Ketones ... something diabetics deal with often but something we have been lucky to stay away from for the most part.
What are ketones and what causes them?
Ketones are the result of the body burning fat for energy or fuel. For a person with diabetes, ketones are often the result of prolonged high blood sugar and insulin deficiency. Without the right amount of insulin, glucose starts to build up in the blood stream and doesn't enter the cells. The cells burn fat instead of glucose, and ketones form in the blood and spill into the urine.
High levels of ketones can poison the body. When levels get too high, you can develop DKA. DKA may happen to anyone with diabetes, though it is rare in people with type 2.
We have had 'trace' amounts of ketones before which is very manageable and we push the fluids and go potty often and they go away. But this time we had LARGE ketones and mom got a little, ok, a lot nervous.
Trey hasn't been himself for about two-three weeks. He has had a cold, complained of a sore throat, hasn't been eating much, and complaining of a tummy ache often. I thought he was being a stubborn 5 year old boy, trying to delay bedtime or trying to get out of eating something I made in order to have something 'bad' for him. His sugars seemed to be normal, but we finally ran him to the doctor to see what was causing it all after he threw up Wednesday night. Thursday he ran a temp off and on and just wasn't our fun loving Trey and didn't even want to play with Grandpa Dan.
Friday we had the funeral for Pop and he was very sad about it. Again, he didn't want to eat much lunch but I did let him have a bar that had a brownie, carmel sauce and crushed M&M's on it. We arrived at the burial 60 miles away and he told me he was going to be sick ... he indeed was. I chalked it up to the brownie which was probably 30 carbs and just too much on his little tummy. A half hour passes and he's 'starving' so I give him some goldfish from my purse. He soon says his tummy hurts. He vomited again and I knew we had to get him home. On the road home, his sugar started dropping so we picked up some apple juice and I had him take sips of it to keep his blood sugar from dropping lower but not too much that it would upset his tummy.
Upon arriving home, I had decided he was probably just backed up and needed some Miralax to help move things along and ease the tummy pains as we've had this issue with him before. One more time of being sick and I said we better check ketones and that's when I saw the brightest color on the stick and I couldn't believe it. His sugar was only 84 -- ketones are usually present with high sugars, not low. I called Jordan, who was at his grandma's house and asked him to come home immediately as we probably were headed to the Emergency Room. I then phoned his doctor in Sioux Falls and left a message for the office staff to page him. By this time, Trey had napped a little and was starving. I gave him two saltines and 1/4 cup of chicken noodle soup which was recommended on our paperwork from the hospital upon his diagnoses and pushed the powerade zero. He was still hungry but we managed to wait to feed him more until we knew his tummy could handle it and a call from Dr Gupta. I knew he needed more insulin to clear the ketones, but with a low sugar already, I didn't know what to do!
We were instructed to get his sugar up, quickly, to 250. Once we hit 250, give him 1.5 units of insulin and check ketones. If he threw up again, we had to get to the ER for an IV of fluids and the staff there would be in touch with Dr Gupta for further treatment options.
His tummy handled it all well and it seemed like forever to get to 250. (We gave him apple juice to get him up). Then my Trey seems more like himself already and says "I'm so hungry!" so he had some chicken nuggets daddy cooked for him. Ketones were coming down, but still in the large category. I was scared to go to bed, but by now, my tummy had rumblings too and I knew I couldn't be sick if I had a sick kid I had to take care of.
He slept great - me, not so much. He woke up with blood sugar of 200 and Small ketones. He still needed more insulin so he had applesauce and 4oz apple juice for breakfast and then 1.5 units of insulin again. I also pushed the fluids and encouraged him to potty as much he could.
He was determined to play in his hockey game at 8:45am today. I told him if he had ketones, he could not play as it would only increase the ketones and brew yet more illness. I told him what we could do for the next 45 minutes and he was determined to play in his game. This is when he picked his own high carb breakfast and filled his water bottle and peed four times. The last time, at 8:15 showed between none and trace amount of ketones and even though he said his tummy still kinda hurt, he was playing hockey.
In today's game, he scored four goals. I cried after the first one. I was so proud of him for finally scoring a goal because he's been trying so hard. I smiled, banged on the glass and had tears for the next three as well. Technically, my boy had a Hat-Trick today - his first ever!
As I watched him play the rest of the game, I couldn't help but to think of so many things. 1) Papa got to see his first hockey game and I'm certain Papa helped with those goals and 2) I was so proud of him for playing his best game to date, but I'm more proud of his determination to PLAY the game and not let diabetes stop him. Five years old, did whatever he had to do to get rid of the ketones and go out there to have the best game of his life thus far ... take that diabetes. We BEAT you today!
Chalk up another FIRST for us on this journey we are on ... and thankfully everyone's prayers helped and we were able to avoid a ER visit and avoid DKA! God Is Good.
Saturday, December 31, 2016
Wednesday, December 28, 2016
Merry Christmas & Happy New Year
What a couple of weeks it's been. All the holiday parties at school, two birthday parties and Christmas ... it's been hard to keep blood sugars in range, but we did the best we could.
Due to the weather, we changed Christmas up a bit this year. We celebrated with the Westby's on Christmas Eve at the nursing home where Great Grandma Fern got her own hockey stick and Trey taught cousin Alex about hockey. Jordan received a call that afternoon that his grandpa (Papa) had passed away from cancer. Christmas Eve night we headed out to Aunt Jeff and Paula's for a Casanova gathering. Trey ate four bites of food and then played with his cousins. He made Uncle Jeff, who also has T1D, administer the insulin via his pump. Christmas morning the four of us opened gifts and then headed to my mom's in Groton for a quick Christmas lunch and celebration. Instead of heading south to Conde for the Thomas Christmas, we came back to Aberdeen and went over to Nan's house.
Trey didn't eat much at all for these two days. Even surrounded by sweets and candies, he did really well keeping sugars in check. We did splurge and have 2 peanut butter balls that spiked him to over 250 in a hurry but he did come down from it nicely.
We hit the Pizza Ranch on Monday in memory of Papa (his favorite place to eat ... My dad's also!). Plugged in 100 carbs for Trey. I almost cried. He had breadsticks and pizza and dessert pizza. I was so proud of him I when I told him "100 carbs buddy" and he said, "Are you going to dual wave me?" I smiled so huge and said, "yep ... I think that's a good idea." Grandma Karla and Grandpa Dan were lost when he asked. I love that Trey is understanding all the 'tricks' and knows when it should be used. I try to educate him the best I can, knowing sometimes the information I tell him won't stick, but he amazes me when he tosses it back to me. He got a lot of insulin for that meal, but he did come down thanks to dual wave.
My hope for 2017 is that I update this more. I don't know who reads it, but it's part therapy for me and part information for the readers on what diabetes does to our family. It's been a long, exhausting, tricky, hard, sad year for us, and to think that March will mark the 1 year anniversary of his diaganoses seems impossible. I look back and how far we have all come in our knowledge and how proud of Trey I am for everything he has been through and I smile. I thank God for the people diabetes has brought into our life, I thank God for the technology we have, I thank God for Trey's overall health and awareness to the disease. We are lucky, to be honest. Here is hoping 2017 furthers our education/knowledge, Trey continues to grow and educate others, and more life long connections are made and of course, we will keep praying for a cure.
Merry Christmas & Happy New Year!
Due to the weather, we changed Christmas up a bit this year. We celebrated with the Westby's on Christmas Eve at the nursing home where Great Grandma Fern got her own hockey stick and Trey taught cousin Alex about hockey. Jordan received a call that afternoon that his grandpa (Papa) had passed away from cancer. Christmas Eve night we headed out to Aunt Jeff and Paula's for a Casanova gathering. Trey ate four bites of food and then played with his cousins. He made Uncle Jeff, who also has T1D, administer the insulin via his pump. Christmas morning the four of us opened gifts and then headed to my mom's in Groton for a quick Christmas lunch and celebration. Instead of heading south to Conde for the Thomas Christmas, we came back to Aberdeen and went over to Nan's house.
Trey didn't eat much at all for these two days. Even surrounded by sweets and candies, he did really well keeping sugars in check. We did splurge and have 2 peanut butter balls that spiked him to over 250 in a hurry but he did come down from it nicely.
We hit the Pizza Ranch on Monday in memory of Papa (his favorite place to eat ... My dad's also!). Plugged in 100 carbs for Trey. I almost cried. He had breadsticks and pizza and dessert pizza. I was so proud of him I when I told him "100 carbs buddy" and he said, "Are you going to dual wave me?" I smiled so huge and said, "yep ... I think that's a good idea." Grandma Karla and Grandpa Dan were lost when he asked. I love that Trey is understanding all the 'tricks' and knows when it should be used. I try to educate him the best I can, knowing sometimes the information I tell him won't stick, but he amazes me when he tosses it back to me. He got a lot of insulin for that meal, but he did come down thanks to dual wave.
My hope for 2017 is that I update this more. I don't know who reads it, but it's part therapy for me and part information for the readers on what diabetes does to our family. It's been a long, exhausting, tricky, hard, sad year for us, and to think that March will mark the 1 year anniversary of his diaganoses seems impossible. I look back and how far we have all come in our knowledge and how proud of Trey I am for everything he has been through and I smile. I thank God for the people diabetes has brought into our life, I thank God for the technology we have, I thank God for Trey's overall health and awareness to the disease. We are lucky, to be honest. Here is hoping 2017 furthers our education/knowledge, Trey continues to grow and educate others, and more life long connections are made and of course, we will keep praying for a cure.
Merry Christmas & Happy New Year!
Rant
I was recently talking with my best friend about all the stress of the holiday season. We also discussed both having a year of "firsts". She's having a year of firsts without her father, who passed away in February. My firsts are diabetic related.
Diabetes has become my life. It is something that is on my mind always. I either take a look at how many carbohydrates are in food; look at the CGM app on my phone to see what Trey's sugars are; plan out what different food choices I can make depending on what Trey's sugar is; how many carb snack he can have for how high or low he is running; knowing where his kit is; looking at the calendar to see what days we change out his sites; etc. It's hourly ... Sometimes many times an hour. It's in the middle of the night, when I roll over and grab my phone to check his Dexcom. It's always ... Always on my mind. I don't expect anyone who is a non D parent to understand, and I'm not searching for sympathy, I'm simply saying this disease is a jackass.
A very good friend of mine recently sent me a photograph she found of a little boy, sitting naked (backwards) on a rock staring out into the ocean off of Hawaii. He had a Dexcom CGM on his arm. I smiled, then my heart broke a little bit. I know that mother's agony. I replied to my friend, thanking her for sending it to me and then started ranting ... I hate diabetes. I love the technology that diabetics have now, but I pray for a cure. I hate that insurance companies don't think they need to cover things such as a pump or a CGM. I hate that the cost of insulin has skyrocketed to an astronomical amount that some families cannot afford. The damn world is so un-fucking-educated about diabetes and it pisses me off. Sorry for such language ... But it's so true.
Today I read the obits in the local newspaper and I see a person in their low 30's who passed. Intrigued I read the entire obit, even though I did not know the person. Then I see ... "Diaganosed at age 16 with diabetes" and I felt like I was going to puke. It does not say that the young man passed from his diabetes, but it still makes my heart hurt.
Today Trey came home from school with sugars in the 90's and an arrow down on the CGM. He has a sugar free Popsicle. He continues to decline, now in the 70's, so a 'real' Popsicle is had. Current sugar 1 hour after the Popsicle is 182 with an arrow up. The first Popsicle had 0 carbs. The second Popsicle had 8 carbs - 5 of which were sugar. Over 100 "points" up in an hour from 8 carbs. Maddening. I hate diabetes.
I hate waking my child up at 4am to do a finger poke and force him to drink some Fairlife chocolate milk. I hate seeing his sugar go over 300 when he's at school because his morning was too packed full of exercise and it didn't agree with him. I hate having to tell him "no, you can't have the bun" when he wants a hotdog at the Wings game. I hate that he is too embarrassed at school lunch to have his nurse administer his insulin in the gym, that he wants to make it a private affair where the other kids can't see because he doesn't want to answer questions. I hate feeling like my husband and I cannot go out for a simple supper date without our children because there is no one that really knows how to take care of Trey's needs. I don't even want to ask someone to watch him, because truthfully it's a lot for a person to understand even though Trey basically knows the in's and outs of the disease and pump himself. He has great self control. As I said before, I hate that insurance companies don't want to cover the CGM as they don't find it medically necessary to manage the disease. Thank God our insurance did cover it, but it's so very wrong for them to think it's not a NEED.
End of Rant
Diabetes has become my life. It is something that is on my mind always. I either take a look at how many carbohydrates are in food; look at the CGM app on my phone to see what Trey's sugars are; plan out what different food choices I can make depending on what Trey's sugar is; how many carb snack he can have for how high or low he is running; knowing where his kit is; looking at the calendar to see what days we change out his sites; etc. It's hourly ... Sometimes many times an hour. It's in the middle of the night, when I roll over and grab my phone to check his Dexcom. It's always ... Always on my mind. I don't expect anyone who is a non D parent to understand, and I'm not searching for sympathy, I'm simply saying this disease is a jackass.
A very good friend of mine recently sent me a photograph she found of a little boy, sitting naked (backwards) on a rock staring out into the ocean off of Hawaii. He had a Dexcom CGM on his arm. I smiled, then my heart broke a little bit. I know that mother's agony. I replied to my friend, thanking her for sending it to me and then started ranting ... I hate diabetes. I love the technology that diabetics have now, but I pray for a cure. I hate that insurance companies don't think they need to cover things such as a pump or a CGM. I hate that the cost of insulin has skyrocketed to an astronomical amount that some families cannot afford. The damn world is so un-fucking-educated about diabetes and it pisses me off. Sorry for such language ... But it's so true.
Today I read the obits in the local newspaper and I see a person in their low 30's who passed. Intrigued I read the entire obit, even though I did not know the person. Then I see ... "Diaganosed at age 16 with diabetes" and I felt like I was going to puke. It does not say that the young man passed from his diabetes, but it still makes my heart hurt.
Today Trey came home from school with sugars in the 90's and an arrow down on the CGM. He has a sugar free Popsicle. He continues to decline, now in the 70's, so a 'real' Popsicle is had. Current sugar 1 hour after the Popsicle is 182 with an arrow up. The first Popsicle had 0 carbs. The second Popsicle had 8 carbs - 5 of which were sugar. Over 100 "points" up in an hour from 8 carbs. Maddening. I hate diabetes.
I hate waking my child up at 4am to do a finger poke and force him to drink some Fairlife chocolate milk. I hate seeing his sugar go over 300 when he's at school because his morning was too packed full of exercise and it didn't agree with him. I hate having to tell him "no, you can't have the bun" when he wants a hotdog at the Wings game. I hate that he is too embarrassed at school lunch to have his nurse administer his insulin in the gym, that he wants to make it a private affair where the other kids can't see because he doesn't want to answer questions. I hate feeling like my husband and I cannot go out for a simple supper date without our children because there is no one that really knows how to take care of Trey's needs. I don't even want to ask someone to watch him, because truthfully it's a lot for a person to understand even though Trey basically knows the in's and outs of the disease and pump himself. He has great self control. As I said before, I hate that insurance companies don't want to cover the CGM as they don't find it medically necessary to manage the disease. Thank God our insurance did cover it, but it's so very wrong for them to think it's not a NEED.
End of Rant
Thursday, December 8, 2016
Illness .. Cookies .. Birthdays
We made it through the first Thanksgiving with Type 1. Since Trey isn't big on potatoes, it was the buns I had to watch. He did get one bun and then ran high the rest of the day. One stinking bun ... It's crazy how much that can affect someone.
We haven't had another hockey game that we have made it to. We had Thanskgiving weekend off and last weekend we were doing our annual cookie baking at Grandma Lori's. This weekend we are back in action and I can't wait to see him do what he loves most!
Speaking of cookie baking, surprisingly Trey's numbers were pretty good. He ate some cookies and licked some frosting and I didn't even have to give extra insulin to cover it. He didn't beg for more or get upset if I said 'no'. His self control - at age 5 - is something I admire greatly.
Trey did have some higher blood sugars last week. Ended up coming down with a heck of a cold. Even the slightest bit of food would send his sugars over 300, driving me crazy! Extra fluids and extra insulin and he's back to having better numbers. It's probably time to get in touch with Teresa in Sioux Falls again and have her adjust a few more numbers as our mornings are still higher than we'd like them to be. It's normal to have higher sugar in the morning, but waking up in high 100's low 200's isn't where we want to be.
I wasn't aware of this until the school nurse brough it to my attention today, but Trey wouldn't allow her to administer his insulin in the gym after lunch. He would make her go back to the classroom so no one could see. This would cause him to miss some recess time and he would get frustrated by that. Today she told me they eat lunch with their boots and snow pants on and he allowed her to do his pump in the gym as long as she blocked other kids from seeing it and he was able to go outside with his class and get FULL recess in. When he had the shots, I know sometimes he woudln't like others to see and I assumed with the pump he was better about it. I mean, we hook it and unhook it in the locker room at hockey three times a week and he doesn't say anything. Guess it's a discussion I need to have with him. I don't want him to be ashamed and I know he's trying to avoid questions being asked. I want him to be comfortable of course, but I need to him know it's OK if people see it and Mrs Osborn will handle the questions if there are any.
We have another first coming up. Trey has been invited to a birthday party this Sunday. The parents know of Trey's diabetes, but they do not know specifics. Jordan or I will attend the party with Trey so we can administer the insulin and watch his CGM. The "firsts" are always the hardest. I know he will have a blast and I'm happy the parents still invited him and didn't exclude him just because of T1.
Christmas is coming up ... Fast. If you're reading this due to the letter I sent out with the blog listed at the bottom -- welcome. You can put your email address in over to the right and when I do update the blog it will send an email to you so you don't have to look up the site often.
We haven't had another hockey game that we have made it to. We had Thanskgiving weekend off and last weekend we were doing our annual cookie baking at Grandma Lori's. This weekend we are back in action and I can't wait to see him do what he loves most!
Speaking of cookie baking, surprisingly Trey's numbers were pretty good. He ate some cookies and licked some frosting and I didn't even have to give extra insulin to cover it. He didn't beg for more or get upset if I said 'no'. His self control - at age 5 - is something I admire greatly.
Trey did have some higher blood sugars last week. Ended up coming down with a heck of a cold. Even the slightest bit of food would send his sugars over 300, driving me crazy! Extra fluids and extra insulin and he's back to having better numbers. It's probably time to get in touch with Teresa in Sioux Falls again and have her adjust a few more numbers as our mornings are still higher than we'd like them to be. It's normal to have higher sugar in the morning, but waking up in high 100's low 200's isn't where we want to be.
I wasn't aware of this until the school nurse brough it to my attention today, but Trey wouldn't allow her to administer his insulin in the gym after lunch. He would make her go back to the classroom so no one could see. This would cause him to miss some recess time and he would get frustrated by that. Today she told me they eat lunch with their boots and snow pants on and he allowed her to do his pump in the gym as long as she blocked other kids from seeing it and he was able to go outside with his class and get FULL recess in. When he had the shots, I know sometimes he woudln't like others to see and I assumed with the pump he was better about it. I mean, we hook it and unhook it in the locker room at hockey three times a week and he doesn't say anything. Guess it's a discussion I need to have with him. I don't want him to be ashamed and I know he's trying to avoid questions being asked. I want him to be comfortable of course, but I need to him know it's OK if people see it and Mrs Osborn will handle the questions if there are any.
We have another first coming up. Trey has been invited to a birthday party this Sunday. The parents know of Trey's diabetes, but they do not know specifics. Jordan or I will attend the party with Trey so we can administer the insulin and watch his CGM. The "firsts" are always the hardest. I know he will have a blast and I'm happy the parents still invited him and didn't exclude him just because of T1.
Christmas is coming up ... Fast. If you're reading this due to the letter I sent out with the blog listed at the bottom -- welcome. You can put your email address in over to the right and when I do update the blog it will send an email to you so you don't have to look up the site often.
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