Last week, Alex was running high all week long. In truth, she’s been a lot higher over the past month or so, leading me to believe that the honeymoon is about over. Anyway, she was even higher still last week, and woke up a couple of mornings pointing to her neck and telling me it hurts. She’s been sniffling and snorting and coughing, too. So, I’m figuring she’s got a cold coming and it’s affecting her blood sugar.
On Thursday morning, the school calls me that Alex’s sugar at snack time, 9:15, is high, and it is (13.4 or 241 in American numbers; she’s supposed to be between 4 and 8 or 70 and 140 American) but I gave her her insulin at 6:00 am, so she’ll probably start to come down right around then. I tell them not to worry. Twenty minutes after that, another call from the school; Alex doesn’t feel good and wants to be picked up. Okay, off I go to get her.
When we get home at 10:30, I run her number again, and she’s 13.8 (248), a bit higher than earlier, so I know now I’ll have to keep a watch on her. She’s high all day and even the insulin correction isn’t helping bring her numbers within range.
Thursday afternoon I email Alex’s doctor and ask her review Alex’s numbers and tell me what to do. I’m really clueless, because this is Alex’s first sickness since diagnosis. The response comes back that I’m to give her lots of liquids and soluble insulin – easy enough, it’s what I’ve been doing – and to check her for ketones using something called Multistix or any ketone strips if they’re not available. That, as it turns out, is easier said than done.
Now, here’s where I get a little bit peeved. At Alex’s last doctor’s appointment in September, I specifically asked the doctor if we needed ketone strips. I’d been reading on the forums how it’s an indication that the insulin is insufficient. The doctor’s response then was a simple no. I was told that as long as I give her soluble insulin every 6 hours, she should be fine.
So, why now do I have to go scurrying around to buy these things? Urgghh!! At 9:30 our taxi driver, Ekow, comes to get us to drive us to the local hospital, cause I’m thinking that’s probably where I’ll find these.
First stop, the out-patient pharmacy. They’re not sure what I’m talking about but suggest I go to the in-patient pharmacy. Okay, where the hell is that? Public hospitals in Ghana are unlike anything in the U.S., and this one is no exception – large and sprawling and with no signage whatsoever. Fortunately, an information desk is out front and a very nice lady offers to take us where we need to go. Good thing, because I forgot my bag of bread crumbs. Five minutes later, she directs us inside the Men’s Surgical Ward. I would never have even considered looking in there!
The clerks at the in-patient pharmacy also don’t know what I’m talking about. So, they call a doctor over. A white lady in a smock comes in and they point us out to her. From her accent, I’m guessing she’s from Russia or the Ukraine, or one of those countries that end in “stan.” She wants to know what I want, and when I explain, wants to know why I want them. Really, what difference does it make why I want them, I just want them! But I go ahead and explain that Alex here has Type 1 Diabetes and she’s been having high numbers, etc., etc. She looks at Alex and says to me, “How can it be? Someone so young with diabetes?” I’m thinking, is she clueless or what? But, I give her the benefit of the doubt; maybe she doesn’t know that Type 1 is the new name for Juvenile diabetes. (Scary thought, either way, for a doctor to make that comment, in my opinion.)
She walks us to the lab where she thinks we might be able to find them. The lab doesn’t have any, but they offer to run a urine test for Alex right then and there. You don’t have any, but you can do a urine test? Makes no sense to me. In any event, I don’t think so. The place is filthy and there are about 100 people in the waiting room. Not only that, but I’d have to check Alex’s urine every 4 hours and I’m not coming back here to do it.
Off to our waiting chariot and we have our driver take us to a big pharmacy in town. By big, I mean it’s bigger than breadbox, but not much bigger. CVS has nothing to worry about.
We get there and wait our turn at the pharmacist window, but we’re told that they don’t have ketone strips. At least he knew what they are. I’m encouraged. "Have them now, or ever?" I ask. The pharmacist’s response is, "Well, we only have a couple." "Oh, so you do have some." "No, we don't have any more." I'm ready to slap the guy. "Do you have any suggestions where I can find these things?" I ask. He sends us to another neighborhood. Only good thing about going here is I found that they carry some of her insulin, so I pick up a bottle of Humulin R, which costs about $8 more than my regular pharmacy who was out. Oh, that and a box of Tic Tacs for Alex – that girl can’t resist.
We try five more pharmacies. No luck.
Thinking well, now I'll take her to the local (well-run, clean) laboratory and at least have them check her for ketones. Good news! They can do it. Bad news! They send the urine to the lab in Accra and the results won't be available until Monday. Fat lot of good that would do us.
So, home we go. Ketone strip-less. I’ll just have to do my best with what I have. I give Alex insulin corrections that are doing very little to bring her numbers down; she doesn’t have a “normal” number until Saturday around dinner time.
In the meantime, I’ll continue to be on the lookout for ketone strips for a future emergency; I’m sure I’ll find them when I don’t need them. And I don’t care what anyone says, ignorance is not bliss. It’s scary.
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