Thursday, February 7, 2008

J.J.'s Diabetes Diagnosis: Symptoms

The incidence of diabetes is on the rise.  Our endo said it's dramatically increased in the past 10 years.  As of now every 1 in 300 children will contract this disease.  The hospital and diabetes center we went to in St. Paul, MN saw 20-something (can't remember the exact number) new cases just in the month of November.  So when we showed up in the beginning of December they were swamped.  With the increased incidence I so strongly believe more information should be shared with parents and children of the symptoms.


We had never been around or knew anyone with T1 Diabetes, and it doesn't run in our family…so we thought.  I was definitely not informed about the symptoms of this disease.  I thought I would share J.J.'s progression….the symptoms he exhibited.  Keep in mind that there are no definitive, quick, easy tests for this disease PRIOR to its onset.  Once the pancreas does begin to shut down, however, symptoms can progress rapidly.  Please, if you are reading this and suspect you or your child has diabetes….call your doctor!!   Here is how diabetes progressed and presented itself with our son:


·        Increased urination:  We noticed he was going to the bathroom a lot.  This wasn't alarming at first since we've always encouraged our kids to drink plenty of water.  This symptom was dismissed as "Well, he must be drinking more."


·        Weight loss(1):  As typical parents we didn't keep a daily, weekly, monthly, or even yearly chart of J.J.'s weight.  He looked healthy, so putting him on the scale didn't cross our minds.  However, we noticed he seemed to be getting long and lean…his face looked thinner.  We dismissed this in the beginning as "Well, he must be going through a growth spurt…losing that baby/toddler fat."


·        Bed Wetting:  J.J. began to wet the bed.  He was still in a pull-up because he wasn't fully trained at night, but the bed-wetting was excessive.  He would literally pee gallons.  He would wake up in the morning soaked…p.j.'s, bedding, sheets, and sometimes even his pillow were soaked through.  We had a daughter do this for a short time at about this age, but it was intermittent and not to this extreme.  So when this first started I didn't think much.  But as it went on for 2 weeks, and we were washing bedding every morning my MAMA RADAR kicked in.  I thought, "Now, this is not normal. There is something wrong."


·        Excessive Thirst:  Because of the bed-wetting we had been limiting J.J's nighttime fluid intake in hopes to relieve the constant washing.  However, one night my husband woke up at 2 a.m. and found J.J. on the bathroom counter drinking straight from the faucet. 


(It was that last symptom that got my Mama Gut Radar beeping really loud!!  I knew at this point we were dealing with something big.  That's when I began to research on the internet for symptoms.  What I found was so hard to weed through, because the searches often led me to sites that mingled Type 1 & Type 2 diabetes symptoms.)


·        Nausea & Vomiting:  1 ½ days after the bathroom incident J.J. began to vomit.  Again, this vomiting didn't present itself as a typical stomach virus.  He could eat and drink fine for 12-18 hours before he vomited again.  Usually with a bacteria or virus, there's no eatin' without vomitin' until the "bug" passes.  So by this time my Mama Gut was just sick…it was screaming….THIS IS NOT NORMAL!!!


·        Weight Loss(2):  The day before we took J.J. to the doctor I was giving him a bath and I could count every rib, every vertebrae, and his hips were protruding.  I told my husband he looked like those kids we see on the commercials who are starving in Africa.


·        Desire for Sugary/Sweet Drinks:  Also this day I noticed J.J. drinking glass after glass of apple juice.  He hates apple juice!!!!  We rarely have it in the house.  I buy it only to make juice cubes to maintain hydration when someone is vomiting. 


·        "Spaced Out" Look:  The morning we decided to take him to the doctor he sat on the floor and spaced out.  I would ask him a question and it was like he was somewhere else…..that may seem normal at times….but this was different…..I was in his face and he wasn't really hearing me.  It was like he wasn't there.


(For the physiological reasons to these symptoms, scroll to the end of this post!)


It was a Saturday morning when that last symptom developed.  Our pediatrician had Sat. morning hours but at a location that was a good 50 minutes from our home, not the one closest.  These Sat. morning walk-in appointments were supposed to be for the typical, normal every day common kid illnesses…..ear infections, strep throat, sinus infections etc.  So I called to see if we made the drive if they would even check for diabetes.  At first the nurse said "No, there are a series of blood tests we like to do to confirm the diagnosis, and those would need to be scheduled during the week."  So I said "What does an emergency look like in a diabetic then?"  She had me describe everything we had been seeing in J.J., then she said "Get him here NOW!"


We were off as quickly as possible.  J.J. slept the entire way.  When we got there he was real wobbly when he walked, and seemed lethargic.  We finally got situated in a room and he had to go the bathroom.  The doc hadn't arrived, and I knew they would take a urine sample, so I begged J.J. to hold it for me.  But it was apparent that he couldn't.  By this time he couldn't walk so I carried him to the restroom, but someone was in it.  The nurses station was right there and they looked really concerned, and asked if I needed help.  It was while I was waiting I noticed the doctor heading for our room.  I decided to take J.J. back to the room so we wouldn't lose our turn with the doctor.  The doctor read the chart of why we were there…I had written down "Diabetes Diagnosis & Dehydration".  He took one look at J.J. asked a series of quick questions in which we replied "Yes" to all of them and that was it….this doctor moved fast.  Commanded all his nurses "This boy needs a urine sample, blood sample…I want him tested ASAP."  The doc quickly made sure the bathroom was clear.  It was just a few minutes later when the doctor came in to tell us….."Your son has type 1 diabetes."


I was not stunned by this news.  My mind and heart had been prepared for this diagnosis.  As much as I wanted my Mama Gut to be wrong….it rarely is.  I have what we dub in this house as a "military mind"…my thoughts just went to "O.K…that's what it is, now what are we to do about it."  My husband and oldest daughter, however, teared up immediately.  Jess was scared.  And we didn't know what to expect.  So much of this was foreign to us. 


The doctor had to figure out which hospital in the Twin Cities had the children's diabetic center attached to it.  He called ahead and let them know we were coming, and gave us a quick idea of what would happen over the next few days.  I will never forget the look of pity on the nurses faces as we left….and especially one who came into our room and told us J.J. would be fine….I don't think I had ever experienced that kind of look.


Physiological Reasons Behind the Symptoms


Type 1 diabetes begins when the body attacks the cells in the pancreas that produce insulin.  Insulin acts like a key to allow glucose to be used as fuel for our cells.  If there is no insulin the cells cannot use glucose for energy, so the glucose begins to accumulate in the body.  The body naturally tries to get rid of the glucose, which is why the symptoms begin with increased urination.  With increased urination comes increased fluid intake.  Eventually there is a desire for more sugary drinks since the cells are still being deprived of glucose.


Because the body can't use glucose for fuel it begins to use fat for fuel.  That is where the weight loss comes in.  Unfortunately fat isn't the greatest source of fuel, and releases ketones as a by-product.  Ketones in the system make the ph in the body become acidic.  This is why there is nausea, vomiting, and that spaced out look.  Ultimately if the keto-acidosis is not reversed it can lead to coma and death.  



Donna said...

Hi Lynnea,
I got chills as I read that list of symptoms. They were pretty much the same for me when I was 7. This can be a difficult disease, but, believe me, it can be managed. It just takes some getting used to. You're doing the right thing by researching and educating yourself & others about it. I'm sure JJ will be fine because you sound like a great mom who will do everything in her power to take care of this sweet child. God bless you. :)

Sarah said...

I’m sorry to hear about your son’s diagnosis. My peanut (now age 4) was diagnosed in November of 2006. We are Minnesotans as well. Gracie goes to the Mcneely Diabetes Center in Saint Paul for her care. Hang in there.

I want to say things that will make you feel better, but then I also really want to say that I know how you feel and assure you that the grief does not last forever (but you never forget it)

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