College and diabetes follow up

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1

So as every good diabetic does I made sure I was eating well and getting sleep and not over doing it throughout the whole semester until finals week. Now let me start by saying I am a freaking studying machine the two weeks of finals and this time it got the best of me. It started with a meal skip here or there and then no sleep nights and then the less testing equals more study time which by the way is a big NO NO!! don't ever rely on the CGM for results people. always test!! Okay now I got to my fist class that morning did fine and was going to put in my CGM right after class since I was running late last Thursday. I forget to put it in because I was getting in one more hr of study time with my group and then went to class. well I am not one to feel a low BG. I got to class and finally tested for the first time after not eating breakfast and my professor is a nurse and stands there always checking out the number before I take any exam and it popped up a 31 mg/dl. I was seriously like no way and trying to deny it while my professor is like sit don't move. He comes back with juice and crackers and tells me to eat it and then proceeds to lecture me on type 1 diabetes control and uses this time as a great way to instill certain diabetes points into my classmates. ugggh really?? I mean I am fine can we just take the test already?? uhh check again 37 mg/dl so he decides it is time for an ambulance I look at him like seriously?? I am still awake and can treat myself!! Not good enough for him so her comes medics into my class stretcher and all and they decide to agree with him and talk me into going saying that I could come back for the exam if the doc okays it. So off we go to the ER where the real problem happened. I get there and I know that this is the ER where my other professor works so I might get out real quick like. No she was not there and the doc comes in says to start a line and push D50 1 amp. ohh and eat this while they work on that. okay no problem. Well 14 IV sticks later including 2 EJ's it was not happening now I am all for showing some love to the ER staff they make my life easy most of the time but I sat in the room for 14 hrs with no IV access and a BG of no higher then 40 mg/dl at any given time! This is an epic fail on the ER docs part because her has the training to start a central line and it was warranted in this situation after finding I had a hella kidney infection which for some freakish reason always causes lows in me ( so ha so not my fault on lack of sleep or skipping meals well okay maybe a little) Anyways It is like 11 at night now mind you I got to the ER at 10:30 am and all this time with no access and no rising in BG. They sent me to the floor with no IV access and what they call a critically low BG. The floor flips a lid but has to take me and calls in the surgeon and he puts in a central line and apologies for the lack of care in the ER saying he was going to ensure this never happens again. Now even worse was the pic line person that was on call was 5 hrs away yes 5 but the on call surgeon who was great was there in 5 Min's. I get amp's of D50 and and put on a D 10 drip till morning. here pops in a nurse every hr to check the sugar and ensure my safe sleeping. My doc shows up in the morning and he apologizes for everything that was an epic fail and decided based on previous admissions and history that I needed a port for the future and he scheduled it with the surgeon who put in my central line and so now I am good with access for the future. Now my numbers are getting better and off of the D 10 I go and I shoot high in the 300's for the first time in a while so I feel like crapola and the doc didn't ask me what my correction factor was he just decided that 1 dose fits all or something cause he did the BG-100/20 which equaled out to be 7 units. Way to much for me people!! if it would have been calculated by my correction factor bg-100/50 I would have been fine but No lets not listen to the diabetic who deals with her doses daily!! I fall asleep and the nurse comes in to check the sugar and finds I am at 41 and wakes me up and I am so tired and sweaty and it was my professor she was working the floor that night and had me some juice and why I am addicted to gram crackers in the hospital with the lil peanut butter cups I have no clue but she had those too ( I have been known to grab a couple on busy days when I am dropping off a pt ) She told me about the port placement and how that was going to go and asked me if it was okay to talk to my other professors about still being here and needing an extension on my exams and said heck yeah. so I am assuming it was a slow night cause she sat in there with me for a bit till I was nice and leveled again and then she did all my checks for the rest of the night instead of the tech. I learned a lot from her though out this stay with her care towards patients and families and even other nurses she showed me compassion and Patience's she also showed me how a true nurse is the patients advocate. She stayed after he shift was over and was there when I got out of the surgery for the port ( not as bad as I thought BTW ) and she even helped me knock out some studying for exams I got out of the hospital 6 days after my admission and was spoken too by the hospital administration who I guess was worried I was going to make a big fuss over this who ER fail thing but I told them while I am really upset that it happened I just wanted to ensure that it never happened again. A lot of nurses ( my professor said they should have been questioning the doc as to why he was not treating my lows more aggressively and made sure that I was okay because A BG of 40 and below for 14 hrs is unacceptable )

So now I am finished 4 of the five classes I have 4 A's!!! yeah me!! and it is looking like I am going to end up with a high B or low A in the final class it depends on how I do on the final which is scheduled for the 3rd of jan. and then my new classes start on the 5th. there are many things I have learned

1. my diabetes care comes first otherwise I will never graduate! lol

2. NEVER EVER trust the CGM as a sub for my meter!! trust me people!!

3. Don't over do it!! it is not worth a hospital stay!!

4. I can do this and maintain my health thanks to my professor who happened to be my nurse in the hospital I am more confident in my ability to care for myself work and do school and I have her for 2 classes next semester!!

2

What a story. That hospital story is unbelievable and very scary.

Congrats on your grades and thank you got sharing all this. I’m sure it’s very easy to get engrossed in studying and forget about D a little.

3

It is scary but they are working on ensuring it never happens to another person and as for school I just have to remember that while my grades are important my health is more important and I will be applying this to next semester thanks lorraine

4

Looks like the professor who sent you to the hospital was right about your needing more care. I'm glad they caught the kidney infection!

I was in the hospital for a coma in September. Nursing care wasn't great (like when they removed my urinary catheter, and then let me lay in my own urine for 12 hours), but at least they kept me alive, and got my sugar down. Even if not very efficiently -- they assumed I was a Type 2 and didn't need insulin if my BG was good, totally ignoring that if I was going to eat, I needed insulin to cover the meal. Plus my dawn phenomenon.


Then they sent me to a convalescent home, because my BGs weren't down sufficiently, and there, they had an antiquated sliding scale and I had to fight to get sufficient testing and correction to actually lower my BGs. I was there for 3 miserable weeks.

The problem, I think, is that their protocols demand that one size fits all, and that is patently untrue. It's best to have an advocate who knows YOUR diabetes, and can fight for you when you are too out of it to do it, as I was for the first day and a half I was there. Even after that, I was pretty fuzzy -- when your metabolism is screwed up, your brain is, too.

I sure hope neither you nor I have any more dealings with hospitals!

5

Glad things worked out in the end. I am a nurse also and sounds like the ER needs some serious help. Hopefully they will rectify it, and yes the nurses should of been on top of it and a surgeon should of been called immediately to get a line in you.You said your professor is a nurse, are you in college studying nursing? Good luck with your studies, you have a good head on your shoulders, make sure you take care of yourself.

6

I just finished my B.S.N and ow working on my NP. I have been a medic for over 9 yrs and decided I wanted to do either emergency medicine or endocrinology not sure which yet. I am really learning what college and work together can do to my diabetes and I am learning to not put my diabetes on the back burner. I am blessed to have wonderful professors and the two that were involved with this are nurses one is apart of a bigger hospitals transplant team and the one is the nurse at the hospital I was at and she is amazing! I only hope that I am as compassionate and caring for my pts and advocate for them as she does! I have her and the other again this coming semester! I am one of 2 type 1 diabetics in this program and we help each other out and everyone knows we have it they especially know i have it now lol

7

WHEW!! Luckily all ended well THIS time!!!

8

My heart goes out to you. On many levels. As a fellow Type 1. As a woman studying like crazy to get good grades.( I have gone through a Bachelors, Masters and Doctorate.) And getting a BG of 31. I remember the panic I felt, knowing I had to get that number up . Fast. I cannot imagine the time you spent in that number range, and what you must have felt during the ER failures. I too, have had moments in hospitals for different things at different times, when they screw up. And I tell them. I learned at 16, getting an operation, not to take no for an answer/ The nurse came in my room , with my insulin shot. I knew the dosage was supposed to be half because I was about to go into surgery.(This was a zillion years ago, before my pump, before BG testing before anything. We were still testing urine.) Anyway, I refused the shot. The nurse could not believe her ears. She insisted I take it, I said, No way. She said I will have to get the doctor. I said , Please do. I then explained the dosaging, and the dosage was quickly changed to half the dosage not double. I guess the point of your story and mine, is that we have to be our own best advocates, even when our brains are functioning with half the oxygen from a 31.

9

WOW, I'm glad your ok.

I think you'll make a great NP

Congratulations on your fantastic grades.

brn

10

Thanks everyone for the encouragement I am really gearing up for next semester i have 4 classes 4 days a week and it is going to get interesting!! I know I will do so much better with the knowledge i learned from this go around.

11

Thanks for the post! I agree; it’s hard to take the time to do the studying while managing the diabetes. I started on the CGM this semester. I have been known to time the change in sites so that it didn’t interfere with when I was in class… Good luck studying for the last exam!