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Emmy was admitted to hospital last week, ended up in DKA...

Discussion in 'Parents of Children with Type 1' started by linda, Dec 18, 2010.

  1. chbarnes

    chbarnes Approved members

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    Our hospitals here allow patients to keep and manage their own insulin pumps - but almost no-one would know how to run one.
     
  2. BrendaK

    BrendaK Neonatal Diabetes Registry

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    Ugh, so sorry. It only takes one bad experience to realize that you often know more than doctors do about diabetes in children. We had one experience where we had to transfer hospitals because the dr. decided to let him eat fruit, apple juice and a ton of other high carb things and refused him insulin. He even started yelling at me that I wasn't even to give him water without his permission. Then he got on the phone with the endo and started yelling at him because he allowed me to make insulin adjustments on my own. Good grief, we had to transfer to a more competent hospital and DS was in mild DKA at that point.

    I DO know from a lot of experience in the ER with D and vomiting that it is standard protocol to give regular insulin through an IV with a dextrose drip. The regular insulin through an IV is more effective at clearing ketones than Novolog through a pump.
     
  3. JeremysDad

    JeremysDad Approved members

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    Going of on a tangent here but it still might be related. When Jeremy went to his Endo last week for his checkup, we were told that if his BG gets too high (300's) he should temporarily stop the pump and take his insulin the old-fashioned way. The reason was that while we believe the pump is working, we cannot tell 100% that insulin is being delivered (as opposed to an air bubble or perhaps his pod occluded but didn't beep.) If you MDI, you have full control over how much insulin you are dosing because you can see it. Maybe that is why they have that policy.
     
  4. jilmarie

    jilmarie Approved members

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    That's how it works here as well, although some patients actually prefer to be on the insulin drip. The exception to allowing the pump would be if the admission is directly diabetes related - if they are admitted for DKA or hyperosmolar hyperglycemic state they are put on an insulin drip in my experience.
     
  5. joy orz

    joy orz Approved members

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    Ava was in for a stomach virus and high fever and ketones that wouldn't stay cleared. She was there for for four days because the ketones and vomiting kept coming back. Even though I assumed she was in dka (or on the verge), they assured me that her acid levels were ok based on blood draws they were doing. BUT, it was a bad cycle of vomiting, ketones, then ketones causing vomiting and just not being able to keep food down.

    I think if they had been more aggressive with the correction and gotten her into a better range with temp basals or something, we would have been out of there sooner.

    In hindsight, I would have paged her endo from my cell and spoken to her directly each day we were there. Our endo knew she was there, but thought it would just be a simple one night stay to get rehydrated. She didn't know we were there for so long and so the insulin orders were coming from someone who didn't know Ava as well.

    So I guess my advice would be to call your endo and say you are on your way to the ER, and check with them about the treatment plan.

    To get back to your original question though, I think it took a couple of weeks to feel back to normal. I hope your daughter is feeling better soon. I'm so sorry, it's just awful to go through this.
     
  6. linda

    linda Approved members

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    oNCE WE WERE ADMITTED INTO THE picu THE INTENSIVIST WAS EXCELLENT!! He also wanted her pump suspended, which bothered me at first but then realized the common sense here during this critical dangerous time, he had to be sure of what he was doing to balance out her electrolytes, still learning but , realized he was right!..The other downer was that she was hungry but he didnt want her to eat until the electrolytes were right too, so she basically lived on the IV for 3 days.
     
  7. linda

    linda Approved members

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    Yes and thanks.
     
  8. linda

    linda Approved members

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    Yes that is what I did, was on the phone with endo when I told him (on call not our regular) that we were on our way!...Still the ER takes over...I will have more knowledge "next time" (hopefully NOT)...I agree the error was no insulin at the beginning, i would love to chat with all involved, but they will probably be too afraid of a law suit, maybe ADA can help???
     
  9. linda

    linda Approved members

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    This is what happened when Em was there last year for Flue! We were l;ucky I guess that she was admitted to PICU, now i know.:rolleyes::eek::confused::cwds:
     

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