Individualized Health Plan: Medication and Food

In my previous article, I detailed Margo’s Individualized Health Plan (IHP) and our initial meeting with the school nurse. We left the meeting so energized and felt completely comfortable that Margo’s needs would be met from day one.

Medication and snacks

At our meeting, we filled out the medication authorization form and were able to drop off several bottles of Margo’s pancreatic enzymes.

An exciting change for us: Margo’s new school allows nuts! What a relief for us to be able to send high-fat, high-sodium snacks that she loves. Margo loves eating straight peanut butter from the jar with a spoon, so we can even accommodate that by sending in travel packs of peanut butter.

Throughout Margo's time at daycare, we instructed her teachers to give her a set number of enyzmes for snacks, rather than calculating the amount of fat. We wanted to avoid any potential confusion. Now, with a nurse administering the medication, we explained the calculation (i.e. 3g of fat = 1 pill) and she understood and included it in the IHP. Not that this is a particularly challenging calculation for her teachers at daycare, but again, we just wanted to make it as easy as possible.

Additionally, she invited us to drop off snacks for Margo that she will keep in nurse’s office in case Margo needs additional calories on any given day. We decided the best snack will be toasted peanut butter crackers- full of fat and salt and something she will enjoy if she needs it.

Lunch and milk

Margo is very excited to buy her lunch at school, so we decided to support this for as long as she is interested in doing so. Her school’s menu looks good (especially compared to what my elementary school lunches were in the 1990’s—yikes!) and we can supplement the meal with high-calorie snacks. One detail included in the IHP is that Margo be served whole milk with lunch as opposed to the reduced fat option. We had our clinic send a letter supporting this need and it was easily taken care of. They even accounted for chocolate milk by providing chocolate syrup she can stir into whole milk! They truly thought of everything.

Other takeaways from the meeting

The computer program that tracks medication administration is amazing. The nurses showed us how it works and it added just another level of reassurance for us. It lists all students who will need medication that day and what time they need it. Once the child receives the medication, their name drops off the list until the next day. It also lets the nurse know when how many pills are left and when a refill is necessary. As a parent of a new elementary school student, this was my first foray into the world of school nursing and we were thrilled with it.

We discussed Margo’s twice-daily treatments at home and how sometimes she requires a third and even a fourth treatment when she’s sick. The nurse said we could either bring her vest in that day or show the nurse how to do manual CPT. We will likely opt for the vest option but we appreciated the offer to learn the manual techniques. They also keep a nebulizer at school—we would just need to bring in the mouth pieces and medication.