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[IP] hospital experience--very long

Hi Holly--

 Well, you know about the highs and insulin not
working. Wednesday evening my bg was HI with moderate
ketones. Not feeling well at all and I knew how things
were not responding to insulin at all lately, so my
dad took me to the ER. I was HI on their meter. My
family doc walked by, (before i got to see the er doc)
and went and talked to the ER doc about me. I got in,
they did an iv and bg through the lab so it would be
able to read teh bg, came back at 839. They did
nothing. Did another test a few hours later (so they
did no insulin, just fluids) and I was 721. Er doc
called mine, and b/c I was acidotic (not vomiting and
no large ketones), they were going to let me go when
My bg dropped 200 points (so i'dbe over HI still).
They wanted to do shots of R and NPH to get to that
point, but to leave the pump going. My dad and I were
skeptical..1. pump OR NPH NOT both, and 2. that was a
high bg to have. But also 11 yrs ago at diagnosis I
used NPH but was taken off of it, the doc asked why
but I couldn't remember what exactly the problem was. 
 It all started about 7pm at the ER. My dad and I
insisted they talk to my peds endo (there is no endo
locally, regular or peds) about doing the shots and
having the pump going. The doc called him, his
suggestion was to 1. admit me b/c of the high bg and
to start a drip of insulin and 2. to keep me in
hospital, get me back on solely the pump and keep me
until things were stabilized. (i guess all the shots i
was doing at home you coiuld call unstabilized.) The
er doc called my family doc (who was on call till
midnight) and they decided to admit me. I must have
peed at least once eveyr 20 minutes.
 The plan of action was....i wasi n peds, they were to
test my bg every 2 hrs and do regular accordingly, but
only if over 200. (regular every 2 hrs seems too much
to me!). That night I still had the iv in. I went down
to 40 at one point, but Thursday wsa still up high.
 Here is when the next doc on call comes in...another
family doc in the same practice whom I do not get
along with. He told me they were going to get me on R
and NPH, possibly let me out that afternoon if bg
stabilized, and to forget about the pump. He said just
to get me under some control (<500) to keep me going
until I can see my endo on Thursday, Jan. 13. He said
the fmaily doc from teh night before and my peds endo
had agreed on THIS plan of action, not what we were
told in the ER. My dad and I explained how NPH would
only complicate pump matters and how my endo adn I had
discussed me temporarily going on shots for
stabilization back in NOv but decided atgainst it b/c
it would mean being hospitalized for the pump
RE-start. The family doc on call now (the one i hate
and have not gotten along with since a bad appt a few
months ago) didn't agree and said what's 3 days in
hospital with my endo? sorry, but I have school,
friends and a job and living in the hospital is not
something I volunteer to do..
 He called the endo. this is thursday morning
still..nurse did a shot of 5 NPH at 11am. I was
300something and needed regular too but for some
reason they wnated that in a separate shot (15 mins
later). When the R came she told me we were going to
put me back on teh basals of my pump, b/c that's what
the endo told the family doc to do. OK, she wanted to
watch and my dad asked if they had a bottle of Humalog
we could use b/c to see if it was my bad batch and
that was causing highs. Between 1 am and 11am thursday
i had no insulin, so not surprised I only went up
since Wed. night I'd had only 5 NPH to keep me going.
 I was allowed to use my pump when the huamlog
came...3 nurses watched b/c they'd only heard of pumps
nad never actually seen one...i had no problem
 BG still high. 3pm they let me bolus for a high. 5pm
still high, they called doc and this was the plan of
action now...ONLY use pump for basals, NO boluses, and
to continue bg checks every 2 hrs and giving shots of
regular depending on those bg (TALK about major
overlapping!--yes, i did complain but the nurses can't
do anything w/o the doc's consent...). dinner comes, I
ask should I bolus or take insulin for it...No, only
insulin I'm supposed to have is basals from pump and
regular every 2 hrs as needed.--so no wonder i was
300-400 almost the whole time.  Doc did not stop by
last night.
 Went low int eh middle of the night again,woke up at
127, breakfast not till 8:30, ate, 5units worth I
would say...now carb counting is a habit, i felt weird
NOT bolusing!...9am bg check...352, shot time. Doc
comes in about 10am. I was going to be relesaed!!!
Said I wasn't exactly stable but I could do this at
home and he was curious why I was ever admitted. Also
said didn't know why i was pumping seeing that I was
doing 6-7 shots a day anyway. (that was b/c of his
stupid plan of using REgular insulin). Let me say
this... 1. they never used insulin in an iv to get me
down as the endo suggested, and 2. they never allowed
me to try to stabilize myself on teh pump, rather it
was tag with regular after meals and correcting highs
all day long..not much sleep!
  NOT a good experience. I think if it'd been under my
endo's supervision or even if they had followed his
suggestion of insulin in an iva nd then watching me
with the pump until I wsa stable, it wouldn't have
been bad, but ouch! My eyes feel so bad now! The doc
there I HATE! My dad didn't mind him at first b/c he
was strict with policies (fighting doing what we'd
been told in teh ER, and telling us he'd talked to his
colleague) but we did convince him to call the endo,
so luckily i'm not on long acting insulin now.
 However, would it have killed the doc to listen to my
endo? He did call and even told me b4 I was
discharged, that my endo was the expert, so listen to
him..so why wasn't I allowed to use the pump? why did
I not get to bolus? why did they do NPH??
 The nurses were great, but they could only follow
specific written orders, each time I asked to bolus
for carbs they'd find it in writing not to bolus with
the pump at all. A nursing supervisor came up to me
right b4 leaving and asked if i'd mind coming back in
a few weeks to teach the nurses about the pump....of
course I said sure! I'd love to, I had no problem each
time the shift changed people coming and asking
aboutthe pump..I do wish the doctors themselves would
take teh time to learn. Or at least if tehya re going
to ask for advice from another doc, USE IT! But I
guess that's a lost battle. I don't think my dad ever
wants to go back to that hospital.. that was where i
was diagnosed and have been 2x for stomach flu and
once for a low and things had never been so bad and
madet hings worse there, but boy that doc did!
 I'm respecting my endo now. He gave clear
suggestions. i called him as soon as I came home from
teh hospital..discharge instructions were to. 1.
basals ONLY from pump, 2. to check every 2 hrs and use
regular as needed (sliding scale) adn 3. to keep appt
with my endo on thursday...endo got me back on the
pump fully..said he'd said that all along and doc must
have misunderstood..I'm sure he heard him but didn't
want to admit he didn't know what he was doing. Now I
am fully on the pump, I hate that ignorant family doc
and it wsa just my luck that out of 10 docs he was the
one on call all week.
 My a1c will be awful> i could've had better bgs at
home. now i am. Not good but not 300-400 non stop.
what an experience. they didn't want me to switch to R
in my pump there, but jsut resume how it was.
 complicated, complicated, complicated.!
 I was glad to be leaving, now I know why so many
adults i know hate that hospital..I don't blame the
hospital, just the physician's ignorance, which is 2x
as bad when a specialist can simplify for them adn
they still not get it.
 Last bg was 75 at home!!!! 
 Pumping away...but next set change is from my own
bottle of H and i Hope it works as well as this set
now b/c I don't have an rx for a new bottle!
--- email @ redacted wrote:
> When you are up to it I look forward to hearing
> about and learning from your 
> ordeal.  Sounds like you are lots better off at
> home, a tragic thing to say 
> about our current medical hospitals.  The little you
> did say is 
> unbelievable!!!  My heart and prayers are with you.
> Holly

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