Hello All! Last Sunday I had to take a trip to the ER due to terrible stomach pains. I got to the ER about 1:30 AM and at 7:00 AM found out that my appendix was inflamed and I would need to get surgery right away. This was my first trip to the ER and my first surgery so I was a little shocked and scared. I was extremely worried about my sugars because I hadn't eaten anything for a while and was worried I would be going low. Luckily the surgeon hooked me up to some sugar (i'm sure it wasn't just sugar, but I was highly medicated at this point so I'm not clear on everything) to keep my levels good during surgery. Everything went well and I am feeling much better with just a little soreness. Everyone in the hospital was very great and helpful with the exception of the diabetes team that came to visit me. I am on a pump and if I do not eat my blood sugar will drop. So, I took my pump off but kept checking my BG to make sure I was in good shape. I was on a clear liquid diet at this point. Well, the diabetes-lady insisted that I put my pump back on (my BG was 74 and it had been off for a few hours). I told her that I didnt want to put my pump back on yet and would do so when I was eating solid foods. She basically told me that I had to put my pump on or she would inject me with an insulin pen! I was so disturbed by this. So, to make her happy I put my pump on. When she left my room I just put the basal on a temporary rate of 10% so I was practically receiving no insulin. (My basals are very low at the moment). My main concern with all of this is, what if something would happen to me and I would be unconcious? Would I just have random people pumping insulin into me, with no concern on how much I need? Also, I didn't quite understand how the surgeon was the only person in the hospital who understood that I needed sugar, not insulin. I was just curious to see if anyone else had experienced this. I am new to Diabetes, so this was my first hospital stay where I had to worry about it. Hopefully my last!
I have been in the hospital several times in the past 3 years since I have been on insulin and have found that when in the hospital I feel completely out of control, and my blood sugar is never as in control as when I am at home, for a variety of factors, including time and amount of insulin doses, types of meals available and when they are available, and fasting as mandated by tests and such. I have tried to tell the nurses/doctors/whoever will listen about when I need my injections, units I need based on food intake or current bg reading, but they seem to ignore me and have their own schedule/dose. I pretty much have given up and relegate myself that they treat everyone with diabetes as a generalization while in the hospital, with no input from the patient. If they did anything I think would be dangerous to me, I would definitely rant and rave, but usually my bg is higher than usual while in the hospital so I worry less than if it was too low.
I had a similar experience in the hospital and I have the same fears you do. I went to the ER with terrible stomach pain 2 years ago. Long story short I went in at 3 a.m. and had surgery at 8 p.m. to remove a piece of my colon and they also removed my appendix. Surgery went fine. I spent one night in ICU and those nurses were great.
The scary part was when I was moved to the general surgery floor. I was on nothing by mouth. I am not on a pump but am on MDI with Lantus/ Humalog. At the time, the Lantus would make me go low if I did not eat for long periods of time. They would not allow me to give my own injections. I tried to tell the night nurse that the dosage he was going to give me was too much and he would not take no for an answer. Injected me and was back a bit later to give me a glucagon shot. The one and only time in 25 years that I've had one.
The second night was a different night nurse. I told him what happened the previous night and told him the dose was too high. My daughter was with me and told him "She's been doing this a long time and you should listen to her." This nurse thought about it and listened to me thankfully. I was fine that night.
The next day I was put on soft foods (carbs). I needed Humalog. No nurse was available to give me a shot. My mom went down to nurses station... no nurse came. After 15 minutes, I grabbed my kit and gave my own shot. No nurse ever came with an injection. Thankfully I was released that afternoon. I was so happy to get out of there.
If I had it to do over again, I would have insisted that they call my endo even if it meant causing a scene. The sad thing is that even on major pain meds and asleep half the time, I still had enough sense to know what my insulin needs were...and they just wouldn't listen to me.
Thanks for both of your input! I'm glad everything turned out well and the rest of the staff was always helpful. Maybe when I see the surgeon on Tuesday I'll ask him why their diabetes management is so generalized.
Frightening how little nurses know about diabetes management & what their ignorance & stubbornness can do to us. In case I'm hospitalized, I had my doc write a letter stating that I'm educated in my own care & capable of calculating my doses & injections. Won't do much good if I'm unconscious!
The issue is that hospitals are prisons for sick people. It's about control over bodies first.
Good idea to speak with your surgeon. Also a good idea to speak with the hospital administrator to file a complaint about the lack of staff education. If anything happens regarding care while hospitalized, ask to speak with the hospital administrator immediately. Don't waste time talking with doctors or nurses.
Wow, that is really disturbing. Do you have an endocrinologist or Internal Medicine physician covering you? A Team approach in the Hospital is necessary for good care. I have not been in the hospital for the last 30 years (except for same day procedures), and when I am in the hospital and coherent I make sure they know I am in control. The nurses joked and called me an "A" personality regarding my health and let me manage my diabetes. As a matter of fact, I am. In addition, my husband is diabetes No. 2 in control.
Always make sure that whomever is following your case knows the details of your diabetes. If possible have a loved one or friend with you who is knowledgable enough to watch over you.
I agree w/ others that the situation where the nurses seem to have no idea how to deal w/ diabetes properly is extremely frustrating and unfortunate.
You mentioned that you're on a pump and "if I do not eat my blood sugar will drop". It sounds like you might have your basals set a tad too high, b/c ideally with the pump you could miss any number of meals (24 hours worth, for example) and you shouldn't ever drop completely (assuming you're not doing any sort of activity that would require more glucose burning than normal). I might suggest running a basal test to make sure your basals are set appropriately so that you don't see that drop or have the necessity for food.
Glad to hear the appendectomy went well! I hope you don't have to have another hospital stay any time soon either.
Talking to the admin. is great advice, I will try to remember that if I ever have an issue again. Pat - I do have an endocrinologist, who does in fact work in the hospital. She must not have been there that night. The problem with my endo is that my last appointment was her last day in the office I go to. Also, one of the ladies that saw me in the hospital was who I was supposed to have my next appointment with in January. She informed me that shes also leaving. SO, at the moment I have no idea who my endo is and why there are so many changes happening. Bradford - I also believe my basals are set a little too high. Every time I see my endo, we lower them. I was diagnosed in December of last year and they said that I'm honeymooning. They have set my basal rates so low, I don't know if they can even be any lower. I guess I'm still learning and figuring alot of things out.