https://integrateddiabetes.com/wp-content/uploads/2022/07/Kathryn.png
My Experience at the Emergency Department with the Flu and DKA
I got hit with the flu on Christmas Day and could not keep anything down.
I had traveled back to Pennsylvania from Florida for the holidays. I know I tell people I work with that when you travel or least expect it, is when things always tend to go wrong and to ensure you’re always prepared. Naturally, I do not always practice what I preach. I had no Zofran (or similar med) and I became severely dehydrated. My urine ketones were large (the ideal way to check ketones is by blood but the strips were all I had). I also did not have my g-voke kit which would have allowed me to deliver more insulin while mini dosing. The one thing I was able to do was push enough insulin to remain within a normal blood glucose range (which is honestly a miracle).
I had to head to the ED knowing that I was in a very dangerous position. For hours I advocated for myself multiple times, but I waited in the ED for over 6 hours. I was begging for IV fluids. My fingers became prunes. My mouth felt acidic. I was lethargic and light headed. The nurses downplayed my situation. They told me they “knew diabetes well”. I was not moved up in the line at all. My fiancé had security called on him because he started to take down names as we began to get worried I might lose my life. I tried to reach out to my healthcare team for them to advocate for me, but no success there either.
Gary, the greatest boss anyone could ever have, was doing everything he could to try and help. He was ready to drive to Penn State Lancaster from the Philly area (approximately a 1hr 45 min drive). As it’s very possible I wasn’t sounding as smart as I could, Gary also tried to get on the phone with the staff there but they refused. Eventually, I finally got IV fluids and zofran and I am ok (thank God)!
Unfortunately, euglycemic diabetic ketoacidosis (EDKA) is life threatening but often overlooked, as is DKA.
This puts people with diabetes in a very dangerous position. I am a diabetes care and education specialist personally and for this to happen to me, I can only imagine how bad it gets for others with type 1 diabetes.
After this experience, I was sure to follow-up in every way I possibly could to ensure this NEVER happens at this facility again. They called me and seem to be taking it seriously and said they will be implementing a DKA protocol. I’m fearful of this happening to others. I think we need to come together and ensure that people working in the emergency department know how to triage us.
With that being said, here at IDS we always strive to equip our patients with knowledge to advocate for themselves. Additionally, we now plan to give every client a DKA protocol sheet to give to the Emergency Department if they ever are in a position that they need to go there, signed off by their HCP to ensure it is taken seriously. Small steps are needed to see big necessary changes.
January 2024 Newsletter
6 Responses
Horrifying and wonderfully written article about Katheryn’s experience in the ER. I could not stop thinking about this last night. Is there anyway you could make the DKA ER instructions available to print to everyone getting the newsletter? We were clients for many years when my son was in his teens but did not have access to this document to give to medical personnel. Please…and thank you!
Thanks for the feedback Dawne, we will tag in with our design team about getting this on our resource page.
I am so glad you are okay and got through this. I am so frightened to ever be in an ER or hospital . Twenty years ago I had open heart surgery I am a Type 1 for 60+ yrs). I know my bg was low & rang for the nurse. I waited & waited. I finally got out of bed & started down the hall. She was passing meds & I was told to go back to bed. I told her my bg was low. She said I will be with you. She had several rooms to go & finally came in. When the tech came she tested & it was vert low. I was asked if I wanted a graham cracker! I said I need sugar. I finally asked for cereal & milk which I got & it brought my sugar up. But this all lasted quite awhile & no hurry. Another incident was when my brother also a Type 1, different hospital, whien dtr who is an RN & was working the ER at that hospital came to see her dad. He was not talking or acting right & she rang for the nurse to have his bg tested. The nurse acted like she did not want to bother & had an attitude. My niece then told her she was an RN & worked there & this was her dad & she suspected he was in insulin shock. The nurse changed her attitude & had his sugar tested & found out it was extremely low. All these scare me to the point I do not want to be in a hospital. I know there is a good chance I may some day. The staff does not know about diabetes. Their knowledge is VERY limited and I feel they justj don’t care either. No training!! You see how they ignored you. That’s how they ignore us too! Very frightening!!
Unfortuantely sad but true Joyce.
as a nurse I’ve seen it first hand form both sides. Staff are overworked and pulled in a million directions with unreasonable demands from administrators. but at the same time even fundamental education on diabetes is simply ineffective at best. The entire problem stems from clinicians making assumptions. When assumptions are made people are put at risk and errors happen.
I am so glad you are doing ok. Very scary!!
So sorry to hear about this Kathryn! I have never experienced a “serious” event in my twenty-something years of being a type 1. Your sharing your ordeal helps me see how woefully unprepared I am. Have to get my ducks in a row, life’s just been relentless. Hopefully I will make a way and you’ll hear from me soon.