Friday, November 29, 2019

That Time I Almost Died

~This is the ninth chapter of my year-long exploration of
living with Type 1 diabetes for 50 years.~

My good fortune is not an occasional coincidence or winning the lottery. My kind of luck is a steady force, propelled by an unsettled life of testing limits and pushing boundaries. Often that brings me to the right place at the right time. After living with diabetes for nearly 50 years, I’ve beaten the odds. It is not uncommon for Diabetics to be blind, have lost a foot or a finger from poor circulation, to be suffering from cardiac ailments or liver failure or depression. I’ve had a few rough knocks, but who hasn’t?

Perhaps part of my fortuitousness comes from pursuing the things that I love to do despite the challenges of managing the extra burden of balancing daily medication, exercise, and food.


He asked me to come with him. “You can do it.”, the Boyfriend murmured in my ear as he nuzzled my neck. I was nervous. This was our first big outing as a couple, after a number of day-long ski trips together. He was currently not working, happily living off savings until he found the right fit. I had an intense job. There was always a negotiation with my work demands, flexibility and priorities.

With a steady job with decent health insurance, I’d started to use an insulin pump a few months ago. The small machine delivered insulin through tubes and cannulas that were placed under the skin. I was not sure about this technology, but I’d decided to try. This trip was the first run with it. 

Map of the proposed route 
After more discussion with the Boyfriend, I decided to go. I prepared the skis, sled for supplies, clothing, and contingencies for a four-night trip across the Resurrection Pass in the southern end of the Chugach Mountains. There were public use cabins for each night. The long days of spring season light, snow and relatively warm temperatures were inviting and exciting. I was on the edge of my abilities, but I was strong and determined. It was the four of us- the Boyfriend, his stoner, bipolar athlete friend and the Stoner’s beautiful, fit and petite girlfriend, and me. I was out of shape, clearly out of my league.

We headed up the long slow slog uphill. Very quickly, I had to adjust my clothing and remove layers when I started to sweat. I reduced the amount of insulin delivered by the pump, realizing that the exercise was going to be taxing. Even from the start, it was hard to keep up. My skis weren’t as good as the others, I certainly didn’t have the experience.

Within two hours, my gut felt twisted. The Stoner got impatient, clearly tired of waiting for me to catch up and getting chilled in the process. Finally, they pushed on and left me and the Boyfriend to catch up. I took a minute to check my blood sugar, warming the meter in my armpit first. My blood sugar was high, but I felt that was ok. I took a sip of water. The Boyfriend kissed me on a flat part of the trail, darkness falling as we were surrounded by trees and hoar frost and deep silent space of the winter. The moon shone brightly. Then I vomited the water I’d just drank.

Not me- file photo

It was too late to return to the cars. I had to move forward to the cabin. The Stoner had gone out to gather large trash bags, filling them with snow to melt drinking water. I got settled into the space, stripped down and checked the blood sugar again. It was high but not crazy high. I delivered insulin with the pump. Checked again another hour later. Still high. Changed the pump set, ate dinner. More insulin. Stoner’s girlfriend was supportive and sympathetic. I was thirsty, feeling claustrophobic, the cabin was too hot. We played cards. As the night progressed, I ran outside to vomit repeatedly. In the quiet night outside the cabin, I found myself panting uncontrollably, then retching alongside of the cabin where I could see my pee holes, dark and ominous in the snow.

I was as sick as I had been my entire life. Consumed with doubt, mentally addled by the Ketone poison that was coursing through my blood. A lack of insulin and rigorous exercise created a firestorm. Instead of using insulin and carbohydrate to burn calories, my body was burning fat for energy. The ketones raged.  The acid burned my throat with each vomit. They don’t teach you how to cope with this. The rest of the group tried to sleep, while I was up at least once an hour, tormented by my body and worried about what tomorrow would bring, The gray sky emerged from the dark.

The Stoner grumbled about not being able to sleep. I was weak, exhausted, stiff. Every physical movement was laborious. My blood feeling thick. The glucometer simply registered “HI”, indicating that I was over 500 (normal is 100.) The long valley stretched below the small porch outside of the front door of the cabin. One could see forever in each direction, the mountains stretching out in front and behind. I inhaled a deep breath of clear crisp air. It was a new day.

In an instant, I noted small brown movements. A pack of 13 wolves moved below, a line and in bunches. At times taking small detours for play, they were on the move to points unknown. I opened the cabin door and silently motioned to the Boyfriend to come outside and we stood silently and watched the processing. The Stoner and his girlfriend were inside, obliviously packing. They were committed to carry on and leave us to make our way down the mountain.

I strapped on the skis and tried to take a deep breath before beginning to shuffle forward. Each step like molasses, overcoming huge inertia. My muscles were screaming, unable to move. I had to stop frequently to gather my energy to move again. Trying to move forward would be the only thing that would save my life.  The trailhead was 4 miles, but it was all an easy downhill.

We passed another cabin that we’d detoured around on the way in. The small group who’d stayed there milled about, chatting excitedly about the wolves and cheerily asking, “How is it going?”.  At that moment, I knew that unabashed honesty was called for.  “Not too good.” I rasped (my voice was hoarse from vomiting) “I’m Type 1 diabetic and I think I’m in ketoacidosis”

At that moment, a tall, bearded man looked at me deep in the eyes and said, “I’m an ER doctor. I can help you.” I wept with relief. His friends, nurses and others cleared out their cabin so that I could lie down. The doc came in and we checked the glucose again. The ominous result of “HI”. “You’ll get ten units to start”, he directed. “I’ll stay with you a bit to see how things go.”

Within an hour, my skin gained color again. In the second hour, the meter went from “HI” to 500, a good sign. Over and over again, deliver 10 units, check the glucose. A little Gatorade to replenish. “You’ve been through an internal trauma of some vital organs.” the Doctor said, “Your entire body broke down and poisoned itself.”

After another night in the cabin. I started coming back to life. The next day, we skied out slowly, I was still recovering equilibrium and confidence, but I was on the way to recovery. We made it to the car, drove two hours to his home. I continued to work on replenishing fluids. After about a week I was back to normal but changed forever.

While I’d thought that this experience would be a test for me, perhaps instead it was a test of a relationship that I thought could be lasting. We spent the rest of the weekend together, for the first time, in a haze of recovery and comforting. The relationship didn’t last longer than a year. I was not keen to have children. There turned out to be someone else with stronger chemistry. They married, procreated, moved from Alaska and then divorced. We’ve lost touch, but I'll never forget that experience.