advertisement

  1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.

So we had to use glucagon...

Discussion in 'Parents of Children with Type 1' started by Catiesmom, Apr 27, 2014.

  1. Catiesmom

    Catiesmom Approved members

    Joined:
    Oct 26, 2009
    Messages:
    93
    She ate dinner Monday night, got her full bolus, almost 5 units. She then went to take a shower, came out of the shower and said her tummy felt bad. Dexcom said 100 and straight south. I hoped it was the shower. She said she felt nauseas, I gave her a Zofran tablet. Dexcom buzzed low 80 and headed further south. Gave her 5 tablets and a juice pouch,39 carbs. Still felt nauseas, then she felt hot. I tested her - 38.

    I got the glucagon out, said baby, let's do this just in case. She threw up all the juice, dinner, the Zofran, everything. I mixed up the glucagon and used the needle that came with it to inject. I know about the mini dose method and have mini syringes, but when I looked briefly at the instruction sheet in the case, the only words I saw were, "there is no overdose of glucagon." so I injected about 3/4 of it. The rest I couldn't get out due to bubbles.

    In 15 minutes she was up to 80. After an hour she only went up to 154 with no more IOB. Still nauseas. I told her glucagon could make her nauseas. Got dh on the phone and told him to get home, now. She continued to throw up while I called the endo's after hours line. The pediatric fellow called back. I asked her if she knew how long glucagon could make you nauseas. She had no idea. She sounded so young. After 2 more hours of vomiting we went to the ER. It took an hour to get hooked up to the IV and get IV Zofran.

    By 4 AM the regular pediatrician came in and recommended we go home and sleep in our own beds even though she was still vomiting some. She got 2 liters from the IV. He wanted to see her n the office the next day to follow up. So we went home.

    By 5 AM dh was puking and a call to grandma revealed she was puking. Damn Easter buffet was the culprit, apparently grandma found out several others who ate there got sick the next day. Somehow I was the "lucky" one who didn't get it.

    By Friday Catie was still very tired and couldn't go on her 8th grade class field trip to DC, she said she didn't have the energy and cried her eyes out. She is still eating without her blood sugar going up until hours later, so I'm just chasing highs right now so we don't bottom out from a bolus.

    Reflections - I would give the glucagon again, and give most of it because she is at 105 pounds now. Be careful of the needle it comes with, it's very flimsy. It broke off when I tried to recap it after the shot. This happened to me when playing with an expired kit in the past. Keep extra syringes around just in case.

    PS - The direction sheet that comes with it makes a good cat toy :)

    Stomach bugs suck.

    Catie, almost 14, dx at 8
    dx 6/19/09, Animas Ping 9/28/10, Dexcom 10/14/11, Omnipod 6/11/12
     
  2. rgcainmd

    rgcainmd Approved members

    Joined:
    Feb 6, 2014
    Messages:
    1,314
    Catiesmom, what a freaking nightmare!

    Not that you need my commendation, but looks like you did the right thing (and then some). Although chilling, I think it's very important for parents (especially newbies like myself) to hear about incidents like yours in order to learn more about what to do when the low BG hits the fan.

    I hope Catie is feeling like her old self soon. Never a good time for something like this to happen, but right before her scheduled class field trip to DC makes it especially suckish and not at all fair. Fate owes your daughter some especially good karma!
     
  3. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,647
    You did well. :)

    Hope she's feeling better soon.
     
  4. mmgirls

    mmgirls Approved members

    Joined:
    Nov 28, 2008
    Messages:
    6,026
    Good job!

    I have not done a glucagon or mini-glucagon, but know that I need to not be so scared of it. We have done a couple of ER trips, after a bad tummy bug and after the Start of a strong antibiotic, basically the same issue with both, what you saw last night. A fully bolus end meal an little or no absorption of those carbs.

    I have taken to putting in a regular syringe into the glucagon case, just in case.

    I have always told people that diabetes is a huge window into how the body works, or does work in this case. I hope that you are able to deal with all of this in short order and that she bounces back quickly.
     
  5. shannong

    shannong Approved members

    Joined:
    Sep 15, 2012
    Messages:
    568
    You handled everything so well! I can only hope I handle a situation like that so well. Thanks for sharing.
     
  6. DavidN

    DavidN Approved members

    Joined:
    Sep 7, 2012
    Messages:
    741
    I'm glad everyone is safe. Good job!
     
  7. mom24grlz

    mom24grlz Approved members

    Joined:
    Mar 30, 2010
    Messages:
    1,799
    WE had to do the glucagon on 4/19. We also did the "mini" dose. She was low for 3 hours and wasn't coming up despite stopping insulin 2 hours prior and drinking 3 large glasses of orange juices, glucose tab, and smarties. We did 15 units glucagon. And it took her from 55-122. Ashleigh gets shower lows quite frequently. She actually has to test before shower, and then eat an uncovered snack. If she doesn't she'll drop to at least 70 or lower. Most times she'll be in the 40-50 range. It happens at all times of day.
     
  8. wilf

    wilf Approved members

    Joined:
    Aug 27, 2007
    Messages:
    9,647
    This is not something I've heard about before, except for people on MDI where the shower activates the Lantus/Levemir they have on board.

    Have you thought about reducing basals in the couple of hours before a shower? What does your medical team think may be happening?
     
  9. rgcainmd

    rgcainmd Approved members

    Joined:
    Feb 6, 2014
    Messages:
    1,314
    I didn't know that activation of long-acting IOB could be a cause of some (if not most) of these post-bathing lows. Good to know. My daughter likes to take a 30-minute or so hot bath before school most days. I learned the hard way not to have her take her a.m. Humalog (she's still on MDI), eat her breakfast, then take a bath. We now do bath first, then insulin and breakfast, and lows happen a lot less frequently. But they still happen on occasion. The activation of long-acting insulin may very well be the reason. Once she's pumping, we'll have to try the strategy of reducing basals for a couple of hours before baths and see if that is helpful.

    This is the kind of stuff that I doubt we would ever learn from our comprehensive diabetes team, probably because most of them do know about these "tricks of the trade" (unless they happen to have a CWD.)
     
  10. Christopher

    Christopher Approved members

    Joined:
    Nov 20, 2007
    Messages:
    6,733
  11. rgcainmd

    rgcainmd Approved members

    Joined:
    Feb 6, 2014
    Messages:
    1,314
    Thank you, Christopher. I think I came across this briefly during the first few days after dx, but there was still so much going on that I didn't give it much more than a glance. Now that things are considerably less crazy (knock wood and thank you, honeymoon!) I'm going to read this thread from start to finish at least once a month!
     
  12. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432

    We have similar problems with shower lows. We have to be careful that she no insulin working except basal, & sometimes she'll still go low.
     
  13. MomofSweetOne

    MomofSweetOne Approved members

    Joined:
    Aug 28, 2011
    Messages:
    2,659
    It's amazing how YDMV. My daughter will take her breakfast and eat during a long, soak bath sometimes, and we never see lows from it. I'd forgotten hot water was even a possible contributor to lows.
     
  14. Lee

    Lee Approved members

    Joined:
    Oct 5, 2006
    Messages:
    9,633
    I just became 'brave' enough to use the minigluc last year, now we use it with ease for tummy problems. We just had a bad bug last month where her BS just wouldn't stay up and nothing would stay down. I keep a regular syringe with big red now.
     
  15. mom24grlz

    mom24grlz Approved members

    Joined:
    Mar 30, 2010
    Messages:
    1,799
    Hey Wilf reducing or stopping insulin beforehand does not make a difference. Her endo staff is perplexed too. They suggested doing the uncovered snacks and it helps. She still drops, just not low. Example she may test at 130 eat a 20 carb snack (uncovered) and finish the shower with a BS of 80-90. Lot better than 40-50s
     
  16. mom24grlz

    mom24grlz Approved members

    Joined:
    Mar 30, 2010
    Messages:
    1,799
    Oh and water temp doesn't seem to matter. We've lowered the temperature and haven't noticed a difference. She experiences lows while in our pool too.
     
    Last edited: May 3, 2014
  17. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432
    This is interesting. Dd has lows in the pool as well, but I've always assumed it's from activity.
     
  18. mom24grlz

    mom24grlz Approved members

    Joined:
    Mar 30, 2010
    Messages:
    1,799
    It might be in your daughter's case. But we have an above ground pool, so all she does is float around. Not a lot of room for actual swimming.
     
  19. kyles_mom

    kyles_mom Approved members

    Joined:
    Jul 7, 2008
    Messages:
    304
    Kyle has had quite a few episodes lately where it was just after his dinner bolus he's jumped in the shower and gone low and not just a little low, dropping dramatically where it takes a lot of carbs and time to bring it back up. I had read about hot water making the insulin work faster, but I was never quite sure this was true until his recent episodes. After almost 6 years in, this is something new to us.

    As for the mini gluc, I've used it a few times. It's usually when he's had an unexplained low that he just can't seem to bring up. After countless juice boxes, soda etc he will get full so it's either the mini gluc, or the risk of him throwing up all the carbs he's just ingested.
     

Share This Page

advertisement