The RT News
Newsletter of Division 11
September 2004
Association for the Education and Rehabilitation of the Blind and Visually Impaired
LETTER FROM THE CHAIR:
REHABILITATION TEACHERS IN ORLANDO: A DAY OF HONORS
Being able to bestow honors on our members is only one aspect of the activities we sponsor in the Division. We know that you all are out there working hard every day and each of you deserve recognition. So we cheer you – each and every one – for the good work you do.
The Bruce McKenzie Award for Lifetime Achievement:
Barbara Hunt, IL & Lisa-Anne Mowerson, PA
Certificate of Recognition:
Debra Sokol-McKay, PA
Rising Star Award:
Vasant Garcia, AZ
WHAT'S YOUR OPINION?
Elizabeth Chamberlain, Ph.D., RTC
I recently read an article by a parent of a teenage daughter who is visually impaired. The father expressed concern as to whether his daughter possesses the skills to live independently at college. I work as a Rehabilitation Teacher in the public schools. I have students on my caseload ranging in age from 4 to 18 years old. In addition to providing direct instruction in the home and school, I have the opportunity to work with Orientation & Mobility specialists, and we go out for half-day or full-day trips in the community. We work on a variety of practical skills such as grocery shopping, money and time management, using public transportation, and eating at restaurants.
Elizabeth Chamberlain, Ph.D., RTC
I would like to get feedback for other RTs on issues related to working with children. First, are recent high school graduates lacking in skills necessary to live independently in a college dorm or an apartment? For the RTs who work with young adults, do you see a need to provide services to children? If yes, when do you believe services should begin? Also, are there any RTs who work with only children? If yes, how many are on your caseload? How often do you provide services? What is the referral process to receive an RT evaluation? At what age do you begin working with a child? Finally, is there a difference in providing services to children versus adults? Please share your thoughts, and they will be published in future newsletters. Send comments and responses to Nancy Paskin at npaskin@lighthouse.org for inclusion in the next newsletter.
RT MARKET PLACE
TOTE BAG: Natural canvas, generously oversized, with the RT logo and Website address imprinted in green. $15.00
SUNGLASSES: Green plastic, UVA and UVB protection, imprinted with “Rehab Teachers SHINE.” $5.00
COMMUTER MUG: Beautiful stainless steel commuter mug. Features the motto "Qualiter Signum" (Whatever Works) in black script. Also features the RT logo and Website address. $10.00
NECK CORDS: New design: White with blue lettering: “Rehabilitation Teaching” and Website address. $3.00
BASEBALL CAP: Stonewashed green cotton cap. Features the RT logo with the motto “Qualiter Signum” (Whatever Works) in black script. Adjustable sizing strap. Sale $5.00
Please add $3.50 for shipping and handling of all orders. Make checks payable to AER Rehabilitation Teaching Division.
Send your orders to: Nancy Paskin, c/o Lighthouse International, 111 East 59th Street, New York, NY 10022-1202; phone: 212-821-9230; email: npaskin@lighthouse.org.
Due to the possibility of items selling out, please also include an email or phone number so we can notify you if a change in our supply may affect your order.
MEET THE NEW EXECUTIVE TEAM:
ELECTED AT THE INTERNATIONAL CONFERENCE
CHAIR: Nancy PaskinELECTED AT THE INTERNATIONAL CONFERENCE
Contact information: npaskin@lighthouse.org
Work: Lighthouse International, 111 E. 59th St, NY, NY 10022 Attention: Nancy Paskin, 5th Floor.
FYI: Lives 50 miles north of NYC with husband, Sam.
CHAIR ELECT: Mary Beth Harrison
Contact information: marybeth.harrison@med.va.gov
Work: Hines VA Blind Center, Hines, IL
FYI: Was our Secretary/Treasurer 2000-2002.
SECRETARY/TREASURER: Susan B. Dalton
Contact information: smdtvp@joltmail.net
Work: TransVision, Marengo, IL
FYI: Also holds the office of Treasurer in MACRT and is looking for a photo to share with us.
There is no Past Chair for this term, but we have great backup from several past-past-past chairs including Maureen Duffy, Lisa-Anne Mowerson, Barb Hunt, and Don Golembiewski to mention only a few. Thanks to one and all.
CONGRATULATIONS: NEWLY CERTIFIED AND RECERTIFIED
REHABILITATION TEACHERS
Newly Certified: Gail Beard, Eileen Brennan, Leloni Cordilione, Felice Eisenegger, Angelone Cae Hillmer, Barbara Ann Johnson, Cathleen McGuire
Recertified: Melanie Beagle, Kathleen Carlisle, Ira Chomsky, Angela Farmer, Olukanyin Bodeharrison, Patrice Gonzales, Sandra Hix, Robert Lyles, Elisabeth Mann, Paul Miller, Maureen Moscato, Hope Renee Roberts, Tricia Sproles, and Jeanne Travaglino
THE SUGAR BLUES:
HYPOGLYCEMIA: WHAT EVERY RT SHOULD KNOW
Debra A. Sokol-McKay, RTC, CDE, CLVT, OTR/L
The major acute complication of diabetes is hypoglycemia or low blood glucose. It can be a source of concern, apprehension and even fear for the client, their family and for rehabilitation professionals. It is an event that requires prompt attention and treatment; it does not resolve itself on its own.
HYPOGLYCEMIA: WHAT EVERY RT SHOULD KNOW
Debra A. Sokol-McKay, RTC, CDE, CLVT, OTR/L
What is it? Hypoglycemia is a blood glucose less than 70 mg/dL. Hypoglycemia is not a result of diabetes itself but is a consequence of its treatment. Insulin and certain oral medications (but not all) that are used to control blood glucose levels can result in blood glucose levels that are even lower than desired. A client should consult his or her physician if unsure whether or not a medication can result in hypoglycemia.
What causes hypoglycemia? Typical causes can include:
- Too much insulin when eating less, or irregular timing of insulin;
- Skipping or delaying meals or snacks;
- Irregular timing or carbohydrate content of meals;
- Insufficient carbohydrates to support physical activity; physical activity schedule is too variable;
- Other causes: certain medications, alcohol intake (especially if consumed without food), and change of season.
- Sweating, shakiness, fast pulse, difficulty concentration, decreased coordination, blurred vision, dizziness, weakness, headache, feeling of something not right. Symptoms vary from person-to-person and episode-to-episode;
- Trouble or more effort in performing a routine task may be indicative of low blood sugar;
- Can result in severe confusion and disorientation, irrational behavior, unconsciousness, seizures, coma, death;
- Hypoglycemic unawareness: the client is unable to recognize the symptoms of low blood glucose due to medications or neurological complications of diabetes.
- First step in treating hypoglycemia is for the client to check his or her blood glucose level if possible;
- If the blood glucose level is between 50 and 70 mg/dL the client will need to consume a food or beverage containing 15 grams of carbohydrate. This treatment should increase the blood glucose level by 30-45 mg/dL over 15 minutes. (If the blood glucose level initially is less than 50 mg/dL, 30 grams of carbohydrate should be consumed.) After 15 minutes the client should recheck his or her blood glucose level and consume an additional 15 grams of carbohydrate if it is still below 70 mg/dL.¹ This is known as the 15/15 rule.
- If a meal is not planned within 1-2 hours of treating a hypoglycemic reaction, then a snack containing 15-30 grams of carbohydrate should be consumed to prevent another episode of hypoglycemia²;
- Carbohydrate sources (15 grams):
- 3-4 glucose tablets;
- 1 tube of glucose gel containing 15 grams carbohydrate;
- 4oz non-diet soft drink/fruit juice;
- 1 tablespoon honey or sugar;
- 2 tablespoons raisins;
- 7 Lifesavers or 9 Sweet Tarts
- Exclude products high in fat such as chocolate, candy bars, cake, and potato chips, as they absorb too slowly and increase weight;
- If a client becomes or is found unconscious, or you are in doubt as to why symptoms occur, immediately call emergency services.
- Do not interfere with mealtimes (or medication times);
- Schedule “physical” activities one to three hours after mealtime;
- After a hypoglycemic incident has occurred and been treated by the client, discontinue teaching activity to allow for return of mental and motor function which may have declined during more significant hypoglycemia;
- Client should have their blood glucose monitor and carbohydrate source readily available at all times.
- Identify oral medications and insulin and to obtain proper dosages;
- Tell time to insure timeliness of meals and medications;
- Monitor blood glucose when hypoglycemic and vision may be unreliable or at it's lowest;
- Access food/meal plan, nutritional guides and food labels, to insure appropriate carbohydrate content of meals;
- Measure or obtain desired portions of carbohydrate foods to follow meal/food plan and to avoid over treatment of low blood glucose;
- Methods to identify and locate carbohydrate containing food products and distinguish between non-caloric/low sugar products like diet soft drinks from those that are non-diet;
- Readily access emergency phone numbers or emergency assistance;
- Record blood glucose results and events that may have contributed to low blood glucose for self-review and review by client with physician or health care professional to make adjustments in diabetes therapies.
Additional Resources:
- “The Rule of 15” pamphlet and oral glucose gel (Glutose 15-1 tube 15 carbohydrates): Paddock Laboratories, Inc. 1-800-328-5113 or www.paddocklabs.com
- High/low blood sugar symptom/intervention chart and glucose tablets (1 tablet 5 carbohydrates each). Becton Dickinson and Company. 1-800-237-4554 or www.bddiabetes.com
Footnotes:
- Leahy,J., Cefalu, W. (2002), Insulin Therapy, Burlington, VT., University of Vermont College of Medicine, Marcel Dekker, Inc., p. 58.
- Id.
- Franz M. J., Freeman, J., McCloskey, B., Nath, C., Polonsky, W. (2003). A Core Curriculum for Diabetes Education, Fifth Edition. Volume “Diabetes Management Therapies;” Chicago: American Association of Diabetes Educators, p. 218.
AER REHABILITATION TEACHING DIVISION NEEDS YOUR HELP!
We're looking for talented, committed individuals to serve as newsletter team members for the 2004-2006 term. Requirements: good computer and writing skills; familiarity with Microsoft Publisher is a plus. Nancy will be the editor, but she needs a team of reporters, researchers and editors to maintain the quality and variety of information this newsletter is best known for and to best serve our Division. Interested? Please contact Nancy Paskin at npaskin@lighthouse.org.
NOTES AND NEWS:
ACVREP's Board will be meeting over the weekend of September 11-12, 2004 to, among other things, vote on the new name for certificants in rehabilitation teaching.
New Division Bylaws were passed at the AER Conference in Florida and will be sent out to the membership in the near future.
We are now the Rehabilitation Teaching Division of AER...no more #11
Many states and regions are holding Fall Conferences. Attend and be ACTIVE RTs!
Keep in touch. Let us know what's happening in your state, your district, “what's the news across the nation?”
Nancy Paskin, RTC
Editor, RT News