
One night after we arrived home from our wonderful family "WE DID IT" vacation to mark the 1 year anniversary of Cara's diagnoses we woke up to a noise that every parent hates. The sound of your child vomiting...crap was the first thought in my head, the second thought with 6 kids is I wonder who that is? and of course the third thought with a diabetic is please do not be Cara (the diabetic).
Me and my husband got out of bed to see who was in the bathroom.....and it was Kylie. I felt a little relieved seeing my poor little Kylie hovering over the toilet and not Cara but I knew that this was only the beginning. We had spent 3 days with each other in close contact and a 4hour car ride to and from the falls. This ways not going to be good.
By the end of the 2 weeks all six kids and myself ended up with the flu and of course the one that was the most sick was Cara. She woke up in the middle of the night on Thursday I was thinking it was her usual pee wake up break....boy was I wrong. She was crying at the top of the stairs mumbling something that I could not quit make out, I ran up to her and I figured out very quickly what she was saying.....she had thrown up in bed and it was coming up again for round two. I brought her to the bathroom and called my husband who was pulling a late night at work. I put her on the couch, got the bucket, got a blanket, put on the t.v. and waited for Chris. Just before he walk in the door the panic started to creep in.......What the hell are we suppose to do again??
It had been 1 full year since she was dx, 1 full year since the cram session you receive at the hospital trying to take in all this new information and at the same time trying to grasp the fact that yours, Cara's and your families lives will never be the same again. So needless to say we could not remember anything about sick day and what to do. So we turned to our books, it was 12:00am and my husband and I where reading every page that the hospital gave us on how to care for Cara and really nothing that we read was going to help us. Every note on sick day read if she throws up more then twice go to the hospital, well we were well over throwing up more then twice we were most likely at the double digits by then with the highest ketones I have every seen, really the highest that the pee ketone strips can show. Ketones are a very poisonous by product that the body makes when a diabetics blood sugars are high and during sickness.

We continued looking through all of our notes on sick days for some kind of answer. But all I could remember was at discharge 1 year ago they just kept telling us if there is anything that you need you can call us at the hospital and someone will get back to you. So in our panic and really trying anything to keep us out of the ER for the night we called the peds floor at the hospital where they where completely no help and they transferred us to the ER and they were absolutely no help. At the end of the phone conversations they even ask my husband if he knew the number for tele-health and that is when he got really mad, swore and hung up on the person on the other end of the phone.
Now feeling completely alone and still having know idea what to do about the ketones, trying to stop the continuously vomiting 4 year old Type 1 looking like she is going to pass out at any moment from going to the ER we finally found some useful information in our books from the hospital:
never omit insulin
if blood sugar is higher then 8mmols or 144 push clear fluids and if less then 8mmols or 144 drink regular kinds of juice or soft drinks
check blood sugar (they say every 2 hours but I was checking every half an hour)
give gravol
and check ketones ever bathroom visit or if you are lucky enough to have a blood ketone meter use it. (after this sick day we now have a blood ketone meter)
This really helped us but I'm not a doctor so always ask your doctor what to do during a sick days!

With this information in hand we made it through the night with only one hour of sleep but a much better looking Cara, her ketones where starting to decrease and the vomiting stopped at about 4:30am. However we were not out of the woods just yet now the battle was on trying to keep Cara's blood glucose up. We finally where able to call our clinic and get some information from people who knew something about Type 1 diabetes, we decreased her insulin and tried to get her to eat whatever we could but her blood sugar would just not go up and the last straw was the vomiting starting up again at 12:00 pm that afternoon. The clinic asked us to bring her in to the hospital to get some fluids and blood work done. All that work and we where heading to the hospital anyways.....poop score 1 for diabetes!

On arriving at the hospital Cara was given a room on the pediatric floor, there was no one from our clinic around just regular doctors and nurses however we still felt a sense of relief we were finally going to get the help we needed....so we thought! But when you are dealing with a child with Type 1 diabetes I am quickly learning that things just don't go as smoothly as they should.
Our first indication that things were not going to go as smoothly as we thought was as they where hooking Cara up to a bag of fluids the doctor order the fluids with sugar in it, the nurse looked at Cara and then the doctor and polity suggested maybe they should give her the sugar-free fluid, they went back and forth for a little and both decided on the sugar-free fluid. They also drew some blood for tests which I still have no idea what they tested for because while at the hospital I needed to use our pee ketones strips to check her ketones. I have no idea why they did not do a ketone blood draw?? Well I should not say that, I know why some things where done and others where not because they had no idea what Type 1 diabetes was and how to treat it!! After the 90mins of sugar free fuilds where done I was finnally able to check Cara's ketones with our ketone pee strips and her ketones where back to large as large as the strip can show and they still told us to go home, I was wondering if they even knew what Ketones were??
We had stayed up all night with only one hour sleep, we where stressed, unsure, disappointed in ourselves that T1 has been with us for a year now and there is so much more that we need to learn. All we wanted, all we need was for someone, a doctor to take control for only a few hours. Cara would be safe, we could relax and let our guard down for a little and this is not what we found at the hospital. All we found was a doctor who was unsure of what to do with Cara and know one really who had a clue how to help her. They sent us home with super large ketones, given her fluids, but the wrong kind (we later found out that they should have given Cara the sugar fluids but with her insulin which would have lowered her ketones).
Back at home I got her ketones down, she started eating again and blood sugars leveled out, well as best you can do with a Type 1 diabetic and had made it through our first really sick day!!
7 comments:
Yes I feel for you Nicole and yeah this was a hospital and they did not know what to do for ketones ? that is really strange . i hate hospitals .
WOW Nicole,
That sounds like a HORRIBLE experience. You guys did marvelous! It is really scary to have a type 1 kid puking with large ketones and a LOW blood sugar...ARGH.
From the hospital-side of things I can totally see them NOT getting it. I worked in the pediatric ICU at a level one trauma center and some of the nurses that I worked with when Joe was diagnosed did not even understand that he would need insulin. It is pretty unsettling for sure.
Glad to hear about the blood ketone monitor!
xoxo
Hi Nicole,
I am very sorry you just went through your 1st sick day. We did too and it was very scary. A great resource is the BC Children's hospital. Our nurse here in Calgary taught us a "Mini Glucagon" trick, from the BC Children's web site. Below is the link and hope it is helpful for future times trying to stabilize stubborn low sugars, from illness. (This is NOT used for severe lows). I wish you had better support, we are so blessed with our system here. Hoping you are all well again,
Michelle
Calgary
http://www.bcchildrens.ca/NR/rdonlyres/8954ADE9-2B5B-4524-9715-93F1E0CD5ED0/22136/minigluc.pdf
So sorry to hear that you had to go through all of that, how terrible! I hope EVERYBODY has recovered by now. You also reminded me that perhaps Fred and I need to revisit Elise's sick day plan, since it was given to us when she was 12 months old and its now a year and a half later. Thanks!
WOW!!!! You did a great job...so proud of you :) :) :)
And guess what...YOU WON!!!!!!!! Take that, D!
WOW that's horrible!!! It's so sad that the hospital/doctor could help you.
I know when Tristan is sick and has ketones the most important is to push fluid and keep giving insulin. The insulin will bring down the ketones. I remember once his CDE telling us to give him whatever he wanted to eat.... she said I don't care if he wants cake for breakfast, give it to him.... anything that has carbs so that you can give him insulin! But when the child vomits everything.... that's a problem :(
I'm glad that she's doing better. Also, give yourself a high five... you did a great job! :)
This post hit so close to home, the worry of sick days is overwhelming. I don't know what it is, after all the sick days we have had...when a new one pops up it's like I'm starting all over again. I forget a lot. I have to go over my notes to refresh my memory. Probably just another thing I block out until I NEED it. I'm glad she is back to her old self again. (HUGS) to Cara! And to her Momma too!
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