Ivy slept all weekend. She woke every couple of hours to drink some water and go back to sleep. Both friday and saturday night, she woke needing a new nappy, she normally lasts the night with the same one, but these were more than saturated. She was soaked through, her vest was wet right up to her neck and her cot sheets needed changing, we just put it down to her drinking more water.
We have taught Ivy to do some simple baby signs and on the Sunday morning she made the sign for food, we thought this was a sign she was getting better, as she hadn't had any solids since that pear on Friday (we now know it was because she was literally starving). We gave her a yoghurt and disappointingly, she was sick within the hour. It was after this that her tummy became very bloated and her breathing very heavy, her chest drawing right in. After calling the NHS 111 number, they advised we take her to our local out of hours service. There we saw a wonderful GP who had enough of a 6th sense to request a urine sample, going above and beyond what she could have done. Sam took the sample back to her a couple of hours later, he rang me saying that there was glucose in Ivy's urine and we had to take her to Stepping Hill Hospital.
We arrived at the Tree House, the children's unit within the hospital, and assumed we would be told she had a virus and she would be monitored for a while.
Ivy sat on my knee, trying her best to be interested in her 'That's not my hamster' book but quickly became quite limp and her head flopped back, she couldn't hold it up. The assessment nurse checked her bloods and couldn't hide her shock when it read 24.1, exclaiming that it was very high. A normal range is between 4 and 7... shortly after that a senior consultant came and sat with us, pulling the cubicle curtains to hide us from the ward she very gently explained that as well as having high glucose levels, Ivy also had something called ketones in her urine. These 2 indicators combined are typical of Type 1 Diabetes. She said it will take a few minutes to sink in, I felt like I'd been hit with a sledge hammer and I cried, instantly thoughts were flying around my head, I questioned and blamed myself, had I fed her the wrong foods? Had she had too much sugar? Some of the many myths that surround T1D. I felt guilty that her pancreas didn't work properly, I made her so surely it was my fault it was broken? I was reassured, there is no prevention, it will happen regardless of lifestyle and environmental factors.
Ivy was taken to the High Dependency Unit, her ketone levels were 5.9, emergency treatment is needed at 3. By this time her hands and feet were purple, her body was shutting down and keeping it's blood near to her heart. For 2 hours the consultant and 4 nurses tried to insert a canula into her tiny veins, they prodded and poked but it was proving impossible. It was so urgent to get her rehydrated and start flushing the ketones from her body, that they decided to drill into a bone in her calf, at this point we left the room. We waited outside for 45 minutes, hearing the occasional painful, cry. A nurse eventually came out and asked our permission to shave her hair, the drilling hadn't worked and they'd decided to access the veins on her head. When we eventually went back in to see her, she was lying flat on the bed, with tubes attached to her head, being flushed with saline solution. She was drifting in and out of consciousness but at least they were able to start removing the acid that had built up in her blood.
They moved us to a room in HDU where she was connected to a drip; wires were connected to her for monitoring her heart rate, oxygen levels, blood pressure and breathing rate. She looked so small and we felt so helpless. A registrar explained that they had never had a baby diagnosed with T1D, so young, and they were unsure about the amount of insulin to administer, they decided 0.3ml per hour was to be the starting point. They were in constant contact with the specialist diabetes team in Manchester. The phrase DKA was mentioned several times but nobody explained what it was.
We later found out that Diabetic Ketoacidosis (DKA) is a dangerous complication of diabetes caused by a lack of insulin in the body. It occurs when the body is unable to use glucose because there isn't enough insulin to break it down. Instead, it breaks down fat as an alternative source of fuel. This causes a build-up of a by-product called ketones.
DKA is potentially very serious. High levels of ketones in the blood disrupt normal working of many parts of the body. The more ketones in the blood, the more ill a person with DKA will become. Left untreated, DKA can cause potentially fatal complications, such as severe dehydration, coma and swelling of the brain. The NHS advises that you seek emergency medical assistance if you show any of the symptoms (extreme thirst, tiredness, frequent urination) and vomit; this was Ivy on the Friday.
Ivy had to have blood tests every 1-2 hours and because they hadn't succeeded in inserting a canula for taking bloods they had to use a heel prick test and simply squeeze, squeeze, squeeze her little feet to extract enough blood for 2 vials, a gas test and a glucose test. For days after, they were bruised, sensitive and swollen.
After 24 hours Ivy was allowed her first breastfeed since getting to hospital, the effect was instant, she relaxed and was so gentle. I will cherish that moment forever.
The 0.3mls of insulin didn't work and it was decided Ivy should have her first injection, they gave her the smallest, possible amount 1/2 a unit and the effect was quickly noticed. 12 hours later we were downgraded from HDU to Special Care, a big step in the right direction for our Ivy Revival.
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