Hey, listen to me!

There are some ancient medical practices that in today’s scientific times seem ludicrous, dangerous, and in extreme cases: positively barbaric. I’ve watched movies that take place in an age when all illnesses were believed to be carried through the blood. Their natural thought pattern led them to then drain as much blood from the patient as possible in order to rid them of whatever their affliction was.

It makes me wonder how many of these poor people died of blood loss rather than whatever it was that made them sick in the first place.

Did you know they used to use mercury to treat wounds and other ailments (seriously!) or that heroine was often used to cure coughs (interestingly this actually works, of course you may die…). Lobotomies were used to “cure” depression and mental illness (nothing like another hole in the head…).

It seems laughable.

Doctors would never use such outdated ideas today. As medical research advances, I’d like to think that it filters down to us as patients. I’d like to think that our Doctors and nurses make changes to their regimes and policies as new and (hopefully) improved medical information becomes available.

Well, we all hope that, don’t we?

A few weeks ago I woke up with pain…. down there. An all too familiar type of pain. My heart plummeted into my stomach – I was so scared to look… I took a peek and – lightning split the sky, thunder roared in my ears, dogs began an unearthly howl, birds fell from the sky and none of that really happened but I would have taken any of those things in exchange for what was actually the case.

An abscess.

Again.

It was on the surface this time, and small as far abscess’ go. But painful enough to not allow me to sit up. And the bigger it grew; walking was becoming more and more tricky as well. I packed a little overnight bag: extra clothes, toothbrush, book, snacks. I knew the drill. Off to the hospital.

*Sigh* here we go again.

It was the same sort of thing as every other infection hospitalization I have had. Young attractive, male intern-doctor…and a horrible horrible embarrassing extremely vulnerable situation. Wow, ladies… if it’s the young hot doctor thing that does it for you… get yourself an infection. And then maybe a salon appointment on your way in. And smile a lot despite intense pain…. Hah… anyways…

Due to the area and sensitive nature of my “issue” as I will now refer to it as, I was moved up to the Woman’s Hospital … aka- Gyno. Nice and quiet there, nurses were actually to be commended. I had some I felt went out of their way to help me when I got upset. And I really appreciate the little things, like handwashing my pants when I stained them due to my wound and got very upset. Thank you for that.

I was inspected (OW. With inspecting abscess’ everything is ow.)
I was poked for blood often.
Given morphine. (pain was bad. Could not move easily)
Poked more.
Prodded a little
More blood taken.
Hooked up to pumps for dehydration and antibiotics to get RID of this stupid thing on me that is inconveniencing my life.
Inspected again (Ow.)

I basically had to wait this one out in the hopes that antibiotics would take care of it. I was under constant scrutiny because my sugars were all over the place – like I was doing this on purpose. Like I had sugar cubes hidden under the mattress or something. I had not anticipated a lengthy hospital stay and did not have my own insulin with me. At the mercy of the institution. At the mercy of despair.

This is where the story gets dicey.

They had put me on an insulin sliding scale. Sadly I did not understand exactly what that meant for me at the time. Basically if my blood sugars read between 0 and 8 I am not allowed any insulin, between 8 and 12 and they give me a set X amount, etc.

I bet you can already see how this is going to be a problem…. Can’t you?

At 2:00am, the middle of the night I woke up starving so I wheeled my pump down to the vending machines and bought a bag of Cheetos. I then took my Cheetos and wheeled my silly-beepy-pump to the nurse’s station to get some insulin so I could eat my Cheeto-goodness.

They asked what my sugar level was.

7.2 I said proudly.

Nope. Not allowed to have insulin.

….‘K-what?

Since I was in the 0-8 range I was not allowed insulin, I was informed. At first I didn’t think they understood. Yes, I was good now… but I wanted to eat Cheetos. Didn’t they get that I needed insulin to do that?

Nope not allowed, said the nurses. I could eat my Cheetos, then in an hour or so they would come check my sugars and give me insulin to bring it back down. So I was supposed to continually let my sugar get very high in order to get my insulin to bring it back down? I was told yes. I was told that was how they always do it.

Whaaaaaat…?

Is something wrong with this picture? Please, my fellow diabetics… write to me and tell me what you think of this.

Well at that time, even through my drug-induced haze, I was sure this lunacy must have been some kind of weird mistake. That seriously couldn’t be what they “always” do with diabetics… make them ill on purpose? It just didn’t make any sense. But I didn’t want to fight about it. I just wheeled my way back to my room and decided I just wouldn’t eat until I could get insulin and speak to somebody with sense.

I was very upset.

A little while later the overnight doctor came to see me, I guess having heard about my dispute with the nurses. She asked me what ‘my problem was’ (literally).

When I explained to her my issues with the Cheetos and the nonsensical sliding scale, I was again told that was how it was always done. I told her that was wrong. I told them that would make my sugars yo-yo, which was just wrong. I knew I needed to keep my sugars more stable, lower, if I ever expected my infection to heal.

The fight that ensued was neither professional nor practical. I had not intended to get into it with her… fighting with doctors never accomplishes anything, they mostly have the attitude that they are always right (even if they are not). But I did feel provoked and spurred on by my own internal self-righteousness. She was disrespectful and sarcastic, implying that I did not know how to carb-count (as if it was some impossible thing no one could do) and kept challenging me to carb-count things and demanding to know how much insulin I would take for different hospital foods. She kept saying “Prove it! Prove it!”

It was such an unnatural, strange experience. By the end I had to tell her to leave, repeatedly because I was so upset. Finally she did.

I did not eat.

I was enraged. I knew I’d been right in trying to administer preventative insulin, instead of only corrective. The next morning the doctor I’d been admitted under came to see me. I guess news of my fight had gotten around. After telling her my views and the basic play by play of what had happened, she told me I had been right – that she did not agree with the sliding scale and assured me she would speak to that gynecologist-doctor that had fought with me and the nurses from the night before.

It felt a bit better that someone had listened to me. That someone had taken my side.

The doctors and nurses within our healthcare system are generally caring, intelligent people. They’re here to help us and guide us. They do an amazing job.

But there comes a time when we need to take responsibility for ourselves, for our own bodies and healthcare. We carb-count everyday, we dial our own insulin, inject our own shots. And we are knowledgeable and capable. If something doesn’t feel or sound right to you, you have the right to ask and speak for yourself. After leaving the hospital I did my own research. What really was a sliding scale? Why were they using such a system that seemed so contradictory to what I’d been taught?

First I realized that there is more than one kind of sliding scale. Endos sometimes use them in patients individual night time long acting insulin regimes… the type I was more interested in was when they use them to treat diabetic patients in hospitals. The results I found were interesting and shed some light on my weird hospital stay.

It seems it is generally agreed amongst the endo-community that this is an old, outdated, and cringe worthy process. It is spoken of the “lazy” way to take care of a diabetic in hospital. It’s an “easy” way for the attending doctor to leave a simple guideline for nurses to administer insulin without the need for “complicated” checking, analysis, and calculating of proper insulin needs. It takes the need for the doctor out of the picture by leaving it up to the nurse. And it ups the risk for the patient by astronomical proportions – depending on their reason for hospitalization in the first place of course. It does not take into consideration what the patient is eating or when, what their condition is, or other insulin regimes. It’s dangerous, to put it bluntly. It is reactive rather then proactive. It is shameful that this is considered common practice where I was. And what is far worse, is the way my own insight into my own condition and my own body were so quickly tuned out and disregarded. Absolutely no one took half a moment to hear what I had to say… that is until my attending came to visit me the next morning.

My nurses didn’t know better and were trying, I think, to do the right thing. .. I don’t know who or what was responsible for this sliding scale nonsense but it needs to end – now. It scares me to think of extreme yo-yo blood sugars that are completely unnecessary in a place that is supposed to be safe for us. My abscess would never have healed if I’d let that situation continue.

My urgent advice is to learn from my mistake. Have your nurse’s, your doctor’s, your endocrinologist’s (especially), phone numbers, beeper numbers… have everything with you all the time. Because I was unprepared.

I won’t be again.

If they won’t listen to you, get them in touch with those who they will listen to. It’s your body, It’s your health. Don’t let anyone disregard what you have to say.