I have waited 2451 hours to face my greatest fear of Ellie T1 Diabetes. It has been hiding in the corner, a veritable dark shadow, licking it's lips in anticipation of just the right moment.
That right moment arrived Thursday at 10:30pm when Ellie's 2-hour stubborn 'low' ended with a a slurry of juicy juice, grape glucose tabs, a beef stick and 2 peppermint candies thrown up into a plastic red bowl.
The Stomach Flu.
Why the fear, you ask? Because a person with T1 Diabetes needs a fine balance between glucose and insulin; and when one of those two is being hurled into a bowl at 90 miles an hour, the other is left with a wide open playing field. Blood sugars plummet, ketones rise and DKA can take over over in the blink of an eye.
Our first hint that something was wrong began on Thursday night at 9:20pm when Ellie had been in bed for about an hour. She knocked on my door and told me her tummy hurt. This is Ellie's way of knowing her sugars are too high or too low, so I didn't immediately worry that she was getting sick. We tested her blood sugar and found she was at was 55, so she downed a 4oz box of Juicy Juice. We retested 15 minutes later and she was only up to 65, so she slurped another 4 ounces of Juicy Juice. Another poke read 67 so we went for 3 grape glucose tabs and a beef stick (for some protein to make the sugar 'stick') and we threw in a couple of peppermints for good measure.
Another finger prick yielded a measly 91 from the meter. At this point I call my Diabetes Angel, Stef, and ask her why Ellie's numbers aren't through the roof with all that sugar in her system. Stef told is to give her another peppermint and then recheck in 10 minutes.
A whoppin' 118 says the mini meter. What the?
I text Stef and she replies "I hate to tell you this, but Ellie might be getting sick. As in grab-a-trash-can-she-might-just-vomit sick."
You can guess what happened next. And again and again and again until bile was the only thing left for her tummy to toss.
This was not all, though. In addition to worrying about how I was going to keep Ellie's blood sugars stable without the help of glucose, I knew I needed to get her into the bathroom to test for ketones.
The first test read "small". Okay, I can handle small. Push water and . . . . crap, how can I push water when she is puking?
A couple of hours later, Ellie retested and the ketone strip read 'Moderate' and I have to admit, my first thought was that we needed to bundle her up and take her to the hospital. It was 4am at this point and while that shouldn't have swayed my decision, it did. Here was a sick little girl who was still vomiting every hour and I knew if I told her we needed to get up and leave for the hospital she would get very upset. As in s-t-r-e-s-s-e-d. As in stress = potentially lowering her already unstable blood sugars.
So we stayed put and I pulled out my instruction binder from the Endocrinologist. "If ketones are small-moderate, inject give 10% of the total daily dose usage of insulin (we are on Humalog/Lantus MDI). Repeat every 3 hours until ketones test negative."
Okay. I can do this. Insulin without any glucose in her system, though? How does that work?
It didn't. By 7am her ketones were "Large" and once again I turned to the binder. "If ketones are Large-Xtra Large, inject 20% of the total daily dose usage of insulin and repeat every 3 hours until ketones are small-moderate."
Deep breath. Okay, I can do this. More insulin in her body, yet still no intake. The last time she puked was 6am.
Another couple of hours go by, this time without any more vomiting. Her blood sugars are miraculously hovering around 160-170 despite the extra insulin. In addition, we had dosed Ellie her Lantus (24-hour controlled release insulin) the evening before, so we had no control over what was already floating around in her blood stream.
At 8:15am I call the Dr. I know, I know. "Why didn't you call before????" You ask.
Well, several reasons. 1. I had my Diabetes Angel, Stef, who is a mother of a T1 herself and has been through it all before, 2. I had the instructional binder from the Endo's office, 3. The DOC (diabetic online community) had provided stories and examples of 'been there, done that'. and 4. I just knew in my heart that staying at home was the best place for us to be .... at that time.
Would I repeat that advice to anyone else who asked? Heck no. You do what YOU need to do, what works for YOU in the situation.
The nurse confirms we were doing all we could do and to keep at it. If for any reason we feel uncomfortable, or if Ellie's blood sugars dropped and she continued to puke, then we should head for the hospital.
Well, the seconds turned into minutes which turned into a couple of hours and Ellie slowly began to improve. Sips of water stayed down. Dry heaving stopped. Ketones moved down to Large-Moderate. And finally, Ellie and I slept.
The hubs hit the couch so Ellie and I could have the bed. Used test strips were strewn EVERYWHERE!
The infamous instruction binder . . . . with more used test strips. I am still finding carnage from the bloody battle.
But today we are on the other side and we survived. You can bet I made certain the door smacked the stomach flu's ass as he walked out the door.
Thank you. Thank you all out there in the DOC. You made my first experience as a fake-pancreas-tackling-puke doable. You shared YOUR stories and YOUR experiences so I could arm myself with information when it came time to fight OUR turn.
Another 'first' with T1 Diabetes now behind us. Good riddance!