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First ketone check since hospital...no sleep for me now. ;)

Discussion in 'Parents of Children with Type 1' started by mcphelster, Mar 5, 2015.

  1. mcphelster

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    I know you'll all probably laugh and think "What a noob!" but that's okay because, yes I am so totally new to this (Friday is 2 weeks since his diagnosis) and I've discovered a problem. If you stay up for the 2am sugar check, you may never get to sleep at all. Dragged my -weary, so ready for bed as soon as this sugar check is over- body into my son's room only to get 343 as the result. This is the highest it's been since we left the hospital and let me tell you, I was instantly awake. All I could remember to do was that over 300 meant check for ketones...so off I ran to get them. Before I had him get up, I checked him again, still over 300, but 313 instead of 343..at least it was lower. Still, as per our hospital instructions, I had him pee on the stick and thankfully there was no color change, whew! So relieved, in all my running back and forth, I managed to clue my sleeping hubby in on what was happening, so he was up in an instant and was relieved to hear all was okay and he could go back to bed and now I am AWAKE! My heart is racing...after all the stories people have helpfully shared with us in the last few weeks of family and friends who've lost limbs, gone into comas or died from diabetes, I may be a little on the freaked out side..go figure.





    Okay, thanks for letting me get that out. Please pray for sleep, as I have to spend the day with twelve 2 yr olds tomorrow!
     
  2. sszyszkiewicz

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    In the T1D world you are never alone at 2am! Did you correct him?
     
  3. mcphelster

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    No, we are not there yet. Right now, they just have us giving him a prescribed dose and eating a certain number of carbs per meal. There were no ketones present, thankfully.
     
    Last edited: Mar 5, 2015
  4. sszyszkiewicz

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    Unless you miss his basal insulin dose the chances of ketones being present in dangerous quantities are really low. There are also blood ketone meters available. The strips are expensive but are worth every penny when you really need them. Good for you by the way for the nighttime check! It is a thankless job.
     
  5. Sarah Maddie's Mom

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    Remember that meters have a +/- 20% margin, so assuming the 313 was closest to the truth, you could have seen readings ranging from 250-375 in the extreme. Just remember, when you are dxd they have to give you some rather arbitrary "placeholders" like "test ketones at xyz", "correct at abc" when actual diabetes management if far more complex, organic and fluid. It's good to have benchmarks but when the tools are imperfect the benchmark is rather hollow.
     
  6. 22jules

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    I wish I could like this comment because of how true it is. Also sadly I don't like this comment because of how true it is if you know what I mean!
     
  7. Mimikins

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    ☕ Here's a cup of coffee! Unfortunately, it seems to be the only thing to keep me awake after a night of flushing out ketones or treating nasty lows.

    When your son is on MDI, there isn't that big of a risk of ketones unless you happen to miss a Lantus/Levimir dose or he experiences a period of increased insulin resistance and needs A LOT more basal, such as during illness. With an insulin pump, because there is no long-acting insulin present, ketones can happen a lot quicker due to a pump issue (I typically notice ketones within 2-3 hours of not receiving any insulin). There have been times where I would have moderate ketones with BG levels as low as 200 due to a site issue, so I've been ignoring my doctor's advice to test if I'm above 250 and test any time I feel like insulin delivery was affected (I ended up doing a ketone check for a 180 reading yesterday after a site change).
     
  8. KHS22

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    Yup. I haven't slept since she was diagnosed. WAY worse than having a newborn…And know you aren't alone when you are up at that hour! THink of us and feel some company!

    I was up for 2 hours last night, after a whole day of super high sugars and large ketones, she crashed and was in the 1's and 2's (like 40) for over half hour!! Scariest diabetes moment I'd ever had!
     
  9. jenm999

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    Hang in there, newbies. It doesn't get easier per se, but you get better at it and get used to it. Approaching one year in a few weeks, can't believe we made it.

    Get thee a blood ketone meter. My doc gave us 2, one for home and one for school. Strips are ridiculously expensive but are individually wrapped so you don't have to worry about expiration once you open a package. Insurance might cover them (ours does, but I know not all do). I can't imagine getting my son up to pee in the middle of the night!
     
  10. BarbDwyer

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    Oh my goodness! Long nights - agree - never alone. Little comfort at 3am.

    I had no trouble with the newborn years and my kids woke at night until well into their toddler years - some even longer. Not a household of sleepers. I thought I'd reached parenting nirvana and now this. I'm to damn old to be getting up every night now. ;) I'm so exhausted all the time - makes me not always such a fun parent for my extremely ADHD household.

    It used to take me forever to go back to sleep. The good news is I go back to sleep quickly now. He has not had scary lows yet that do not come back up at night so I'm lucky there. He is high (around 350) once in awhile at night (depending on what his before bed food was - I'm working with him to put a little more thought into that for routine days). Anyway - I've quit making him check for ketones in the middle if I know it is a food high. He's never had any. He checks in the morning. His germaphobe ways are paying off because he hasn't been sick yet! :D
     
  11. Nancy in VA

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    If you're seeing 300s more than once in a blue moon, they need to be giving you a correction factor and allowing you to correct. Its not healthy for the child and honestly, they don't feel good when they're high. I would talk to Endo today about a treatment plan for readings in the 300s more than 3 hours after an insulin dose.
     
  12. susanlindstrom16

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    Not being able to get back to sleep is the worst! That happened to me the other night- I was awake until 10 minutes before my alarm went off (of course).
    The good(sort of) thing is that all of these annoying "firsts" are learning experiences, so then the next time something like this happens, you can hopefully not get worked up about it because you've been through it before and know what you have to do.
     
  13. Snowflake

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    Agreed. Our prior insurer didn't cover them, but our current insurer does. I think that more insurers have improved coverage of them recently because they provide much better real-time information than pee sticks. I'd be willing to bet that the blood ketone readers have averted more than a few very expensive trips to the ER.

    If your insurer declines coverage of blood ketone strips, check out American Diabetes Wholesale website, http://www.adwdiabetes.com/, where they currently sell for $23 for a 10-pack.
     
  14. Snowflake

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    I know this is the CW, and maybe it holds true for most people, but this is also a bit of a YDMV situation. When our daughter was newly diagnosed, with a very wide sliding scale correction on MDI, she definitely ran ketones more than she does now on a pump.

    Part of it was that her insulin needs were so tiny that she had to be at 300 before we could correct with a half unit, and we didn't have a CGM to know how long she'd been sitting at that number. And part of it was that she was a toddler in the world's germiest preschool, where she picked up a new bug about once a week, boosting insulin resistance as mentioned.

    I have memories from our brief pre-pump life of treating ketones a lot more frequently than we do these days. All of which is to say that the original poster should keep up with the recommended ketone checks until she gets a firm sense of what's normal for her child.
     
  15. Lakeman

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    For a person who calls herself a "noob" you handled it perfectly given the education and tools you had at your disposal.

    Someone mentioned the ketone meter - yes it is a great tool for checking ketones without needing to get up to go to the bathroom.

    IMO the endo/clinic might teach you what to do too slowly. when the time comes that you feel comfortable doing corrections and feel comfortable using ratios don't hesitate to talk to you team about it. That being said they are right to let his body adjust to not being high all just yet.

    In the year ahead you will get tons of information from here, from books, from the internet, and from what you figure out. It may seem overwhelming (which is why your team is feeding it to you slowly) but it will make your life easier. You will even have nights when you can sleep through the night:) The Dexcom continuous glucose monitor is a great tool and I bet very soon there will be quite a few used receivers available for sale (or free) if your insurance company does not cover it now that the new Dexcom share receiver is out.
     
  16. caspi

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    Ah yes, those "well meaning" friends with their horror stories. Don't you just love them. :wink: In time you will learn to tune out all the extra noise in the background from these well intentioned folks. The reality is that our kids can and will live long, healthy lives with very little risk of serious complications.

    Those first few weeks can be a rollercoaster of numbers as your endo team tweaks his insulin. It's all perfectly normal. Just keep sending/phoning your BG logs to them.

    I also highly recommend the blood ketone meter. The pee sticks are hours behind.

    And believe it or not, you will sleep again! :smile:

    You're doing great! We all remember those early days/weeks/months and are here for you if you have any questions or concerns!
     

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