sick child-flu

[suzi]

Despite a flu jab back in Oct, Andrew has the dreaded flu. Temp 38.6 down from last night which was 39.7, keytones 2+, bs14.6. Sore all over, especially back, slight cough, runny nose feels like cr*p(his words) and swollen glands on side of neck. As we just started basal/ bolus in Dec, Levemir at night, humalog with meals and only done 1 of 3 FABB courses, could do with some advice. He has no appetite but is drinking plenty of SF fluids. His DN isn't in the office til 10am today.
Any advise greatfully accepted, as i have no idea as to what to do about his humalog as he isn't eating but needs to get his bs down.
Suzi x

 

[iHs]

Hello Suzi

Andrew will still need some bolus even though he doesn't feel like eating. Any illness can make bg go right up. All you can do is give fluids, monitor bg levels and have some lucozade handy in case bg starts to go low. Once his bg starts to drop with a correction bolus , the keytones will start to go and he should start to feel like eating something.

If you are really worried though, best phone the GP.

 

[suzi]

Thanks ihs,
Finally got through to his DN, basically said the same, give bolus plus a correction @ 10% for every +keytone. Just done bs 14.4 temp 38.4, he just wants to sleep, i just want him to do a wee pee as i can smell the keytones off his breath and need to know what ratio of humalog to give him.
Suzi x

 

[phoenix]

Its just gone 10 so hopefully youve been able to contact the nurse As IHS says you may need to do a correction dose and check BG 2-3 hourly.
I did find an excellent flow chart as to what to do with a sick child on basal bolus (both eating and not eating) but its American so BG levels need to be divided by 18 (and for safety calculation of correction doses OK'd with own doctor.)
http://www.cincinnatichildrens.org/...2097/bb6cc56b-2bde-430b-8242-9a1e1ff207c8.pdf
Try to get as much rest as you can yourself, looking after any sick child is worrying and tiring, and obviously more so when the child has diabetes.

(I'll post but probably redundant )

 

[iHs]

Hope Andrew starts to feel better soon Suzi.

I have had keytones when I was a kid due to a gastric bug thing going round. In those days calculation charts were not about so you just had to use trial and error in figuring out how much insulin to use to get bg to lower. As long as you are able to monitor Andrew's bg every 2-3 hrs dont worry too much. Once his bg is down below 12 he should start to feel a bit more perky and fancy eating. A tiny piece of fairy cake works wonders when you feel like death

 

[suzi]

spoke to his DN twice now, Andrews got 3+ keytones but some may be due to the fact he hasn't ate since 2pm yesterday as his bs is still 14 and temp the same @38.4. Just about to give 8u humalog. Poor lamb just wants to sleep and is addament he does'nt want the fenpaed(calpol) or sf drink,so am about to bully him into taking some. Either that or a trip to the kiddies ward for a fluid drip, which he hates, blackmail works wonders, though i find the coaxing more tiring than a sleepless night!
Many thanks for the replies
Suzi x

 

[iHs]

Try and get Andrew to eat something Suzi. Doesnt have to be bread or cereal, it can be anything really that you know he will fancy. I have always found that insulin works best if food is eaten even if bg are really high. As long as the food is not above 10 grams carb try that and see how his bg levels go.

 

[suzi]

Hi ihs and phoenix,
thought i'd keep you posted as you were both kind enough to reply. He gave himself 8u of humalog, drank some water then some apple juice(DN advised small quantities of fruit juice to help starvation keytones as bs 14) is now up out of bed and lying on sofa watching Tom & Jerry. He certainly does'nt look as pathetic as he did this morning, if only we could all bounce back as quick as kids do! He's still sore all over despite the fenpaed and glands still swollen, so looks like i won't be back to work til wed/thurs, thank goodness i work flexi days. Kids have the abitlity of going downhill so quick, but its good to know they can bounce back just as quick. Will try and get him to eat something, even if its only a GF biscuit or small ice-cream.
Suzi x

 

[iHs]

Sorry I forgot he was Coeliac. My partner is too.

Glad he is starting to feel better

 

[suzi]

no need to apologise ihs, i sometimes forget Andrews coeliac, and end up eating 2 burger kings lol. Anyhow he's feeling lots better, just managed some scrambled egg and tomato sauce! didn't fancy the toast or icecream. Still has keytones +3, hoping to flush them out by making him drink more water, temperature coming down now 37.4 and bs 8.8. DN popped in for a quick chat and visit, Andrews due his Hbac1 done tommorrow (to check his new regime)if he's well enough, if not she'll bring the machine round on wednesday, which i thought was really kind of her. Anyway by the looks of Andrew, he'l managed to go to the hospital tomorrow.Thanks for the advise, i'm not so sure if it's flu now, more likely to be a viral infection with flu like symptoms, anyhow it knocked him for six for a good 24 hrs, and he's beginning to perk up now, and thats the main thing.
Take care
Suzi x

 

[suzi]

Andrew is feeling slightly better today, still has stiff joints, cough, sore throat ect. has only ate 1 portion scrambled eggs and about 3tbs fried rice since Sun. Was at hospital today for very quick Hba1c ( for his new insulin regime) has gone up to 8.8 from 8.1 since Nov, DN said not to worry as he's sick and still has 3+ keytones, what upset me the most was the fact he's lost 6lb since Nov and can't afford to lose any weight. Next Hba1c is 3/2 his quaterly full check up, hardly enough time to rectify the Hba1c levels, but we'll try.It's the weight lose thats worrying and honestly feel he's lost that 6lb over the last week, bs have been 4.9 - 12.8 so not terribly high considering he's not well.
Suzi x

 

[suzi]

well folks after a very long 5 days, and many sleepless nights, Andrew is recovering nicely, infact i'd go so far as to say he's 70% fit. He is wrapped up on the sofa shouting into his brain train DS! Appetite slowly returning and bs fairly stable, keytones still present but down to 2+, still giving him the Fenpaed, plenty of fluids and some small glasses of fruit juice, and insulin at low doses because most of what he's eating has no carbs whatso ever, but if its what he's choosing to eat, then i can't argue. Hopefully sending him back to school on friday, i'm in work tomorrow, so his Dad can take the reigns! Thanks again for all the advise i've recieved,
Suzi x

 

[phoenix]

That's good to hear, if he's making a noise , then he must be getting better! Lucky Dad!
Look after yourself,
Helen

 

[hanadr]

A good rehydration mix for children is, Orange juice diluted with an equal volume of water and a few grains of salt dissolved into a glassful. You won't taste the salt.

 

[phoenix]

ditto to Hana's mixture, I use it myself when running, far better and cheaper than costly sports drinks.

 

[suzi]

thanks Hana & Phoenix,
Have used that mixture myself before now and on unexpected kids!
DN phoned me this morning regarding Andrews weight loss, have to get in touch with his dietician to get him a high fat protein shake! Well that ain't going to happen 1) dietician is off with flu! 2) surely increasing his fat/ carb intake would do the same job and be much more pleasent to eat/drink. What do you think? Andrew tends to lose weight easily and finds it hard to put back on.
Any suggestions as usual are greatfully received,
Suzi x

 

[suzi]

Re: relapse child flu/need advise

Andrew went back to school on mon only to be off yesterday, thought he was fit enough today, but i was wrong, sent home from school. His appetite is at about 60%, his total weight lose through flu 8lb, keytones trace again! bs 5-11, back to where we were this time last week. I know its hard to get back to being 100% after the flu, but were now on day 12, andrews legs where he has injected are black and blue, tummys ok. He is complaining of considerable pain in his legs, even finding it hard to walk, stand after sitting for a period of time. Giving fenpaed and he's just had soak in a warm bath, Dr's appointment today at 4.30,( as usual only Dr available isn't too familiar with diabetes, though it could be something else i suppose) Anyone any ideas, could this be something else? something to do with diabetes that i'm unaware of? I apologise for the rant and if i seem neurotic, i'm just a very worried mum
Suzi x

 

[blackbird]

Some diabetic children do seem to take longer to recover from viruses than others. My son was ill before Christmas, he had two weeks off school. I don't understand about the leg pain, do you mean in the joints? My son complains about pain in his legs a lot, but having been checked out by the diabetic specialist at the hospital and being given the all clear, it's a mystery! I hope your son is feeling better soon.

 

[suzi]

Thanks for answering blackbird,
Pain in his legs is like muscle pain and where he has injected, suppose its all down to the flu. I hate to see him in so much discomfort and there's only so much fenpaed i can give him. Hopefully the Dr this afternoon will be able to give him something to help speed up his recovery and build him up a bit.
Suzi x

 

[suzi]

Well the Dr yesterday was a complete waste of space, never seen him before, though he'd obviously read Andrews notes, i didn't have to tell him Andrew was T1 with coeliac disease, he was able to tell me he'd also had flu since the 20th Dec and didn't feel right himself yet!!! No tonic or supplements required as the NHS don't prescribe them any more, despite the phlegm (his chest was clear) no antibiotic needed! just another bottle of fenpaed! plenty of rest and fluids and it won't be long til he puts all that weight back on!(8lbs!) Oh He did say give him plenty of potatoes/pasta and let him eat what he wants to put the weight back on DOH!
Sorry for rant so totally p**SED off
Suzi x