The Dreaded D Strikes Again – complete with TMI
If you follow me on Instagram you already know I spent a few hours of last night in the ER. I hate admitting to all these things but I feel like putting it all out here can maybe help other diabetics avoid the same fate. Let me start at the beginning (be forewarned: there is much TMI in this post.)
It all started last week, or 2 years ago, depending on how you look at it. In March of 2010 I had a copper IUD inserted. It was my second IUD since the 1st one had been removed a few months earlier after it was discovered it had punctured my uterine wall (OUCH! – a story for a different post – maybe). I chose copper instead of Mirena (the hormonal IUD) because since my diabetes diagnosis, my body hasn’t handled hormones the same (or as well). I wanted to find a method of birth control that was non hormonal and convenient (aka NOT condoms). I did some research on the Paragard and decided, “Ok, heavier periods, more severe cramping but birth control I don’t have to think about for 10+ years? Sign me up!” Ho. Lee. Fuuuuuuck! The pain was unbelievable! I went through lots of pain meds and heat for at least one week every month (the cramping would usually start at ovulation and continue all through the duration of my period – which had gone from 2 days to 8 or 9.). Every month I would say to FF, “I don’t know if this is worth it. I don’t know if I can do this.” and we would assure me that he supported me whatever I decided. May was a tough month for me pain wise and I had officially given my body warning, “Another month like that and we’re done!” Well, apparently that IUD wasn’t any happier than I was because this month’s pain – out. of. this. world. It was so bad last Thursday night that I actually passed out from the pain (ok, it may have been from lack of oxygen from holding my breath to try to get through the pain but – details.) Anyway, I called the gyno on Friday, went in, described what was happening and they decided that Paragard & I? Not a match made in Heaven. DUH! So since they were removing the IUD, I had a quick chat with the (not my usual) gyno about other forms of birth control. I decided on the Ortha Evra patch because I liked the idea of only having to think about it once a week. I discussed (quickly) how I was concerned about starting hormones again and how it would effect my blood sugars. So we set up a 4-6 week follow up and decided to give the patch a shot. Bad move!
I put the patch on Sunday night before bed. By the time FF picked me up from work on Monday I was feeling kinda nauseous. I attributed it to the fact that I have a generally disagreeeable tummy, the heat, the spaghettios & meatballs I ate for lunch – basically, anything I could think of. Tuesday brought more nausea that lasted throughout the day along with blood sugars that were becoming increasingly more uncooperative (think 300s+ with lots of SWAG & RAGE bolusing) and the vomiting (sexy!) started. That evening I was able to get down a few saltines and drink a bit but I did mention to FF that I was having trouble pushing fluids (even water aggravated the nausea). I was taking my good friend Zofran religiously as well. Wednesday got even rougher. Sugars were soaring into the 400s. I was positive for ketones. I was so very damn uncomfortable! I called the doctor and they were able to get me in for a lunchtime appointment and FF came with me. They did blood work and a urine dip (I’m not pregnant – shocker!) and pretty much sent me on my way. They said to keep doing what I was doing and to get better about pushing fluids. I got back to work about 1:30 and realized I hadn’t had anything but half a cup of coffee all day and I should probably eat to keep my strength up. So I had a Lean Cuisine Chicken Parm (which is really tasty believe it or not) and? It tasted DELICIOUS! I thought I was finally turning the corner…but I was wrong.
By 4pm on Wednesday I was pretty much camped out in the work bathroom. At 4:30 my insulin pump expired and I didn’t have the energy (or foresight) to change it right away (I figured FF could do it when he picked me up). My coworkers were worried, I was scared and I began to have an inkling in the trouble my body was in. I called FF at about 4:45 (15 minutes before quitting time) crying and said I was sick. He told me he was in the middle of something but would come get me as soon as humanly possible. The girls at work were concerned and walked me outside and stayed by my side til he showed up (I did remove the hormone patch at about 4:30 as well – I figured it was the only way to determine if it was the culprit). We had plans to go water our garden (I MUST tell you about our garden sometime! It’s so exciting for us!) since the weather was a scorching 95° (that’s 35° C for all you non Farenheit users!). We were about halfway there when I had to ask FF to pull over (at my old middle school no less!) because I was going to be sick. Again. I decided then that I wanted to go to my parent’s house because they have AC & we don’t (and as awesome as FF is, vomit is soooo not this thing. I needed mom to rub my back and put cool compresses on my neck & forehead.) I barely made it through the door of my parent’s house and I was back in the bathroom. My mom got me through the tough stuff then FF came in to get me hooked back up to my Omnipod and do a finger stick (if your partner needs to do your finger stick – sign #1 that you’re in trouble!). And the magic number was ::drumroll:: 425. YIKES! I toook a bolus (6.5 units) and set a temp basal of +50% for 4 hours (I had been running a +30% temp basal most of the day but decided I was sick of fucking around and needed to show my blood sugars who was boss!)
Mom and FF had a discussion and decided, even if I thought I had control over this (three days of puking and sky high blood sugars – I clearly was delusional) that I needed some medical intervention…and quickly. You may remember that I mentioned in my post about my DKA experience that I officially gave FF clearance to make medical decisions for me when he felt I was in danger. This is the first time he’s needed to do it in 6 months and I hope it’s the last time for a while.
We got to the ER about 6:30. This is one time when I am thankful I am a diabetic let me tell you. They skipped me up in the triage line (ahead of about 4 people) and assessed the situation. The traige nurse took my vitals (blood pressure was a wee bit high for me at 116 over 67. I’m normally about 90/50 but I was sick and nervous so that’s to be expected.) and informed me that not only was the ER full but there were 15 people ahead of me in the waiting room. I looked at FF and said I wanted to go home. I mean, who wants to sit in a crowded waiting room with lots of other people and having to use a public hospital bathroom to toss their cookies? Not I! But he said until I could keep food down on my own and get my blood sugars down I wasn’t going anywhere (that man is a saint but sometimes I really dislike him for it!). Ten minutes later I was in a bed getting hooked up to an IV – in the hallway. They didn’t have a room for me but were so concerned that they actually put me on a bed in the hallway of the ER. To be honest, it was the best care I have EVER received there (no offense to all my buddies who work in the ER – you do an awesome job taking care of me – but you have other patients to deal with!). There was an EMT putting in a line, a med student taking my history and then the attending coming over to listen in (and order a blood gas to rule out DKA. I heard those words and fought tears with every fiber of my being. Those are easily the scariest three letters I have ever known.). The saline got hung, my labs came back good, they decided to give me one more litre of saline and then send me on my way. I stayed hooked up to my pump and was doing finger sticks every 30-45 minutes.
By 9pm we were leaving the hospital (and finally got to water our garden – it was extremely grateful!) and my blood sugar had come down to a nice, managable 206. I awoke this morning to a 66 (which felt AWFUL after so many days in the 2, 3 & 400′s) and was feeling pretty wiped out. But I soldiered on and in 3 hours I will have made it through yet another work day (I haven’t missed any time for this sickness minus a half hour yesterday for the doctor. Probably another one of those not so smart decisions. But, when you don’t get paid sick time you do what you have to do). But in looking back, I can see lots of errors on my part that I could have changed and maybe avoided all this. Here are some of the things that are running through my head that may have changed this outcome:
- After a day of a +30% temp basal and your blood sugars are still not cooperating, try changing your insulin pump. I am still kicking myself for this.
- If there’s a voice in the back of your head telling you to be scared, BE SCARED! And then go to the hospital.
- There is no shame in walking into the ER on your own feet and asking to be rehydrated. It sure beats the alternative…
- I thought about changing my insulin pump (because of its pending expiration) several times yesterday and never did. I am dumb.
- No matter what circumstance you think about after the fact that you could change to avoid this next time, next time will bring a whole new set of agonizing circumstances. Learn from mistakes and move on. Dwelling on how things could have been different won’t actually change the outcome.
And with that…xoxo
P.S – You may have noticed (or not!) that FF & I have been a bit quite in the Twitterverse. We’re taking a little break and may or may not be back. But I’m still lurking and checking in on all of you!
P.P.S – A big shouted THANK YOU to my coworkers, FF & my mom without whom this experience would have easily been a gazillion times worse <3