How DKA Scared Me Into Shape
Three days before I went into diabetic ketoacidosis (DKA), I walked off a plane and into a dirty Tex Mex bar in the Dallas Airport. I had a two-hour layover and I was in pain: a sore throat, unquenchable thirst and a headache that felt like my brain was planning to escape via my left temple. I wanted the pain to go away and quickly, but the various over-the-counter meds I’d gobbled in-flight had yet to help. So I stumbled into a brightly lit bar, with a menu full of booze and egg frittatas, looking for a cure.
I wanted a drink to work the way you read about it working in books—a magic potion that clears away the dust of a bad day. It didn’t matter that alcohol made me fuzzy with bad decisions and sent my blood sugar bouncing. I needed a quick fix. I ordered and the bartender slid me a mimosa proving everything was indeed bigger in Texas.
I took a sip and my throat yelped in pain. My tongue fizzled and burned and my entire body asked me if I was kidding myself. Tears clouded my vision and my headache thumped like the bass in an EDM song.
I shoved the drink back after a painful sip or two. The bartender looked up, confused. It’s not helping, I told him. I could not longer medicate my pain with booze.
Since being diagnosed with type 1 diabetes nearly three years ago, I had gone from being a very bad diabetic to a slightly-less-terrible diabetic.
I had gotten my A1C down from 9.8 to a decent 7.0. I’d gone from pretending it didn’t exist—oops, I’m out of Lantus; it’s probably fine to miss a dose!—to checking my sugars regularly and counting carbs before meals.
But I still refused to understand how serious this disease was, until I found myself in the ICU, an IV drip of insulin in one arm and a feeding tube in another.
Maybe I thought that because I was such a late type 1 diagnosis—25 at onset, 26 when they stopped calling it type 2—I was immune to this swell of the disease, and to DKA, its fatal complication.
Maybe I believed diabetic ketoacidosis was just a Mary Poppins name for a complication I didn’t expect to have. Maybe I didn’t even really believe I’d been diagnosed with another chronic disease, another crappy continuation to my barely functioning body of bad luck.
Diabetes’ complications were certainly not something I could have imagined those first days of high blood sugars, when the doctors thought a 550 blood glucose was a side effect of the Prednisone I took for lupus, or perhaps a complication of losing my thyroid to cancer when I was 21. No one then seemed to take it too seriously, so why should I?
But now, in the sunny room on the fifth floor of the UCLA Medical Center in Santa Monica, it was clear that this was serious. This was diabetes.
Loud. Painful. Visceral.
The day after my ill-fated drink in Dallas, I spent 10 hours in Santa Monica with my friend’s kids, turning my face in the diner so they wouldn’t see me cry as I struggled to swallow my omelette. In the back of my mind, I knew this wasn’t a normal sore throat—this was worse, a fungal infection in my throat called candida esophagitis.
When I was a baby, I was diagnosed with an immune disorder called chronic mucocutaneous candidiasis. My body does not fight fungus; I’ve been on antifungals since I was a toddler.
In April, my rheumatologist worried that the medicine was having a negative effect on my liver. We ceased treatment on a trial basis. I bleated, knowing I was susceptible to fungal infections even more now that I was diabetic. She reassured me I was strong, and my diabetes was in better control than ever before.
Three months later, I was in that ICU bed, watching as an ear, nose and throat doctor (ENT) stuck a camera down my throat and whooped aloud at the patches of fungus lining my throat.
And then my endocrinologist appeared, sympathetic and concerned.
“You are also in DKA,” she said. “This is what it feels like.”
Thank God you’re here.
I had spent considerable time in hospitals before, but my battle with DKA and a nasty, systemic fungal infection left me more battered than I’d ever been before.
I spent seven full days on an insulin IV drip. I was pumped full of painkillers and steroids. The fungus and inflammation was so bad that my throat nearly closed and doctors debated giving me a trach to breathe. I was on a feeding tube and required constant suction, as swallowing my own saliva was impossible. It was a week before I could swallow ice water and Jello.
After my release, I was shocked to realize I remembered almost nothing of my hospitalization. Looking back I only see flashes of myself: a foreign subject, in a familiar gown, repeating tasks, receiving treatment, losing parts of herself to the disease.
The DKA fuzzed my brain, played with antenna, left me dehydrated and delirious. The steroids used to fight inflammation activated a psychosis that had me thinking my suitcase was Garfield the cat, painted blue. The painkillers turned my words nonsensical, hysterical and mean. The antifungals left me retching and in a pain that challenged what I thought I knew about my own resilience.
My parents, my steady sources for information, looked stricken when I asked them about my stay. “You were like I’d never seen you before,” my dad said. “Completely out of it, delirious.”
I asked what I had jabbered on about and he cocked his head, perhaps unwilling to share the actuality of my madness. “I think that new Full House show came up at one point?”
My mother looked exhausted and pained as she repeated the details to my family.
I felt ashamed that I let myself get to this point of illness. But I was even more mortified to admit I’d had a drink during the ramp-up to my hospitalization. And that it wasn’t the first time I had tried to ease my pain with alcohol.
Since my diagnosis with diabetes, I’d gone from an overly eager, possibly problem drinker to a much more conservative, social one. It wasn’t an amazing transformation that required my great strength and determination—it just was no longer worth it for me to get trashed every time I went out. I was scared off by stories I’d heard of young people with diabetes binge-drinking and dying in their sleep.
Moreover, when I did have a third drink, I’d wake up the next day with a depression so thick that the rest of my week became a colorless blur. I’d shake from anxiety and dehydration all day. I never made a decision I was proud of, and it was rare I went out and didn’t regret some comment or ill-executed dance move.
My progress on this only made me feel worse as I lay in bed, thinking of what signs I’d shown of DKA. I was dehydrated on that plane and knew it and I had a drink anyway. I had reached for that mimosa like it was going to save me from myself. If this wasn’t denial, I wasn’t sure what was.
Like the illness itself, alcohol scattered my recollection, leaving me alone to construct a reality that could only bring more pain. I’m grateful my body had reacted to it like the poison it was; I could only vow to remember this the next time I was thirsty for my former crutch.
I was a mess of anxiety and guilt over the stress I caused family and friends, the mess I’d left my roommate, the money I’d wasted of my parents. Why wasn’t I stronger yet? Why was I such a screw-up? Why did I have that drink, eat that candy, stay up late? I should have battled harder, ate less carbs and more kale.
These all haunted me as I healed and rehydrated. But alongside this pain, one bright, burning truth soared across my brain:
I am a type one diabetic. It is not going away. It is never going away.
It’s time to accept that, at least.
When my mind floats to the ways that I have failed at managing my diabetes, I actively try to think of how I want to live productively with these chronic diseases.
As I look to my 30th year, I know that the best version of me is in grad school, working toward my future as a child psychologist. I hope to one day practice in an environment where I can help kids with chronic illness and cancer, predicaments I understand because I lived it myself. I know that their acceptance of disease won’t be linear; it will ebb and flow, no matter what their parents do. I will take my skills as “The Baby Whisperer” beyond excellent fart impressions and into something that could really help the lives of children suffering from type 1.
That’s what I envision when I think of living beyond. And while diabetes and lupus have forced me to postpone school yet again, I know I will get there one day.
For now, I must work on healing and acceptance. This means taking my diet seriously, ensuring I am filling my body with the right ingredients to combat another fungal attack. This also means restricting my alcohol intake even more —I will not deprive myself of the very occasional drink, but I am certain that I do not wish to risk my health for a margarita anymore.
This also means seriously—seriously!—tampering my sweet tooth. Even waffles. Oh sure, I can have some healthy kind made with quinoa and millet and Dr. Oz’s tears or something, but my lazy days of eating must end. It was another crutch, a temporary cure for a permanent problem.
I can’t forget the Hell I just experienced and I can’t allow myself to ever live it again. I must take responsibility for my part in all of this. I owe it to my family to take better care of myself.
But most of all, I owe it to myself to get really, truly healthy. To learn to love the body I have, despite its flaws and to treat it with respect. Because if I don’t, I won’t help anyone; I’ll forever be fighting myself. I’ll be useless at healing others until I have healed myself.
My name is Kelly Bergin and telling my story is how I live beyond.
Read Depression, Alcohol and the Night I Almost Died by Brittany Gilleland.