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[IPk] When to call the doctor



Hi Beverly

With reference to your "when to call the doctor" thought, last week I made
the decision to call my DSN when my BS was staying high despite frequent
boluses, ketones had been present for 5 hours and I was still being sick. We
liased over the phone for a couple of hours, but made the decision I should
go to hospital when my blood sugars started rising, despite repeated
insulin, and we still couldn't shift the ketones.

I am very fortunate in that I have a brilliant DSN who is always willing to
advise on the phone. In the past few months I have contacted her over what
are probably fairly trivial matters, or just for reassurance. If you are
likely to only be able to contact a doctor who knows less about diabetes
than you then I suppose early contact is fairly pointless.

I think how you feel is a good marker of when to get help though - after
all, no one heading for DKA feels well! Ketones that refuse to shift, and
blood sugars that won't go down or are actually rising despite insulin would
indicate to me that I was out of my depth.

Caroline


> Date: Mon, 16 Sep 2002 07:59:41 +0100
> From: "Smith, Beverley" <email @ redacted>
> Subject: RE: [IPk] Re: Minimed 508
>
> Hi Caroline
>
> I have my second 508 (boring charcoal I want my funky blue
> one back!) and have never experienced the kind of problem
> that you describe.  Yes the syringe wobbles (I have noticed
> it myself) but it has never resulted in any delivery
> problems.  I have one on loan as mine failed when all the
> buttons failed to work (as described previously) and I
> bolused with a syringe until the replacement arrived (basals
> worked fine).  My only possible episode of DKA occurred when
> I changed the infusion set before going to bed (stupid stupid
> stupid) and woke up 6 hours later feeling like death.  BGM
> was 24.  I corrected with a syringe and went back to bed for
> 90 minutes.  I then got up changed the infusion and went to
> work.  BGM back to normal by mid-morning and I felt fine.  I
> have often wondered though at what BGM I should phone the
> doctor?
>
> Bev
> _______________________________________
> Beverley Smith
> Principal Development Geologist
> SNS Team Leader
>
> Phone: 0118  929 2422
> Fax: 0118 929 2660
> E-mail: email @ redacted
>
>
> >
>
> ______________________________________________________________________
> BG Energy Holdings Limited (a member of BG Group)
> Registered in England No: 3763515
> Registered Address:
> 100 Thames Valley Park Drive
> Reading
> Berkshire   RG6 1PT   UK
> Telephone: +44 (0) 118 935 3222
> Website: http://www.BG-Group.com
>
> This e-mail is intended only for the addressee named above.  As this
> e-mail may contain confidential or privileged information, please
> advise us immediately if you are not the named addressee or the person
> responsible for delivering the message to the named addressee.  The
> contents should not be disclosed to any other person nor copies taken.
> ______________________________________________________________________
> - ----------------------------------------------------------
> for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
> help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml
>
> ------------------------------
>
> Date: Mon, 16 Sep 2002 10:03:15 +0100
> From: Diana Maynard <email @ redacted>
> Subject: Re: [IPk] Re: Minimed 508
>
> Hi Bev
> I don't think there's a specific BG at which you need to phone the doctor.
If
> it's a one-off then no matter how high (as long as you are still
conscious!)
> then you should try to bring it back down. If it doesn't start coming down
> after a few hours and it is very high and/or you have ketones for few more
> than a few hours then you might want to ring your doctor. I think it
really
> depends on the cause. If there is a known reason (like a problem with the
> pump / infusion set / miscalculated bolus / whatever) then it's likely to
> come down once you either take an injection or sort out the pump problem.
> I think basically if you're worried, your BGs are high and **staying**
high
> and you can't get them down then it's time to ring the doctor. Having a
high
> BG - even in the 30s - for a few hours is not in itself a problem as long
as
> it responds and starts coming down once you do something about it.
> Di
>
>
>
> >My only possible episode of DKA occurred when
> > I changed the infusion set before going to bed (stupid stupid
> > stupid) and woke up 6 hours later feeling like death.  BGM
> > was 24.  I corrected with a syringe and went back to bed for
> > 90 minutes.  I then got up changed the infusion and went to
> > work.  BGM back to normal by mid-morning and I felt fine.  I
> > have often wondered though at what BGM I should phone the
> > doctor?
> >
> > Bev
> > _______________________________________
> > Beverley Smith
> > Principal Development Geologist
> > SNS Team Leader
> >
> > Phone: 0118  929 2422
> > Fax: 0118 929 2660
> > E-mail: email @ redacted
> >
> >
> >
> >
> > ______________________________________________________________________
> > BG Energy Holdings Limited (a member of BG Group)
> > Registered in England No: 3763515
> > Registered Address:
> > 100 Thames Valley Park Drive
> > Reading
> > Berkshire   RG6 1PT   UK
> > Telephone: +44 (0) 118 935 3222
> > Website: http://www.BG-Group.com
> >
> > This e-mail is intended only for the addressee named above.  As this
> > e-mail may contain confidential or privileged information, please
> > advise us immediately if you are not the named addressee or the person
> > responsible for delivering the message to the named addressee.  The
> > contents should not be disclosed to any other person nor copies taken.
> > ______________________________________________________________________
> > ----------------------------------------------------------
> > for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
> > help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml
> - ----------------------------------------------------------
> for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
> help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml
>
> ------------------------------
>
> Date: Mon, 16 Sep 2002 11:54:36 +0100
> From: Pat Reynolds <email @ redacted>
> Subject: Re: [IPk] Charlie Dalton
>
> In message <007a01c25cfb$d3e8a0e0$email @ redacted>, Barbara Dalton
> <email @ redacted> writes
> >Can anyone tell me - when there is a blockage and the alarm sounds how
> >audible is the alarm - can it be turned to vibrate like a mobile? As a
> >chorister this small detail could be crucial in his final decision.
> >Thanks
>
> It is such a shame that John isn't around at the moment, because he
> could reassure Charlie as one music professional to another.  John is an
> opera singer, currently, we all hope, recovering well from surgery last
> week.
>
> Both pumps can be set to vibrate rather than audibly alarm, although
> both _do_ audibly alarm if the vibration is ignored.  It's always
> possible (although _not_ recommended) to turn it off rather than dealing
> with the alarm.  It should be possible (unless the cathedral wears very
> untraditional robes!) to have the pump in a pocket, in a 'thing' (a
> velcro strap with a lycra pocket attached), or clipped to clothing, in a
> place where from whence it can be discretely fished out, should it
> alarm.  The tube comes in different lengths, so if, for some reason, he
> ends up wanting to have it strapped to his cuff while being inserted in
> his thigh, that won't be a problem.
>
> He might want to go for a boring colour model, or get a cover for it
> which will not contrast with his robes.  A sports case might be useful
> for day-to-day wear, to protect it from roller-blading crashes, and
> those come colours more in keeping with a roller-blading lifestyle.
>
> Best wishes,
>
> Pat
> (dm 30+, 508 1+)
> - --
> Pat Reynolds
> email @ redacted
>    "It might look a bit messy now, but just you come back in 500 years
time"
>    (T. Pratchett)
> - ----------------------------------------------------------
> for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
> help SUPPORT Insulin Pumpers http://www.insulin-pumpers.org/donate.shtml
>
> ------------------------------
>
> End of ip-uk-digest V2 #207
> ***************************
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