Vomiting, Diarrhea, Ketones, and Other Bad Words.

This past September the flu hit our house.  The only one to not get hit by the flu apocalypse was Jilly.  Ryker got it first right before our trip to California and a little during and then after we got back Brady got it.  This wasn't just your typical run of the mill 24 hour puke bug.  It was full on puke once a day, no appetite, fever, body aches, week long bug.  It was awful and when these types of bugs hit Brady they really do a number on him.  Whenever he pukes our first worry is that he will develop ketones, which can quickly lead to diabetic ketoneacidosis.

Here is a quick explanation of ketones and ketoneacidosis:

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication in patients with diabetes mellitus. It happens predominantly in those with type 1 diabetes, but it can occur in those with type 2 diabetes under certain circumstances. DKA results from a shortage of insulin; in response the body switches to burning fatty acids and producing acidic ketone bodies that cause most of the symptoms and complications.  DKA may be the first symptom of previously undiagnosed diabetes, but it may also occur in people known to have diabetes as a result of a variety of causes, such as intercurrent illness or poor compliance with insulin therapy. Vomiting, dehydration, deep gasping breathing, confusion and occasionally coma are typical symptoms. DKA is diagnosed with blood and urine tests; it is distinguished from other, rarer forms of ketoacidosis by the presence of high blood sugar levels. Treatment involves intravenous fluids to correct dehydration, insulin to suppress the production of ketone bodies, treatment for any underlying causes such as infections, and close observation to prevent and identify complications.  DKA is a medical emergency, and without treatment it can lead to death. DKA was first described in 1886; until the introduction of insulin therapy in the 1920s it was almost universally fatal.[3] It now carries a mortality of less than 1% with adequate and timely treatment.

 Here is a picture of Brady on day 7 of the puke bug.  He had been in the hospital twice for iv fluids and when they weighed him then he weighed 50 pounds, down 2 from his normal weight.  I'm guessing by the time I took this picture he had lost a few more pounds than that. He looks like a little bobble head doll.  For a little more reference, the lower picture was taken in July.

 It's pretty easy to see how scary thin he got by looking at these pictures that are two months apart.  It seriously makes me sick to look at it.  Seeing him this thin keeps me awake at night and I'm a stressed out bitchy nightmare of a person to be around during this time.  I can't help it, I'm usually on he verge of a nervous breakdown. The bitch of diabetes and any puke bug is the fact that for Brady his blood sugar tends to run really low during these episodes of puking and diarrhea.  We usually treat low blood sugars with juice since it's such a concentrated form of sugar that will bring his blood sugar up the fastest.  But if he can't keep any liquids down then we can't treat with juice. Which means we can't feed him either or give him insulin since he is running low.  Liquids and insulin are the only two ways to get rid of ketones.   It;s like a really bad joke his body likes to play with us.  So we take him to the ER and he gets IV fluids which he hates because his veins always blow out when they try to insert the needle for the IV.  The poor kid had to endure 6 failed attempts of being poked before they finally go a good IV line in.  He did not handle it well and he was hysterically crying and yelling things like "this is the worst day ever!" and "Son of a biscuit!" all the while I'm trying not to punch the nurse in the throat.  It sucks that he has to go through shit like this, but he was pretty proud of himself afterwards and he made sure I posted on facebook how many times he had to get stuck with a needle.   Thankfully he is now eating great and I'm pretty sure he is almost back up to his normal weight.  But it's episodes like this that turn me into a crazy person and thankfully I have my Mom close by to come help with the day to day things with the other kids since I usually turn into a zombie from not sleeping for 7 days straight.  Thank goodness it's all behind us and I always learn a little something to help me get through the next time a little easier.