Battling liver failure and type 1 diabetes at 19 years old

Rachel Ng was scheduled to get a blood test on July 7 last year, as she had not menstruated in three months. She never got to go for that blood test, however. A day earlier, she collapsed at her neighbourhood market and was brought to the hospital. 

“What I could remember was being in a wheelchair and when I woke up, I was on a bed,” the 19-year-old polytechnic student said. 

She recalled having a high fever, going into septic shock and requiring a breathing tube. She also needed multiple cannulas and a feeding tube.

As her blood glucose level was 23.9 mmol/L – much higher than the norm of below 7.7 mmol/L – she was diagnosed with type 1 diabetes mellitus, an autoimmune disease with no known cause. 

The disease started when her immune system attacked her body’s insulin-producing cells. As her body did not have the insulin needed to break down glucose, her glucose level rose dramatically. For the rest of her life, she would have to inject insulin into her own body.

But that wasn’t the only bad news she received. Four days after her hospitalisation, she was also diagnosed with acute liver failure and had to be transferred to another hospital, her oxygen tank still in tow.

“I didn’t even know my diagnosis. I remember I just felt very confused and was wondering why they wanted to transfer me.”

At the second hospital, she was treated for her liver failure with two rounds of plasma exchange, using 36 packs of blood each time. 

She only remembered feeling very cold and tired. Her father took three weeks off at work to look after her and discuss her condition with the doctors, but she was too weak to listen to them.

As she slowly recovered, she started physiotherapy. Her religious faith kept her going too, so instead of feeling upset at her predicament, she just wanted to “recover and get out of the hospital”. 

The worry only crept in when she reached home after being discharged.

“I remember thinking: ‘Why did this happen to me? How am I supposed to explain this to my new classmates?’” she said.

As Rachel was hospitalised a month before her tests at the end of the first semester in her second year, she deferred her studies temporarily. While her friends moved on to learning new things, she had to stay behind to repeat that semester.

She had to join a foreign class full of people who were already friends with each other, making it hard for her to fit in. 

“I faced worries like how my new classmates would react, or if they would think I was a remod student,” she said.

Now, while her friends have all moved to Year 3 and are working at their internships, she’s still in Semester Two of Year 2.

Graduating later than her friends was the least of her worries when she returned to school.

When she was first discharged from the hospital, she had to take a concoction of medicine – including steroids, multivitamins, Vitamin C, magnesium, iron pills and insulin. She also needed to eat all three meals a day so she could take her insulin regularly, but she ran into another problem: there weren’t enough healthy options at school.

 In order to ensure her glucose level did not rise too much, she had to avoid carbohydrates – including bread, rice and noodles – which were everywhere on campus. 

She said: “My family and friends tried to motivate me to get well soon by telling me that I can eat good food when I recover. But because of my diabetes, I have to limit the number of sugary foods I eat.”

While type 2 diabetes can go into remission and remain stagnant with lifestyle changes like exercising, type 1 diabetes cannot be cured at all.

With type 1 diabetes, Rachel has to prick her finger to test her blood glucose level three times a day, as well as inject insulin into her own body four times a day. Without insulin, her glucose level would rise dramatically, putting her at risk of amputation or blindness.

Rachel also shared that she dislikes it whenever someone asks if it hurts while she’s testing her glucose levels.

“Don’t ask whether or not it hurts, because even if it’s painful, we still need to do it. When you say that, it’ll just affect our psyche,” she said candidly.

While Rachel will have to prick her finger and inject herself with insulin for the rest of her life, she doesn’t let type 1 diabetes bring her down. Instead, she believes that diabetes shouldn’t affect her life and that other youths with diabetes should “just live as normal” while monitoring their insulin-to-carb ratio.

She said: “Even when I have all these conditions, I still continue to move forward, survive and live life.

“I wish I could’ve told my past self that I’ll be stronger out of this.”