After an unexpected vomiting episode, my inability to keep juice in Q and keep her blood sugar up despite suspending her basal insulin, and the development of ketones, I rushed her across town to the emergency department at 1:30 in the morning. (Read The Flu (Part 1): On a Dime.)
The triage nurse asked what her blood sugar was as I checked it yet again. 92. She said, “You consider that low?” Why yes. Yes I do consider that low for my child in the middle of the night. I do consider that low for my child who is vomiting over and over. I do consider that low given that’s the highest I’ve been able to get her even suspending her insulin delivery.
Why are nurses so narrowly educated about diabetes? For the non-diabetic, 92 is a perfectly fine number. But this nurse almost didn’t seem to think that 92 was an “emergency” situation as I did because it seemed perfectly acceptable to her.
Trying to skip a few steps and speed things along, I told her that the doctor needed to call the endocrinologist that I had been consulting with that night. I asked if she could write down the number and name so that the doctor could call right away. “No, the doctors don’t do that.”
But I of course know that they will based on our previous experience. I know that they do this because there is not a doctor that will make decisions about diabetes care for children in our city. I know they will because the endo on call told me to have them do it. I know they will.
I said she needs to get on a glucose drip right away to bring her blood sugar up and she needs anti-nausea medication to stop the vomiting. She tells me the doctors will decide this.
I know this is what she needs. The endo on call told me this. I know this from our previous experience.
I was about to begin protesting but luckily we were moved to a room right away.
More vomiting and the doctor, examining it, said we were way beyond throwing up food, this was bile. That after the first time I shouldn’t have given her juice because she was just going to throw it up again. That I should have given sips of water. But I explained that I was trying to get some carbs in her at the time.
This time the IV went in with relative ease and few screams (but not totally without protest, nervousness, and a few screams). Dextrose drip in. Anti-nausea medicine given.
An aid saw me trying to get comfortable in a chair and found me a recliner.
We tried several times unsuccessfully to get Q to give a urine sample, but she was so dehydrated.
In the wee hours the doctor said that if he couldn’t find a pediatrician who would agree to oversee her that she would need to be transported to St. Louis. I pleaded that I really didn’t want to make that trip and asked him to try.
I felt at this point that it was under control. I just needed help when all I knew how to do was exhausted or not working. We just needed that IV and anti-nausea medication and monitoring. I knew she’d be better and released soon. A trip to St. Louis in the middle of the night would be a logistical nightmare. As it was, my husband was home with our sleeping three-year-old.
At maybe 4:00 am the on call pediatrician came to see us. I have a feeling she had to get out of bed to come in. She talked about her children at home. (Yes, I know that’s her job when on call to come in at all hours as needed.)
She said that she had reviewed the chart and talked with St. Louis and they would admit her here. We’d be moved to the pediatric ward soon and probably released that afternoon. She said I would be in charge of all of Q’s insulin needs. She said after all, I am “the expert.”
(To be continued…)
Read more about this experience with the stomach flu:
The Flu (Part 3): Pediatrics (coming soon)