Hannah Postles: Left to manage my own condition, I nearly died after collapsing at home

WHEN Hannah Postles was diagnosed with type one diabetes in her mid-20s, she was given a crash course about how to handle her condition, handed a bag of needles and shown how to inject herself and told “you’ll be doing this for the rest of your life”.

Hannah Postles, 29

Had she been diagnosed in childhood – as many with type one diabetes are – she would more than likely have been given specialist support in managing her illness. Miss Postles admits to not managing her diabetes “perfectly” – but while being acutely aware of the dangers of low blood sugar, she said she was ignorant to the immediate dangers of high blood sugar.

A year ago she collapsed and almost died when her blood sugar levels soared – causing her body to become acidic and her organs to start to shut down.

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Now the media relations officer at Sheffield University has written a blog about her experience and is calling for more support for young adults diagnosed with diabetes.

I HAVE no memory of this time last year. I was unconscious.

I didn’t know it, but my blood sugar levels had soared and poisonous chemicals were pumping through my veins. My body was, in essence, becoming acidic.

I have type one diabetes and had developed diabetic ketoacidosis.

DKA, as it is known, is a life-threatening condition. It happens when a severe lack of insulin means the body cannot use glucose for energy and the body starts to break down other body tissue as an alternative energy source. This causes a build up of poisonous chemicals called ketones. If unchecked, this can be fatal.

For me, it nearly was. And I had not seen it coming.

A few days earlier I had been at bridesmaid at my sister’s wedding. I was full of energy, running around chasing my baby nephew. Family and friends had commented on how well I looked. The next day I started to feel a little nauseous, but put it down to perhaps one too many glasses of wine at the reception. Overnight, I felt horrendous. My smoke alarm battery had died and it was beeping incessantly, but I felt too ill to deal with it. Perhaps I should have taken that
 as a warning sign. I remember staggering to and from the bathroom to be sick. I remember lying on the sofa wondering what the number for NHS Direct was. That’s all I remember.
Two days later I woke up in intensive care.

The gaps have been filled in for me. Colleagues, who had become worried when I didn’t turn up at work, leapt into action. They called my family, who had seen me looking healthy and well just three days earlier. A workmate’s partner was sent to my flat, where she found me babbling incoherently on the floor behind my front door. I have no idea how I ended up there.

I was taken by ambulance to hospital where I was immediately admitted to intensive care. I had kidney failure, was severely dehydrated and struggling to breathe. A central line was put in my neck and I was pumped full of fluid, insulin, antibiotics and sodium bicarbonate. I’m told my eyes were rolling around my head and I was making little sense.

My first memory was having a feeding tube forced down my nose. I must have appeared responsive as a doctor asked me: “Do you know where you are?”

“Hospital,” I replied.

“Do you know which one?”

For some reason, I gave the name of the hospital in my hometown. A place I have not lived for 11 years now. I was clearly still delirious.

I then remember waking up wearing a “space helmet”, or CPAP as the doctors called it. My sister says the first thing I said to her was: “What’s this thing on my head?” I was later told the helmet was replicating the effect of sticking my head out of the window travelling at 100mph down the motorway, forcing air into my lungs to help me breathe.

From then, I was conscious, but still not well. My kidneys weren’t working properly. Within a week of being in hospital, I had put on four stone in fluid. When I was admitted to hospital I had shrivelled to just over seven stone. I was now 12 and a half stone.

I was bed-bound, relying on nurses to clean me. The bedsores were excruciatingly painful and I couldn’t move. After a week on intensive care, when I was first moved to a ward, two nurses struggled to roll me over to wash me and change my bed sheets.

After two weeks of being unable to move, when I was finally free of a catheter, I made my first attempt to walk the few steps to the toilet. Within seconds I’d collapsed into a heap on the floor. I had to lie there until a passing nurse heard me calling out for help. My body didn’t feel like my own. My legs were like tree trunks, my arms like Popeye’s and I could barely waddle a few steps. I felt like I had no dignity left. I cried.

Doctors, concerned about some unexpected pressure around my heart, feared I had a blood clot. My kidneys were not functioning well enough to cope with the dye for a CT scan so I had an ultrasound on my legs. Nothing
was found, but it could still not be ruled out.

Despite all this, I had many reasons to be thankful. Firstly, that I had even been found when I collapsed. Had it been any longer, I dread to think what might have happened. Family and friends visited me every day and
gave me the positivity and strength needed to cope with three weeks in hospital.

Eventually, my kidneys were able to handle water tablets. I was losing half a stone a day. In fact, once all the fluid had gone it revealed a frail, weak frame. My muscles had wasted away. A CT scan revealed I didn’t have a blood clot and the pressure around my heart soon disappeared. After 21 days in hospital, I was discharged.

That doesn’t mean it is over. Hopefully no long-term damage has been done, but I am still diabetic and always will be.

I wanted to share what happened to raise awareness of how dangerous diabetes can be. I had it and I didn’t know. I knew low blood sugar could be immediately bad and high blood sugar posed risks in the long term. But I didn’t realise it was possible to get so ill so quickly.

Many people ask me why this happened. I don’t know. I had not 
been controlling my condition 
well, but I had not been deliberately skipping insulin. There are two possible explanations for what 
went wrong: I became sick and 
my blood sugar rocketed, or my 
blood sugar was high and it made 
me sick. I’ll never know which one it was.

What I do know is when I got
sick, I didn’t know what to do. To manage my condition, I inject myself with insulin four times a day. When I’m unwell, I have a flowchart to follow which involves giving a certain percentage of the previous day’s
insulin every two hours. Initially, I hadn’t felt sick enough to consider following my “sick day rules”. By the time I did, I was too sick to contemplate doing it.

I was only diagnosed with diabetes two and a half years ago. I’d had 26 years without having to enforce a regimented routine of counting carbohydrates and injecting insulin. I found it difficult to adjust and I’m still learning now.

Had I been a child when I was diagnosed, I believe I’d have been given more support. Within 24 hours of diagnosis, I had been sent home from hospital with a bag of insulin and needles and told I would be giving myself injections for the rest of my life. I was then largely left to my own devices.

I’m still not the perfect diabetic. I probably never will be.

But I now know how important it is to look after myself properly. My life depends on it.