Caring for a Son with Juvenile Diabetes

My friend Bruce Sr has a son named Bruce Jr. When Bruce Jr was 7 years old he was always asking for water to quench his unquenchable thirst and he was urinating frequently. His pancreas had begun to shut down, unbeknownst to his parents, and within a couple of months it became obvious to them that something was amiss.

At first, since he was one of three children, Bruce Sr and his wife (name withheld) thought Bruce Jr was seeking attention. Then his symptoms concerned them more as he started sleeping excessively and having major highs and lows with his moods. They decided to take him to the doctor.

Bruce Sr talked to the doctor on the phone before the appointment. After hearing the symptoms the doctor stressed the importance of getting Bruce Jr in to see him immediately. The doctor then sent Bruce Jr to the hospital for treatment. Sadly, Bruce and his wife now had a brittle diabetic son to care for.

While in the hospital they tested Bruce Jr's blood-sugar level and it was well over 300. A normal level is lower than 100. 300 is categorized as critical. Results of a critical reading like this could have resulted in a heart attack or coma for their 7 year old son. He had been diabetic for nearly two months and untreated.

Bruce Jr was diagnosed with Type 1, juvenile brittle diabetes. The definition of this kind of diabetes is a type of diabetes when a person's blood glucose level often swings quickly from high to low and from low to high. This is also called "unstable diabetes".

Now that they knew what was wrong with Bruce Jr they would need to learn about his treatment and his care. There would be many obstacles to overcome with this illness such as mood swings, character changes, and a proper diet. Feeding a diabetic is much different than feeding a normal child. Someone who is not diabetic is not always familiar with the sugar content of unsuspecting foods such as potatoes, corn, bread, snacks and sodas. Dispensing a strict diet to a diabetic child was difficult. The right portions had to be given, which can be hard when you are feeding an active, growing child.

These things would all have to be monitored 24/7. They would need to be able to recognize by looking at him if he was going into a distress situation by his behavior and by what the state of his palms were (sweaty or dry).

Bruce Sr first learned how to give insulin shots by practicing on himself in front of his son so that Bruce Jr could see what to expect. Bruce Sr learned how to do home blood tests, how to read the strips, and how to administer the proper dosage of insulin by needle. Humulin, which is taken from animals, was a 24-hour time-released insulin and needed to be mixed with regular insulin. If the blood-sugar level was high regular insulin would regulate his sugar level to bring it down. You can not bring it down fast or it may send the patient into insulin shock. When the insulin level got below 80 Bruce Sr would give his son Coke or orange juice. He would then need to do another blood test to find out where the level was rising to. This leveling could go on for hours. At times, when achieving an adequate level was impossible at home, Bruce Jr would have to be rushed to the hospital for aide. He oftentimes would stay over night so they could keep him alive.

There is something tricky about insulin shots. When administered under the skin, the insulin forms into pockets and is not totally absorbed into the system because it's foreign and the body fights it. This results in constant highs and lows due to its sporadic release.

A critical insulin reaction would result in a diabetic coma. A diabetic coma is due to not enough sugar. Treatment for a diabetic coma included having glucose in the refrigerator at all times. Refrigeration is a must for both types of insulin. The insulin has to be shaken so it's mixed well. Their survival bag in their refrigerator at home included syringes, testing strips, regular insulin, humulin, and glucose. In the event of a diabetic coma occurring, they would have anywhere from 15 minutes to one hour to bring him out of it or he would have died. When at home, if Bruce Jr went into this coma, Bruce Sr would have to force his mouth open, put glucose on his tongue, and make him swallow it. Continuous blood testing needed to be done at this time. Since they lived 55 miles from the hospital, home care was crucial many times.

Bruce Sr was always attuned to his son during the night. If his son made a noise it was important to get up and check on him. They soon could tell by the sounds he made in his sleep if he was having a problem.

Let's go with Bruce Jr to school. A typical day for Bruce Jr in his second grade class was much different than his classmates' day. So many times people are not informed and given the right knowledge concerning arising medical situations. This was true for Bruce Jr and his brittle diabetes. The school was ignorant to his condition. Because of this they were afraid of law suits. Bruce Jr had to carry a bag with his blood-testing equipment. He also had to carry insulin and needles to give himself shots. Kids and adults at school were uncomfortable with him giving himself blood tests and insulin shots. Teachers would disapprove of him needing to eat candy at times, arguing that if he did it the other kids would want candy too. They got aggravated because of Bruce Jr's need for water intake and many trips to the restroom during the day.

While he was at school he would at times go into epileptic-like seizures. This happened because he was learning how to regulate his own body. This was a tough job for a 7 year old! The teachers were worried that he would die in class. The other children would call him names like "spaz". (Gotta dislike mean kids) The teachers failed to take the time to explain to the other children that Bruce Jr had a serious medical condition that had to have special treatment all the time.

Bruce Sr and his wife made many trips to school to help with Bruce Jr. Bruce Sr and his wife decided to educate the school on their son's condition. They called in an expert. A dietician went in to speak to the school administration about Bruce Jr's diet needs. She also explained what diabetes was and how it had to be treated. After this attempt, the school failed to respond in an understanding way. They still acted scared of the diabetic boy and the problems he brought to school with him.

When Bruce Jr was about 11 years old his math teacher got frustrated and angry and threw a chair at him. Bruce Jr had been unable to concentrate and had become whiny and difficult due to an insulin reaction. This teacher had dealt with Bruce Jr from age 7 but had always had a problem with the child. Especially after this man threw a chair at a child with an illness, one had to wonder which one of them was the child and which one had the worst illness!

With the loving care of his parents, Bruce Jr made it through his childhood years and became a young man. While Bruce Sr, Bruce Jr, and three of their friends were on an elk hunting trip in the mountains of Montana there was trouble one early morning at about 2:00 a.m. Bruce Jr, who was 18 years old, rolled out of bed onto the floor of the camp trailer they were all sleeping in. Always aware of his son's condition, Bruce Sr called out to him and asked what was wrong. Bruce Jr answered that it felt as if his kidneys were on fire. Bruce Sr immediately jumped up and sounded a vocal alarm for their friends to get a vehicle ready to make an emergency run to the nearest hospital in Harlowton, MT which was an hour and a half away from their camp. One of their friends put Bruce Jr in the front of the pickup truck while another friend went to a local town down the mountain to make a call in to the hospital to let them know that they were on the way with a young man who was going into a diabetic coma.

After reducing an hour and a half long drive to a mere 45 minutes on a deer-infested winding road, Bruce Sr got his son to the awaiting emergency staff at the hospital. There was an intern doctor on call that had never dealt personally with a brittle diabetic. The doctor, who was flying by the seat of his pants, ordered immediate saline solution be given to Bruce Jr. Four full bottles of saline, that had been stored in refrigeration, were poured into Bruce Jr's body through a vein in his foot. He had been conscious at the time and was screaming out in pain. The cold saline brought his temperature down so rapidly that he started shaking as if he were going into hypothermia and he went into cardiac arrest. Fortunately an RN who was better prepared and had more experience immediately took over. She called for every staff member to come to the emergency room immediately. She kicked the doctor out of the room and used paddles to bring Bruce Jr back and stabilize him. To bring his body temperature back up they began to warm the saline that was going into his body. Then they began testing his blood-sugar.

The RN went to Bruce Sr and told him that Bruce Jr should go to the bigger hospital in Billings, MT. Before he left the small hospital in Harlowton his heart failed a second time. After they re-stabilized him again they were able to transport him by helicopter to Billings. When he reached the bigger hospital his heart failed for the third time. During this time his organs were shutting down and needed to be revived. Why had all of this all happened? Bruce had been so excited about the hunting trip that he had forgotten to give himself a nighttime shot of insulin. This is how quickly life can switch to death for a brittle diabetic.

Since he will always live with this serious form of diabetes he may face loss of limbs. Currently he is losing his sight in both eyes. All of his toenails have had to be pulled. If he were to get an infected toenail it could lead to the loss of his entire foot. There are not adequate antibodies to fight infection because of the insulin fight. Stress is one of the diabetics enemies. They are more susceptible to heart trouble.

He went to stress management and handles a high-stress job well. He married a very nice lady. They will not have their own children because they fear that they will bring a person into the world with this horrible illness.