Frustrated and starting over again
ScrappyKat
Posts: 34 Member
Mid December I ended up in hospital because my BSL's were out of control and I had to have an operation for a cyst to be removed. I was in there just a few days, but came home and went straight onto a very low carb diet and started researching Keto with a vengence. I was even able to lose weight over Christmas. I was in Ketosis,I was feeling great and started walking up to 1.5 hours a day. During this time my antibiotics for my wound was changed and this is where I went down hill. On 2 Jan I had dh take me to emergency, because I was so sick. I had gastro, couldn't keep anything down and knew I was dehydrated.
I was attended to very quickly and discovered that I had C.Diff, no electrolytes, low potassium and other nutrients, and had ketoacidosis. (Now I'm not sure if it was really ketoacidosis, because as far as I know I don't have Type I diabetes, I have Type II, and I was definitely in ketosis, because by the time I went to the hospital I had barely eaten in 3 days.)
So I ended up in the ICU for 4 days, and then in the wards for another 6. Of course they fed me full of carbs, and couldn't get my bsl's under control, where as before actually going into hospital that Saturday morning, I had perfect control with my meds, insulin and keto diet.
So now I'm going through cravings for vegemite sandwiches, and all things wheat. Sigh. I just feel like I need some extra support as I get going again. I'm going to go make some lemon fat bombs I think.
I was attended to very quickly and discovered that I had C.Diff, no electrolytes, low potassium and other nutrients, and had ketoacidosis. (Now I'm not sure if it was really ketoacidosis, because as far as I know I don't have Type I diabetes, I have Type II, and I was definitely in ketosis, because by the time I went to the hospital I had barely eaten in 3 days.)
So I ended up in the ICU for 4 days, and then in the wards for another 6. Of course they fed me full of carbs, and couldn't get my bsl's under control, where as before actually going into hospital that Saturday morning, I had perfect control with my meds, insulin and keto diet.
So now I'm going through cravings for vegemite sandwiches, and all things wheat. Sigh. I just feel like I need some extra support as I get going again. I'm going to go make some lemon fat bombs I think.
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What a rough time you've had I'm glad they were able to get you healed up. C diff is no good.
We're here for you. Many of us have had hiccups recently and are getting back to the basics currently. It sounds like you know what you need to do
in a few days I bet you'll be feeling great. Keep extra eye on electrolytes to make sure you don't have issues with that again.
Did your Dr say anything about the suspected ketoacidosis? Be sure to double check that, seems they were probably just seeing the ketones and use the wrong term, but you don't want that to happen again if it was an issue.0 -
My endo is going to get me a metre to read ketones. They are also testing to see if I have Type I or Type 1.5 diabetes. But there is a long wait for those results evidently. They took so many bloods and blood gases while I was in hospital I'm pretty sure one of the tests checks for ketoacidosis. My ketones were like 7.6 or something on the Saturday morning.
Of course the letter to my GP says my blood glucose levels were out of control and that is why I was sick, but I had them under such strict control for 3 weeks, I know it isn't the case. My levels were all between 4 and 7.5 for that period, even Christmas Day. So that has me a bit peeved. My endo was upset because she had to take me off my new medication that I was doing so well on to make sure that I don't have another 'episode'. I don't want to end up in hospital again. 2 times in a month is enough me thinks.0 -
Well that's good. Your right twice in a month is way too much. 7.6 doesn't seem crazy but I'm no expert on that stuff, I think it has to be a lot higher for ketoacidosis. Good thing to monitor just in case.0
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The c-diff can affect blood sugars from the general inflammation that goes along with it. So sorry, btw! This can take a while to over come! Readjusting to LCHF, after the carb overload while inpatient can be over come too! Remember to keep making the right choices, and the cravings will be gone quickly! Don't sweat what the doctor documented about your blood sugars either. Once you follow up with your endocrinologist you can get that straight.
My opinion on the ketoacidosis diagnosis (without examination of your labs....) is that it was a mis diagnosis. I think they saw ketones in your urine and assumed this. It's just a guess, but I believe you would know if you're type 1 diabetic.
Keep Calm and Keto On!0 -
You have my sympathy. I hope that your C. diff infection is gone!0
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Oh wow.
I hope you are on the mend for good this time. What a time you've had...
I too doubt it was ketoacidosis but you should probably double check it. Your result will vary depending on the units used. 7.6 mmol/L is between moderate and large ketones (on the higher end but not near the highest of 16+), but 7.6 mg/dL is between trace and small ketones. Either way, a 7.6 wasn't dangerously high.
Feel better soon!0 -
My daughter is T1D and has Ketoacidosis several times. You would need higher blood sugars due to lack of insulin. If your pancreas still produces any insulin at all, you wouldn't be able to get Ketoacidosis. The presence of insulin would prevent it, even in the case of ketosis or dehydration.
My opinion based on everything I know about both ketosis and acidosis is that unless you actively supplement sodium from day 1 while getting into ketosis, you will get low magnesium and potassium levels, GUARANTEED. This also happens with Ketoacidosis because of the same mechanism of the body switching to ketones to stay alive in the absence of insulin to pull glucose into the cells. In acidosis, however, water isn't dumped because of glycogen being spent, it's dumped because of flushing out the acetate in an effort to balance PH and not become acidotic. A thirst like you've never known before is unrelenting because of the body begging for more fluids so that it can rid the acetate through urine. Meanwhile, blood glucose levels are high because there's no insulin and typically begin to rise even more due to the stress of the illness and our livers just love to dump glucose on us in times of stress. This part likely explains why yours wouldn't come down easily. So, I think just like they said above, dumb doctor simply saw ketones and autopilot come on to play the recording he learned in an outdated textbook 15 years ago.
Now, if your test comes back as T1D or 1.5 with full beta cell death, then acidosis could've been what happened. Or if you're T2D with a pancreas that has completely lost the ability to produce insulin, you could've become acidotic. I suppose if the pancreas produces tiny amounts still, it could still happen, but it would have to be barely sputtering anything out at all. But T2D is a problem where too much insulin is produced. High blood sugar alone won't cause acidosis, it's just a symptom. The problem is lack of insulin. If there were to be enough insulin to provide some glucose metabolism, the body wouldn't kick the ketones into high gear. The body is trying to prevent brain death since it does need at least some glucose. Without any insulin at all, it eats up fat faster than a room full of Keto dieters! Lol
it's actually another awesome thing that is misunderstood. Ketones are what prevent brain death in this scenario. They are literal life savers.
And I am very surprised that you didn't get a definitive answer about acidosis or not since all they have to do know for sure us a simple PH test on your blood. To be honest, I don't think those doctors understood how it works. Neither have most of the emergency room and hospital doctors I've ever encountered with my daughter.
Being sick will cause your liver to dump glucose to boost your energy. And that can make blood sugar control difficult. Especially if you just take metformin or insulin at the same dosage on a schedule every day. Without being taught how to dose and give insulin on a need only basis, you end up feeding the insulin instead of injecting to cover food in a more natural way. That leaves you incapable of correcting when illness strikes.
My daughter was getting lectured by a ER doctor about carb counting and eating right and exercise the last DKA she had. This guy literally called it "sugar diabetes"! She had Ecoli and he thought BG was high because of mismanagement! I was about to kill a doctor that day! I literally had to snap at him that we know what we're doing and just hurry up and send her to ICU so we can be done in ER. He rolled his eyes at me and sent a dietitian to make a room visit the next day. I swear the number of stupid doctors is ridiculous!
We also had a dietitian tell us that low carb, not even at Keto levels, would make my daughter have DKA. Ummmmm, not as long as she keeps taking insulin! Lol yeah, we never went back. Even Keto levels would be fine for her. Actually, she would have the best chances at a long, healthy life if she would go that low. There's a kid about 10-12 years old that Jimmy Moore interviewed that maintains a 4-4.5 A1C as a T1D on Keto diet. According to the dietitian, he shouldn't be alive!
Anyway, I hope your tests come back negative because then you still have a chance of gaining control through diet only. Best of luck to you!0 -
great discussion. SunnyBunny has a clear understanding of DKA
thanks
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Thank you Sunny Bunny for that great explanation. Personally I don't think I was DKA either. I didn't have an excessive thirst and I was being really strict with my carb intake, I had it down to well under 20g a day. I told them over and over and over that I was on a low carb diet to control my BSL's and even the night before my levels were only 9 (which was quite high for me at that stage) and that the high levels of that morning had only occurred that morning. I guess they lump all diabetics in one category when you are ill.
I am getting better, my levels are still in the teens though, I'm having trouble getting them down, but persistance will win eventually.0 -
ScrappyKat wrote: »Thank you Sunny Bunny for that great explanation. Personally I don't think I was DKA either. I didn't have an excessive thirst and I was being really strict with my carb intake, I had it down to well under 20g a day. I told them over and over and over that I was on a low carb diet to control my BSL's and even the night before my levels were only 9 (which was quite high for me at that stage) and that the high levels of that morning had only occurred that morning. I guess they lump all diabetics in one category when you are ill.
I am getting better, my levels are still in the teens though, I'm having trouble getting them down, but persistance will win eventually.
Is it going down by the end of the day some and high again in the morning?0 -
Some Hospitals really don't understand LCHF. I was lightheaded and they didn't know what to do with me. Glad ur home and learning more. Looking back I won't go to a hospital on a Saturday instead of waiting til seeing a Dr on a Monday who understands Ketosis nutrition. But you did the right thing going to hospital because of the other infection. Glad you are learning more. Your on a lifetime journey & this is only a speed bump. It will make you stronger. Sending good LC vibes.0
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Sunny Bunny, yes that is exactly what is happening. I'm changing the timing of my Lantus now to the mornings before breakfast and see if that helps0
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ScrappyKat wrote: »Sunny Bunny, yes that is exactly what is happening. I'm changing the timing of my Lantus now to the mornings before breakfast and see if that helps
If you were taking the Lantus at night before, you might wake up even higher in the morning if you stop taking it at night and switch to the morning. It's also important to be consistent on the time you take Lantus since you only get about 12-18 hours out of it.
Another option would be to eat most of your daily protein as early in the day as possible so that you are metabolizing as little protein as possible overnight. I would try to make dinner as low as possible on carbs and protein, and try not to eat dinner too close to bedtime. You want to give your body time to metabolize as much of that last meal as possible before going to bed.
Lots of hormonal things go on while we sleep and the liver provides glucose during this time also. This happens to everyone regardless of any metabolic issue. But the insulin resistance associated with T2D makes this a problem and you wake up with all that glucose still hanging around. One way you could get your liver to chill out a little is to give it something else to work on overnight so it's too busy to release glucose. While you're processing alcohol, your liver can't make glucose. So try a single glass of dry red wine at bedtime and you will receive less glucose during the night. Don't overdo it or you'll be making a potty run in the middle of the night. If you don't drink, you could try a shot of vinegar instead. I think you can even get vinegar pills.
I hope you get it ironed out. High blood sugars don't make you feel very good.0 -
Well, it seems the universe thinks I need a refresher lesson on DKA... I wonder how many dumb things I'm going to hear from medical staff this time...
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oh NO!! So sorry, Sunny Bunny! Praying she is smiling and on her way home soon!!! And that that you don't assault a Dr.
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Oh no Sunny Bunny, I hope she is feeling better soon.
My GP was threatening to send me back yesterday. I have a UTI on top of everything else now. But my body is fighting it according to the urgent blood tests and everything else she ran yesterday afternoon. If I get a fever I have to go straight to emergency though.
So last night I took a half dose of Lantus at bedtime, and at 4 am checked my bsl's and took the full dose. 6 am is too late, so I'll be setting my alarm for 4 am every morning because this mornings level at 8am was under 10 finally.
So now to get them even lower, otherwise I'll be chucked back in hospital again.0 -
oh NO!! So sorry, Sunny Bunny! Praying she is smiling and on her way home soon!!! And that that you don't assault a Dr.
Thank you! Right now the morphine is her best friend!
A little interesting detail about this visit compared to every previous time she's had DKA. All the past times, her potassium would be dangerously low and it would take 3 days on IV potassium, which burns terribly, to get back into range. Since I've learned so much about electrolytes over the last 8 months, I told her to drink salted water while she was trying to get her blood sugar under control all day today and now, they said its really low but not that bad and she can just take pill supplements this time. She's very happy about that!
So far, I haven't met anyone that I want to murder either, so that's definitely good!0 -
I hope she is continuing to improve! The potassium needs (or lack thereof) are wonderful! Hang in there! Hugs!0
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The IV potassium does hurt horrendously. It felt like someone was trying to rip my arm off, so they had to dilute it for me and drip it in really slowly. I'm glad she can just take the pill supplements this time.
I don't know what is going on at this end, after my reasonable levels this morning, I checked my levels a little while ago (a couple of hours after my breakfast of eggs) and I've hit 15 again. Argh! I'll check again in a little while, I was so sure they would have dropped some more.0 -
Oh @Sunny_Bunny_ I'm sorry! I hope you're out of there soon!0
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Sunny_Bunny_ wrote: »oh NO!! So sorry, Sunny Bunny! Praying she is smiling and on her way home soon!!! And that that you don't assault a Dr.
Thank you! Right now the morphine is her best friend!
A little interesting detail about this visit compared to every previous time she's had DKA. All the past times, her potassium would be dangerously low and it would take 3 days on IV potassium, which burns terribly, to get back into range. Since I've learned so much about electrolytes over the last 8 months, I told her to drink salted water while she was trying to get her blood sugar under control all day today and now, they said its really low but not that bad and she can just take pill supplements this time. She's very happy about that!
So far, I haven't met anyone that I want to murder either, so that's definitely good! I hope she is well again soon... And you avoid the murder rap. 0 -
ScrappyKat wrote: »The IV potassium does hurt horrendously. It felt like someone was trying to rip my arm off, so they had to dilute it for me and drip it in really slowly. I'm glad she can just take the pill supplements this time.
I don't know what is going on at this end, after my reasonable levels this morning, I checked my levels a little while ago (a couple of hours after my breakfast of eggs) and I've hit 15 again. Argh! I'll check again in a little while, I was so sure they would have dropped some more.
Did you end up changing your Lantus to the morning? I was wondering if that might make it higher upon waking.0 -
Yeah, I'm setting an alarm for 4am to take it and get it working. This morning when I got up at 7:30 it was down to 7.7. Now to keep it down there.0
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You might ask your doctor about Tresiba too. My daughter was switched to it from Levemir because her endo said its longer acting and releases differently so that it tends to provide better control. My daughter does seem to think it's better than the Levemir was.0
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I might have to go and try having a bullet proof hot choc for breakfast (I don't drink coffee, can't even stomach the smell of it). Eggs for some reason are pushing up my bsl's unacceptably. I had a 7.7 this morning and after breakfast a 10.3. Before I got sick, my levels would have dropped not gone up on a breakfast of eggs. Argh!0
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I've had a win today. Apart from my bsl reading at 4am, no readings over 8 and my post lunch was a 4.9. Lunch was some salami and happy cow wedges. It wasn't a big lunch but it filled me up. Of course my body is doing the shakey shake thinking it's having a hypo, but it just needs to get used to proper bsl's again. I did put myself back on my tablets again that I was on before ending up in hospital, it's the only way until I get keto adapted.0
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ScrappyKat wrote: »I've had a win today. Apart from my bsl reading at 4am, no readings over 8 and my post lunch was a 4.9. Lunch was some salami and happy cow wedges. It wasn't a big lunch but it filled me up. Of course my body is doing the shakey shake thinking it's having a hypo, but it just needs to get used to proper bsl's again. I did put myself back on my tablets again that I was on before ending up in hospital, it's the only way until I get keto adapted.
You're working so hard! Great job! It will pay off big time for you! So happy to hear about the lower numbers!0 -
I have to admit I did put myself back on the medication that my gp stopped while I was in hospital because she thought it may have caused the ketoacidocis. I could see that it would be the only way to get my levels down to where they need to be. I set my alarm for my 4am insulin, but with a 5.2 saw that it wasn't necessary today. Phew. It was nice to roll over and go back to sleep.0
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Yay! Making strides a little at a time!0
