November 5, 2010

Emergency Hospitalization for People with Diabetes

Another hospitalization situation that can cause problems for people with diabetes is going into the hospital alone in an emergency situation and no medical alert identification. A case in an emergency room about 65 miles from here this summer really emphasized what can go wrong. These are the type of instances that get my feelings in an uproar when they should not have happened.

The person had collapsed and passed out from heat exhaustion (I'm guessing heat stroke). He was transported to the hospital with an IV in place per orders of the emergency room doctor. When they arrived at the hospital no alert identification was found so the IV was continued and a second one added and and then his billfold was opened. An emergency telephone number was found and called.

The person arrived at the hospital and went to the room where he had been admitted. This person was not aware he had diabetes so could give no insight into treatment or who the doctor was. So the IV's continued. The fellow did not come out of the heat exhaustion, so no changes were made. They did stop the IV's after the fifth one. On the second day the fellow still had not come around, but the emergency person had contacted an older brother, who arrived. Even he did not know about the diabetes, but knew of the doctor his brother was seeing.

Contact was made with the doctor then and it was discovered that he had diabetes Type 1. At that point they did a blood glucose test and if I understood correctly it was “HI”, so they had to do a test from a blood draw. This showed over 900 and I was not given a more accurate figure. Of course they administered insulin. Then they started testing every hour and administering more insulin every five hours. They also continued to test him regularly.

They continued monitoring him and on the fourth day he came to. When the nurse told me about the following, I nearly fell off the chair. The patient said nothing about having diabetes and asked for a Pepsi to drink. When he was told no, he got abusive, and asked for food. When he was told after his insulin, he went ballistic and refused to be treated. The fifth day he checked himself out against doctors wishes.

I don't understand totally what happened as I was not able to get more information. I do not understand why this person did not want to have diabetes identified and when it was, why he reacted this way. I know from the diabetes forums that some people will come out on them, but will not say anything to people near to them or wear a medical alert of any kind.

I can understand privacy, but not the extreme desire for it. He should be thankful that an older brother did know the doctor and that the doctor gave out the information. There are lots of unanswered questions about this, but the nurse would not identify anyone and only gave me a little that she could.

I think she was wanting me to see how important it was to have proper medical alert information on me. When I showed her mine, she asked to see it and thanked me for wearing it. I wear mine on a necklace and need to have it updated for sleep apnea which is not on it presently.

This is why I feel so strongly about educating close friends and family so that they can advocate for you and prevent these types of instances from occurring. And in this case, the person on the emergency notice did not have information. This is not what should have happened.

November 2, 2010

Enjoy Your Holiday Food!

It is interesting how families celebrate holidays. The question is how do you celebrate the holidays? Do you go overboard with the meal and deserts? For people with Type 2 diabetes holidays can be one of dread and fear of the diabetes police.

First, relax! This is not a rant about the holidays. Hopefully you have a few holidays under your belt and have found yourself able to cope or are looking for ways to do better. If you are new to diabetes, the holidays can be real problems. Hopefully this will provide some help and guidance.

For the parties and friends social gathering, read this for some tips. I would only emphasize that moderation is the key to these events. Do not overdo and select the serving size that is small enough to not raise you blood glucose into the stratosphere.

The next article is definitely for families and is one of the better articles for people with diabetes. I appreciate the statement by Marlene Schwartz, PhD, deputy director of the Rudd Center for Food Policy & Obesity at Yale University when she says “don't tell family members that they're eating more healthfully”. She calls it "stealth health".

This is sound and sage advice. If the food is just served without comment, everyone should be content. They also advise you to involve immediate family members in planning of the menu, especially if they are picky eaters and the younger generations.
There are many good tips and from experience I know that they will work for most families.

The third article is another take on planning for the holidays. It does suggest making a game plan to avoid problems and if you make it work, you can still enjoy the holidays. The best plan is sticking to the plan. Realize that this is the holidays and one day (at a time) is the best method for not being overwhelmed. If you happen to overindulge do not berate yourself. Just be careful the next few following days, and take care of yourself.

From Thanksgiving to at least New Year's Day is often very tempting for people with Type 2 diabetes. Be assured that you will find yourself being tempted, but by careful planning and conservative food selection you should survive. So relax and happy holidays!!!