2 weeks ago we received a telephone call from someone who works in a hardware store. A family he knew had a 16 year old girl who was very ill. She was at a clinic in Cabaret but had been referred for hospitalization. However, the family could not get the patient to a hospital due to political unrest- the roads were blocked both North and South of the clinic they were at. So they wanted to bring their loved one to Cazale. We had no idea what was wrong with the patient or if we could help her, but there weren’t a lot of options. So the patient was brought to Cazale. She arrived unconscious. She was breathing fast, heart rate was elevated, oxygen was ok. She had a small fever. Her blood sugar was 544. So, she had new onset diabetes, probably type 1 (juvenile) and was likely in diabetic ketoacidosis (DKA), a very dangerous, life threatening complication of untreated type 1 diabetes. In the United States, patients with DKA are admitted to the ICU. They have labs done every 2 hours and blood sugar checked every 1 hour. They require insulin in IV fluid with the dose changing frequently. 2 IVs were placed and the patient was given IV fluid and started on an insulin drip- prepared with donated insulin (thanks Corey!). Her electrolytes and blood gases were checked often with our recently donated iStat. We monitored her blood sugar every hour. Our lab technician worked tirelessly in order to run her labs overnight. I am happy to report that this young patient pulled through. She stayed with us an additional week after she was stabilized to get her on a stable insulin regimen and to educate her how to give herself insulin shots and learn about diabetes. Diabetes is a significantly monumental disease for a 16 year old to learn to manage. It’s been a rather exhausting process, but I think we are finally there. She will be discharged today. By the grace of God, we had everything we needed (with some improvising) to take care of this patient. Pray for V that she will remain steadfast in managing her chronic illness and not to become overwhelmed or discouraged.