It finally happened: our ER visit

Ever since Rosie has been diagnosed (nearly five years ago now), I have lived in fear of the day that we would have to make a hospital visit for a simple virus.  I somehow felt like that would mean I hadn't done things right, or we had let things get out of control.   I know, I know... that's just that silly d-mom guilt thing.

Last weekend, Rosie's younger brother had a bad case of the flu.  He came home from school early on Friday vomiting, and pretty much spent the whole weekend being sick and laying on the couch.  Rosie and I were gone over night on a Girl Scout trip, so Little Brother was home with Dad.   I had hoped that Rosie might not catch it since we were gone.

Monday, Rosie was fine.  We even commented on how great her numbers had been all day that day-- a so-called "no hitter" on the Dex screen.   (In hindsight, I should have known better than to voice this out loud, right?)   

Well, you know how this goes.... yep, that night she was up through the night being sick.  By 6am she had a bg of 600 and large ketones.  DH tried giving her a Zofran, and she couldn't even keep that down.   I called the endo's office, expecting the standard issue instructions: sips of Gatorade, more Zofran, etc.   Nope.  The nurse immediately told us that we needed to bring Rosie to the ER.   Since Little Brother had also been sick that morning, he was staying home.  I packed up Rosie and DH stayed home with Little Brother.

The hospital-- which is also where our endo's office is-- is only about ten minutes from our house.  Poor Rosie got sick as soon as we got there-- she ran to the trash can in the parking lot.  A security guard saw us and kindly went inside to get a basin for Rosie.  They had a room ready and set to work on her IV, drawing blood, giving her Zofran in the IV, and hooking her up to various monitors.   By this time my normally happy girl was downright grumpy... she was getting mad about trivial things, like having a band-aid on her finger, and she was just not acting herself at all.

One thing surprised me: after we'd been there an hour or so, we were told to disconnect Rosie's pump.  They were not giving her any insulin at that time.  This worried me, so I stopped the ER doctor (stereotypical ER doc, who didn't want to slow down for questions-- grrr-- but actually was very nice) and asked about this.  He explained that the theory is that if there's something wrong with the pump, they won't know it, so to dose by pump might mean that she is not getting the correct amount of insulin.   They prefer to inject insulin.   That made sense to me, but there was still a good hour or so when she was sky-high and completely without insulin.   The whole process was hard for this mama bear to watch! 

After a couple of hours of waiting around and more bloodwork, Rosie was allowed to eat.  She ordered a cheese omelet (one of her favorite foods) and oatmeal.  Once she ate, she was like a whole new kid-- back to her normal personality and much more calm.  

An hour or so later, we were cleared to go home.  Her bg was down around 400, and evidently her ketones were down-- I don't recall them actually telling me what they were.   Rosie spent that evening and part of the next day sleeping, and by Thursday, she was back to normal, with blood sugars only spiking around 300 on occasion.

Whew.   All in all, it turned out that going to the hospital wasn't as bad as I'd feared.  It was kind of nice to be there and feel safe in knowing that there were plenty of people who could help her when she was so sick.  It's not something I'd want to repeat if we can avoid it, but if we have to go, I think I'll be much more comfortable with the idea next time.

 

Thankful for Zofran

The flu is bad enough.  The flu with Type I Diabetes is miserable.

Rosie didn't keep anything at all down for most of yesterday.  Not chicken broth, not Sprite, not water.  I finally called the endocrinologist's office to see if they had any suggestions.  I had run through my usual arsenol:  giving regular Sprite instead of Diet to get some carbs in her,  sips of broth, etc.    She was showing "trace" amounts of ketones and her numbers were good-- in the mid-100's all day-- but I was starting to worry about dehydration and increasing ketones.

Usually when I call, we get right through to the nurse or the nurses' voice mail, and they call back pretty quickly.  Yesterday, though, I was on hold for 15 minutes, and after speaking with the nurse, it took nearly an hour for her to speak with the endo and call me back.  She said that this area has really been hit hard with the flu bug and they were getting tons of calls for sick kids yesterday. 

At any rate, the endocrinologist prescribed some Zofran.  Zofran is one of the best drugs ever invented, in my humble opinion.   When I was pregnant with both kids I suffered from severe hyperemesis, and Zofran (plus Reglan in a pump that I wore 24/7) was the only thing that helped me.    So, anyways, I was thankful to hear that's what they wanted to try with Rosie. The plan was to try the Zofran and if she was still getting sick, to page the doctor last night and have Rosie admitted.

The Zofran is working.  Rosie sipped some broth, and later had a small bowl of chicken noodle soup last night.  This morning she's had some toast, and so far, so good.   Whew! 
 

Sick

Poor Rosie got up around 6am vomiting.  It was a rough night-- at bedtime she had one of those lows that just wouldn't go away.  50% temp basal + juice box + glucose tabs only got her up to 77.  Her Dex alarm was going off constantly.   Then she finally came up around 1am, and we both got a few hours of sleep before she starting feeling sick.  Ugh.

I never know how diabetes will affect a "normal" illness.  Generally, Rosie goes sky-high a day or two before she actually shows symptoms of an illness.  Last night, she was low- go figure.  This morning she's running high, but nothing scary- I think she hit 320 at the highest point so far.  (Not good, of course, but we tend to see at least one 400 when she's sick.) 

So, here we go again... just waiting to see what extra challenges diabetes will throw our way.

 

Sick Day with D

She's got a sore throat, headache, fever.  Normal illness for a school-aged child, right?  These things go around all the time.

Then you throw D into the mix.

We are constantly monitoring blood sugars, trying to bring down high blood sugars while still keeping carbs in her system.  Rosie tends to go sky-high about a day before she actually shows symptoms of illness.... I should have known yesterday that we'd be up all night!

We're checking for ketones, praying to just see that tan color and nothing worse.  Trying to keep her hydrated.  Making sure we have enough keto strips in the house.

We have to double-check any over-the-counter medicines to make sure they don't contain any acetaminophen, which would interfere with her Dexcom.  The first time I tried to buy cold medicine after she got her Dex, I think I stood in the aisle reading bottles for a good 20 minutes.  It seems to me that nearly every children's cold medicine has acetaminophen.  Now, at least I know which brands are usually safe, and I go with a homeopathic remedy if she just has a sore throat without a fever.

A little bug is never little with a D-child.  There are so many extra things to worry about.  Fortunately, both kids already had Dr. appointments scheduled today for flu shots and check-ups... I guess now we'll just make those into "sick" appointments!

 

Puppy Knows...

Rosie had a bad day at school d-wise... the clinic aide (whom I filed a complaint on this morning due to ongoing problems... but that's another story for another time) called at the END of the day and left a message to let me know that Rosie had been in the clinic 8 times, and was low each time. One her teacher sent her to see if she had a temperature, because she kept saying she didn't feel right.   First off, I was concerned about all the lows.  Then later it hit me-- why on earth didn't she call me earlier in the day???  I would have brought Rosie home. That's getting added to the complaint list, of course... but as I said, that's another story.

Anyways, Rosie comes home from school and settles in on the couch.   Our puppy, Angel, clearly knew something was wrong with Rosie.  Angel was determined to lay down with Rosie, either next to her or on top of her.  (Bear in mind that our puppy, a 5-month old Golden Retriever, is nearly as big as Rosie!)  After repeatedly being pushed down, Angel went and got a bone, and laid it down right next to Rosie's face as she slept.   Angel finally had to be put into her kennel so that Rosie could get some rest.   Aren't dogs the sweetest things?  :)

As for Rosie, this evening she's running a fever and has the sky-high blood sugars that we've come to expect when she's sick.  She just went up to bed... we're on a 200% temp basal and a fresh dose of ibuprofin for her, with a cold drink and a new book for me.  I predict a long night ahead for both of us.  I pray she feels better by morning!

 

Stormy Day

Cloudy this morning.  5:30am check of 260.  Breakfast check at 7:40am: 400, but negative for ketones.  Bolused, fed, bolused the carbs.   I downloaded her pump and Dexcom and emailed the info to her endo, since she's been having a lot of highs lately.  Rosie said she felt fine, so off to school she went.

Thunder.  9am call from school: blood sugar is over 600.   I head to school to change her site and set a temp basal.  I also sneak in some ibuprofin to ward off the headache that's sure to hit Rosie as she comes down... ibuprofin is still an issue of contention with the school.  Wish I'd taken some myself as I deal with the clinic aide.

Lightening.  11:40am phone call: it's lunch time and she's still reading over 600.  This is going on three hours now, and we're getting really worried.  Daddy is at home, so he's dispatched to go pick her up.  I'm half an hour away at work... not really getting anything done, but there, just the same.  I pace my office and try to be a psychic long-distance pancreas.   I can't for the life of me figure out why she's so high.

Lull in the storm.   12:55pm.  I can't stand it... I'm not getting anything done at work for worry over Rosie.  I call home.  She's down to 450.   We joke that it's a bad day when we're actually celebrating a 450.

2:45pm.  I'm home.  I was useless at work.  It seems that Daddy and Rosie have found a magic formula that works to bring her blood sugar down: lunch from McDonald's and playing at home.  Not my first choice of ways to deal with it, but, whatever... she's ok.   Rosie is playing around the house, laughing about the McDonald's cure for her crazy high.  She's down around 189.   I'm exhausted, worried, and relieved, all at once.

Raining again.  Rosie's at 131 with an arrow straight down.  A 15-carb snack levels her out.  We'd normally let a number like that ride a while, but we know better-- she typically crashes after coming down from a crazy high like that.

Supper: calm skies.  She's fine.  Glucose in normal range, no headache, anxious to go to softball practice and Brownies with her friends.  To look at her, you'd never know that the last eight hours have been a diabetes rollercoaster. 

Ironically, after supper we head out to softball practice, where it promptly started raining, for real. 

.

Which comes first...

... high blood sugars or not feeling well?    In our house, it's always a guessing game.  Sometimes, high blood sugars for a couple of days seem to come just before Rosie starts showing symptoms of the flu or a bad cold. 

Other times, like today, she just doesn't feel good... achy, tired, headache... but I blame that on being mostly in the 300s all night long last night.  I would imagine I wouldn't feel very good after staying that high for 8-10 hours, either.    I'm going to change her site and crank up another temp basal after she finishes breakfast. 

At any rate, we're home today to monitor for ketones and get some rest.