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Annoyed

Discussion in 'Type 1 Diabetes' started by Adrian1981, Apr 25, 2014.

  1. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    sorry i failed to answer a few of the questions asked previously..


    The pain was in the very centre at the top of my abdomen and didn’t spread anywhere else.

    I haven’t recently lost wait and not considered Crohns and noticed no difference in any bowel activity or eating habits.


    Prior to being admitted the first time my blood sugars were on a bit of a roller coaster that week but on the day of the admission my sugar levels were 6.1, 9.6, 9.2 and 10.3. Arrival at hospital my bm was 12.5 and keytones was over the recommended level of 1.5.


    On the second admission my bm was 9.0 and 0.2 of keytones.


    on the first admission in a&e my gasping for air and stomach pains were treated with anti sickness injection and a shot of insulin.

    on the second admission i was given morphine to treat the gasping for air and stomach pains.


    I understand that they were correct to treat me for early signs of DKA on the first admission but im unsure if a shot of insulin followed by fasting and no insulin was the correct treatment plan.


    I cannot get my head around the cause for the pain the second time. I had been sent home with the all clear less than 36hr before and at the time of admission as mentoned by bm was 9.0 and keytones 0.2.


    Im not 100% clued up on DKA but how long does it last and is it resolved once the keytones have disappeared from the urine and that the bm levels are good?

    Were they right to discharge me the first time based on just the two factors in the sentence above?


    another though is that the first time i was sent to the medical ward and the second to the surgical ward. if they thought it was dka/diabetes the second time i doubt i would have been sent to the surgical ward.



    Sorry for all the questions and troublesome case.

    thanks for all the comments.
    Adrian
     
  2. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    Sorry i failed to mention. i already have ceoliac disease since 2005.

    Regards
    Adrian
     
  3. Spiker

    Spiker Type 1 · Well-Known Member

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    I am shocked that they discontinued all insulin while (apparently) treating you for DKA. That sounds totally wrong. Is it possible they gave you a very large injection of insulin at the outset? Maybe a long acting insulin?

    On readmission was that a 0.2 urine ketone or blood ketone? They can be several hours out of sync and it is the blood ketone level that causes the illness, the urine ketone level is just a symptom.

    It's possible that a second bout of DKA could have been caused by them withdrawing all insulin during the first bout, in particular by the delayed effects of them stopping your Lantus.

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  4. Spiker

    Spiker Type 1 · Well-Known Member

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    Not really. Normal BG and nil blood ketones are good signs but that just removes the causative factors, it doesn't mean that the resulting derangement of your blood chemistry has normalised yet. That can take additional time. Though it should just normalise with rest and fluids and correct electrolytes. Really they should check your blood chemistry for diagnosis and check again before discharge. But I suppose it's understandable at an A&E for them to clear the bed once your BG and blood ketones are normal.

    I'm thinking that the reason for the relapse was them denying you short and long term insulin during the first admission.
     
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  5. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    Arh ok thanks Spike.

    They did give check my full blood count in both occasions (bloods taken to the labs) before being discharge and sorry for confusion but a&e was my starting point for both admissions but was transferred to a ward both times afterwards, first time to medical assessment unit and the second time to a surgical assessment unit.


    I’m home at last so will just knuckle down and get back on top of my BMs.



    Adrian
     
  6. paul-1976

    paul-1976 Type 2 · Well-Known Member

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    Good luck Adrian and hope everything works out alright.:)

    Best wishes

    Paul
     
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  7. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    I spoke too soon.

    Having eaten my dinner 2 1/2 hours ago my stomach is starting to hurt and lots of burping going on.

    I have a high pain threshold and have only had two days off work in the whole of my working life ( apart from the 4 days with this issue) of 14 years.
    I had 100% attendance for the whole of my secondary school duration but this last week has been the worst I have ever felt.

    I'm going to ride it out and stay home and just hope that it doesn't affect my breathing. I feel even more annoyed that I have been in hospital twice this week for these stomach pains and sent home both times with no fault found.

    :(
    Adrian.
     
  8. jack412

    jack412 Type 2 · Expert

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    as soon as symptoms appear, I'd get back to hospital and this time I wouldn't leave till they find out what's wrong
     
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  9. robert72

    robert72 Type 1 · Well-Known Member

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    What did you eat?
    How are your numbers?
     
  10. donnellysdogs

    donnellysdogs Type 1 · Master

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    Are you sure the pains not from under eating?

    Have you tried say eating small snack size meals every few hours?


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  11. Spiker

    Spiker Type 1 · Well-Known Member

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    Adrian I think something serious is going on there and it's not DKA. Maybe DKA was a side effect (eg due to infection). I agree with Jack, get yourself seen ASAP.

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  12. donnellysdogs

    donnellysdogs Type 1 · Master

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    I think that as a minimum you should see GP on Monday. Or go to a different A&E.....

    I know I have had chronic pain in my stomach but this was due to blocked up bowel and then bald looseness andbeing afraid to eat... This on top of the drugs I had been given caused me absolute chronic pain inmy stomach. I had 111 calls, paramedic and out of hours GP.... Not taken in, but encouraged to eat something regularly... Complan and soup initially.
    Medics were right.

    I think tho that this is unidentified problems at moment and seriously would go to GP on Monday or a different A&E if this continues.. ( do not say you been to a different A&E with same prob)


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  13. mooshk

    mooshk Type 1 · Well-Known Member

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    I really really think it's gastroparesis. Especially as the pain is central-lower and after you eat. I had all of this and lost 2 stone in 3 weeks with it. I really think if you're able to, get the test. Hope you're ok today :)
     
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  14. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    I'm down at the hospital now waiting to be seen, typical the pain eases when I arrive.

    My dinner time BM was 4.1 and I ate two slices of gluten free bread and boiled eggs.

    My post dinner +2 hr bm was 5.2.

    The timings are the same as before. Pain increases in the evening of the day after discharge and a few hours after my evening meal.
    Strange though as I ate dinner last night when I got home from hospital and breakfast and lunch today ok without issues.

    Adrian
     
  15. Adrian1981

    Adrian1981 Type 1 · Well-Known Member

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    Hi all,

    I am back home having been given some anti acid tablets for my stomach. Not what I was hoping for and I'm not convinced that it's the right thing either but they know best.

    Mooshk, sorry to hear you had gastroenteritis for so long. What clears it in the end and did the cramps and nausea last for the whole few weeks. That must be awful, I'm fed up after just a few days.


    Adrian
     
  16. C burns

    C burns · Well-Known Member

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    I had similar symptoms last year and I got sent for gastric emptying study to test for gadtroparesis


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  17. Indy51

    Indy51 Type 2 · Expert

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    I can't help but suspect that maybe the gluten free bread you ate possibly had some other ingredient that doesn't agree with you. A lot of really overly processed foods are used to make that gluten free "junk" food. But it does sound a lot like gastroparesis as well. Maybe start keeping a food diary and noting the ingredients of the food you eat? Maybe keeping the food as unprocessed as possible may help. Sounds like something may be stopping the sphincter between your stomach and small intestine from opening. I remember something similar happening to me after an inadvertent gluten exposure and I ended up throwing up because the food just couldn't clear from the stomach.
     
  18. Alanp35

    Alanp35 Type 1 · Well-Known Member

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    Adrian,
    I had dreadful belly pains earlier this year and even went for an ultrasound. Everything was fine, except that I wasn't. I have now taken to having a bowl of stewed rhubarb after my evening meal, could have it after lunch I suppose. Matters have much improved with no adverse "rhubarb" effects. I prefer using natural fixes if possible. We all have too many, much needed, man-made chemicals in our bodies.



    Late onset T1, several auto immune issues.
    Humalogmix25 twice a day, Methotrexate 25mg once per week, FolicAcid 5mg once per week, prednisolone 5mg daily, Allopurinol 300mg, Calcichew-D3 800iu, Levothyroxine 50mcg, Atenolol 50mg, Losarten 100mg, Aspirin 75mg, Nicorandil 20mg, Nitrolingual GTN spray, Metformin 2000mg, Allimemazine 10mg, Lanzoprazole 30mg, Atorvastatin 20mg, Co Codamol 8/500mg, Depo Medrone (Methylprednisolone) or double Prednisolone for 7 days in case of RA flare.
     
  19. mooshk

    mooshk Type 1 · Well-Known Member

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    How are you feeling now, any better? Yeh i ended up fasting for 10 days in hospital as I couldn't keep any food down without throwing up and having the gastroparesis pain. I think that and the morphine drip managed to calm me down but I still had another few a&e visits. I've always had ok blood sugar control but after the gastroparesis I've tried a lot harder. Here's some information on gastroparesis in long term type 1's http://www.aafp.org/afp/2008/0615/p1697.html
     
  20. benjygirl

    benjygirl Type 1 · Well-Known Member

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    I had the same symptoms when I had pancreatitis. They gave me morphine which sent me loopy !!


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