Monday, October 4, 2010

Something Interesting I Wanted To Share!

This morning I decided to call Children's Hospital of Pittsburgh and talk with the nurses on call about finding an alternative location for Lenny's pump sites. After explaining to her that his butt is forming hard spots from using his butt all the time for site changes, and his blood sugars are running high because of it, as well as the incident that happened last night (which I will go into in a few minutes), she suggested I try the back of his arms. I also asked her about this cream that so many other mommies with diabetic kids have told me about that numbs the area.

She told me the name of a couple different creams on the market... but then, she told me about these wipes that also help with pain relief. They are called ReliOn Alcohol Swabs with Pain Relief.

She says its not supposed to be a strong feeling of numbness like some of the creams out there, but, unlike the creams, there is no 30-45 minute waiting period for it to work. You wipe the area, the alcohol in them disinfects it, wait till its try, the benzocaine numbs the area a little, then proceed with putting the site on.

She suggested trying that first, at least until it is time for his next appointment at the end of the month. So, we shall buy some and try it out. Hopefully this helps and will not freak him out so much the next time I try to put the site in a different area other than his butt.

As for the events of last night. When we came home, the kids played and ran around the house till bedtime, with the exception of eating bedtime snack. At bedtime snack his blood sugar was 67. Gave him ONE glucose tab, and his nightly ritual bedtime snack.... yogurt. After he ate and was dosed, the kids went back to running around the house like a mad man. I actually expected him to be on the low side for the midnight check. Midnight rolled around, his blood sugar was 315 at the first check. That didn't seem right, so I rechecked.... 323. Checked ketones, no ketones. Gave a correction and waited.

At 3am I rechecked him, figuring he'd come down. 404 at 3am. Checked ketones with the Precision Xtra Blood Ketone meter. It read 1.3 which means moderate ketones... almost large though. I figured since he had a drink of water before bed and still hadn't peed the bed, I would wake him up to go pee, to help prevent him peeing the bed. While we were at it, I checked urine ketones. They read between small and moderate. Hm, what a predicament! Which reading do you go with? I decided to go with what the Precision Xtra meter said, since blood readings are more accurate than urine. I gave him 0.5 units more than the meter recommended for the high, to cover the ketones, and administered it via syringe. Decided to do a site change at that point also (yep, site change at 3am, sigh).

After removing the old site, what do I see? A bad kink. In the photo above, you will see something hazy looking inside the red circle (sorry, did the best I could to get a good shot of it lol). For those of you who are not familiar with diabetes and pumps, or those of you who may be familiar with diabetes, but not yet on a pump, that little hazy looking thing in the red circle is the cannula. The cannula is the part of the site that remains under the skin. The way it works is when you tell the pump to inject X amount of insulin into the person, the insulin you request runs down a tube/line, into the cannula. From the cannula, it is then sent into the persons body. Sometimes the cannula can get kinked. Kinks are caused by various reasons. This particular kink tonight was due to the location of where the site was, was getting a hard spot. If you notice in the photo, the cannula is almost flat. This prevented him from getting the much needed insulin he needed, for several hours. In turn, it caused his blood sugars to rise after bedtime snack to 323, and because it still wasn't correct by 3am, caused his blood sugars to continue to climb despite the correction, and in turn, develop ketones.

I hope all of that makes a little sense. If you have any questions, please don't hesitate to leave a comment and ask!

After doing a correction at 3am via syringe, and doing a site change, by breakfast this morning, he crashed... hard. His blood sugar before breakfast was 51 at 7:15am. Gave him 2 glucose tabs (because I don't usually like to give him the full 4 before a meal or snack because normally when I do, he has a bad rebound high), rechecked him 20 minutes later. He only came up to 58, so, I gave him 4 oz milk and rechecked another 20 minutes later. He came up to 177 then, so I let him eat breakfast. I called him off school today because I didn't feel comfortable putting him on the school bus with an initial blood sugar of 51. I was afraid of him crashing on the school bus. I know he has an aid that gets on the bus, follows him around school, and rides the bus home with him, but, I figure it is better safe than sorry.

Now it is almost snack time. I will blog later on about how the rest of his day goes.

No comments: