A Near Death Experience

I had an, ah, interesting experience last weekend.

Last week I realized I was nearly out of my insulin. I was so used to getting it regularly from the mail-order pharmacy my health insurance uses that I forgot it had changed. Everyone's prescriptions were supposed to seamlessly transition over. Clearly something had not gone seamlessly. I called them up and they said, "Oh, uhm, yeah. It looks like there has been a mix up. We'll get this fixed as soon as we can."

Except that it wasn't fast enough. Saturday morning I ran out of insulin. That means my body could not process carbohydrates and my blood glucose level was going to go up. I thought I would be okay for a couple of days if I stuck to a diet of nuts, non-starchy veggies, and water as none of those things have much in the way of carbs. Yes, my insulin would go up, but it shouldn't go up high enough that I wouldn't be okay for a couple of days until my order came in.

The only problem with that clever plan is that I forgot about other medication I take.

Every week I take an injection of Avonex. This nasty drug is for my multiple sclerosis. It has the pleasant side effect of flu-like symptoms for approximately 24 hours after injection. The first couple of times I took it, it knocked me on my ass and I could barely get out of bed. Since then I have gotten somewhat used to it so that now my body aches from head to toe all day, I feel more exhausted than usual, and I just feel rather blah. I take it every Saturday night so I can spend my Sunday feeling like crap instead of trying to deal with it during the work week. Without even thinking about how it might affect my insulin-deprived body, I took it as normal Saturday night and set myself on a nasty course.

Sunday morning I woke up feeling worse than I usually do on Sundays. My stomach was a tight knot and I felt on the verge of vomiting. My mouth was extremely dry and full of cotton. I tried to sip some water because that's all I felt I could stomach. Unfortunately, even that was too much as I started vomiting. Anything in my gut from the previous day was quickly sent back up. Anything heavier than water or 7-Up sounded sickening, but even those had me puking and dry-heaving. I felt like I had no water in me and, in fact, the one pleasant side-effect of my vomiting was that it put just enough moisture in my mouth that I could talk.

I continued to feel worse throughout the day. By early evening I knew the only way I was getting better was if I went to the Emergency Department. I also knew that I was going to be admitted to the hospital. As dehydrated as I was I knew my bg was sky-high and the only way to get it down was insulin. This was not a decision I made lightly, but I needed to if I was going to get better. My mother called my brother who picked me up and carted me off.

Since I work there, most of the staff know me and were clearly concerned about me just seeing me before I even started telling them what was going on. They got me a room, started pumping me full of fluids and gave me Zofran so I would stop vomiting. They drew blood and took a urine sample. As the tests started coming back the doctor came in, gave me a look, and said, "You're sick." Thanks, doc. I actually felt like I was being tickled by thousands of butterflies, but now you've gone and set me straight.

The diagnosis was diabetic ketoacidosis. This is a potentially life-threatening condition caused by very high blood glucose which begins to cascade through a whole series of other wonderful things. Sure enough I was admitted and not just to any floor but the Intensive Care Unit. This was so they could closely monitor me and allow me to rest.

Rest? Ha! For anyone never having the opportunity to stay in an ICU (this was my first), rest is about the last thing that happens. I was lucky to have a 30-minute period of being uninterrupted by someone coming in and drawing blood or checking my vitals or something. Despite not getting much in the way of sleep I started feeling better rather rapidly. With insulin and fluids pouring into me, I was getting somewhat back to normal. With the Zofran on board, I was able to drink some actual water, too. The ice water the nurses gave me was about the best thing my arid tongue had ever tasted.

Later in the morning with my numbers stabilizing, I got transferred to a medical floor. I ate a normal meal. Well, I tried to eat it. I ordered a fruit bowl and a piece of toast, but the roof of my mouth was so raw from the vomiting that the natural acids in the fruit burned too bad to eat much. Even the crunch of the toast made it difficult to swallow.

By 6:00 pm, I was much closer to normal if not quite there, yet. My doctor sort of wanted to keep me another night, but I told him I would rest much better at home (which is very true) and he let me go. I went home, ate a bit and before too long I was in bed. The next morning I was up and going to work. It's not 'cause I'm sort of tough guy. I was just feeling better and I've got a ton of stuff on my plate.

I'd like to say I learned some deep truth from my near-death experience or that I had some nugget of wisdom to offer. In the future I intend to watch my insulin supply more closely especially when changes are made to my health coverage to try to prevent this from happening again, but that's rather banal for any sort of grand statement. I got very, very sick. I pulled through thanks to modern medicine. I'm back to normal.

Really, what more could one ask for?