Interesting blog about a diabetic kid's experience on a DCL cruise

[Maggie'sMom]

I'm saddened this family had this experience, but I also believe this could have been prevented if the mother had gone with her son to the Oceaneers Club/Lab before he went there his first time. She could have spoken to the CMs and made sure there were no misunderstandings in how things would be handled. She could have helped work out a solution. They might have been able to keep his Skittles at the front check in desk and allowed him to check out and treat himself in the hallway and then re-enter the club. Or they might have offered the apple juice as an option and the mother could okay that plan or explain why it might not work.

My DD is on the high-functioning end of the autism spectrum. She is now 13, but when she was in the Oceaneers space, I always went to the Club/Lab with her on the first day and spoke to a CM. We were on this same cruise on the Wonder that the blog was referring to. On embarkation day, my DD and I went to the Edge to check it out. When DD was getting the sticker for her KTTW card, I quietly prompted my DD to talk to the CM about her autism. She did a beautiful job advocating for herself, but I was also there to help if there were any questions from the CM or to fill in any information my DD might have left out or not communicated clearly.

Could the CMs on this cruise have handled the situation better? Yes. They should have talked through solutions with the son other than him returning to his stateroom if he experienced a low. Could the mother have handled the situation better? Yes, she should have visited the club and made sure the CMs were informed and that the candy was allowed in the club or what the other options were.

 

[elvispursley]

do not expect that CMs are trained to treat a diabetic low; expect them to call for medical services.

Yes! I think this is my primary concern with the whole thing. There must have been some major miscommunication with the mom and staff. It sounds like they were 1st-time to DCL, and for a lot of us, we take what shoreside tells us with a large grain of salt because whats true onboard may be vastly different that what info is given shoreside. I question if mom did not have an in-depth conversation with the kids club re. her child's medical issues. I do question why, regardless if the 12 yr-old checked himself in, why his "medication kit' wasn't checked in as well (e.g his low blood sugar supplies/skittles/glucose tabs, etc). And a pp makes an excellent point of how the club was even aware that he had skittles. I do agree that if he was in a lab coat already, and was somehow eating skittles because he was having a low, then yes, he needed to be separated from the rest of the kids. From here, is where my issue arises (and given that it's not my kid and we are only getting one side of the story, I can only advocate that for any child with type 1, further attention needs to happen other than telling a 12 yr-old they need to return to their room--no flame! Only going by what the blog says).

 

[gotomu212]

This really is sad and I have empathy for the family as someone who has several Type 1 children in my extended family.

However I agree with others that the problem is they wanted to let the child self-treat in a SECURED children's space. He was fine in the Edge because they have different protocols, but when he went into an area with preschool-12 secured programming they naturally have different rules that apply based on the ages there.

I think that the mom assumed since her son was 12 with check out privelages things would be the same in every area and didn't speak with the secured club CMs. If she had been with him at check in and discussed the issue she would have known what they can and cannot do in that space and then made a decision whether the Lab was a good fit.

It's sad communication wasn't better, but it really doesn't rise to horribly exclusionary behavior to me.

 

[WildEyed]

We've been on 2 DCL cruises so far with our son who has Type 1 Diabetes - looking forward to our third cruse in August! He was age 6 on the first one (Fantasy) and 8 on the second one (Wonder).

For both cruises we went to the Oceaneer’s Club/Lab on the first day and asked to speak to a supervisor about our son’s medical needs. We showed them all of his supplies – blood glucose monitor, insulin pump, glucose tablets, glucagon syringe (like an Epi-Pen for diabetics), extra snacks (e.g. granola bars).

There was a lot of back-and-forth about what he could and could not keep on his person while in the club but it was very clear that no food would be allowed, including the glucose tablets. The sole reason was because of food allergy. This made sense to me as the CM’s can’t really be expected to be aware of which kid might have a food allergy and which kid might be carrying any sort of food product around, and then try to assess risk probabilities. It did stress me out the first time though as we never go anywhere without quick access to sugar.

The plan they suggested (and we agreed with) was that his stuff would be stored in a large Ziploc bag in the staff room (not sure what it was called but was near the entrance). The idea was that if he needed it, it would be easily accessible. We also STRESSED the importance of recognizing and treating a low blood sugar, mentioning the words “coma” and “seizure” a few times. There was a flag on his file so every time he checked in, the word DIABETIC appeared as well as a few words about signs of low blood sugar – the staff always repeated this back to us.

I agree with other posters who mention that during a low BG episode you wouldn’t necessarily be able to make the right decisions – definitely going to “his room” would not be appropriate.

Overall I’d say that DCL does…okay. Personally I’d like to see much better understanding of Type 1 Diabetes but to be honest I feel this way about school, day camps, and other places that you’d need someone to care for your kid. Based on experience everywhere else, as the parent I felt it was my responsibility to get the club up to speed and provide them with as much information as possible. I can’t tell from the original account whether the family consulted directly with the kids club while on board – they may have felt they didn’t need to after talking to the Special Needs people in advance. On the other hand I also feel like maybe the CMs could have handled it better, e.g. could they have offered to store his supplies in the staff area for the 30-minute session?

The other part of my job as a parent is teaching my son how to deal with adversity arising from his medical condition – he already knows that most people don’t “get” Type 1 diabetes like we do and that sometimes people may say or do things that are more to do with lack of understanding than anything else. So far any problems we’ve run into have been an opportunity to learn “how can we make this work?” I feel sad that this kid was so defeated by the experience but it seems more like miscommunication than anything else.

 

[WildEyed]

With respect to the chocolate - honestly that was just a room attendant trying to be thoughtful. Perhaps a previous passenger had requested no chocolates due to the fact that they had diabetes (e.g. an older adult with Type 2? or a family with a Type 1 that was more restrictive about sugar intake). All she had to do was say "actually we are fine with the chocolates, thanks for trying to think of what our family might need!"

 

[MunFam]

With respect to the chocolate - honestly that was just a room attendant trying to be thoughtful. Perhaps a previous passenger had requested no chocolates due to the fact that they had diabetes (e.g. an older adult with Type 2? or a family with a Type 1 that was more restrictive about sugar intake). All she had to do was say "actually we are fine with the chocolates, thanks for trying to think of what our family might need!"

I agree...and I bet she would have left a big pile of chocolates to make up for it, too. I think the important thing to look at is "was DCL given the OPPORTUNITY to right their wrongs"...if the answer is no...then that falls on the customer/passenger.

 

[bbel]

Honestly, with a child that has severe food dye (hives and breathing issues) allergies, I could see why DCL didnt want the child just eating those in the lab just anywhere in case a child like mine was close and yes, she is still young enough if she found it she could pick it up (maybe not eat it as I believe she is past that age). But I also understand that DCL should really have better protocols for T1D also as there is no way that child would make it back to his cabin to get candy. Couldnt they have a room that stores things for children like epi pens, candy for T1D, etc? Wonder how DCL is going to handle epi pens now that they can administer that. They cant just call someone as those need to be close by (coming from personal experience with epi pens). This is why I am my child's best advocate and I take responsibility for what she eats and comes in contact with. It sucks when she's at school but educating her helps.

I really hope they give DCL another chance. Dont flame me but we are only getting the one emotional side of the story.

Epi-pens are, in a way, totally different.
CMs have training in how to administer epi-pens, you can't really get it wrong. They're never going to train you in how to 'treat' diabetes because it's so much more complicated.
The first time you drop off and epi-pen the parent signs a form to give DCL consent to administer an epi-pen if needed. That would happen right away then as soon as possible parents and medical are contacted.

 

[bbel]

At the end of the day, the rules are there to keep everyone safe. They're not there to be difficult howeve that might seem...
You let one kid in with 'just' skittles, the next family read about it somewhere (I don't know...maybe like here...) and they want their kid to be able to go in with different food, because it works better for them or they don't like skittles...
Then a kid with a different medical condition requires different food again.

Like I said before. This is one side of the story. Yes there are bad CM, but I really doubt that they would have told him to get out and not offer to keep the candy out of the space for him and give it back when he leaves.
Pretty much every day a kid will go into the spaces with food in their pockets, get it out to eat, and get it put away by a CM until they check out. Yes some kick up a fuss and some even chose to call their parents to pick them up to leave because of it, but I suppose those CMs just need better training too...

 

[_auroraborealis_]

In these kinds of situations (kid clubs, day camps, etc.) you simply cannot expect every staffer to be trained in every childhood medical condition, and be prepared to administer advanced first aid for all sorts of conditions. It's not reasonable and it won't happen.

You need to both represent your child's condition, and work on an accommodation that works in the environment and the rules they've set, which are often there in part to protect from liability because those staffers are NOT medical staff. Their first aid training is mostly bumps, bruises and small cuts, with some allergy protocol and a healthy dose of "when to call the on-board medical."

 

[elvispursley]

I don't think that it's unreasonable if you're going to be working in the kids club to have some basic knowledge of the more common medical conditions that kids might have (food allergies, T1 diabetes, asthma, even epilepsy). Even when we have our vacation bible school at our church, if a child has any health conditions, their name tag is marked and their counselor is informed. We wouldn't expect the counselor to treat the child, but certainly we expect that they would recognize if something was going on. The CMs who work in these environments are required to have basic first aide training, including CPR--the above chronic illness/diseases could easily lead to cardiac arrest if the symptoms aren't quickly recognized and action taken (including calling for the medical team). Of course it is the parents responsibility to have conversation with the CM when dropping off, preferably with the supervising CM to ensure all questions are answered, on both sides (e.g @WildEyed makes sure the CMs are aware of what low blood sugar signs are and the importance of treating). I think for the most part, the CMs do recognize the more common medical conditions, but as parents of children with special needs, even (or especially) of a 12 yr-old who may be checking himself in/out, it's critical to have a conversation.

 

[bbel]

I don't think that it's unreasonable if you're going to be working in the kids club to have some basic knowledge of the more common medical conditions that kids might have (food allergies, T1 diabetes, asthma, even epilepsy). Even when we have our vacation bible school at our church, if a child has any health conditions, their name tag is marked and their counselor is informed. We wouldn't expect the counselor to treat the child, but certainly we expect that they would recognize if something was going on. The CMs who work in these environments are required to have basic first aide training, including CPR--the above chronic illness/diseases could easily lead to cardiac arrest if the symptoms aren't quickly recognized and action taken (including calling for the medical team). Of course it is the parents responsibility to have conversation with the CM when dropping off, preferably with the supervising CM to ensure all questions are answered, on both sides (e.g @WildEyed makes sure the CMs are aware of what low blood sugar signs are and the importance of treating). I think for the most part, the CMs do recognize the more common medical conditions, but as parents of children with special needs, even (or especially) of a 12 yr-old who may be checking himself in/out, it's critical to have a conversation.

It's not unreasonable. And they do.
Quite a lot of training. Quite often. Believe me.
Don't let one persons bad experience make it a reason to argue that all CM are untrained. That's not fair.

But you also have to remember that there can be literally hundreds of children in care at one time. No CM can be expected to know every medical condition of every child, especially when they're brand new kids every few days.
Even more so if a family haven't given any information about medical conditions when registering. CMs might be able to work magic at times, but they're not mind readers or doctors.
Yes they have to make sure that all questions are answered, but sometimes some parents don't mention medical conditions because they think their kids won't be allowed in the space, or they just want to register and get the band because they have other things to do, or they think their kid is old enough to deal with it and know about it better and CM don't need to know...

 

[Dug720]

It's not unreasonable. And they do.
Quite a lot of training. Quite often. Believe me.
Don't let one persons bad experience make it a reason to argue that all CM are untrained. That's not fair.

But you also have to remember that there can be literally hundreds of children in care at one time. No CM can be expected to know every medical condition of every child, especially when they're brand new kids every few days.
Even more so if a family haven't given any information about medical conditions when registering. CMs might be able to work magic at times, but they're not mind readers or doctors.
Yes they have to make sure that all questions are answered, but sometimes some parents don't mention medical conditions because they think their kids won't be allowed in the space, or they just want to register and get the band because they have other things to do, or they think their kid is old enough to deal with it and know about it better and CM don't need to know...

And then there are the parents who will shriek "but it's our privacy". I know our school nurse deals with this a lot (I teach special ed and we have more than a few "fragile" kids). No matter how much he assures the parents that only he will have access to the information and it will only be accessed if there is an emergency and the parent cannot be reached, some simply will not disclose invisible conditions or even medications that the child is on. I was talking with him about it one time and he said that he has at least one friend where there was an emergency and the parents could not be gotten a hold of so they had to call 911 and give them all the information they had. The child ended up in more of a medical crisis because they were given something that had a bad reaction with a medication the child received at home but the school was unaware of. Thankfully the child survived, but it shows how important it is that at least one person has the information.

 

[_auroraborealis_]

About 200,000 children under 18 in the US have T1 diabetes (this is per JDRF so I feel like this number is probably good).

About 7 million children under 18 in the US have asthma (CDC numbers, so I feel this number is probably good).

About 6 million children under 18 in the US have a food allergy (NIH estimate, so again... seems okay for a source).

So, again: I think this starts falling into the category where you cannot expect every camp, daycare, etc. to have protocols and training to deal with it, and the scale of the issue is much more narrow than either food allergy or asthma. (It is more common than childhood cancer, though.)

 

[Miggee]

Who in the world is allergic to Skittles??? It's just sugar, for the most part. That's BS

i would have thought the same as well, that is until i found out a kid in my daughter's preschool is allergic to red dye.. I never thought that would be possible, just go to show there are many exceptions, i just feel bad for the kid, not easy on parents either.

 

[elvispursley]

It's not unreasonable. And they do.
Quite a lot of training. Quite often. Believe me.
Don't let one persons bad experience make it a reason to argue that all CM are untrained. That's not fair.

But you also have to remember that there can be literally hundreds of children in care at one time. No CM can be expected to know every medical condition of every child, especially when they're brand new kids every few days.
Even more so if a family haven't given any information about medical conditions when registering. CMs might be able to work magic at times, but they're not mind readers or doctors.
Yes they have to make sure that all questions are answered, but sometimes some parents don't mention medical conditions because they think their kids won't be allowed in the space, or they just want to register and get the band because they have other things to do, or they think their kid is old enough to deal with it and know about it better and CM don't need to know...

I apologize if I made it sound that "all CM" were untrained. I actually stated that they all had to undergo basic 1st aide and CPR (and I'm sure they have to be certified quite frequently and extensively, just like any daycare provider, only with all the hygiene standards involved with a cruise ship). I think that out of all the positions on the ship, CM in the kids club (primarily the younger clubs) and the life guards have some of the most stressful jobs on the ship, and even though my kids hated the clubs ("too many little kids mom"), I can't even begin to imagine it and recognize that it is NOT an easy job.

Where I become upset is reading (and I realize I'm only getting the blogger's side of the story) the mother's report that they told her son he could return to his room to treat it. I would hope if this actually didn't occur and things have just been exaggerated in frustration. Especially when other parents have said they have had no issues with their children and T1-diabetes after x-number of cruises. It makes this" diabetic disaster" seem more and more a tragedy of miscommunication.

Just out of curiosity, how does it work when there is a food activity and there are a lot of kids participating...how are the kids identified who do have issues with allergies or diabetes? I know you worked in the kid's club and would love to hear how this works (if you can, totally understand if you're not)

 

[Dug720]

I apologize if I made it sound that "all CM" were untrained. I actually stated that they all had to undergo basic 1st aide and CPR (and I'm sure they have to be certified quite frequently and extensively, just like any daycare provider, only with all the hygiene standards involved with a cruise ship). I think that out of all the positions on the ship, CM in the kids club (primarily the younger clubs) and the life guards have some of the most stressful jobs on the ship, and even though my kids hated the clubs ("too many little kids mom"), I can't even begin to imagine it and recognize that it is NOT an easy job.

Where I become upset is reading (and I realize I'm only getting the blogger's side of the story) the mother's report that they told her son he could return to his room to treat it. I would hope if this actually didn't occur and things have just been exaggerated in frustration. Especially when other parents have said they have had no issues with their children and T1-diabetes after x-number of cruises. It makes this" diabetic disaster" seem more and more a tragedy of miscommunication.

Just out of curiosity, how does it work when there is a food activity and there are a lot of kids participating...how are the kids identified who do have issues with allergies or diabetes? I know you worked in the kid's club and would love to hear how this works (if you can, totally understand if you're not)

Just my guess, but I think we also have to remember this is a tween boy we're talking about here. Having worked with middle-school aged kids before I know many of them take things to extremes that actually never occurred nearly as dramatically as they seem in the tween's head. I find it far more likely based on all these other reports and experiences that he was advised he could check out and treat himself - as others have stated was the protocol - and he heard it as "go to your cabin". Again, just a guess - but as you did acknowledge, we only have her side of things, and since she was not there when the event occurred, she is basing that on what he told her - which is hearsay.

And as many have said, it could have been prevented had the mother had a conversation with the staff - and a supervisor or manager - in person. I'm not a parent, but I suspect if I was I would want to have that conversation in person no matter what I'd been told over the phone by someone who's not even on the ship if I had a child with a serious medical condition.

 

[elvispursley]

And as many have said, it could have been prevented had the mother had a conversation with the staff - and a supervisor or manager - in person. I'm not a parent, but I suspect if I was I would want to have that conversation in person no matter what I'd been told over the phone by someone who's not even on the ship if I had a child with a serious medical condition.

Absolutely! My kids are vegetarian (have been their entire lives) and I remember the first time I checked the boys in I made sure I spoke to someone to ensure that they would not be given anything with meat. I know this is a little over the top, but one of boys was given pepperoni when they were in daycare by mistake (goes against our religion) and I was upset but didn't make a big deal, until we got home and my son was vomiting (his stomach, having never had meat, had a very difficult time digesting). So if I went to the extreme of speaking to the CM regarding their diet, you bet that if either of my kids had a serious condition, regardless of age, I would definitely speak to a CM, especially the first time. Forget shoreside (I look at them like getting pre-info and then confirming the info once onboard )

 

[bbel]

Just out of curiosity, how does it work when there is a food activity and there are a lot of kids participating...how are the kids identified who do have issues with allergies or diabetes? I know you worked in the kid's club and would love to hear how this works (if you can, totally understand if you're not)

Whenever a child is registered and there is any need - medical or dietary their band is fixed in place with a red x-lock (even if its something like shell-fish or horses that they'll never come in contact with in the spaces, if its mentioned its noted down). All other children (4+) just get a grey x-lock. Some parents can be funny about it and think their kid is going to stand out - if its a serious allergy, it could potentially save their life....
Counselors have the ability to see all the kids that have allergies/medical conditions (ones that are checked in, checked in in a certain area, onboard....theres multiple options)
A few minutes before and activity or meal theres is a designated CM who will look through all that, highlight ones that need to be 'hunted down' (They're probably going to ignore the horse allergy if it pizza for dinner...). If theres no allergies checked in, all kids are good to go. If there are the notes and parental requests will be read. Some parents want to be called, or their child move to the other room, or doing a different activity. Those kids will be found if still in care. Any kids that need to be observed will be identified to the relevant CMs. Sometimes if its for cooking, a child just needs to wear gloves.
If there are a number of allergies then as a child goes up for food or to join the activity then every child's bad will be scanned to check that they're ok (usually they just scan all the red locks, but most of the time all kids do because YA CM are still human and the wrong lock may be put on.
If a child is eating in the space and they have a severe allergy or are having a special meal then they will usually be sat at a separate table (sounds harsh, but safety fist). Same if its cookies, there might be a no-egg end of a table, and a gluten free table...
So many activities require children to have their bands tapped before joining (cooking, science, marshmallow olympics (they don't even eat them), play doh, facepainting...)
Which is why we ask the locks to be kept on the band, I know people like to remove them but it can make things go so much quicker, as this process can often happen multiple times a day...

Bit of an essay...but with a job that revolves around protocols, stories like the one that this thread started from always make me wonder what bits of information have been potentially missed out....

 

[elvispursley]

Whenever a child is registered and there is any need - medical or dietary their band is fixed in place with a red x-lock (even if its something like shell-fish or horses that they'll never come in contact with in the spaces, if its mentioned its noted down). All other children (4+) just get a grey x-lock. Some parents can be funny about it and think their kid is going to stand out - if its a serious allergy, it could potentially save their life....
Counselors have the ability to see all the kids that have allergies/medical conditions (ones that are checked in, checked in in a certain area, onboard....theres multiple options)
A few minutes before and activity or meal theres is a designated CM who will look through all that, highlight ones that need to be 'hunted down' (They're probably going to ignore the horse allergy if it pizza for dinner...). If theres no allergies checked in, all kids are good to go. If there are the notes and parental requests will be read. Some parents want to be called, or their child move to the other room, or doing a different activity. Those kids will be found if still in care. Any kids that need to be observed will be identified to the relevant CMs. Sometimes if its for cooking, a child just needs to wear gloves.
If there are a number of allergies then as a child goes up for food or to join the activity then every child's bad will be scanned to check that they're ok (usually they just scan all the red locks, but most of the time all kids do because YA CM are still human and the wrong lock may be put on.
If a child is eating in the space and they have a severe allergy or are having a special meal then they will usually be sat at a separate table (sounds harsh, but safety fist). Same if its cookies, there might be a no-egg end of a table, and a gluten free table...
So many activities require children to have their bands tapped before joining (cooking, science, marshmallow olympics (they don't even eat them), play doh, facepainting...)
Which is why we ask the locks to be kept on the band, I know people like to remove them but it can make things go so much quicker, as this process can often happen multiple times a day...

Bit of an essay...but with a job that revolves around protocols, stories like the one that this thread started from always make me wonder what bits of information have been potentially missed out....

First off, thank you for sharing! I do indeed recall the red locks on my boys' bands (both are vegetarian and one has migraine headaches--nothing I'd consider severe but would definitely warrant a call to me or DH to come get him ASAP so we could take him back to cabin and get meds in him)! All I have pictures in my mind is the phrase, "hearding cats" Wow, that is a lot of work! Does DCL pay for all your ongoing training/certification for CPR, etc?

 

[dclpluto]

About 200,000 children under 18 in the US have T1 diabetes (this is per JDRF so I feel like this number is probably good).

About 7 million children under 18 in the US have asthma (CDC numbers, so I feel this number is probably good).

About 6 million children under 18 in the US have a food allergy (NIH estimate, so again... seems okay for a source).

So, again: I think this starts falling into the category where you cannot expect every camp, daycare, etc. to have protocols and training to deal with it, and the scale of the issue is much more narrow than either food allergy or asthma. (It is more common than childhood cancer, though.)

That's really high numbers. 74.2 million kids are in the USA. Wonder why the numbers keep on going up for kids. With the really high numbers of kids having problems now DCL should be well trained.