Sriram wasn't responding to most of our texts initially as he was unsure of how his teacher and classmates would react.  We brought up this issue in his yearly 504 meeting.  His teacher and nurse agreed to be part of a texting group and help us out in case Sriram doesn't respond.  The arrangement definitely helped in bringing down his A1C to all the way down to 6.3 by the end of the school year.

Sriram is in fourth grade this year.  Again, this year is going to be lot different from the last one as we started using the Loop, artifical pancreas system over the summer.  We met Sriram's fourth grade teacher the day before school this year.  She seems to be knowledgeable about T1 to a certain extent as her aunt passed away due to diabetic related complications.  This would definitely make her cognizant of the fact that high blood sugars are as bad as low blood sugars.

Kids with diabetes here in US are protected under the American Disabilities Act, also popularly known as 504 act.  Such legislation can go only so far as the people willing to implement them.  Therefore, schools, as in teachers and staff play a huge role in managing diabetes at school.

Sriram's school has been willing to provide us with the accommodations we have requested thus far.  We want Sriram to be as independent as possible this year to make sure that we are not involving the school and its staff as much as we did last year.  The new Loop system he is using is taking care of a lot of insulin adjustments.  Hence, our involvement is going down by the day.


Sriram's classmates were always helpful and he has never complained of any sort of bullying.  Sriram's fourth grade classroom has a whole set of new kids.  His school has over 100 kids in each grade and they juggle around the students every year.  Only 6 kids in his new class are familiar with Sriram's condition.  Therefore, I gave a talk to the class this week about Sriram's condition.  I explained how food gets processed in the body and how this process is altered in a diabetic's body.  I showed Sriram's CGM & pump to them and explained how they are used.  That lasted only for 10 mins.  The kids bombarded me with questions for the rest of the 20 mins.  I found some of the questions to be very thoughtful.  For instance, couple of them asked if there is a cure for this disease.  I told them that technology is the only solution for this as of today and the artificial pancreas system he is using is the closest to cure.  But, science is advancing each day and we don't know whats in store for the future.  They accepted my answer with a very dejected nod.

One other kid asked me directly if its possible to die because of diabetes.  I didn't want to scare her or rest of the class.  But, at the same time I wanted to tell the truth.  I gave a list of scenarios such diabetic ketoacidosis, severe hypoglycemia etc. could cause death.  I already knew from the show of hands that a vast majority of the kids had  a diabetic relative.  Therefore, I capped my answer by saying, taking adequate precautions and care would avoid most of these scenarios.  At the end of the day, I was glad that I spoke with his class. I think that I did a fair job.

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