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Occupational Therapy referral advice

L

Little My

Active Member
Messages
28
Type of diabetes
Type 1
Treatment type
Insulin
Hi there
Apologies for the long message!
I'm looking for some advice from any fellow teachers coping with diabetes.I have been a Type 1 diabetic for almost 3 years and teaching for 4 years.I have been working in the same school for 14 years.

In Jan 2016 I requested to reduce my hours from full time to 4 days due to struggling with stress and work load of teaching and managing my diabetes.Although this would have an impact on my finances I felt the opportunity to have 3 days break from work would help me cope more easily and be able to rest. I was allowed to reduce hours but was told I would have to wait until the start of new school year in Sept 2016 to minimise disruption.

I am currently working 4 days and have recently found myself struggling again with stress and excessive workloads. It is having a negative impact on my health and causing me to have insomnia and erratic blood sugars.I am constantly exhausted and ended up being signed off last week from work by the doctor for 2 weeks with stress and anxiety.

I have been in contact with my headteacher and have asked if I could be referred to Occupational Health on my return after the Easter break. I feel that my colleagues do not see my diabetes as a life long struggle or that it impacts on my role as a teacher. I am often expected to miss breaks frequently, work thorough lunches and stay late for long staff meetings and parents evening after a busy day teaching.

None of my colleagues understand how I need to treat hypos and hypers or trained to know what to do if I was to have a severe hypo.I am often alone in my classroom without another adult and worry that I might collapse one day and nobody would know what to do. I have often thought about telling my class children about my diabetes and what to do in an emergency but as they are quite young I worry they may try to inject me by mistake or not get help quick enough. Also worried that they will tell their parents and then they might think I'm not fit or well enough to teach their children.

I wondered if anyone else has had positive results from an OT referral?

The majority of the time I have good control but when I get too tired or stressed I end up needing time off school to recover. I am worried about my attendance records and people thinking I'm faking it or using my diabetes to get extra time off. As it's an invisible illness I often have people saying to me "you look fine!" Or "you don't look ill" or "have you not got your diabetes all sorted yet" It's so frustrating!

I love teaching and try my best to cover up my diabetes and just get on with it and be the same as other teachers in school. I feel embarrassed to ask for any special treatment but I fear if I continue like this I will end up having to quit the profession.

All advice welcome
M x
 
Hi @Little My have you taken a pro-active approach with your colleagues? Instead of trying your "best to cover up my diabetes and just get on with it and be the same as other teachers in school", take the opportunity to say "Yes, I am different, and this is why", and at one of your staff days, ask for the opportunity to explain to the rest of the staff about type 1. It sounds as though there haven't been any type 1 kids at the school either, and it would be really beneficial for the staff to learn about the condition from one of their own, including what to look out for in terms of symptoms.

I daresay that you would find that they were a lot more understanding than you expect, as most of them will be associating Diabetes with the press definition of Type 2. I've found that being open and talking about it with colleagues helps their understanding enormously, and means that they know what the options are in most situations. Most won't have any idea what living with T1 entails, so it's worth making that effort and saying "this is what I deal with, don't I do well?".
 
Hi @Little My , sorry to hear about this. I find it a struggle, too. I am in a spiral of feeling I have to justify myself and explain myself all of the time, and explain to people, including myself, why I'm unproductive.

I'd recommend having a chat with a sympathetic colleague in the first instance, and explain to them what it's really like dealing with this on a day to day basis. You might be pleasantly surprised by their reaction. There's some useful stuff here - http://www.diabetes.co.uk/forum/threads/explaining-what-its-really-like-to-live-with-type-1.103794/

I work for myself. I am (and therefore have) the least understanding, most evil boss imaginable. I give myself a REALLY hard time. And I don't know why I'm so horrid to myself.

#baringmysoul

Love Snapsy
 

Thanks for your reply. When I was first diagnosed I asked if I would be able to mention my diabetes at a staff meeting but my head said health conditions are not usually discussed in staff training sessions.She also said first aiders learn about diabetes on their training so no need to.She suggested 2 teaching assistants for me to talk to and show them how to use the glucose kit for treating hypos. Both TA approached me after the meeting and said they didn't feel comfortable with the responsibility of being my allocated support if I was to have a severe hypo. I drew up my own care plan and put a copy in the first aid room and on my clasroom wall in case something ever happened and I needed help.I also got some leaflets about looking out for hypos/hyper symptoms and left them in staff room and first aid room but apart from a couple of people who had a quick glance I don't think anybody has time to worry about educating themself about my health with such a busy work load. Which I understand as I barely get 2 minutes in a day myself! We don't have any diabetic children at my school or other adults.
In my early diagnosis days I had a lot of hypos once my blood was 1.7 and I fell over whilst teaching. I got myself to the staff room and grabbed something to drink and eat. By the time someone finally realised I wasn't ok and came to the staff room they said 'shall I get your epi-pen so you can have your injection!' I wasn't able to explain properly at that point but later I told her to have insulin when my blood is low could have killed me.Another memeber of staff closed the staff room door whilst I was having a bad hypo and said best leave you on your own for some peace. I fear people want to avoid me when I'm unwell because they don't understand what help to offer or want to be involved.
M x
 
Hi @Snapsy
Thank you for taking time to reply! Like you I think I'm the toughest critic of myself I don't want diabetes to define me as a person and just want to be like my other colleagues!
I will try and talk to a couple of my close friends at work again and see how I get on.
Thanks for the info I will have a read.
Don't be hard on yourself - take care
M x
 
Hello @Little My - I think we are all guilty of being our own toughest critics, particularly when it comes down to our type 1.

It's hard trying to explain to others what life is like living with type 1, as you look ok you are therefore ok, so what's the deal ? I personally feel that living with my type 1 held me back in my last job, simply because I had to give it my all, and to be honest my type 1 had to come first, as I couldn't function unless I was managing it ok so sadly I gave up the job, had one too many hypos in meetings that had run over and I was still new-ish in my type 1 management so still getting my head round injecting and becoming confident with how the insulin would react based on my activity levels and carb counting etc.

Couple of things spring to mind which may help you - have you considered a pump ? I've been on a pump a year now, my hypos are now less frequent and less severe since i've got my insulin settings adjusted, they still happen but only 1-2 a week and easier to treat as less severe. A discussion with your diabetes nurse explaining the impact on your job would be a good starting point. Also if you can afford to using a libre sensor is good for being able to monitor your BG levels without a blood test, and more convenient when you are on the go, it's also good for spotting if going high/low so being able to respond before going low.

In regards to your role, I appreciate you have to educate those around you, however I don't expect anyone around me to know what to do under the circumstances, despite telling them time and time again, unless they live with it they will never fully appreciate what I go through, as long as they know that if I am low I need glucose then that's all I expect of them. I used to be embarrassed about being a type 1 because it meant I had to rely on others, over time I am not embarrassed in the slightest however I still don't want people getting in the way of my diabetes, I want to carry on as normal without people interfering or worse still making ill-informed comments about my diabetes, so the more I can do to carry on as 'normal' the better. In some respects I guess I am trying to say that if you can manage this better so that you can carry on as normal as possible then the easier your job will be.
 
@Juicyj thank you for reply! I am wondering whether the job I'm in is the right choice! All I wanted to be was a teacher and I worked hard to do my degree at night whilst I worked as a Teaching assistant full time. Within a month of starting my teacher training I found out that I had Diabetes....this made my training double as difficult but I survived. I guess what I'm trying to say is I don't know if I'm finding teaching more difficult because I'm now diabetic or because it's just a really stressful exhausting job anyway! I feel like if I give up teaching diabetes has won but maybe it just isn't the right job if it's making me feel so stressed and anxious all the time!
Do you think the OT referral will help me? I'm not really sure what will happen as a result or if it will make my employers understand my condition any better. The teachers union I am in advised me to ask for a referral to OT so I did!
M x
 
Also do you pay for your own libre sensor or is it on prescription?! I've been wanting one for a while but thought they seemed a bit pricey!
 
Hello @Little My - Sadly you haven't been in your role as a 'non diabetic' so it's hard to visualise what the role would be like without type 1 and to differentiate the stress associated in doing the role vs stress bought on by managing your type 1. OT is certainly an avenue to look at, but will this necessarily help ? If it is stress associated with managing your type 1 then will there be provision for this ? I would be asking the union for what OT would offer you first before going down this route, to help manage your expectations, otherwise it may be a pointless exercise.

The libre is purely self funded, however it is a good investment and it is worth trying this, particularly in a job like yours where it's difficult to stop and test, it will also decrease your anxiety as you will feel confident knowing what is happening with your BG levels whenever you want to check.

It's really about reaching a happy place where you feel confident doing your role and less stressed about your type 1 management, particularly with going low, whether the job is right for you or not, you didn't have type 1 when you were training however life has changed since then and admitting defeat if it isn't right is a brave decision to make, but certainly see if you can change a few fundamental things first before making that decision
 
I had some OT sessions when I was first diagnosed and didn't find them particularly helpful, but then I got the impression the OT was on my employer's side rather than mine. That said, it's no doubt worth a shot.

I do feel that you should try to get a Libre, even if just as a trial. I expect it will help your confidence in the classroom if you can quickly and discreetly check your sugar levels without having to go through the time and faff of a fingerprick test. Sometimes not knowing where your levels are can be as stressful as seeing an actual high/low - and Libre can eradicate that completely. The Libre will also help you spot trends and can better educate you as to what external influences impact on your sugar levels and to what degree - your ultimate goal should be to get through a day at school in range and without worrying about your levels and over time the Libre will likely help you achieve that.

When you hear about how many teachers are signed off with stress etc. without diabetes or any other condition it is nothing to be embarrased or upset about that you are struggling. What people often forget is that those of us with T1D still have the same problems and stresses as everyone else but ON TOP OF THAT we also have all the stress and anxiety involved in dealing with a 24/7 condition that never gives us a break. Whilst I suppose we should be grateful there are no visible outward signs of our condition it does mean that the vast majority of people have absolutely no idea what we are going through and the multitude of things whizzing around our head (am I high? am I low? what's my current blood sugar? is it rising? is it falling? when was my last bolus? will this food be subject to my usual carb count or should I adjust for the walk I'm about to do? where is my insulin pen? do I have my needles?) .....
 
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