[breezeonby]

When I was in the hospital the first week of August, I was concerned about how I would manage my diabetes. Medications are usually given 4 times per day except PRN meds. The hospital did not use carb counting so I needed to come up with a sliding scale for my Novolog injections. With the help of my doctor, we came up with a decent dose that would cover meals, the increase due to infection and to cover the increase in blood sugar due to the steroids that I am on. We settled on 25 units at mealtime and I am used to taking my Novolog after meals but found that this was going to be difficult to get my shot at this odd time so I took the chance and was getting my Novolog before meals, this made me nervous to say the least. And then I was nervous about the size of the carb servings, which were mostly small except for the "modified mashed potatoes" that was served nightly. I would get my blood checked at 6AM, 11AM, 4PM AND 8PM. I remember one morning I tested at 65 and you would have thought this was the end of the world. The nurse brought regular chocolate pudding, 3 packs of graham crackers and a carton of milk and told me to eat up. I ate the pudding but didn't eat the rest and they kept testing my blood glucose to see if it had come up. I explained that this was a low number but not for me. If I would have eaten everything that they told me to, I would have then been high. And what they gave me to eat was not exactly fast acting carbs. I also had several times when I got my Novolog 2 hours after eating and then I was due for more Novolog in 3 hours and refused a couple of shots. Diabetes management really needs to be stepped up while you are in the hospital. If there is a next time, I will have my glucose meter brought from home and will smuggle in my own Novolog. Oh, they also don't stock Lantus so I was using Levemir.

 

[Guest]

Ahhhhh.. BreezeOnBy's Post Presents a Interesting Question..!

As people with diabetes, what recourse or (in this case), action can one take/do when it comes to implementing our daily prescribed medication routine when in the hospital?

Don't you think it would be better for us (being in the know), to continue on the regimented routine we've been accustomed to instead of bowing to the whims of the nursing/hospital staff?

BreezeOnBy brought up something that I had never considered, so..

"What Say You!?"

Breeze 2 User

 

[Joshua Shorter]

The last time I was in the hospital it was when I got diagnosed. Now that I have a pretty good regiment, it would be hard to just say yes. I think I would get my Dr. on the phone and require that we determine what to do...

 

[breezeonby]

As people with diabetes, what recourse or (in this case), action can one take/do when it comes to implementing our daily prescribed medication routine when in the hospital?

Don't you think it would be better for us (being in the know), to continue on the regimented routine we've been accustomed to instead of bowing to the whims of the nursing/hospital staff?

BreezeOnBy brought up something that I had never considered, so..

"What Say You!?"

Breeze 2 User

I even asked if I could keep the insulin pens with me and one of the nurses told me that was against hospital policy. The injections have to be given by a nurse. Our diabetes management is left in the hands of nurses and hospital staff. I wasn't even able to get a correction bolus when my blood sugar was over 200. There was simply nothing that I could do except not eat and I wasn't about to go hungry. There was a diabetic meal plan with little to no options. You ate what you were brought. :hungry:

 

[Shanny]

Isn't it a shame that they're willing to compromise a patient's wellbeing just to cover their own butts?

 

[breezeonby]

Isn't it a shame that they're willing to compromise a patient's wellbeing just to cover their own butts?

You are so right! Get your guns back out!

 

[breezeonby]

Isn't it a shame that they're willing to compromise a patient's wellbeing just to cover their own butts?

I forgot to mention that I had 2 nurses that left the keys in the medication drawer in my room. I was just busy looking around, since I had nothing else to do and happened to notice the keys in the drawer. That was totally careless and unacceptable. It crossed my mind to take the novolog pen out of the drawer but there were no pen needles on it.

 

[onaughmae]

You know, after reading this I starting wondering about it also. Especially if I was in the hospital for something not related to my diabetes control. I think if they even wanted to take my insulin pump away and manage me on injections that they decide I need there would be a real fight on their hands. If I ever have to go to the hospital for something I am going to make sure I talk to the doctor about it before hand. That would simply be unacceptable to me.

 

[Shanny]

That would be a key piece of the puzzle - our own docs need to be on board with our self-management.

It sounds ludicrous, but the notion just popped into my head likening this to turning over your bolusing to the waiter when you eat out in a restaurant. Seems to me some hospital staff are about as clueless as the wait staff would be!

 

[onaughmae]

That would be a key piece of the puzzle - our own docs need to be on board with our self-management.

It sounds ludicrous, but the notion just popped into my head likening this to turning over your bolusing to the waiter when you eat out in a restaurant. Seems to me some hospital staff are about as clueless as the wait staff would be!

Crazy isnt it? I was talking once to someone that had an issue with airport security once. They wanted her to take her pump off (for a 4 hour flight) and put it in her baggage. She told them there was no way she was putting her 5000 dollar pump in her suitcase. She also asked them if they required all their passengers to remove their pancreas and place it in their baggage. They finally let her keep it.

 

[Joshua Shorter]

Crazy isnt it? I was talking once to someone that had an issue with airport security once. They wanted her to take her pump off (for a 4 hour flight) and put it in her baggage. She told them there was no way she was putting her 5000 dollar pump in her suitcase. She also asked them if they required all their passengers to remove their pancreas and place it in their baggage. They finally let her keep it.

I am fairly certain that a request like that would be against the law. We need our diabetes management equipment and we are allowed by the FAA and the airlines to keep our medication and equipment on the plane with us. Someone tried seperating me and my equipment at a concert I went to shortly after I was DX. Needless to say, it did not go so well for them.

 

[goldengirl]

I think "hospital policy" is a default position for the nursing staff. I would be adamant about managing my own BG if not hospitalized for D-related issues . The reason I'd have to take this position is that I disagree almost entirely with their protocols.

So far, I've only been in the hospital for outpatient surgery & tests since my dx, except once when I flat-lined. Obviously, that didn't last long & I didn't insist on anything while it did. But, I had a pacemaker implanted just hours after the flat-lining incident and when home so it did not become an issue.

 

[Shanny]

So far, I've only been in the hospital for outpatient surgery & tests since my dx, except once when I flat-lined. Obviously, that didn't last long & I didn't insist on anything while it did. But, I had a pacemaker implanted just hours after the flat-lining incident and when home so it did not become an issue.

Yikes! Thank heaven for pacemakers!

 

[cathyy]

Never forget that you always have the AMA (Against Medical Advice) option. You can refuse any part of your care. You can also simply leave the hospital. The hospital policies are indeed in place to cover the ass of the hospital, not ensure optimal care. I ought to know, I'm a nurse who actually worked in a hospital for a while.

I agree that it would be a fine idea to have a specific diabetes self-care standing order from your physician, much like your advanced directive. Keep a copy in your hospital record, and you keep a copy at home, too, for when they lose the copy in your records. But the hospital will hate it.

 

[jeremiahtren]

I definately agree

 

[breezeonby]

Never forget that you always have the AMA (Against Medical Advice) option. You can refuse any part of your care. You can also simply leave the hospital. The hospital policies are indeed in place to cover the ass of the hospital, not ensure optimal care. I ought to know, I'm a nurse who actually worked in a hospital for a while.

I agree that it would be a fine idea to have a specific diabetes self-care standing order from your physician, much like your advanced directive. Keep a copy in your hospital record, and you keep a copy at home, too, for when they lose the copy in your records. But the hospital will hate it.

My PCP was making most of the calls, we discussed my diabetes care plan the first day that I was in the hospital. We knew that carb counting wasn't going to be an option so we came up with a sliding scale to use. I was way too sick to think of going AMA, I needed to be in the hospital. I just wish that taking care of diabetes while in the hospital played a more important role and those in charge would see that things like giving insulin on time should be a top priority. When I asked why my insulin was being given late, I was told that the nurses have to give the meds within a certain time frame. And they had an additional hour in which to give meds and they still would be considered giving the meds on time. What really got me was how willing the nurses and techs would give you any kind of juice if you asked for it. Fruit juice is loaded with carbs and no one seemed to care. And then the there was a guy from physical therapy who gave me 4 packs of graham crackers and two tubs of peanut butter for being "a good patient", no questions asked if I was under any type of dietary restrictions. I know I didn't have to drink the juice or eat the crackers, but I was on steroids and I was hungry all of the time. Even the best thought out plan for your diabetes care while in the hospital will fall by the way side if a nurse or tech has a more pressing issue to attend to. That is just the way that it is.

 

[breezeonby]

Got my detailed bill from the hospital yesterday and I was shocked at what the hospital was charging for insulin. They charged a $1.00 per unit and my Actos was $10.67 per pill and my Glipizide was $3.25 per pill. I laughed at the price for a 750MG Levaquin pill-it was $26. This is highway robbery!

 

[Shanny]

Oh Breeze . . . that really is insane! And it's criminal that they can get away with it!

 

[breezeonby]

Oh Breeze . . . that really is insane! And it's criminal that they can get away with it!

My pharmacy bill was over $4,000. I take 80 units of Lantus every evening and the hospital made some money off of me and my insulin needs. You can purchase an entire vial of Lantus for $125.

 

[onaughmae]

Unfortuantely, hospitals often inflate prices to try to recoup money lost from the millions of dollars that go in unpaid bills. Fair? No, of course not. But I guess they have to keep the electric on and pay their employees too. I cant even imagine what they must pay in a monthly electric bill. I am not too sure what the answer to it all is. I hate getting stuck paying for other people's bills too