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Trying to stay out of the Hospital.

Discussion in 'Parents of Children with Type 1' started by Mymommymommy, Dec 9, 2007.

  1. Mymommymommy

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    Presley had a fever all night of 103. this morning she had Moderate Ketons, so her dr wanted her to go to the hospital. She could hear the hesitation in my voice (just because i am scared, this is her first time being sick with diabetes) she told me that we could try to stay on it at home but that she had to have Motrin and Tylonal fluctuating to keep the fever down, to get her gatoraide and to have her drink some every few min. then to give her insulin ever 2 hr's about 1/2 a unit. Her BG is still on the high side, but her ketons say negative. I'm trying to keep her really hydrated, she's not interested in eating, she 1/4 of a sandwich and was done. But her spirits seem to be better. But i'm still nervous and am praying the Ketons dont come back. Her Dr has me calling her every so many hr's for updates. So I feel good that I have her Dr helping me. I hope i'm doing okay, and that i'm not making a mistake not taking her straight to the hospital. I feel better that her Ketons are gone. If her Ketons hadn't gone away the second time we checked them, I was going to take her in. Do you all think it's okay to try to take care of Ketons on your own. Or do you all normally go straight to the hospital?
     
  2. Riley'sMom

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    i think as long as she doesn't have ketones and she is willing to drink, it is a good idea to stay home. seems like a lot of the time they end up picking up something else in the hospital or having a dr not familiar at all with D in kids,
    the problem comes when they have ketones and won't eat or drink so you can't give insulin to clear the ketones. that's what landed us in the hospital before.
    sounds like you are doing a great job with it so far! just make sure to keep checking ketones, because if she is not eating a whole lot she could develop starvation ketones.
    good luck, hope she feels better soon!
     
  3. Rachel

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    Sounds like you are handling it all really really well! And great to have such support from the endo. We've been lucky to never had had to do a hospital run for ketones - using the support of our endo and tackling it at home as you are doing.

    Watch throughout the night too as the ketones may well be building up just over night when there is no extra insulin getting into her system. Ask your endo on this, but you may want to keep up the carbs and insulin throughout the night.

    During a sickness bout this fall we had 3-4 mornings when the ketones appeared only after about 3 am, grew to large by morning, and flushed out quickly with breakfast insulin and a correction. Once we learned the pattern of what was going on, I'd get up at 3, test for K. and if they were starting to go up, I'd give juice and insulin to cover it. It helped keep the K down.

    That was our experience, but YDMV ... and your endo support sounds wonderful. Hang in there!
     
  4. KatelinsMom

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    Poor Presley. I hope she feels better soon. It sounds like you are doing a really great job with keeping her hydrated, and at least you know you can take her to the hospital if needed and her endo is just a phone call away. :)
     
  5. zimbie45

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    I HOPE presley feels better soon.. YOU are doing an awsome job.. I would make the same choice and stay home
     
  6. WestinsMom

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    We always try to stay home if possible...now that being said...I know it isn't easy with a young one. Until you feel like you can't control it, keep up the great work. But if you feel like it is getting to be a loosing battle, take her in.
     
  7. wilf

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    We would only take our children to hospital in a true emergency. You seem to have your situation well under control, so no need.. Congratulations to you, and to your medical team for providing such excellent support.
     
  8. sammysmom

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    Some people go to the hospital when the kiddos get ketones and some are more comfortable handling it at home. Our endo taught us how to handle it at home so we are comfortable that way. Either way it only matters how comfortable you are with the situation. There have been many times that I questioned going to the hospital but we managed it at home, with the dr's support and a lot of patience.

    At the hospital, an IV might move things along a little bit quicker but most of the time even without the IV ketones (yes even large ones and high readings on the ketone meter) can be managed at home. We did go to the hospital one time and that is when he was throwing up non stop and could not keep anything down. One time in 6 years is not bad!

    I really think it boils down to the comfort level of the parent. There is nothing wrong with going to the hospital though.
     
  9. AP-Mom

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    After having been in the hospital last week, I wouldn't wish a visit on anyone. If Presley is still willing to drink, that is in your favor. How is she feeling today? Ainsley had large ketones and was refusing to drink, so we had to go.

    Hope Presley is feeling better and kudos to you for your diligence. :cwds:
     
  10. EmmasMom

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    It sounds like she's doing pretty well. As long as she can drink and you can give insulin there is no need to rush to the hospital.
    We never go to the ER unless Emma is vomiting with sustained large ketones that we can't clear, (low BG and unable to drink), or she's very dehydrated w/ large ketones. Our endo is very anti-ER, but we both know there comes a point that treating at home becomes dangerous. If you have a good, experienced endo they will be able to help you make the decision.

    I agree that ketones can be managed at home most of the time, but it's very important to know your limits and follow your instincts. If a young child has large ketones that can't be reduced, (in a few hours) because they can't drink you can get into big trouble that can't be fixed at home. Small kids can have significant PH changes with large ketones and dehydration and can end up very sick if left untreated.

    Just keep doing what you're doing! It's working great!:cwds:
     
  11. Mymommymommy

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    So her Ketons went away after our second check yesterday, she only at 1/4 of a sandwich for lunch, but did eat some pizza for dinner. We've kept her hydrated with Gatoraide s/p? and been keeping up on insulin shots. Last night at her late night check, her BG was 115, and there were no ketons. I checked her again around 1:30 at her BG was 150. This morning it was 82, but she wouldn't eat. So I gave her some more gatoraide, and just checked ketons again (waiting for cotton.) and she has moderate ones again?? :confused: I guess it's normal for them to come and go? So i guess we're chasing ketons again today. So tired... makes me sad.
     
  12. Lee

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    I think that is normal... that they come and go. It sounds like you are handling this like a true pro, and I hope she feels alot better soon!

    Also, ask your endo fro the Precision Blood Ketone meter - it is a GREAT BIG HELP!!!! No cotton balls, and you can just squeeze a second, bigger drop when testing to test ketones also.
     
  13. EmmasMom

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    Yes, the up and down of ketones is totally normal during an illness. The key is that they are responding to the insulin and not getting worse and staying that way. As long as she continues to drink and you continue to monitor her BG and ketones closely she should be fine.

    I know it's exhausting but you're doing great!:)

    I agree that a blood ketone meter is a fabulous thing, for kids in diapers... beyond priceless!
     
  14. semperwife

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    I have some of the ketone strips if you can get the meter. Just let me know and I can met you somewhere. I agree that is probably the easiest way to get the ketone reading while you are testing her sugar at the same time.

    I hope she is feeling better. Another trick to getting her sugar up a little bit so you can give her insulin is powdered jello... just make sure it isn't red. Just melt a little bit on her tongue and it will cause the sugar to go up slightly.
     

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