Diabetes Self-Management Blog

Here’s the deal. Last week ("Is It Just Always Something?") I wrote about my thyroid nodule and how I was scheduled to have a biopsy on April 23. That’s today. I’m writing this blog entry following the fine needle aspiration ultrasound biopsy.

So, my intention: blog this week about the biopsy procedure. You know, what I experienced, what I felt — all that good stuff that goes with a hospital visit.

I was going to write about that. I have notes that I took in the radiology waiting room (I was 30 minutes early), and some thoughts about how to tie the procedure into my Type 1 diabetes. It was going to be a pretty good blog entry, especially because it’s been a quiet week for me on the diabetes front. (Nothing like a good thyroid nodule to get a person off the hook for writer’s block!)

But the thyroid biopsy blog entry will have to wait.

I’m home now, having decided to use the noon appointment as an excuse to not go back in to work. The procedure itself was more interesting than it was painful, but I felt that I’d come home and take it easy. After all, I did have six two-inch needles, one after the other, inserted into the nodule (or mass) in my thyroid: The doctor went into my neck above my clavicle, each needle lingering about a minute while the doctor palpated the nodule on my thyroid, all while I was able to watch the needles on the ultrasound screen.

Right now, it feels as if I’ve swallowed something large that won’t go down, and I’m experiencing mild soreness, but nothing major.

That, and I think that the anesthetic messed up my stomach (as it’s done before). Lovely stuff, the human body.

Let’s return, however, to the radiology waiting room at the hospital. I was, as I said, early. I sat there writing my notes for this blog when all of a sudden I feel that twitch of uneasiness in my legs, the slight, nearly imperceptible woozy feeling, that says, Uh-Oh, maybe you should check your blood glucose. I pull my kit out of my backpack and run a check and discover I’m at 90 mg/dl.

Not bad, not dangerous; but if I’m soon going to be called in for a 30-minute procedure, I don’t want to go low. And, typically, if I’m testing over two hours after a meal without having had anything to eat in the interim, then most times when I’m below 120 mg/dl my blood glucose is probably going to be going down rather than up.

But a problem? Nah. I had my backpack, and I’d intentionally thrown some extra white grape juice boxes into it because I knew something like this might happen. So I open my bag, take the straw out of its cellophane wrapper, and prepare to poke it into the foil-covered hole on top. That’s when I hear, “Sir, there’s no food or drink in here; people may be fasting.”

The radiology receptionist.

Well, damn. But did I explain myself? No. Instead I ran through my options, thought about what else I could do. I could leave the waiting area. But wait: I’m waiting for a biopsy. I’m in a waiting room. If I leave the waiting room, I might not hear them call my name. Besides, I’m in a hospital; I have Type 1 diabetes; shouldn’t correcting my blood glucose with Food and/or Drink be allowed? I wasn’t in an operating theater. I wasn’t going to drop Junior Mints into a surgery-in-process.

This is the first time I’ve encountered poo-pooing of diabetes low-blood-glucose correction attempts. So I was silent. Dumbfounded. What did I think about, though? Not only my diabetes. It was the stupidity of her saying “people may be fasting” as the reason to not allow food and drink. Umm, really? So there may be someone who hasn’t eaten since last night, and she might, what, tackle me because I am drinking grape juice?

I’m not opening a sack of McDonald’s in front of all of the people. I’m not slurping on a milkshake and saying “Ha ha ha” to people who can’t enjoy one with me.

I wanted to have a sip of fruit juice to correct a dropping blood glucose level before my thyroid biopsy.

I go back to writing my notes, but now I can only think about what I should do. Do I step into the hallway and slam the juicebox? But what if they call my name? And I don’t want to slam the juicebox. I wanted to sip it for 15 minutes or so. Why should I go stand in a sterile hallway to sip my juice? Am I being punished for my disease?

I decide I’m going to play the diabetes card, much as I don’t want to…

I walk up to the receptionist and lean on the counter, and I say, “How much crap are you going to give me if I have a drink in here? See, I’m a Type 1 diabetic and I’m insulin-dependent, on an insulin pump, and my blood glucose is going low.”

What does she say to me?

“You can take it out into the hallway.”

Well, anxious already about the procedure I’m about to have, and not in my best arguing mode, I simply said, “Oh, OK,” like a good passive boy. Of course, I continued to simmer on the inside. I went into the hallway, drank my juicebox quickly (which I don’t like to do), and then went back in for them to call me.

Now, I’m asking you — because I am really tempted to do so: Should I write the hospital’s comments section about how I was treated? I’ve done this before when I was first diagnosed and treated horribly by a person in billing. I mean, the hospital’s motto is Patients and Families First, and I feel that a policy such as this No Food or Drink thing is not one that has to be or should be strictly enforced. I understand all the reasons for it, but my for-instance is a perfectly good reason to let it slide.

I feel that I was dealing with someone (the receptionist) who can’t find it within herself to bend the rules, who’s Ms. Literal by the Book for everything she does.

I don’t know. It just ticks me off to be treated like rule-breaking high school student.

Suggestions? Thoughts? Has this kind of thing happened to you?

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Comments
  1. I don’t know.Could you have said that juice is your medicine for going low? So she cannot prevent you from taking it?Wonder what she would have said.I feel the same way you do….I need it so give me a break.
    I have told guests not to touch the juice in my fridge before since it is my medicine.
    Laura

    Posted by Laura |
  2. I took a friend into surgury one morning and while we waited with others who were all getting preped and brought back in the waiting room I had my cup of coffee in my hand. A nurse told me I can’t have it there because people are fasting. It was not in a timmies or star bucks mug, just a plain travel mug. I was told I had to go down the halway to drink it or hide it in my jacket till I left the area. I think it is for the comfort of others who might see you drinking it and they want one real bad but can’t. I did not like it but it was better then being kicked out and having to leave my friend alone I guess. At 6 am I need a coffee so she was lucky I was not a real grouchy bear about it :-)

    Posted by sally smart |
  3. I can see multiple reasons to limit the presence of food and beverage in certain areas of a medical facility. However, in cases where it could be life-threatening, or if you feel your experience was made worse than it needed to have been made, then I would request directions to the Patient Advocate’s office and discuss the issue there.

    The few times I’ve had cause to search out a Patient Advocate I’ve found them business-like and understanding, and they will document both the objective and subjective facts of the matter.

    Posted by tmana |
  4. Regrettably, this receptionist needs to be educated. I believe that you have been discriminated against under the Americans with Disabilities act. Allowing you to manage your Diabetes in a manner that doesn’t stigmatize you in a public place such as a hospital is a reasonable accommodation; especially when it prevents you from having a medical problem. See of hope.com/pdf/diabetes-civil-rights-law.pdf
    Unfortunately, there are some instances where it is bettter to ask forgiveness than to ask permission. You would have to determine if this is one of those circumstances. Perhaps you should contact the hospital’s patient relations or similar department to ensure that this doesn’t happen to others in similar circumstances. Good luck to you.

    Posted by concerned diabetic |
  5. You should have told her you were a Democrat and this is part of the new Obama health care plan. And the grape juice was government issued medication or since there is no government law about juice drinking in the waiting room I would have smiled just after I finished drinking my juice and enjoyed watching this woman have a canniption fit and then I would have responded “Give me break lady my blood sugars low and i am doing what my doctor told me to do”

    Posted by mtryon40 |
  6. I respect your decision to not play the “diabetes card,” but sometimes, it needs to be played.

    This - as ridiculous as it might sound - is a form of discrimination. I’m all for the office not allowing food or drink for its own reasons (b/c I’d be miffed if I were fasting and someone were eating next to me) but this case is different.

    You should’ve bucked the receptionist and drank the juice in the office. I know that sounds a little harsh, but I’ve had too many instances where I was inconvenienced because of my diabetes. I don’t think it’s fair or right. It’s a medical condition you cannot always control, so if you need juice, drink your juice. Let someone kick you out of the office b/c your sugar is low and you’re drinking juice; I mean, seriously.

    Thanks for the article… enjoying keeping up with the biopsy process.

    Posted by vec |
  7. Hi all. An update regarding this blog. I did submit my concern to the hospital’s patient comment section of the website. I’d written them once previously, when first diagnosed, regarding how I’d been treated by a person in billing the same day I received my Type 1 diagnosis. They handled that promptly, so I wrote again with the hopes that they’d be great about this.

    I just received a call from the hospital and they were very thorough in going over what happened, as well as asking me how I’d have liked to have been treated. They were going to submit the materials (including this blog, I think) to the receptionist’s supervisor. As other people have noted in the comments, and as I suspect, it is simply a lack of awareness about how a person with diabetes can treat a low (or pending low) blood glucose.

    So, yeah, take heed folks: advocate without getting irate. It feels good.

    E

    Posted by Eric L. |
  8. I think you should have explained your needs immediately, then drank the juice. If the receptionist had a problem you could ask her to call a supervisor, after you drank the juice.

    Not giving her enough information led her to dismiss your needs. Bringing it up by asking her how much crap she was going to dish out just put her on the defensive.

    Posted by laurie |
  9. I think you should have asserted yourself and told the idiot that you needed to sip this juice slowly and in a sitting position. If this didn’t go over well then ask for someone with a little medical knowledge. I’ve been a Type 1 since 1960, so my glucose level drops very easily. Any time that I’m having a surgical procedure and I’m NPO I try the night before to keep my blood glucose over 150. The last surgical team insisted on giving me some insulin because my reading was 220. I begged them not to since I knew I would bottom out. However they slipped it in my IV. Surprise! They couldn’t wake me up afterwards. because I’d gone into insulin shock. Wish some of these people could live this for just one day

    Posted by Gail |
  10. honestly? I think that you acted immaturely. how could the receiptionist be discriminating against you? if you were the only one to whom she said anything, that’s discrimination. presumably, she would have said the same to anyone. And, the attitude when you spoke to her. Either sneak it, tell her you must have it for medical reasons, or ask her to call you while you are in the hallway. this woe is me/passive aggressive/discrimination stuff is too pervasive in our society.

    Posted by cat |
  11. What a pity that she was couldn’t respect your need for life support in a hospital. I would have continued to sip with a brief apology to anyone in sight that it was either do this or have those results. I’m sure the other patients would have been more aware and understanding than a hospital employee that needs more education in her deskside manners!

    Posted by Carla |
  12. Sorry but I have to agree with cat on this issue. Where is your compassion for your fellow human? Would it have been that hard to explain to the receptionist that your sugars are low and that you need to step out into the hallway to drink some juice and that if your name comes up, you will be right back or to please summons you from the hallway?

    I seriously think that your stance in itself is extremely rude and inconsiderate towards others that may be there for something more critical than you are. Also, wouldn’t the exercise of walking out to the hallway have been much more beneficial to you than getting all worked up over the thought that you were being discriminated against?

    Posted by John |
  13. Personally, as long as you were not required to fast for the procedure, then you should have been allowed to have the juice or anything you needed to treat low blood sugar. I would report this to the Patient representative and let them know what happened. You were not the one required to fast,etc. so why should you be made to drink in the hallway. I am assuming that others in the waiting room would not have minded at all.

    Posted by deafmack |
  14. Please just be open about your diabetes and your need to take care of yourself on doctor’s orders! What makes you less important than anyone else in that room?

    If you had simply said,”I’m diabeteic, I’m having a low blood glucose episode and I need to sit here and sip this so I don’t pass out in front of your desk.: it would have probably ended there.

    Then if she objected you could take it further with: “It might really upset your other patients to see me pass out, need the EMTs to come in and revive me and then cart me away. Oh, and there’s the financial aspect - if I pass out and need attention, I expect the hospital to pay for it because I have attempted to regulate this myself and you’ve refused to let me treat a medical condition by sitting here and sipping the juice slowly so it can regulate my blood sugar.”

    Then whip out that notepad that you had and write down a running commentary on what was going on and ask her to sign it as evidence that you had informed her of your problem and her refusal to allow you to medicate yourself.

    You’d be surprised just how fast writing something down and asking for signatures to prove that you’ve discussed a problems can get some action.

    See, if you take action and are bold about it, you might feel better yourself and even educate the little idiot with a Hitler complex at the front desk.

    Posted by anncats |
  15. Was their a sign that said, no food or drinking posted on the wall or on her desk. If not, I would have just drank my juice box and tell her to deal with it.

    Posted by LThaw |
  16. With the rate of both types of diabetes skyrocketing it amazes me how many in the health profession are still clueless.
    Its never a “card to play”..Its ALWAYS a real life or death issue and we MUST speak up for ourselves! We are our only health advocates and over the years Ive gotten more pushy..but polite.
    Its never in bad taste to defend your health..Its just when others get loud and obnoxious that people get upset.

    Posted by begonia05 |
  17. As the wife of a diabetic I carry a backpack as do you. we were in a waiting room as you were and if I didn’t know better it may have been the same receptionist. My husbands count went down to 85 and I gave him white grape juice. We ignored her and on her second comment i told her ‘oh well”,
    Next time just go for it.

    Posted by me too |
  18. Maybe I’m getting to intolerant as I get older, but I would have responded, politely but very forcefully, that I was a diabetic whose blood glucose was dropping, and that I am going to drink the juice now to prevent complications. If she had a problem with it; call security. Then I would have sipped the juice where I sat.

    Posted by phils1024 |
  19. I find this interesting since I have had several procedures where I have had to wait in a reception area. Besides sitting with my butt hanging out, I had to watch those accompanying me partake of a selection of donuts and pastries, coffee and juices. The hospital was more than happy to make them comfortable. I was fasting. Afterwards, when I came out of the anesthetic all I got was 7-Up and crackers.

    Posted by Amberinuit |
  20. You have received many interesting responses. It is always easier to look hindsight and give a suggestion that responds to the emotion, tact of customer service, and right or wrong of a shared situation.
    By sharing your experience, you enlighten me on raising my sensitivity of interacting with others. I may have asked for a comfortable place to sit and sip my juice while waiting to be called. Explained a desire to respect their guideline for the waiting room but invite their empathy for my need to treat my disease in a respectful way too.
    Yes, I would share your experience with the hospital. Maybe not as a complaint, but “walk in my shoes” sharing with people who try to meet everyone’s needs that it is far greater to understand a diabetic client could have a hypoglycemic event in their waiting room or miss their call and mess up their schedule. People benefit from having information about their service and how people have been treated.
    Thank you for the opportunity to read about your experience and be able to respond.

    Posted by ssmsf74 |
  21. I would have just drank it after explaining this is a medical thing, not a refreshment thing. If a middle age person fasting cannot handle you taking a drink, then they can wait out in the hall. I thought the stupid PC stuff had passed. Compassion is great but I will not allow myself to be harmed because someone MIGHT wish they could have a juice box. Should you not sit in a waiting room with a bunch of fat people if you are thin as it will mean they will want to be thin?
    I just did the colenoscopy fast thing and sat there and watch people eat, and was fine with that.
    I could see if you had a pizza delivered, you might not have gotten out alive.
    Next time transfer your juice box contents to a liquid medicine bottle and the other will feel pity instead of envy

    Posted by ray |
  22. I would have told her exactly what was happening, due to me being diabetic. If she’d said I needed to leave the room, I’d have explained that while I’m consuming the drink I need to stay where I am, so my blood sugar doesn’t drop further.
    Good advice the others gave you to contact Patient Relations; the receptionist obviously isn’t educated on diabetes care — or handling situations tactfully.

    Posted by spinsandknits |
  23. Take note Cat and John. He is neither being immature nor does he lack compassion for his fellow man. Low blood sugar is nothing to fool around with.

    When my blood sugar is going low, the last thing I want to do is get up and walk around. You described the feeling you were having as “woozy feeling”. I know that feeling all too well and sometimes after that feeling, you become dizzy or even pass out.

    It is unsafe to have to walk out to the hallway to drink the juice. I would explain that I am diabetic and need the juice here and now. If the receptionist tells me to go out to the hallway, I would tell her that if I do go, she may have to call someone to pick me up off the floor.

    Eric, you are not rude or immature. You were just trying to be safe. I’ve worked in a hospital and a medical center for over 20 years. I’ve “broken the rules” many times for the preservation of safety or just to help out a patient that has needs that may be different than others. Never did I get reprimanded for helping a patient.

    Posted by cindyj |
  24. It’s tough to think on your feet sometimes when you’re taken off guard by people as you’re just trying to keep your diabetes managed. We can all think of witty, tart retorts after the fact when people make comments or offer “advice” or criticisms for checking our BG’s, taking insulin - or treating a low.

    I know what I would have wanted to do under those circumstances. I would have wanted to tell her I was going to take care of my diabetes, and if she had an issue with it, she could call her supervisor or security or whoever else. Or I would have told her I could sit there and wait until I needed emergency intervention, and she could take a poll of the other people in the waiting room about which was more unsettling - watching me drink juice, or watching a team of medical personnel rush in to save me. Then I would have treated my low right there in the waiting room.

    Now, if I were really in that situation, I can’t say for sure that’s how I would actually handle it because how stubborn, contrary and willing to draw my line in the sand I’m feeling can vary from one moment to the next, and if I’m low and not quite as sharp as I’d be otherwise, that just adds another variable.

    In the moment, you did what seemed best though. As far as complaining, I totally would. You have a medical condition that needed to be treated, and that’s the bottom line. Her inability to comprehend that needs to be addressed so hopefully that won’t happen again for someone in a similar situation.

    Posted by leeannthill |
  25. Clearly, you were being a menace to south central while drinking your juice in the hood
    http://www.imdb.com/title/tt0116126/

    Posted by Aaron |
  26. I face this issue everyday. I have my am snack at 10am to keep me from dropping too low before lunch. Everyone at work knows this. Every week we have at least one meeting at 10am so I bring my snack (usually something like 1/2 an orange or a small bag of 100 cal cookies) and eat my snack and then be done with it. No big deal right? Well come to find out there is a “no eating in meetings” rule that is in place that no one clued me into until 2 weeks ago. And the last thing they said to me was “but you have a medical condition so the rules don’t apply to you” OMG– did I ASK for diabetes just so I could have a snack? UM NO.

    I think that the receptionist is a short-sighted woman and that you should have asked for her supervisor right then and there so that you could get it in writing that if you do pass out they will bring you down to the emergency department or call 911.

    I wish that non-diabetics would get a clue sometimes.

    Good luck with the biopsy, I hope all goes well.

    Shelly

    Posted by Shelly |
  27. Hi Eric,

    I agree with some of the others -you were discriminated agianst even if unintentionally. I would definately speak with patient advocate and a diabetes advocate as the receptionist (especially in a medical facility) needs to be made aware of the serious consequences this could have had -both with not drinking it and with the fact that you had to drink it fast. Drinking it fast means you had to drink a lot to be sure it was enough rather than drink it slow and test your blood in a few minutes so you would not have to over treat your low blood sugar. Did your blod sugar go high after? She needs to know that both high and low have serious consequences. You were in a hospital, which means you could havehad a critical incident that they would be responsible to take care of should you have passed out while the doctor was doing your biopsy. The mere fact that you old her you needed it to correct low blood sugar because of a medical condition rather than for pleasure shows how ignorant she is.

    As for the fact that others were fasting -were you in a children’s ward? If so I can understand because a child may not understand and be able to wait but if it was only adults in the waiting area she was just plain rude. As an adult myself and having fasted in the past I know that it is not pleasurable to be thirsty and watch others drinking something BUT I am an adult and need to act like one by not complaining that someone else had a drink when I wanted one.

    I believe that the receptionist was not just sticking by the rules and she should have been concerned when you told her that you were ill at the time. Imagine if you passed out in the hallway unable to drink the juice and unable to help yourself…imagine the liability for the hospital if something happened to you because you could not have a sip of something that saves your life.

    I hope you speak to a diabetes advocate because as someone with a disability you have the right to ue whatever treatment you need for medical emergencies. That is exactly what you had “a medical emergency”.

    If not for yourself please speak up for the sake of others as if this is not addressed appropriately now it could be a child that experiences the same thing but that child may be too afraid to go into the hall to treat the low and may believe that since it was a hospital they would not let something bad happen. It is important to speak with a diabetes advocate and the patient advocate along with some higher ups in the hospital as they ultimately need to address concerns like this.

    Take care and pleasehold those responsible. It may help people to learn about diabetes and the seriousness of it.

    Posted by Tracy |
  28. Actually, I’d probably have answered her from my seat since she chose to speak to you from hers. I’d have replied, I’m diabetic and my sugar level is going low. If I don’t drink ir you may be admitting me to the ER for passing out right here.

    Posted by Ephrenia |
  29. Well, there does seem to be a certain inflexabilty from both ends - had you really wanted to, you could have asked for everyone’s attention and asked them, does anyone mind if I drink this juice box? I’m diabetic and need to nurse this to manage my blood sugar.

    Without protest from other patients, why not?

    At the same time, noone actually stopped you from drinking it in the hospital, they just asked you to do it in the hall, like they would have asked anyone else to do.

    I was asked not to drink a bottle of water in a hospital ER once when I was there to get myself checked out for DKA/kidney issues. I, too, almost played the D card, but, policy is policy.

    I carry Lifesavers now. One LS is the perfect remedy for a moderately low BSL.

    Posted by Bosstonez |
  30. I think this is just wrong. Would she rather
    you pass out in the waiting area? I think is is
    worth sharing with the dept. head. When I have
    any type of medical test that calls for fasting,
    I make sure I tell them I am diabetic and want
    to be scheduled first.

    Posted by Polin |
  31. Many hospitals have rules that represent contempt prior to investigation. And they hold to them with an iron hand. With people who have to use hospitals for tests and other services run into problems. We know more today about diabetes today then we ever have, however we make rules that circumvent that knowledge. Ridged rules don’t usual work for everyone. Type 1 is a much harder form of diabetes to manage. I’m Type II but having read a good deal of information about both I would side in your favor. Fasting test are test we all have to do. If you need to drink a cartoon of juice to keep your glucose lever in check do it.

    Posted by John |
  32. Interesting points of view.

    I would add this…

    Since you were not dangerously low, but just making sure you didn’t end up there at a much more in-opportune time, perhaps a glucose tab would have been a better option than juice?

    I can’t imagine that taking a giant neco-wafer looking tab would have been a problem, and it would have been in your mouth before she could stop you anyway, and is essentially a “giant pill” so would qualify as medicine and not food.

    Just a thought.

    If it were me, I would have started doing jumping jacks on the possibility I could drive my BS low enough to pass out during the procedure and then sue the heck out of them. But hey, I’m evil that way.

    Posted by Charlie L |
  33. This has happened to me a few times over the last 29 years of my diabetic life. Usually I tell whoever, that I am diabetic, and I am low, and i WILL be drinking my juice or eating my snack. I have never had a problem after I explain why I am sweating and shaking and starting to act a little kooky..

    Posted by Lisa Young |
  34. well you know i have never encountered that and when i have had those outpatient procedures the doc makes it clear that i am fasting and to be taken in immediately and watched..they even did my cataract surgery when i arrived and put me under because i am also deaf and can’t hear without reading lips which are all covered in those sterile areas..my blood sugars dropped out both times and they were right there on it all and nno one has ever been rude and when it happens i always somehow have i chair under me because someone notices and goes to work right then..maybe it’s the place or maybe something else but i know i am diabetic and will tell them i can’t wait

    Posted by mary little |

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