Monday, February 2, 2009

Thoughts on Hospitalization

Last Saturday, I was struck with sudden panic at finding out I needed to have emergency surgery to remove my appendix. I had plenty of reasons to worry. My appendix could burst and send infection throughout my guts. I had never had any major surgery before, aside from oral surgery to take out my wisdom teeth a few years back. I have never been hospitalized for anything since I was diagnosed with Type 1 by going into all-out DKA when I was 8 years old!

I fretted and fretted over this and that, but yet my biggest worry was that nobody was going to know how to handle someone with Type 1 diabetes in a hospital. You read a lot of horror stories and accounts of people complaining about incompetent staffers. As people with diabetes, I guess we are supposed to be prepared in any situation, but I had never come up with any kind of action plan for when something like this would happen. I crossed my fingers and hoped for the best. I tried to think of what kind of numbers I'd be happy with in the hospital. Which arm was my IV in? Would anyone know what to do with my insulin pump? Would anyone try to disconnect it? What about checking my sugars?

Well, I was met with a friendly and surprisingly open-minded hospital staff. Some of the nurses had never seen an insulin pump before, some were familiar with its workings; I showed it off to everyone. My hospital-assigned internist really loved it.

"So, all I have to do is tell you what your numbers are, then you can do the work?" he grinned. "You make things so easy for me! Thanks!"

Thanks to the pocket design of my hospital gowns, I was able to thread my pump through my shirt pocket and have it in close proximity at all times.

But let me tell you...when you are in the hospital, in pain, drugged up on Morphine, having a fever and battling infection with not one but two types of antibiotics, you take whatever numbers you get and then correct them. I even tried playing around with some increased temporary basal rates, but my BGs were pretty consistently between 200 and 250 no matter what I did or ate. I am pretty sure it was some combination of stress and meds.

It is a strange feeling having someone else check your blood sugar after pretty much doing it alone for 17 years or so. Of course, hospital meters need to carry and store more info than your average consumer meter, so they are still the size of bricks. (You know, flashy, ergonomically shaped bricks with scanners on them.) They still require everyone's favorite--the hanging drop of blood. I had purple bruises on half my fingers when I normally have tiny, pin-sized marks. However, under the aforementioned feeling-bad-and-being-on-drugs protocol, I didn't care too much that they seemed to be dicing my digits before meals and bedtime. I expected numbers to be high, so I corrected and made sure I drank water as much as possible.

I would think for a planned hospital stay, I would have preferred my own meters, of course, but this was something I had never even considered. Do you have an emergency action plan in place? I had to wonder if I was the least-prepared diabetic on the planet. My tips for an emergency hospital stay...assuming you are conscious enough to engage with your medical professionals:

1. Make sure you tell them every med you are on, and how often you take them. Try to remember dosages, or have someone check on your bottles at home and let them know. The nurses were concerned at my extremely high heart rate until I told one of them that I hadn't taken any of my usual Atenolol. They got it for me, and I came back down to normal!

2. Try to keep a good attitude. Some of the most frustrating moments I had at the hospital involved not being able to get a nurse to come in when I needed them, but many days it was because they were short-staffed or another patient was having a REAL crisis. Sure, I really needed that pain medication, but some deep breathing got me through the next 15 minutes until the nurse showed up.

3. If you pump, see that you can be in control. Keep an open line of communication with your nurses and doctors. Don't let them leave the room without telling you your numbers!

4. Hospital menus don't have carb counts on them, though mine did suggest that "artificial sweetener" was a "starter". Like an appetizer? Truly, I would have preferred some mozzarella sticks or hummus as a starter! Anyway, you'll be giving it your best guess, but they seemed to do a good job with providing lower-carb options. You just have to make sure you order them!

Well, as I said before, good riddance to that lousy old appendix. I am just happy to be feeling much better and blogging again. If you're looking for me, I will be plopped down, relaxing, catching up on like, every episode of "Arrested Development" from season 2 onward.


  1. Anonymous8:43 PM

    Glad to know you got rid of that nasty Appendix. Although we're never really prepared for a hospital stay here are some of the things I do in my every day life (just in case).

    1.I've kept a list of meds on my puter for years when something is changed I include it on list (I carry a couple of list with me). 2.I always carry a monitor in my purse that way I always have one with me. Taking charge of your Diabetes in the hospital is important to me it helps keep you on the road to recovery....stay well.
    Betty Jackson

  2. Thanks for the good wishes and advice, Ms Betty! I hope to see you soon! (When's Gary's next meeting?)

  3. this was me two years ago at just about this time! They kept my pump on during surgery - even gave me a correction bolus while I was out of it. The only thing I would do differently is to go straight to a sick say (increased) temporary rate. I think I was scared about going low but with all the stress on the body, that's not a real worry! Glad you are on the mend!

  4. So glad that you are back home and are feeling better!

  5. Anonymous8:53 PM

    Haven't received notice when he's having his next meeting.

  6. Hannah - Glad your feeling better and are rid of that no-good Appendix!
    Thanks for your hospital advice- will keep it in mind in case I ever find myself there.


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