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Got Questions? Ask Them!
August 4, 2009
“They warned me about you,” my nurse said as he busied himself with blood pressure cuffs and other paraphernalia.
“Warned?” I mumbled around the thermometer in my mouth. “’bout what?”
“I’m told you ask a lot of questions,” he responded.
Darned right I do! When you have diabetes, you’d better be asking a lot of questions, especially when you are in the hospital. In fact, you’d better be asking a lot of questions when you are in the hospital, diabetes or not.
I had what I hope is the final surgery on my leg and foot resulting from a torn Achilles tendon. This time it was to remove some hardware from my heel and to clean up and put a graft over another part of the incision. While the first two surgeries were outpatient, this time I was admitted because there was some concern I might have an infection in my bone. (I didn’t.) More good news: When I saw the doctor last week, the graft was incorporating and my heel — which had not been doing well — was healing.
But I digress. When you have diabetes, it’s imperative that you know how to take care of yourself. After all, that’s what you’ll be doing for the rest of your life. Diabetes is an ongoing condition. That’s why it’s called a “chronic” disease. Nobody is going to be hovering over you, telling you what you need to be doing. There is no magic pill that will get rid of diabetes. It’s up to you to keep yourself safe.
That’s true even in a medical setting, such as a hospital. Maybe especially in a hospital. I remember an incident several years ago when somebody was about to run an IV antibiotic into me. “What’s that?” I asked. “What’s in the bag?”
“I’m allergic to penicillin,” I told her.
Oops! I’ve never seen anybody unhook something so fast.
Ironically, the hospital seemed more fascinated by the fact that I used an insulin pump — which is all it had written on the outside of my chart. What should have been there? A bright orange sticker with my allergies written on it. I’ve since learned to check for that, too.
When I am in a local hospital, my family practice doctor is in charge. He has agreed to let me use my own medicines in the hospital. I take them in their original containers, the pharmacy checks to make sure they’re the proper meds, and the nurse dispenses them to me.
This time, however, I was out of town and the doctor did not know me. For some reason, he refused to let me take my own meds. (At least, in the beginning.) Aside from the fact that an aspirin cost $5, one 500-milligram metformin (brand name Glucophage and others) was charged at $12, and so on, many of the medicines I take were not on the hospital’s formulary. In other words, they were unavailable and substitutions were made. As I had the nurse tell me, pill by pill, what each drug was, I refused those that had been substituted. After a couple of days of that, I was allowed to take my own pills. (I’d been sneaking them, anyway.)
To add insult to injury, the doctor did not approve the full dose on two of my medicines. He didn’t believe in taking more than 1,000 milligrams of metformin (I take 1,500 milligrams) and, for some reason, only approved one-fourth of my usual dose of blood pressure medicine (which was not the one I take, anyway).
Food was another problem. The first day, I kept asking people for something to eat or drink. After all, I’d had surgery that morning and hadn’t had food or drink for something like 15 hours. Did anybody pay any attention to me whatsoever? Nah! I finally sent my husband out to get a salad and a grilled chicken breast. Frankly, it was a lot healthier than the noodles with spaghetti sauce, canned fruit, and whatever else was on the tray that my husband ate.
In the meantime, I had some fun when I asked yet another person for something to eat: She muttered something about waiting for dinner, and I told her that my blood glucose was at 42 mg/dl (it really was!). She panicked, saying “I didn’t know you were diabetic!” and dashed off.
The head dietitian came to see me and gave me a list of foods that were available all of the time so I could make up my own meals. The doctor agreed that I could have food brought in from outside. The kitchen made a chef’s salad especially for me — and it was yummy.
The bottom line? If you let people know that you know what you’re doing, and you actually eat healthful foods, you’re more likely to get to choose your own meals. I suspect I had some help on my side, too: My traveling bud, Sandy, was the CDE at that hospital for 15 years, and I suspect she whispered in some ears. The head dietitian has Type 1 diabetes, so she is aware of what is involved in caring for it. Several years ago, I had been instrumental in convincing one of the nurses there that an insulin pump would be helpful to her. She is now head nurse. It helps to have friends.
Tests? Oh, do be sure to question any tests you’re not sure of. One morning, a nice young man appeared in my doorway to inform me he was there to take me to dialysis.
“I don’t do dialysis,” I said.
He was insistent. So was I.
“No, really,” I said. “My kidneys are fine. I think you have the wrong room.”
Which he did.
Oh, yeah. Take your own stuff to treat hypoglycemia (low blood glucose). Don’t depend on anybody bringing you juice or something when you need it. I had plenty of stuff because I know me: While most people’s glucose goes sky-high after surgery, mine drops. I’m not sure anybody would have believed that I needed that much sugar as I got my revised basal rates and insulin-to-carbohydrate ratio worked out.
In fact, I’d had so much sugar that first night, the breakfast of French toast didn’t look good. My substitute breakfast of scrambled eggs and toast didn’t taste good. I called Sandy and asked her to bring me a veggie omelet.
It’s good to have friends who will help you take care of yourself.
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