Erin has been battling a stomach bug for the past two days and with that came the realization that a stomach bug is no longer just a stomach bug. Erin had been nauseous and dizzy, fatigued, had a decreased appetite and ended up throwing up what little food she did eat yesterday. Talking with the resident (non-transplant) doctor we decided to suspend her night time feed to prevent further vomiting and we were concerned about a possible insulin overdose if she did vomit again. It all made sense in my head until the head nurse started rambling off all of the concerns and issues that resulted simply because we didn’t do a feeding. Everything is more complicated now because everything is intertwined. Erin’s diabetes is more severe since transplant including the addition of a short acting insulin used to correct high blood sugars caused by the immunosuppressant drugs she is taking and to counterbalance the amount of carbs she takes in at every snack and meal. When we skipped the feeding, we readjusted the insulin, but we didn’t take into account her fluid loss. The fluid loss caused a couple key transplant factors to hit some scary numbers, thus causing a need for medication readjustments and additional monitoring, not to mention panic and concern from the head nurse. Today’s lesson: fluid intake, whether via mouth or tube feeding, is critical, every day from here on out. There are many more lessons to be learned and this is why we are here for 3 months post transplant. Today Erin and I had a 90 minutes diabetes education and tomorrow we will have a two hour post-transplant education, all designed to help us figure out how to navigate this new life.