Friday, April 17, 2009

When you least expect it... no answer,,, and we move on,,

So after my hooky day that I mentioned earlier... we had some random Low BG's... and then some more, and then some that were harder to recover from than before... 15 carbs, test still low(if not lower) 15 more carbs.. rinse and repeat for an hour before we got up to 80! 2 nites of this and on the second nite... we decided that with a white poop and a mysterious 'non absorbtion' of carbs.. or over absorbtion of insulin, we would call the dr hotline(s).. I called 3.. none had advice but to go to the er at childrens for some answers.. they were all anticipating some storm was about to happen in his body... within an hour he did vomit... and then the low... got lower!

I whisked Jared off to the Er while DH stayed home with my daughter and sure enough.. more lows... when we got there, they gave him the antinausea med (which he asked for when he got there! to quote him " I wish I had a Zofran"... the nurse said that any kid that would wish for that must know what is going on and how could she refuse... they were fast getting us in a room, and fast to get labs drawn... I was not sure for what... we did not have ketones, so no IV was 'yet necessary' unless he dehydrated...but the line was in the arm if needed

post anti nausea med, he was still low, and downed 4 more juices.. we finally hit 80. We shut off the pump...(not sure why I had not thought of that earlier that night.. ) I down dialed the pump the night before when he was going low, by only 15% and he woke up with ketones... from one extreme to the other - Yikes... this is odd and crazy... especially for Jared.. he is happy in his range of 80 - 180 and prefers to stay there ;) as do we for him ;)

They admitted us, with thoughts of liver or adrenal or hormone questions/problems unanswered in the horizon.. labs they were running a plenty... that night, jared went from 59 - with 15 carbs to recover, to 42 so we added 16 more carbs, he went up to 62 ... and so on... you get the picture...
they shut off the basal, again he woke up high after going low until around midnite..

they kept us another day.. now thoughts of celiac were on the mind... and all the good endo's seemed to have left for the day.. leaving us with a rather un confident, un competant dr... who after a day with no lows just results and supervision suggestions...decided that after a low of 67 just before dinner(which really is not that bad) which we decided to (at dinner time) let him eat off, rather than fill up on juice (Which is not our preference for a low anyway, we usually stick with milk as we feel that the protein/carb combo for a stable recovery) so he consumed 58 carbs... fifteen minutes later, we checked, he was 104.... perfect, my plan was to cover him for 58 minus the free ones... and move forward with a plan for discharge... Dr incompetanto decided we were here battling lows, and we should not give him any insulin and see what happens

(we interupt this blog to remind those who even might not know someone with diabetes that almost always if you don't give a diabetic insulin with food.... they go HIGH and ketones will surely follow)

I sucked it up... thinking he had a plan. He followed up by saying... and with no insulin on board, we can hold off on checking him for 4 more hours! (WTF!!!!!) okay, call me crazy, but I can play it that safe (or stupid) at home, and don't need my son in the hospital for them to play silly games that really did not seem at all logical.. I can assure you we have never had an experience like this before, and this new dr, clearly did NOT have a plan!

He came back 10 minutes later, and said, you really think that if we don't cover him or give him insulin or correct him, he will go high enough to wake with ketones?? I confidently, yet humbly said that I was sure it would, but maybe there was something I did not know, but I would be checking him every hour to watch him climb, as I am a data collector by nature, and never again would I not bolus my son for a meal and see what happens (for fun - NOT!)

We checked him after an hour, he had gone up 100 more, an hour later, 100 more... then I cryed... quietly in the hall, so not to alarm jared just after he fell asleep. A nurse advocated for me and made me feel it was okay for me to feel strongly about my son getting some insulin tonight.

The dr came back, i stood up for myself gently telling him, i could play it safe at home, and not 'collect data' by not checking him often if I was at home, which even then i would not do.... I needed them to allow me to give my son finally at 380 he agreed would could do a half a correction (Still no basal) that half a correction was equivalent to the basal rate he would have gotten had he been on one.... and so... shall we play a game here, quess what happens next?.....

with a barely basal rate of a correction every 2 hours, he stays at that 380 from 8 at night, until 8 the next morning,.... steady as a rock.... and woke up with????? you guessed it... ketones.

okay, so my husband calls to say goodmorning, and as i am relaying this message, he is reminding me that we brought him there for guidance and safety not expecting all this and now, they are making him sicker... or sick.

we clear the ketones, I pony up again when rounds happens, with that dr standing there, and I said that I was not happy with his treatment last night, the obvious happened, and we need a plan, so i can take my kid home...

long story short.. a few more tests( and yes, 2 seperate (more) blood draws) later we have kind of had it... we increase his insulin ever so slightly, get him in the 200's and ask to be discharged.

The happy ending is that Jared is home, and eating normally again, and his blood sugar was 190 before going to bed, I will as i would have anyway, watch him like a hawk when he sleeps, and continue a conservative basal rate and conservative correction.

3 days at the hospital was enough to be greatful for all the uneventful but still diabetic days we have. We can handle this, the unknown is the hard part, but almost 2 years into it, realistically, i his mother aka pancreasparent know him best, and once he was out of the low woods (at risk for coma and seizures) I should have been bolder to do what i would have done at home in the safety of the hospital instead of letting them do nothing, but keep him 'safe' the test results for celiac arrive next week, everything else was negative thankfully... I will keep ya posted.

I think I needed this, a vent, and a breath, and to be home in my pj's with my hubby and daughter.

Home again, home again,,, jiggity jig :)

1 comment:

Jill said...

Bless your heart! It sounds like you were put through more drama than you needed to be by Dr. NotKnowItAll. Good for you to stand up to him! Mommies know D-kids know their babies better than anyone else :) You did the right thing! Maybe he was fighting off the touch of some kind of stomach bug. I'm glad he's better now! Take some time to rest this weekend :)