I’ve been in the hospital four times since being diagnosed diabetic (15 years ago). Once for accidentally giving humalog instead of lantus insulin, a memorable story you can read here. Another time 4 years ago because of kidney stones, another more recently for ruptured ovarian cysts, and lastly when I gave birth to my twins last June.
Each time, I noticed something which frankly, bewildered me. The medical staff didn’t know much about diabetes.
I can explain…
The time I was in the hospital for my accidental insulin switcheroo I came in fully in control and explaining to the staff I would need intravenous glucose ASAP because even though I ingested a lot of sugar on the way to the hospital, I did the math and knew it wasn’t enough. There seemed to be more focused on how I made the mistake. I was even asked if I was having a fight with my fiancé or suicidal. When we got past that they decided they would check my blood sugar every hour. I instead checked it every 20 minutes. It is a good thing I did because each time my sugar was low and coming down really fast. We would call the nurse and she would say something like, “wow you’re coming down quick! we need to give you more glucose!” At one point she pushed the glucose in my vein so quick something strange happened to my vein. It protrudes now and looks bumpy along the inside of my wrist and forearm. She said, “oops, what did I do here…?” I thought, seriously??!! Thanks a lot! Anyway…I don’t like to think what would have happened to me had I not checked my sugar more frequently than they saw fit.
The time I had kidney stones was scary, too. Not once did anyone care about what my glucose numbers were running. I was in there hours and it was as if I wasn’t a diabetic. I had a procedure done to laser blast a huge stone and before I went under anesthesia no one seemed concerned with what my blood sugar was. Again, I was kind of baffled. I wasn’t worried too much because I purposely didn’t give any insulin 2 hours prior to the procedure so that I would only have my steady basal rate functioning and just before they came and got me I made sure my sugar was 160. Not too high, not too low.
When I went into the ER for major pain from ruptured cysts I asked if my polycystic ovarian syndrome could be tied to my diabetes. The doctor said no. She said there was nothing I could do to help it either, except take birth control pills-oh but those are bad for diabetics because of the blood clot risk, yikes! I went home and searched medical journals for information and found many links between that syndrome and diabetes. I also found out what diet changes to make and other helpful things to do. My new doctor also told me the diabetes is probably to blame for the syndrome and after discussing with her the changes I have been trying to make she said, “good, keep that up”. So far I haven’t had any more cysts form. Let’s hope I can say that next year.
The worst experience of them all, you won’t believe this…
When I had my babies last year I had an extremely hard time at the hospital. They wouldn’t allow me to administer my own insulin, which ok, I understand. They couldn’t get humalog so they gave me novolog instead and said, “Is this switch ok?” I was like, “I don’t know ask my doctor?” They asked me how many units of insulin I typically gave with meals. I told them it varied all the time, you know, sometimes I had an egg and other times toast. They didn’t seem to understand and instead attempted to administer me their own measure of 5 units of insulin before breakfast, lunch, and dinner. (Regardless of my glucose at the time and regardless of what meal I was brought. Then I was given a diabetic diet which consisted of all fat free and all sugary stuff. When I tried to send it back there was a huge set of hurtles which had to be cleared first. They didn’t think it was good I ate anything like meat because “diabetics can’t have fat” said one nurse.
Perhaps the most shocking thing was when they couldn’t figure out how to use their own insulin pens (“no one ever showed me” said one nurse) and at first gave me only a partial dose (the nurse pulled the pen out early and insulin squirted everywhere which was supposed to go in me). From that point on I requested to use the pen myself, with two nurses watching for liability reasons. On another day they were 2 hours late with my lantus (which is VERY important to take on time) and at one point they “lost” my insulin (I had asked for it to be stored in a fridge to be kept cool). It took 1 whole day to recover.
On one occasion the nurse was coming to test my blood sugar. I felt my blood sugar was high so when she came to prick my finger I licked it so saliva would mix with my blood (I know I know-I’m awful) The reading came out 102 so she said “great!” and left. I immediately got out my meter and checked my own blood sugar and saw it was 209. I gave myself an insulin shot. My mother and husband saw all this and jaws dropped to the floor. I explained that they would have taken so long to get my insulin and so in a moment of exasperation I took matters into my own hands. I didn’t want to be up to 250 by the time they brought it! (I don’t support this behavior I’m just showing you how fed up I got).
I was very confused and now a sore, exhausted, and overwhelmed new mom was losing her patience with an ignorant system. After a couple of glucose readings in the 200’s (because of the hospital being late with my humalog delivery-meaning I also ate cold meals) I finally told a nurse I was going to adjust the humalog amount the way I had been taught by my diabetes educator and endocrinologist. She was very sweet and said, “alright you do that and just let me know how many units you’re giving so I can put it into the computer where we log everything”. I said, “sure, no problem”. Well, moments later a doctor comes in to check on me and looks at the computer. He takes the nurse outside and in a very upset tone says, “We cannot allow patients to decide on how much insulin they give themselves, that is a hospital policy!” They argued back and forth and I took a deep breathe and thought, “man, this is hard on everyone!” The doctor was worried, the nurse got scolded for trying to trust my experience, and I had to be at the mercy of a system that just tries to cover itself it seems.
I left the hospital after 5 days, healing well from the c-section, but in a lot of pain and very tired-in part because I felt I had to be ultra-vigilant about my diabetes, even in a hospital. I thought they could take care of me but, I don’t think so anymore.
I absolutely loved my doctors and nurses. 99% of them were kind, intelligent, hardworking, compassionate, and efficient at their job. The problem (and several nurses admitted to me) was that they just didn’t have the training and knowledge needed to really take care of a type 1 diabetic.
A word of caution to you if you ever have to be in the hospital-stay on top of your diabetes! and err..don’t cheat the meter…;)