Thursday, 10 October 2013

Diabetic ketoacidosis

Sunday, Monday, Tuesday.
One of the most boring days of my life. This week I had an unfortunate encounter with DKA- for the third time. Third time lucky? No. The third time was actually the worst bout of DKA I've had. From the vomiting, to the extended stay in hospital, to having to be on the adult ward and being bored out of my mind.

And lets not forget my "ward buddies" Pam, Eleni and Maria- all of whom were three very confused old ladies. 

Let me take you back to Sunday.
Sunday morning I woke up at 4am- thirsty. Go downstairs, pet the bunnies, have a drink. Check blood sugar: 12.4. Ok not too bad, just correct and go back to sleep. Obviously diabetes had other ideas for my Sunday. 

When I woke up in the morning I had a really bad headache, blood sugars hardly budged. Staying high at 11.9. I ate breakfast, but not much because I felt sick. Then I did my best to carry on with my day but I was so unbearably weak that I just wanted to sleep by the time it reached midday. I checked BG, my eyes nearly fell out of my head when 16 screamed back at me. Took out the pump for the billionth time, and entered in my blood sugar so I could correct. Then, I waited. 

And fell asleep for ten minutes...and woke up; feeling incredibly groggy. By now my blood sugar had crept up to 20 and decided I should check my ketones with the ketone meter. 
5.7 
I know that any blood ketone reading above 3 is really bad so my heart skipped a beat. I went downstairs, guzzled two cups of water and changed my infusion site. All the while whilst thinking "Please work please work please work" 

1pm rolled around and I checked my blood sugar. 26.9. WHAT. I was in despair; I had absolutely no idea what was going on and was really fed up by this point. Anyway I asked my mum to get me some more water and we also did a correction with my injection pen- having drank all the water in about ten seconds. I felt the dreaded nauseous feeling and before I knew it I was hunched over the toilet and it felt like my insides were about to fall out. 

Ketone test: 6.6 
Ok, this is bad now.Hospital. 

Here is pretty much how it went after that:

Drive to the Hospital. Bicker with receptionist to be seen quicker than three hours. 
Fifteen minutes later- "Ellie Huckle?" Finally. 
Triage nurse. Blood sugar 26. Heart rate 144 b/pm.
Go through to A&E. See funny Australian doctor. 
Questions asked "How do you think it happened?" "What happened?" blah blah. 
Get I.V's started and sit through painful attempt to take blood from hand, for the record it took two attempts, my veins were not co-operating. Yes I did mean to put the 's there. I had one I.V drip in each arm. How fabulous for me- I literally couldn't move my arms or the FOUR different I.V pumps that were attached to me would start to beep like there was no tomorrow. 

I was in A&E from 2pm till about 10pm on Sunday night. Then I was moved to CDU- Clinical Decisions Unit. Apparently because I am 16 years old now I am seen as an "adult in the eyes of the NHS" so that ws pretty unfortunate because I was literally the youngest person on the ward. I had my blood sugar tested every. single. hour. and had my blood pressure done every four hours. Yes, by every single hour I mean all the way through the night too, but I suppose it was fine because I couldn't sleep anyway, for various reasons... And now you get to hear all about Pamela, Eleni and Maria- the three old ladies who were in the same bay as me. Yippee...

Let me just tell you that Pamela and Maria were highly confused and for the most part did not even know where they were. Maria was cute for the first few hours, then she got incredibly confused. Pamela screamed bloody murder all night and day and well Eleni was just really cute and every time someone spoke to her, the reply was "Meep" 

Maria was irish from what I could gather and very chatty once you got speaking to her...the only problem was that she didn't quite understand what she was actually talking about. She thought she was in a hotel and that we should all go "downstairs for breakfast" so she could get to her room and make herself some tea because it was "raining outside and when it rains you really just want to be in your room with a kitchen and make yourself a drink" I had no idea what to say to her so I just sat and listened. Eventually she would stop chatting away and attempt to get out of bed where she would be greeted by some very panicky nurses repeating "You're in hospital not at home!" 

This all happened on Monday. 

I hardly noticed her on Sunday night- mainly because it was very late and she came in late. I also actually managed to sleep for a little bit on Sunday night, apart from the times I woke up for blood sugar testing and had a venous blood test at 3am Monday morning. The doctor came in at 3am.

-"Ellie, sorry I just have to take some blood!" 
-*wakes up in a bit of a daze* "Okay" 

He took about two minutes pressing on the veins all the way up and down my arms looking for a vein to stab. I had I'V drips in both arms so this made it especially hard for them to find a vein. He had to peel of the I.V adhesive slightly so he could poke the veins that were around there- he literally had to dig the needle around in my vein in the hope that it would give some blood. Nope. Attempt number two. More manipulation of my veins, tiny amount of blood. "That should do!" 

Half an hour later.

"Ellie I'm really sorry but the machine wouldn't process it so I have to do it again!" 

Attempt three- 3rd vein. Third time lucky this time? Yes! Although this time it was taken from a vein further down my arm and it was even more uncomfortable. Oh well at least I could get back to sleep...ha ha what was I thinking? I had about an hours sleep before the 900th blood sugar check and from there on I couldn't fall back to sleep. 

I had my chat with Maria that I mentioned earlier. Then my mum and sister came to sit with me for a while- then mum had to go to work but the Nurses let Lauren stay with me because I was "the baby of the ward" Aw, cute. The 3am blood test showed that I was still slightly acidotic so I had to stay on the I.V drips. Then rolled around the most painful blood test I have ever had. I'm not scared of blood tests but this one freaked me out a little. 

A young (and good looking should I mention) doctor peeked his head round the curtain and once again "Sorry, I'm here to do your blood test!" So he came over to me and noticed the "dilemma" that was, I had two drips in each arm. He disappeared off again and a few minutes later he came back, then he left again and came back with another young and good looking doctor, yes. I'm sorry but they were both good looking! 
So the second doctor sat at the end of my bed and felt for my veins and then he said 

"Okay, there is a different way that we can do this, because you have the drips in both arms. We will have to do an ABG anyway and take blood from your wrist" 
That didn't sound to fab...so I just said okay and let them crack on with it. 
He asked for my hand and I had to turn over my wrist to expose all my juicy veins for the needle to violate. 
ABG stands for Arterial Blood Gas. This was no ordinary blood test, they had to get blood from the artery deeper in my wrist and this required a bit more patience, a higher pain tolerance and a longer needle. 

At first it felt, okay...because he only put it into my wrist slightly. Then the next thing you know, he pushes it even further down. It felt like my wrist was cramping up- whilst he was doing this he was basically teaching the other doctor that "this is how you do an ABG" Surprisingly, despite the pain, I didn't flinch. Luckily my pain tolerance is quite high, but my sister was squirming as she watched. He mentioned that I was "dealing with it quite well"...yeah I was dying inside. 

This blood test showed that the acidosis was gone. 

My arm is still suffering the after effects. The bruise was just developing there. My wrist is all the colours of the rainbow now.

I was supposed to go home on Monday but they wanted to keep me in for another night until I got back on my insulin pump and they wanted to make sure my pump kept my blood sugars level and that they stayed stable. I was very sad because I was so bored and Pamela was starting to scare me because she would just randomly wake up and start screaming or being really verbally abusive to everyone. 

Monday night was even worse than Sunday night despite being off of the drips, being back on my own pump and being able to use my OWN pricker to test my blood sugars with because hospital finger prickers are brutal. My fingers are still feeling bruised and it's been nearly two days since I got home. It was only worse because Maria the confused old lady was especially active and decided she would come over to my bed, having wandered around the room- played with Pamela's medicine and shut all of the windows.

"There is someone out there! When you see her at the window, let her in and see what she wants" Guys I am telling you I nearly passed out. She was creeping me out. Obviously I knew there was no one out there but then you get flashbacks of scary films were everyone thought the old lady was crazy but turns out she was actually a witch or something. She was so confused. I mean, earlier on Monday she took her cutlery, stood up feebly, then ran off like speedy gonsalez! I'm telling you, she was constantly on the run. 

I had a 2.8 and a 21.6 on Monday night. Which was really annoying because my sugars had to stay stable in order for me to leave. So I hardly slept at all and woke up properly at about 6am. The nurse had the cheek to say "Good Morning" at 5:30am. I was thinking, are you kidding me?! The sun is not up therefore in my books this is not morning. It's the middle of the night. 

The doctors did their rounds. 
The usual. Hourly BG checks. Ketones gone. Blood sugar 4.5. No more I.V's. Energy back. Eating and drinking. Come on, let me go home! The lady doctor who came round in the morning wanted me to have lunch and see if bg stays stable then I can go home. But then the lovely man from the diabetes team came down to see me and got them to let me go home because he said there was no point in them keeping me there. YES. I was so happy. I got the cannulas taken out of my arms, packed up my stuff and waited for the discharge papers. 

Eleni said meep one more time before we left and Maria and Pamela were snoozing away. I said bye to all the nurses and doctors and was so happy to see the back of that place. The sun was shining and it was a great time. Once I got home I said hello to my bunnies and my sister and I had lunch. Then we both crashed out on the sofa for like, four hours. I showered, went on my computer, checked my e-mails, informed my family and friends on my arrival home and finally got to catch up on cuddles with my mummy and daddy (hehe) and watch TV.

It felt SO good to sleep in my own bed too. Even if mine and my sister's room was very messy it was home. I went back to school the day after I was discharged, on Wednesday. Boy did I have a story to tell all my friends! 

My arms are still sore a couple of days on but I'm okay. My blood sugars are under control and I'm so glad to be out of that hospital. 

DKA is one of the worst things a diabetic could go through. But I survived and although I was getting fed up by day two I kept my head up. I always try to remember that I was given this life because I am strong enough to live it. 





-Ellie
[Peace&Insulin]

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