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Would LOVe to be on contact with parents from ONTARIO, on this forum.

Discussion in 'Parents of Children with Type 1' started by Serenia, Jul 21, 2012.

  1. Deal

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    I think you are misjudging my intentions. I have sent letters and received responses from my local and provincial representative. I was wondering if you were getting a similar message.

    My signature tag was modified in Jan 2010, just under 3 months after being diagnosed. Notice it says we added Lantus? I asked at our first quarterly endo appointment for the script as I felt I could manage the extra shot at school. I also felt overnights would be easier without the spike NPH has and we would be able to get lower A1C's by using Lantus as our basal insulin.

    Not all parents can manage lunch time shots at school and that makes the use of NPH very helpful in that scenario. Sometimes primitive tools can be very useful if you know how to use them.
     
  2. C6H12O6

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    Well we also live in an age of evidence informed decision making when it comes to treating patients, and I doubt that you will find a journal article that claims the use of NPH is superior to lantus, levimir or csii.

    Injecting peaking insulin at bedtime is beyond irresponsible and counterintuitive. I gathered from your signature that you were using NPH and Lantus. I?m not trying to be mean to you but in the case of NPH in addition to lantus to me it just boils down to a case of you can put lipstick on a pig but its still a pig.

    It just seems like the peds diabetes teams are in cahoots with the schools around here. The OP makes sick kids sound like a house of horrors (okay a bit of hyperbole there)
    (ex Sick Kids CDE says- Sorry the school won’t do glucagon too bad so sad. Oh here's some NPH we won’t bother to tell you about other treatment options or provide you with any literature on any other treatment options – as to whether that’s ethical – again too bad so sad. And ironically the NPH puts the child at a greater risk of a severe low. And once again another resounding too bad so sad. )
    I sure hope they didn?t teach this nonsense about diabetes is a chronic illness, therefore, it can?t cause you to become acutely ill and die the OP was educating us with
     
    Last edited: Jul 23, 2012
  3. Lisa P.

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    Deal, as much as I appreciate the passion of the other posting member here, I think it's important that no one ever feels the need to justify their choices here regarding care. I have seen many people over the years here who have intentionally added older insulins in because the specific way they use the insulin makes for better care for their child. I have considered making a change myself, and may some day. I'm finding that our Humalog lasts for about 6 hours with Selah, so that if I overbolus her to avoid a breakfast spike I often coincidentally, didn't plan it, wind up being able to give her lunch without a shot and it can actually make for a much more even day, in some cases. It has made me interested in the older, longer acting insulins. It's all good.

    But if you don't mind my asking, are you saying you don't have the choice to use MDI and the log insulins (besides Lantus) at all? You're not saying your endo won't prescribe those, are you? And you're not saying that you only have the choice of using a long acting insulin or going to the school to give shots yourself, are you? Is it accurate that children in public school in Canada cannot receive insulin injections or life-saving Glucagon injections from school personnel? Tell me I'm missing something or I'm misreading.
     
  4. MomTo4Girls

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    We were perscribed NPH (actually Humulin N) and Humalog at diagnosis this past February. This was because we do not have nurses in Ontario schools and if we wanted to use Levemir or Lantus instead, we would have to arrange for a special nurse to come into the school just to bolus or we would have to go. Our teachers and administrators do not have to give glucagon or insulin injections as per their union agreements. This is not true of all Canada I believe. There are other provinces with much better legislation in this regard. We continue to contact our members of parliament to try to change this but thus far it is like banging our heads against the wall :(
     
  5. Sarah Maddie's Mom

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    Fwiw, up until very recently, here in CT, only school nurses could administer glucagon ( I don't know about insulin, I assume it was the same).

    To be honest, I would never expect a teacher to administer insulin and were I a teacher I'd probably not want that responsibility. Glucagon is a bit different in that it can do no harm ( other than vomiting and a mess of bgs following, especially if used at the wrong time) and isn't a day-in, day-out medication.

    We were also on NPH for a long while. It really wasn't that horrid for us, YDMV though.;)
     
  6. Lisa P.

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    Thanks for the clarification. I am honestly shocked, I didn't know the practices were so different. Of course, my only experience of any part of Canada is one train ride into Canadian forestland 20 years ago and the crush I had on the star of "Due South", so my ignorance is not surprising. :p:p
     
  7. diabetesgoddess

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    I was asked to jump into this lively thread and provide a bit of insight into the Canadian system. I do not live in Ontario but have been dealing with school issues for the past 11 years.

    You are correct in noting that while the Toronto Public School Board has implemented a diabetes policy, the Catholic board has not. The Trillium video is a great teaching tool, as is the Kids in Schools packet from the Canadian Diabetes Association. You may also want to look into getting assistance from CCAC (?). Depending on your child's abilities, they can provide a nurse to do lunch time injections and monitor behavior.

    Lows can be very dangerous and are serious. It is wonderful that your child can already detect his lows. Make sure that you are able to tell your child's teacher(s) what his symptoms are and specifically how you treat him. This should be noted in a care plan. You may also wish to create a file to be given to supply teachers which gives a quick diabetes care lesson for your son. This is also why some schools will ask to display your child's picture in their staff room. It is to be used to identify a child with specific health issues on the playground or in the halls. If your child is wandering aimlessly, he is more likely to receive help if all of the staff is aware that this is a sign of impaired blood glucose levels.

    You can arrange to meet with the principal and teacher before school starts in September. If you are not confident meeting with them alone, your diabetes center can often provide someone to assist in the education process. It is vital that you be there however, because as the debate over the best method of insulin delivery has shown, everyone is different and responds differently. The school staff needs to know your son's needs...not someone else's.

    Once you have the school situation under control, you can then work with your clinic to look at other insulin regimens. As people have mentioned, many people do not use NPH insulin any more (although some people do do quite well with it). They will use a long lasting insulin or an insulin pump. Ontario does have a provincial insulin pump program so you do not have to overly concern yourself about private insurance coverage.

    I hope you have a slightly clearer picture of what you need to do and how to begin. Contact the school. Contact the public health nurse. Arrange meetings.

    diabetesinschools.ca is a great resource for Ontario and is run by very dedicated parents.

    Please let me know if you have any more specific questions.
     
  8. Deal

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    I have no problem sharing anything I know or do. At the time of diagnosis I was in no position education wise to question any instructions I received from my endo/diabetes team. They had us start out with NPH and Novorapid and as you all know we had a steep learning curve and I was on a crash course reading everything I could about our new reality.

    It was here on these boards that I learned about Lantus. When I brought it up with the endo he had two concerns. One was how would ds react to having an extra shot or two a day, and the other was could we manage to coordinate giving shots at school. He mentioned the legal ability to get a nurse to come in but had some bad experiences with area nurses being understaffed and not showing up or not really diabetes trained and didn't recommend that option. That was not an issue for us as I am able to be at school within minutes of a call and also have all of my kids home for lunch. After this brief discussion he went ahead and wrote out a script for Lantus and we never looked back.

    It is true that in our school teachers/staff will not administer insulin or glucogen. Their union does not allow it. The board does not allow it. There is no standard care plan for us. This ended up working to my advantage. I approached the school and presented information about diabetes and a specific school plan for us. They questioned things like testing in class and my explanation for everything was that I wanted ds treated as closely as possible to other kids and not have him lose time in class. For two years this has worked out and the school has accommodated us. There is no guarantee that some of the provisions we have would be universal under legislation.

    Unfortunately some parents have a negative experience and end up battling their school over issues. This is a terrible position to be in because the school holds all the cards. If the school wants all 'needles' (including lancets) to be stored and administered in the office then that is the way it is for some kids. If they don't want any snacks in class and the parents cannot convince them to make an exception then that is the way it is. Each parent has to convincingly negotiate for what they need. They cannot demand it.

    For the most part teachers are willing to help out with test times and snack requirements post testing. Our endos team has offered many times to come to the school and help with any issues we may have or simply to educate the staff. They spend quite a few days a year in various schools in the district. In my experience the school staff care about the kids and want them to be happy and safe at school just like we do. We have had great luck so far as have most parents I have talked with.
     
  9. Lisa P.

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    Thanks, that's interesting!

    Personally, I feel like most everything is best worked out on a case by case basis between individuals of good will, I've found in the schools here we've worked with that you cannot count on that happening, but it could be a chicken / egg thing -- I tended to run into staff that wouldn't do anything they didn't legally have to do, so maybe having more legislation in the schools has made the situation worse, not better? Still, being entirely within the school's discretion on essential medical issues would make me very insecure, and the glucagon thing is a biggie for me. I can't help but think this system means many, if not most, Canadian parents of CWD must make some pretty big adjustments to their lives to make this work? I wonder how the private school and home school situation sits?

    In any case, thanks for giving me more appreciation for the hard work Canadian parents put into this.
     
  10. C6H12O6

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    You do realize that all of these actions ex not allowing testing in classroom etc violate human rights legislation ? The refusal to provide reasonable accommodation ex glucagon in an emergency situation violates human rights legislation .

    It?s pretty sad when you have to fear retribution against yourself and your child if you stand up for their legal rights. Aren?t people who become educators supposed to love and care about the wellbeing of children?
     
  11. Deal

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    This is my last response about this in this thread. Feel free to start a different thread but be prepared to quote specific legislation and legal opinions to support your claims. Your interpretation of our human rights differs from the mainstream. Our children do have a right to public education. You would have an easier time arguing that blood testing in the classroom creates a risk to the other 25 students then you would arguing that blood testing in the office precludes a child from obtaining an education.

    As well, in my experience all the educators do care and about the well being of the children in their care and go above and beyond their required legal duties to assist us. However, as in most personal interactions, they will be less willing to accommodate an unreasonable persons demand versus a friendly compassionate request for assistance.
     
  12. C6H12O6

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    Since you don?t care to listen I suppose this post is pointless. Making up an excuse that blood glucose monitoring poses a risk to others in close proximity would just be outright fear mongering not to mention insulting and hateful.

    I just sincerely hope your child does not suffer brain damage or worse due to glucagon not being administered by school staff. The original poster was correct in asserting that Sabrina?s law came as a result of Sabrina dying. The fact that school staff will administer epi pens is because Sabrina lost her life.
     
  13. Christopher

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    Just so I am clear, you are against classroom testing? Interesting. My view is that if you make a child go outside the classroom everytime they need to test, that is time that they are missing the teachings that all the other children are sitting there receiving. To me, that is "precluding" them from getting the same education as the child without diabetes. I want my daughter to have the same access to an education as a child withought diabetes. I do not think that is an "unreasonable demand".

    But to each their own. :cwds:
     
    Last edited: Jul 24, 2012
  14. Mimi

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    Really uncalled for and very aggressive.

    I'm not sure what you are trying to get across here? Are you angry because the poster has not taken it on as his personal crusade to force teachers to administer glucagon in the rare instance it might be needed at school?

    Or are you angry because the poster has had no issues with the staff/teachers at his child's school and has worked with them and within his abilities and limits to ensure his child is receives appropriate medical care while at school?

    I really don't understand your aggressive attitude. :confused:
     
  15. C6H12O6

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    I don?t agree that refusing to administer glucagon is appropriate or okay. Statistically you could argue that you rarely need a seat belt , but I am sure you make your kids wear seatbelts.

    He is the only one who seems to be offended by this assertion - inferring it is right wing in one breath and that my assertion is incoherent in the next.

    I am not in a position to file a human rights compliant bc one needs to have standing in the matter. If I did have standing in the matter I sure would.

    I am sorry if it is a scary thing to hear but the lack of immediate access to a glucagon injection could result in death or brain damage. That is just a fact. A child is at higher risk of experiencing a bad outcome than an adult.

    Doctors wouldn’t prescribe glucagon kits and insurance companies wouldn’t shell out over 100 $ for them if they weren’t medically necessary
     
  16. Deal

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    Heck no. My child tests in class because that is what I negotiated. I fear that a 'universal' health plan agreed to by lawyers for the Board and Teachers unions could be much less accommodating.

    That other poster is taking his anger out on the wrong people. The teachers are not the problem. Their union and the board would tell them to stop if they found out they were administering injections. If it ever becomes a legal requirement for injections to be provided by 'the people' / government then nurses would have to be hired. Even their union would get involved if someone else started to do their jobs.
     
  17. Christopher

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    Glad to hear that, thanks for clarifying.
     
  18. MomofSweetOne

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    What would happen if a child needed glucagon? I can't fathom letting a child be in a coma without taking action, knowing their life is at risk and I could be doing something to help? Does no one feel concern or compassion? Are you allowed to tell them about glucagon and that it's in their tote? I find it mind-boggling that in a workplace with multiple adults all would let a child risk death, despite what their union says. To me, glucagon seems far, far easier and less risky than CPR to the one administering it.

    I think we also need to recognize the the other poster is a young adult that has lived under this. I imagine I would have extremely strong feelings as well, if I felt no one would come to my aid if I had a medical issue that could result in death and people in authority around me weren't willing or expected to help.
     
    Last edited: Jul 24, 2012
  19. Deal

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    What can I say. Our medical plan says to call 9-1-1 immediately followed by a call to myself. This is what they would do in a situation any kid had a seizure or hit their head and became unconscious. I'm pretty sure our teacher this past year would have stored a glugagon kit in her classroom and had no problem using it if required. Given that I was the one injecting insulin and managing carb intake I really didn't feel the need for imposing this on her when I knew that it would put her in a compromising position with her boss/union. I trusted her to be watching him and she showed a great amount of competence in this regard.
     
  20. Lisa P.

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    I have to say I wouldn't make that comparison. If a child has a seizure or hits his head and is unconscious, there's nothing a school can do, while a child unconscious due to a low can be revived and damage limited with glucagon. Considering glucagon is simple to use and you can't hurt a child by doing it "wrong" (except for the vomiting aspect), I'd make more of the comparison of a child in day care sinking to the bottom of a tub and the staff calling 911 and waiting for the experts to come rather than pull him out.

    I take the point that you have no choice, of course, except to remove your child from the school system. I have no idea how Canada regulates home schooling. I have to assume that if they refuse to provide basic life-sustaining care within the school the laws about schooling your child elsewhere are liberal (no pun intended).
     

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