This day in the life was a sick day that evolved into a weekend...
Thursday 3.33pm: The children have just arrived home from school. I encourage them to have a snack and complete their homework. Taylor sheepishly appears at my door and says "I'm HI". We investigate what's happening and find that she has had insulin all day properly. We give 4 units. 1 unit brings her down 6 points.
Thursday 5.38pm: Taylor's bolus has bought her down to a whopping 32.1. My stomach sinks through the floor as we give another 4 unit correction. Ketone test shows moderate ketones so Taylor is asked to drink plenty of fluids. My heart sinks through the floor. I have just had four days of a nasty virus going around the hospital. Nausea, tummy cramps, temperature, body aches, vertigo, headaches. I have tried to stay away from the kids, but with John working out of town, and only arriving home today there is only so much you can limit your contact as the sole parent.
Thursday 7.18pm Time for dinner, Taylors test is now 28.4. 'Oh God this isn't boding very well' Now she has 3 units for dinner and a 6 unit correction and we begin testing every half hour to be sure she doesn't crash.
Thursday 9.45pm I'm in bed, woken by John to say Taylor has vomited and test is still in the 20's. 23.6 to be exact. I drag myself out of bed and give another 5 unit bolus, encourage her to keep drinking. Tell John to give lots of insulin every 2 hours till she comes down, and I return to bed, as I have to work tomorrow.
Friday 3.00am After being woken every half hour over night with bsl updates and bolus questions I'm feeling pretty knackered right now. Taylor is still vomiting, so it's time to head to ED. Friday 6.00am Taylor has had bloods done and already been given a 1 litre bag of fluid. They've now started a 500ml bag with 20mmol/l Potassium as we've given her so much insulin. Then we'll chat with the Paeds doc to decide what to do.
Friday 10.30am Taylor is looking better. BSL's are still 18.8 but no vomiting for 5.5 hours so they decide she can go home and we'll just keep bolusing to knock it over. So home we go.
Friday 1.30pm Time for me to head for work. Taylor has slept a lot of the morning, bsl is now 15.5 and she has some nice colour in her cheeks. No vomiting since 5am so it's all looking good.
Friday 5.39pm Phone call at work to say Taylor has vomited again. BSL is HI so I speak to my boss and rush around trying to organise all of my patients so I can leave early.
Friday 8.24pm After lots of medication administration, documentation and tidying up I can finally leave work. I head home to pick Taylor up just to go straight back to the hospital and sit in a different department with her.
Friday 9.34pm I am extremely frustrated with the ^&&^%%*(()% intern who has absolutely no idea what he's doing. Taylor is the sickest I have ever seen her.. EVER EVER EVER! And this tosser has spent the best part of an hour 'trying' to get a cannula in. Well not really the best part of an hour, he spent the first 30 or so minutes bitching at me about taking Taylor home this morning.
"Do you think this was a wise decision, or a stupid decision?
I think it was a stupid decision. Yes?"
Considering the decision wasn't mine, but was made between the ED doctors, Paeds Doctors and the Diabetes Educatiors I'm close to telling him exactly what I think of him.
Taylor is visibly decompensating before our very eyes. She's now saying "I'm so tired mummy, I can't keep my eyes open. My arms and legs hurt so bad mummy." Right about now I want to do physical harm to this intern.
Another doctor walked into the cubicle, a doctor I knew, another intern who had recently had her psych rotation on my ward whom I'm knew very well. I vented to her about the incompetence of this other idiot. Apologised to her knowing that there is nothing she can do, as each case is allocated a doctor and god forbid anyone that interferes. I was wrong, there was something she could do. She saw the fear in my eyes, asked if I was scared and I explained why. She then spoke to the ED chief about my concerns. He came straight over, asked what was happening. While it was being explained to him he effortlessly slipped in a cannula and took bloods then ordered the fluids.
Friday 11.55pm Taylor is on her second bag of fluid, she is awake and feeling somewhat better. I have been up since 3am so it's decided John will stay with her tonight and I'll go home and grab some sleep. This feels weird as I've never left Taylor at the hospital before, or any of the kids, with anyone else, even John. I always stay with them.
Saturday 7.15am After text messages from and to John all night querying doses and asking advice I'm awake. Time to go to the hospital and see what's what. When I arrive an intern is there. She explains that the Consultant will be in between 8 and 9 and he'll see Taylor and a decision will be made. They've taken Taylor's pump off and connected her to an IV insulin infusion, along with several bags of fluid. I call the roster centre and arrange for family leave for this afternoon.
Saturday 10.25am The Consultant never arrived... can't believe I actually work in this hospital, it's really opened my eyes at the slackness of some people! John is going home now and I'm staying for the day. Taylor's BSL's were down to 9 early this morning but after breakfast went through the roof again, so she's not out of the woods yet. Ketones are massive.
Saturday 1.16pm After hourly testing and corrections Taylor's looking lots better, bsl is down to 10 again so the Consultant decrees by phone we can disconnect the IV infusion and reconnect her pump. He says "Mum is to run the pump just as she would at home. No one is to interfere unless the bsl's go over 20 and then she can be given a bolus of actrapid"
Saturday 5.39pm Amazingly Mum has NOT been allowed to run the pump as she would at home. We had a nurse most of the afternoon who wanted to query and debate my every move. The same nurse the day before that wouldn't work with that pump thing because she didn't know how to work it or really what it did. I was very close to blowing my stack again when changeover happened.
THANK GOD! We got a male nurse from the UK who had mountains of experience with type 1 kids on sick days and he was great. I did whatever I wanted. We set a 50% temp basal increase and bolused every two hours. Taylor was doing beautifully. Even stayed at good numbers after dinner, so well on the way to recovery now.
Sunday 6.48am Taylor has been sitting between 6.0 and 10.0 all night. We just have to get through breakfast and if all is going well we get to go home again. I am past being knackered, past being exhausted. I feel like I'm barely functioning.
Sunday 10.21 Time to go home. Home to bed so I can sleep and then go to work at 1.30 again.
Sunday 11.27pm Home from work, Taylor is doing great. BSL's are much better and she's sleeping soundly. Now I just have to force myself to get up again at 2am to test her, boy it's been a long looong loooong time since we've had to do that! But I'm confident now that the crisis is over.
