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[IPp] Mary's visit to the ER, DK and DKA

Glad to hear that Mary is okay, but it still is an exhausting eperience.
Question for everyone:  is there any way we can know for sure that its not 
DKA and only DK while at home?  Probably not, as I don't think even the 
doctors know until they see the results of the blood work.  

If it is "only" mild DKA, can we successfully and safely treat at home with 
hydration and insulin?

I don't want to repeat this story too often, but I have honest questions.  
Claire woke up one morning in August, happy and playful, seemingly well.  
When we checked bgs, meter said HI.  I immediately checked blood ketones on 
the Xtra and they were at a high level as well.  Did a large bolus (I know, 
should have done by injection) and started getting her to drink water.  Less 
than one hour later, when I was about to check if bgs were coming down, she 
threw up the water.  So I knew it was now DKA (mother's instincts??).  Called 
doctor and re-called again 15 minutes later when doctor hadn't returned our 
call.  Ten minutes later I phoned the hospital back to say cancel the call we 
are heading to the ER (doctor was at hospital).  By that time Claire was 
passing out, or falling asleep--take your pick.  
     I don't think the doctor thought it was DKA.  It took about 4 hours to 
get an IV line in, meanwhile I was still trying to get her to drink, which 
got thrown up all over the hospital bed and I gave her an injection of 
insulin myself.    
     But the results of the blood work did show that the blood pH was too low 
and thus Claire would be admitted.  A couple of hours later the IV that took 
hours to get put in, failed.  So the doctor said that if she could drink xxx 
amount per hour (can't remember exactly how much) she could go without the 
IV.  Well she kept throwing up, so another IV was started at 11 pm. 
     Okay, so does that mean that if you can get your child to drink enough 
water, you don't have to go to the hospital for DKA? 
     Kerri has written that her daughter has had DK a couple of times and she 
has treated it at home herself.  But how do you know it was only DK?  Doctor 
told me that the pH level only has to move down a tiny amount to be a lot 
sicker.  So past experience with DKA might not be indicative, because perhaps 
that time the pH was a few tenths of a point lower.  
     I don't ever want to have to take Claire to the hospital again, so wish 
I had all the answers!
     I want to mention that I suspect Claire's problems this summer might 
have been due to a bad box of Quick-sets.  Had problems for one month with 
erratic high bgs out of the blue.  Since starting a new box when she was 
hospital she has had great bgs.  Do you think the company would even admit 
this as a possibility???  Her HA1c has gone up to 8.6 in September, from a 
lovely 7.1 in May, due to the summer stuff.  

Barbara, Mum of Claire 8

> We thought it was DKA but it was DK.....got her hydrated and left as the ER 
> doc knew NOTHING and wanted to know nothing....didn't trust her pump, 
> thought 
> her basals covered carbs, and wanted to give her a boatload of Regular 
> after 
> he way overtreated the low HE caused by refusing her any carbs when she was 
> headed down......AND...AND,,,, in front of Mary told me that it could have 
> been fatal (three times) and that her Mom caused 
> it.....grrrrrrrrr.....great 
> nurse though!
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