How incredibly dangerous the stomach flu can be with t1d.

I have sat and thought about this blog post over and over while writing it in my head without putting it into actual text many times. I don't want to come across as ungrateful for my knowledge of type 1 diabetes (aka t1d) or ungrateful that my child has a disease she can, God willing, live a long lifetime with.  I do, however, feel it is necessary to share just how dangerous a stomach/gastrointestinal virus can be with t1d.  

My little warrior had a crazy day, which I blogged about on April 8th.  Well unbeknownst to me she was coming down the the stomach virus/flu as we all tend to call it.  She woke up at 430am on Saturday, actually made it downstairs and puked.  Then puked a few more times.  Then her blood sugar started falling.  After lots of crying and begging her to eat some smarties, just like glucose tablets, she ate a few and her blood sugar came up a bit.  Incredibly scary moments.

That whole week was something like out of a nightmare.  I ended up creating a sick day profile on her insulin pump and it was actually off, she needed almost none or very little insulin for 6 days.  Her pediatric diabetic team and on call doctor gave us Zofran, thank God, because it stopped the puking and a lot of the nausea by Saturday.  I had to give my daughter an abdominal exam over the phone with the doctor and have her jump up and down to try to rule out appendicitis. I had no clue anyone in her class was sick with the stomach flu at this point in time.  I did later find out her best friend had in fact had the stomach flu.  

Then the ketones came because she was basically having starvation ketones, which people who eat a keto diet strive for because it means you are burning body fat.  That's great if you are trying to lose weight.  Not so much if you are a 5 year old small person with t1d and have zero weight to spare.  I got those flushed out with more water, some food and a teeny bit of insulin.  

Then the large ketones came, which teeters on the edge of diabetic keto acidosis.  Which is bad because you can slip into a coma, have brain swelling and die basically in a nut shell, it's a very dangerous condition.  So more fluids more food and a lot more insulin.  I got those flushed out in about 3 hours or it was out to Iowa City E.R. for her!  She ended up losing 2 pounds from being sick for a week and it wasn't water weight because I was pushing that hard. We have been working so hard to get weight on her since she had gone undiagnosed for an unknown time and was under weight. So I am hopeful she can put it back on easily.

Forcing a kid with the stomach flu to eat and to keep eating because her blood sugar kept going low was very stressful and very hard on this momma's heart. She cried a lot and was clearly very mad with me and even more mad she has this damned disease.  

If I didn't have the Iowa City Children's Hospital CDE Nurses to talk to and help me through all of this, we would have been admitted for the entire week.  I have no doubt about it. It was so very scary and so very stressful.  I can't thank her nurse, Sue, enough she has got to be an angel in disguise.

If she had needed an emergency shot of glucagon to bring her blood sugar up in an urgent sort of manner, it would not have worked.  Her glycogen stores in her liver were completely depleted.  I even tested this theory when she dropped to 60...and was not coming up.  So she drank some more juice, with sugar which is not our normal stock, and more smarties and she came up.  I even made her eat a spoonful of honey, which she hates. 

I can't thank my parents enough, because my Dad got juice, Zofran, saltines and ran it all out to our house.  We live out in the country.  My mom checked in all the time and came out to see her when she was feeling much better and had no more puking. She also brought us more pedialyte which ended up being desperately needed.  Her energy levels were scary low and the amount of sleeping she did was also very scary and totally uncharacteristic of a typical virus for her.  The pedialyte helped, though now she hates it and forcing her to take bites of food.

It was so very scary.  My brother told me he had also had a very scary experience with the stomach flu.  I had the stomach flu and so did my little warrior a few months before her diagnosis so I was shocked that we got it again so soon.  I also needed much less insulin and I don't think I needed any insulin for the tiny amount of food I was eating. It was definitely not a normal situation. It scares me to think how close she probably was to diabetic keto acidosis back then and I had no clue. 

So with all of that being said we were totally unprepared for her to catch this stomach flu with her being newly diagnosed with type 1 diabetes.  A parent must have on hand; regular juice, Zofran, pedialyte and saltines or some other bland food that doesn't cause stomach upset.  

She started feeling a lot better this past Friday, after we flushed the large level of ketones and on Saturday she felt a whole lot better and then today she was 100% back to herself.  I turned her pump back on and she is back to needing insulin for basal/background insulin and bolus/to cover food insulin. I am still hesitant to over do her insulin and send her low but I think tomorrow I can try harder to be less scared. 

I'm crossing my fingers that preschool goes ok tomorrow and there are no crazy stupid low blood sugars that they have to fight her over.  Also crossing my fingers I don't have an emotional break down over her going to school tomorrow. 

Thanks for reading and following along on this incredibly stressful journey and hopefully soon I can be less angry about her diagnosis. It's going to take some time.