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Scheherazade in Blue Jeans
freelance alchemist
While I'm waiting for Judah's call... 
21st-Mar-2013 09:31 am
...here is the backstory!

He'd been losing weight over the past few months and feeling generally fatigued, but he thought it was just stress. (Startups, man.) He was always hungry, but couldn't put on any weight. Unbeknownst to me, he'd recently started to be thirsty all the time. He mentioned that to his stepmother on Monday, and she and his dad urged him to go to a doctor ASAP, which he did yesterday.

Now, the thing is, Judah has not had health insurance. He applied for Commonwealth Care, borked the first attempt and landed the second; his insurance was set to kick in on April 1st. So the doctor only did a urine test, because Judah was paying out of pocket and bloodwork is super expensive.

Sugar in his urine sample. Doctor said "You need to go to the ER, because you could be in diabetic ketoacidosis."

To the ER he went! And in triage, he had a blood glucose level of 500, which is superdoubleplusnotgood. >.< By the time I got there, they'd pushed insulin, which brought him down to 157 - but the descent was too rapid and had him woozy. Then he had a sandwich, which bumped him up to 230, which is apparently too much for a sandwich...

...yeah, lucky Judah, he developed a condition that I do not yet know like the back of my hand! Adam's diabetic, but not SuperDiabetic like this; he's never required insulin or even regularly blood glucose testing. So we're all learning, and since I know many of you are diabetic or are caretakers, I'm just throwing all the info I have up here and hopefully it can be sorted out.

They were originally just going to put him into a regular hospital room for observation, but since he wasn't stabilizing and was considered too brittle, they put him in the ICU. At some point in the night, he got moved to stepdown care (literally a step down from ICU-level care, and a step up from a regular hospital ward). The nurse I spoke to this morning was the one who had him last night; she says that he's stabilized and his sugar has been under 200 most of the night.

So. That's the story so far! Judah just called, and I'll be on my way over shortly. *nod*
21st-Mar-2013 01:56 pm (UTC)
500? Amateur. When *I* got diagnosed, my blood sugar was above 600, and the meter wouldn't even read it :-P

Seriously, I'm glad the doctor caught it, and that they're getting him under control.
21st-Mar-2013 02:04 pm (UTC)
My best friend and the guy I'm not married to are both Type I from childhood. Based on that observation, it's a lot more boring most of the time, and you get really used to watching finger sticks and injections. Good luck, and I hope you all get to the boring part soon. (And that the insurance coverage kicks in.)
21st-Mar-2013 02:36 pm (UTC)
I just went through this with my oldest friend from college, my semi-cousin. Scary symptoms, and I feel for you.
21st-Mar-2013 02:40 pm (UTC)
Sending good thoughts to all!
21st-Mar-2013 02:41 pm (UTC)
WOW. I'm glad that they got him to the doctor, but not glad that he needed to go...here's to hoping that he can get it under control quickly and easily.

Worst case scenario, he may need an insulin pump - the good news (if you can call it that) is that diabetes is generally well-understood by the medical community, there are numerous treatments, and it's easy to control once diagnosed. Plus, the accoutrements are usually covered by health insurance; there may be a few hoops, but they're not flaming hoops that are 10 feet off the ground. :)

Good luck and good thoughts to Judah!
21st-Mar-2013 04:23 pm (UTC)
Scary, scary stuff - I'm so glad the problem got diagnosed quickly. (Also sorry that Murphy's Law kicked in and it didn't happen after April 1st - and don't think it doesn't piss me off that so many of us Americans have to think that way).

Let us know how we can help, once things get settled!
21st-Mar-2013 06:31 pm (UTC)
Well I'm glad they caught it, but I'm sorry y'all have to go through this again. Tell Judah I'm thinking of him.
21st-Mar-2013 06:49 pm (UTC)
Wow, scary. I'm glad you're all over the hump. o_o
21st-Mar-2013 08:12 pm (UTC)
Glad they caught it in time. Tell Judah that in the future he is to share all his symptoms with you and Adam. I mean, tell you about them, not make you feel them. That would be creepy.

Anyway, I'm glad he's okay, and I hope he stays that way.
21st-Mar-2013 10:03 pm (UTC)
I'm so glad he went to the doctor when he did and that he's doing well.
21st-Mar-2013 10:03 pm (UTC) - Wow
Just... like, wow.
22nd-Mar-2013 12:51 am (UTC) - My diabetes tips for newbies...
As a type 1 diabetic, the best regime I've been on is one shot of long-term insulin per day, which covers the body's basal insulin needs, and a fast-acting insulin that I use when I eat.

The tricky thing is to get used to calculating how many carbs the food he eats has, and getting the correct dosage of the short-term insulin based on that. There are some guidelines, and there's also trial by error. For a while, it's probably a good idea to take a blood reading before eating, and for best control, also about two hours afterwards, and to track all those numbers. And not to snack before those two hours are up, since that makes it hard to determine the effects of the insulin. There are books with tables that show how many carbs various foods have, and of course, most packaged foods have the carbs on them.

The body also has its own rhythm re: how it processes sugars, and he may need more insulin at various times of the day.

If you find he's acting erratically -- having trouble thinking or communicating, walking straight, responding appropriately, or if he's sweating unreasonably for the conditions -- he may have a low blood sugar. Because the brain is affected, it might be hard for him to recognize that's what he's having. Have some glucose tabs handy (failing that, a non-diet soda or a clear juice like apple juice) for those situations. Do not give him anything with fat in it, since that slows down sugar absorption (a lot of people say to give Diabetics with low blood sugar chocolate -- this is not a good idea). Your doctor will surely give you more details.

It's a lot of shots, but the good news is that the shots are generally painless. The blood sugar readings smart a little more, IMO, and it makes sense to test with different lancets until he finds one that hurts less than the others.

It's a big, scary diagnosis, but the good news is that it's a very manageable disease. And especially since he's not living alone, and has you, Adam, and Elayna to keep an eye on him, when the scariness fades, it will just be another one of those things we humans do to take care of ourselves. Important is to really commit to controlling those blood sugars, though. It's do-able, and the consequences of not doing it can be severe.
22nd-Mar-2013 03:44 am (UTC) - Re: My diabetes tips for newbies...
Glucose tabs are usually gluten-free, and come in both big jars and smaller rolls. They are an excellent thing to have on your person at all times in case of emergency, and can also be used in situations where the non-diabetic person in the room is starting to melt down and will entirely delaminate if they do not get food within the half-hour or sooner, preferably sooner.
(Deleted comment)
22nd-Mar-2013 05:34 pm (UTC)
Hiiii! :)

FWIW, I usually remember what happens when I get a low blood sugar. It probably depends on the person. It's absolutely true, though, that the brain doesn't work right. It doesn't have the fuel it needs to function. It's like driving a car when the power goes out suddenly, and the wheel and brakes lock up.

In the 90's, I also gave myself 2 shots a day. The regimen I have now, with a shot each time I eat, is a lot more shots, but it's so much easier to keep my blood sugar stable.

Most people tend to shy away from shots, but I don't recommend that. The shots aren't usually painful, and they give so much more freedom when it comes to what to eat and when.

I've never tried a pump myself. I know people who had trouble controlling their blood sugars who swear by them, but I never much liked the idea of having a needle with me all the time, and my doctor's always said that as long as my blood sugar is stable, I don't need to. I thought during pregnancy I'd need one, but I was able to keep a very stable blood sugar level without (and even get compliments by the hospital's doctors, about how little effect the diabetes had on Alexander. I'm very proud of that!)
22nd-Mar-2013 02:33 am (UTC) -
Yikes! So glad he's okay.

My best friend has had diabetes since he was a kid. According to him, the thing everyone gets wrong in the first few months after a diagnosis is forgetting that you *need* sugar. Especially if you take a daily long-acting dose of insulin in addition to small doses after meals. Low blood sugar with too much insulin in the body can become just as dangerous as high blood sugar.
22nd-Mar-2013 03:48 am (UTC) - Re:
The rule that I learned for a case of unconscious diabetic with no information about their blood sugar and no quick way of testing was to get a little bit of glucose into them *fast*, because if the problem was low blood sugar that is the correct treatment, and if the problem was high blood sugar, a little bit more wouldn't be as bad as blood sugar remaining that low would have been.

This was in ~1995; nearly 20 years later, this should be checked with a trained medical professional.
22nd-Mar-2013 11:43 am (UTC)

I'm glad he's going to be okay, and I hope he gets to the nice, boring, mundane part soon.
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