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What am I missing?

Discussion in 'Parents of Children with Type 1' started by Abby-Dabby-Doo, Jan 16, 2009.

  1. Abby-Dabby-Doo

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    Abby started creeping up with b/s on Wednesday. When she woke on Thursday she was high all day in the upper 300's (360-380's).
    I ran a 170% basal rate all day, inspected the site (no kinks because we use the steel needle), no bubbles in the tubing, checked her pump settings, checked bolus history, asked her if anything hurt, she's perky and happy. The only thing that is going on that is out of the ordinary is a front tooth is coming in.
    With all those things being okay I pitched the insulin (we just opened it on 01/02/09) and changed the site anyway. After removing the adhesive pad Abby had a bruise where the site went in that was being covered by the adhesive pad so it wasn't noticable just looking at it. The spot where the site was at is raised up, and purple, but not red, and it's not hot to the touch.
    We got her down to 87 before bed, had 5 carbs free, and put her to bed. Her 3am check was perfect. She woke at a 163- so things turned around:D

    Now I get a call from school- she was a 360 post breakfast and a 383 before lunch with 1.1 ketones:eek: The nurse checked her temp and she's normal. What the heck am I missing?????????????????????
     
  2. Nancy in VA

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    That bug might be 2-3 days away from showing itself.

    I would say the breakfast ratio needs changing except for the ketones.

    Sicne you know its not a bad site, I would lean toward pending illness.
     
  3. Christopher

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    Sorry Lanae, that sounds frustrating.....illness or growth spurt maybe?
     
  4. Abby-Dabby-Doo

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    You guys are thinking what I'm thinking but growth spurts don't normally effect her during the day and I've never seen ketones before the illness. I've seen raised b/s before the illness, but not ketones.

    I can offically say I'm stumped, but that's whats scaring me the most!
    I guess with this disease you can never say never:(
     
  5. hold48398

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    I am sorry, Lanae, I would have done exactly what you did... :confused:.:(
     
  6. Gwyn

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    I hope things will turn around soon Lanae--thank goodness it is Friday so maybe you can get things under control over the weekend.
     
  7. Boo

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    You are absolutely certain that the breakfast bolus was done? And for the correct amount?
     
  8. Abby-Dabby-Doo

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    Yep, I went through the bolus history to make sure. I'm at a loss:confused:.
    I have a phone call into the Endo, but I'm supposed to call back after I get her post lunch number, and ketone reading since the time is so close.

    By the way... IT'S GOOD TO SEE YOU BOO (Beth)!
     
  9. Shirley and Jamie V.

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    Have you checked to vial in the pump against the Total Daily numbers? I remember someone having pump problems where it wasn't delivering what the screen said it was delivering.

    There is also a mean stomach flu going around here that may be making its way to your neck of the woods.

    Good luck!

    SHirley
     
  10. Schpoodle's Dad

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    We saw periods of increased insulin requirements whenever our daughter was teething.
     
  11. Abby-Dabby-Doo

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    Happy 1 year anniversary Schpoodle! :cwds:
    I'm wondering about the tooth, but enough to produce ketones? I guess anything is possible.
     
  12. Schpoodle's Dad

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    Actually 2 yrs..... Seems like an eternity. (Thank-you for the support though!)

    I don't think we ever tested for ketones so I can't answer that part. Makes sense though if she is short on insulin.
     
  13. StillMamamia

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    Maybe it's just a normal insulin increase, no other reason???

    Hang in there.


    ETA - or a rebound from overnight lows??
     
  14. Abby-Dabby-Doo

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    I didn't think of that one Paula- thanks. I went back and checked her CGMS and it's a great flat line between 350-380. :rolleyes:
    Talked to the Endo, he said were doing everything right. Watch the old site to make sure it isn't infected, and maybe an illness on the verge.
    The ketone's are down from 1.1 to .1 after lots of fluids, basal is still running at 170%. I checked the max basal rate on the pump and it was at .9 an hour so I turned that up (thanks Mama2H for the reminder). Checking every hour and correcting.

    It's going to be a long night. DH is getting ready to leave, work has called:rolleyes: once again. So I'll be in chat later tonight if anyone wants to yuck it up!
    Thanks for the ideas everyone, and if anyone thinks I'm missing something please chime in.:cwds:
     
  15. Nancy in VA

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    Gotta love that flat line. Gotta hate that its at the 350 mark!

    We are actually running reduced basals by 30% for the next 24 hours trying to get Emma UP and give her poor liver a break because it must be working hard with her staying between 40 - 60 last night!
     
  16. Heather(CA)

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    Have you tried giving a correction with a syringe, just in case the new site went bad too for some reason?:confused: I'm going to go see if your in the chat...
     

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