I’d Rather Not Think About It

I’d like to preface this post by explaining I have lots of exciting, super-duper exciting things to post about, but those will have to wait for now.  This past weekend was a big one, but there was a big bump in the road (yes I just typed “pump” and stared wondering why it was the wrong word. Diabetes much?).

Friday, I ate lunch.  A few hours later, I puked like crazy & could not have been colder (not as bad as Pukefest 2012). The doctor on-call for my doctor sent me to the ER.

At the ER, a nurse took me into Triage quickly. Dexcom said bg was 277.  Hospital meter said 324.  I had been running between 77 to 126 all day even while puking.  Dehydration was kicking my butt.  After getting my vitals, I explained to the nurse everything that had and was currently happening to me, I concluded by saying I needed to take a correction.  She told me not to.  Actually she said she could not advise me to take a correction.  Ummmm what?!?  She said I needed to wait for a doctor.  Ummmm more what?!? This is the same woman who, when I showed her my pump and Dexcom, asked if they control each other.  I explained it isn’t a closed-looped system.  That did not help my cause.  She asked if my blood sugar is normally that high.  I politely explained my current HbA1c is a 6.4 so NO my BG is NOT NORMALLY 324!  I was told again NOT to take any additional insulin, was handed a puke bucket and sent to the waiting room.  I immediately took a mini correction.

30 minutes went by and I felt less nauseous (believe me there was nothing left in my system).  I started to feel desert-like thirst though.  Time did that thing it does, you know, ticking by. I took another mini correction.  BGs eventually in upper 200s and staying steady.  No one had checked on me.  They’d told me NOT to take a correction until I saw a doctor, they knew my most recent BG had been 324, and they LEFT ME!   I sipped diet ginger-ale I’d brought in my bag.  Baby sips.  I seethed.

I finished my drink.  I waited.  I needed a hand (well an arm) to get to the reception desk.  The woman who checked me in (not triage) explained there were people with more serious emergencies and that would delay my seeing a doctor.  Fair enough.  I told her I needed to take more insulin and explained I’m diabetic, on a pump, on CGM, blah blah then I stopped because I didn’t think I was connecting with her.  I apologized (not sure why), and asked if she was a nurse.  She was less than pleased but since she hadn’t been responding I wondered if my T1D/puking chatter was clicking.  Yes, she was indeed a nurse.  She said my vitals were good.  She told me I was looking at a 3 hour wait.  Ummmm what?!?  I needed fluids.  Give me the IV and I’ll figure it out myself out.  3 hours?!?  3 MORE HOURS?!?  So I explained, for the record, I was taking a necessary correction.  She told me not to.  I told her she was too late.  She said they didn’t want me to crash.  I said that wouldn’t happen.  I got feisty in my I-am-wearing-pajamas-with-multiple-sweatshirts-and-why-are-my-legs-wobbling-so-damn-much way.  I told her I’d been diabetic for 33 years and “they” could not expect a T1D to sit for 3+ hours with a high blood sugar and do NOTHING about it.  I *may* have even tossed out the word insane.  She explained they needed me to NOT take a correction so the doctor could see what was going on with me.  I could feel the heat in my neck.  I stayed calm (well calm-ish).

Then she said it, “They need to make sure you aren’t going into DKA.”

In my mind I may have punched her.  In my mind I also shook my head in disbelief like a cartoon character.  In my mind I stopped shaking my cartoon head and punched her again.  I leaned across the desk and slowly explained that if you tell a diabetic who’s blood sugar is in the 300s and escalating, NOT take a correction bolus while they continue to dehydrate, you will have bigger problems than possible food poisoning.  She argued back about not crashing.  I was about to crash her.  I tried to sound strong but I’m pretty sure my voice shook as I informed her that without a correction, there was no doubt they would be treating me for DKA.

We waited and waited.  No one EVER checked on me.  No additional BG checks.  My BG hovered between 185 and 194.  I’d take that.  Exhaustion was kicking in.  4 hours after I’d checked-in, I was taken into treatment.  A gurney in a hallway with another patient at my feet and another patient at my head.  A doctor arrived.  He was familiar with my story.  He may have been Doogie Howser.  I told him about the correction debacle(s).  I informed him of my present BG.  He told me that he felt T1Ds on a pump know more about their diabetes than they do so I should continue just doing my thing.

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I got an IV like a harpoon.

Yeah I got pics.

I was there FOREVER.  Anti nausea stuff and fluids perked me up.  The head doctor visited.  I got sassy as is my way, and we all smiled.  I told him the correction debacle.  He repeated what Doogie had told me, that I know more than they do about my diabetes, keep treating myself and they will treat the rest of me.

 

I continued checking my own BGs.  I saw some crazy stuff go wheeling by.  I got silly.  I was sent home at 3am.

 

12 thoughts on “I’d Rather Not Think About It

  1. I experienced DKA for the first time this year. I went to the emergency room. They were just as clueless as your ER nurses. They also told me not to bolus when I explained what was wrong. I stared at the nurse, told her I’ve been diabetic longer than she’s been a nurse, and looked at my pump and bolused. I continued to bolus every 15 minutes for 2 hours, and no doctor came. I left. They asked me what I was doing. I told them I came into this ER with a life threatening condition, and no one would treat me. They’re lucky I don’t sue them. Oh I was furious. They actually sent me a bill!!! I haven’t and won’t pay it.

    • Once I was able to drink fluids and not puke them back up, I contemplated just leaving but I was still pretty ill and in pain so waited it out. And yes, furious was my feeling too.

  2. Holy Crap Alecia….what a horrible tale! You know i went through this exact debacle back in 1998 when i first moved to NYC and was so sick – I would have thought almost 15 year later the situation would have gotten better. Remember dr. Busta? He had Ralph walk over to ER at NYU with me, where I SAT, ignored and in complete pain, for 13 hours, munching glucose tabs and testing my own sugar, until they finally admitted me at 2 am (this later ended in my appendix rupturing on the operating table in Chicago). A day or two later, I was on no food/fluids, and I was crashing a bit and asked for glucose tabs…the hospital didn’t have any so I asked for milk…the Intern on duty saw me drinking and had a fit that was EATING….I yelled at him, and the next day dr. drexler came in with a pocket full of dex tabs…..Suffice it to say I learned that if you EVER find yourself in a hospital, the best thing to insure your safe EXIT from the hospital is to stay as conscious and in control of your own blood sugar as possible, despite interns, nurses and technicians who would prefer for you to let THEM manage your diabetes……I hate to think of the horrible treatment I will get if I go in unconscious!!

  3. Sorry about the bummer evening. Why does bureaucracy in medicine sometimes translate to making a patient worse so the care provider can CYA? Hope you’re feeling better.

  4. Ok, you’ve convinced me. From now on, in addition to my old pump, I’m carrying an extra reservoir and Silhouette infuson set (the one with the long, angled needle) in my emergency kit. In case of dehydration, I’m sticking the Silhouette in my vein, cranking up the basal on the backup pump as high as it will go, and infusing Poland Spring until I’m feeling better. Sometimes you’ve got to take matters into your own hands, cause you can’t trust anyone else. (Don’t try this at home).

    Glad you’re feeling better.

    • I have an incredibly similar plan Scott. I also have the same anti nausea meds I got in the IV now (except in pill form) so I’ll smash that and put it through my old pump too. 😉 Glad we can smile about these things!

  5. i absolutely REFUSE to be without my insulin pump and my dexcom. i was on insulin syringes, way back in 1994, and the nurses would not allow me to cover myself for hours… i was so tired of being over 200. i had my parents transfer me to another hospital. STAY AWAY from the emergency room, eh? I despise them. I would like to “crash” many people, including my own sister, who commented, “WHY isn’t the pump just DOING IT ALL FOR YOU?”

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