I am embarrassed.
@DrBB have you seen Memento? It’s about a man who has retrograde amnesia. I don’t want to tell you the story but towards the end there’s a scene with a woman living with T1. BTW, I didn’t like the ending.
As an proem every time the hospital gets a new intern in the endo dept they get me to give them a lecture on the diff between Type 1’s and Type 2’s and the different treatment’s and tests they need, they start off with the attitude “i’m a med student so i know everything about medicine” i then walk them back to a room where 2 other prof’s give them a viva on the subject they end up with a classic hang dog look and realise just how much they have to learn in the next 6-7 years b4 there let loose on patients… Funtastic!!!
“Ew. I would NEVER be able to inject myself!”.
(Not a question, but a remark. Sorry.)
To which my usual answer is “Contact lenses freak me out. I could never just sit there and stick something to my eyeball.” Which is true–glad I don’t need 'em.
Ugh. Cortisone shots. Yes! I have a wonderful hand surgeon who did the obligatory offering of 1st line of action cortisone shots for my carpal tunnel, but was actually really glad when I said “Nope. SURGERY!” He was so relieved that I understood, without having to be told, that the cortisone shots would probably just put off the inevitable and would likely really mess with my blood sugars.
I swear, hospitals are out to kill us though. He was the third surgeon I went to before settling on one.
The second one scared the bejabbers out of me. His scheduler told me to fast from midnight on, take half my insulin in the morning, show up for my surgery around NOON for pre-op and finally have surgery around 2pm. When I told her “But half of what? I take an amount based upon how many carbs I’m going to eat, but of course if I don’t take any I suffer from Dawn Phenomenon, and I’ll go high until I finally eat…” I just got a blank stare. I tried again with “OK. So what is the target glucose range to be in before surgery?” She had no clue. Couldn’t answer, and couldn’t get an answer out of the surgeon. I was told to just show up and if I was too high or too low, the anesthesologist would send me home and we’d reschedule. How about… no. The second surgeon scheduled me first thing in the morning, gave me a target, and told me not to take any insulin unless I was in danger of going high.
When I was in the hospital in '09 for gallbladder removal the first meal they gave me after surgery had whole milk (after I’d just been told to avoid fat), sugar-sweetened cranberry juice, blended-and-strained oatmeal with a pat of butter, and something else that was pretty much straight sugar as well. And they’d only give me, a Type 2 who has a crazy 1:2 insulin:carb ratio in the mornings 4U of Novolog, and only if my BG was above 140. Yeah. My husband brought me my own supplies and the doc and I had a knock-down drag-out about it. He was amazed, however, at how well I healed for a diabetic patient. Go figure.
Living in NY, I was lucky enough to have had carpal tunnel release done on both hands 6 weeks apart at the Hospital for Special Surgery.
I was ambulatory for both surgeries and everything went well. Procedure typically takes 20 minutes and done under local anesthesia.
Being D, type 1, every and all surgeries and procedures are always scheduled in the A.M.
I’m not on a CGM, but use OmniPod. BG was checked by me immediately before surgery.
It’s important to speak up and alert booking staff of your D status so you are taken care of in a timely manner.
One variant I’ve heard is, “I would die if I had to give myself shots!”
After experimenting with several answers, mostly snarky, I finally settled on, “No, you’ve got that exactly backwards. You’d die if you didn’t.” That usually produces a surprised silence, followed by a dirty look at me for being so logical.
Oh. They WERE aware! That’s the scary part.
I asked her, “So, you want me to not eat after midnight, take “half” of my morning insulin… show up at NOON, not have my surgery until -maybe- 2 o’clock IF the doctor who was over 1 hour late to my appointment today is running on time, and so go what, 15+ hours without food, as a diabetic after taking insulin?”
I got blank stare. She just totally didn’t get the issue. I went with a different surgeon.
Had the same issue in the hosp after my abdominal surgery. They wanted to give me R/NPH and I absolutely refused. I had my own lantus & novolog but they weren’t going to let me do my own dosing. All kinds of prohibitions on letting patients dose themselves with their own meds in the hospital but this is different. Anyway, we eventually reached a wink-wink arrangement where I would set the dose and they would administer it, which was so absurd that in reality they just let me do it.
Fortunately these days even for major surgery they get you up and walking and try to have you out within a few days–I was in for 3. So at least you’re only subject to this stuff for a minimal amount of time.
Wow, that is appalling. You were right not to go with these guys. My experience matches @JoedyRose’s. I’ve had major surgery as well as arthroscopic day surgery and as soon as I tell 'em I’m T1 they bump me to the top of the day’s schedule. Same even for procedures like GI exams.
I’ll have to file this away and remember it. I’m not T1 but I am insulin dependent, which amounts to the same thing as far as these sorts of issues are concerned. Thank you all for the heads up.
Good for you! Improperly trained staff should get educated to know how to take into account a patients history and their needs.
Every colonoscopy I’ve booked the staff are aware of my D status and proceed to give me early mornings w/o me having to ask.
Here’s hoping D awareness (with a lot of attention to detail) will improve.
Perhaps a fairy god-mother can sprinkle knowledge and understanding on those in need in the medical field, enabling them to become more cognizant in dealing with D’s.