#72 Type 1 Diabetes: A Crash Course for Teachers and Schools with Kim Rossi

Katie: 0:00

Hello everyone. This is episode 72 of the sugar mamas podcast. And today we are doing another back to school episode called type one diabetes, a crash course for teachers and schools. I think as a type one parent, probably the hardest thing I've had to do is let my kid go somewhere where she's not under my care and control and where she spends her most time away from me is at school. So it is extra important to me that. I know she's safe at school. And I know that in the event of an emergency or really just a regular type one day, her teachers and the staff at that school will know how to help her and how to handle it, to keep her safe. So that's why I wanted to do a little mini series on back to school today. My guest is Kim Rossi, and I will let her tell you her personal and professional connection to T one D and just a bit. But first I want to make a quick announcement. Next week on Thursday, June 2nd, 2022. You will not see a new episode in your podcast. I'm taking that week off because we will be on vacation. I will still be posting on socials, but I will not be attempting to edit and publish an episode while on a plane or in a rental car. It's just not going to happen. However, as soon as I get back, we are launching into our think like a pancreas book club series that will last 10 weeks. And the first episode of that will be with the author of the book himself, Gary. He will be answering my questions about chapter one. So just a reminder to go grab your copy so you can follow along. That first episode will air on June 9th. I cannot wait. Last. My guest today is very involved with the organization, touched by type one. And if you'd like to learn more about that, go back and listen to episode number 66. Where I get to interview the founder and CEO of touched by type one Elizabeth forest. It is a fantastic organization and they are doing wonderful things. so go check it out and give them all the love and support that they deserve. All right. I think it's about time. We get started with. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks.

Kim: 2:49

my name is Kim Rossie. I have a daughter that was diagnosed 20 years ago with diabetes when she was four years old. She is now 24 years old. March 1st was our 20 year anniversary or diversity, I guess, is what you call it. Also before that, my niece who also we live in the same town was diagnosed 10 days after her first birthday. So that was 25 years ago. So we've had diabetes in our family for 25 years personally, with my daughter and being a parent of a child with diabetes for 20 years.

Katie: 3:26

Wow. I'm curious, you said diversity. Did they, was that a thing back then or is that a fairly new thing? The diversity?

Kim: 3:32

I don't know if it was back then. I think it is now. I, every March 1st, like I send a thank you letter to the people that take care of my child or did take care of my child's diabetes when she was younger. So far, I think a lot of parents do that. I don't know if my D my daughter has no, clue of what day it is. Every time they ask her when she was diagnosed, I have to tell her March 1st, 2002, she doesn't remember my niece remembers cause it was, you know, exactly 10 days after her first birthday, but most people maybe they get diagnosed young, have no clue, but the parents, I think, do remember that. And I don't want to say celebrate that, but sometimes you do want to say celebrate that diagnosis that you are still going and still surviving and doing well with diabetes could, is not easy.

Katie: 4:24

Yeah, that's what we celebrated. My daughter will she'd been diagnosed now for a little over a year and a half, but yeah, that's what we celebrated on the, on the first diversity, not diabetes. Cause nobody wants that. Miss we, we just celebrated our strength and resilience and just how much we've learned and how far we've come even in just a year or so. So your niece was diagnosed first and, right, correct. Yes. Yes. Okay. So when things started happening with your daughter, did you kind of know right away or did it still take you a little bit to kind of think, oh, this might be diabetes,

Kim: 4:55

Looking back now, you know, as a parent, you didn't realize it as somebody that now that does this as a job, we recognized it very early on to look at a four year old and say she was drinking three or four bottles of water in the 15 minute drive from preschool to home. And to look at it and say, okay, we were leaving preschool one day and I was like, let's go. And she's drinking out of the water fountain. And I went, let's go. And. Physically grab the water fountain. So I couldn't pull her away from it. The light bulb went off in my head because those were the same symptoms looking back that my niece had of extreme thirst, but really much harder to, to see in a one-year-old for my niece. But then you start putting all these little pictures together, like why is my four year old wedding, the bed? And that all came together. So we went to the pediatrician. We were never admitted to the hospital because we did have those symptoms that we knew of in our family. And what still gives me chill bumps to this day is my niece at the time was five. When my. Daughter was diagnosed. And my sister her mother, you know, told her and she's, and you're telling a five-year-old this too. So you think, okay, what does a five-year-old no, but she goes, Lexi, your cousin has diabetes. And my niece is like, oh, I'm so happy. And my sister is a parent's like, why are you so happy that she has diabetes thinking, why are you happy that now she's going to have to do all these things that you do. And my niece at five went because I'm not alone anymore. To say a five-year-old was aware enough that she was the only person that she knew that had diabetes in our family or at her school at that time was not so

Katie: 6:41

profound. That's very profound. That gave me chills. Yeah. That's, that's so sad and so sweet and just all of those things all at the same time. Wow. Well, that's a pretty good segue into my next question. Cause you mentioned your job and your profession, and I know you have a professional connection to type one diabetes as well. So why don't you tell the listeners what your professional connection is?

Kim: 7:03

I do. So I am now give all my fancy titles. Now I am now a registered nurse. I'm a certified diabetes care education specialist. So those initials are CDC CES. We used to be called certified diabetes educators. We just call ourselves diabetes educators and I will also. The diabetes program coordinator at Nemours children's health in Orlando, Florida. So we have four clinics that run diabetes clinics in a hospital. Of course, that takes care of children with diabetes as well.

Katie: 7:34

did you become a diabetes educator before or after? I'm assuming after just thinking about the timeline, but did you, was it before or after your daughter was diagnosed?

Kim: 7:44

It was after where I work now is actually where my daughter and my niece were diagnosed with diabetes. I was a professional dancer and a dance teacher since I had, you know, for as long as I've been an adult. And we were at Nemours. Great, great, great, great, great care education. And then we moved to Las Vegas for my husband's job. And when I went to Las Vegas, I quickly realized that diabetes education was. They didn't have that everywhere. You know, there was not a great facility in that location where we were that had tons of educators and tons of doctors and tons of nurse practitioners and dieticians. And so naively, I would say, you know, I just don't think I can be a dancer till I'm 50 or 60 years old. So maybe I'll just go and become a diabetes educator. I'll just go back to a nursing school or go to nursing school, not back, I hadn't started. Let me go to nursing school and then somehow figure out how to become a diabetes educator. That, that was such an easy thing. So that is what happened. And I was in the right place at the right time and a hospital that did not have any diabetes educator and became their educator. And then a job opened up back here in Orlando, where I'm from at the same facility that my child was diagnosed and my whole family still lives in Orlando. So we said, yes, this is a place that I want to be able to give back to the, families. Like I got that opportunity and was given for ha to have great education from those people. Now I can give back to families. So then we moved back across the country and I've been working there for the last 12 years. Wow.

Katie: 9:26

Talk about coming full, full circle. That's quite, that's impressive. I mean, I thought you had are, were maybe already a nurse, you know, that was your professional ready when your daughter was diagnosed, but you, you had to start from square one. That's crazy.

Kim: 9:44

And then the guy said so night, I was just going to nursing school. I was going to do that, you know, become a pediatric diabetes educator. And those nursing school is hard enough as it is, you know, once I got in it and realized that, and then to find a place to become a diabetes educator and a pediatric one, because there are so few of us out there, like I said, right place, right time. Sometimes the universe intervenes and says, this is what you're supposed to be doing now made things fall into line. So just happened to, you know, I think a little bit of hard work on my end probably did some of it, but some things were just where they were supposed to be at that time for me. And hopefully for the families that I get to educate.

Katie: 10:25

I have thought I have pondered it because I'm a physical therapist and physical therapy is on the list of professions that can become a diabetes educator. And so I feel like I've checked all the boxes, except for the thousands of hours that you have to have. You know, you, somebody has to supervise you basically educating people that have diabetes and working with them. You have to have the documentation of all those hours. And I mean, I feel like that's, that's really hard to do as a physical therapist. Cause you're not really a lot of my patients have had diabetes, but we're not talking about diabetes necessarily. I mean, it might come up when you're kind of making an exercise plan for them. But I'm like, no, I don't think that's going to happen, but it's, it was definitely intriguing to me. About a year ago, I thought seriously about it, but I think that would require right now I work from home for like a virtual physical therapy app. And I think that would require. Probably go back into the work, you know, go back to work full time to get all those hours. And I'm just not ready to do that right now. So we'll see. It is, it

Kim: 11:24

is it's hard. And even when I was a nurse on the, on the pediatric floor, before I started, you know, working there and at the endocrine practice, just taking care of somebody with diabetes does not count towards those hours, a thousand hours and two years of education that you have to do to be able to sit for your certification. It has had to be actual education on self-management or taking care of your diabetes at home. So it, it was going to take a lot. It took a long time to get to.

Katie: 11:54

Oh my gosh. Yeah, it, it definitely it's a lot. My sister is a registered dietician too, and she's thought about it at one point in time, but same thing, she like looked into it and she's like, you know what? I think I'm just going to keep doing what I'm doing. It's a big sacrifice. All right. Well, I know that you are very involved with the touched by type ones T1 in school program. So just tell us a nurse, how did you first become involved with touched by type one? And then how did you kind of become their spokesperson for the T1 in school program?

Kim: 12:21

So it's a very interesting story. And when it was happening, I didn't realize I was becoming involved with them. So since my daughter has been little, I mean, I think she had had diabetes, maybe five months, she has been volunteered for everything and anything. And I volunteer with her to, you know, go to walks, to go sell hotdogs, to be the keynote speaker at conferences where there's 3000 adults that are listening to her speak. So I will volunteer her or voluntold her for everything that has to do with diabetes to raise awareness, to raise money, to do whatever we need to. So I moved back when we moved back from Las Vegas and we were volunteering for a bunch of stuff. Somehow this lady named Elizabeth at the time, I didn't know how important Elizabeth was and what she was doing. Got our contact information. I still don't know from who. And she asked us if we wanted to, or my daughter, not may. She didn't want me at that time. Wanted to know if she could fill. My daughter talking about her experience with diabetes. And it's so interesting. Cause before touched by type one was actually called dancing for diabetes, but now that's just one part of touched by type one organization. So we met, I think it was at the veteran's Memorial park in Sanford, outside. She filmed her, they were interviewing her. She interviewed her and thought that was it. Well, then we did a couple other filmings for them about awareness with diabetes, you know, parents, what are symptoms of diabetes, still not knowing that we were getting involved with a big organization. And that was my fault. I should have, you know, research what, who are talking to then my daughter became a Seminole high school Dassler and it's their dance team and Alyssa. I was on this dance team at some point, and they really, really, really supported this dancing for diabetes show. So as a Dazzler, my daughter performed in this annual dancing for diabetes show and all of a sudden I was like, well, I know her that's who we did the filmings with. And all these people that we had been connected with somewhere else in these filmings was like, oh, maybe I should figure out what this organization is. And then we just stayed involved anytime they needed my daughter to do anything, to talk, or they needed me to do something I would, you know, as always would say anything you need anything that helps. You know, raise money ways, raise awareness, anything that you need, we are available for. And at some point through my job and their outreach and talking to them, I already was going to schools and speaking to school nurses about education on how to take care of people with diabetes. And they started this T1 in school program. So it was sort of just a really easy fit that they asked. Hey, do you mind going to speak to the nurses in this county or can you do you know taping during the pandemic when we couldn't go out to places for this? Or can you go to this private school? So I sort of just got involved because I've known them for years, probably since about 2010, 2011, and just evolved as they have evolved.

Katie: 15:36

gosh, they've grown so much. We Sarah had the opportunity to participate in the touch by type one, dancing for diabetes showcase last year. So we got to go and watch that. And she was actually on stage with all the other type one kiddos in their, like their big dance. It was very fun. So I love touched by type one. We're, we're pretty close literally. We also live in the state of Florida, so I feel like that's actually an organization that's doing big, great things that I could, you know, attend some of their functions. So it's,

Kim: 16:03

and for me having a background of being a dance teacher as well, and a dancer, it's sort of, at that time when it was dancing for diabetes, a really easy fit. So there are times that I've gone in their annual conference that they have when we were having them in person and spoke with, Staff or his parents or whoever. And then in the next section session, I was teaching dance to the kids with diabetes at the same time. So for me, it's, I'm like, oh, this is a perfect organization. I can use both of my worlds that I have had both the medical side and the dancing side in one thing. So it's wonderful.

Katie: 16:38

Yeah. That's great. Talk about combining all your talents. Wonderful. All right. Well, tell us a little bit about the type one in school program. I actually had a friend. A good friend of mine, whose daughter is also a type one diabetic. And she reached out to me and said, Hey, you should really do. This was like her, her daughter got diagnosed in the summer. So now it's time for everybody to go back to school. And so they're kind of scrambling to figure out like how it's going to work. Her daughter also is at a private school, which can be a little different sometimes. But she texted me and was like, Hey, you really should do an episode on like a crash course for teachers. Like what teachers and staff need to know when it comes to having a type one kid in their class. So that's kind of where I S the idea for this type of episode came in and then just interviewing Elizabeth. She's been on the show before. I learned about the T1 one in school program. So I thought I will, I will see who's in charge of that and ask them if they can come on to do a little kind of type one in school crash course. So tell us what the type touched by type one T one in school program. What, what resources does it offer? What information does it cover?

Kim: 17:41

So it offers both in-person hopefully we'll be able to start back doing in-person education. And we did some virtual training sessions as well. So virtual training sessions, I know are available if you contact them on their website and believe that's touched by type one.org, and then in-person too. If you wanted somebody to come out and speak with you, if that's allowed, now, that's something that we could do as well. So it gives or provides the opportunities for school personnel to learn from specialist experts to better understand what it's like to live with type one diabetes it's signs and symptoms, what to do and how to care for someone with diabetes and to keep them safe at school.

Katie: 18:26

When you have a session with a school or staff members, are you, is it usually just a one day for a couple hours? How long do they typically last?

Kim: 18:35

It depends. So we've done. There's the virtual ones I know are about an hour and a half to two hours, but we broke those up. They had some for transportation staff, they had it for nonmedical staff and then we've had it for medical staff. So it gets a little bit more progressive. So the ones for the medical staff, usually when we go, it could be a two to three hour session that we've done. Because it covers pretty much everything. And it also covers the medical part of it. How do they take care of, you know, how do they read the doctor's orders? What are situations that happen with them and answer their questions on how to use technology that's coming out and how to do that. Then you have the school, the medical staff, or nonmedical staff, sorry, you know, teachers, administrators, anybody else that would not be, say a nurse or a clinic aid or something that is nonmedical. How do you care for those kids? And we're not going to worry about in that that might be an hour, hour and a half. We want them to understand that. What diabetes is. And I will tell you, even though we do talk mostly about type one, we do also discuss a little bit about type two, because sometimes in how they treat diabetes, they are the same for children. It's not as different sometimes as adults. So we talk about diabetes in the whole about what it is, what are the symptoms? What can they do you know about testing? How do you take care of somebody in the classroom? How do you work together with the school medical staff and taking care of diabetes? How do you communicate with parents? How do they do standardized testing? How do we do field trips? How do we do get on the bus? All of those things that are not medical too, we discuss with the nonmedical staff. And then of course transportation staff, because they are going to come in contact with children with diabetes. There's would probably be the least, you know, what is diabetes? What are some symptoms of highs and low blood sugars that they need to be aware of and what to do in an emergency? If they were on the bus with them or being transported by them, there's would probably maybe be 30 minutes an hour, depending on what needs to be educated.

Katie: 20:55

So you, you said a lot that you're educating both the medical and the nonmedical staff, I guess I I've done a lot of assuming, and I should not ever assume, but I guess I assumed that if you were kind of called into a school to be educating the people there, that there wouldn't be any medical staff on hand, like for instance, at my daughter's school, there's there's not a nurse there. So we had to, we had a nurse come in and do some education for the staff before, before she went back to school. So, but you're also educating like the school nurse that's there.

Kim: 21:25

So I have done both most public schools. I think they have to have medical staff. It could be from a clinic aid that is been trained in practicing under the school nurse. It could be an actual RN Anything in between sometimes. So we want those people to be trained and they are the ones that need to be trained on. You know, even though it's a nurse and I will tell you, it's somebody that went to nursing school was a nurse. You don't learn how to take care of diabetes, like in the school system. And you don't learn a lot about type one diabetes, and you don't learn a lot about pediatric type one diabetes as an in nursing school or as a nurse, because that's not something that you deal with every day type two adults deal with that a lot more. So some of the people that become school nurses, maybe they spent their entire career as an or nurse somewhere, or as a nurse on an adult cardiac. And now they want to do something that they thought was going to be easier. I don't think so at all, but they wanted to come to a school and be a school nurse with all of its challenges because I've had somebody say, oh, I just want to do something easier. And I'm like, that's not school. Nursing is not easier than working in an Orr. These children are awake and you have not, you know, they have every element under, under the sun, not just diabetes, but I need to make sure that they know how to take care of diabetes and diabetes. What we do for it is changing. I mean, technology is benefiting type one diabetes, like, like you don't even know, you know, with all of the technology with continuous glucose sensors and insulin pumps. I mean, there seems to be as an educator every year, I'm having to get new training on a new device that comes out. So we are the ones, or I am the one, or whoever's doing that training or teaching the school nurses and the school medical staff. What has come out next, you know, over the last year, what has come out over the last year? How are they supposed to use it? What are they gonna see? New medications, you know, new rescue medications that come out that they don't know what they are. That's what I'm teaching them on top of reminding them that every child with diabetes is different. So in the public school, they still need refresher education as technology and treatments change. And if they are new to that profession as a school nurse or a clinic aid or something, you know, we do need to give them refreshers on what to do or educate them from the beginning on what to do with students with diabetes. Because I think a lot of people think. Type two when they think of diabetes, oh, they just can't have sugar. Oh. You know, maybe they have to check their blood sugars a couple of times, you know, a day, instead of what some of these children do where they're checking 7, 8, 9, 10 times a day, and they're wearing an insulin pump and a sensor that are beeping and the information is going to their parents and everything else. So, all of that information has to be given to the school nurses. So they have that information to be able to care for the children with diabetes and keep them safe.

Katie: 24:36

So are the, have you found that these are schools that like all of a sudden they had no type one kids at the school and now all of a sudden they do or are these schools that maybe have had type ones throughout the many years and are just needing a refresher? What have you seen

Kim: 24:51

both? You know, we'll have some schools that will come in and it means statistically one in every 400 children have type one diabetes, but if you have a school. It has 4,000 children and it, you should have what, 10, however, many kids not going to learn math, you know, you should have, but then you'll get kids that have 800 students and they're telling me, well, I have nine kids with diabetes, so that's way more statistically. And then you'll have a school that might have none or might have one. And those nurses, even though they have some knowledge, they really need the help when they've had their first one. And they also need help. How to deal with the teachers or the teachers need that education. How do we deal with so many? Cause you could think for somebody that is nonmedical, they could've gone their entire teaching career or however long, and never had a student with diabetes in their class. And now mid year when somebody is diagnosed, mid-year you start at the beginning of the year with nobody now, by the end of the year, you've got two people that have diabetes. And how do we take care of that? Or, you know, next year I have somebody coming in and I've seen their medical stuff and they have diabetes and I've never had a child. How do I do that? And then you'll have teachers that are like, eh, I have one or two every year. And sometimes that's good. And sometimes that's not good because as my experience was, we would have, we were one of the very first people ever, back 20 years ago that had diabetes that went through the school system. But then you would get somebody that said, oh, I had so many last year that had diabetes. And if they didn't take care of themselves well, that teachers sometimes really didn't know how to take care of my child or help with my child or if they were on a different regimen. They would assume that this is what my child needed to do, and everybody is individual. And that is something that I teach all in the school nurses, all the school personnel, that every child is different, even though they have the same diagnosis, we, they are all different, not just in what made me their medication type is. Or if somebody is on a pump or not, or on a sensor or not, their medications might be different. They've all had diabetes, different timeframes. So you could have two, 10 years. One 10 year old has had diabetes for six years. They are an expert. They could tell you everything about their diabetes. One has had it for 10 days. And even though a ten-year-old could probably help with giving themselves injections or some of the things that they need to be able to do with diabetes. This one that's had it for 10 days, clueless because it is brand new to them. And you could do that at any age. You could have a 15 year old that was diagnosed 10 years ago or 15 year old, that was diagnosed 10 days ago, or just, you know, they come to school Monday after being in the hospital with this new diagnosis. And they don't know. I mean, they've been taught how to take care of their diabetes, but that's a lot to take on for somebody of any age. So you have to remember. You can't put these children in a box and go, you have diabetes. I had somebody last year that had diabetes, same age, same class. You should be able to do the same things. That's not the case. And we have to remind both school nurses and medical staff and teachers and administrators that everybody is different.

Katie: 27:59

Yeah, that's such a good point. That's such a great point. I don't think I've really, just kind of, I don't think I've really brought that up with my daughter's teachers and you know, it's, I don't want to come on too strong to be like, you know, look, I know you might have a family member with type one, or you might have a friend who has a kid with type one, but you know, just know that everyone manages this disease differently. Everybody responds differently to insulin and low treatments. And so I would appreciate it if you didn't Pass judgment on my child and the way we manage things based on what you've seen in the past or in your own life and life experience. That's, that's a good point. Yeah, because it is so different and that, you know, it was somebody who was diagnosed 10 days ago, or very, very shortly ago there there's just so many more layers to it. I would think than somebody who's been doing this for years and years, you know, now there's, especially if there's a T you know, there's a, they're a teenager. They might be self-conscious, there's the fear factor. It's all still very scary and new. Do you spend any time educating staff and teachers on just the mental and emotional burden that diabetes can be? Or do you just focus on the medical side of

Kim: 29:03

things? So I educate on both parts on what has to be done, medical and the stress of having diabetes. Many adults cannot handle this diagnosis. So why do we expect children? To be able to handle the diagnosis, you know, not only do we also then layer on top of just being a child within school nowadays, you know, we look at middle school and I always pick that because my goodness, that just is a hard time trying to fit in and being the same as your peers. And then I'm going to give you diabetes, which is going to make you. feel, and sometimes on the outside also appear as so different. Like before I got to go to lunch with my friends and hang out and I didn't have to go to the clinic every day and then come back or I didn't have to leave class and come back. Or now I'm wearing, a device that tells not only me, but the entire world that I have some kind of medical, you know, diagnosis because I have to wear a sensor or a pumper or something 24 hours a day. It is very stressful. And you know what? Some kids are just stressed with life that we have gone through through the last two years or so. That's been enough for everybody. And now we're going to add diabetes on top of that. Oh my goodness. Yes. You know, we do have to remember that this is a stressful diagnosis and having. People around them that support them. If it's friends that support them or adults that should support them, there should not be staff either in medical staff or teachers or administrators that look at children with diabetes and look at less, you know, that they are less because they have this diagnosis, they have a medical diagnosis. I don't think anybody is going to look at somebody that has say asthma and go, we look at you as less because you have, as you're having an asthma attack and you can't do PE. But for some reason, when somebody with diabetes has a low blood sugar or doesn't feel well, or has a high blood sugar, then they look at them like, oh, it's your fault that you do that. It's not their fault. They have a medical diagnosis that is very hard to manage and we can't control every aspect of it. So we have to remember that you have to support these children. In their journey with Dyke diabetes, because if we don't, they're not going to be successful. If they are told to be independent and statistics show that of children. Independent with their diabetes care before the age of 18, they do poorly with their diabetes control for life. So do do I know that a child that is 17? I mean, I've seen it at my clinic. I've seen it with my child. Do I know, you know how to give injections and count your carbs and check your blood sugars? Absolutely. You could do that. You, when you were five or six years old, possibly. But do you have the mental capacity to understand that there are going to be complications if you don't know you don't. So if you don't learn that diabetes is important from the adults around you, because they're always checking up on you, then you're not going to do well for your life, because it just doesn't ever become ingrained that this is important that you take care of this disease and you take care of yourself. Hmm.

Katie: 32:33

that's a good point. Yeah. I'm really hoping this episode is something that not, not only parents will listen to you know, to kind of know what they need to come to the table with at like, let's say a 5 0 4 meeting, or just sort of any type of type one education meeting that you're having with people at your child's school. But I'm hoping it's something people share with, they're the teachers and staff at their school that have type one kids in the school so they can kind of just hear You know, just from two mom's perspective of what it is like to have a kid with type one. And just to come at it with maybe a little bit more compassion and empathy and understanding for what it is they go through on a daily basis, because it's definitely stressful. I know I was, when my daughter got diagnosed, it was the day before with her third grade year in the middle of the pandemic, it was 2020. And I remember, you know, I wasn't, I never, I don't even think I ever had the thought of, I'm worried of them thinking of her as less than I was worried about them thinking of her as a burden because the school year was already so burdensome with the pandemic that I was like, and here we are, like, here's one more thing that we all get to deal with now. And our school did not the only other type one kid at the time. Much older middle schooler because it's a charter school and they it's a K through 12. And and he was very independent with his management for the most part. So it wasn't really anything they had to step into often to, to help with. But so I remember thinking, you know, I just, I just don't want anybody to think of her as a burden and I don't think they have, I mean, I think they're they're more than willing to always answer my texts and, and answer my emails when a diabetes issue comes up. But. But, yeah, I just, you know, I think it's important for teachers to know like how they're talking to we're really just kids in general. I mean, we should be kind to everybody. Right. But you know, a kid with type one, like if they have a problem, you know, try not to say heavily or slouched down in your seat, like, oh, it's one more problem we have to deal with you know, pay attention to your body language, I guess, in the way that your tone of voices. Hey, just a super quick break to say thank you to our most recent, buy me a coffee supporters, Myrtle and judge. If you guys don't know, buy me a coffee as a way for amazing listeners like yourself to support the show, whether it's a one-time gift or a monthly membership, each donation goes to making this podcast come to life every week it helps fund things like the physical and virtual equipment needed to produce a podcast such as. I use pod page for that and a recording platform. I use squad cast for that. It also helps fund the podcast hosting platform that I use, which is bud sprout and the editing software that I use, which is descript. I truly appreciate support from listeners like you. So from the very bottom of my insulin cartridge, Have you been positively impacted by this podcast? If so, would you consider donating today and supporting the sugar mommas podcast? I will leave a link in the show notes so you can check it out. All right. Now, back to the show and my chat with. I mean, we should be kind to everybody. Right. But you know, a kid with type one, like if they have a problem, you know, try not to say heavily or slouched down in your seat, like, oh, it's one more problem we have to deal with you know, pay attention to your body language, I guess, in the way that your tone of voices.

Kim: 35:45

Yeah, I mean, we have had students that have come into our clinics or, you know, patients for us, but students that said, you know, and they're older, it's not a younger child, but younger children too. And they have said, you know, they've had a low blood sugar and they've had to go to the clinic or they've had to do something. And out loud in the class, a teacher has said, oh, are you using your diabetes to get out of class again? No mop every hair on the back of my neck, everything I'm like, what's your score. I'll call him right now. I will call him right now, because that is first. You just told everybody in the class what this child's medical condition was, which isn't fair. And you think that she's using a low blood sugar in your class to get out of your class when her sensor is alarming, I don't, most people don't want to have low blood sugar, so we're not doing that. And I did end up calling the supervising nurse and I said, this is going on. I don't know what class it is. This is the student. And I need you to talk to the parent. I told the parent to reach out to the nurse, even reach out to the principal because, oh, that, that made me very angry because. Our job is not to as, as parents and not letting kids be able to be in school because of their diabetes really gets me angry. And really, you know, that gets, I'm not their mom, but it makes my mama bear stuff. Just get so much like, no, that's wrong. I mean, I have gone to 5 0 4 meetings for a family because the school said, oh, they don't need that. And I was like, oh yes, you do. And they said, oh no, she doesn't. She has straight A's. I go, that's not what this is for. I'll come to the meeting there. She's like, will you? And I was like, yes, it's right down the street. I'll come at my lunch. So, I mean, I can't do that for every child, but somebody has got to be the advocate and parents, we do recommend, but sometimes they get such pushback and are told, no, these are the rules. And these are the, you know, what we have to do at school. I'm always telling me, no, that's not true. You know, there are laws that protect your children and there's laws that do protect the school and you can't say, oh, I'm going to miss school every day. When my blood sugar is something goes one point higher, one point low, you know, we have to all work together. And that's the thing, like we're all here for the common good of taking care of this child and making sure they get the education they need while staying safe with diabetes while they're at school.

Katie: 38:09

Yeah, absolutely. You, you, you mentioned go into a few 5 0 4 plan meetings. Is that something that the T1 in school program educates people on just the 5 0 4 in general? Like kind of what's in it or is it just kind of, you know, broadly mentioned since there's separate meetings for that type of thing?

Kim: 38:25

I would say, I know when I do it, I broadly mentioned it. I mean the 5 0 4 plan is something that anybody with a medical condition that needs accommodations should go to their schools and go and say, I would like to speak with the 5 0 4 coordinator at your school. You want to set up a meeting so you can set up accommodations that this school will now provide to support that student's education and to be able to take care of their medical conditions. You know, sometimes I will list a couple you know, students with diabetes should have access to bathroom and water, you know, they shouldn't, I know some schools. My child had this at one time and I was like, that's going to go away from my kiddo that you have a pass and you have so many passes to go to the bathroom. And if you don't use them, you get a special whatever. And I was like, oh no, we're not doing that. We shouldn't be doing that for anybody because you don't know what's going on with them, medically that they need to go to the bathroom more than somebody else. So now you're telling these kids not to go to the bathroom. If they have to, that's not really good. You know, they should be able to go to the bathroom. They should be able to have extra time to make up exams if they are out because of their diabetes. at lunch or anytime if they have a low or they have a high that they're able to treat those things and then they have time to make up exams. If they need you, that they are able to go on field trips and somebody will be trained to be able to be there, to take care of them. Be a parent, be a school nurse or somebody that's trained. You just don't send somebody on a field trip with no trained people. That's not acceptable. Another thing that I do recommend is that they are able to monitor or check blood sugars during standardized testing. So that might need that they move out of the normal classroom with everybody else. And they go to a classroom where there's somebody else that is able to monitor them, that they could have their sensor information. I know a lot of folks that goes to their smartphones. So we can't have that sitting next to a child when they're taking a test, but it could sit up on a counter with somebody that is watching that room. And if it goes off, their test, time is stopped. They're able to treat if they're high or they're low. If they have to go to the bathroom, they have to get a drink of water. So some of those things, you know, when we start talking about, I mean, I've, I have Googled 5 0 4 plans and. I've saw one with 74 accommodations. And I was like, I wouldn't be able to remember 74 accommodations. Like you don't take any tests if your blood sugars over X number. And then I thought, well, what if you have lunch? And then you have a spelling test afterwards, what if you're a little bit high and you you're never going to pass anything. You're never going to be on the take tests, but to say, you know, you don't take a test if you're low. No, that's yes. I don't care what time that happens. That doesn't happen. And if you're really, really high that you don't have to take a test because that does affect with your cognitive function and how you think about things. So it doesn't have to be 74 accommodations. I really don't think it needs to be that, that that's that's a lot. But couple that you think of, and here's the other thing when you're newly diagnosed and somebody says, go in and get a 5 0 4 plan and you're like, for what, what do I need accommodated. You have no idea. Now, some of these folks at this school, if it's a 5 0 4 coordinator, they might say these are some of the ones that we do for most of our children with diabetes. And let's do that. Now you can always attend it during the school year. Usually it should follow you from school to school and year to year. So you can always attend it when you, oh, I need this because I, this wasn't happening when they were diagnosed, but now I need this. Okay. We're gonna set up another meeting. We're gonna talk, it's gonna get attended. We're all gonna sign a copy. You get a copy. I get a copy as a parent, and then we'll go on from here and then we'll look at it the next year. So it is something that you do want to have in place, especially with how. much emphasis they put on some of these standardized testings. If not just for that, then I think that's something that everybody should have in place if they do have diabetes.

Katie: 42:25

Absolutely. No, I totally agree. I've seen people ask on social media, like, do you really think I need one? And everybody responds? Absolutely. Like, even if you don't think you need one, please go get yourself a 5 0 4 plan. I've already recorded two episodes on the 5 0 4 plan. One of them was much earlier on in the in the podcast. And then I just kind of did another one, like a part two, and that one's going to actually go live this week so people can get some more information on the 5 0 4 plan. so I just want to kind of touch on, you know, what, what do you tell teachers about keeping. safe in school. Cause it's all important, but I guess if you really have to break it down to what's the most important it's keeping them safe in school. So that makes me think of like the really emergent, low blood sugar situation. So what kind of you know, education and advice do you give to teachers and staff?

Kim: 43:14

So I think communication is key both from the parents, to the teachers, the teachers, back to the parents, also parents adding in the medical staff and the teachers with the medical staff. They have to follow this diabetes, medical management plan. Private schools don't have to, or sometimes we fill that out, but if it is a public school, then every child has to have the medical orders from the doctor. And it really does lay out their medical plan, but not everything that can happen or you can even think about. It can be in that plan because it is just the doctor's orders. You know, making sure staff are trained by going to touch touched by type one and watching what diabetes is, knowing the symptoms of what that child's low blood sugars are. Now we know that issues with high blood sugars will happen, but the number one emergent thing for somebody with diabetes is severe hypoglycemia or low blood sugar, or not even severe, just low blood sugar. That if we don't look at the symptoms and treat that it could go to where it becomes severe, where they not aware of their surroundings very severe where they have a seizure and they become unconscious or something. So that is something to keep people safe at school. parents do need to understand what schools can and can't do. You know, they, I know we've had some schools and some parents who go, I want them to do this. That's outside of a teacher's, you know, scope. I say, scope of practice as we talk about with nursing, but they're not medical staff. You don't want them to be the sole person that is taking care of your child's diabetes when they're in second grade, you know, or any grade they have, I don't even know how many students are in a class now at 30, 40 kids in a class. What if you telling them you treat this low blood sugar and you're not involving the school clinic or the nurse or anything, or having a plan outside that classroom? What if somebody else in the classrooms bleeding or gotten a fight or thrown up, or goodness knows what they have to deal with in classrooms? They have a lot on there. I, I used to volunteer in classrooms and I was like, oh, these people are saints. My goodness. And, and nowadays I don't even know, you know, with everything going on. I don't know how the, if they have volunteers that are allowed in the schools, so they're probably it, but you have to have a plan. You have to have plan of what's going on. I only did this from when my child was in second grade every year until she graduated high school, this next part. And I recommend this to everybody. You make a one page letter and you write it from the perspective of your child. So my daughter's name is Lexi. So I would say, hi, my name is Lexi. I am in your sixth grade class. If you want to put the period or whatever, I don't think you need to, I just need to put it in your sixth grade or fifth grade or 11th grade class or first grade or whatever. I have type one diabetes, my mommy or my nurse, or the school nurse will talk to you about this later on. But. I would list her symptoms of lows, because if you just list every symptom of low, that does no good because my child did not have all the same. You know, she was shaky, she got confused. She got really pale and sweaty. So I'm not going to list that she, some of these other ones that she didn't have, these are her symptoms of lows. If she has these symptoms, she has. Treat this immediately, you know, this school nurse will discuss how we're going to treat that. And here is my number, my parent number, you know, the school nurse will talk to you about stuff. And really that was it. And I, if she had an insulin pump or a sensor, continuous glucose sensor, I also would put that on there. Cause I wanted them to know if you know, and I would put if I'm beeping it's because one of my devices needs attention. My mom or the school nurse will talk to you about that. And then I put a current picture, usually was the last year school picture or something that we had taken during the summer. And every year when I walked in to do meet the teacher at whatever grade. I had one or two, or really like six or seven because every special PE art library, every teacher got that. When I w were meeting everybody, my daughter was just, by the time she was in ninth or 10th grade, she was like, please don't do that letter again. Don't don't, I'm like, we're doing it. And then when she, you know, and then in middle school and high school sometimes, or even elementary school, They'll have those switch classes. Oh, there's too many kids in this class. Is there not to now you're in a new class. Well guess what a new letter went in with the letter and you're picturing it to them and we'll be setting up a meeting later. And my thing was, is they knew who she was day one because the school nurses do a great job of getting medical care plans out to the teachers of anybody that, you know, comes in contact with that child. But it doesn't happen on day one of school, especially when they have all the ones that they have to do. So I knew day one, this person knew that my child had diabetes. Maybe she didn't remember him in ninth grade because they have so many classes that they could go. This person's telling me she's low. Oh, wait. That, that crazy mom gave me this thing. And I see her picture here and I know what she's talking about. I'm like, is this somewhere? So if you have a substitute, my child's picture and this is on the front. So they also know that this person has diabetes in case there's an issue because just putting the letter is great, but adding a picture to go, here's this child, this is the same kid that's sitting in front of me. Oh, it makes you remember it a little bit differently. So I always did that every year. All I did was change the grade. If she was, you know, she was on a pump and a sensor, if that changed. And I changed her picture every year and everybody got that. And a lot of the teachers were like, thank you so much because I have 40 kids in every class. And I changed classes, you know, or the PE teacher, how many kids do they have come in their class? And they would know from day one that this was going on and then set up a meeting with the school nurse and all of the teachers soon. I mean, especially elementary school set up a meeting sooner than later before school, if you can, but at least they will, you know, they'll have something day one to go. Well, I think that's huge of informing the teachers of the diagnosis and letting them know a little bit low. And numbers, if they need to call somebody and the school nurse is a reference at any time.

Katie: 49:45

Yeah. I th I would want to put in there too. We've had a couple of times where, I mean, maybe this is getting too detailed for that letter. You could do this in the meeting that you would have afterwards, but there's been a few times where I've you know Sarah has needed to. Go outside of the class to treat a low, I mean, not, not that she had to, but for whatever reason, they sent her out of the class to treat a load. She didn't need to. They just, they just did. And so I would learn about it after the fact that she's walking down the hallway to the, you know, the front office to deal with this low, without anybody else. So very quickly I realized that that needed to be addressed. That like, you know, if they are having these symptoms of lows, like you cannot send them out of the room by themselves. They need to be accompanied with somebody who can be with them in case something happens while they're in route or whatever the case may

Kim: 50:31

be. That is something that I also would put in your 5 0 4. I did not mention that. That is something that I tell teachers that I tell all medical personnel, because same as you, my child was in 60. We had just moved back to, you know, he, or she'd been in school for maybe a month, thought I had everything set up, you know, okay, you're going to go here to check your blood sugars and give your insulin. And she had a low and she always like, I always, even younger said, you will have something with you everywhere you go. For lows. Well, she had run through that and needed to go to where she was going. Well, that person was now gone, just not at where she was and all this stuff was locked up and there was no money to get it. So they sent her walking around, you know, middle school campuses. Aren't huge, but they're not small. Like, you know, some campuses walking around to look for, oh, the next look for this lady. And where can we find the key? And where is her emergency medication? Oh, that's locked up in another building. And the person that knows how to give her. All right. Well, I think we're going to be showing up at school tomorrow at nine o'clock when you open and we're going to have a meeting, I need the nurse there, you know, and normally I tell parents be a little bit flexible. You know, you're going to give your child a snack at 10 15 and the, and the, and the class snack. Is it 10 20 or 10, 10 or 10? That's a little bit flexibility. Having my child walked by themselves when their blood sugar is 50 around the campus to look for there. That is not flexibility. That is not going to happen. So they flexible on certain things and discuss things. But you are your child's advocate and it ultimately should be you making sure that they are safe. So if you have a good relationship from the beginning to say, yes, we're a little bit flexible on certain things, but certain things, no, my child will have a snack. I know the rest of the class doesn't have one, but my doctor has said that she will have a snack. It is on her medical plan and she will have a snack. Well, the teacher says, no, I don't really care what the teacher says. I'm sorry. This is my child's medical plan, and this is what she's doing. And we're going to have to figure that out and we're going to do it in the classroom. She doesn't need to be sent to the bathroom to have her snack or sent outside of the room because it makes it look like she is wrong for needing this. And it needs to be separated so that, you know, now separates her and makes her different than everybody surveys like, oh, why do you get a snack? Why do you get to leave class everyday? Are you being bad? Are you being whatever? So it is communication, but it is, you know, it's hard as a working parent, I know to know what's going on, but having that communication and knowing that if there's something that's not right, you got, we're not going to let this go. Okay, well, they walked this one time. Maybe they won't tomorrow. Oh no, we're going to have a call. We need to set up another meeting, you know, show up. You don't need to yell at school staff cause they're just trying to do their best, but we do need to fix things because we have to keep your children.

Katie: 53:27

Yes, absolutely. Totally agree. Yeah. I try to just as time has gone on, I've tried to make as many, I've tried to make it clear that I want Sarah to leave the classroom as little as humanly possible. I mean, there's really no need for her to leave the class to treat a low there's really no need for her to leave the class to treat a high. She can just push a few buttons on her pump and, and correct for that. You know, and you know what, even if your kid is on MDI injections if they're comfortable enough with it, they can sit right there in the classroom and treat their high like that. that's for sure. Allowable that's in section five before you know, that they are allowed to do

Kim: 54:01

it's actually in bill 7 47. So the state of Florida has a bill that if your doctor's office and the parent agree that your child can care for their diabetes wherever they want. So they do not have, you know, I've had students that were in 12th grade and principals saying, oh no, they can't check their blood sugar in class, or believe it or not, they can't have a weapon in class. And I was like, what, what are you bringing to school? And they pull out their landset device. Okay. Nobody that has diabetes looks as that as a weapon. We don't want to use it anyway, but then that's here. Let me give you a copy of this bill. And if you want, we can call and talk to a supervising nurse. If this still doesn't get resolved, because that principal does not get to determine. If the doctor's office and the parents say they are independent in their care. Now our practice does not do independence before middle school. I know there are some kids that are able to be for that, but just as a flat rule, that's what we do. Other practices are different. Other schools might be different, but for us, we start looking at that and we try and get them independent. You know, I don't, you are at school to go. But my daughter, when she was young thought she was at school to help other children in the clinic with the ice packs. And I was like, what are you doing? She hit the bump. I got the ice pack with the smiley face, from the freezer. Oh, thank you very much. Now go back to class. You were done taking care of your diabetes. So she loved it up there because the people in the clinic are generally so sweet and so nice and so loving and caring to our kids with diabetes. So they love it up there and they get one-on-one attention usually. So it's really nice. But they are at school to go to school. And as little as we can keep them out of the classroom, like you said, in checking blood sugars and giving injections, if that's okay if using their pump treating lows. Definitely. Now I don't expect a kindergartner all the time to be doing all this, or, you know, a third grader or even a sixth grader that was diagnosed over the weekend. That might be something that we still say for the first month, let's go to the clinic to get some help. So you know what you're doing. But like I said before, every child is different in where they are in their diabetes journey and where they are comfortable of letting other people do their care, you know, or you seeing them do their care and what help they need. So it is, we have to, you know, figure out what works for them, but be in school to be in school, not to give out ice packs like.

Katie: 56:34

I love that. That's so funny. Sarah hated leaving the classroom because if she felt singled out when she would have to leave, so she, luckily she did not enjoy going to the front office, but so it wasn't that big of a deal, but that, that's funny. I would like to know when you are educating people, how specific do you get with like different types of technology? Like, are you educating staff members on how to use certain pumps or systems or like, maybe glucagon's like, you know, now there's this nasal spray glucagon, and then there's the injectable glucagon. Like, are you getting into the nitty-gritty of that type of stuff or do you leave that up to like the parents.

Kim: 57:06

So first with the emergency rescue medications, there are now one to four, four emergency rescue meds. When I started, there was one, when we go UN I teach school nurses and that medical staff, I usually go over them, especially since over the last years or two we've added before it was just glucagon. It was the intramuscular injection. That's all there ever was. Then we added one that was an inch smaller injection. That was pre-mixed. Then we have the nasal spray. And now we have a pre-mixed one too, that looks like almost an epi pen. It's called the hypo pen. So you don't have to do any mixing. I still pull those out. I'll bring samples. Sometimes if schools ask for them, we can get them from our representatives so I can give them to supervising nurses and they can use those to train, especially clinic aids or at least have to show their own staff as new stuff comes out. So that. I've gone over in detail with nursing and you know, so for example, one year I went and did all of Elisha county. We did a three-hour education for all of Alicia county and I pulled out those and showed them. Cause there was new stuff. I did the same thing with Polk county. One year that we did the whole like did all the nurses in the entire county at once. I'd rather talk to, you know, 200 people at once. Then one person, two under times let's get it all done. So we did talk all about that. Now pumps, when we do education for school staff, We're a little bit more general. Now we talk about the pumps that are out and sometimes pumps that are coming out. The last time I did an education, the new Omnipod pump had been released two days before it FDA approved, not released. So we talked about it and I personally was like, I don't know everything. It does just got FDA approved. I'm not trained yet. So we did say this is, you know, coming to a school near you on a child near you. So we don't go into actual button pushing. I talked to them what continuous glucose sensors, read what they're going to see what parents are going to see what they mean. Like all the trend arrows. I talked to them about what those mean, and, you know, looking at saying a child going on a bus when they're 120 blood sugars. Beautiful a child going on a bus with 120 blood sugar with two down arrows, not beautiful. They're not going to make it home before they hit low. So to think those things that we think about an insulin pumps, because the parents or the children get really detailed education and they should be getting that from their practices and their diabetes educators or their pump trainers on how to use that. A lot of times the children are doing the button pushing, especially as they get older, but for younger children that need help the parents, we talked to them and say, you need to educate your school nurse or your clinic aid or whoever, and that's who should be doing that supervision. You know, certain schools are different, certain ages are different. So is it a teacher that's able to watch that? Yes, but I still don't love that because the other reasons that I said before that, what if something else comes in class, you know, Johnny and Susie are fighting over in the corner and then Sally's thrown up on something and then somebody else is having an issue. And somebody having a low, who do you take care of? First, the fighting, the throwing up something, an asthma attack or the low. And I think that needs to be that's when the school nurse or whoever that's medical staff that needs to come and help with those medical issues. So the teacher can take care of the teaching or maybe behavioral issues in the class. So I don't, we don't go into detailed, like this is where you would change a Bazell Rainer. This is how you would insert a sensor. That is, I think the family's job to do that. And the family's job to. Educate the school staff on that.

Katie: 1:00:51

that's something I really want to make sure we do before next school year. Sarah's on the Omnipod and I haven't had to go up there very often for a pump change, but there's been a few times, like one day her pump just fell off and the other day, another time her Kanyola was completely kinked. And so there's been two or three times where I've had to go up to the school to help her with a pump change. But I would, she always carries an extra pod with her. So I would like for there to be somebody there that knows how to, I mean, it's, it takes three minutes to change a pump and I'd really rather not drive 20 minutes to get there. And 20 minutes home to have to change a pump for three minutes. I mean, you know, I was willing, but now I feel like we need to get somebody educated on, on how to do

Kim: 1:01:29

that. And being in a private school sometimes has different challenges, especially I know many of them do not have nurses. Cause those are the, some that I've been into and done education for all the staff when that new diabetic had come into the school. But. You know, children, if their pump fails or if a sensor fails, they should always have backup injections or backup a meter and to do finger sticks. So there is a way to continue giving care for diabetes. Even if those things fail at school, there should always be that stuff there at the school. If the child is not yet able to, you know, do PA pump site change, because apart is much easier than some of the other ones too. But, you know, you can always do injections. You could do MDI for a lunch or something, and you could still do finger sticks to know what the.

Katie: 1:02:24

Yep. That's a good point. I probably need to, because now that Sarah's on a pump, I don't really have her carrying around like all of the, the, you know, the pins that she would give a bolus with. But maybe I just need to have an extra and leave it up at the front office and paid something like that happens. And honestly, Sarah can do her pod changes on her own. She just prefers to have the emotional. Occasionally physical support of an adult. So it'd be good if somebody knew how to just sit there with her and make sure she's going through all the steps properly and everything. Okay. So let's see. What, what questions should parents be asking teachers at the beginning of the school year? I know I always ask anything that has to do with food. Like what time are you gonna be eating snack? What time are you gonna be eating lunch? And physical activity. I always ask about, you know, w when is recess every day, what day of the week is PE and how long does it last? What time does it start? You know, are you okay with me having your cell phone number in case there's absolutely an emergency or whatever the case may be, but what other questions should parents be asking teachers other than that?

Kim: 1:03:20

Well, I think to, to do that one page or something that gives them information on their trial, I think everything that you just said is perfect. I am from a thought of. I think that the school nurse, if you have one, I know you said that your school does not, or the clinic aid should be the point person, because if that teacher is off for the day or out of the room or dealing with one of the other things that we have talked about and you text them or send them a message or something, and they aren't able to get to it. If you see on the sensor, you know, if somebody that's on a sensor, not everybody's on them, but if you see, Hey, I recognize that my child is going to be low. If we don't intervene within the next 45 minutes, I think it should be the nurse or somebody administrative or whoever, you know, if it's the school, if it's the teacher, because if you don't have a nurse in certain schools, I understand that. But I still think that should go to the nurse. Cause that is that person's job. So to call them or text them, but then is that teacher going to let you know. Every time they are absent. If they're out sick, if they're on vacation, do they let you know that? Because if not, you could be texting them all day and they are somewhere getting their nails done and they're pedicure and they're not going to answer your message or, you know, they're just off, they're in their deductible, whatever they're doing, you know, that's you need to have, is it the clinic office? Because even if you are texting an individual school nurse, the same thing, they are off they're out there dealing with something else, but you have to have, how are we going to communicate things? You know, if something's going on and I need to let you know something. I definitely think knowing the time of does the class have snacks, you know what your child's schedule is like they have breakfast at this time. This is the time we want to snack. This is the lunchtime. What do you do for parties? Like, can we say if somebody brings food in. That it's given to given out at lunch. You know, if the cupcakes given out, let's give it out at lunch. So most children can go ahead and add those carbohydrates to their carbohydrate. Count at lunch, we do it at, you know, nine 30 in the morning. I don't know why a teacher would give kids cupcakes at nine 30, but let's say we do it at nine 30. Your child may not be able to have that snack with that carbohydrate count at that time. So then we say, let's save that till snack time, or let's add that to lunch, or let's bring that home at the end of the day. And we can have it for dinner because excluding them completely from it. And that's the thought of, oh, people with diabetes can't have sugar. Nobody should have cupcakes, every meal, even though I want to, and my children would have argued when they were little that we should, but no should have that. So to have it occasionally, and I know it's hard end of the school year, we got some birthdays, we got this, we got that. All the rewards that we seem to give are based around food and stuff, but sometimes that's got to come home. I mean, I have the story of a wonderful teacher that went out and bought this little cupcake holder and the little girl couldn't have cupcakes at that time. So she would put the cupcake or whatever the snack was in this little holder and would send it home with this little girl every day. So then she could still have it and made a big deal out of you get to have this at a home with your mommy and daddy, are you good to have this at home or whatever? So it's just communication and to say, I went, you know, I learned over the years as a parent, my first letter that I gave out gave out the formulas that my child's pumped into the school, that teacher didn't need to know any of that stuff. It was like three pages long later on. I realized we just need to give symptoms of Lowe's and my telephone number. And if she's beeping, she's fine. She's not, you know, it's, it's not whatever. So it's evolved the same thing with the food and, you know, carbs stuff saying, okay, we can have this at this time. You can't, you got to send it home. I think that's just discussing that with the teacher and. Parties, you know, I even went and I sent a letter out to all of the parents with permission. If you're going to send in food, can you please send in the food label? So I know how many grams of carbohydrates don't write down what you think. Cause I don't know what a sir, please just send in the packaging so my child can still participate in have this. Cause I think now you're not allowed to bring in pre-made stuff. It has to be packaged, right? Most schools. So back then you could bring in whatever, you know, my child, 18, 19 years ago, you could bring in whatever it was. But now at least to go, can I please sit down a Lennar to every parent and explain why my child has type one diabetes. She can have these snacks, but we have to have that food label. Please send that in nowadays. You could say, could you just take a picture and text it to me? Here's my number. So then you would know as a parent, how to include those snacks into your child's diabetes.

Katie: 1:08:27

unfortunately I wish it wasn't this way, but it definitely is, you know, when you have a type one in your family, your lives just revolve around food. So I just have tried to make it a point to the teachers. Like, I know it's a pain, but you know, if you're gonna bring in treats for the kids, like, please let me know what the carb count is or what you're bringing in. And then if somebody, another kid brings in a treat, just let me know what, what it is. I mean, I'm, I'm, you know, you can even guess guesstimate for a cupcake if there's not a label on it or whatnot, as long as you have a picture of it.

Kim: 1:08:54

Yeah. But then you bring in something out, you know, they'll bring in muffins. Sam's club they're as big as their head. And you're like, I can't even think about it. Like, I know a cupcake with icing what that's got around, but this muffin of chocolate chip muffin, that's bigger than my child's head. I can't even comprehend how many carbohydrates that has in it. So then it is, can I get that label? Something else you might want to talk about with teachers? And this happened during the pandemic when we had some kids on, you know, when we're all on video, but something that one of my child's teachers did instead of her making a big deal and having to get up. When she had a low, the teacher said, can we have a secret special signal that you don't have to get up? And what it was is my daughter would raise her hand in the air and hold up her pinky, not her whole hand, but just her pinky. And she knew that when she held up her pinky, that she was feeling low and it was, she was so what they did. She had like her stuff in like a little, this was maybe second or third grade in like a back corner. She had all of her stuff and she would go sit at that table there and, and have her, her juice or whatever she needed to if it was in the classroom. But she wasn't even going to ask her why she was getting up. She saw the pinky and that, that was what happened during the pandemic. We asked. Kids. Like if you have to step away from your computer, cause you're treating a low or you need to change a pump site or do something, how does the teacher not see you? And we, one of the parents like said, I told them to get a blue piece of construction paper and they would put that over to where the teacher could see that blue paper or whatever color, you know, blue for diabetes awareness blue in front of the camera. So when that was up, she didn't have to ask, well, where did Lily go or whatever the name was, you know, she knew she was taking care of her diabetes and when she was done, the blue paper went away and there she was back on the screen. So just some things about especially younger children. Great, an older children too. How do you want to let me know if you need to do something with your diabetes between the tr you know, and it was, my daughter was like, I have a special signal with my teacher. Nobody else has this signal. So it actually met her, made her feel special with her diabetes and being able to take care of it. And she didn't have to sit there and get up and walk and try to explain to her that she was low or felt low. She just did it. And this was well before sensors were out and stuff. So it wasn't as if she was alarming. But even if your child got an alarm on their apple watch or their phone or whatever, with a sensor or their pumps, They would be able to signal the teacher too and let them know.

Katie: 1:11:32

I love that. That's a great idea. I don't know. I don't think Sarah has a special signal that she gives to her teachers, but I know the few times that I've had to text the teachers to be like, Hey, Sarah is low and she hasn't responded to my text. I know that they have texted back like, okay, I gave her the signal and and I don't even know what the signal is. I should be asking more questions now. Like the more I sit here and listen to you, I'm like, I need to ask some more questions, but you know, they'd be like, okay, we gave her the signal and I'm like, well, you know, it makes me happy to know that they're like not shouting in a class, the classroom, you know what I mean? Like, Hey Sarah, you need to eat some Skittles. But they're, they have a way of communicating with her. Her lows are like, Hey, you need to check your phone or whatever it may be without making it a huge, a huge deal. So that's,

Kim: 1:12:16

I feel like a bat signal, except you, it would be a tooth box or something that goes up in the corner, you know?

Katie: 1:12:22

Yes. That would be great. You take one to the end of a flashlight and she could just clip it. Oh, well, thank you so much. I guess let's end with you know, I would just love it. If you have any words of encouragement for maybe staff members, teachers at a school who are just a little intimidated about having a type one kid in their vicinity. Cause it can be nerve-wracking especially if the school isn't used to having type one. it can be a little intimidating at first. So do you have any words of encouragement for, for teachers?

Kim: 1:12:54

Well, you can do this is of course always. I mean, they're taking care of these. They're a teacher. They can do anything, I think, cause they they're just superheroes in my mind, but get educated, listen to podcasts, you know, talk to your school nurse, go on and do the education stuff from touched by type one. The more you get educated on anything, I think the more comfortable you feel with it, you know, talk with that parent, even if you've had children with diabetes in the past, this one could be different and is going to be different. Not could be, is going to be different. So really learning that child, but you can do it. And I will tell you, I tell the school nurses, I tell the teachers, I say, thank you. Thank you. Thank you. Because as a parent of somebody with diabetes, I knew that I could send my child to school and they would be safe at school. And you don't know how huge that is because you spend 24 hours of your day, every day, worrying about your kiddos diabetes, because it doesn't go away at night and it doesn't go away on the weekends. It doesn't go away, you know, during the summer, it's there all the time. So to know that you have extremely knowledgeable and caring people that are willing and able, and they do help to take care of your kids when you're at school. I always, you know, as an educator, thank you. But mainly as a parent of, of some incredible people that got my child through her entire school career, the other thing too is these kiddos, these kids with diabetes, I want to say they're bad asses. You know, I don't know what I'm looking around. I'm alone here, but they are incredible kids. They are amazing. They can do anything they want. I don't want you to look at them and say, because you have diabetes, you can't do a, B, C, and D, or you won't be able to. That is not true. There are very handful, maybe like three things, job wise that they can't do, you know, active military long haul truck drivers before commercial airline pilots. And in the last couple of years, we've had one that it was commercial airline pilots who really two things. My daughter is a police officer. So that's a pretty, you know, difficult job. And if she can have type one diabetes and be a police officer and, you know, professional athlete teach. Supreme court justices. They can do whatever they want and diabetes should not stop you from encouraging them to reach for the stars. So really, you know, don't give up, you know, don't say don't cut them some slack because, oh, I have diabetes. I can't do that homework. Oh yes, you can. Let's treat your low let's fix whatever's going on with your diabetes. And other than that, you expect them to shoot for the stars. And they they're, they're an amazing group of people. They're people with diabetes, they're usually much wiser than their counterparts of the same age. Cause they deal with a lot every single day. So, you know, push them there, help you. There'll be able to, with your help, there'll be able to.

Katie: 1:16:12

Yes, absolutely. That's such a good reminder that we shouldn't, you know, we shouldn't be coddling them or treating them any differently just because of their diabetes, because you're exactly right. Most of the times they're, they're more awesome and stronger than a lot of the other kids out there, so they can handle it and they can be challenged just like any other kid or student. well, thank you so much, Kim. Thank you. That I know that was a long recording, but I appreciate you sticking with me. I think school is just one of the most topics I see that come up on just, you know, all the different social media groups, where parents of type ones are gathered together. So I think there's going to be a huge help to parents and teachers and just staff members at schools. So thank you so much.

Kim: 1:16:53

Oh, you're very welcome. And again, if you, as I've volunteered my daughter for everything, anything that has to do with diabetes, please, if you need anything usually configure out, you know, how to help and volunteer or whatever you need. Well,

Katie: 1:17:04

thank you so much. And I will definitely be leaving a link in the show notes to you know, maybe your people are listening to this and thinking, Hey, we really need to have somebody come to our kids' school. Or, you know, teachers are thinking we need somebody to come to our school and give us a little bit education. I will definitely leave a link in the show notes to, you know, the T one in school touched by type one program. So people can easily find that and sign up for the, the classes.

Kim: 1:17:26

Yeah. And they D they know how to get hold of me. And hopefully, like I said, we'll be able to get back in person and do education because videos are great, but it is, you know, you can't ask questions and specific stuff. So it's always wonderful in person to be able to do.

Katie: 1:17:40

Yeah. And thank you for volunteering your time. That's a lot of time. I mean, if you're spending 2, 3, 4 hours with these people, every time you're doing one of these educations, that's quite the sacrifice. So thank you very much.

Kim: 1:17:50

Oh, you're very welcome. And like I said, it's become a passion of mine of having these kids take care of their diabetes at school. Cause I I've had some bad experiences, well, one or two, and then they ended cause we put an X to it, but you know, I hear a lot of things that kids have to deal with and it's not always from students. So as much education as we can give people and help them. That's what we're here for.

Katie: 1:18:14

Yeah, that's right. All right. Thank you again. Have a great day. Thank you, you

Kim: 1:18:17

too.

Katie: 1:18:18

You're welcome. Bye. that's it for our episode today, I will be leaving a link in the show notes to the touched by type one in school program. if you want to learn more about that and perhaps even schedule some education for your kids school, I will also leave a link to the two episodes I have done on the 5 0 4 plan, which are episodes number 16 and 17. All right. My friends, I will chat with you soon, but until then stay calm and bolus on by.