Back to school - for me, too!

Whilst we have been at home, hunkered down and trying to get to grips with the pumps and the new way of infusing insulin, Tom’s teacher took paternity leave having become a first time father. This is lovely news, of course. He has been very supportive and caring about Tom all this year, and I am sure will make a lovely dad. However, this meant that today, Tom and Joe’s first day back to school with insulin in the pumps, Tom had a supply teacher in the class. Oh, and he had PE first thing just to make life even more complicated.

 There was no way I could leave him at school with a supply teacher, with the school new to pumps, Tom new to pumps and the supply teacher new to diabetes in general. So, I became an honorary class room assistant for the day. The head had to clear this with the supply teacher - who turned out to be a very nice woman as it happens - and if she had refused I suspect I would have had to keep Tom at home. It just wouldn’t have felt safe to leave him to cope on his own all day.

Blood sugars before PE were 18mmol! Oh joy, first dilemma then; lesson about to start gave Tom a 0.5U correction even though he had had a much higher bolus ratio with breakfast so was sure he would drop. Disconnected pump and went with him to PE. Lots of running and tumbling later, reconnected pump and did blood glucose to see if he would need the missing basal from being off the pump for over 50 minutes. Tom on 10.2mmol. Decided to leave him as he was and see what happened later. A very happy Tom went out to play with a nutrigrain bar, for which he bolused using his bolus wizard without giving it a BG reading. A very tired me sank into comfy seat and drank from funny toddler-style ’safety’ cup - they didn’t have them in my teaching day; we just used mugs (its amazing I never managed to scald someone!).

It was maths after break, not my forte to be honest but I can manage Year 4 level. Before lunch Tom was on 9.8mmol. He chose what he wanted to eat whilst I helped the key worker who is to supervise his pump at lunch time add up the carbs with him and programme then into the bolus wizard with the BG level. This means Tom is bolusing for his lunch whilst in the classroom and then has to walk over to the hall to eat. I explained how he cannot be kept waiting for more than ten mins at most, and then began to imagine all the things that can go wrong with this system. Must think some more about that one.

 Joe then came down from his class to show me his levels and choose what he was going to eat. I am adamant that he be allowed to do this for himself pretty quickly, but for the first few days we have to be sure he knows what he is doing at school. He had tested in the class before coming down to us, and had been on 4mmol. By the time he got to Tom’s room he was feeling properly low and had his 15g cho Jelly Beans. This then meant we had to wait for 15 mins in the cloakroom. Joe was missing playtime and so was the key worker. He came back up to 4.7mmol and took himself off to lunch. He had been at 12.8mmol at 10am so something is not working in his morning regime. I don’t think the bolus going up is going to stop the spikes. I think we have to do it with the basal and pull back the bolus so he doesn’t drop lower later.

Joe then was on 14.5 at home time - he forgot to do an afternoon Bm - and gave himself a correction dose. Tom had been on 10.1 at the 2pm test but dropped to 4.9mmol by 3.15pm. He treated himself for a hypo before he came out to me and then was on 6.6mmol by the time we got home. They both enjoyed choosing their smoothies from the firdge as a snack on getting home. It is certainly giving the freedom to eat and Tom’s main observation about today being back at school was the fact he only went to the toilet once. He usually goes so often he loses count. Joe was most pleased at the speed bolusing gives you to get to your food; none of the air-shot, insulin into leg, pack it away and then eat business he usually puts up with.

I am glad to have gotten the first day back out fo the way. Joe has his first PE lesson tomorrow which I feel a bit more prepared for and will go and watch to try and work out levels of activity and whether he should take off his pump. Tom will undoubtedly have another supply teacher, so I suspect I will be in school again for most of the time. Hopefully though we will get to make out the different patterns they will need for weekdays.

I have to go and get some coffee to trick myself mentally into staying awake (I only drink de-caff). I had quite a few wake-ups last night. No sooner had one child been high, had a correction and waited an hour to come down, then the other was high and I had to do the whole thing over again. I actually ignored part of the protocol last night, feeling sure Joe would come down and didn’t need a set change. It took two hours rather than one, but he did come down. The basals are just not right for the early part of the night yet. I have a feeling both children will need their largest amount of basal between 7pm and midnight.

I feel a large glass of red wine coming on as Olly is on duty tonight.