View Full Version : Pneumonia/ER visit
Christopher
03-11-2008, 04:19 PM
Hi all,
Danielle had been coughing for a few days and yesterday was seen by her ped and was dx with Pneumonia. He started her on an antibiotic (Zithromax) and a steroid (Orapred). He did warn that the steroid could cause her bg levels to rise and sure enough she has posted several numbers in the 300's since yesterday.
Had a pretty rough night last night. Her pneumonia and coughing got a lot worse and she was having so much trouble breathing I took her to the ER. Spent almost 4 hours there and she got two nebulizer breathing treatments (Albuterol). When I finally got her home she was still coughing a lot but went to sleep. About an hour later around 4am, she was saying she felt sick and she threw up several times. This morning I checked her and she had moderate ketones. So pushing fluids and possibly going to change her correction factor and also her bolus ratio per CDE.
If anyone has had experience with this and has any advice I would really appreciate it. Thanks,
Adinsmom
03-11-2008, 04:21 PM
Gosh I have no advice. But I am sending get well and rest wishes to your family.
Judy&Alli
03-11-2008, 04:35 PM
I haven't had to deal with sick days and ketones yet. I just wanted to offer some support to Danielle! Hugs and prayers coming your way!!!!! Get well soon!!!!
Judy
Mom2Will
03-11-2008, 04:37 PM
aw, Chris, hope Danielle gets better soon, I'm so sorry :( and just wish I had some advice for you, you've been so helpful to me. She and you are in my prayers
StillMamamia
03-11-2008, 04:50 PM
Chris,
Many, many hugs to you and Danielle...I do hope she recovers very quickly!
No much advice for you, but just to let you know you're doing fine...you've helped so many over on the chat, and I'm sure you will do well with Danielle. You're a great dad!
Keep pushing fluids, and keep in close contact with endo / CDE...and whenever Danielle is able to, try to get her to eat some carbs.
Again many hugs!
OSUMom
03-11-2008, 04:52 PM
Well wishes for Danielle from me too!!!!!!!!!!!
momtojess
03-11-2008, 04:55 PM
No experience, just wanted to say hope she gets feeling better quickly.
MelissaC
03-11-2008, 05:02 PM
Avery had her first big illness a few weeks ago where we saw LARGE (I mean the pee stick was almost black!) ketones.... I called our endo and we upped her basal rate by 25% she was getting 8 units of Lantus prior and she upped to 10.5 units - as far as for her bolus he pretty much double her IC ration until all her ketones we negative - took about one day but she is just now back down to 8.5 units of Lantus!
I would call your endo team about the steroids b/c yes they will spoike her numbers.... good Luck!
WestinsMom
03-11-2008, 05:12 PM
Yes, get advice from endo on the steroids. We weren't on that brand, but we did them recently for pneumonia too. We were up to 200% basal and not seeing great numbers. How long does she have to take the steroids? Hopefully it will be a quick thing.
On the ketone front, keep her hydrated and obviously with already high numbers it will be easy to keep giving lots of insulin.
Momof4gr8kids
03-12-2008, 07:47 PM
I'm sorry, Chris!
Feel better soon, Danielle!
hold48398
03-12-2008, 10:46 PM
I'm so sorry she is sick :(. Mia had pneumonia exactly one year ago. We too were on steroid inhaler and had to crank up her insulin A LOT. Definitely get endo guidelines for how much. If you can keep the ketones down, she will feel much better. Mia did get dehydrated to the point where we went to the hospital for a few hours to get some saline into her. It made her SOOOO much better.
Best wishes for a quick recovery.
Hi all,
Danielle had been coughing for a few days and yesterday was seen by her ped and was dx with Pneumonia. He started her on an antibiotic (Zithromax) and a steroid (Orapred). He did warn that the steroid could cause her bg levels to rise and sure enough she has posted several numbers in the 300's since yesterday.
Had a pretty rough night last night. Her pneumonia and coughing got a lot worse and she was having so much trouble breathing I took her to the ER. Spent almost 4 hours there and she got two nebulizer breathing treatments (Albuterol). When I finally got her home she was still coughing a lot but went to sleep. About an hour later around 4am, she was saying she felt sick and she threw up several times. This morning I checked her and she had moderate ketones. So pushing fluids and possibly going to change her correction factor and also her bolus ratio per CDE.
If anyone has had experience with this and has any advice I would really appreciate it. Thanks,
The steroids will drive up her BG and just suck the insulin out of her bloodstream. She needs a steady much higher than usual amount of basal insulin. Chat with the endo - my sense would be 100% more, give or take 50%..
Since you're seeing ketones she needs extra carbs and insulin to cover, plus lots of water. Note that the throwing up could have been ketone-related.
Hope things get better for you soon.
Oh jeez, not another kid sick! I really hope she feels better soon!
Armyemily
03-13-2008, 05:32 AM
Hi all,
Danielle had been coughing for a few days and yesterday was seen by her ped and was dx with Pneumonia. He started her on an antibiotic (Zithromax) and a steroid (Orapred). He did warn that the steroid could cause her bg levels to rise and sure enough she has posted several numbers in the 300's since yesterday.
Had a pretty rough night last night. Her pneumonia and coughing got a lot worse and she was having so much trouble breathing I took her to the ER. Spent almost 4 hours there and she got two nebulizer breathing treatments (Albuterol). When I finally got her home she was still coughing a lot but went to sleep. About an hour later around 4am, she was saying she felt sick and she threw up several times. This morning I checked her and she had moderate ketones. So pushing fluids and possibly going to change her correction factor and also her bolus ratio per CDE.
If anyone has had experience with this and has any advice I would really appreciate it. Thanks,
I just got over pneumonia GET HER OFF STEROID!!! Call her Endo mine admitted me because he did not trust any bodyelse
Any news - how is Danielle doing????
Kaylee's Mommy
03-13-2008, 02:21 PM
I'm so sorry that she's sick! I hope her treatment starts working and she's fealling better fast!
dbz2988
03-13-2008, 11:09 PM
I'm so sorry she's been sick! I hope she feels better soon!
Christopher
03-13-2008, 11:28 PM
I just want to thank everyone for the advice and especially for the kind words and thoughts. As for an update, things are still pretty rough. She is still feeling rotten, still VERY insulin resistant, still having bg's in the 300 to 400 range, and still coughing a lot with chest pain (probably from all the coughing!!). I did speak to her endo and the reason she said she didn't want to adjust the basal right now is that Danielle could get better soon and then you are "stuck" with the increased dose for at least 24 hours. Not sure that makes sense to me, but I need to go with the doc. So for now we have just upped her correction factor and increased her bolus ratio. No ketones either so that is at least one good thing (today at least). But after a week of this I have to admit I am pretty burnt out. I would not wish this on anyone. Thanks again for the responses.
I just want to thank everyone for the advice and especially for the kind words and thoughts. As for an update, things are still pretty rough. She is still feeling rotten, still VERY insulin resistant, still having bg's in the 300 to 400 range, and still coughing a lot with chest pain (probably from all the coughing!!). I did speak to her endo and the reason she said she didn't want to adjust the basal right now is that Danielle could get better soon and then you are "stuck" with the increased dose for at least 24 hours. Not sure that makes sense to me, but I need to go with the doc. So for now we have just upped her correction factor and increased her bolus ratio. No ketones either so that is at least one good thing (today at least). But after a week of this I have to admit I am pretty burnt out. I would not wish this on anyone. Thanks again for the responses.
I respectfully disagree with the endo's advice. You can split the Lantus into two 12 hour doses if there is such a worry about being "stuck" with a too high basal. In my view it's better to be fighting Lantus lows for a day (which aren't near as bad as bolus lows), than leaving her stuck up there at 300 to 400 for a week..
Boy I sure hope she gets better soon either way. Good luck.