Cystic Fibrosis in the Classroom: Allissa s Quick Guide

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Cystic Fibrosis in the Classroom: Allissa s Quick Guide Table of Contents Enzymes 3 Infection Control. 4 Proper Hygiene. 5 Weather 6 Nutrition. 7 G-Tube... 8 Headaches/Illness.. 9 Hospitalizations.. 10
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Cystic Fibrosis in the Classroom: Allissa s Quick Guide Table of Contents Enzymes 3 Infection Control. 4 Proper Hygiene. 5 Weather 6 Nutrition. 7 G-Tube... 8 Headaches/Illness.. 9 Hospitalizations.. 10 Inhalers/Breathing Extra Info/Contact Info 12 Notes Enzymes Pancreatic enzymes (Creon 2400) are a requirement for Allissa. Her CF has left her with complete pancreatic insufficiency. This means her pancreas no longer creates the enzymes needed to break down and digest food. She will carry her enzymes on her at school and will dose herself as needed. Although Allissa is usually selfsufficient, she needs to be reminded at times to take her enzymes. Enzymes are viable in the gut for 30 minutes. Any food eaten after 30 minutes requires more medication. If she eats without taking enzymes she will experience tummy aches, constipation, gas, heartburn and frequent need for restroom use. Her discomfort could be compared to a non cfer eating a large extra oily pizza Even with enzymes Allissa still does not absorb all of the fat and nutrition in food, this will result in frequent restroom use. She should be allowed to excuse herself as needed. Her current doses are: 3 pills with a meal- A meal would be breakfast, lunch, pizza parties, etc. 2 pills with a large snack that contains complex starches and proteins- A large snack would be cupcakes, cheese and crackers, or veggies with dip 1 pill with small snacks that do not contain protein- A small snack would be a handful of pretzels, a few chips or a small piece of candy. 3 Infection Control With CF the mucus in the lungs & sinuses is very thick and sticky. This causes bacteria to thrive, viruses to grab hold and infection to run rampant. When Allissa gets a respiratory illness her lungs create scar tissue. This tissue becomes fibrotic and that area no longer works properly. This leads to loss of lung function and hospitalizations. Avoiding illness is a HUGE part of keeping Allissa healthy! When people around Allissa are ill, they should avoid contact, generally trying to keep a 10 foot distance. Allissa should be seated in a wellventilated area. Papers should be handed out with either Allissa receiving them first, or her papers being delivered separately. She should not use the classroom stock of supplies, but her own personal ones. During in class meals, Allissa should be the first served. Hand washing and sanitizing should be available and encouraged. Tissues should be readily available and elbow covering of a cough or sneeze should be encouraged. If an ill student, teacher or staff member must be in close contact with Allissa, PLEASE contact home and Allissa can be sent home to maintain safety. 4 Proper Hygiene Keeping Allissa safe as well as the other students begins with proper hygiene! Hand washing should be done regularly. According to the CDC, this is the proper way to wash hands: Wet your hands with clean running water (warm or cold) and apply soap. Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails. Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the Happy Birthday song from beginning to end twice. Rinse your hands well under running water. Dry your hands using a clean towel or air dry. When washing is not available, using hand sanitizer can be as effective. However, hand sanitizers may not be as effective when hands are visibly dirty!! The CDC says the proper way to sanitize is: Apply the product to the palm of one hand (read the label to learn the correct amount). Rub your hands together. Rub the product over all surfaces of your hands and fingers until your hands are dry. 5 Weather The root cause of Cystic Fibrosis is a genetic default in the CFTR gene. This gene tells the cells how to move chloride in and out of the cell. In people with CF, the salt does not move properly. This is what causes the sticky mucus. It also causes CFers to lose significantly more salt through their sweat than a non cfer. In the heat a CF child can become ill very quickly. Because of this, Allissa should not be outside in warm weather, (greater than 85 degrees). In temperatures less than 85, if she is sweating she should be allowed indoors and access to water. In windy and poor air quality conditions, (ie fire), Allissa should also be kept indoors. Windy conditions are a danger due to the bacteria and other contaminants that she may inhale. Generally, Allissa will notify you if the weather conditions are not ones she should be in, but a gentle reminder never hurts! 6 Nutrition Due to Allissa s problems absorbing nutrients, she has a difficult time gaining weight. Her body requires constant fuel. She will have snacks packed in her lunch box and will eat throughout the day. Her typical snacks range from fruits and vegetables to pizza pockets. She will frequently be sent with salty and high calorie foods, this is not considered junk food for her, but maintenance food. She should be sent to the head of the lunch line daily so that she has the maximum amount of time to take her pills and consume her food. Allissa works hard daily to maintain her healthy weight and slowly put more weight on. 7 G-Tube Nearly 2 years ago a mickey button or gastronomy tube was placed into Allissa s stomach. This tube is used to deliver high calorie formula directly to her stomach as she sleeps. It allows her to maintain weight and supplement her nutrition. The tube is held in place by a balloon filled with water inside of her stomach. If this balloon were to pop, the tube would likely fall out. In this scenario, allow Allissa to put the tube back into the hole and hold it in place. It can be taped or simply held in place. She will need to be sent directly to the office and parents need to be immediately contacted. Although the balloon is not likely to pop, it can happen. Simple precautions can help to prevent this type of emergency. Avoid high impact games like dodge ball or soccer. Any direct impact games lead to a higher risk. 8 Headaches/Illness Allissa has had 9 sinus surgeries. She suffers from chronic and severe CF sinusitis. This causes her to lose energy quickly as well as face daily headaches. As she spends more time in your classroom, it will become easier to recognize the symptoms of these headaches and illnesses. She takes 200mg of Ibuprofen to reduce the swelling and pain in her sinuses. If she takes the Ibuprofen and her symptoms don t improve, it is likely she has another problem or illness coming on. Please do not hesitate to call home, send her to the office or even send her home in these instances. If she is sent home, please send her with a day or two of work so she does not fall behind. When she is ill she is seen by her specialists. These appointments are generally on Tuesdays. If she has to be sent home she will likely be absent until the following Tuesday, please send work accordingly. We will do our best to keep the teachers and office updated on her daily condition. 9 Hospitalizations CF people generally are admitted to the hospital for tune-ups 1 to 2 times a year. These are generally between one week to several months; depending on what health issues need to be addressed. Allissa typically is in for 2 weeks. During these times the doctors fine tune her medications, perform necessary surgeries and get her lungs to function at their best possible rate. Her days in the hospital are filled with treatments, therapists, needles and lots of food. We ask that during these times her class work be sent so that she is able to stay up to speed with her classmates. However, please limit the volume of work sent. Please keep assignments to objective driven and avoid busy work, as she is generally kept pretty busy getting well. Also, she treasures getting notes and cards from her classmates! They truly brighten her spirits in those tough days. 10 Inhalers/Breathing While at school Allissa will cough. This is a normal part of CF. This coughing is how she moves and clears the mucus in her lungs. When her cough becomes persistent it is time to send her to the office for her Albuterol inhaler. She uses this to open her airways. If the cough is continuing after albuterol or it is accompanied with lethargic behavior, it is time for her to be sent home. Allissa is generally good about letting you know when she isn t feeling well or needs to use her inhaler. 11 Extra Information Allissa wakes up at 6 am on school days to be able to do ninety minutes of treatments and therapies. She fights every day to be healthy. Please help us make this battle a little bit easier on her. The precautions that we are asking you to take are not just to keep Allissa healthy, but you and your entire class as well. If there are any ways that I can help you help us, feel free to ask. Also, if there are any questions or concerns that you have please feel free to share! Mary Gabriel (Mom) Cell- - Buddy Gabriel (Dad) Cell- - Jinny Iodice (Family Alternate) Cell Notes 13
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