Diabetic ketoacidosis (DKA)

I guess it had to happen eventually? After five years, 10 months and two weeks of living with type I diabetes, Arden experienced diabetic ketoacidosis for the first time. The day after we lost most of Arden's diabetes related technology to a gust of wind and a swimming pool we woke up to a new and much more frightening problem.

Turns out that the OmniPod that we switched to after the pool accident (see the link above) experienced a bent canual at some point in the evening after the July 4th picnic, we didn't know because Arden's BGs where good and we put her to bed.

I'd like to be able to tell you that I hear Arden's DexCom every time it beeps but that wouldn't be the truth. Sometimes I sleep right through it. Her BG began to rise around 3 am and I was unaware. When I woke up in the morning I checked on Arden as I always do, I was surprised at her elevated BG but let's face it... it's not the first time I've seen a 300 number so I didn't over react. I tested her as she slept, bolused and went to the first floor to take a phone meeting that I had scheduled for Arden's Day Gives. About an hour later Kelly (who was home from work for the holiday) screamed that Arden was vomiting. We knew in an instant that this was type I related because no matter how sick they may get, our kids never vomit.

As I cleaned up the floor Arden sarcastically said, "I'm glad we have hard wood floors", great sense of humor on that kid...

We calmly but quickly flew into action. Ketone meter, insulin vial, syringes, new pod and a bottles of water. Her BG was very high but not at the point where I thought we needed the hospital. Then I checked her ketones and almost threw up myself... 3.8. I didn't think I'd ever see a ketone number over 1, this frightened Kelly and I both. I injected for the high BG and the ketones and told Kelly that I'd like to wait about 90 minutes before we made a decision about the hospital. Arden, feeling awful looked at me and said, "hospital?". We explained that she may need IV fluids if her ketones didn't come down soon and with that she drank two bottles of water over the next half hour. As sick to her stomach as she felt, Arden pushed that water down to avoid having to go to the hospital. She's one tough little girl! Ninety minutes later her ketones were 2.8 which felt like progress. 

Arden showed her toughness again about two hours after the insulin injection when her BG began to fall quickly. I couldn't believe I was asking her to eat when she felt so sick to her stomach but there I was and I was asking. I promised her that she was going to feel better soon (ketones now 2.1) but that she needed to eat to keep her from experiencing a hypo. This moment called on my bravery. I had to bring myself to bolus for the food Arden was eating, I so did not want to give her too much insulin and cause her to have to eat again but there was no way that I was getting on the diabetes roller coaster after the morning we were having, ketoacidosis was about all I could handle for the day.

Arden was fine about four hours after she vomited and for the remainder of the day and far into the evening she worked the word "vomit" into every sentence that she could. 

Please don't take this story as medical advice. You should immediately follow your Endo's ketone protocols when you or your child shows any of these signs.