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LadyRenegade

Had a bad day....1st time high ketones

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LadyRenegade

Still haven't pinpointed the exact cause, other than pump problems. Here's what happened: I picked up my sons from school and noticed a strong fruity-candy smell. After verifying that no one had candy, we hurried home to change his inset, which was reaching the 48-hour point. Eddie is only 6 years, 60 pounds and tall for his age - no extra meat, so not much choice of inset sites, hence the quick turnover.

 

He was elevated prior to change with trace ketones, but his new bolus brought him down to 81. Yay! Then while I was out grocery shopping, Dad had to do a new inset because the first came loose. Boo! We've been having trouble with our last 2 boxes of insets sliding and kinking the cannula, or coming off completely. Dad's inset job looked great, but the BG numbers climbed steadily overnight despite bolus. Eddie woke spilling mod ketones and BG 364!:eek: Pulled a great looking inset that was 12 hours old, tossed a bottle of Humalog that should have had 6 more days before expiring, and plied Eddie with Diet Coke and sugar-free Wyler's lemonade till he peed negative. (His 2nd pee of the day showed large amount of ketones. When I saw that maroon test strip I nearly cried! I think we avoided an ER visit but thismuch.)

 

I did speak to Animas and they are getting me a new box of insets, and we're working from a new lot number now. I am just shocked how fast things went south! Anyone know if this means the honeymoon phase is over? BTW, I'm a newbie to the forum -sorry with intro-ing with a "war story" but I'm sure we all have them!

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Jan B

Gee, it really sounds like those insets are bad. It would be a wild guess on my part about the honeymoon period. From my experience - I know - way different - but I went from a good bg number at bedtime to over 500 the next morning with a kinked set. Just a side note . . . when I was pumping, and ended up way high, I would always use a syringe instead of depending on bolusing with the pump. It sounds like you are doing a great job with your little one.

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k_dub

Hi LadyRenegade,

 

I'm an Animas/inset user. I've been on the Ping for over 2 years and I've had NO problems with the infusion sets or the pump. I have way more problems getting my Dexcom sensor to stick.

But everyone is different and some people do better with different sets. There is a "sticky post" somewhere (maybe under Pumping Insulin) just about infusion sets. It was super helpful for me when I was picking out my pump and for me to understand all of the different options out there.

 

I know this may be a stupid question, but I just wanted to check to make sure that you are not using the recalled Animas cartridges that were recently recalled? I had been using them before being notified of the recall. I believe that they were leaking.

 

Have you tried the angled infusion sets? They may be better for your son since he is thin.

 

Hang in there! I agree with Jan, you are doing a great job! We all have surprising numbers/unexplained highs sometimes. This is a great forum to problem solve.

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LadyRenegade

Thanks for the replies & support. I use the inset-30 for Eddie, so, yes, it is angled. Cartridges were fine - we've had no leak issues. Jan B, I agree that the symptoms do point to a pump problem. We may have had a "perfect storm" of 3 inset problems in a row: 1st was 48 hours old, 2nd came unstuck, and 3rd, although it looked fine must have had something wrong. My husband did insert it into Eddie's quad near his knee - perhaps too much muscle, not enough fat to allow for good insulin absorption. We did resort to the pen a couple of times.

 

Good news is his numbers have been much more normal since "The Incident". His team and I are now trying to tweak his nightime basal rate. He must be having a growth spurt, as he has BG numbers between 85-100 then an hour after he falls asleep, is 100 or more points highter. They tell me it's the growth hormones.

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Subby

Good to hear things are settling down for now. To have basal needs that change overnight is a common issue, and while I've also heard they suspect growth hormones, happens for adults as well. The pump is great to reduce this issue, as you can program in additional basal settings to gently increase dose when it is needed.

 

I wanted to underline what was said above that everyone is very different when it comes to pumping techniques, sets, etc. I found with the pump it was important to keep trying alternatives if things just are not working well. In this case it might be that there is a better set out there, or at least to keep that in mind if problems persist. Finding that better set, may be due to an obvious reason, or it might just be a case of suck something else and see.

 

I'm intrigued by the placement in a quad near the knee. Is that down the leg some way? Did your educator recommend that? It might be fine, but my initial reaction is it might be problematic there.

 

Falling back on injections as soon as things get a bit out of hand, is a great tactic to take in my opinion.

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LadyRenegade

Subby, yes, hubby placed the inset just above the knee. No idea why! And, no, the educator recommended fatty areas. But hubby went to a bar with a colleague instead of attending our pump training session - don't even get me started!

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Fairy Nurse

I always make a rule (as someone else mentioned) that if the set is not working and my blood sugars get higher and higher, even though I am giving a bolus, I remove the whole set and then give an injection of whatever the pump recommends. Then I know for SURE that insulin is getting in, regardless of whether the pump is doing it. Then I will put a new set in and try again.

 

I recently made the mistake of not following this rule-- along with other factors, and I ended up with ketoacidosis intesive care 5 days. :(

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lorilei
Subby, yes, hubby placed the inset just above the knee. No idea why! And, no, the educator recommended fatty areas. But hubby went to a bar with a colleague instead of attending our pump training session - don't even get me started!

 

 

 

OMG!!!!! What the heck????? Hope you have gotten him on board..and i think i'd request that he attend a formal session!

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