Nearly 800 miles from the hospital where her daughter was fighting for her life, Carolyn was trying hard to stay calm.
"Is she going to die?" she asked her husband, Ken, who had called her from the Critical Care Unit at Phoenix Children's Hospital to break the news about their daughter's sudden onslaught of diabetes.
"I don't know," he said, unwilling to offer more assurance than he felt. He was crying too hard to say much of anything else. A nurse pulled the phone out of his hand and took over the conversation.
"She's not going to die," the nurse told Carolyn, offering firm but gentle reassurance. "You need to get here as fast as you can, but she's not going to die."
Carolyn had flown out of Phoenix the day before to spend a long weekend with a friend in San Francisco. Ken took two days off work, looking forward to spending uninterrupted time with 7-year-old Hannah. The pair had planned to go horseback riding the first day, but Hannah woke up with a sore throat and a slightly upset stomach. Ken assumed his daughter was coming down with a cold or the flu, and made a quick change of plans to spend a quiet day watching videos at home.
But the day turned out to be anything but quiet. Hannah's symptoms worsened as the day wore on, and by mid-afternoon she was screaming from stomach pain.
"I assumed I was dealing with a burst appendix," Ken said. He whisked Hannah into the car for the three-minute drive to their doctor's office, where they were re-routed to the emergency room of a community hospital. A physician there diagnosed Type 1 (insulin-dependent) diabetes.
"If this was my daughter, I would want her to be at Phoenix Children's Hospital," the ER physician told Ken. By this time Hannah was only semi-conscious, and Ken quickly approved the transport to PCH. Forty minutes later, he looked on helplessly as a helicopter took his little girl away.
"I will never forget the image of them wheeling her into that helicopter," he said. "It felt to me like I was losing her."
Indeed, his daughter was in grave danger. She was dehydrated, and her blood sugar levels were extremely high. Medical staff worked to bring the levels down slowly, taking periodic blood tests to monitor their progress. Within two hours, Hannah had regained consciousness, and doctors were able to offer the first real hope that she would likely survive the ordeal.
Carolyn arrived later that night, having waited an agonizing three hours for an available flight back to Phoenix. She had spent the time wondering what lay ahead for her daughter.
"I didn't understand anything about diabetes," she said. "I didn't know anybody who had it."
Her understanding grew considerably after her arrival at PCH, where the family spent the next few days learning about their daughter's disease from doctors, nurses, a nutritionist and a diabetes educator.
"It was really like going to Diabetes 101 as a family," Ken said.
Diabetes, they learned, occurs when the pancreas does not make enough insulin, a hormone which allows glucose to enter cells and to be used as energy for the body. Without insulin, glucose builds up in the bloodstream and urine, and the body loses its main source of fuel. Hannah would need daily insulin injections, but her parents were relieved to learn that she would be able to live a normal, healthy life.
A nurse taught Ken and Carolyn how to give the needed injections, offering her own arm for practice. She also taught them how to do the "finger pokes" that would be necessary to test blood sugar levels four times each day. Hannah took on that responsibility at once, wanting to have some measure of control over the disease that seemed to have taken control of her.
Recently, she told her parents she was ready to begin giving her own injections.
"It's been a huge breakthrough," Carolyn said. "Emotionally, she's in charge of it."
Technological advances may simplify Hannah's life in the future. Doctors talk about the possibility of insulin available in eye drops, and ways to test blood sugar levels without finger pokes. Endocrinology staff look toward the possibility of a cure in the future.
"I'll stay guardedly optimistic," Ken said. "At least it's something that's manageable."