The school year is just around the corner for 10-year-old Emmy Cartwright.
That means a whole new group of teachers to train and rounds to the doctor for the girl and her mom, Helen.
The fifth-grader at a Chandler charter school was born deaf and wears a cochlear implant. Two years ago, she was diagnosed with diabetes. Last year, she learned she has celiac disease, a condition in which her body can't process gluten - which is in many foods, such as bread.
"We just did our endocrinologist appointment to make sure her levels were all in check," Helen Cartwright said. The endocrinologist also checked to make sure Emmy's insulin pump is providing the right dosage to address her diabetes.
Going to school for some East Valley children isn't as simple as picking up a backpack and heading out the door. For those with medical conditions - from asthma to food allergies to diabetes and celiac disease - it may mean providing the school with medications, equipment and, as in Emmy's case, training.
Cartwright said she will send backup equipment for Emmy's cochlear implant (which assists with her hearing) to school, as well as a bag of gluten-free snacks should Emmy need something to eat due to a low blood sugar issue. She will also sit down with all her daughter's teachers.
"All teachers are trained in diabetes, but not necessarily Emmy's reactions," she said. Cartwright will let them know what it looks like if Emmy's blood sugar levels are high or low and what needs to be done. In addition to her insulin pump, Emmy has a syringe at school that can deliver glucose.
"I'll meet with all the teachers she comes in contact with: P.E., Spanish, library, everybody," her mother said.
Nadine Miller, director of health services for Mesa Unified School District, said there are "quite a few kids" with medical conditions such as asthma or diabetes. Some - especially younger children - may need more assistance at school checking blood sugar levels or knowing when they need to reach for an inhaler.
Parents need to take several steps to get ready for classes to begin, Miller said, including getting doctors' orders, delivering needed equipment to school (such as inhalers) and making sure medications haven't expired. Parents should meet with nurses and teachers right away or even before school starts to make sure a child's needs are met or to provide training if there are special concerns.
"We usually train multiple people ... to see that their care is managed each day at school," Miller said.
If a child has food sensitivities for any reason, and he or she wants to eat meals provided by the school, it's important to talk to the cafeteria manager about options as well as how food is prepared, said Dr. Swati Kolpuru, a pediatric gastroenterologist with Cardon Children's Medical Center in Mesa.
"It's very important that parents have a conversation with the people in the cafeteria," Kolpuru said. "A lot of people may not know small crumbs can be dangerous with kids who have celiac disease. If they're providing gluten free items, parents need to ask how the cooking is done. Is the same grill used (as non gluten-free items)? The same tools? If so, then no, it's not gluten free."
It is possible, Kolpuru said, for children to eat at school if parents are proactive.
Miller said it all boils down to keeping everyone informed about any health or medical condition a student may be facing.
"We just need to have good communication with the parents and the physician," she said.