DKA (Project 365/2010)

I knew what it was this time, but it was even scarier to watch. I knew it could happen quickly (in as little as 4 hours), but I had no idea just how quick it was. Cameron got up this morning and looked terrible. In hindsight he was already in DKA, short for Diabetic Ketoacidosis. Hindsight is a pain, isn't it. His numbers were in the 400-500's. He was dropping ketones, but honestly, we thought it was because he hadn't taken his full dose of Lantus (slow-acting insulin) the night before he started insulin in his pump. We did the protocol, gave correction insulin doses, drank water, checked every hour, and by 11 am I knew he was going to the hospital. I called his endocrinologist, but our nurse wasn't there. The one on the phone was a terrible stand-in. She told me to take Cameron to the nearest hospital. I took him to St. Mary's, where the triage nurses got pissy at me about how I knew he was in DKA. They took his blood (467) and took us straight back...where we sat for 2 hours without seeing a soul. My son was in such pain, abdominal pain is a symptom of DKA. He was crying and NOTHING was being done. NO IV! Then. I. Heard. It. A nurse told another nurse, "It's not like we can do anything for a DKA kid anyway." WTH? Are you freaking kidding me? You can't? You can't put an IV in him and start flushing his system? You can't put him in an ambulance and send him down to Loma Linda where they CAN treat him? Ah, hell no. I told Cameron to get up and we walked out (15 minutes later a doctor from St. Mary's ER called my house to see where Cameron was).

I put Cameron in the car and we drove down the hill to Loma Linda. During our drive, another symptom of DKA reared it's ugly head, vomiting. I was ill prepared for this, and thus, my backseat floorboard caught it all (and in June heat it baked while we were in the hospital). We walked into the hospital and he went straight for the trash can. I asked the triage nurse if she had a bucket. I ran to Cameron, sat him down, bucket in hand and signed Cameron in. Within 5 minutes (NO EXAGGERATION) he was tagged and being wheeled back into the Peds ER. Within 15 minutes an IV was started, his blood was drawn, and they gave him something to stop the vomiting. About 45 minutes after that we got word he was in DKA. NO SHOCK THERE! We were told he was being admitted, and originally they thought he would go to the regular floor. The nurses hooked him up with a video game system, and a Star Wars game ... and all was right in Cameron's world.

When the second IV came into play, Cameron wasn't happy about it, but Mr. Independent took it like I knew he would. He was frustrated. Seriously, 10 years old and 2 hospitalizations in less than 2 years, I'd be frustrated too. Cheryl, our nurse, drew more blood, and took an arterial blood gas. These results proved his acid and bicarbonate levels were serious enough that they would need to send him to the PICU. Exactly where I didn't want him to go.

I left the room to make some phone calls after the second IV was in and when I returned Cameron said he saw one of the doctor's from diabetic camp. A little while later he came back in and I instantly recognized him. When he introduced himself, Vance, I told him I had a picture of him, but no name. Vance asked if Cameron was going to camp this year, and I told him we were still lacking funding. He is a SUPER great guy and continued to check on us until we were moved.

Wouldn't you know it, right before shift change Cameron was moved upstairs. He was in an ornery mood, when his blood sugar is elevated his mood swings are TERRIBLE. I had to keep telling him to be respectful, but it was clear my son was NOT HAPPY TO BE THERE! His nurse, who we saw for maybe 10 minutes, came in and got him all hooked up and did another blood sugar check on him, his number was going down. I knew I had to come home tonight (I'm still passing a kidney stone), but wanted to meet the night nurse and make sure Cameron was comfortable. Thank God I stayed. Our night nurse, Cherry, turned me into a person I did not recognize, as well as a Mama who scared her son (Mama Bear post).

After Cameron was MOVED from Cherry's care, I made sure he was okay with my leaving and promised to be back up first thing in the morning. He was tired, and seriously needed his rest anyway. I will call his nurse periodically in the middle of the night to check on him.

We don't know how long Cameron will be in the hospital. We don't know the status of his insulin pump (except that it's still attached and the alarm keeps sounding letting us know it's on suspend). Vance said they might restart it in the hospital to monitor it. Sounds like a plan to me.