Wednesday, August 23, 2017

The Day Our Whole World Changed

We've been having a lot of difficulty with Dovid over the last few months, and after blaming so many things for his issues, we've finally figured out what was really going on...

Since about June, Dovid has been drinking as though he could never get enough water. He would sneak down in the middle of the night, parched, and get himself water, even though we told him a thousand times not to. He would also sneak down for snacks. Then the pee accidents started. During the day, over night, you could never trust him not to pee. He was soaking everything, too - his bed, the couch... We blamed his medication, we blamed him just being lazy, we blamed the water before bed causing accidents (technically true, but there's more to it than just that). He also fell off the growth chart. Not that he's ever really been on it, but his plateaued, and his pediatrician was worried enough that she was going to send us to see a gastrointestinal doctor. In the meanwhile, I was going to take him to the child development clinic to see someone about his pee accidents.

Fast forward to last Sunday evening. We had a delightful party of sorts at our next door neighbor's house as a birthday celebration for our friend, Ron, whose birthday is this week. Dovid went to the bathroom (after having no less than 4 glasses of water) and stepped on their bathroom scale. He came out and proudly announced he weighed 39 lbs. *record screech* 39 lbs...he had been over 40 lbs at some point. He was not only not gaining weight, but now losing? And I know he's eating. As I said, he was sneaking snacks even! And he'd eat plenty at dinner. There was no excuse for him losing weight.

When I got home and sat down at my computer and really started thinking about it, my nursing brain kicked in. What else could make a kid drink, pee, eat, and lose weight? I got on Facebook and asked around for a glucose meter, and luckily a friend of mine down the street had a spare. I immediately went to get it, hoping I was being a hypochondriac nurse mother. She tested it in front of me, so I knew how to work it and that it actually worked properly. I took it home and tested Dovid while he was still asleep. The screen said "high glucose > 600". My hands shook. My heart sank. I ran down the stairs, screaming for Shmuel. I showed him the meter, because I couldn't actually say it out loud. He suggested I retest, even though I knew in my heart it would show no different. I went back up and used a different finger...same result. Crap. I asked my friend if she ever got a result that high. The answer was no. Double crap. We called the pediatrician, though I knew this was an automatic straight to the ER glucose result. Shmuel carried Dovid down to the car, and I took him to a local hospital (Newton-Wellesley).


At the ER, of course Dovid feels totally fine, just thirsty as all heck and asking every living being if he could have a glass of ice water. Don't let looks fool you, of course. They tested his glucose again...same result as at home. Well done, mom. They sent his sample to the lab to get an actual value...851. Triple crap. Luckily, somehow Dovid with all of his energy and water drinking managed to keep himself out of DKA (diabetic ketoacidosis) for months with high sugars. He still had high ketones, but his blood pH was decent - just obviously compensated. After a bag of fluids and, yes, a nice glass of ice water, they gave him insulin and we were transferred via ambulance to Children's Hospital.



 One last note about Newton-Wellesley is that they have child life specialists for pediatric patients who help when any procedures are done and give them activities to do (coloring, iPad, etc). She helped to educate him and calm him, and Dovid is a kid who HATED needles. He caused a major scene at CVS getting his flu shot last year. She also gave him a REALLY nice Lego set (for keeps). They really know how to treat children there, and I was very impressed with the way they handled everything.


These two pictures above are of Dovid in the ambulance. He was entirely enthralled, as this was his first time in one. Hopefully he will never need to see the inside of one strapped to a stretcher again.


At Children's, they repeated Dovid's blood sugar and labs, and of course it was all still high. Then he was admitted, but unfortunately they didn't have any "legit" rooms, so we got put into a treatment room. :( By this time I was so exhausted I was almost not coherent. Once we were settled, Dovid, who had at least gotten a few hours sleep, enjoyed time on the iPad while I was passed out in the bed. Once the day started in earnest, all manner of doctors, nurses, educators, and dietitians came to talk to us about diabetes care and treatment. We were lucky enough to be offered a chance to participate in their day program, so we could be discharged that night (Monday) and come back the next day (Tuesday) for education for the latter part of the day.

So far we are all hanging in. Dovid is a real trooper and has given us no problems with the finger sticks and insulin shots. I am incredibly proud of him and his maturity with all of this. He doesn't really seem perturbed, even when I have to keep him from eating long enough to count his carbs and give insulin. And he doesn't mind needles now...at least not the teeny insulin ones. I also felt so loved at the outpouring of support from everyone on Facebook and especially those (like Ron, our nanny (Melissa), my amazing neighbors, and the mom of one of Dovid's friends) who visited in person, brought me food, helped with the kids, and drove us home.

I never thought I would ever need to know about diabetes at all (aside from obvious nursing/midwifery related things), let alone get a crash course in type 1. Life is going to be a whole lot different, but we'll get through as we usually do. Now we just have to get Dovid onto a regimen where his sugars are controlled and hopefully get him a continuous glucose monitor and insulin pump. That at least will take some of the weight off. Until then, I better get to sleep. 2am is finger stick time.
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