So Wednesday, while my wife and daughter were out of town, I check out of work early and take my son to his routine annual physical late in the afternoon. It starts out normal enough: height, weight, vision check, blood pressure, temperature, ears, nose, throat. All business as usual. They ask him if he can provide a sample for urinalysis. He says sure and complies. They do a finger stick for a blood sample. Start asking the basic questions. Everything is cool.

The nurse leaves for a few, comes back and says, “the results of the blood test aren’t right. We need to do it again.” The boy is not thrilled. He’s not great with needles and really kind of despises the finger prick, but obliges. Nurse goes out with the new sample…doctor comes back a few minutes later and says, “so I need to do a third finger stick, but I figure now I need to come in and explain why. His blood sugars are way beyond normal and not safe. I need to do one last test to verify them and then it looks like you guys need to go direct to the ER to start treatment for Type 1 Diabetes.”

“SAY WHAT?!?!?!”

Just that quick after a third finger stick and a blood sugar count closing in on 400 and we’re off to the ER.

It is at this point that I call my wife, who’s been driving for 6 plus hours already and say, “Hey, when you get about 30 minutes out from home call my parents. They’ll meet you at our house and look after M (our 8yo daughter) for the night. You’re going to need to meet me at the Duke Pediatric ER. C is being admitted for Type 1 Diabetes.”

There’s an awkwardly long pause and then….”really?!?!”

“Yeah, Babe. Really.”

“Uhm, ok. Thanks. See you soon.”

With that it was off to the hospital to get the boy checked in, assessed and admitted.

So now we’re sitting in the ER running more tests and flushing his system with an IV and it’s explained to us that ‘basically we’re just trying to work out whether he can go to the regular Pediatric Ward or the ICU?

Now my mind has gone straight to ‘What the Ever-lovin’ holy-F are you talking about!!!”

It was at this point I had to ask. “OK, please walk me through the flow chart of the decision making process here. Because we have gone from going to a routine phyical with what we thought was a very healthy young man showing no external signs of any illness to a life altering diagnosis and a possible night in ICU?! Someone explain to me how we got here.”

The staff was fantastic at explaining the logic. Basically it all came down to, if his blood sugar levels settled to an acceptable level after the IV, then they would admit him to the regular pediatric ward because they would not need to test him as often through the night. If they felt his situation warranted hourly checks, then he would go to ICU.’

Fortunately his numbers settled pretty quickly.

By 10 PM he was out of the ER, admitted to a room in the pediatric ward, and Erin was settling in for a night in a hospital recliner.

The assessment process was pretty interesting and borderline amusing if the situation wasn’t potentially so grave.

Everyone at the hospital kept asking, “so this was caught during a routine physical?”

Us: “Yes.”

Them: “He hasn’t had any symptoms?”

Us: “What are the symptoms?”

Them: “Frequent urination, dehydration, losing weight, belly pain, lethargy…”

Us: “No, we some times joke about how he’s something of a camel. His hydration seems normal. You can see his vital results, he’s growing and gaining weight. No pains and as for lethargy he’s a straight A middle school student involved in three academic clubs and a member of his track team. No. Lethargy is NOT a word we would ever apply to C.”

Them: “Wow. So this is really kind of out of left field for you guys, eh?”

Us: “Well, we’ve gone from a presumed perfectly healthy son to a young man with a life altering and potentially life threatening condition. So, yeah. From the Fucking warning track deep!”

Erin and I both knew one of us would be staying the night with C. We couldn’t see leaving him alone and scared and frankly, no one was going to separate us from him at that point. You might wonder how after a full day’s travel she drew the short straw and spent the night rooming in with him. It was her choice.

I was pretty certain who it was going to be, but I had to make the offer.

I looked at Erin and suggested, “I can stay with him. Do you want to go home tonight?”

“Not really,” she answered. So, decision made. I went home to the house and the dog.

That pretty much sums up the first night of a two night hospital stay and the treatments and education that followed.

Some observations from that first night:

1) After mouthing an initial “oh, FUCK” at me in the pediatricians office, C was an absolute champ about everything that followed. At one point in the ER, after we had both sat mulling over our own thoughts. He turned to me and said, “The doctor said about 1 in every 300 people has type 1. That means if I have it, no one else in my school has to have it. That’s cool. I can handle this.” I promise you. My thoughts were not nearly so noble.
2) Since that moment he has been absolutely on top of this whole thing. He’s a science guy and mathematically inclined. He’s diving right into counting carbs, figuring out insulin doses based on blood sugar readings and administering his own shots.
3) The finger sticks for the blood sugar readings are a challenge, but he’s facing it head on. We can’t ask for more.
4) While we’re all still a bit shell-shocked how everything changed so fast, we are grateful that this was caught so early. As it was explained to us typical cases endure longer hospital stays because the first priority is getting people out of the dangerous acidotic stage which develops once symptoms surface. After that, folks spend a day or two in the hospital getting educated, and demonstrating that they can manage the situation and the processes involved.

We never had any symptoms. C was never really acidotic. So his stay was really about ensuring that he was stable, which happened very quickly and then it was on to the education process.

We keep swinging along the emotional pendulum from “Why us” to “we are so lucky!” It’s making us a bit dizzy. Consider the following:

1) C was born in January. That’s when we normally do his annual physical. We missed it this year and only now got around to scheduling it. If he’d had that physical in January, then we never would have caught this until his condition was much more advanced.
2) The physician has NEVER done a urinalysis or blood test like this for him before. I don’t know why she chose to this year, but again, we’re eternally grateful that she did.
3) We’re so grateful for the care we got at Duke. It has been phenomenal.
4) Our family, friends and everyone near and far have been amazing. The outpouring of love and support has been wonderful. We do not take it for granted and we appreciate all of it.

It’s going to be a winding slippery path for all of us I suspect, but we’ll manage and navigate it together. We’re going to be just fine.

Advertisements