The Stomach Flu Away-from-Home — Prepare Your College T1D
I opened my eyes and fumbled in the dimly lit room for my phone. The time read 6:48 a.m. Time to get my groggy-self out of bed.
The texts from my son had come at 1:58 a.m. “Just threw up.” “I have a stomach virus.” Instantly, I was awake and on hyper D-mom overdrive. Attempts to reach my college freshman son went unanswered for an agonizingly long and frightful 25 minutes.
By a string of bad luck, he had no roommate and was assigned to the only dorm on campus where Verizon users had no cell service. I shot a text to the RA, who had already proven to be of little help in matters relating to T1D, so I didn’t hold out much hope of him awakening Austin.
My phone lit up at 7:15. It was Austin. He was sitting outside his dorm, waiting for the ambulance. His first call after stepping outside was to 911. That I was relieved to hear his voice is a vast understatement. Our minds can go to some pretty dark places when our kids’ lives are on the line, can’t they?
He told me that he had thrown up for 5 hours and that he had large ketones. I praised him for having checked for ketones and for being wise enough to call for help, and then told him I would see him in 3 hours at the ER. Knowing he was now safe and in capable hands, I was able to calmly make the journey out to his local hospital to be with him.
No one wants their child to get the stomach flu, and especially not their college-age T1D child! Word of what happened to Austin quickly spread in my T1D community; I had missed a JDRF Executive Board meeting to be with my son. So many questions. Everyone desperate to know the same thing: how can we keep our kids safe?
And so, what follows are my thoughts on college preparedness when it comes to diabetes and the stomach flu.
Prepare for the Stomach Flu Away-from-Home:
1 – Develop some pat phrases that you use over and over again, before they head off to college.
The one I used most frequently: “You throw up; you go to the hospital!” Even though I wasn’t really sure he was listening, it’s clear he was! My second most frequently used pat phrase had to be, “Always check for ketones when you’re sick.” (See next paragraph!)
2 – Always check for ketones when you’re sick.
So often we only think about checking for ketones when there’s an unusually high blood sugar, but people with T1D can get ketones even with a low or normal blood sugar. (See my story: “What Saved my Son’s Life” for another real-life example.) It was crucial that Austin knew to check for ketones. Ultimately it was his large ketones that drove him to call 911, not just the vomiting.
3 – Have a Medical Power of Attorney on file at your child’s college and also at the local hospital.
(In my son’s case, the college sent it electronically to the hospital the day I gave it to them.) We are so familiar with diabetes management and the excellent care that our endocrinologists give us, that we forget that the team in an ER is not as up to date in T1D as we are! For example, my son’s blood sugar was a comfortable 170 upon admittance, and the ER team was happy to keep it there. Because I had a Medical POA for my son, I was able to guide them to actually increase his blood sugar by hanging a bag of Dextrose in addition to the fluids so that he could then give himself some insulin to flush out the ketones. (He also put on a basal decrease to help elevate his blood glucose.) Less than 2 hours later, his blood sugar had drifted upward enough to give himself a good dose of insulin, which helped bring down his ketones. The ER team was very happy to have my guidance and to learn about what our diabetes educators had taught us.
4 – Keep that scary red glucagon box in plain sight!
Austin keeps his on his desk shelf, right next to his bed where anyone could easily grab it. When you’re sick it’s no time to begin the hunt for the little red box!
Editor’s Note: Nasal Glucagon BAQSIMI was approved by the FDA and is now available in the United States, as of August 2019.
5 – Include more than one bottle or can of Coke/Gatorade and Diet Coke to sip.
Sugar versus sugar-free depends on blood sugar levels, but both can be used to stay hydrated after vomiting. My son finished the 2 tiny cans I had provided in his emergency supplies and then had to switch to water. Needless to say, none of that H2O stayed down!
6 – Enlist peer help.
Have a willing friend or two as your child’s designated D-buddies. Be sure to have their phone numbers and a commitment from them that they would be bold enough to pound on your child’s door and walk right in to check on him/her. RAs are employees of the school, so they will undoubtedly refer you to Campus Safety if you are concerned about your child’s health.
This time, our story ended well. I thank God that my dehydrated son was even able to pee on a ketone strip. I’m thankful that he knew to do so and didn’t just drift off to sleep with large ketones. I’m thankful for his boldness to go outside in the cold and call 911. I’m thankful we had a Medical POA and that the hospital was so willing to listen to what I knew about flushing out ketones.
The day that began so stressfully ended rather peacefully. My older sister, who lives 15 minutes from the college and has lived well with T1D for over 45 years, met us at the hospital, and welcomed us into her home that night. She and my brother-in-law nourished us with homemade chicken noodle soup, and cocooned us in the warmth of their home and the warmth of their love, and we knew that everything would be okay.