Posts tagged post hypo headache

Crazy Days And Mondays Always Get Me Down.

This is the first time today I have been able to stop and do anything else, other than deal with hyperglycaemia symptoms.

Sigh.

You see, every September, when the air starts to get a little bit sticky, and the sun begins to bite your skin, I KNOW we are going to have three months of pandemonium.

Lance is like me, he has skin of milk, that gets a light blush even from the smallest amount of direct sunlight. Unlike my mum, who wouldn’t have been aware 30 years ago of just how dangerous the Australian sun is, I have always been pedantic with sunblock application, floppy hats, and avoiding the sun during 11am and 3pm. I have suffered from some terrible sunburn as a schoolgirl, and as a result, I have horrible freckles on my forearms. (One of my fave actresses, Julianne Moore, a fellow redhead has them too, which has made me feel less self-conscious of the fact that I have deformed skin pigmentation times two thousand.)

Julianne Moore Made Freckles Look HOT!

Julianne Moore Made Freckles Look HOT!

 I have managed to maintain a good skincare regime since I was 14-ish, and unlike many Aussie redheads, I have escaped the nightmare of a freckled-dotted face.( I happen to think freckles are gorgeous-just not on me.)

Anyway, back to the weather. We have been waking up at 6am lately, our linen dishevelled, and a slimy layer of perspiration covering our bodies. Yep, it’s that time. The time when glucose drinks and jellybabies live beside the bed, and it’s simply too hot to stay asleep.

Which brings us to this morning.

I drifted off into a light trance-like sleep around 4am. I did one final test on Lance; he was 4.2mmol/L.  I slammed my head into my hand, out of sheer rage. I gave Lance a few gentle shakes, and brushed a straw against his lips that would filter a pure glucose mixture into his mouth. Naturally, he was resistant to drink it, he thrashed about the bed for a minute or two, whimpering. I don’t think he was feeling hypo, I think it was the fact that he woke to find it almost impossible to breathe, and that his bedclothes were glued to his skin.

Finally, he drank, and I felt content that he had consumed enough to get him through ’til morning.

I turned up the fan, pointed it in his direction, and he rolled over and went back to sleep.

I woke to my alarm bleeping, and the early morning sun blaring through a space between the window and the wooden slat blinds. I was sticky, annoyed and after listening to Lance’s breathing pattern for about twenty seconds, I was so furious that I knew I would find him hypo.

I rolled over to find him fast asleep, his hair matted to his forehead, and his skin a ghostly white.

I fumbled with the glucometer, waited for the countdown, and felt immediate nausea when I saw a 1.9mmol/L greeting me. I jumped up, grabbed his glucose gel, sat him up, and squeezed myself behind him. His head dangled forward like a sad puppet, and I felt a few seconds of “Help Me”, directed at no one in particular, I just didn’t want to be alone in this situation.

Lance began to groan, which was a good sign, because it meant that I just might be able to get some glucose gel past his lips, and not sprayed back into my face. Fortunately, he was quite compliant, and sucked the sticky, thick paste straight from the tube. He actually had the entire dose, which was quite an achievement.

We haven’t had too many “one-ers” since Lance has been on his pump, and when he is really low, his hypo symptoms have become far less severe. The pump is such a blessing-Lance’s hypos were something that used to really worry me-I used to shudder imagining me holding him down as a 16 year old, copping a fat lip and a black eye-his strength is a force to be reckoned with now, let alone as a strapping young teen!

I would have looked like a victim of Battered Mother’s Syndrome.

His blood sugar had climbed up to 8.6mmol/L. He was crying, unable to get out of bed, due to the blinding headache that always follows an incident such as this. I administered a dose of ibuprofen (much better than panadol for post-hypo pain). He was just nailed to the bed, despite the glucose now surging through his blood, he was flattened, an insidious combination of the humidity and the hypo.

I lay beside him and he put his hand in mine, I could see the beautiful pink roses returning to his cheeks, however, he was beginning to sport some sinister black circles under his eyes. So poetic, really. Everything related to Diabetes seems to have a compromise involved. You can eat this, as long as you have this…You can go here, as long as you test at x o’clock. You can play outside, as long as you have your shoes on. Nothing’s ever simple…easy…okay or without the cause and effect phenomenon.

When Lance finally woke, he looked much better, but he was very flat, the chatter that usually fills my house was absent. He smiled and nodded when asked a question, but he wasn’t himself at all.

BSL: 5.1mmol/L.

I gave him a glass of juice, which he was happy to drink. I then suggested that he would feel better after a cool shower. He said he didn’t feel like he could stand up, so I took in a plastic chair for his to sit on while the water refreshed him.

I had just managed to get the water temperature at a perfect level, when I saw it.

Lance had taken his shirt off, and was just about to continue undressing when I discovered that his site had come unstuck from his tummy. All of that squirming around and moisture in the air had obviously attributed to this-something that I have yet to encounter since Lance began pump therapy.

I calmly ( innardly, I was madly panicking) put Lance into the shower. I only changed his site yesterday. “Oh well,”I thought,”at least we can start the day fresh, with a new site, and move on.”

Lance was rejuvenated after his shower. He felt much better, and even requested some breakfast.

BSL: 5.8mmol/L.

He had two slices of wholemeal toast, a mango and a bowl of yogurt, all washed down with two tumblers of water.

Site change was successful, I put some antibiotic cream on the old site, just-in-case.

Two hours later, Lance commented that he was hungry and needed a rest.

BSL: 18.5mmol/L.

Ha! So, we are going to have a “Nothing Makes Any Sense” Day, are we?

That’s okay, I’m ready for it. Bring it on.

I gave a correction on his pump, made a low carb snack and presented Lance’s filled water bottle to him. He asked if he could do some reading whilst lying down. Naturally, I agreed.

Should I ring the Diabetes Clinic? I should. Better to nip this in the bud, even if they tell me what I already know.

I bought the phone into Lance’s room, and rubbed his aching legs whilst making the phonecall.

Hmm. No answer. I gave it another shot.

I was a nanosecond away from saying, “Hel..” when I realised I was listening to a recorded message. I left my details, a brief description of the problem and hung up.

I smiled at Lance. “You’ll be feeling great soon, honey. The wizard in your pump has given you the perfect amount of insulin to come back down to the healthy range.”

“I hope you’re right, Mum.” he replied.

I wheeled the air cooler in Lance’s room. After hanging out a small amount of washing, I had a wet face cloth wrapped around my own neck. The heat was just frightful.

BSL: 7.7mmol/L.

“You were right, Mum!” Lance called from his room.

“Hey! That’s fantastic news! How do you feel inside of your body?”

“Ergh. My legs really hurt and I have some tummy pains, too.”

“Maybe you are hungry and you could do with some food?”

“Actually, I AM really hungry!” he laughed. He requested some fruit salad and ice cream.

He had two bowls of FS and IC, and then asked if we could make pikelets.

It was the last thing I felt like doing, but I was happy for him to want to eat.

We whipped up a batch in no time, and Lamce demolished four pikelets. He appeared with our trusty carbohydrate book, and asked how much he should bolus for them. The recipe I used already has the carb values worked out per serve, so after completing some quick maths in my head, I gave him the number, doubled checked as he pressed it into his pump, and he pressed ACT.

“Do you feel full now?”

“No, not really.”

“Well. we’ll do a test in an hour, and we’ll see what your bsl is. Maybe I can make some noodles with vegetables or something like that?”

He eagerly nodded his head.

Half an hour later, Lance appeared in front of me.

“Mum, I wasn’t feeling well, and so I did a test.”

24.4mmol/L.

I quickly handed him his water bottle, and got out a blood ketone strip.

Oh fantastic!!! Ketones had decided to join the madness!

The blood test showed 0.3% of ketones were present. Lance, ever the perfect diabetic, also did a urine test, “just for backup.” It showed 3+++ and 4++++ of glucose in his urine.

I picked up the phone and rang the doctor’s surgery.

No appointments. Okay.

I asked if I could speak to my doctor. This is an arrangement that he has given all of his staff permission to follow. If I call in an emergency situation, I am to be transferred through to his phone line. I’ve done it dozens of times.

“Look, I’m sorry Kate, Dr Dutch has gone overseas for two weeks. Therefore, Dr Congo is taking over all his patients. He’s really much too busy to speak to you at the moment. He has a difficult patient with him right now.”

“Well, Carol, I have a difficult problem that I need to speak to Dr about. What do you suggest I do?”

“At this stage, I could only suggest you present him to Emergency at the hospital.”

“That won’t be happening, could you please ask Dr Congo to contact me in between patients? I know he won’t mind.”

“Well, it’s Monday, and he hasn’t had a break, no lunch-nothing. So I beg to differ, he WILL mind.”

Haughty, miserable cow.

Lance corrected himself again. I investigated every part of his tubing, looking for air bubbles, making sure that the site looked as if it had “taken”…that was the only thing that I could think of. Or he had a virus of some description. My inner D voice told me that it was just “one of those horrorshow days” that come to haunt us every now and again, just to keep us on our toes.

5pm passed…Diabetes clinic didn’t call back. GRRRRRR.

At 6pm, BSL was 28.8mmol/L. I suspended the pump, and gave an injection of Novorapid. Lance was making frequent visits to the bathroom and guzzling back water. His legs ached terribly, he placed a pillow between them and rocked backwards and forwards to allieviate the pain. I changed the site. I could smell insulin the moment it was removed from his tummy. The cannula looked perfect-no kinks, no bends…

So, here I had my son, insulin dependent, receiving continuous insulin infusion, but blood sugar skyrocketing.  Temperature:normal. Ketones present. Limited medical help available.

BSL: HI.

I rang his endocrinologist’s mobile number, but another endo answered. We had met before, so he did know a little about Lance and his Hypos.

“Well, Kate, it sounds like you have it all under control. You are doing all the right things-I can’t fault what actions you are taking.”

Thanks a lot, Doc, I appreciate the compliment, but, !!!!!!!!!!!!

“Keep up the Novorapid. Call back if you are worried.”

Did that REALLY just happen??

I hung up the phone and calmly strolled into my bedroom. I buried my head deep into a pillow and screamed to release the fury and frustration I felt.

I packed up a bag of emergency items, and accepted that we were off to the Emergency Ward.

I asked Lance for one more blood test.

“Mum, I’m 13.6!!!!”

I couldn’t help but laugh-we were both so hot,we had been tormented all day by crazy blood sugar numbers, had ridiculous encounters with our trusted medical team, and now-his blood sugar had dropped over 20mmol/L in 40 minutes..it really was quite comical, in a manic, crazed way.

So, now, it is 10.37pm.

Lance is 8.2mmol/L.

No ketones in sight.

Ravenous appetite present.

Leg pain is no longer present.

I have all of this documented, and I have an appointment with Dr Congo tomorrow. I want to show him just how crazy things can get. As much as I adore him,  he has bothered to learn more about Type 1, and has treated Lance very deftly and appropriately in emergencies-I NEED him to see the rollercoaster numbers and just how quickly situations can turn around.

For now, though, Lance is ready to rest his body. Afterall, his entire body went through quite a workout today, yet he barely moved a muscle.

This day has shaken me considerably, but pump or no pump, this is how Lance’s Diabetes responds to the change in season.

We are fortunate enough that we can spend the majority of the summer in air conditioned luxury this year.

 (Thanks, Pat. You’re still looking out for us.)

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The Ultimate Type 1 Survival Kit.

A few newly diagnosed families have written to me lately, asking what is the Ultimate Diabetes Survival Kit.

I have two versions-one for everyday trekking about town, and the other, for overnight visits or holidays. 

However, I will concentrate on what I take around with me on a day-to-day basis.

Basically, it’s IMPERATIVE to never leave the house without some form of confectionery or soft drink.

Hypo’s love an audience, so the best way to combat them is to have a range of easily consumed soft lollies, or your child’s favourite sugary drink. (Poppers are ideal, but again, it’s up to individual choice.) If your child becomes so hypo that they refuse to eat, drink or cooperate, you can buy tubes of condensed milk and tubes of icing in a variety of colours from the supermarket. Rubbed into the gums, they will absorb into the bloodstream quickly, hopefully quickly enough that a popper won’t be thrown back at you in disgust. (The danger here is choking. If your child is really upset, and crying and thrashing, DO NOT attempt to put anything into their mouths. Resorting to using a Glucagon Kit is a far more sensible idea, and you KNOW it’s going to work.)

But, first things first.

You are going to need a backpack with lots of different pockets. Of course, it’s up to you entirely what design, shape or colour you select, but it’s vital to choose something that isn’t easily misplaced in a hurry. Have an attachment to a zipper with your name and contact details that are easily legible.

The Essentials.

Glucometer-fully stocked with strips,extra strips, lancets and a spare set of batteries.

A spare lancet device is also handy-the number of pens that have broken in a crisis…it feels sometimes as if Diabetes is giving me a test to see if I break down due to stress.

A container with your insulins inside it; if you are injecting, you’ll know what apparatus to bring with you. It’s great if your insulin doesn’t get too overheated, hence keeping it in an air tight container. Carry a small sharps container to dispense of any used “sharps.” A few alcoholic swabs never go astray, either.

Cans of soda, packets of lollies and other Hypo treatments that are favoured, as well as bendy straws. It’s amazing how a sugar deprived brain has no idea to send a message to the mouth, telling it how to drink out of a can or bottle!! Lucozade is also fantastic, as it has extra glucose than standard soft drink, and a lid, in case your child tells you to get knicked. Keep all of these in a clip seal bag.

GLUCAGON Kit. Yeah, I know I’m annoying with my ranting about glucagon. It’s just that it has literally saved my son’s life, when he has been too uncooperative to eat or drink. Get a prescription from your GP and have it filled immediately.  If an ambo officer sees the “orange box,” they’ll know exactly what they are dealing with, too!!

Throw in a packet of glucose tablets. If your child is displaying symptoms in a queue, it’s great to be able to pulverize them into the earth, (the symptoms, not the child…) by allowing a burst of glucose to keep them safe until you get out.

It’s also fantastic to get an ID card made up, stating that your child has Type 1 Diabetes, or any other allergies or ilnesses. An Australian company, Diabete-Ezy,make these cards-all you need is a passport photo, and list  whom your child’s next-of-kin is. Elissa, the Founder of Diabete-Ezy does the rest!

It’s also good to keep a list of your GP, your Endo and their contact numbers, your last AIC result and what insulins you are taking, plus your daily dosages.

Along the way, I have also learnt to include Children’s Panadol, in case your child gets a pesky post hypo headache. A bottle of water is a must, in case blood sugar levels get cheeky and leave you stuck with nothing but a bag of sugar, and also a few bandaids of all different sizes. Lance has a habit of crashing into a fixture in a store when extremely low, and leaving a generous sized portion of skin behind…

If your child has had an attack, whether it be hypo or hyper whilst you are away from home, and you are concerned about not being close to them, include enough change in a container for a taxi to the nearest doctor, hospital or home. Just in case your mobile runs out of battery, keep a berocca bottle full of coins to make calls to people who can help you out.

A pack of handwipes are also a great idea, in case Panadol gets spat in your face, or in some cases, a really bad hypo can cause an unexpected upchuck. A change of clothes is also a great idea; if it is warm weather, still include a jacket, as sometimes kids’ can feel cold after a hypo.

Some muesli bars or fruit bars are helpful if your child has safely recovered from a hypo. They will need something that will take lower to burn-muesli bars, although riddled with sugar, are ideal for keeping blood sugar stable until you get into your safe environment.

This is a little far-fetched, but I still do it anyway…

If you are in a shopping centre, a library, a cafe-just about anywhere, don’t be phased if you have a managerial looking person approach you and question why you have syringes or vials of “drugs”  etc. I have been accused too many times to count of giving Lance “drugs.” Inform the staff member of the situation, if they still are giving you ‘tude, inform them that you are going to report them and their workplace to the Human Rights and Equal Opportunities Commission in regards to blatant discrimination. Look up the number in your state/country and watch how quickly they back off. An asthmatic wouldn’t get looked down upon for using their inhaler now, would they?

Your NDSS Card, Diabetes Australia Membership card, and your child’s “Disability Card” never go astray either.

Well, that would have to be close to the ULTIMATE hypo kit, However, if any other brilliant, genious mother/father/carer has something not on my list, I’d love to add it on!!

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