Just spent a week in hospital. I swear dietary is any thing but. They thought low carb means 50% carb (And low fat). Gave me heaps of rice (though I told them I don’t eat rice) and heaps of fruit.
Good thing I was too sick to be hungry. …
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yeah they feed you all the carbs and then don’t give enough insulin. I was in the hospital prior to getting my insulin pump and they had that sliding scale protocol that was designed over 50 years ago. I was glad to get out after a week.
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The hospital told my father in law that rice is a vegetable.
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I ran into that a few years back. I had to spend 4 days in the hospital recovering from surgery back when I was on MDI, and when they came in with the R & NPH vials the first morning I freaked. Thing is, when you’re in there you’re not allowed to do your own meds for anything, even stuff totally unrelated to why you’re there. So they were pretty adamant. But so was I. In the end we came up with a compromise where I told them what lantus and novolog doses to give me, and we all pretended they were administering 'em… though we all recognized that that was ridiculous so they let me do it anyway.
I would guess, though I haven’t experienced it, that with the pump you’re not subject to this, partly because it would be impractical, and administratively via the loophole that it’s technically a prosthetic device not a pharmaceutical. But I don’t actually know–maybe someone else can weigh in on that.
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Oh, Dr. BB , I had to laugh at your post! I was only in hospital overnight, and managed the evening sandwich, white sliced bread with meat and salad, by pretending that the salad would help me digest the carbs. But breakfast totally freaked me out. Orange juice, cornflakes, milk, sugar, toast, margarine and marmalade. Not even a nod to low carb. Luckily I am T2 and had my own tablets administered to me and so as you see, I survived.
Luckily my Dr gave strict instructions that I was to manage my own diabetes (am on mdi) unless I couldn’t (even though it is totally against hospital policy) and just report my blood sugar results. I would totally freak to have them try to control my blood sugars.
I laughed in their faces when they tried to give me sliding scale instructions. They gave carbs at every meal and snack. Corn, sweet potato, rice porridge… arch. And this is even after talking to them several times.
I remember one time a had a low (56) while visiting my mom in the hospital. When I checked myself, the nurse looked over my shoulder. When she saw the number she FREAKED OUT. Within less than 5 minutes I had over 140 carbs in juice, crackers, a sandwich, and applesauce all in front of me. Even worse, she sat there and WATCHED me eat it. I had to take a huge shot to cover that mess.
I’m not a low-carber by a longshot (I eat like 200g carbs a day), but 140 carbs for something that should have only taken 20 was some extreme overkill on their part.
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I work in a nursing home and I’m surprised any of the type 2s (we have plenty) or the 1 T1 is still alive. A lot of this has to do with the dietary workers who are minimum wage workers with no training on nutrition. Every resident has meal ticket that states what they can and can’t eat (and what they are getting for that meal). NCS means No Concentrated Sweets. So, instead of sugar free pudding or jell-o for a dessert, these people get fruit. Not one of the dietary workers understands that carbs are the problem. So, lets give a diabetic (who is on a sliding scale) a hot dog on bun, potato salad, baked beans, a cup of fruit in syrup, milk, and juice. But it’s okay, you, know, since they got fruit instead of pie.
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DrBB:
i was under the assumption that b/c the pump delivers “medication” it is NOT considered a prosthetic device but a pharmaceutical one.
Yep, hospitals and ER’s are a nightmare with diabetes. I refuse to let them touch my pump, supplies or monitor. I have my endocrinologist write a detailed letter explaining I have it under control, and it’s best to leave me to manage it.
I also have friends bring me the right kind of foods. If left to their own devices, they’d kill us an all we’d be is another statistic!
I think that’s why they call it practicing medicine.
I was happy to read this as it’s how I envision handling the situation. I will do my diplomatic best but I am not giving up my pump, meter, or CGM if I am physically and cognitively capable. I consider hospital and ER protocol archaic. It’s under-informed with one eye on their legal defense. It will be a big challenge for me to not over-react to their ignorant nonsense but I will not let them compromise my safety as well as my ability to heal from surgery or injury.
I’ve heard more than one nurse explain that they “like to keep their diabetics on the sweet side.”
This is a good idea. Hard-bolied eggs can easily sustain me. Then I could pick and choose off of their “diabetic” food plate.
I was in there for heart attack so I had a “cardiac diet” and it was very hard to find something that I could eat. They did not care about the diabetes and they admitted they didn’t have a clue. i finally bitched enough that an internist wrote the protocal for me which said, just let me do it .
I even looked one nurse and told him, I have my insulin over there in that red backpack. I’ll go get me 12 unites and pretend we didn’t have this conversation. That’s when I had finally convinced them I could manage my own diabetes.
Blood Sugar got up to 354 though before the decided to listen to me.
Wow. Maybe I’ve just been really lucky, or maybe things are different in Canada, but I have always had control over my own blood sugar, diabetes equipment, and food. Granted, the hospital food wasn’t the best, but I just picked the few lower-carb things and ate those, and they didn’t seem to care that I left half the food uneaten. I’ve always been able to use my own glucose meter and pump, even with no letter from my doctor. Usually I’ve just had to let the nurses know when I test and what boluses I take. Last time I was hospitalized overnight, the doctor actually asked me if it would be okay to remove my pump if I were to go unconscious and they had to take over.
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Like Jen, I must also be really lucky. I’m not in Canada and the hospital food here is nothing to write home about, but I was also able to manage my diabetes, choose my own meals, administer my own insulin and perform my own blood glucose testing and management. The nurse(s) did ask for blood glucose results and marked them down. The only folks interested in my plate was the kitchen (this hospital operates like a room service and it’s awesome - you call in your order and they bring it to you)! No one cared if I only called for coffee, I drank a lot of coffee when I was incarcerated (oops I mean hospitalized) 
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Just going by how my insurance company (Blue Cross/Shield) covers it, which is admittedly rather byzantine but I think it’s typical. My pump and infusion sets are considered prosthetic but the insulin that goes in 'em is a pharmaceutical.
thanks, good to know. whenever i am in the hospital, it takes so much to explain the pump to most of the doctors and the nurses. you’d think that people in the medical profession would be more up-to-date on such a current device. so many people are on the pump these days. its been out for a long enough time for them to know about it. my current challenge is my dexcom sensor; explanations are close to impossible for the uneducated. and god forbid you have a D-related problem and need to go to the ER, no one hasn’t a clue unless they, or some one they know, wears one.
i am scheduled for surgery in the fall. i have had my endo specialist write out written instructions for both the surgeon and the anesthesiologist regarding wearing my pump during the surgery and how to set it on an 80% temp basal rate. doc would rather i go high for a short period of time, than go low during the surgery (which is apps. 2 hrs)
Yikes… Again, every time I go to emergency the doctors and nurses know what my pump is with no explanation. They were asking me if it also had a blood glucose sensor long before I had a CGM. I’ve only had one procedure in hospital since getting the Dexcom, and I don’t think the nurses I met had ever seen one, but they thought it was great.
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what a pain in the A.
With my health plan - if admitted a PWD has to “surrender” (their word) our device(s). No way! side from using R insulin, and not getting near my 10-15 bg checks a day (and I would also have to give them my CGM). I’ll be damned if I am admitted. So the statement that with a pump it doesn’t happen, is sadly, erroneous.