What a champ you are! I cringed when you told me how they put your bones back in place - and I’m not a squeamish person. So glad you’re on the mend, and if you have to have PT or OT that it goes well. I’m sure you’ll push through.
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Sorry to hear about your accident & all the pain involved as well as missing your daughter’s graduation. It is nice to hear how you were allowed to self-manage your diabetes. The fact that the ER nurse seemed relieved that you had your own insulin with you is very interesting. Also interesting that diabetics are to blame if they don’t have their insulin with them. Makes me think that things might tend to go badly for T1s if the hospital pharmacy & protocol for treatment is the alternative. Your experience says a lot about inasmuch as possible always being prepared. As for me a T1 & his pump are not easily parted. Thanks for sharing your experience.
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I just got a message back from someone at JDRF. She agreed there’s a need here, has heard similar stories, unfortunately, and said she’d check with the Advocacy arm in DC and get back to me. So hopefully there will be more to come!
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Back in the 1990s, I worked at a hospital (as a social worker) and would repeatedly talk with patients who were suffering from diabetic mismanagement while hospitalized. I also found that nurses were doing their best, but could only follow doctors’ orders. My approach was to talk with the doctors and suggest they write orders that would give the nurses more power, e.g. “If bg falls below 100, give fruit juice”, etc.
In regard to my own control when I have needed inpatient treatment, My endo will write an order giving me the management of my diabetes.
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When hospitalization is non-emergency I will not be separated from my pump. No one has ever fought me on that. Nurses always glad for it.
I might get a tap on the wrist from my moderator friends as I think I’m skidding a little off topic on thin ice but - I’ve worn a Medic Alert practically since I was diagnosed. The engraving says I’m diabetic and use a pump, and as you know there’s a number to call where more specific info can be provided, one piece of which is my endo’s name and phone number. Thankfully I’ve only had a couple of emergencies of any type, and on the one occasion when I was unable to speak for myself I was accompanied by someone who knew me well and could provide needed info. Since I’ve never had to rely on my emblem to guide emergency personnel, I’m wondering
- Do they even check for them?
- If so, at some point does someone actually call the number for additional info, or do they simply go by the engraving?
That second point may have to wait until the crisis has passed, but I’ve always thought Medic Alert was a tool whereby someone could notify my endo, who could instruct them to let me manage my insulin needs (situation allowing) as well as providing details and instruction for hospital personnel on using a pump. After all, their website says MedicAlert speaks for its members in an emergency.
Has anyone had experience with a hospital using their Medic Alert that way? Do they go deeper than just reading the emblem?
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I began the thread & believe that your question is germane to the discussion. You raise an interesting question. If someone was admitted through an ER & they were wearing a Medic Alert ID that indicated use of an insulin pump would info about the use of pump be pursued? If the diabetic was unable to respond to questions would medical personnel call Medic Alert & pursue the information? The alternative of course is to remove the pump & treat the diabetic according to hospital protocol. I already know from responses here & even more on 2 diabetes related fb pages that results from that course can be life threatening for diabetic patients. So have diabetics with Medic Alert had the info on their treatment regimen researched? Secondly & very importantly, if medical personnel had the information did they use the knowledge for bg management? On this site & from 2 fb groups the stories abound about informed medical staff ignoring the normal treatment regimen used by diabetics. If any readers have experience in this regard would you please respond?
Wrist intact - thank you. But saying that IS going OT so I’ll shut up as I look forward to responses😊.
Thank you for rephrasing what I was trying to say, so well.
My experience: I had everything necessary for normal bg management. My glucometer, test strips & lancets as well as my Tandem t:slim x2. And even though in pain I had the wherewithal to use the technology. Nevertheless the hospitalist ignored me, had my wife take my pump home & put me on the inadequate hospital protocul. It would be interesting to know how many hospitals receive treatment info on diabetics from Medic Alert or 3rd party & choose to ignore it.
Dorie @wadawabbit. I’ve made inquiry of on-the-ground, over-the-road, and through-the -air of EMS personnel and of ER Staff about the questions you ask, and the answer is YES, they usually look for emblems; but they generally, in an emergency will not go searching. An emblem worn on the wrist is said to be most effective, a neckless is much less effective because of the way one can slip around. Skin-ink is often missed. Remember, EMS and ER personnel focus attention on saving life - think EMERGENCY.
I have been a MedicAlert Member for 55 years, and it has been used. I keep my record up-to-date and print my full “emergency” paper with each update. I fold that paper so it fits in a pocket of my wallet with the word “MedicAlert” highlighted in red clearly visible. On an occasion when I couldn’t speak EMS knew all about me, and handed the paper off to ER along with my body. Later, I was thanked for having it readily available A bonus of this page; when at a doctor appointment when given a clipboard and pen and told to up-date my record, I hand over my MedicAlert Summary and tell them to just make a copy - works every time.
Your other thoughts about will nursing staff study pump instructions and learn? Probably not, and unless staff is willing to listen, your pump may be taken from you just as what happened to Henry @Hen51. I’ve been fortunate relative to diabetes when in hospital - ER nurse who was connected to a 670G who asked for t-Slim instructions, and on another hospital stay when a couple of the floor personnel asked my for T1D instruction.
Thank you @Dennis . Printing the record to keep in your wallet is an excellent idea. I appreciate your feedback - as always.
I can personally say when I was a certified EMT-I running volunteer with EMS, when a patient was unresponsive, I and other EMS crew members when doing a primary body survey were trained to look and feel for medical braclets and necklaces. I personally over my 19 years of volunteering found only a couple of unresponsive patients that were wearing a Medic Alert or Medical jewelry ID. It would truly help to give a heads up to have patients who can’t speak for themselves give first responders a lead on how to treat them.
I met a woman many years ago who saw my ID bracelet and asked about it. I told her I was diabetic and she said she was as well, but didn’t wear one. I was surprised - it was such a practical measure I thought it was pretty universal. The stats you shared from your experience are scary. I’m glad and grateful that checking for a medical ID was part of your process. Thank you for your front line work!
I have one word of advise for those of us that choose to wear medical ID jewelry. If you wear a bracelet or necklace, don’t adorn them with multiple charms or other items that may distract from the primary reason you’re wearing them. I had an unconscious patient one time that had a charm braclet with multiple charms and amongst them was a small octagon charm that said EPILEPTIC in tiny letters. By the grace of God the charm was flipped to the side showing a red star of life emblem that drew our attention to it. Make the alert plate bold and an attention grabber.
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One other thing to mention. Don’t use customized stamped military dog tags that maybe over looked. Had a man that was Hepatitus/HIV positive due to drug abuse that wanted to notify medical personel of his situation if he overdosed. Appreciated his honesty but he still endangered people trying to help him by using the dog tag method to reveal his medical conditions because the tags weren’t read due to no medical insignia.
Bill, Please excuse me. I’m not replying to the topic of wearing Medical IDs. I hope my jumping in doesn’t discourage anyone who wants to comment on ID’S. I simply didn’t know how to give an update to my original post. Perhaps someone will inform me. So…
Thank you to all members who posted their experiences of bg management while they were hospitalized. From the replies of this community & 2 fb groups I have found that there have been some good experiences while others have experienced very bad standards for bg management. A few even experienced life threatening methods which resulted in ketoacidosis & transfer to ICUs. Many diabetics have been ignored when reporting how & types of insulin used for managing bg at home. These folks were all fully conscious & conversive. I want to update by also mentioning that the American Diabetes Association published a position paper on Diabetes Standards of Care in 2016. I also have a link to a Yale Standards of Care of Hospitalized Diabetics should anyone be interested in it. The paper with current updates can be found on the ADA website. Chapter 13 Gives Standards of Care during Hospitalizations. 2 points caught my attention as they relate to my own experience.
• A basal plus bolus correction insulin regimen is the preferred treatment for noncritically ill patients with poor oral intake or those who are taking nothing by mouth. An insulin regimen with basal, nutritional, and correction components is the preferred treatment for patients with good nutritional intake. A
• The sole use of sliding scale insulin in the inpatient hospital setting is strongly discouraged. A
I was denied the 3 prong approach of the preferred treatment given in part B of the first bulleted point & I was the victim of the discouraged bg management given in the 2nd bulleted point. With this information in hand I intend to contact the hospital patient advocate. I also intend to send a letter to the CEO & 2 Vice-Presidents of the Hospital in re: to the hospital protocol mentioned in my original post. I have no wish to tarnish the reputation of this fine hospital nor make a complaint to JCAHO. I only wish to raise awareness of a serious concern.
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Hi @Hen51 please don’t apologize - this was your topic and the ID discussion belongs in another thread.
I hope you are successful in raising awareness and I hope it makes a positive impact on your hospital- you could be saving someone’s life. You could be saving your own life.
The more I think about the hospital sending someone into DKA the more furious I get. It is certainly malpractice.
Anyway I wanted to wish you good luck in this important issue!
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Henry @Hen51 I admire and strongly encourage this approach; I hope that you receive an open and positive response for the hospital and that your in-put be requested.
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It wasn’t this hospital sending someone into DKA. 2 others on a fb group ended up in ICU of hospital where they went for different surgeries unrelated to diabetes. BTW my wife could tell I had high bg in hospital by my breath. I was never tested for ketones.
Update on care T1s receive in hospitals. I feel a bit foolish bc I did internet search. Found JC/ADA Standards of Care for Hospitalized Diabetics. So many things wrong with my experience as well as that of other T1s. . Maybe the question to raise is whether or not the Standards are being enforced? My story & those of other posts are only anecdotal.