Co Fermanagh mum's urgent hospital dash with daughter on the brink of diabetic coma
A routine trip to the doctor revealed that 12-year-old Aoife O'Donnell, from Co Fermanagh, was on the brink of a dangerous diabetic coma. Her mother, Roisin, who with husband Conor runs the award-winning Tara Lodge hotel in Belfast, tells Una Brankin their harrowing story
After a busy morning making breakfast for her five children and doing the school runs, Roisin O'Donnell was looking forward to an appointment at a beauty salon in Co Fermanagh.
That day, in April 2017, had begun with a detour to the GP with her eldest child, Aoife, who had a yeast infection.
After dropping her off at school, Roisin, from Rosslea, headed to the beautician to have her eyebrows shaped.
As co-owner of the award-winning Tara Lodge hotel in south Belfast, good grooming has always been important to her.
However, before she got through the salon door, an urgent call from the GP's nurse came through on her phone.
"We'd only left the surgery half an hour before - that's how quickly life can turn on its head," Roisin says.
"The doctor had tested Aoife's bloods. The nurse told me to go quickly to the Ulster Hospital and that they'd phoned ahead.
"It turned out that Aoife's blood sugar levels were 33 - the normal level is between three and four.
"Of course, I panicked. I hadn't a clue where Dundonald was. They had to give me directions... I've no idea how I got there."
Aoife, then 12, was on the brink of a diabetic coma. If she had delayed seeing her GP any longer, she could easily have died.
"It was just before Easter and we'd planned to go to our caravan in Rossnowlagh, so Aoife could have gone into a coma away down the field or somewhere," Roisin says.
"Diabetes hadn't crossed my mind. I had noticed Aoife drinking a whole pint of water one day, but I thought that was good and that she was being healthy. We had gone to the doctor's just to get her infection cleared up before the Easter break. The next thing, I was rushing her into the hospital.
"It was scary, going into the unknown. There were no symptoms, apart from the thirst, but Aoife knew there was something wrong, coming down the steps of the school, after she'd been told I was coming back to collect her so soon. Her brothers and sisters had to come out too."
Somehow the GP's message failed to register at the Ulster Hospital's A&E department but, recognising the gravity of the situation, the medics admitted Aoife immediately and began working on bringing down her blood sugar level.
"They had to get the insulin out that she was still producing on her own," Roisin says. "I hadn't a clue what was going on - all I knew about diabetes was from my father, who has very mild Type 2 (diabetes).
"But they were very reassuring and explained everything to my husband, Conor, and me.
"When they got Aoife stabilised, they taught us how to inject her.
"That was hard. I'm not good at all with needles, and when you have to inject your own child... I still find it difficult but it's second nature to Aoife now."
Aoife was closely monitored for four days before being discharged on Good Friday for a trial run of home care overseen by a specialist diabetes nurse from the South West Acute Hospital.
As well as receiving instruction in administering Aoife's insulin injections, the O'Donnells were taught how to regulate her carbohydrate intake by weighing her food.
"I learned how to work out the ratio of carbs and protein in her meals - there's a bit of calculating to do and (she's allowed) no convenience food," Roisin explains. "She has her dinner same as the rest of us, but I have to be careful with her packed lunch. It's usually a tuna sandwich on brown bread, yoghurt and a pancake or a scone for a snack.
"Fruit is a bone of contention - it's not cool to have a piece of fruit in your lunchbox, apparently, but she has a gluco-juice which she keeps in her blazer pocket, to get her bloods up when needed, and a bag of Jelly Tots. She used to have Fruit Pastilles, but they took too long to have an effect.
"I make sure she has some digestive biscuits or a Breakaway bar too, but there's no Haribo or chewy sweets for any of the children now.
"They're all much more aware of diabetes now and they know not to ask for a bag of pick-and-mix in the shop or cinema. That's not good for any of them."
Aoife, who's now 13, injects insulin four to five times a day, depending on her blood sugar level.
She is on a waiting list for an expensive insulin pump - a medical device that's attached to the body and is also known as continuous subcutaneous insulin therapy.
A standard pump includes a disposable reservoir for insulin and a disposable infusion set, including a cannula (narrow tube) for subcutaneous insertion and a tubing system to connect the insulin reservoir to the cannula.
In the meantime, Aoife wears a waterproof Libre scanner on her arm, which measures her blood level. She also has an app on her phone that keeps track of things.
Roisin admits she is constantly "harping on" at her daughter, asking what her levels are. "I'm the most nervous about the whole thing, whereas Aoife has adapted very well," she says.
"She can usually guess her levels - she knows her own body and when she's going low.
"She's very laid-back, which is a good thing because stress directly affects the level.
"When she was told about getting the HPV vaccine last year, for example, the nurse was concerned that her bloods were running high with the stress and anxiety over it.
"You don't realise stress can have the effect it does.
"I was also very nervous about going out to eat. Timing is important for Aoife's injections and I'd be worried about a delay in the food coming, but there's an app you can download now, which helps.
"I'm looking into getting a device to attach to the Libre scanner which would send her blood level readings to my phone.
"That would stop me from harping on at her all the time and it would give me peace of mind for her first school trip coming up, to Paris.
"I'm a wee bit anxious about it, to be honest, but I don't want to hold her back."
Aoife's diabetes nurse, Damien McHugh, has visited her school, St Kevin's College in Lisnaskea, to brief her teachers on the condition and treatment of it. He also runs fun days for diabetic children in Omagh and Enniskillen, taking them bowling or to the cinema, then out for a pizza afterwards.
To help Mr McHugh with the expense of running the service, Aoife recently asked her principal about organising a 'Soak the Teacher' fundraiser at school.
"Basically, they've to put their faces through a screen - which her dad is going to make - and the pupils throw sponges from a bucket of water over them for 50p a go," Roisin says.
"I don't know how many of them will be up for it. It could be just me and her dad on the day!
"It's good for her to be proactive and to give something back. She's helping to raise awareness of diabetes, so the injections are not something secretive you have to do.
"It is a lifelong condition, unfortunately, unless you can get a new pancreas, but who knows what the research will turn up?
"The pump will make a big difference. The only thing is that it has to be attached to the body. She is happy enough to do the injections for now."
Aoife lives a normal life. She plays the violin and goes swimming, even with her scanner on.
Rather than following her parents into the hospitality sector, she is thinking of a medical career in the future.
Roisin hopes another one of her children - twins Olivia and Claire (10), Aodhan (7) and Oran (2) - will carry on the Tara Lodge brand one day.
"The rest of the children are in good health, although I'm more wary now - I worry if they're pale," she says.
"Looking back, I wonder if I missed something with Aoife. I remember she was snappy and argumentative, but I put that down to her age.
"You blame yourself for not noticing symptoms or having gone wrong, but the doctors put it down to environmental factors. It's not hereditary.
"We try to keep things as normal as possible. Making a fuss makes children self-conscious.
"Maybe there will come a time when she thinks, 'I hate this', but she's very confident with injecting herself now when she's out.
"She just goes into the toilets and gets on with it, four or five times a day.
"That's the thing about children - they can adapt. They could teach us all a thing or two about resilience."
- The Soak the Teacher fundraiser for the fun day run by South West Acute Hospital diabetes staff takes place at St Kevin's College in Lisnaskea on Thursday, March 14. See facebook.com/stkevinscollegelisnaskea
Diabetes facts and figures
● There are 100,000 people in Northern Ireland with diabetes, and that figure is set to rise, according to the Diabetes UK charity.
● Celebrities with Type 1 diabetes include actress Sharon Stone, popstar Nick Jonas and singer and actress Vanessa Williams.
● Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.
● Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.
● Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterised by deficient insulin production, and requires daily administration of insulin. The cause of Type 1 diabetes is not known, and it is not preventable with current knowledge.
● Symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly.
● For further information, visit www.diabetes.org.uk
How hotel punches above its weight
● Roisin and Conor O'Donnell's Tara Lodge was recently placed at number 11 out of thousands of UK hotels on TripAdvisor in the influential hospitality guide's Travellers' Choice awards. The small hotel off Botanic Avenue was also placed at number 11 for best service.
● The modern premises has no bar or spa but offers excellent accommodation and gourmet breakfasts and a great location for both tourists and domestic visitors. It was voted Belfast's number one hotel on TripAdvisor for 10 consecutive years, beating the big players from the Europa to the Merchant. It still features in the top 15, despite increasing competition from new hotels in recent times.