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Excessive nurse visits

Discussion in 'Parents of Children with Type 1' started by BittysMom, Sep 7, 2012.

  1. BittysMom

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    While I use the word "excessive", I realize my daughter wouldn't. Caroline is in 1st grade, 6 1/2 yrs old. We're one year into dx and pumping for about 4 months. Lately she's been catching many of her lows, but certainly not all. She very often has false positives where she wants to test because she feels low, but is in range or high.

    We have 3 scheduled nurse checks- morning snack, lunch, afternoon snack. She has been going an extra 1-2 times a day saying she feels low (hot usually, yesterday wobbly legs on playground) and has been fine at these checks. She isn't fearful of her diabetes and doesn't seem to have any anxiety over it at all. I don't know if she just enjoys nurse visiting or what, She just says "I felt___, so I went" Makes sense to me.

    I just don't know what if anything I can do about this. She is losing some class time, but that isn't really my main concern. What's bothering me is it just seems to affect her day more than need be. Our nurse is wonderful and doesn't complain at all but this is very time consuming for her too.

    My only thought was a CGM but I'm not sure that would help. If she felt low and it was giving good #'s she should get herself checked anyway, correct?

    Any other ideas/ experiences? Thoughts on the CGM idea? Thanks.
     
  2. hawkeyegirl

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    Well, I'm a big CGM proponent in all situations, but that's really neither here nor there.

    At this age, I wouldn't sweat it if she's down at the nurse 1-2 times a day between scheduled checks. You want her to learn to trust her body, and she needs to be able to check if she feels low.
     
  3. LoveMyHounds

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    I agree. They will do whatever the hospital order says (at least at our school).
    I think you should talk with your endo about it.
     
  4. selketine

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    You might want to let her have the time while she is still little to figure out what is low and what is hungry, etc. William rarely would realize he was low until around this age - and he slowly started to catch them. William wasn't anxious about it either - but I think he couldn't tell what the feeling was.

    He got a cgms at the end of 1st grade - and that has helped quite a bit. Eventually you learn whether to trust the sensor. The additional feedback helps him figure out whether he is likely low. Sometimes he is just dropping fast and feels bad from that.

    A cgms may show you problem areas you didn't know you had. I can't say enough positive things about a cgms.
     
  5. sooz

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    At her age I wouldn't think twice about it. For one thing, her number could have been dropping rapidly and still read within range, but she is feeling the drop. That is a good thing. She is learning from going there what her body feels like at that number.
     
  6. andeefig

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    I could have written your thread verbatim last year. Son was in 1st grade, had same scheduled nurse visits but every afternoon after lunch recess he always felt "something"...low, hungry, shakey. And 95% of the time his BG was good. For him, these feeling subsided after about a month or so. We chalked it up to starting a new routine and eating on a schedule. He had about 2.5 hrs between when lunch started and pm snack and at home he grazed a lot. Many times he WAS hungry. We packed an extra snack and sort of phased it out as he was no longer using it. We never told him it wasn't OK to go get checked any time he felt funny even though at that time he was rarely low. No matter what, we said to get checked and nurse 100% agreed. It worked itself out in a little time.
     
  7. MelissaAL

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    Sounds alot like my daughter last year. She was diagnosed in March and for the rest of the school year, would check at least 1 extra time, but usually more like 3 unscheduled checks at school, especially in the morning. Her problem I think was breakfast always spikes her up so she is feeling her drop down to an in- range number at lunch. At her age and time since dx, I wouldn't worry. It is important for her to know what different feelings mean and what different numbers feel like. Also, for my daughter, it was time to get to know and trust the nurse and office personnel. She missed quite a bit of after lunch recess because she would chat with the nurse. To me, it is hugely important that she trusts those at school that are caring for her.

    I will say, the first week back I thought we were going to be in the same situation, but she has cut back to testing at lunch and maybe one other time during the day. Her classroom is further from the office so she is testing in her classroom or at her locker this year. Not sure if that is making the difference this year or not.

    I would say, if it is making your daughter more comfortable with her care at school, I wouldn't worry. She may "grow out" of it as she learns and gets more comfortable. We are thinking about a CGM too because I think it would help some of those, "I wonder what I am" checks.
     
  8. BittysMom

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    Thanks everyone. It is the kind of "problem" that you shouldn't necessarily do anything about. Maybe we could parlay this thread into a CGMS thread.

    It's astonishing to me that I haven't jumped for getting Caroline on one. I find myself wanting to manage her D as if we had one. I think it would benefit her health over the long term tremendously, and be a huge safety net when she's more independent. I'm hung up on how it would benefit her quality of life now. I only see it as another contraption she stuck having stuck in her that I can for the most part avoid by doing lots of fingersticks.

    I just feel bad.
     
  9. BittysMom

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    I see we we're not the only best customers at the Nurse's office :) Seems it's pretty common.
     
  10. Sarah Maddie's Mom

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    Btdt. Totally normal. Just chat with the nurse about making the visits a bit more dull and she'll tire of the extra trips in time.
     
  11. Lisa - Aidan's mom

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    Sure sounds like she is in good company!

    My DS went to the nurse for EIGHT checks yesterday. It's a new school/new nurse. Sometimes I think he likes hanging out in the nurses office :rolleyes: he knows all about her now - where she lives, that she is a Yankee fan, etc. .....and he's only been in school two days, lol. I better get her more strips for sure.

    He often confuses highs and lows, i.e, she will write in his little notebook: felt high, given H20, BG: 59 :confused: I don't know what a high or low feels like, so how can tell him to not visit the nurse?!

    That said, I'm waiting for insurance approval for a DexCom CGM and looking forward to getting started with it.

    Good luck to you!!!
     
  12. BittysMom

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    Eight checks! :cwds: How does your son feel about going on the CGM? I've talked to Caroline about them and shown her a video of a little boy happily having an insertion done. Not surprisingly though, she wasn't all "Hey Mom! Get me one!" ;)
     
  13. Deal

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    For the 2nd year in a row our school principal called me into her office concerned that I am asking ds to be checked too many times. I have him test before recess, lunch, afternoon recess, and bus departure. I just stared at her and made her uncomfortable. She repeated her concern, I then asked her how she was making out with the buses as they seem to be arriving late. I think she understood but I'm not sure.
     
  14. virgo39

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    In first grade, my DD was a "frequent flyer" to the nurse's office. After discussing it with the nurse, I decided to discuss the issue with the school psychologist. For my DD, she was using D to leave the classroom when she was feeling anxious/afraid. She and the psychologist talked a few times and worked it out.

    It sounds like that is not your issue, but I throw it out there for future reference -- your school may have some resources if things change.
     
  15. BittysMom

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    I guess you'll know if she tries again next year! We're walkers so no bus check here but she wants a snack when she walks in the door so we check same time of the day, just at home.
     
  16. BittysMom

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    That's likely not it because she left the playground yesterday and she loves recess. It's worth keeping in mind for the future though. Glad it worked out for you daughter.
     
  17. Lisa - Aidan's mom

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    DS is 'ok' with getting a CGM, I think. He's tough as nails and doesn't mind all the shots; he doesn't pump so we shall see.
    DS doesn't use the nurse visits as an excuse to get out of class either; he visits her randomly...everything from gym - math - recess, etc -- things he likes.

    His 504 states a required BG check before lunch, after gym, before boarding the bus home and "as needed"; guess he is really taking advantage of the "as needed" part.

    Good luck!
     
  18. maciasfamily

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    Our son is younger (3), but we love the Dexcom. It's been great at catching a lot of lows and helping to spot trends we didn't know he had.

    The insertion itself can appear a little scary, but our son handles it really well. We don't use any numbing cream, and he says a quick ouch and we're done.

    The one thing that might help your daughter is seeing that maybe she is dropping post breakfast or post lunch, but the Dexcom can help her see if she stays in range. For ex, our son would spike before pumping up to 300's after breakfast. He'd come crashing down, but would land in the mid 100's. So I bet he probably felt some of what you're daughter feels. But the Dexcom could help her 'see' that drop and then 'see' that her body stabilizes at a good number.

    Glad though she's feeling something and acting on it! Better that, than her not doing anything.
     
  19. hawkeyegirl

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    I wouldn't want a 6 year old relying on a CGM. What I mean to say is that I don't think you want her to use it as this age to decide whether she should check or not. There are too many variables to consider.

    Honestly, from her perspective, there are zero advantages to a CGM at this age, so I wouldn't spend too much time trying to sell her on it. Either give her veto power over getting one or tell her that it's something that you're going to try, but I wouldn't bother trying to talk her into it either way.
     
  20. BittysMom

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    The thing I'd love to see with a CGM is her #'s post meal. Since we test mostly before she eats, our meter readings are showing us basically her best numbers. I try to see what her spike is, but if I see a 250, that may have been 300 a few minutes earlier etc.
     

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