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Rashid Al Khlaiwi was admitted to JHAH Dhahran with a life-threatening condition caused by undiagnosed diabetes. This is the inspiring story about how his diagnosis and treatment gave him the confidence to live life to the fullest.
Rashid Al Khlaiwi decided it was time for a health kick. In the run-up to Ramadan this year, the 15-year-old cut back on fast food and soda, started playing football, and began jogging. He lost weight — and fast.
“We thought he would drop maybe a couple of kilos before Ramadan,” his father, Bader, recalls. “But he lost a lot more weight than we expected. Of course, we were happy for him, because that’s what he wanted – we were just surprised about how quickly it was happening.”
But Rashid’s mother soon noticed something unusual in her son’s bedroom: a stockpile of bottled water. She asked Rashid how much he was drinking, and the answer shocked her: between 15 and 20 of the 330 ml bottles every day. She had a feeling something was wrong and immediately booked an appointment at Johns Hopkins Aramco Healthcare (JHAH) Dhahran.
On the first day of Ramadan, Rashid visited the hospital for blood and urine tests. He was found to have an unusually high blood sugar level, even though he was fasting. Meanwhile, his blood was found to be highly acidic — its pH had plunged from a healthy 7.45 to a dangerous 7.2, below which there is a risk of slipping into a coma. Rashid also had elevated levels of ketones in his urine and blood.
The diagnosis was clear: diabetic ketoacidosis, a life-threatening condition that occurs when the body cannot produce enough insulin. This insulin deficit causes the body to break down fat for fuel, which floods the blood with ketones; a harmful, acidic byproduct. Left untreated, diabetic ketoacidosis can be deadly.
“There is a spectrum of symptoms for diabetic ketoacidosis,” Dr. Jumana Amir, an endocrinology consultant at JHAH who treated Rashid, explains. “Sometimes, people present with stomach pains, nausea, and maybe vomiting. They may feel constantly thirsty and need to urinate frequently — as was the case with Rashid. They may also feel tired or confused. Whatever the symptoms, once the diagnosis has been confirmed, there’s always a rush to get the patient the treatment they need.”
Dr. Amir says it is relatively rare for a patient to present with diabetic ketoacidosis with only mild symptoms, especially without an earlier diabetes diagnosis. “Rashid can be thankful for his mother’s instincts,” she says.
Rashid’s next stop was the emergency room. Dr. Abdul Zakir Mohammed, family medicine consultant, who had seen Rashid earlier in the day, stayed behind long after his shift ended to ensure the team in the emergency department was properly briefed about Rashid’s condition. Upon arrival, Rashid received intravenous insulin, intravenous fluids, and oxygen. He was then transferred to the intensive care unit where his blood sugar, potassium levels, ketones, and blood pH were monitored to ensure the resolution of his acidosis.
“My wife was beside herself with worry,” Bader says. "Rashid is our oldest son. Seeing him like that in the hospital — she was devastated. But the way the doctors and nurses talked to her, comforted her, held her hand — it made all the difference. They made clear that his life was going to be normal, especially with all the technology available today to manage his condition.
“The nurses were also amazing with Rashid. Late one night, when my wife was exhausted and sleeping, Rashid was awake, bored, and playing with his iPhone – which promptly ran out of battery. One of the nurses found a charger for him and then sat down to talk with him while his phone was charged. They spoke at length about what he wanted to be when he grew up and what sports teams he liked.
“They told him not to worry because they’d had lots of patients like him before and reassured him that his condition was controllable. They told him about famous athletes who are diabetic, like Nacho, the former Real Madrid defender. Later, Rashid spoke to me about how friendly they were at the hospital, and how much he liked talking to the doctors and nurses.
The collective efforts of the care team not only addressed a serious medical condition but also instilled a sense of hope and confidence in us. Thanks to their swift actions and compassionate approach, my son is now on the road to recovery and managing his diabetes.
Rashid was in hospital for four days. He describes his stay as a “positive experience that changed my perspective on health” and says he is now feeling “really great” about life in general.
“I can live well and do what I want,” he says. “I can play football, eat at restaurants with my friends – I don’t feel limited in any way. Of course, when I was diagnosed with diabetes, I was worried. And in the hospital, I felt a bit down. But those concerns went away when I began to understand that it’s not hard to manage my condition.”
Rashid wears a continuous glucose monitor, which allows him to track his glucose level on his smartphone without the need for finger prick testing. He regularly visits a dietician and a diabetic specialist at JHAH, who review his insulin program and meals. “They tell me I can eat almost anything I want — it’s just about knowing how much insulin to take,” he says.
Rashid says he is now hitting the gym six days a week and is being coached in weightlifting. He swims and plays football, too.
If I’ve learned one thing, it’s that diabetes doesn’t stop me doing anything,
Dr. Tasneem Al Aqzam, a family medicine consultant who treated Rashid, says that a teenager’s response to a diabetes diagnosis can go in many different directions.
“Some patients are in complete denial,” she says. “This creates a high risk of further complications and places a huge burden on the individual’s family. Other patients feel bad that they won’t feel as normal as other kids; that they’ll be restricted from doing things.
“And then there are extremes like Rashid, who has changed his lifestyle completely, and gone above and beyond all our recommendations to improve his health. It’s been wonderful to watch him flourish since he left our hospital.”