A Scare

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.