Last year, dance teacher Elaine Mannix of Commonwealth Dance Academy in Walpole, Massachusetts, learned a 10-year-old student had been diagnosed with type 1 diabetes. The dancer had just added hip hop and lyrical to her class schedule and would sometimes dance three hours a day, building toward participating in more competitions as she approached middle school. The news was frightening to Mannix and the dancer's parents, but thanks to technology and communication, the dancer has been excelling in her classes and learning—along with Mannix—to monitor and manage her disease.
As a teacher, you're in a caregiving role to your students, and those with chronic conditions like diabetes, asthma, autoimmune illnesses and even cancer may need customized support to keep enjoying class. Here are some steps you can take.
Learn what's going on.
When Jennifer Leone Vordermark's 11-year-old daughter Ingrid started intensive treatment for juvenile dermatomyositis (JDM), an autoimmune disease that causes skin rashes and muscle weakness due to inflammation, Vordermark met with Ingrid's ballet teachers. She gave them literature from Ingrid's doctors and explained what support her daughter needed—permission to rest when chemotherapy sapped her energy and a heads-up if other students at the studio fell ill (Ingrid's immune system was suppressed as part of her treatment, so she was particularly susceptible to getting sick). Vordermark also let them know what kinds of worst-case scenarios they should plan for, like her increased risk of breaking a bone if she fell, due to the high dose of steroids she was on.
Similarly, Mannix met with her student's mother shortly after the diabetes diagnosis. “Her mom came in with some paperwork for us to read over just to have a better idea of what she was going through," she says. The mom also brought an emergency toolbox containing contact information, apple juice and Skittles to keep on hand for the student.
Understand there isn't a one-size-fits-all plan.
Part of the reason it's important for you and your staff to read up on the illness and to communicate with the student's guardian is that there isn't one umbrella formula for accommodating a sick child at your studio, and the same dancer won't have the same needs every day.
Students like Vordermark's daughter Ingrid might just need to sit down and rest if they're feeling side effects of heavy treatment. Occasionally, the steroids would give Ingrid major mood swings. Her mom has a sad memory of a teacher who kicked Ingrid out of class. “They said, 'You need to leave the class. You're acting ridiculous.' They knew she was sick, but because she could dance most days and they didn't see what was going on behind closed doors, they didn't believe her. They thought she was this overdramatic kid."
A dancer with type 1 diabetes might simply need to grab a snack when her blood sugar levels drop, but she could also act confused if her levels are too high. Whether it's easy access to a bathroom, an inhaler on hand or something else entirely, having flexibility will help you learn the nuances of your student's needs over time.
Vordermark with her PNB partners. Photo by Ashley DeLatour, courtesy of Vordermark
Plan for absences.
One of the most comforting things Vordermark saw teachers do for her daughter was give her an understudy. “She would feel stressed and say, 'What if I don't make that show? I'm going to ruin the whole dance,'" Vordermark says. But the teachers had a plan. “They always had a backup: 'If Ingrid's not here, here's how we're going to do this.'" That took away the pressure to be there for her classmates.
Some of Ingrid's teachers also sent work home—summaries of exercises they were working on, so that she could keep track of what she'd missed.
Help them feel normal.
Mannix's student wears a blood glucose monitor that checks her levels constantly and beeps when she's high or low. The dancer's mother has an app on her phone that alerts her to any changes. And it lets the student know, too. “There were a couple times when I'd hear a beep and I'd look at her, and she'd go to her bag and eat something," Mannix says. “I didn't realize it could be so managed." She says the student hasn't shown any signs of distress. “It never stopped her. She was here for every class, alert and eager." The glucose monitor is invisible under a leotard, so Mannix says there hasn't been a need to tell the other students. She even built in a journaling and snack break during class blocks that run past two hours, so that everyone gets a chance to eat something. It doesn't have to be about one student's condition.
The difference in Ingrid's case, however, was that telling people helped her feel like less of an outsider. “Year after year they moved up together and became a tight-knit group," Vordermark says of Ingrid's ballet friends. “Everybody knew what was going on with her, and if she was out, they knew why."
Let older students own their condition.
Living and dancing with a chronic illness will be a journey for the student and everyone who cares for her. But as a dancer matures, ideally she'll develop a routine for living with her illness.
Katelyn Prominski found out she had type 1 diabetes when she was 28, after a career performing with The Suzanne Farrell Ballet and Pennsylvania Ballet. She started dropping weight like crazy.
She thinks some teachers didn't believe that she was eating normally, but those who did, including Farrell, urged her to figure out what was wrong. Since then, she's valued the support of directors and stage managers. “My stage managers, choreographers I've worked with and peers I've danced with always want to make sure I'm feeling OK," she says. “They really put the ball in my court," she adds, and she prefers it that way.
On a show day, she sets juice boxes at either side of the stage and lets her director know if her blood sugar is running high or low that day. She wears a glucose monitor, just like Mannix's young student, and stage managers watch it during her performance. But, she says, a beep doesn't mean she's incapacitated. If she's smart about it, she can still perform with her blood sugar running a little high. That's because she knows her body and her disease. For a younger dancer, she says, ongoing communication with teachers is essential for the student to continue learning her limits while devoting herself to classes.