Thursday, June 3, 2010
Gabe is too sweet
Literally. So Gabe has always been a little sweaty after feeds. We often thought this was due to gass, discomfort from reflux, overfeeding, etc. Feedings have gone much better every since we started overnight feeds. He's been eating much better by mouth. The problem comes about 10 minutes after his tube feed is complete. He starts sweating to the point that his hair gets wet. The GI RN suggested slowing his rate down from a 30 minute feed to a 35 minute feed, but he was still sweating. I was talking to a respite nurse about this and she said it sounded like dumping syndrome. Typically, food gets broken down in your stomach and slowly empties into your intestine where nutrients are absorbed. With dumping syndrome, it empties quickly from your stomach to your intestine, so you have a ton of nutrients to absorb all at once. This causes blood sugars to go a little higher. This makes your body release a ton of insulin all at once, then causing low blood sugars. This up and down often causes sweating. So, being the diabetes RN that I am, I just happen to check Gabe's blood sugar on my expired home meter during one of these sweaty spells and it was over 200. I checked myself and I was 80. I called the pediatrician and she wrote a script for a new meter and test strips to see if I noticed any trends. Gabe's blood sugar is normal before feeds, then after a feed when he sweats it goes into the 200's, then an hour later it's in the 50's - 70's. So, I called the Endo MD I work with to get some advice. 200 is definitely not a normal blood sugar and I was afraid of diabetes. Kids with Down Syndrome have a much higher incidence of developing Type 1 diabetes than the average population. I din't want to take him to the ED since he looked great other than having sweaty hair. She gave me some instruction and I was able to get him a clinic visit today. They think it may be dumping syndrome and want to go down that route first. Endo is going to talk to GI and they are suppose to let me know a new feeding schedule to try. He may require smaller, more frequent meals. We'll see what they suggest. They also may do a gastric emptying scan to officially diagnose this. If it turns out that it is not dumping syndrome, then we will go down the diabetes route. We will have to do some testing to examine Gabe's insulin producation. In the mean time, we're taking it day by day. I've been checking Gabe's blood sugar about 8 times a day to detect these trends. It may be awful to say, but I really hope this is dumping syndrome...diabetes would be really really awful. It's one of my biggest fears since it would mean the chance of Gabe being able to live independently one day would be in question.
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Oh, Michelle. What a yucky place to be! I'm sorry to hear of Gabe's discomfort and both of the possible reasons. I pray for quick answers for you!
ReplyDeleteMan our boys sound so much alike. I'm so interested to see what it may be. That might be the same thing we are battling!
ReplyDeleteOh I don't know about the sweating part to much, but I have heard of dumping syndrome just recently however it was explained differently. I am going to try to look it up. Anyways hoping for the best.!!
ReplyDeleteThank goodness for your initiative Michelle. You are such a good mommy. Keep us posted.
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