I was out of town for a couple of days this week for work, and I’m pretty sure that I was *this close* to ending up in DKA again.
I think it was one of those “perfect storm” type of events. I’d gone out to a concert Tuesday night and was out late, hadn’t had any water to drink all day, so I know I was dehydrated. The Saturday and Sunday before that, I had been running fever out of nowhere and was asleep most of the weekend. So clearly my body was still recovering from whatever that was. Then mother nature decided to show up Monday night, which always causes some high bgs. Then I had a flight out first thing Tuesday morning, and flying always makes my bg’s high so I use a temp basal.
When I left my house early Tuesday morning, I was ok. My bg was 140. I set my usual temp basal to 125% – nothing out of the norm.
By the time I landed 46 minutes later, I was almost 300. Wasn’t overly concerned. I felt incredibly tired, but I chalked that up to only getting 3 hours sleep and having to make a 7 am flight. First stop at the airport was Starbucks for a coffee (which I never even got to finish) and breakfast sandwich.
Felt a little out of sorts, but again, assumed I was just tired. BG wasn’t coming down, even with a rather large corrected tacked onto my bolus to cover the breakfast sandwich (which was a usual sandwich for me, so I knew the carb count.)
On the way to the office, I decided to stop at the store and buy some ketone strips because I had not packed mine from home. Not sure why I’d decided to stop, other than I’m guessing it was a gut instinct. Which turned out to be a correct one.
Over the next couple of hours, my bg continued to rise. To the 400s. Checked my ketones and they were dark purple. Well crap.
I had a phone interview to conduct, and I feel kinda bad for that girl because I was not able to concentrate at all. By this point, I felt sick to my stomach (NOT a good sign, especially with such high ketones.)
I’ve been in DKA 3 times before and this felt different, but similar. I felt like I was in a fog. By now my bg was 433 and not even attempting to come down. I corrected with a syringe. And waited for what felt like an eternity. Tried to call my Endo to see if he could either talk me down, or make the call for me to go on into the ER.
Started filling up water bottles and at one point I had 3 in front of me. Was drinking as much as I could. Ketones weren’t budging. Finally my bg started to come down a little. At this point I was glad to see something in the high 300s instead of the 400s.
When I finally connected with my Endo, he said to give myself 10u an hour, via syringe, and call him back every hour until I started seeing significant improvements.
It took several hours, but I finally did start to come down and my ketones came down to Moderate, and I felt less sick to my stomach. For the first time that day I felt like I was going to be ok.
I went back to my hotel and fell asleep by 7:30. Woke up the next morning feeling SO much better.
So was I going into DKA? I don’t know for certain. But my gut tells me I was. And the scary part was I seriously considered leaving the office and trying to check in early to the hotel so I could lay down – I needed to sleep through that fog. But it crossed my mind that being alone in a hotel room may not be the best option at that point …..
But everything turned out ok, and I flew home that next night and perfectly fine now. That’s what matters. I am just glad that I was able to get ahead of it.