Alcohol - A & E Visit

[Tina63]

Ok so I guess it was going to happen sometime!

Got a call from my son's friend at 11.40 last night that he was the worse for alcohol and could I go and collect him. Thankfully I had the foresight to take a bucket with me!

I arrived to find him sitting on the edge of the kerb, in a pool of vomit, sweating violently and barely coherant. Goodness knows how, but we managed to get him into the car and belted in, bucket in lap (which was used several times on the less than one mile journey home) and then had the fun of trying to get a 6' 2" drunken hefty lad out of the car and into the house. He slammed into the garage door, he was completely out of it.

He continued to vomit, so once got him slumped on the sofa I went and got his testing kit. First test at midnight 30.2. Tested for ketones, 0.2. You could tell he was out of it, he didn't flinch when I tested him. Didn't really know what to do so after doing my headless chicken bit I got his Novorapid and injected 5u (and wrote it all down - aren't I a good bunny!) I then kept poking him and keeping his head from falling back as he was still vomiting, got a bowl and flannel and sponged him down and tried to get his wet/vomit soaked clothes off him, then after 15 mins tested again - 33.2 - ketones still 0.2. He was becoming more and more difficult to rouse and his eyes kept rolling. I freaked out a bit so went and woke my daughter for her opinion/help. Tested again, meter just said HI. Decided at that to dial 999.

Paramedic was here before my daughter had finished the call. She was brilliant and called an ambulance immediately. The whole lot of them were fantastic. None of them 'off' because it was all drink related, they were wonderful and so professional and lovely.

They couldn't get into a vein, he was very dehydrated, so off we went. Half way to the hospital they decided to stop and try again and luckily got in so set up a drip. His temperature was ridiculously low at 34.9c. They had put the heat on in the ambulance and that was a sauna, and in hospital that rose to 36c fairly quickly thankfully. By the time we arrived at the hospital his blood sugars had come down to 25.4.

The long and the short of it was that he was given 2 litres of fluids by drip, by which time he was much more human again and full of remorse and at 4.30am we were discharged! Had to wait for a lift home though so didn't get back here until 5.30am. So I am absolutely knackered. He is tucked up nicely in bed, I have phoned in work and claimed he has a stomach bug(!!!) He looks like a human pin cushion because they struggled to get a drip in, then when they wanted to take blood tests had trouble again, so he is covered in cotton wool balls and tapes, as well as all the fingertips that have been massacred by them and me in the last 10 hours!

So, not sure exactly what to expect today. They didn't tell us his levels on last check, but it was 14 something half an hour before leaving, so still high, but then 'normal' for him. Today I WILL be on his case whether he likes it or not. He was full of apologies and remorse last night, so lets hope he really has learnt something now.

 

[Northerner]

How dreadful Tina! It sounds to me like you coped admirably - I hope he realises what have done for him and isn't too embarrassed to admit it this morning. I really hope that it makes him sit up and learn/do what he needs to now and begins listening to his mum more ! 🙂

 

[Newtothis]

Sorry to hear this Tina but well done to you and your daughter for your quick actions...

I hope after last night he won't be trying that again in a hurry.... This might just be the kick up the back-side he needs. xx

 

[Tina63]

Thanks both of you. I have just been in to check on him and try and do a BG test, but just got a mouthful of verbal abuse - so at least I know he is conscious! I should imagine he feels the pits this morning, though from my own younger days (reformed character now I must say) I do think vomiting it all out helps you recover more quickly. He said his head is fine but he is absolutely shattered and just doesn't want me fussing. Oh well, tough. I will be fussing rather a lot today I am afraid!

He really did seem sincere in hospital saying it brought back too many bad memories being back there, and that he is going to stick to diet coke from now on. I did say the odd beer is ok (oops forgot he is only 17) as long as it is only one or two and that he eats whilst drinking. Hopefully it has put him off for a while though, and I am also glad his mates have witnessed how bad he was. I left them both chastising them for letting him get in that state, but also thanking them for ringing me, but said it would almost certainly end up an A&E job. His best mate knows what has happened and hopefully it has shaken him up too.

And so to fight another day........

 

[Tina63]

Oh and my dear daughter was a star yet again, bless her. She was able to be so much calmer than me. She made the phone call. I was shaking to much - pathetic or what? Just glad I remembered to take some clean clothes and his trainers in with us or he could have looked a sight coming home!

 

[Twitchy]

Oh dear...what a horrible experience! Hate to admit it, but I had a similar one myself in my teens...just the once was quite enough, so maybe I learnt the lesson - hopefully your son will too. I hope he's man enough to put his hand up in the cold light of day & take on his shoulders the fact that he is in control of his life & what happened last night was down to him, without just cr***ng on you because he's feeling dire... From what you've said I think there's a good chance he owes you & his sister a huge thankyou for saving his life! Best of luck... Xxx

 

[Ellie Jones]

His hangover won't be as bad as it should be, because A&E rehydrated him, but dependant on what alcohol and insulin he's got on board, he's in danger of having a hypo, which can be difficult to treat..

As while the liver is processing the alcohol it's not replenishing the livers glucose stock, the live doesn't multi task, but the glucose store in the liver will continue to dribble into the blood stream, until it's depleted... Once it's all gone, any background insulin in the body when then work like quick acting insulin,..

This is why diabetics when drinking, blood glucose rise to begin with, then plumment later on..

It takes about 1 hour for the average person to process one unit of alcohol...

So keeping an eye on out for hypo's is a must..


He's was lucky getting out of A&E so quick, my friends son's drinking venture landed him in hospital for 3 days with DKA... He was a little bit older at 18 but had slipped on his injections for a while... But it did give him a bit of a wake up call, and he took notice. He's now almost 26 and hasn't repeated it.

Hopefully it might with as well with your son..

He does need to know, the effects of alcohol on the liver, and impress on him, hang over or no hangover the next day he's going to have to keep an eye out for hypo's..

 

[Caroline]

Hopefully not too much damage has been done and that a lesson has been learned.

I give you top marks and then some for being such a wonderfull mum!

 

[Pumper_Sue]

Glad you are feeling better Tina, ((((((((hugs))))))))))
No offence meant but do so hope your son feels the worse for wear for the rest of the day, little toad.
As to son moaning he doesn't want to be fussed, just point out he is making the fuss not you and if he wants to act like a baby then he must be expected to be treated as one.
Hope you can have a restful day day now.

 

[robofski]

He's lucky to have a Mum that cares so much for him! Hope he's learnt a lesson.

 

[Steff]

Tina,
Very sorry to hear about your sons and the rest of the familys visit to A and E not pleasent at all, as others have said I hope he feels the effect but not to much and learns from this.

Hope the rest of his day goes well.

 

[HOBIE]

Get your son to read replies ! Ellies is a good one. Growing up T1 is sometimes harder than a normal person. Well done for looking after him TINA ! 🙂

 

[Tina63]

Thank you everyone for your messages of support. I truly believe if I showed him this he would never forgive me for writing about him. I have filtered through things that have been said though in an innocent kind of way

Amazingly, looking at him now you would never believe how things looked only 12 hours ago. He is awake, full of the joys of spring, eating, music booming out, enjoying a day off work!

His sister and I have talked a lot to him about it though. He has at times told us enough is enough, but then she remembers something else to add and the conversation starts again, until he has had enough again, but we keep chipping away. We are keeping it lighthearted but slipping in the odd serious message. He does understand the seriuosness of what happens and is remorseful. He still stands by his 'I will stick to diet coke from now on', but of course that's easily said whilst he is away from temptation. Still, I am confident it has certainly made an impression on him.

I always assess things after an event though, and I do wonder if I over-reacted calling for help. What would anyone else have done in this situation? Should I have given him more Novorapid? I was so unsure even giving him 5u as I knew the danger of hypos after alcohol are there, but wasn't sure of the timescale. We have never properly been taught correction doses despite me metioning it several times, but I knew once we were told 1u to 4mmol over 8, so in my panic I was doing 4 x 5 = 20 so thought 5u was a good starting point to at least in theory bring him down to around 10. I know Novorapid is fast acting, but didn't know how long after the event the alcohol itself would bring him crashing down, so I was scared to give any more. I didn't also know if I should give some, then maybe half an hour give more, but I thought that's probably not safe. It's these sort of things we have never been told about. We were given a sheet about alcohol some time ago and told basically to avoid spirits and for every pint of beer/glass of wine have something like a bag of crisps to eat and something starchy before going to bed. But nowhere in our information is there anything about what to do in this very situation. That would have been helpful last night.

There was no way I could get him to drink anything, he was just too far gone. It's when his eyes started to roll I felt we were in big trouble. I am mindful of people abusing the NHS though, and have never called an ambulance ever before (not that I did this time, dear daughter did) but still feel guilty we may have wasted valuable resources. Let's just hope this is the one and only time.

Thanks everyone again.
Tina

PS. I'm absolutely knackered now. Had a doze during the grand prix, feel utter poo now, but got things to do, including food shopping, ironing and I guess dinner to cook! Ho hum!

 

[Newtothis]

Stop beating yourself up - you did the right thing calling an ambulance. Its better to be safe then sorry.... xx

 

[Pumper_Sue]

Hi Tina,
you did exactly the right thing by calling 999. That vomiting with those high numbers was DKA so he was a lucky boy he had his Mum to call on.
Have you any idea how much he actually drank?
Does son know this will go to his GP as well as his hospital records? The sh!t will hit the fan then.

I remember from your post regarding his climic apt your son was pleased to be treated as an adult when he went to clinic last time, perhaps remind him of this by writing out a bill for the washing and nursing services you provided and the taxi home.
Also tell him the cost to the tax payer that his A&E visit cost.
Perhaps also tell him quietly you wont in future be making excuses to his employer if it it ever happens again.

 

[Twitchy]

Don't beat yourself up Tina - frankly I think he's very lucky to be still on his legs today, let along out of hospital. Vomiting, being drunk & roaring high BGs are a nightmare combo. 999 was the only thing to do. (((((hug))))).

I can't help feeling it's a shame you or your daughter didn't video the events of last night on your mobile etc - I suspect on a nice sunny day like today it will be easy for him to dismiss it as a but of an adventure & a day off work, but maybe seeing with his own eyes how bad things were might be harder to shrug off...horrible to have to do that kinc of thing to get through I know. Not easy for you, bless you. Xx

 

[jalapino]

Oh dear....he has been a norty boy!! lucky for him he has a very good and caring mum like everyone says hope he will learn by this...it could have turned nasty. x

 

[Ellie Jones]

You kidding, you did everything correctly..

You didn't know, how much or what he had to drink, there's noway of really knowing how much of the vomiting was alcohol induced or was due to DKA it's impossible to say..

The only thing for certain, is that he lost his safety net of being able to 'liver dump' and with alcohol on board this compromises the correction procedure, as if you over shoot then a 'Glucogen' Jab is utterly useless... And if he's hasn't sobered up enough to oral consume fast acting carbs to counter react the hypo, the only other alternative is Glucose straight into the Vein....

Hopefully he's learnt his lesson, and so has his mates where drink is concerned perhaps it might put them off drinking a little... But should make them more understanding towards your son's reasons for keeping a clamp on not joining in with major drinking sessions..

 

[everydayupsanddowns]

I always assess things after an event though, and I do wonder if I over-reacted calling for help. What would anyone else have done in this situation? Should I have given him more Novorapid? I was so unsure even giving him 5u as I knew the danger of hypos after alcohol are there, but wasn't sure of the timescale. We have never properly been taught correction doses despite me metioning it several times, but I knew once we were told 1u to 4mmol over 8, so in my panic I was doing 4 x 5 = 20 so thought 5u was a good starting point to at least in theory bring him down to around 10. I know Novorapid is fast acting, but didn't know how long after the event the alcohol itself would bring him crashing down, so I was scared to give any more. I didn't also know if I should give some, then maybe half an hour give more, but I thought that's probably not safe. It's these sort of things we have never been told about. We were given a sheet about alcohol some time ago and told basically to avoid spirits and for every pint of beer/glass of wine have something like a bag of crisps to eat and something starchy before going to bed. But nowhere in our information is there anything about what to do in this very situation. That would have been helpful last night.

Tina I think you coped very well in difficult circumstances. Your lad is *very* lucky to have a caring, competent and pro-active Mum like you to get him sorted out.

I would suggest that the 5u you gave was sensibly judged. You'd want to be cautious. But Novorapid rarely seems to kick in earlier than 1 hour after injecting when I'm correcting for me, so you probalby had time to watch and wait. My understanding is that the BG-lowering reputation of alcohol is not so much the alcohol itself, more the effect it has on the liver and digestive system. Reducing the liver's output of glucose (both generally and for emergency 'dumps') and impairing the body's ability to metabolise eaten carbs a little too. In a non-diabetic, the body would respond by reducing insulin production, but the problem for diabetics can be that 'normal' doses already injected to keep them at 4-7mmol/L end up being rather too much. Additionally the diabetic is a little less able to pick up on early earning signs after a few drinks, and nasty hypo and drunkeness can look similar (especially with alcohol on the breath).

To be blunt, from what you have said, your son is rarely (if ever) on 'normal' doses at the moment. If he skipped any doses during the day it would seem a bit less likely to me that his liver getting distracted by the drink would have had enough effect to cause a hypo. Though I'm willing to be persuaded otherwise if anyone knows different. The fact that his levels were so high, despite vomiting out any food he'd been eating seems to reinforce this.

As to the guidelines about a bag of crisps per pint *and* something starchy before bed... this again seems questionable to say the least, and even more so in your son's situation. A pint of beer might have 15-25g rapidly absorbable carbs in. A bag of crisps another 15-20g. If he has 3-4 pints, plus maybe another 25g before bed you might be talking 180-200g in carbs with no insulin. That's the daily recommended intake for an adult woman!

If your son wants to go out drinking again in the future, tell him he has to take and use his meter, to make sure he stays below Xmmol/L and above Ymmol/L. That'd be interesting 😉

 

[fencesitter]

Just catching up, what a horrible time you've all had. I think you did exactly the right thing dialling 999, as he could well have been in DKA, would def have done the same thing. I would say pour yourself a stiff gin but that might not be quite the thing right now. Sending hugs your way and a nice cup of tea perhaps?