Diabetes Notebook and a MATH Lesson on Corrections

So..school supplies are showing up on shelves.  I'm getting New-Crayon-Crazy already!  Yippeeee, I *heart* new crayons!!  New notebooks, folders, paper, pencils, scissors, glue, colored pencils..and all things Diabetes are getting ready for that first bell.

I have a Diabetes Notebook (actually called a Care Guide : ) that I made Mary Claire's first year of preschool (at three years old, gah!), and I just keep updating every year.  Now, Clay needs one too.  Boo.  And they'll be at two schools, TWO NEW nurses this year.  Eeek!!

I took some pictures of the table of contents and the pages in the book (yes, she was into peace signs last year..):
 

First is the Table of Contents, and then there are tabs for each section.  I just printed this on cardstock, then added stickers.  Cause I like to p-a-r-t-y on paper.

Second is our Emergency and Doctor Contacts.  All our numbers, doctors' phone numbers, hospital numbers, family members, Minimed help line, pharmacy..goes on down the line.  Hopefully, they can find SOMEONE to help them, ha!  No, I resisted adding 9-1-1.  And no..I didn't take a picture.  I already have enough crazy people calling..I don't need any more!  Well, I didn't mean you, of course. ; )

Symptoms to Watch is important..especially for substitute teachers AND nurses.  Just in case.

These are 4x6 cards I print (and tape a current photo onto) for specialty teachers (PE, Music, Library, Counselor, etc.) and the office.  Just in case there is a substitute in there too.  (The card even goes outside with the recess teacher on duty, just in case there is a sub for another grade level teacher.)  They usually tape them above their desks or put in their substitute notebooks.  Weird things only happen when the teacher is gone.  Trust me.  All our contact numbers are on the back of each card also.  I'd rather 18 people call my cell phone about her acting weird at lunch than them try desperately to find a nurse on duty.  Seriously.  My caption is almost as big as my picture..cool.

And then..printed instructions for administering Glucagon.  'Cause have you ever tried to unfold and read the teensy, wrinkly, tissue paper instructions that come in that little red box?  When your child is passed out?

Page 2.  Notice Call Mom.  So I can freak the heck out with you too.

Section Three is Quick Reference.  This is the Morning Blood Sugar Check chart (like for Dummies.)  If her blood sugar is this..do that.  Makes it hard to mess up.

Chart 2: Lunch Blood Sugar Check for Dummies.  You'd think someone could use a regular font or something.  I know..so boring though! 

 

Afternoon Blood Sugar Check.  Ditto.

Last Chart: Correction Ratios for a high.  Find the time of day, then the BG, and use the correction required. 

**Note: you can also do the reverse if needed.  If your child is under their blood sugar goal, you can reduce their basal to bring them back up to range.  Example: if Mary Claire's bg is 90 at her lunch check, she's 10 BELOW her target range.  I can reduce her basal to 90% (since she gets a 1.05 units/hour during lunch time) for an hour, and it'll reduce what she receives by a .1 unit.  So..she'll rise in bg about 9.5 points over an hour, since her sensitivity (how she reacts to 1 unit of insulin..one unit brings her bg down 95 points) is 95.  Make sense?  

*Math Lovers:  Just use their sensitivity rate to figure.  If she was 80, I'd reduce to 80% for an hour, if she was 75, I'd reduce to 75% for an hour..etc. It works if she's getting around a unit per hour.  If not..keep reading.

*More Math Fun:  If your child's sensitivity is 200, they get a .1 correction for every 20 they are over their goal (usually 100).  If their bg is 140, they get a .2 correction, if they are 220, they get a .6 correction.

IF they are LOW, and their bg is 80 (20 under goal), you could reduce their basal by .1 unit/hour to raise them without food (so take their basal rate per hour, subtract .1, and figure the percent you need to adjust to.. If their basal is .65/hr, you'd reduce to 85% for an hour since 55/65 equals .85).

*Feel like eighth grade algebra?  I know..FUN!!  Ask if you have questions of if it's plain as mud.

Then I have a section (you know..just in case) on checking blood.  Assuming she's passed out?  Acting hyper and won't obey?  Substitute when she was four?

Informing them..in case they didn't use the Quick Reference Chart.

What the heck..I added pictures for how to check her blood too!  It's a big fold-out poster of instructions.  Pin the blood on the finger! : )

And..how to give boluses on her pump.  These were in here from when she couldn't do it herself.  I just leave them in..for posterity's sake. : ) I used to have huge picture pages of the pump and the functions..but she doesn't need them since she boluses herself..and it made the notebook much thinner to take them out.  And didn't pop open my 3 rings.  I hate it when that happens.  And then your paper comes out the cracks. : P

Last section: Snacks and Carbs.  I always have teachers ask me what kind of snacks she can have.  Should they buy *special* things?  (NO!)  Just give her what everyone else has, and she gets insulin for it.  Here is a handy guide.  I adjust the bolus columns (for before and after 10 am) every year.  As she grows..and becomes more insulin resistant.

This is what I print, cut into fourths, and send in her lunch box. (and yes, Clay's too)  EVERY. DAY.  I write in her lunch foods, the carb counts of each food plus the total carbs, and figure the insulin/bolus.  If she's high or low, she writes in the correction.  (Like +.3 or -.1) 

I felt like I needed to cover all the bases in their care guides, even if the nurse at the school had known my child for five years...I had to be prepared for a substitute at all times.  Better an ounce of prevention than a pound of cure.  (ok..a pound of driving up to the school to pick up my child because someone didn't have a clue what to do with their blood sugar!)  And believe me, the notebook came in HANDY a LOT!! : )

I will say there are some times that a phone call to mom is the only solution, so I tell them to call for ANY LiTTLE THiNG.  Sometimes I need the school nurse to know that my child has a new site and new insulin (be gentle with them!) or that they are stressed (be aggressive with the insulin!)..or that they might be coming down with illness (ditto..aggressive!  Raise the basal rate by 160%!).  Sometimes I just have insight from home that they need to form an action plan for the day.  

I'm not a doctor.  I just pretend to be a pancreas..and try to mimic it's every move.  And pin those moves into charts.  Because control (and a chart!) makes me happy.  And everyone knows if Momma's happy..

Are you still awake?  Did you get Math Brain Fog?  WooHoo!  Class dismissed!  Go forth and color with new crayons!! : )

Or run around in your robe with a naked chest!

Or eat Cheerios on my new chair!

I love y'all.  Or I wouldn't have taken all those crazy pictures of charts.  And allowed you into my control-y, chart-y world.  For reals..it's Friday night!  Hugs!
 

Make every effort to add to your faith goodness; and to goodness, knowledge; and to knowledge, self-control; and to self-control, perseverance; and to perseverance, godliness; and to godliness, mutual affection; and to mutual affection, love.

2 Peter 1:5-7