medical, appointment, doctor

What is the scariest thing that put you in the hospital?

Have you ever heard of diabetic keto acidosis (DKA)? I’d only heard the phrase in TV commercials for Type II diabetes treatments, but I had no idea what it was. My ignorance landed me in the ER in a diabetic coma.

I am a Type I diabetic. For those of you who aren’t familiar, Type I usually occurs in early childhood, and frequently goes by the moniker Juvenile Diabetes. I’m the medical anomaly; I wasn’t diagnosed until I was 42. With Type I diabetes the pancreas has ceased to function. The body no longer makes its own insulin, so the TI diabetic must inject several times per day to maintain normal functioning. TI diabetes cannot be controlled through diet and exercise, as is common with Type II.

On the morning in question I woke up feeling fine. I was off to get a facial, which was a treat, and I was pretty excited about it. Shortly before leaving I felt a little queasy, but I attributed that to only having had coffee and not eating properly. It’s really important to balance food and insulin, but I was running late and figured I’d munch a protein bar on my way to the appointment.

The treatment was just as great as I was expecting, but upon sitting up afterward a wave of nausea nearly knocked me over. The aesthetician, who I’ve known for 15 years, said I went completely white, and she offered to drive me home. I only lived a few blocks away, so I declined, and she walked me to the car. By the time I got home, all of six minutes later, I knew I was going to vomit, and made it as far as the kitchen sink.

My only thought was, “Crap, I’ve got the flu!” My husband had the 24-hour bug the previous week, and I just figured it was my turn. So I did what anyone with the flu would do – I grabbed a big Tupperware bowl, set it next to the bed, and went to sleep.

Unfortunately, I continued to be violently ill, from both ends, for the next 24 hours. Even more unfortunately, we were in the middle of a home renovation, and only had one working toilet in the house, which was down the hall from the room where I was sleeping. I would awake from a deep sleep with that warning feeling in my throat, grab my bowl, and scoot down the hall as fast as I could go. This happened hourly.

After enduring an arduous night, my husband suggested that maybe I needed to go to urgent care. I said okay, then went back to sleep. The next time I was up getting sick he said, “We’re going to urgent care.” I agreed, but wanted to change out of my pj’s first. It took me 40 minutes because I had to lie down after every garment I took off or put on. We decided to go to the ER instead of a local urgent care, because by this time I was throwing up what looked like coffee grounds, and we knew they were going to send us to the hospital anyway.

I remember being blinded by the sun, and cowering in the passenger seat because it was so bright. The hospital is constructing a new surgery center, and I had been to a doctor appointment there the previous week, so even though I was mentally exhausted, I was giving my husband instructions about how to get into the parking garage. I remember someone opening the passenger door and telling me to get into the wheelchair. I kept saying, “Don’t forget my purse!” because I knew they were going to ask for my ID. I had the sensation of rolling and then – nothing. I passed out.

I only remember bits and pieces of the next 24 hours. According to my husband I appeared to be lucid, because I was answering questions from the medical staff. I remember begging for a Coke with ice. I was so dehydrated and completely empty from the involuntary purging. I remember one doctor who thought he was a comedian and kept making jokes. I distinctly remember thinking, “Shut up. You aren’t funny!” I hope I didn’t say that out loud.

At some point I woke up in a dim room, in a hospital gown, with IVs in both arms. I tried to ask for water when the nurse came in, but I couldn’t speak. The repeated stomach acid baths had completely stripped the lining of my throat and mouth. I had to work hard to emit a whisper. The feeling of air passing over the open ulcers in my throat was excruciating and caused me to cough, which made it worse. Thank God for Chloraseptic, which they sprayed down my throat to numb it. I was able to suck on some crushed ice. Solid food wasn’t even a remote possibility, so I existed on gelatin, pudding, milk, and warm tea for the next two weeks. (Silver lining: I lost 10 pounds!)

I spent another restless 24 hours trying to sleep with a constant cough caused by the open sores in my throat, and IVs in my arms while they continued to hydrate me, and then the doctor came to visit. She told me that by the time I was admitted to the ER I was slipping into a coma, and that if my hubby had waited even an hour more I probably would have died. My blood sugar was so high that none of the standard testing equipment could read it, and they had to do a special blood test to figure out what they were dealing with. When I was admitted, my blood sugar tested at 1189 – the highest of anyone ever admitted to their ER. For reference, normal blood sugar measures 70–120. So mine was roughly 10 times normal. I whispered that it was a miracle I didn’t die.

And then the doctor said something that chilled me to the bone. “Oh honey, you were dead. You came as close to dying as anyone can without their heart stopping. If you weren’t a fighter, you wouldn’t be here now.”

I think I started crying. Up until that moment, I hadn’t been scared at all. I was way too out of it to be scared. I think I was hanging on until we got to the hospital, but once I was there, I instinctively felt that I would be taken care of by professionals, and everything would be okay. That’s when I let go and lapsed into the coma.

I was in the hospital for about 4 days, and then I was basically on bed rest for the next two weeks. My mom, God bless her, slept on an air mattress on the concrete floor in one of our recently renovated bedrooms and nursed me for a few days. I need to ask her how she perceived me during that time, because I clearly was not in my right mind. In fact, I remember telling her, “Bring your yoga gear, because there’s a great class on Monday at 12:30!” Little Miss Optimism – I could barely walk to the bathroom, and I expected to do yoga!

The repercussions of a severe bout with DKA can be devastating: loss of liver function, loss of kidney function, blindness, numbness in the extremities or complete loss of use of the hands and/or feet. I’m BLESSED to report that I have some light neuropathy in my feet and some changes in near vision (I now need readers) but other than that all my vital organs remained unaffected. I was told that the DKA was sparked by a urinary tract infection, which tricked my body into allowing blood sugar to spiral out of control. The vomiting and diarrhea were the body’s way of dumping as much of the excess sugar as possible; the coma was the body’s way of trying to slow blood flow to the vital organs and protect me.

I am now hypervigilant about checking my blood sugar (I’d admittedly become pretty casual about it before) and adjusting my insulin accordingly. If I become ill, I’m on standing orders to go to the hospital if I vomit for more than two hours. If I experience a UTI or any other kind of infection, I’m at the doctor immediately. What I went through was HORRIBLE, and I never want to go there again. I was fortunate to make a near-full recovery, and I don’t take that blessing lightly. I may not be as fortunate the next time.