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Brand new "mom" to this life - international exchange student arrives next week

Discussion in 'Canada' started by Storybookmum, Aug 17, 2017.

  1. Storybookmum

    Storybookmum New Member

    Aug 17, 2017
    Hi, there. I have a student arriving next week from Asia. She is 17 and is insulin-dependent, on a pump. I don't know much else yet. She was diagnosed last May.

    I'm scared. I want to take good care of her. The agency placing her said that she's well-managed and independent and would come with a supply of medication and all her equipment and would go to a walk-in clinic if necessary.

    I have been in contact with the pediatric metabolic clinic at our local hospital, who went ballistic at that, and insists that she be referred to a doctor and have supports in place (and training for us!!!), so we don't kill her, or end up mismanaging and have her in ICU or ER.

    I called the agency, who seemed finally to grasp the liability issues and said they'd call the clinic right away.

    I feel very overwhelmed. I have ordered "Live Like a Pancreas... from Amazon.

    I'm daunted by an anticipated difficulty with language barriers (obviously she speaks English, but I know from experience that she won't be fluent), by a complete change in diet for her from Asia to our western diet, by our hectic pace of life that I know is, in and of itself, a risk to her well-being, and by so many things.

    I need some hand-holding as I learn things. I'm hoping this is a good place for that.
  2. Snowflake

    Snowflake Approved members

    Dec 1, 2013
    Wow, that's a doozy! You are absolutely correct that the agency should have given you more advance information and training. But I also don't think Type 1 should be an impediment to an educational experience. There are a lot of parents of 18 year olds on this forum who are getting ready to send them off to college with less "adult" supervision than your exchange student will have. This is totally do-able -- it just takes the kind of advance legwork and planning that you are doing.

    My Type 1 child is much younger, but I imagine that a 17 yr old mature enough to travel internationally is probably also mature enough to self manage many diabetes tasks. I think it's great that you want to educate yourself, and I think the main things you will need to understand is the risks of extreme high and low blood sugars, management of a diabetic when she is sick, and the need to count carbohydrates when you prepare meals. If you want a high-level overview that doesn't go as far into the weeds as "Think Like a Pancreas" (which is like a graduate seminar in insulin management), you might check out a caregiver guide like this one : https://www.amazon.com/Type-Diabetes-Caregiver-Confidence-Caregivers/dp/0995827427

    I would also suggest that you ask the agency or the student if she has a continuous glucose monitor in addition to her insulin pump. This is a wearable medical device that provides real-time approximations of blood sugar levels, and which can be an invaluable safeguard against diabetes emergencies. I don't know how common they are in foreign markets, but if she has one, it should give you great peace of mind.

    Good luck!
  3. Storybookmum

    Storybookmum New Member

    Aug 17, 2017
    Thank you for your encouragement. I absolutely agree it shouldn't be a barrier to education and travel. We didn't hesitate long on seeing the condition on her profile before saying yes. But you've hit exactly the important thing - I want to be able to help, support, plan meals, and deal with it safely if she gets sick or has a complication or extreme readings.

    I do tend to plunge into the deep end when I need to know something, so I'm not afraid of reading Think Like a Pancreas, but I'll certainly look at the other resource.

    I'm VERY relieved that as of today I got the go-ahead to start training with the metabolic clinic, and we have our first appointment scheduled the day after she arrives.

    In my very minimal email responding to questions that I sent to the agency who forwarded it to China, they replied that S doesn't need to test during the day, so I'm very much hoping that she has a CGM!
  4. MomofSweetOne

    MomofSweetOne Approved members

    Aug 28, 2011
    Welcome to CWD! We're glad you're here. As far as feeling scared and overwhelmed, that's exactly how we felt taking our kids home from the hospital.

    I'm glad you've made contact with your local hospital and that they're advocating. Walk-in clinics are a scare, even for those of us who speak English and have experience. When my daughter leaves for college, we've already been told to have an endo and a gp lined up in advance to meet with to go over her case history together.

    My daughter is 17, and when I told her about your post, she said she would probably find it annoying to be asked constantly about BGs, but that the support would be important. Numbers are going to far less than ideal; we work extremely hard at this together and still see 200s daily, if not worse. The important thing is to be a team, problem-solving why the numbers are happening, not judging the number.

    Carb counting meals is especially appreciated; scales are wonderful. https://www.amazon.com/Greater-Goods-Nourish-Portions-Nutritional/dp/B00O5U4NDQ/ref=pd_sbs_79_1?_encoding=UTF8&pd_rd_i=B00O5U4NDQ&pd_rd_r=TB1J5ZEZCKMP7TJSB0KZ&pd_rd_w=sDZQo&pd_rd_wg=ygggd&psc=1&refRID=TB1J5ZEZCKMP7TJSB0KZ

    I would become very familiar with glucagon and mini-glucagon. There are practice glucagon kits, but the company won't send them to parents, only to nurses or doctors. I had a friend order one for us. I The first outdated glucagon I practiced with shattered in my hand, and I didn't want that to happen in an emergency. I worked at the steps until I knew them rote (I'd forgotten to remove the guard that prevents it from injecting.) Mini-gluc gives a smaller dose in an insulin syringe. It can be given during flu bugs or while still conscious if staggering or slurring from a low BG. http://www.childrenwithdiabetes.com/d_0j_20w.htmApparently they can be ordered here: http://www.schoolnurse.com/products/item21.cfm My daughter's friends had great fun giving glucagon to Lenny. :smile:

    Vocabulary that you need to discuss together are words if she's running ketones, but if she wasn't in DKA at diagnosis, she may not recognize the symptoms. My daughter feels ketones quite early, but even so, "I feel nauseous" or "I feel like throwing up" or "I feel like puking" are code words that trigger automatic ketone testing in our house. It's so much better to catch ketones early and stay on top of them rather than have them get serious. And just for your info, pump sites that pull out or illness are the worst offenders for creating them.

    If your student was diagnosed in May, her insulin needs will likely skyrocket in a few months as more beta cells die off. This typically happens about 6 months post dx, but everyone is different. I don't know about your liability in adjusting doses, but she gets lots of high BGs, you'll need to be talking to the dr. often about changing doses. I took over adjusting about 3 months post dx, but for the first 6 weeks, we called in daily and then every 3 days or so. You may need that kind of support.

    Something we've always insisted on is that my daughter wear a medical ID. I know not everyone does, but I didn't want her to be in a situation where she might be unable to communicate without ID. D can get serious too quickly, and anything that would leave her unable to communicate would also affect what is happening with D.

    You'll do great...and you'll need support. Keep coming back as often as you need!

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