Day 3 – When DKA stopped being the scariest thing

Day 3 is where the story stops being “I’m in DKA” and turns into something much harder to process: my heart started failing.

Up until this point, the working assumption was that I was critically ill because of diabetic ketoacidosis (DKA). That was true — but it turned out to be only part of the picture.

The overnight shift: from unstable to crashing

Overnight, my heart rhythm had been bouncing all over the place. What started as extremely fast heart rates eventually revealed atrial fibrillation with rapid ventricular response (AFib with RVR). Medications slowed it down, but my body wasn’t stabilizing.

By the morning of Day 3, several things were happening at once:

• My blood pressure dropped dangerously low
• IV fluids weren’t enough to keep my circulation going
• I needed vasopressors (medications that force blood pressure up)
• An echocardiogram showed my heart wasn’t pumping well

At this point, DKA wasn’t just stressing my body — it was overwhelming my cardiovascular system.

Quick explainer:
Vasopressors are medications used in ICU settings to keep blood pressure high enough to perfuse vital organs. If you need them, things are already serious.

The echocardiogram that changed everything

An ultrasound of my heart showed something no one expected:

• Severely reduced ejection fraction (how much blood the heart pumps)
• Both sides of my heart were struggling
• My circulation was collapsing despite treatment

This explained why fluids weren’t helping anymore. My heart simply couldn’t push blood forward.

At that moment, the medical team shifted from “treat DKA aggressively” to:

This is cardiogenic shock.

Cardiogenic shock means the heart cannot pump enough blood to meet the body’s needs. It’s one of the most dangerous forms of shock, with a very high mortality rate if not treated immediately.

The STEMI alarm — and why it mattered

An EKG showed ST-segment elevations, which usually trigger a STEMI alert — essentially a “possible heart attack” emergency.

That set off a chain reaction:

• The cath lab was activated
• A higher-level cardiac center was contacted
• Transfer plans started immediately

Even though I was young, thin, and had no known heart disease, the data was clear: my heart was failing fast.

Why I had to be transferred out of the hospital

The hospital I was in could manage DKA.
It could manage arrhythmias.
It could not manage advanced cardiogenic shock.

I needed:

• Emergency cardiac catheterization
• Advanced heart failure specialists
• Mechanical circulatory support if things worsened

So the decision was made to transfer me — not to a regular hospital floor, but to a tertiary cardiac center equipped for the worst-case scenario.

This wasn’t about convenience or precaution. It was about survival.

What I remember (and don’t)

By this point, my memory gets fuzzy.

• I remember brief conversations.
• I remember being told I was being transferred.
• I don’t remember the transport itself clearly.

What I didn’t know at the time was how close things were to escalating even further.

The quiet realization

Looking back, Day 3 is the day I crossed an invisible line.

Up until then, I thought:

“This is awful, but once the DKA resolves, I’ll start getting better.”

Day 3 proved that assumption wrong.

DKA didn’t just reveal diabetes.
It exposed how fragile my body had become — and how quickly things can cascade when multiple systems fail at once.

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Next: Day 4 — arrival at a new hospital, a failing heart, and the moment modern medicine quite literally took over keeping me alive.

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