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Sorry to hear about your daughter, but have to say that the pump doesnt
necessarily mean no severe hypos or fits.  My son Anthony has had two fits
whilst on the pump, one in which we found him in his bedroom after he had
fitted and the room was splattered with blood, he had two black swollen eyes
and nasty gash between his eyes and chunks out of his tongue and cheeks.  We
found him face down on the wooden floor in a pool of blood.  He has also
broken his retainers on his teeth whilst having a hypoglycaemic fit.

It may well be the extremely hot humid weather that caused Sasha to have
such a bad episode this time.  I know from Antz that I have to reduce his
insulin dramatically when the weather is hot.

He has just come back from a local support group weekend where I reduced his
insulin even more than usual, but the nurse said he still had a few bad
hypos.   There is no rhyme nor reason to why these things happen with our
diabetic children, its not even a case of trial and error will sort it out.
We just plod along.  But he wouldnt be without his pump and the fact that he
is no longer tied to the clock and having to eat copious amounts every 1 1/2
to 2 hours.
-----Original Message-----
From: ip-uk-digest <email @ redacted>
To: email @ redacted <email @ redacted>
Date: 29 June 2003 17:35
Subject: ip-uk-digest V2 #437

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>ip-uk-digest           Sunday, June 29 2003           Volume 02 : Number
>PLEASE edit the subject line of your reply messages.
>This issue of the digest contains:
>[IPk] nice opinion piece in BMJ about why doctors should volunteer to work
at children's diabetes camps
>[IPk] Justification for pump?
>[IPk] justification for pump
>[IPk] Bad Hypo 999
>Date: Thu, 26 Jun 2003 21:18:07 +0100
>From: "Elizabeth OShea" <email @ redacted>
>Subject: [IPk] nice opinion piece in BMJ about why doctors should volunteer
to work at children's diabetes camps
>The subject line says it all. You may be able to get to it via this link:
>You have to register for BMJ, but it's free.
>If you can't get to the article via the link above, search BMJ.com for an
>article entitled 'Children's diabetic camps: doctors can gain too'
>- ----------------------------------------------------------
>for HELP or to subscribe/unsubscribe, contact:
>Date: Fri, 27 Jun 2003 11:48:51 +0100
>From: "J" <email @ redacted>
>Subject: [IPk] Justification for pump?
>Our consultant has suggested that I email him with a
>request for a pump for our daughter, Emily (11), giving our
>reasons. He seems very pro-pump; he gave a talk on pumps to
>patients a few days ago and I believe the clinic is taking
>part in a trial for very young (3 and below) children using
>pumps soon.
>The problem is, Emily does not fit the NICE criteria. I'm
>hoping for advice on how to approach this and would
>particularly like to hear about any research into the
>negative effects of high and low BG's combining to produce
>an OK HbA1c.
>I am also concerned about the moral side of applying for
>NHS funding. Should we even be thinking of applying for
>funding in our situation or should we leave the money for
>those with worse control? It's difficult for me to judge
>because I don't really know how Emily's control compares to
>Emily is currently having 1 Glargine and 4 Novorapid
>injections per day. I carb count and adjust the dose
>according to Emily's BG and activity level. We take around
>8 blood tests per day, around half of these are taken
>during the night and early morning while Em is asleep. We
>have been having problems with variable BG's at night
>though the last few days had been more stable (touch
>wood!). Before this, Emily's BG was starting at around 7-8
>at bedtime and either dropping to hypo levels a few hours
>later or rising to the high teens before breakfast despite
>increasing the Glargine dose from 9 to 13. On the occasions
>when we discovered hypo's we have corrected with around 12g
>carbs which would normally raise Em's BG by around 4mmol,
>but again her BG have been in the high teens before
>breakfast. We have been quite successful at bringing her BG
>down by lunchtime recently by increasing her dose by up to
>30% to counteract insulin resistance if her BG has been
>high for a while.
>Emily's last HbA1c was 7.3; previous HbA1cs have been below
>7. The latest one was higher because we have been running
>Em's BG's higher over night in an attempt to reduce night
>time hypos after a really bad one with convulsions and 3
>hours of vomiting. We have managed to reduce the number of
>night time hypos but still get the odd one and feel unable
>to stop testing at night just in case. Over the last 30
>days there have been 2 readings below 3.3 but there have
>also been 8 other readings between 3.3 and 5 which I have
>also treated.
>I feel we were lucky last time Emily had her bad hypo
>because I was up late working. If it ever happens when we
>are all asleep we may well not realise as Emily didn't make
>much noise or wake up enough to get help even while
>vomiting. Very scary thought. It's so annoying really, if
>we didn't bother doing BG's over night, Em would probably
>have had several more bad hypos and we would qualify for a
>pump according to NICE. But because we tire ourselves out
>taking blood tests every night we don't qualify! (not that
>I begrudge the night waking but I'm not at my best during
>the day because of the lack of sleep and the whole family
>suffers as a result :-( ).
>Anyway, enough waffle, here are some statistics, taken from
>our meter software, all covering the last 30 days:
>Highest reading - 26.1mmol
>Lowest reading  - 1.7mmol
>Average - 9.5mmol
>Hypos (=< 3.3mmol) - 15
>Using targets of 4mmol - 8mmol:
>31% of readings in range
>56% above
>13% below
>Using targets of 4mmol - 10mmol:
>49% of readings in range
>38% above
>13% below
>A graph showing all BG's indicate peaks around 4-7, 9-11
>and 15-18mmol.
>Well, thanks to anyone that's managed to plough down this
>far <g>. I would
>really appreciate any advice on either the practical or
>moral aspects of applying for NHS funding for a pump for Em
>and on the best 'angles' to use if we do.
>- --
>Mum to Emily aged 11, dx Oct '99
>Novorapid x 4, Glargine x 1,
>Robert aged 12 dx Mar '03
>Novomix 30 x 2 (+ Novorapid when hungry!),
>and Matthew aged 7.
>- ----------------------------------------------------------
>for HELP or to subscribe/unsubscribe, contact:
>Date: Fri, 27 Jun 2003 13:01:48 +0100
>From: "Abigail King" <email @ redacted>
>Subject: [IPk] justification for pump
>If Emily is having hypoglycaemic convulsions then isn't this one of the
>criteria? ( hypo needing assistance)
>Even if it can be prevented by getting up to test, you could argue that any
>hypo could be prevented if you tested oftn enough!
>The HbA1c is really a mixed blessing isn;t it?
>One of theGP mags recently had a discussion on the vveaknesses of this
test. I
>though there vvas going to be a long explanation of hovv unvvell one can
>even ith a good A1c, that it only reflects averae bg and that person could
>having severe hypos affecting  their ability to hold  a job, drive etc, in
>pursuit of a good A1c
>the argument  vvas purely that A1c can be elevated even vvith a very recent
>improvement in control. VVell if they encouraged home testing more rather
>the cheaper A1c..
>Admittedly this argument is mainly aimed at patients treated in general
>practice: for the most part diet or oral hypoglycaemic controlled
>- ----------------------------------------------------------
>for HELP or to subscribe/unsubscribe, contact:
>Date: Sun, 29 Jun 2003 16:04:06 +0100
>From: "Jackie Jacombs" <email @ redacted>
>Subject: [IPk] Bad Hypo 999
> Sasha had a major hypo and seizure this afternoon and I had to call the
999. We
>had just come back from
> Gym, she is in a special training class now and the class lasts two and a
>hours. She has been going
> to this training class for three weeks. The other weeks we have stayed
with her
>to see how things went.
> The first week we dropped the insulin dose and she ended up at 18 mmols
>next week we still gave a
> reduced dose and she was a bit low. This week I dropped the dose again and
>her more to eat. She
> was OK when she got home and her BG was 4.3 mmol, I didn't give her any
>insulin with lunch and the
> twins had a portion of chips to eat. I was busy preparing veg for tonight
>when she came and stood
> next to me without speaking. I wondered what she wanted, but I was very
>because Terry is away this
> weekend cycling. Then she just started screaming and screaming it was
>scary. Beckie was
> terrified because Sashay was hallucinating and it was as if she could she
>something really horrible. I
> got Sashay to drink Lemonade but she still carried on being distressed and
>violently jerking. She was
> saying "Oh my god Oh my god help me" over and over. Making this terrifying
>screaming and wailing noise.
> I then got out the glucagons and injected half the amount. It's so
difficult to
>mix and draw up when
> your panicking. I usually try and use a small disposable syringe to inject
>with, instead of the huge
> needle it comes with. It's very hard to inject when someone is thrashing
>around. The big needle is very
> hard to push in. She still didn't stop fitting and screaming and Becky was
>crying and panicking too.
> I injected the rest but still she wasn't coming out of it. I had to call
>ambulance because although
> we live near the hospital I didn't think that I could actually drive with
>fitting in the car. Of
> course by the time the paramedic came she was coming out of it. She has
>had a couple of major hypos
> in the day before. Most serious ones have been when she is asleep before.
>must have been too low
> this morning to notice that she was going lower still. I am now wondering
>whether she will still be
> able to actually carry on going to gym as I am certain that Dave, the gym
>couldn't cope with this
> mornings do! he certainly wouldn't be able to give the glucagon . It was
>after she had
>actually eaten too so I was surprised that this happen.
> The ambulance man was really nice and made a fuss of the twins. We didn't
>to go to hospital as by
>this time her BG had come up to 6  mmols
> This sort of situation is where if we had an insulin pump things could
>been much better. I really
>don't know what to do about gym now.
>Jackie Jacombs
>email @ redacted
>- ----------------------------------------------------------
>for HELP or to subscribe/unsubscribe, contact:
>End of ip-uk-digest V2 #437
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