“I need help getting to the bathroom,” said Nicole at 3:30am, last Thursday morning.
I went to the side of the bed to help her up.
“No,” she said. “I can’t walk. You’ll have to carry me.”
Even on our wedding day Nicole didn’t like being carried. For her to ask to be carried meant she was really feeling poorly.
“I’ve been having diarrhea all night and more is coming.”
I immediately suspected dehydration. But, first thing first. When you got to go, you got to go. So I scooped her up (sure glad she’s thin) and carried her into the (way too narrow) bathroom. After she was done she could barely stand to wash her hands.
“I’m having trouble breathing,” she said in a weak voice.
I carried her out to couch in the living room. I grabbed a glucose testing strip, her lancet and the glucometer. Her blood sugar was 12 mmool/L. High, but nothing debilitating.
Next, I plugged in the blood pressure cuff. 60/40.
“When’s the last time you drank anything?” I asked.
“Not since before dinner,” she managed to whisper.
Since Nicole’s in stage-5 kidney failure and it had been two days since her last dialysis treatment, it’s not odd for her to be limiting her fluid. But, with all the diarrhea, maybe she’s just lost too much. Still, she actually looked slightly bloated.
That’s when I noticed the heart rate on the blood pressure display: 55bpm. Nicole’s pulse (like many with renal failure) averages 85bpm. This was a good 25 points lower than I’ve ever seen her.
“Alright,” I said getting up and going to the distiller in the kitchen, “let’s try water.”
She couldn’t lift the water bottle to her lips. So I put it to her lips and, one slow gulp at a time, swallowed a cup’s worth.
Within a few minutes she said: “More diarrhea is coming.”
So I scooped her back up and raced her to the bathroom. When I put her down on her feet she just collapsed to the floor.
“What’s going on?” she cried. Later, she told me at this point, she was really feeling scared. She wasn’t losing consciousness. Her mind was alert. But her body was shutting down.
I picked her back up and set her on the toilet. She just flopped forward. So I leaned her against the wall (maybe the bathroom isn’t too narrow after all).
It was looking like a scene from the movie Breathe (where a Englishman contracted polio in South Africa). While polio seemed unlikely here, other possibilities started racing through my mind.
“Don’t move,” I said superfluously. “I’m calling an ambulance.”
Next post, I’ll share what came next. Rest assured, it has a relatively happy ending. Nicole is fine now. The Angel of Death, however, came pretty close to taking her away.
In the trenches with T1D & ESRD,
– John C. A. Manley
P.S. I’m sharing this story for two reasons: 1. We seem to have settled (at least for us) a debate in the nephrology world about how to care for those with renal failure. And 2. To motivate those with T1D to do what they got to do to avoid losing their kidney function (as stage 5 kidney was behind this near fatal Thursday morning).
P.P.S. I haven’t posted for a while because we’ve been busy trying to raise money for our $49.3K experiment. We have been preparing a direct mail campaign to wealthy individuals and organizations who have donated to similar causes in the past. You can see a copy of the appeal we are mailing out here.