Monday, January 31, 2011

HiHo, HiHo, It's Off To The Endo We Go!

Today was the BIG day for Kayleigh. I haven't updated much on what's been going on with her. She's still been having some weird blood sugar readings. She's been sure to eat every couple hours in fear she's going to pass out or go low. Today we finally got to see the female Endo in our practice. Kayleigh threw a fit because she didn't want a male doctor. Dr. S-S wasn't taking any new patients but due to Kayleigh's age and her request for a female doctor, they made an exception and let us see her. We've always seen Dr. R so I wasn't sure what to expect. Can I say...WOWWWWWW! I was so impressed with how in depth she went with Kayleigh's exam and past history. She had gotten Kay's records from the QUACK Doc we saw in December so she was able to review them prior to seeing us.

So now...I'm sure you're asking if we have a diagnosis yet? Nope! Not yet! She said an A1c isn't a simple answer to what is going on. Unfortunately it's a little more in depth that just that. First of all, Kayleigh is scheduled for the 5 hour glucose test...yes FIVE hours, not the 3 hour one. She said she wanted to see what Kayleigh's blood sugar did once it stabled out because sometimes a pancreas can spit some more insulin after it spitted out the first time to cover what she ate or drank. So we have to go down to CHKD for all of that. While they're doing that, they will do an A1c and an antibodies test. Dr. S-S actually went and pulled Kacey's chart to see if they ever did an antibody test on her. I didn't know if they had or not? THEY HAD! Kacey tested positive for those antibodies. So what does that mean? Dr. S-S tried explaining it to me and I felt like I was sitting in a foreign language class. I shook my head like I understood but then I came home and looked it up some more because I wasn't totally sure what that meant?

What Do The Test Results Mean?

A positive result for the pancreas antibody blood test for type 1 diabetes means that there is confirmation that a child or adult has circulating islet cell antibodies such as the ICA, IA2, GAD25, and IAA antibodies. Yet these antibodies are not used solely to confirm type 1 diabetes. They are used along with HB1Ac levels (level of red blood cells that have had glucose added to their cell membranes because of a high level of glucose in the blood). The pancreas antibody blood test for type 1 diabetes is also used in combination with urine and blood glucose levels, and in a small number of cases, by measuring the amount of actual antibodies to insulin.
So now, if we do this test and we rule it out...then theres the next step....Migraines. She went on to explain that migraines and headaches affect the body more than we know. It can give us some of the same symptoms that Kayleigh was experiencing. But we will cross that bridge when we get to it. Dr. S-S seems to think that Kayleigh is having reactive hypoglycemia.

What is Reactive Hypogylcemia?
Reactive hypoglycemia is a type of hypoglycemia that affects people who do not have diabetes. Although the cause of the hypoglycemia is different, the symptoms and treatment are the same. In reactive hypoglycemia, blood glucose levels fall below the norm of 70 mg/dl, just like in diabetic hypoglycemia. Eating a fast sugar source, such as orange juice, regular soda, 5-6 hard candies, or sugar cubes brings relief and raises blood sugar back up to normal.

What is the cause of reactive hypoglycemia?

The exact cause of reactive hypoglycemia is still unknown, but there are several hypothesis that might explain why it can happen.
Sensitivity to epinephrine, a hormone that is released in the body during times of stress.
Insufficient glucagon production. Glucagon is also a hormone which has the opposite effect of insulin. It raises blood glucose levels.
Gastric surgeries can also cause reactive hypoglycemia because food may pass too quickly through the digestive system.
Enzyme deficiencies can also cause reactive hypoglycemia, but these are rare and occur during infancy.

How to manage reactive hypoglycemia?

Limit foods with a high sugar content, especially on an empty stomach. For example, eating a doughnut first thing in the morning can trigger a hypoglycemic episode.
Eat small, frequent meals and snacks.
Eat a varied, high fiber diet, with adequate servings of protein, whole grain carbs and vegetables, fruits, and dairy foods
Carry pieces of hard candy with you, for those times when you feel your blood sugar dropping.
Although she's being tested for hypoglycemia, this still doesn't explain some of the higher meter readings. So we'll see what happens when they run the other tests.

I was so impressed with Dr. S-S that I wanted to see about getting Kacey switched over and unfortunately right now we can't because she is seeing over half of the patients between 4 doctors. She's overloaded right now but maybe once Kacey gets a little bit older then we can switch her too! I will keep you all updated as I get results from the tests.

I also want to send a HUGE Thank you to Bayer A1c Now customer service. This morning, I did the 2nd A1c test on Kayleigh and we got an error code that told us to call customer service. The nice lady on the other line explained that something went wrong when the blood mixed with the solution. She said that she would be sending us a coupon for another FREE kit! Wowwww! She has NO idea how much that means to a Mom like me. I thanked her over and over again. So I can't tell you what Kayleigh's A1c is with the kit from this morning but I'm glad because I wanted it to be a comparison to what she'd be tested with at the doctor's office so we could see how accuate it is. I will test her the morning we go for all of the other testing.
I'd also like to send another HUGE Thank you to Alexis for sending us some blood ketone strips for Kacey. Our insurance doesn't cover them so it's nice to know that we have a little back-up so Kacey doesn't have to pee on that stick! When we got the strips, we went to Walmart and the meter was $15.97 and when I opened the box, there was a rebate form for up to $40 OFF. This means the meter was FREE!!! ***does a happy Mommy dance*** All of you D-Moms know how much we like getting something for FREE when we have to pay out the you-know-what for everything else. Thank you Precision Extra for the nice little discount. 

As for Kacey's rash...well its almost gone. She only has it on her hands and feet but she still goes through phases of it being itchy. She is still on her antibiotic and antihistimine. She'll go back to school tomorrow but she's NOT ready! I can't tell you how many times over the last week she asked me to home school her. It breaks my heart because I know she loves school but sometimes diabetes just kicks her butt. She's not looking forward to walking back in to all the missed learning after a week at home. I'm hoping things go smooth for her!

So please keep the girls in your prayers for different reasons.
Lotsa Love,


Shannon@ The New Normal Life said...

Oh I am so glad you liked dr ss we love her and are so thankful she was assigned to us. Im glad you are getting some answers. Sounds like it was a good day. Let me when you are coming to kd and I'll bring star bucks if I can
Big hugs

NikDuck said...

Wow, that is a lot of information for you to have to process! Hope your week goes well for both of your girls. Everyone I talk to loves Dr. S-S. We see Dr. T (newest in the practice) and I really like him, but I have no one to compare him to.

Unknown said...

So awesome that you're on the road to getting some answers :)

I love it when my D Mamas are feeling good!!!!!

Alexis totally rocks, btw. LOVE HER!

Unknown said...

So glad that you are getting some answers. How are you feeling about it all?

And Lexi ROCKS!

Misty said...

Wow. I will be thinking of you and both of your girls this week.

Alexis Nicole said...

Sorry I have a looong comment lol.

Ok first. Thinking of you and the girls! Hope answers are given and that rashes goes away nooow!! Sounds like this endo was on her job and thats awesome!

I actually suffer from minor hypoglycemia if I go under 100 I get shaky and jittery and must eat fast acting sugar. No clue why, been this way since I was a kid. I found out on my own my threshold by checking my bg. My a1c and fasting are normal though.. Praying that Kaleighs is a simple fix and thats it. Not sure if that helped to hear or not. Sorry.

Ohh and you are sooooooo welcome!! Brought tears to my eyes to be able to help you. Whenever you just let me know!

Wendy and Reyna Im blushing. Love u ladies too!
Love ya!!

Dr. Ordon plastic surgeon said...

It is a restrictive life without sweets and many other fun foods that made your day earlier.I know life is hard but these recipes can bring back some charm in it.And start serving these to the other family members also...I always do because it saved them from the hazards of diabetes.

Anonymous said...

So glad you have found a competent endo who will help get a proper dx. Although I would rather have reactive hypoglycemia than D, it still sounds pretty darn bad and scarey. So I will pray that this is just temporary BS craziness due to illness or some other unknown factor, all is well and that your daughter has neither.