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help re challenging medics? diabetes / dka knowledge please

7 replies

hospitalworry · 13/04/2015 21:00

Dd age 20 in hospital
She is diabetic
I took her in Sunday as I found her in her room 'not right '
Had a shut door and as far as I knew she had returned to uni Friday
Is thought she was dka
Incoherent but able to walk
Admitted. Not as bad as admission for previous dka.
Main thing which seemed odd -unable to talk (but in expected range of dka symptoms)
Saw her this morning. Bm much lower (although admission bm 'only 19'
Still can't talk.
I raised it with staff on Hdu and told she doesn't want to talk as she's probably in pain
In wasn't buying that but...
Husband saw her around lunchtime and told they don't know what's wrong but uncertain it's diabetes related now.
Maybe see neuro tomorrow.
I saw her this evening.
She can comprehend mostly but definitely weaknesses on right hand (can't pick up fork but totally can with left and use it. Still can't talk. I asked nurse and questioned stroke. Told she's been assessed. Normal reflexes and no facial drop so stroke unlikely and if a tia wouldn't show on ct scan
MAY get referred tomorrow for another assessment but unlikely. Again told she CAN talk but doesn't want to. I said I KNOW she CAN'T talk.
While there she had a small fit
In told the nurse who saw the end part of it.
She has had food put out on tray that they don't realise she can't open or pick up and they repeatedly have said 'oh she's very quiet '
NO she can't talk!!
Also if you ask her a question(whether it should be a yes or no answer) she mainly nods or raises her eyebrows and smiles so they think all is well.

OP posts:
hospitalworry · 13/04/2015 21:02

Just want any input please

OP posts:
Stillwishihadabs · 13/04/2015 21:08

Didn't want to read and run. I am a medic who has treated dka on many occasions. Unfortunately there can be neuro complications including stroke (also cerebral oedema secondary to resuscitation).Hopefully her condition will improve and you will get some answers soon. I am sure someone with more expertise will be along soon. Very unmumsnet hugs Flowers

hospitalworry · 13/04/2015 21:14

Thanks for the reply

OP posts:
hospitalworry · 13/04/2015 21:16

Is it normal for Hdu to be so apparently ignorant of this?

OP posts:
Stillwishihadabs · 13/04/2015 21:19

Err I would think not. Have you spoken to the doctor? They should certainly know.

hospitalworry · 13/04/2015 21:22

Not spoken to doctor
I visited early this morning and after work
Told by her nurse (it's 2 patients to one nurse on the ward) unreassuring information

OP posts:
hospitalworry · 13/04/2015 21:28

This APPEARS virtually the same?
From doctor Google
Abstract

We here report one case of hemichorea and Broca aphasia occurred with diabetic ketoacidosis. A 20-year-old woman with type 1 diabetes mellitus had experienced diabetic ketoacidosis fourth time after the onset of diabetes. At the third ketoacidotic episode, the patient was admitted to our hospital for the first time to show hemichorea of the left extremities. Brain computed tomography (CT) demonstrated a high-density area in the right caudate head and low-density area in the right putamen. Magnetic resonance angiography (MRA) demonstrated a stenosis at the root of the bilateral middle and anterior cerebral arteries. The hemichorea disappeared within 3 days. At the fourth ketoacidotic episode, not hemichorea but unconsciousness was there for 2 days even after ketoacidosis disappeared. After the unconscious state, Broca aphasia was demonstrated for 15 days. The cerebral angiography showed a finding compatible to Moyamoya disease. These findings support that chorea and Broca aphasia induced by diabetic ketoacidosis was developed in addition to blood vessel abnormalities such as Moyamoya disease. We suggest that poorly controlled diabetic patients with hemichorea should undergo cerebral angiography.

PMID: 15649579 [PubMed - indexed for MEDLINE]

OP posts:
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