Rough morning

So we were a little surprised when Emma woke up today in the high 300s. Especially since she was 50 at 2:30am and we have gotten her juice at night DOWN so that she ends up in the 100s - sometimes the high 100s but the 100s no less.

So, when I saw the 397 on the meter, I took it again to make sure. The second reading was 409. Within the margin of error.

When you have a pumper with an unexplained high, you check for ketones (which is usually a good sign of whether your pump site is actually working or not). A trace amount of ketones is a measurement of 0.2. The last time she had a bad site, she had ketones of 1.6. I kinda expected some ketones in that range and I was fully prepared to treat those.

I was not prepared to treat ketones of 4.4!! I can't find a smilie that demonstrates the shock at that number. I took it again in the event it was just off - it wasn't. So, we quickly gave Emma a correction dose of insulin at 150% of the calculated correction dose - because the only way to reduce ketones is with insulin. I then paged the nurse to see what else I should be doing. Emma felt hot so we took her temperature and it registered just over 100. So, a low grade fever which COULD have triggered that enormous spike in her ketones.

Celia's response was just to keep testing and slowly correcting, feeding the extra insulin that we needed for the ketones to prevent a low.

Within 1 hour, her ketones were down to 2.2 - a shocking figure if I didn't know they were going DOWN. Within 2 hours, her ketones were down to .3.


Within 3 hours and 15 minutes of her first dose, she was back in range for her blood glucose.

That was a pretty uncomfortable 3 hours - I was actually WILLING time to move faster so that I could see that she was adjusting. And I think I tested ketones about 3 more times throughout the day because she has continued to complain about her stomach hurting despite the fact she is in range and has no ketones.

She still has the low grade fever, so she is probably fighting something. That means another night of extra checking so we can stop this from happening again tonight.

Boy, its situations like this that I wish we had a Continuous Glucose Monitor. For all the challenges and struggles you hear about these new machines, there are definite benefits - such as getting an alarm when that type of high reading comes out of nowhere.