Test Your Breath for Diabetes: A Child’s Story

My friend had a horrible experience that I would never wish on anyone. I was glad that I may have made it a little brighter, because I listened in my Biochem class, but it was still awful.

The story begins a few weeks ago when this friend texted me that her daughter, Sarah, was sick. She was tired, she wouldn’t eat, and always wanted to drink water and juice. She was having seizures, and every visit to the Emergency Department ended the same way: it’s the flu.

I am currently in school to become a nurse. One requirement is to take a Biochemistry class. This day, we were learning about simple sugars like glucose. The professor was covering a section on diabetes, and she shared a story that a previous student told her class. We’ll call her Mary.

About 20 some years ago, Mary’s niece–otherwise healthy–suddenly became sick. She was tired, didn’t want to eat and only wanted water or juice. Her niece began having seizures, and Mary’s brother took his daughter to the Emergency Department. He was told, “it’s just the flu”. Later, the little girl started to vomit black liquid. They rushed her to the ED of a children’s hospital, and the doctors admitted her. They began to run tests, but were not finding any answers. She was taking a turn for the worse. The staff had her resting in bed, when a doctor who wasn’t normally on that floor passed through to get to another area of the building. This doctor popped into the room and commented on her severe acetone breath. Her breath smelled sweet and like nail polish remover.

A round of basic and complex tests were performed, and it was quickly diagnosed as type 1 diabetes. Her blood sugar level was over 900. By that point, it was far too late. The girl slipped into a coma and died. The unique and strange part of this story is that it happened over a period of three days. The doctors were baffled by her case, but there wasn’t time for further analysis.

As my professor relayed this story to my class. I immediately thought of my friend’s daughter, Sarah. I texted my friend and told her to smell Sarah’s breath. She said it was an odd request, but she’d go check. It smelled like acetone. I told her to go to the ED and make the doctors test her for type 1 diabetes. Sure enough, that was the answer. Her blood sugar level was 850 and thankfully, they were able to treat her promptly. Over the next two weeks, doctors worked on controlling her diabetes. They just couldn’t get it to stay under control. It bounced up and down. Soon, Sarah also slipped into a coma and passed away.

The sudden warning sign of one’s breath smelling like nail polish remover occurs when your body is unable to utilize sugar properly, and burns fat for fuel instead. The chemical compounds released during this process are known as ketones. The ketone, acetone – a key ingredient in nail polish remover – produces the telltale diabetes warning sign of fruity-smelling breath. Referred to medically as diabetic ketoacidosis (DKA), this symptom can result in a diabetic coma if left untreated.

There is no happy ending to this story, but I wanted to share, because you never know who out there suffers from the same thing with no answers. Also, I wanted to share this, because you do learn things in the classroom you can apply to actual situations. Please feel free to share your own stories below.

One thought on “Test Your Breath for Diabetes: A Child’s Story

  • May 20, 2015 at 8:17 pm

    When I saw your post on Facebook about your tragic situation, I immediately thought of my type 1 diabetes scare. I wanted to share the story. Here goes:

    My daughter was vomiting. While I had weathered stomach viruses before, something felt different. Her throw up looked like a marshmallow, and her after-puke breath smelled like melon. I keep an eye on her, take the day off work to feed her small tears of toast and homemade Gatorade that she actually liked more than Gatorade. Odd, though, was she was not really exhibiting any other symptoms, so it didn’t feel viral or like a minor case of food poisoning. She fell asleep after her last vomit session and I decided to call our pediatrician’s office.

    “Can you stay home from work for another day?” asked the nurse. “A bad wave of gastroenteritis is going around. If it’s that, in another 24 hours she should be doing better.” I was half-relieved and half concerned I was just being brushed off. I called my husband at work. I don’t know why, but the marshmallow and melon thing did not feel right to me. My hubby said he could work a double that night into the next night, so I called in.

    I let my daughter sleep the day away, but woke her after about 4 hours to eat something. For not having thrown up in 4 hours and getting 4 hours sleep, she seemed very weak and I noticed her breathing was…off. Not being a medical person I don’t know how else to explain. It was labored, I think they call it? She asked for more Gatorade and she finished THREE glasses.

    I texted my husband and asked what he thought I should do. He wrote back, “Honey u r worrrying too much. I hv that meeting. Txt u when I’m on break. I luv u.”

    I called my mother. FIve minutes into the call I remembered why I try not to call my mother for anything that can possibly be blown out of proportion. Inside that five minutes, she had somehow convinced me this could be a medical emergency and we needed to ambulance my daughter to the emergency room. I told her I was not going to put her through that kind of traumatic experience, but if she wanted to come by, I would drive us all to the hospital where they have a rapid care office connected to the ER.

    A nurse walked in and asked questions, as she began gently examining my daughter. “She’s dehydrated. Do you think she can drink this?” she asked. It was a fizzy tablet floating in a dixie cup of cold water. The nurse said this is prescription grade concentrated Gatorade, mixed with some other nutrients Gatorade doesn’t have (and definitely my homemade Gatorade didn’t have). She said my daughter should be feeling better within 30 minutes. That was an immediate relief. An hour passed, with no improvement. Two hours, and I first noticed dark circles under my daughter’s eyes, as if she hadn’t slept in days. Her voice was weaker than before, and she didn’t want to move from the fetal position she had taken on my lap. I called my husband and told him he needed to get here now. He could tell in my voice that something was seriously wrong, because he didn’t mention he was still in the annual review meeting.

    He arrived right as the orderly was wheeling our daughter into a private room. They started to take blood from her finger. My husband said “she didn’t even flinch…” “I know..,” I said, and I teared up. We hugged. A doctor walked in, asked us to please sit down and said they had a diagnosis. I was taken aback at first, because I didn’t know they were even considering diagnosing her. Everyone had acted as if I was really taking this too seriously.

    The doctor said, “it’s Type 1 Diabetes.” My husband said it before I could.: “How do you know that from one finger prick?”

    The doctor went over a list of symptoms and checked them off as I nodded to many of them. Rapid breathing, a face rash, that fruity smell coming from her breath and pores, urine overloading her diaper, and extreme thirst. Then came the part that made me thank god I was my mother’s daughter, and that I worried easily. The doctor told me that if we hadn’t brought her in for this, it could have rapidly gotten worse and she could have died. I asked for a minute, which turned into 10. I ended up in the stairwell and I was wailing.

    I walked back in, red faced, as the doctor was explaining to my husband and my mother, “The vomiting means she’s entered ketoacidosis, which comes from lack of insulin. Her glucose reading is 300 points above normal. Her body is burning fat instead of sugars for energy.” He asked if we wanted to watch a video and we said yes. I had to hold my emotions, as my daughter slept next to us in the hospital bed as we watched and listened to everything that could have and could still go wrong with a new type 1 diabetes diagnosis.

    That was 5 years ago. The first couple of days in the hospital were terrifying, only to be followed by a couple months of nerve-racking changes to many of the things my daughter liked. Plus the blood sugar level checks and the medicines. But most of the time now, we don’t even think about the fact that she has diabetes. She is an otherwise healthy and active kid, who has to do certain things her friends don’t, but we helped her realize the things her friends do that she doesn’t.

    Wow, this was a really long post on a site that I have never been on before. I wanted to write this, because your story moved me and really got me thinking of what happened to our family. I think you will be an excellent nurse and many parents will feel about you the way I feel about the nurse and doctor who took care of my daughter that day in rapid care and the ER.


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