Today is the first day of first grade for Eric. And we're starting off on a really great note for a number of reasons.
Reason #1: yesterday's visit to the endocrinologist found that for the first time, Eric's a1c had fallen below 7.4%. In five years of trying, that has always been the best we've ever achieved — we've hovered there, sometimes for six months or more, but never improved on it. And when the nurse told me it was 7.3%, at first it didn't register, simply because I'd gotten it into my head that 7.4% was the best I was ever gonna get. Goal now is to get it down to 7.0 before Eric's 8th birthday. [Addendum: I guess I should mention, this was done without excessive lows — we've certainly had a few, don't get me wrong, but no more than is usual in summertime, and very few that were particularly severe. The CDE said that lowering the upper limit for correction boluses and lowering the sensitivity probably had a lot to do with it... and we did that again this visit. So we'll see what happens at December's checkup.]
Reason #2: after the debacle of Eric's last 6 weeks of kindergarten, we are starting the school year with a brand new nurse. I don't think I blogged that nightmare out when it happened, so the story, in brief, is this: in early May of last year, the school nurse at Eric's elementary school — who despite being a sweet and caring woman had never been quite as organized about Eric's regimen as I would have liked, necessitating a couple of emails to the assistant principal — abruptly left the school. Resigned? Fired? Health issues? No one ever told me and they were remarkably tight-lipped about it, but the upshot of it was, the one person who knew how to handle Eric's medical needs was suddenly gone. And with only 6 weeks left to the school year, they weren't going to find a replacement until next year. So their solution was to rotate 3 other district nurses into Eric's school. The results... weren't great. "Nurse A" made a point of communicating extensively with me and took the time to sit down with me and go over some key factors of Eric's care. When she was in the office, nothing went wrong. "Nurse B" did some of that, but only after I suggested to her that it was working for Nurse A, and she did not do it as much or as consistently as Nurse A. "Nurse C" did none of it, even after I told her point blank that she should, and wound up double dosing Eric on insulin during one memorable occasion — the spectacular low she no doubt would have initiated was foiled only because the incident happened at snacktime, which came only an hour and a half before lunch (and she subsequently overtreated the lunchtime low and sent him sky high by day's end. Oy.)
The result of my furious complaint regarding the last incident, made first to the principal and second to the superintendent, was that ALL nurses in the district went to the Diabetes Clinic for training on managing diabetes in children, AND (best of all!) Nurse A was permanently installed at my son's school for the coming year. Hurray for Nurse A!
Reason #3: having met Eric's first-grade teacher last night at the open house, I am pleased to see a sense of commitment to making sure that he not only gets to learn in a friendly, caring environment, he also will have close attention paid to his medical needs.
So here we go. First day of school... a fresh new start... I can't wait!