Tuesday, August 27, 2013

Back To School: The Odds

When youngest daughter turned 3-years old and was diagnosed with type 1 diabetes (t1d),  there were no other children in her preschool with t1d.  (There was one kind secretary with an adult t1d daughter but that is an entirely different story.  I still can't help but smile when I think of her wise ways of teaching me how to start this journey!)

The following year, at age four (fall birthday), our youngest daughter started kindergarten at our local public elementary and yet, still no other kids living with t1d. 

By her first grade, I was wondering if we would always be the 'only family'... and while part of me hoped so - since no child should ever live with t1d - a part of me wanted her to have a friend to share and connect with.

In the ironic way that often happens in real life, our oldest daughter was then diagnosed.  Which meant that we had a 'friend' for our youngest.  You can imagine the mixed bag of emotions that was presented to all of us on that fateful day in December.   If you want to read more you can click HERE.

However, our family had the only two children with t1d in the school.  Which once again, you can imagine the mixed message there... surely, our family was doing something to cause this problem in both of our children.  Looking back, I think that period marked the time that I really decided to advocate for a cure and to dispel the nonsense that the general public thought about how type 1 diabetes was caused.  IT IS NOT FROM FEEDING MY BABIES SUGAR, PEOPLE!!!!!

Another year more and another child - for the first time outside of our family- was diagnosed.  I remember crying the day the news came in and surprisingly feeling every bit as sad as hearing of our own children being diagnosed.  I also remember my youngest daughter excitedly wanting to meet him and wondering if he needed her help.  Although, my oldest daughter had moved on to middle school, it was she that came back to her old elementary school to talk to his class about type 1 diabetes - bringing a flurry of excitement and coolness to the younger kids, whom many wished for their own insulin pump, just like hers.

Fast forward to today... our youngest is starting that same middle school that her sister was at just two years ago.  The secretaries told me that there are six kids enrolled at the school that are diagnosed with t1d.

Our oldest daughter is entering junior high and from our initial 504 meeting, the assistant principal shared that there are six kids dx with t1d as well. 

I know the odds are that someone would have been diagnosed.  It is inevitable.  We haven't found our cure - YET. 

However, in our small town, in just these two schools, we went from 1 to 12.  Those are not my kind of odds. 

We need a cure.

And if you want to donate to help us reach that cure, please consider purchasing a Naturally Sweet Sisters t-shirt.  The sale will close on September 1, 2013, so this is the last chance to own an original shirt.  $3.00 of every shirt will go directly to JDRF.  CLICK HERE TO ORDER

Or feel free to donate directly to JDRF by helping our Walk to Cure Type 1 Diabetes under Team Naturally Sweet Sisters.  CLICK HERE TO DONATE

Thank you!

Sunday, August 25, 2013

Back to School: Binders That Are Cute and Functional

Photo: The cutest 7th grade binders in the world!  Reece Ohmer
Super cute binders found by googling Free Binder Templates

My oldest is heading into seventh grade. 

Wow.  Writing that still gives me pause... when on earth did that sweet little baby become such a beautiful young lady?

Sigh.  It just happens.  If you are a parent of a toddler or grade-schooler, watch and see.  The change happens in a blink.

This year, oldest daughter changes classes seven different times.  In our school, that allows for a variety of core subjects, a few electives and PE throughout the year.  Since I am new to parenting this kind of junior high student, one of my fellow mom friends advised me on the 'Binder System' which our school tends to use.

What the Binder System means is that each subject requires one binder.  Within the binder is a series of tabs for organization of class work, a calendar for homework and one pencil pouch. 

Photo: Diabetes mamas...   binders have glucose
Check out that binder pencil pouch.. see the roll of glucose tabs? 

The tabs are fairly self explanatory, but the calendar offers a dual purpose.  Not only will our student write in things like homework or projects due, but she will also record blood sugars on exam days.  That way, if she bombs her test, we (the teacher, oldest daughter and the Naturally Sweet Parents) can refer back and see if she is entitled to a re-test.  It's a great solution for a difficult situation, especially since many of the tests are now done completely on-line and often are totally paperless, with only a grade appearing on the report card.

The other interesting item in the Binder System is that each binder contains a pencil pouch.  This is designed with the purpose of never needing to have a student arrive at class without a pencil.  The pencil pouch will hold extras of pencils, erasers, calculators, sticky notes or even hand-sanitizer.  Taking the use of the pencil pouch one step further, each one will also house a roll of glucose tabs for emergency lows.  Talk about convenient!  Our oldest daughter will have everything she needs for any situation that arises.  It makes all of us feel much more comfortable with the idea of her walking around a very large school with only a few minutes in-between classes. 

Now, you may not feel that this system is right for you and that is OK too.  I shared it with some of my other type 1 diabetes friends and they felt very strongly that the best way for their children to attend upper grades is through the use of a Trapper Keeper or large zip folder.  One of my dear friends said that it worked so well, her son is planning on taking it with him right through college. 

Whatever system you intend to use, it is great to think of ways to incorporate type 1 diabetes care that are seamless for both you and your children.  I listened very carefully to my oldest daughter when she said that she would feel uncomfortable eating a snack while everyone else is watching.  For her (and at this point of time), she asked for 'smaller sized snacks' that she could discreetly eat in the classroom.   She also asked that except for PE, she wanted no 'low boxes' in her classrooms.  She said she would feel awkward having to walk through the class to get a snack.  In PE, she felt comfortable as she could keep a small box in her gym locker and discreetly eat what she needed. 

Since I was once a seventh grader, I completely understood.  This is the age of awkwardness and of needing to fit in.  So absolutely!  My goal as a parent is to make type 1 diabetes a part of her life that she embraces and not something that she begins to despise.  Together, we choose to start off the year with the roll of glucose tabs and she also agreed to carry (and to eat if necessary) No Gii D'Lite Bars by Elizabeth Hasselbeck.  I am not endorsing these but they sure are delicious and what is nice, is the small size.   Oldest daughter can eat one in two bites and still, get 12 carbohydrates and 8 grams of protein.  That should be enough to bring her blood sugar back up and keep it there for several hours. 

I will be posting more in the days to come on how we manage type 1 diabetes and back to school, so keep checking back.   If you are already back to school, I hope this gives you some more ideas for modifying what you are currently using.  From one t1d parent to another... it sure does take a village!

Thursday, August 22, 2013

Back to School : Naturally Sweet Sisters Defense Strategy for Lunchroom Workers

In a recent conversation with a newly diagnosed type 1 diabetes mom, she asked me how her shy daughter should try to handle the sometimes, over zealous, cafeteria monitors.  She shared a story in which, her daughter feeling intimidated over needing a few minutes extra in the cafeteria, was uncomfortable staying, left and felt "low".  The mom further explained that the workers were not understanding of why her daughter should be allowed 'special treatment'.  The daughter was too shy to explain and the mom was forced to come back to the cafeteria and stay with her daughter.


Now is it just me or does this type of situation just break your heart?

As a mom of a very shy kiddo until about the end of second grade, I went through many similar situations.  We even had one unfortunate issue with a cafeteria parent taking a leftover wrapper away from my daughter so that the worker could figure out where to buy the food that I had packed.  As a strict rule during that time, we had been very cautious about explaining to our daughter that no wrappers were to be thrown away until her aide had been to the cafeteria to count up her carbs.  Our daughter understood this rule but felt powerless in stopping the cafeteria parent and instead of speaking up, placed her head down on the table and cried until the aide found her several minutes later.  

That very sad story resulted in a hasty meeting with the principal and the creation of this little laminated card that went into her lunch box for the rest of the year.  In fact, while we have never had that situation again, our daughter has requested to continue the lunch card just so that she feel less worried about the possibility of it happening.


Even typing this out, I still feel my chest tighten and that was from YEARS AGO!

The card is on a cute scrapbook card stock and the words are very simple.  You can choose to add a picture of your child or not.  You can also create another version to be placed in the coat pocket for recess workers or for bus drivers.  Just tailor the words to suit the situation. 

And hopefully, it will NEVER be needed. 

Come back tomorrow for even more Back to School ideas.  See you then!

Hello! I have type 1 diabetes and need to match my

food intake to my insulin dosage.  That means that I

must save my containers, leftovers and empty

beverages.  I may also need a few extra minutes in

the cafeteria to eat my food.  If you need further

information, please see Mrs. XXX or Mrs.

XXX.   Thank you for your understanding.

Monday, August 19, 2013

Back to School : Naturally Sweet Sisters Free Lunch Carb Counts Sheet

The joys of school lunch!

This week, I am focusing on sending our children safely off to school.  It's an enormous task and one that even as a seasoned type 1 diabetes parent, still dreads!  I would much rather have my little girls home with me.  But to school they must go, especially if they are going to achieve those lofty career goals of pilot, dolphin-trainer, singer, interior decorator, fashionista and as always, pediatric endocrinologist and scientist that will one day cure type 1 diabetes!

Yesterday, I gave you a free chart on how to have school staff understand type 1 diabetes at a glance.

Today, I giving you a free sheet for counting carbs for school lunches. 

My kids prefer to have their lunch packed my mom every morning.  While they are certainly old enough to manage this task on their own, I like being able to make sure that they are getting good, sound nutrition and a nice balance of carbs to protein.  I feel much better knowing that they have their carbs pre-counted and that all they will need to do is check blood sugar, eat food and enter carb totals into their pumps to be bloused with insulin.  It's still a lot of extra steps that most kids do not have to do, so making lunch seems like a very small task to give them at least one break in the work load of type 1 diabetes care management.

Now on my sheet, you will notice that I have the 'lunch box item' which is the food that I packed, the Portion Amount in Lunch Box, which is how many that I packed, the number of carbs for each item, and the total Full Serving of Carbs. 

In that way, if I packed 20 grapes, and my little three-year old only ate 10, her aide would know to dose her at the rate of 1 carb each for a total amount of 10 carbs.  The aide would then carry that information over to the yellow box and send it back home in my daughter's lunch box for me to review.  The next time that I packed her lunch, I might even opt to pack less grapes.

You might be wondering at why I chose to dose after lunch in that scenario.  Well, when my daughter was younger, eating was unpredictable.  The safest way that I could think of was to post-meal bolus.  For us, it worked and now as both girls have grown, they have the maturity to know how much they want and to bolus ahead of time.  For our family, that seems to have happened around age 9.  You may have children ready earlier or later, as everyone is different.

Now that both of my girls have reached that older latitude, I still keep the same information because there are days where they are more or less hungry.  They can see what I packed, add up what they want to eat and leave the rest.  Sometimes, the leftovers become and after-school snack and in that case, the carbs are pre-counted and ready to go. 

This will be the first year for my youngest daughter to not have an aide looking over her shoulder, so I plan on adapting the card to remove the yellow box. 

You can also use this sheet as a tool for the school to calculate the carbs in the cafeteria lunch.  Have them write it down and then, send home with your child for you to review. 

I'll let you know how it goes with her being solo for the first time in about seven years.....  wish us luck!

Tomorrow, look for another handy idea on school lunch time.

Carb Counts for School Lunch (Must Use to Calculate Insulin Dose)  
  For Office Use
Lunch Box Item Portion Amount In Lunch Box # of Carb Each  Full Serving Total Carb Actual # of Carbs Eaten
Questions?  Call Parent at ________________ BG_______ Total # of Carbs Packed   Total Actual # of Carbs Eaten  
Name:         Date:___________
Carb Counts for School Lunch (Must Use to Calculate Insulin Dose)  
  For Office Use
Lunch Box Item Portion Amount In Lunch Box # of Carb Each  Full Serving Total Carb Actual # of Carbs Eaten
Questions?  Call Parent at ________________ BG_______ Total # of Carbs Packed   Total Actual # of Carbs Eaten  
Name:         Date:___________
Carb Counts for School Lunch (Must Use to Calculate Insulin Dose)  
  For Office Use
Lunch Box Item Portion Amount In Lunch Box # of Carb Each  Full Serving Total Carb Actual # of Carbs Eaten
Questions?  Call Parent at ________________ BG_______ Total # of Carbs Packed   Total Actual # of Carbs Eaten  

Sunday, August 18, 2013

Back to School: A Naturally Sweet Sisters Free Printable

Back in '11 when they were just little beans heading off to school!

Going back to school is never easy. 

First, there is the voluntary lists of things to buy.  Like new tennis shoes that look 'just so', blue jeans that come from 'that store' and even lunchboxes and backpacks, which at this point 'are not too babyish, mom'. 

Then the involuntary lists arrive in our mailbox.  The schools send requests for school supplies like pens, pencils, highlighters, paper and notebooks, etc., etc.

More often than not, the school list will also include Kleenex, Lysol wipes, animal crackers and oh yes, the approximate number of 48 individual glue sticks.  Really, do kids eat those glue sticks or what???

In our Naturally Sweet Sisters house, I also pick up things like sharps disposal containers, alcohol wipes, test kits for the locker and class rooms, glucose tabs and oh yes, the approximate number of 48 mini juice boxes.

Thank you to the diabetes monster for making me throw those extra juice boxes in my red Target shopping cart!

Life with type 1 diabetes takes that list a step further with meeting with the school nurse, the principal, the assistant principal and various teachers to craft both a care plan and a 504 document. 

So what I thought I would do is create a series of things that I have found useful to use over the years for helping my kids enjoy their school year as 'kids first, diabetes second'.

Today's post is about a document that I created back in '06 to help my youngest daughter attend pre-school safely.  Since she was so little at the time, and also extremely shy, I thought having a quick reference sheet for the staff to refer to would be a huge help in determining her type 1 diabetes needs.

Here are the details up close..... your chart might read differently as everyone has their own unique diabetes care plan, symptoms and ways to manage hyper and hypoglycemia.  Consult your pediatric endocrinologist for the way that is best suited for your family.  This chart is an example only.

Child's Name

Type 1 Diabetes


Target Blood Sugar Range 120

2012-2013 7th Grade 






Blood Sugar (Glucose) 



Unresponsive, Seizure



Inject GLUCAGON (red/orange case - in Blue Bag) and CALL 911

May be: Hungry, Dizzy, Shaky, No Focus, Irritable, Pink Rimmed Eyes, Under Eye Circles, May Not Cooperate Suddenly, Spacy, Lays Head Down, Tired, Tears, Pale, Sweaty


Hypoglycemic VERY LOW

Give (1-2) 15 Carb Juice Box or Carb Snack from bag, Recheck CHILD in 10 Minutes to make sure Blood Sugar is in Normal Range.  Enter carbs/BG in pump.  Call Parent.

May be: Hungry, Dizzy, Shaky, No Focus, Irritable, Pink Rimmed Eyes, Under Eye Circles, May Not Cooperate Suddenly, Spacy, Lays Head Down, Tired, Tears, Pale, Sweaty

60< 100

Hypoglycemic TOO LOW

Give (1) 15 Carb Juice Box or  Snack from bag.  Enter carbs/BG in pump.  Call Parent.

Normal Behavior



Bolus for any snacks/meals.

Says She is Hot, Thirsty, Says Tummy Hurts, Cranky, No Focus, Tired, Sleepy, Can't Concentrate

200 - 300

Hyperglycemic HIGH

Give a correction bolus with or without a snack. Offer access to water.  

SYMPTOMS ESCALATE:  Says She is Hot, Thirsty, Says Tummy Hurts, Cranky, No Focus, Tired, Sleepy, Can't Concentrate.  Personality has an abrupt change and may not get along with peers.

Above 300

Hyperglycemic VERY HIGH

Call Parent and give a correction bolus.  Offer access to water.  Check urine for ketones.  Make sure BG number is in range before giving any academic testing.








Green Animas PING Pump - Apidra insulin

The staff loved it!  They declared it to be a great relief to have a chart to refer to, especially as the world of type 1 diabetes was so new to them.  The following year, our principal asked if we would feel comfortable sharing our chart with a neighboring elementary school.  "Of course!" we said without hesitation and from there, it went to several different schools and through out our local JDRF support group. 

It made me feel proud that something that we created out of a need was actually useful to others.

The sheet has been adapted to suit our daughters growing life and now, I actually print two copies, well about a 20 in reality, as I have two little girls living with type 1 diabetes.

We have added instructions in our 504 plan to teachers to include this chart (with a picture) of our child(ren) for all use by all guest teachers and guest bus drivers.  The secretaries at our large middle schools also used it to help staff (like custodians and food service) understand more about the way type 1 diabetes affects our children. 

All in all, it is one of the most important back to school documents that we send with our child. 

This is a PDF file.  While you won't be able to make changes without converting it to an excel spreadsheet, you can also make your own version.  At the very least, you can see a reference sheet from which to make your own copy.

Tomorrow, I will post a reference for handling carb counts and packed lunches.