Tuesday, November 24, 2009

Ketones and IV Fluids, Part 2...

It was 2:30am by the time they left. I tried to go back to sleep. I knew he was in good hands with his Daddy and Pompa, but I still felt SO guilty. His mommy should be there for him.

I kept texting with my dad to see how things were going, instead of sleeping. BG was going up and ketones were going up. The ER docs had no clue what to do with regards to the Diabetes.

They also did not have a blood ketone meter. I am SO thankful I sent ours with them. BG had gone up to 360 and ketones were 2.1. The ER docs did nothing for the BG. The Daddy bolused The Superhero for the BG to get him to come down. The nurses were very upset that he did this without telling them.

They did get and IV with fluids started. They took some blood to run some tests. They were testing to see how much, if any, acid was in his blood. This would determine if we would have to stay for 24 hours or if he could go home soon.

The blood came back and it was determined that he was already in mild DKA because he did in fact have acid in his blood. They would keep him for 24 hours.

I was anxiously waiting at home for The Princess to wake up so I could nurse her and then head to the hospital. I ended up waking her up to nurse her, since she actually decided to sleep longer than normal. I fed her and then my mom took over sitting here with her so I could go see my little man.

I got to the hospital and went into his room. He was lying in his bed with his Pompa (my dad) watching a movie. He looked at me and did not make a sound. All I saw were tears coming out of my poor little man’s eyes. (Just picturing him with the tears, is bringing tears to my eyes all over again!) I could tell he was happy to see me and sad for all they had to put him through already. He showed me his IV on his hand. I laid in bed with him for a while.

Over the next several hours, we had the endo on call and the pediatrician from the hospital come in to visit. I asked what we needed to do to get him home. They wanted him to be able to hold down food and get rid of the ketones. I verified that if he did this before 24 hours was up that we would be able to go home. They assured me that we could go home once those two things happened.

He ate breakfast and kept it down. Still had small ketones, so we continued watching movies to pass the time until they checked again.

He ate lunch and kept it down. Ketones were gone! Woo Hoo! We get to go home, or so we thought!

The endo was fine with us going home. The pediatrician at the hospital on the other hand was not. She wanted his BG to be back in range. He had been running higher all day. Any parent of a kid with Diabetes (or anyone with common sense) knows that little to no activity all day, fatty hospital foods, and the dreaded breakfast spike WILL cause BG to run higher. It did not matter what we did, though we were cautious of dosing amounts of insulin because he can be very sensitive. He was running high ALL day! No matter what we did. He was high.

Because of the higher BG’s, the pediatrician did not want us to bring him home until he was down into the 200’s again. She said she would think about it after he had dinner. I explained to the nurse (because she was the in between person, since the doc would not come talk to me herself) that if he eats dinner, he will be high from the hospital food, again, and we would be continuing the cycle.

After going back and forth for a couple of hours the endo on call convinced the pediatrician that we knew what we were doing and she agreed to send us home.

So, after all this, I have learned a few things…

1) If The Superhero has a fever and is appearing to come down with something, do NOT decrease his basals if he refuses to eat and BG is low.

2) Get him to eat ANYTHING to be able to give him insulin so ketones do not develop.

3) Get the prescription filled for the anti- nausea medicine.

4) Bring ketone meter to hospital, since they have no clue what one is. Urine ketones are not current/accurate.

5) Give your child insulin if his BG is above target in the hospital, despite the nurses freaking out.

6) Convince the pediatrician that YOU know more about Diabetes than she does.

And last but not least…

7) The Superhero thinks it is REALLY cool when Mommy catches his pee in a cup. :)

I REALLY hope we can avoid the hospital in the future, but am also pretty sure, this will be the first of many visits for The Superhero.

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