Friday, November 18, 2005

A stomach bug ---- we mean diabetes

Friday, November 18, 2005. (about 2 weeks after her first birthday) Emma got really sick and started throwing up, and by the end of the day she was very miserable. We remember she was tossing and turning alot for hours on end. By the afternoon the next day, we decided to take her to the after hours clinic because she hadn't improved any and had developed raspy breathing. We thought maybe we were dealing with croup, too. The after hours doctor listened to her lungs and said it probably was croup based on what we told him. She also had really bad thrush, but we assumed it was from the strong antibiotic she had been on post pneumonia. The doctor sent us home with a prescription for oral steroids. Something in Lisa's gut didn't feel right about the steroids, and luckily we didn't give any to Emma (steroids raise blood sugars uncontrollably high and she was showing signs of acute diabetes melitis). By Sunday morning we started thinking the bug had passed through her because she had stopped throwing up and wasn't thrashing around anymore. And she was finally sleeping for the first time in 2 days, so we let her sleep. After about an hour, we checked on her and noticed that the thrush was excessively bad and it was everywhere. Lisa tried waking her up and as she got closer to her she thought she smelled apple juice ("weird" she thought). Emma would not wake up. Her eyes opened a little bit, just enough for us to see that they were rolled back in her head and she was not responsive at all. We knew this was something more serious and immediately headed for the emergency room. When we got there, triage (emergency room check-in) took one look at her and rushed us to the back. (Just a side note, any time medical staff seem rushed and they give you all their attention, that is usually not a good sign....) Doctors came in and ordered a bunch of tests and tried to start an IV. Emma's little body was so dehydrated, though, that her blood vessels had all but collapsed and were bone dry so they had a really hard time to get an IV line in. We started getting really upset at this point, because she seemed like she had plenty of wet diapers all weekend (we had been monitoring because of the vomiting), but now they were telling us that she was dehydrated. Lisa kept saying to them "none of this makes any sense!" By some miracle, a nurse that had come down from the pediatric floor (PEDS) was able to get an IV line started on Emma in her foot. Shortly after, the preliminary results from the blood tests came back and the doctor said she probably had diabetes. Everything started making more sense at that point after they explained diabetes a little bit, but Emma's condition was extremely critical. Her PH level was extremely off (very dangerous) and her BG (blood glucose or blood sugar) was so high they had to dilute it to run it through the machine again. Just a few minutes before they admitted her to the hospital, the doctor came in and said IT, "it's official, she's a diabetic." Her blood glucose came in at a whopping 1300, the average person is diagnosed with a blood glucose of 300-400. It was one of the highest they had ever seen at that hospital. Needless to say, she was very, very sick.

DKA

Emma was also diagnosed with diabetic ketoacidosis (a life-threatening complication in patients with untreated chronic high blood glucose). Basically, she was in a diabetic coma. She had high blood glucose, high levels of ketones, and acidosis (they said it was like she had acetone running through her veins, that explains the thrashing around....). The croupy breathing was explained to us as being Kussmaul breathing, a complication of severe acidosis. Emma was critical for several days before she started turning the corner. It was a huge miracle for us to watch her come back to life, AGAIN!!!

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