Posts tagged vomiting

The Repercussions of The Australian Summer versus Type 1 Diabetes.

13 December, 2008 · Filed under By Kate, Diabetes Complications, Diabetes me, Diabolic, From Parent to Parent, Insulin Pumps, Peripheral Neuropathy · Tagged , , , , , , , , , ,

I really don’t want to sound like Negative Nancy. After all, it’s the Christmas Holidays, we should be embracing our time together. School is over, Christmas Beetles chirp loudly at night, we can stay outside until at least 8pm-it’s such a relief to watch the sunset, and feel a cool breeze wash over us. Kids walk past our house and exclaim, “Merry Christmas, Lance’s Mum!!” It’s just a wonderful time of the year.

However, where Diabetes is concerned,  Numb November always blends into Dreaded December.

At this time of year, we suffer from blistering humidity. It becomes so overwhelming that you feel like you could almost suffocate. We have had 90% humidity in the air for about 10 days now, along with the Queensland sun burning its little heart out.  Lance’s Diabetes and summer have never been able to meet an agreement where they can give each other a break. We have had 3 out of six Christmases in the emergency ward..it’s SUCH a blessed relief when Summer turns into Autumn.

Last week, Lance woke up, visably hypo. He couldn’t sit up, and his words were slurring together as if he had been sipping vodka all night. I rushed for a handful of jellybabies, and began to speak loudly and in a sing-song-y voice to keep his attention. His eyelids were flickering, and each time I would call his name, he would jump a little, and smile at me. I managed to get him to have 4 jellybabies. He started drinking juice. I didn’t even bother with a blood test, because I knew I didn’t have time.

I lay beside Lance, and began rubbing his hair. He didn’t seem overly distressed, probably because he wasn’t really “with” me.  Then the twitches came.

The leg jerks.

The tightening of his fingers and toes.

A metre long strand of drool oozed from his mouth.

(I have dealt with Lance and seizures before..but I really wasn’t prepared for this one…)

I felt like I was trapped in quicksand. I couldn’t move my feet to grab the phone or the glucagon. I actually had to talk myself through what to do out loud.

First and foremost, I put him in the recovery position, and checked that he didn’t have a jellybaby hiding in his mouth. All clear.

A multi-coloured stain began to bleed onto the sheets from his drool. As I assembled a glucagon kit, I told him how much I loved him, and that I would always make it okay. and that would be all over soon.

I guess, as a result of the whole peripheral neuropathy diagnosis, I am very vulnerable at the moment. My face was awash with tears as  I planted a syringe full of mixed up glucagon into his thigh.

I then kissed his clammy head again, and began to sing softly to him.

I was barely able to dial Lance’s father, Scott. When he picked up, I croaked down the receiver,”I need you!  I need you now! We have a seizure situation here! Please come as quickly as you can!!”

Scott arrived approximated seven minutes later. Lance was sitting up, and falling backwards on the bed. His tenancity to fight the hypo was so difficult to watch, this one had full control of him, and there was nothing he could do to beat it.

I managed to get another glass of sweet drink into Lance-his  bsl was 3.6mmol/L!!! I shudder to think what it was prior to the seizure….

I called my doctor, and his receptionist said to bring him in immediately. As soon as Lance began to speak in sentences again, the first thing he was able to communicate to me was “Mum, I think I may vomit soon..”

I raced through the house for a bucket, and returned, to find Lance’s beautiful strawberries-and-cream complexion had turned into a whiter shade of pale, with a tinge of green.

He was very unsteady on his feet, and was determined that he would not be going to the doctor unless he was wearing  only his underwear.

“Just a singlet and satin boxer shoers, honey…that’s all.”

“No, it’s too heavy on my skin. I will have to go like this or I won’t go at all.

I looked at Scott and sighed.

“Okay sweetie, whatever makes you happy, I just need Doctor Congo to have a look at you.”

“Why? I don’t feel sick!!” An I going to the doctor??

“Um, you had a very bad hypo about half an hour ago my darling. “

“Did I? Can you carry me mum, and turn the lights all off? My head is really hurting.”

Scott rushed out to the car, and I carried my son like a newborn baby and let him lay down on the back seat. I sat with him, and strapped him in as best I could. I told Scott to take the back roads and go as slow as legally possible.

We all made it to the doctor’s.Lance  began to scream when the rays from the sun hit his face.

“MY HEAD!!! MY HEAD HURTS 111 out of 10!!!”

We were immediately ushered into a waiting room, so that inquisitive eyes couldn’t witness his post hypo stupor.

We waited for about five minutes, Lance begging me, pleading with me to go home. He just wanted to go home to bed.

I heard the doctor’s door swing open, and his loud, booming voice bidding a patient farewell. I told Lance that Dr Congo would be with us any moment. He stared straight ahead. I instantly knew what was about to happen.

I grabbed about 30 tissues.

I thought I had done very well, in catching Lance’s post-hypo vomit. That’s until a huge cylindrical explosion sprayed up my arms, in my hair, and up the walls and dripped down on the sofa.

Lance sat heaving,  half crying, his eyes rolling back in his head. A nurse came rushing in and handed him a sick bag, (the type they give you on aeroplanes.) He clutched onto it for dear life, inhaling deeply and exhaling with all his might.

The doctor called us into his room. He didn’t even blink twice, considering that his private waiting room looked like a set from “The Exorcist.”

I began to tell him what had happened. I requested a Panadol suppository for the headache, and a Maxolon injection for the vomiting/nausea. I wasn’t going to allow Lance to suffer any longer than he had to.

By this stage, he was really going to town with the cries of “MY HEAD FEELS LIKE IT’S GOING TO EXPLODE!!! GET ME OUT OF HERE!!!!!!’

The doctor swiftly jabbed him with a shot of Maxolon, and before Lance had time to complain, he had a dose of Panadol in his mouth. Doctor was sure that the Maxolon would work well enough without traumatising him even more by giving him a suppository.

His BSL upon leaving was 6.1mmol/L.  Dr Congo’s large fingers ran through Lance’s hair.

“I really don’t like seeing you like this, Lance! Do you promise you will go home and try and sleep for me? You will wake up feeling much, much better.”

Lance’s lip quivered, and he tearfully nodded.

I tearfully thanked Dr Congo profusely, and hurried Lance back into the car, wanting to get him home as soon as possible.

On the way home, a little voice from the back seat said:

“Mum..can we stop off at Woolworths and get some green grapes and watermelon?”

Without that shot of Maxolon, it would usually have been a good 12 hours before Lance actually requested food. I was happy that I suggested an IM injection, rather than try to get him to injest a tablet or syrup. The maxolon had no choice but to work if it was already in his bloodstream.

We arrived home, and I cleaned Lance up. He still had the most hideous headache. I put him into my bed, and lay down beside him. BSL:8.4mmol/L.

An hour later, I woke up, to discover the aftermath of the hypo. I tiptoed around and cleaned up, so that when he woke up, he wouldn’t be unpleasantly reminded of the goings on earlier that morning.

We have at least one of these hypos EVERY YEAR, as a result of the vicious humidity that goes hand in hand with our summers. I have to ensure that Lance has a sports drink with him at all times, as his blood sugar dances around 4-5 mmol/L no matter how many snacks I give, how hydrated I keep him, or even under-bolus on the odd occasion.I thought that this year would be different, considering that we have the pump. I have gone through all of his basal results and set them according to his recent bsl results. More hard work and constant monitoring, but watching a sugar-starved brain related seizure is something that I would be quite happy to never witness again.

I have said this before-the only joy that came out of this morning of terror is that Lance remembers VERY little. 

Without Air Conditioning, I would have to spend all day and night at the cimema with him to escape the savage Queensland heat.

Again, I was up until 1 am rubbing legs and feet last night..I got some Voltaren gel, which I know isn’t going to help the internal discomfort, but it’s more appropriate than panadol or Deep Heat.(!!!)

The whole episode  was all over the next day-after a solid sleep, Lance woke without a headache, and a voracious appetite. He had lost a day-he had no recollection of the events the day before.

Santa, if I can have ONE wish…

Please let Lance get through the summer without another severe hypo/seizure.

That’s all I want for Christmas.

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Project365:Australia-Day 34:Diabetes Australia Comes To The Rescue

16 January, 2008 · Filed under By Kate, Diabolic, Project 365:Australia · Tagged , , , , , ,

One of the most frightening experiences concerning Type 1 Diabetes, excluding severe hypoglycaemia, is Sick Days.

Lance has generally excellent health, he fights off viral bugs very quickly, and any sores or cuts heal in a matter of days. The only thing that I have NO control over is a vomiting virus.

We have had one severe vomiting virus each consecutive year since Lance was diagnosed. With each episode, I am totally pre-occupied with monitoring blood sugar levels, giving hourly shots of insulin, comforting my ailing patient, taking his temperature, administering Panadol or Maxolon Syrup, cleaning up projectile accidents, remaking the bed with all new linen, checking for ketones, offering jelly and ice blocks in a desperate attempt to get my son to consume some easily digested carbs, keeping in check with the doctor, getting the pharmacy to deliver  Paedolyte iceblocks because the stock I had on hand are out of date (arg).  Last year, I was as delirious as a cut snake, as a result of no sleep and very little food. I emerged looking like I had been a contestant on Survivor: The Australian Suburbs for a month.

I fight so hard to keep him out of hospital and put on a drip, because it distresses Lance so much with the drips and the injections and the bright lights. I can’t stand to see him so traumatised. So I put in the long hours and become a prisoner in my own house. My only source of contact with the outside world is the telephone. If I do use it, the conversations are to the doctor, the pharmacy or the Diabetes Educator-really stimulating and exciting people to talk to about such a riveting matter.

Recently, I found some new information in the Diabetes information section at the pharmacy. I was so ecstatic to find a comprehensive, foolproof guide about how to handle sick days from home! It talks about giving mini shots of glucagon if you are worried about a hypo as a result of lack of carbohydrates. It has suggestions for what to do if your child is 14mmol/L. Or 4mmol/L. It’s just an all round excellent piece of literature that everyone should own or know about.

In this photo is the fold out copy of Guidelines for Sick Day Management for people with Diabetes.

Information about Sick Days-no more sleep deprivation!

Diabetes is a risky and dangerous condition to have if you are sick with a virus, especially a gastro bug.  Blood sugar control is an additional worry to be concerned about, as it often becomes high and difficult to control when there is an infection or illness in the body. If  a person with Diabetes is too high for too long, or has minimal insulin in their blood, they are a high-risk candidate of a life threatening condition called Diabetic Ketone Acidosis. (DKA).

Diabetes Australia has produced and distributed a fantastic guide concerning how to care for somebody with Diabetes who is ill at home.

Organisations like Diabetes Australia make living with Diabetes so much easier through their information sheets and webpages. You can find out a lot of useful information just by making a phonecall or going online. Even a fold out piece of cardboard can be supportive and comforting when you have a sick child with Type 1 Diabetes. Every now and then, there is updated information or new innovations regarding diabetes care that is put out by DA.

For online information regarding Diabetes Australia, click on the link to find out a list of services and advice.

Insulin is not a cure.

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Sickening-Part 1 of 2

29 October, 2007 · Filed under By Kate, Diabolic · Tagged , , , , , , , ,

Probably one of the worst things that could happen to a single parent and full time carer of a diabetic is when you AND your child are both struck down with a virus simultaneously.

Lance complained of having a sore throat on Thursday night, but as he was still chatting up a storm, didn’t have a fever and his blood sugar levels were happily sitting within the normal range for bedtime, I wasn’t overly worried.  I bundled him up and put him to bed, hoping for the best that Friday would be a fresh new day with no mention of further symptoms.

But…I should have expected the worst whilst hoping for the best.

Yes, the sore throat was gone, however, Lance woke as white as a ghost.

“Mum..I think I need a bucket, I’m going to be sick.”

I leapt out of bed and grabbed towels, buckets and clean clothes. I did the first fingerprick for the day, which was an unexpected 8mmol/L.

Lance sat on the floor with a bucket between his legs, overwhelmed with the waves of nausea that were passing through his body.

“Mum, I can’t stop yawning, and I have so much spit in my mouth.”

As I  quickly wrapped a towel around his pyjamas, I very narrowly missed being slimed by a cylinderical tunnel of projectile vomit.  After a horrible minute, at last he was still. I lifted his limp little body back to bed. I broke out into a sweat, recalling the other times when Lance had battled a gastro bug. Ironically, the past three Octobers have seen Lance so ill with gastro viruses that he has required hospitalisation due to insulin dramas and deyhydration. He required  round-the- clock fingerpricks and hourly injections of insulin whilst he was in carbohydrate shutdown mode.

Against his will, I gave Lance a dose of Maxolon Syrup. Despite its bitter, child-unfriendly flavour, it does retard the vomiting relfex, that’s IF you can keep it down.

It wasn’t too long after that when I had to grasp onto the wall, doubled over by an intense stomach cramp. Nausea almost immediately followed. I was also aware of a subtle pounding in my head.

Things went down very quickly from here. We soon had matching buckets beside the bed. I was amazed at how quickly this sickness had swooped on us, leaving us sapped of all energy and burdened with intense stomach pain and matching headache to boot.  Lance and I  both lay in bed, staring into each other’s dull eyes and washed out faces. We compared symptoms and it was blatantly obvious that we both had the same virus.

As Lance had an empty stomach, and had NO intention of filling it, I faced the dilemma of what to do regarding insulin. I reached over and grabbed the phone and dialled the number of our doctor.

He was at a Hepatitis C Conference. The other doctors’ at his surgery were double booked.

I was so overcome with lethargy and weakness that I could barely think of what to do next. Lance had just had 2 units of Levemir in an attempt to keep his blood sugar in a safe range. I staggered out of the bedroom to the office and flicked through my list of emergency numbers. Diabetes Educator. She would be able to help. Except…she has every second Friday off. I tried the Hospital Educator and got put through to a pager service. Ha. What to do…. After hours doctor surgery?? The only problem was that it wasn’t after hours…

 I called anyway, purely out of desperation.

We were lucky enough to get an immediate appointment as a result of a cancellation. I didn’t even feel as though I was well enough to drive the car, so I called a taxi company and booked a driver to take us there. I grabbed Lance’s bsl record book and got Chino ready to go. I locked the house and the three of us sat forlornly on our front steps, waiting to be picked up.

We arrived at the doctor’s surgery,checked in and fell  into two deliciously comfortable leather chairs that enveloped our aching bodies. That was probably the high point of the day.

The receptionist ushered us into an empty room. Chino’s nose was going overtime over both of our  exhausted bodies. We waited for the best part of 20 minutes to be seen by the doctor.

When he finally arrived, he cheerfully greeted us and bustled over to his desk. Without looking up from his computer screen, he asked how he could help us. I told him that I needed some guidance regarding insulin administration whilst my son was fasting as a result of an obvious gastro virus.

“Is he allergic to anything?”

“Yes, penicillin.”

“Any other health problems, any operations?”

“No, just the Type 1 Diabetes. “

He typed details with his two index fingers whilst stopping to make note of allergies and IDDM.  I was waiting for him to grill me about what insulins Lance uses, and how we could devise a plan to keep him safe with no risk of the worst possible scenarios, severe hypoglycaemia or DKA.

“OK, so what medications is he taking?”
“Novorapid and Levemir…I have everything documented in his record book..dosages, bsl readings, hypos. hypers..” I slid Lance’s Record Book towards the Doctor.( A quick flick through this comprehensive mini bible would answer any question about Lance, believe me.)

“My suggestion is to keep him hydrated.”

“Yes, I am on top of that.” I cheerfully (as possible) presented  Lucozade and a water bottle in front of him.

He seemed distant, but not overly concerned. I became slightly more relaxed by his demeanour, until……

“OK… well, I would…I would break his tablets into quarters and adminster throughout the day with MEALS (hello…vomiting?). That should keep any hypos at bay.” (!!!!!!!!!!!!!!!!!!!)

My jaw hit the floor.

“MY SON IS ON INSULIN INJECTIONS!! UP TO FIVE A DAY!!! I BELIEVE I INFORMED YOU HE WAS A TYPE 1 DIABETIC, AND IT IS CLEARLY EVIDENT ON HIS PATIENT RECORDS!!!!” My life is much like a cartoon, therefore it seemed appropriate that I saw a rotating halo of stars appear before my eyes. Either this blatant stupidity and ignorance sent my rage-o-meter off the rails, or I was becoming sicker by the minute. (I suspect the first.) Not even a hospital intern could make such a idiotic blunder. I was positively seething at his blaze approach to a very serious medical situation.

“My goodness! He is awfully young to be a juvenile diabetic!” he exclaimed, his tone shifting, and with the first bite of real interest since I had started speaking.

“Yeah, he is. He was awfully young as a 1 year old baby to have it too, mate!”

At this point, I accepted that I was dealing with another medical “professional” that puts all diabetics into the one basket..the one labelled “epidemic.” With over 140 000 people in this country suffering from Type 1 Diabetes, and 5 more diagnosed everyday, I feared for each and every one of them at that moment.   I actually felt like I had been transported back in time 60 years, when doctors’ would actually taste a suspected diabetics’ urine to see if it was sweet. That is the generation that this “doctor” belonged in.  I snatched back my precious record book and nodded at Lance to motion towards the door. We left without another word exchanged.

Lance was too weak to walk out of the surgery. He was weepy and exhausted so I lifted his 27 kilogram body and plant him on my hip. You can definitely tell he spent a lot of time there as a baby-he still “fits” there like a glove. I would carry him when he was unable to tell me that his legs were as “heavy as concrete” from high blood sugar, or “marshmallow-y and wobbly” when low, much to the disgrace of various family members.

“You mollycoddle that boy too much, Kate. Put him down and let him walk!!”

 As far as I’m concerned, that hip is available until it becomes a physical impossibility to carry him any longer.

I digress..

The receptionist flashed a winner smile at me, whilst whisking out a form fresh from a printer for me to sign.

“That’s $57 today thanks Kate! Wow, your hair is absolutely gorgeous! Who does it for you? Oooh and your nails! Are they real? Ohh and look, your little boy is a red head too. Well, kinda. Does it run in your family? Or is his Dad a redhead too?” This girl was way too chipper and zippidy-do-dah to be a doctor’s receptionist. Sick people need quiet, caring and empathetic staff. I imagined her saying, “That’s $57! +verbal diahorrea” in the same tone of voice to somebody just diagnosed with cancer. I think that gave me the courage to decline to sign.

Her smile suddenly faded. I very politely let her know that I had received no assistance from the doctor and that I had received no medical advice or prescriptions. ( It wasn’t an issue of money, far from it. It was a matter of principles. Why should I reward this man for making my son’s condition seem so trivial?) She looked at me like I had personally offended her.

“I will have to consult the doctor then.” The Disney charm that oozed from her every pore suddenly changed into frosty ‘tude. Despite my increasingly-heavier-by-the-minute appendage on my hip, a puppy pulling on his lead that was securely around my wrist, along with hypo kits weighing another kilogram in the other hand, I wasn’t going to let this rest. I was still horrified that a doctor of 20 years had erred so disgracefully.(I asked Cinderella; she said he had been a GP specialising in family health at this particular surgery for 9 years, and 11 years before that in Melbourne. You cannot expect me to believe that he had never treated a Type 1 Diabetic of any age presented with vomiting before.)

Cinders trounced back to her place behind her desk, refusing to resume any eye contact with me and stabbed a pen across a few official looking forms.

“No charge today,”she quietly muttered.

I left the surgery feeling defiant, but sickened by the mornings events. Ohhhhhh my stomach, OHHHHHHHH MY HIP!!!

(And, for the record, nobody “does” my hair, I am a true blue redhead. No, it does not run in the family, I am a freak child who has no redheaded relations. The whole recessive gene deal.  No, Lance’s father is not a redhead, more salt-and-pepper, except he dyes it ash blonde or platinum blonde, depending on his mood, and yes, my nails are real.)

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