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.