I just knew it!

[hold48398]

After a week of wondering and pondering and wet coughs, chest pains, high fevers, high Bgs and ketones...we finally know what's been causing all of Mia's distress...what we first thought was bronchitis is now...pneumonia!!!!!!!!! It was as clear as day today to our wonderful pediatrician after he carefully listened to Mia's chest, did a blood culture and an in-office breathing treatment. The good news is that her blood count is fine and that it seems bacterial, and that the antibiotics seems to be working already. She was probably at her worst on Thurday, and it is likely that she already had pneumonia even though the chest xray came back "clear". The bad news is that the in-office treatment made Mia's BG jump into the 300s, and we dont know yet for sure what the Albuterol is doing to her Bgs as she was runing high all day since the treatment this morning...

Funny thing is I told my hubby on Wednesday that I just didn't feel that this was bronchitis but rather pneumonia. Then when Mia took a turn for the worse on Thursday, I was CONVINCED that it was pneumonia but because the chest xray didn't show anything wrong and the ER doc reassured me that it wasn't I just thought I was wrong about my gut feeling...for the first time EVER! Botton line is to ALWAYS TRUST YOUR INSTINCTS. The Mommy radar never lies!!!

Sigh, looks like another short night ahead.

[jpb286]

The in-office breathing treatment may have contained a steroid which caused the BGs to go up, but I doubt they gave a steroid. Or more than likely the BG is up due to the stress and bacterial infection draining her system....

Info on the Breathing Treatments:
The breathing treatments are usually 2.5mg Albuterol(Ventolin), and 0.5mg of Ipratropium Bromide(Atrovent), mixed with a 3cc saline bullet. These are the same nebulizer treatments that we administer on the ambulance.

Neither one has any effect on blood sugar levels. Albuterol is a bronchodilator and opens up the airways, and the Atrovent is an anticholinergic which cuts down on mucus production and stops bronchoconstriction. It DOES NOT diffuse into the blood so it cant have any effect on BGs.

[Mama Belle]

Poor little Mia! I bet she feels awful! I hope she gets better soon! And Marisa I hope you get some rest! Definitely listen to that "Mommy Voice"!

[hold48398]

The in-office breathing treatment may have contained a steroid which caused the BGs to go up, but I doubt they gave a steroid. Or more than likely the BG is up due to the stress and bacterial infection draining her system....

Info on the Breathing Treatments:
The breathing treatments are usually 2.5mg Albuterol(Ventolin), and 0.5mg of Ipratropium Bromide(Atrovent), mixed with a 3cc saline bullet. These are the same nebulizer treatments that we administer on the ambulance.

Neither one has any effect on blood sugar levels. Albuterol is a bronchodilator and opens up the airways, and the Atrovent is an anticholinergic which cuts down on mucus production and stops bronchoconstriction. It DOES NOT diffuse into the blood so it cant have any effect on BGs.

I don't know what was in the in-office treatment but Mia had to breathe on it for about 7 minutes. When the nurse took a blood test from Mia's finger, I tested her Bg from the same droplet- it was about 90 minutes after breakfast and before the treatment- and as expected she was a bit high, 255. When my hubby retested her for lunch another 90 minutes later, she actually had gone up to 340. That is super unusual for her... She usually spikes after breakfast esp. after eating the poptart that she had this morning but then comes down right into target range by 2.5 to 3.5 hours after the meal. So this raises my suspicion about the in-office treatment.

As far as the Albuterol goes, it is the ProAir-HFA. It says that "each actuation delivers 108mcg albuterol sulfate equivalent to 90 mcg of albuteral base". It does say that safety and effectivness had not been established in patients younger than 12 but I assume that is standard labeling as with so many other drugs?? It's all Chinese to me :( :confused:

[hold48398]

We are on our third day now with the Albuterol breathing treatments for Mia's pneumonia, and I definitely see a dramatic increase in Mia's insulin requirements. Strange. 20% increased basals didn't cut it (Bgs still in the 300s), so we are now on a 30% increase during the day and 10% - 20% increase for the evening (8pm - midnight). It seems like the effects of the inhaler lasts about 4 hours, so by midnight, I she can go back to regular basals and be fine in the morning :confused:. She gets 3 treatments a day - 8am, 2pm and 8pm. I have no doubts that she needs more insulin just to fight off the pneumonia...