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Glucagon shot!

Discussion in 'Parents of Children with Type 1' started by newatthis, Jul 24, 2006.

  1. newatthis

    newatthis Approved members

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    :eek: I HAD TO USE IT!

    Karsyn was diagnosed 6/17/06 at 4 yrs old. We took the diabetes classes and learned about the Glucagon shot. But they were saying that hardly anyone ever has to use it anymore but just in case, here's how. Well, I guess in the back of my mind I figured I could control this thing to the point of not having to use it.

    Unfortunately, Friday morning I brought my two children with me to work and I heard Karsyn fighting with my other saying "Fine then, I'm not playing!" and stormed up by me. She got to me with a full blown upset fit and I handled it like a sibling rivalry issue. Then I decided I better check her blood sugar because she was so irrational. I went down the hall in a hurry and she followed (the older sister was with her) and I heard her bumping into walls, I looked back and she was stumbling and visibly dizzy. She was about to fall out. I ran and swept her up, held her in my arms, and begged her to drink some Sprite. I tried to get her to eat Glucose tablets but she was already going in and out of consciousness. She was so weak and out of it she couldn't wrap her little mouth around the straw. I knew I had to do something fast. The only thing my panicked mind could do was to get out that shot and inject it. When I laid her on the ground, she was already passed out. I just knew she was going to start siezing. Very scary sight for a momma. The Glucagon shot brought her bs reading from "LO" to 34 in 2 minutes. This whole experience from the time she came to me upset to the time I injected the shot was only at the maximum, 2 minutes. That fast it happened. She usually comes to me with the signs of being hungry first. Well, that didn't happen that day. She had no signs. I didn't know that could happen with no signs. I guess that's why I thought it wouldn't happen to us. So anyway, after she came back to us, I called her doctor to let hiim know what happened. The nurse told me that if she has been experiencing too many lows, her body will not tell her she is low anymore. It will heed the warning signs.

    Ever since diagnosis, we have been decreasing her insulin and she has been constantly running low (20-80). I have a hard time knowing how much energy is burned when they swim. She loves to swim and is always doing so. That morning at 9:00 we ate breakfast (1/2 sausage and biscuit, one whole sausage patty, and 7 hashbrowns) which was not enough carbs for her 2.5 units of NPH but I knew I could get her to eat in about an hour. Well, I was working and 1.5 hours went by and I forgot to give her snack. And she also never came and said she was hungry. Anyways, it was then that she went too low.

    I feel like a terrible mother. I only work 2 days a week and work for people who let me bring my children when I need to. They are willing to let me bring her to work with me (which is stressful in itself). But I can't fully focus on either job when she's there with me. My mother doesn't feel comfortable keeping her anymore because she's scared of what to do or not to do. I don't feel comfortable leaving her with anyone else. I really don't since Friday's incident. I can't help feel like this disease is beating me and I can't stay one up on it. I feel like all I do is diabetes everything and it still didn't work. Needless to say, we didn't give her any insulin for the weekend until last night at supper. She stayed in her normal range (better than ever) until last night. The doctor put her on a new regime....1 unit of NPH at breakfast, only if she eats good, and 1 unit of NPH at lunch, only if she eats. She is having a hard time eating the amount of carbs at meals.

    So, I guess I am telling you my story for anyone who is new at this and has a child who gets low quite a bit. Be watchful if they are staying low because, like us, it can happen so fast and the signs might not be there. I don't want anyone else to go through what I went through and the mental images of my baby white as a ghost, no color in her face or lips, and unresponsive to anyone or anything. By the way, she doesn't remember anything except yelling at her sister.


    This forum is so good to be able to vent our fears and concerns....I love it!

    If anyone has any suggestions on how to live with this every day and still have a life for myself, I would appreciate it so very much. I used to get up and run in the morning, exercise, read my bible, pray before everyone woke up but I can't make myself get out of bed until I HAVE to lately. I feel like at the end of the day, I am WORN OUT! Any suggestions would be great!
     
  2. Amy C.

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    That is scary and I can understand you not wanting to leave your child. It sounds like your daughter is honeymooning and needs much less insulin.

    My recommendation is to discuss using another insulin with your endocrinologist. In my experience, NPH is not the best insulin to use in children. My son took NPH for 4 years (along with R and later H). Life was so much better when he started taking Lantus when it came on the US market in 2001.
     
  3. Jordana

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    I'm so sorry you had to go through that! It must have been so scary, but it sounds like you handled it like a pro!

    You should consider letting Karsyn run a bit high for a week or so (maybe even 2 weeks) so she can feel her lows again. Not feeling lows is called hypoglycemic unawareness, and running high for awhile will take it away. Also, at least for a day or two let her run high because her body will not be able to repsond the glucagon again until her body builds its reserves.

    Please please please talk with your endo about switching to a better insulin than NPH. Lantus or Levimir are MUCH better in controlling numbers and avoiding lows. Even better, ask about getting ain insulin pump which is the best way to manage numbers and avoid those scary lows.

    You are a terrific mom! You are taking great care of your kids and doing the best that can be expected so early after diagnosis. I promise you that all of this will get easier. Consider talking with your doc about getting off the NPH.
     
  4. kittycatgirl

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    Hello

    I am so sorry you had to use glucagon. Good job though!!!!!!!! You probably saved her life! You should feel good about that.

    I also agree that you should look into Lantus. We just switched in June and love it. It prevents a lot of the lows and gives both you and your child a lot of freedom. It was the best thing we did. We were worried about the change because I couldn't even think of adding more to our life but it was so worth it. Good luck and good job. ((((HUGS)))))
    Diana
     
  5. BrendaK

    BrendaK Neonatal Diabetes Registry

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    I am so sorry that happened. It was scary for me to even read your post.

    I also STRONGLY recommend getting off NPH and discussing with your diabetes team other options. If they are stubborn about it, change doctors. Many doctors are even getting adults off of NPH -- my mom was one of them. Her body quit telling her she was low and my dad was having to regularly use glucagon. If blood sugars are running between 20 and 80, it sounds like she is low most of the time!!! Please keep us updated on how Karsyn is doing.
     
  6. Beach bum

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    I am so sorry you and your child had to go through that experience. Like everyone else, I dread the day I have to use it. You handled the situation great! It's too bad that your trainer said that hardly anyone ever has to use it anymore but just in case, here's how. There are some people out there who may take their words to heart, and not carry the kit in an emergency, figuring "that won't happen to us."

    I would definitely talk to your endo about the possibility of switiching to a Novolog/Lantus combo, or even start researching the pump. It just seems for the majority of kids, NPH doesn't work for them.

    As for getting your life back, you will, but it can be slow. My husband is great about encoraging me to get out, and he takes the kids, even when I'm tired I have to force myself to excersice (well, I try pretty hard too!). Basically, you have to work at doing things so that D does not consume you or your family life. The hardest thing for us is that we don't have family around to help, so nights out together are definitely stolen moments. We were so lucky this year to be introduced to a young woman who is a former counselor of a d-camp and is pumping herself. It has been wonderful because she is so responsible and I can go with no worries. I'm just bummed she's going back to college soon! I found her through the CWD network.
    I hope things get better for you and your child. You handled things like a pro.
     
  7. selketine

    selketine Approved members

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    My son William was dx'd at 26 months and is 4.5 yrs old now but he still rarely shows any signs when he is going low. Believe me I'm sure he does not have frequent lows either (cause we test the heck out of him) but I think he just doesn't recognize them - I have no idea why. I like to keep him around 130-180 - I don't freak at 200. I'd rather he be 200 or even 250 than 50.

    I do agree with others about NPH - it is an annoying insulin. However William could not take lantus at first because he did not need ANY insulin overnight for about 3 months after diagnosis. If your daughter is taking NPH both morning and night then she should be able to go on lantus.

    Let me be one of the many who will suggest that you start investigating the insulin pump. William is on a pump as are many kids here your child's age and it is absolutely as wonderful as diabetes can get - heh:p Hang in there!
     
  8. EmmasMom

    EmmasMom Approved members

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    EEEk!! That is so scary! You handled it so well, you should be very proud of yourself! You are not a terrible mother!!!!!
    It is the HUGE problem with NPH. If you change your routine or eating you can be in big trouble fast. You are always committed to the insulin that's already in your body and there's little room for error.
    If she can go all weekend w/o insulin and have good numbers, I'd say she is producing quite a bit of her own insulin. If she needs a very small amount of insulin maybe you could do a sliding scale of rapid w/ meals only as needed, based on her pre-meal number. She may not need a background insulin yet at all. Unfortunately this may change from day to day, but with numbers running that low I would say you have to change your regimen.

    My only advice on living more normally is try to train someone who can help you with her care. The only time I'm ever away from Emma is when my husband has her, but at least I do get a break! Life will never be exactly like it was before, but as time passes it will get easier to work D into a "normal" routine. We've been at this for over a year now and the stress is so much less than it was in the beginning! It really does get better!

    Good Luck, and I hope she's doing better.
     
  9. RobinKop

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    I just wanted to chime in and say I'm so sorry you had to go through that too! That is my greatest fear right now but it sounds like you handled it wonderfully!

    My daughter is 4 also and we are on NPH and Regular. My daughter also does not recognize the lows so we tend to try to run her a little higher too.

    When she as at the height of her honeymoon, about a month after diagnosis, we were down to 2 units of Reg and 2 units of NPH a day - and we stopped her night time NPH all together for about two weeks before her night time reading started creaping back up.

    We were in very close contact with our endos during that time and it felt like we were making changes every 3 or 4 days. Unfortunalty I think that is common with the honeymoon.

    I guess my only advise is to "hang in there!" It sounds like you are handling it very well. Kim's readings continue to inch up every two weeks or so so I think we are nearing the end of our honeymoon. The NPH & R are actually working pretty well for us right now.

    Good luck & take care!
     
  10. zeb'smom

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    My goodness, how scary! You handle everything wonderful, be proud of yourself for not losing your head. I know it is hard but don't beat yourself up over letting snack slip by, or not realizing her temper was from a low, even if you do everything by the book unexpected/unexplainable highs and lows will happen.

    I would definately talk to your endo (is it a pedi endo?) about trying a new insulin regiem. Our pedi endo recommends letting little ones (mines 2) run higher rather than low as low are more imediately dangerous especially in young kids.
    You may also want to consider an insulin pump for your daughter. At first I was squemish about the idea, but having researched it quite a bit now it seems like the best way to go for kids. It allows you to give tiny (.025) units of insulin and means only doing "shots" i.e. site changes once every 2-3 days.
    (We are going for Zeb's first pump appointment tomorrow!)

    Talk to your doctor, if they seem unwilling to try a new insulin or discuss the pump for your daughter look elsewhere. The JDRF and ADA websites both have search tools to help you find doctors in your area. Look for a pediatric endo who has lots of experience with small kids and supports aggresive (Lantus/humalog regiem or pump) treatment.

    Hope you and your daughter are having a better day, it won't always feel this hard.

    Robyn
     
  11. akrickard

    akrickard Approved members

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    I'm so sorry that happened to you and your daughter. Thank goodness you were aware and reacted the right way. How scary.
     
  12. allisa

    allisa Approved members

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    Wow...I was in tears reading that ! THank you SO MUCH for the reminder.....your story will remind me how quick it can turn.....great level head you kept !
     
  13. bethdou

    bethdou Approved members

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    Oh my goodness!

    I'm so sorry you had to do that, but bravo to you for being so calm under pressure!

    YIKES. I have to say that having to use Glucagon is a big fear of mine; we're almost a year into this, and haven't had to do it yet. Had a couple of times where we thought we might, but she was able to get juice down and keep it down without becoming unconscious. THANKFULLY!!!

    Hopefully, as the honeymoon ends and she runs high a bit, she will become more hypo-aware. Meghan seems to be getting more aware as her numbers are going up (due to honeymoon end and puberty, according to the pedi endo). At first, she couldn't tell us either, but now she is noticing the feeling a bit more (whew!).

    PLEASE PLEASE PLEASE don't beat yourself up! You are doing everything that can be done in a totally unpredictable and new situation. It may not seem like it, but things will get a little calmer and it will seem a little more "normal" to go through all the checks, shots, etc etc etc. Glucagon - well, hopefully that was a one-time deal and you won't have to do it again! ;)

    {{hugs}} for you and Karsyn!
     
  14. kristy

    kristy Approved members

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    You did a wonderful job!!! I have had enough close calls, but I was always able to wake Lexie up enough to get her to drink juice. That is a scary moment, but you did a great job!!

    Lexie was on Humalog and NPH from diagnosis up until 2 weeks ago. She was having a problem with lows at night only one or 2 days a week and the other nights she would run high (trying to measure .75 units at dinner was the problem). Anyway, her endo team wanted to put her on Lantus but it concerned me since it was only approved for 6 years and older. When I asked her team about this, they assured me that they have many small children and even babies on it that do wonderfully, and that the manufacturer has to put this in their literature since it was only tested on those 6 and older. Anyway, I know a lot of ppl really like this insulin, but since I was already looking at the pump for Lexie, I decided to go straight to pumping. She started on Animas on July 14th and we love it!! Lexie is so proud of her pump and loves the fact that she is not getting 3-4 shots a day. Anyway, think about what would work best for your family and research it. This will arm you with good information to present to the endo team.

    As for time for yourself, I am still looking for it (LOL). The last almost 2 years has been tough for my husband and I to go out without planning it around her insulin (picking the "safe" times and coming back in 2 hours). Now that she is on the pump, she has had a couple of lows, but they don't sneak up on us like the NPH and a caregiver does not have to worry about giving her a shot. Plus, I like it b/c the pump will tell you how much insulin to give and it gives you a chance to double check before you actually send the insulin to her body. It is hard to mess up.

    Hope this helps!! Hang in there, and give yourself credit. You stayed calm and handled the situation quickly and correctly! BYW, where are you from?
     
  15. pookas

    pookas Approved members

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    Graet Job!!! First of all, for having the Glucogon handy and recognizing the fact that you should check her [even though you didn't get that far]. That's what the Glucogon is for. I would also recommend checking into something other than NPH. They are supposed to be phasing it out since Lantus is on the market. I've heard from docs it could have terrible peaks. Don't beat yourself up about the snack. EVERYONE forgets something at one time or another. You are a SUPERMOM!! We all are, and SUPERDADS. Keeep your head up and keep up the good work!!

    Linda-[NEPA]-Mom to:
    Hunter, 5 yrs, dx'd 11/14/05 type I
    Colby, 7 yrs, migraines
     
  16. Cheryl in CA

    Cheryl in CA Approved members

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    First of all ((HUGS)) and bravo to you for doing a great job with the glucagon!!

    Secondly, please, as others here have already said, get your daughter off of NPH and on to Lantus or something like it. I feel so badly for parent's new to this who don't know that endo's shouldn't be prescribing these crazy regimens for children. NPH works for some, but it's not working for your daughter. Any child that young isn't capable of eating on demand and trying to keep up with the spiking of NPH insulin. Lantus is somewhat of a flat insulin that peaks just a tiny bit. Some doctors prescribe NPH to prevent more shots per day, but if your daughter is still producing her own insulin, and it sounds like she is honeymooning strongly at this point, she doesn't need unpredictable peaks to cover meals. If she does need something to cover meals then that one extra shot a day for breakfast or lunch or dinner would still be easier than unpredictable peaking. Lantus could be given in one shot a day and then you may need to cover one or two meals a day with a fast acting like novolog or humalog.

    Don't beat yourself up for being human and stressing or forgetting. We all forget things. I've forgotten to give shots or gave the wrong shot. It's impossible to not make mistakes. Diabetes isn't always predictable, but it is manageable with rough spots here and there. You've got to give yourself credit for doing what you do. It's hard...but it will get easier. I hope that you can maybe train your mom so that she can help you. Maybe after you get a better insulin regimen going. One thing I have learned is that you have to give up a little control in order to let others help you. It's so hard to do, but it is possible. I'm the worst at trusting anyone yo take care of my kids, but I've learned that I'm so much better off giving up a little to let others step in.

    It will get better. You're dealing with the most difficult time after diagnoses. You'll learn how to manage this and it will become second nature after a while.
     
  17. newatthis

    newatthis Approved members

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    Thank you

    Thank you to all of you who replied to my event....

    I think I am becoming more convinced about the Lantus insulin. I haven't researched it yet but from what others say, sounds like I could put in my concerns/requests with our doctor. The problem I have is I haven't even met him! We don't go for our first doctor visit with the pedo endo until Oct. 9. She will have had diabetes, that we knew of, for nearly 4 months! Without having met me and knowing what type of person I am, I don't know if docs are open to trying different insulins on a phone basis or not.

    Since the Friday episode, we have noticed her pancreas doing crazy things. I don't know if her body is replenishing some of the released sugar and now it's wacked out or what but after going the weekend with no insulin she is running on high end like 240-350, which seems a lot high to me. But they changed when she gets her NPH to bfast and lunch...we've had to give some supper Regular because she has read "HI" on her meter. And then go from 299 to 65 just because she swam for an hour! This can get a little frustrating huh? Especially when you feel like you're guessing at what to do. Seems like she's my little guinea pig.

    We live in Mississippi and drive to LeBonheur in Memphis to the endo since our town doesn't have a pediatric endo here. We love that hospital and they have been wonderful! I just feel awkward putting in calls to them if they are not an emergency.

    I am so looking forward to the day when we can look into the pump...I too think that will make life a little easier. I think. I am hoping to do enough research on them to present my case to the doctor in October when we go. The question I have is can they be put on the pump during the honeymoon or do most docs wait until that period is over? I don't want to leave the appt in Oct. disappointed because he won't even discuss with me about the pump. I am hoping he's aggressive and wants to do it before the end of the year! Is that realistic or not?

    Well, I guess I can try to get an hour of sleep! I have done some overkill on the pricking tonight. Every two hours and it's funny - at that 3 am reading - I CANNOT GO BACK TO BED! It's finally almost time to wake up and I am finally tired!

    Thanks again for everything and all your time to help me...
     
  18. Beach bum

    Beach bum Approved members

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    Call your doc!

    You must never feel guilty about calling your doctor. That is what they are there for, especially since they can't seem to accomodate you until October, THEY SHOULD BE AT YOUR BECK AND CALL! You are new to this, they need to guide you. I would also make sure you're on a wait list for a canceled appointment.

    As for the Lantus, all you can do is ask, and if they say no without giving you what you think is a valid reason, ask again, and again and again! October is a long time from now, and you can't risk this episode happening again. If you are put on a Novolog (short lasting) Lantus (long lasting) regimine, you will need a bit of training for carb counting. It is very easy once you get it down, and there is no reason why you can't meet with a nurse to learn this. In fact, we learned it at the hospital before leaving. For example our daughter will get 1 unit of insulin for every 25 grams of food eaten.

    We are now on the pump, and it has made a world of difference. We were put on the pump 8 months into diagnosis, and we were and still are (a bit) honeymooning. Our endo felt that if we were comfortable with managing Abby's, and show that we can manage responsibly, then, why not!?

    Do you call or email numbers in weekly to a nurse? Ours is actually our main point of contact, and we field most of our questions via her. If so, why don't you start inquiring about the pump now if you are interested?

    Good luck, and as I said earlier, do not feel like you shouldn't be calling your doc. Just do it. :)
     
  19. georgia

    georgia Approved members

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    first of all, good for you, you did a great job handling the situation. I have to agree with the previous poster, call your doctor or nurses. we are almost four weeks since diagnosis and we are honeymooning (which is very scarey to me) but I fax her numbers every other day and I probably call and talk to the nurse that often too. They don't mind, or I don't care if they do. But they are always very helpful trying to explain things to me. I bet they appreciate proactive parents, no one is going to know your child better than you, we need to help them but letting them know what is going on.
    When we left the hospital (after diagnosis) one of the endo's on our team told us to make an appt. for 2-3 months down the road, the other said one month at the most. We saw her last week (3 weeks in), they didn't do much, but it was so reassuring to talk to them in person and for them to see her. I brought a full list of questions. I talked to them about the pump and they said they usually stick with injections for atleast 6 months, but they have lots of young kids on the pump and they are all for it. IT makes me feel good to have some idea of where we might be headed with treatment. We are lantus and humalog and it is nice to think that maybe we'll get off of 4 shots a day. Maybe call and see if they'll see you earlier or even get a call in to your doctor. Heck, I called twice last weekend to our doctor on call, as a nurse in the hospital told me, they are getting paid while on call, make them earn it. I bet they get paid more than most of us.
    Good luck, we can do this.
     
  20. EmmasMom

    EmmasMom Approved members

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    Absolutely Call, call, call! We spent many days at the hospital sitting for hours with our pedi endo prior to Emma's discharge. We learned a lot and discussed options down the road. He was very clear on the fact that things would change quickly and we needed to call often! Even with all the training we got and a lot of experience, (my husband is type 1), we were lost, frustrated, and calling the D nurse almost daily for the first few weeks.
    You must let them know that things are not going well, otherwise they can't help you. It is very common to have a lot of crazy uncontrolled numbers in the beginning, it is not your fault! But you do need help to make the constant adjustments that are necessary to keep your daughter safe. We were testing 15 times a day and changing insulin doses every 48 hours some weeks, and we needed help!!

    Some doctors do think kids should be past the honeymoon prior to pumping. I think pumping could make honeymooning a little easier. You can "turn off" the insulin at anytime, or give tiny amounts that could never be measured w/ a syringe. Then you can correct highs so easily.
    They key for most doctors is trusting that you know what your doing and are willing to stay on top of it. Do a lot of research and go in armed! I filled a binder w/ pump research and a very detailed log of daily insulin, blood sugars, every carb eaten, (and what it was), activity, ketone test results, etc. My doctor was so impressed with my efforts that he agreed to let us get a pump, even though Emma was only 12 months at the time and he had never put anyone under 5 on a pump before. It was worth every minute!!!

    Good Luck!
     

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