Like living with or supporting someone with T1D isn't tough enough everything seems to be thrown out the window and you go back to the drawing book when you get sick. I still remember 28 years ago the main advice I was given to manage the days when things are not going to plan and a virus is taking hold.
"Continue to test, and test even more than usual. Never stop taking your insulin, even if you cannot eat but to combat that slowly sip lemonade or juice."
I think about this a lot these days because of a number of reasons -
1. How simple the advice is when your well and how without experience and knowledge you take it and use the information the best you can.
2. How dangerous it sounds or could . We didn't have blood testing equipment that could detect ketones back then and to be honest we very rarely had the urine strips on hand to manage to get a test done.
I sit and ponder about all the times through out my time as a T1D and I have to be thankful that the information I was given and due diligence, I have never been DKA. As I say that my had knocks the wood table beside me and hope that my luck continues.
Being a parent of a T1 I also know that the more information we have the better we can manage. Something that we didn't seek out earlier but know it is my life mantra. With my daughter we now know that, even before signs of a cold or sickness start showing her numbers start to go hay wire. It can be difficult to pinpoint however it is a process of elimination on everything else (change site, look at insulin validity or see if she has been sneaking food. This happens only rarely but still needs to be taken into consideration). Once we have eliminated all other aspects we begin the process of managing just waiting for the bug to raise its ugly head.
1. Apply temporary basal rates either up or down depending on where the levels are sitting. I have had a number of times over the years where no matter the amount of sugar I have to treat low blood sugar it will just not budge but on the other hand have bugs that push my numbers so that I need 200% of my basal rate while it takes hold.
2. Maintain hydration. Such an important thing to do for each and every person but even more so with having T1. I saw a post the other day asking how to help minimize ketones and one thing is to flush them out of your system by staying hydrated.
3. Have ketone strips handy so that your able to understand when they may be rising. I always believe that it is better to manage in short increments rather than leaving it for hours on end and trying to move a mountain instead of a rock. I have always been told that to clear ketones you need extra insulin and water. Insulin breaks down the ketones and the water flushes them out of the system. Ketones are simply put BAD. They have the ability to poison your system and if left untreated or at a high level then permanent damage can be done.
4. Don't be hard on yourself. A few days of being out with your numbers isn't going to hurt. Every time you get sick it could be different but learn something from each and every time you can. As I said before information with T1D is king. As your getting better know that you can get things back on track.
5. While I was on MDI I did follow directions to a tea and never missed an injection no matter how I felt. Many a time a Gastro bug would hit and the first thing I got was lemonade and apple juice so that I could continue to keep up hydration and continue having something that could keep my levels at bay while I was still having the insulin on board. Now that I am on a pump I still get the lemonade and apple juice however they are not needed as much at all. Used more for my daughter as she has a tendency to have ketones while still having a BGL within range or lower which means we need the insulin not to bring the BGL down but to break down the ketones so the juice or lemonade is used to manage. Non the less it is in the cupboard as an emergency preparation really.
6. Keep in mind always about your options if things change rapidly. A few years back and only a year into our journey with my daughter she developed Influenza A as it turns out and after 3 or so days of managing to keep ketones and BGL's at a reasonable level it was decided that hydration wasn't the best and we needed more help. We headed into hospital and spent the next 3 days keeping things under control while we waited for the virus to move on.
Being sick sucks for everyone but is a part of life. As long as you are open to the information that is given and you have your plan and supplies then you manage the best you can while you can and never be afraid to reach out for help.
