Am i in the right?

[brisr949]

So, still in hospital after a pancreatic problem and up until yesterday all was well as i had my nova with me but ran out yesterday morning and they are now issuing the insulin according to whats written on my notes.
Now they have the standard 3 times a day with nova and levi at night.
So after lunch yesterday at 12.30 i got really hungry at around 2.30 so had a couple of sandwiches and an apple, i had tested prior to eating this and was 12.4 so as per i asked for some insulin and was refused. They said you only have it 3 times a day a d wasnt due till supper at 6 oclock. I tried arguing my case and asked to speak to a doctor as no diabetic team on the weekend and only junior docs on call. The doctor said she could only go bu whats written so i sighed and said forget about it. Pre supper testing showed i had gone into 23.6 with ketones slightly up to 0.3 which as i knew proved my point entirely. Its honestly like no doctor fully understands what an insulin dependent person is or am i wrong?

 

[Robin]

So, still in hospital after a pancreatic problem and up until yesterday all was well as i had my nova with me but ran out yesterday morning and they are now issuing the insulin according to whats written on my notes.
Now they have the standard 3 times a day with nova and levi at night.
So after lunch yesterday at 12.30 i got really hungry at around 2.30 so had a couple of sandwiches and an apple, i had tested prior to eating this and was 12.4 so as per i asked for some insulin and was refused. They said you only have it 3 times a day a d wasnt due till supper at 6 oclock. I tried arguing my case and asked to speak to a doctor as no diabetic team on the weekend and only junior docs on call. The doctor said she could only go bu whats written so i sighed and said forget about it. Pre supper testing showed i had gone into 23.6 with ketones slightly up to 0.3 which as i knew proved my point entirely. Its honestly like no doctor fully understands what an insulin dependent person is or am i wrong?

I've never met a hospital doctor who's been able to answer questions outside of their speciality. That’s a real concern that they won’t issue extra insulin for correction doses. I think you might have to kick up a real fuss, they must have an emergency endocrinologist on call, and if you are getting high numbers and ketones, that is an emergency.

 

[trophywench]

Why are THEY administering your jabs - are you not mentally capable? KICK UP A STINK - NOW!!!!!

 

[Sally71]

Hospital staff are notoriously bad at understanding diabetes if it isn’t their speciality. But they ought to allow you to deal with it yourself! When my daughter had her appendix out aged 7, they put her on a sliding scale and a doctor decided 3 levels that it was permitted to run at based on her blood sugar levels. Well the poor nurses were adjusting it up and down all night, which would suggest to me that it should be set at a rate somewhere in between the two that they were using, but of course the nurses can only do what the doctor has told them to do, and there was no doctor available to change it. (They came round in pairs to change it too, which amused me - yes insulin can be dangerous and of course they have to be careful, but can you imagine if every diabetic person or parent thereof had to double or triple check every single dose with someone else, we'd never get anything done!)

After about 24 hours they allowed her to go back onto her own pump, which was a great relief because I was allowed to take charge again. The nurses were quite fascinated and stayed to watch when I was putting a cannula in, but they accepted that I was used to dealing with it and just let me get on with it after that. I had made sure we were brought to the same hospital which my daughter's diabetes team is based at, and they came to see us a couple of times while we were there. Whether they had to give their permission to the ward staff for me to take charge I have no idea, i've never thought about it before; but there's no reason why an adult T1 shouldn’t be allowed or manage their own condition while in hospital if you are mentally well!

 

[SB2015]

Hi Adam, you cannot let them continue in this way. The levels you are getting are ridiculous and should be an embarrassment to the ward staff!! Is there anyone who can bring in more insulin for you so that you can take back control? They must have access to an emergency endocrinologist and they need the input of them NOW.

I have been fortunate to have been left to get on with my own devices whenever I have been in hospital. They should have a written protocol and I would ask them to get you a copy of this NOW. It should include advice that they let you manage your insulin as you clearly are compulsive mentus.

While you are waiting you will need to match your carbs to the insulin that they are ‘letting you have’. Does that make sense?

Please make a fuss NOW Adam.

 

[Deleted member 25429]

This is unbelievable our specialists encourage and trust us to manage our condition . We all need different amounts of insulin , which we know they don’t .

 

[DaveB]

Hi. Very few in the NHS really understand diabetes and in particular insulin management. I always insist on managing my own injections in hospital and never had a problem. Isn't there someone who can bring in further cartridges/pens? It is difficult for nurses who haven't been diabetes trained to vary what the doctor has written. You must get someone to bring in further insulin and insist that you manage it. I always say to nurses they can finger-prick test as often as they like. BTW never allow Sliding-Scale management as few nurses know what they are really doing with this and if they become busy or short-staffed disaster lies round the corner.

 

[Inka]

https://www.nice.org.uk/guidance/ng17/ifp/chapter/Care-when-you-are-in-hospital

“If you go into hospital because you are ill or need an operation, your expertise and knowledge of managing your diabetes should be respected and followed. If possible you should be involved in food choices, monitoring your blood glucose and any changes to your insulin treatment.

If you can eat, you should be able to carry on with insulin injections (or an insulin pump if you use one). You should be able to inject the insulin yourself if you want to and can do so safely. The number of injections and the doses and types of insulin may change to take account of your illness and any changes in food intake.”

 

[Pumper_Sue]

So after lunch yesterday at 12.30 i got really hungry at around 2.30 so had a couple of sandwiches and an apple, i had tested prior to eating this and was 12.4 so as per i asked for some insulin and was refused. They said you only have it 3 times a day a d wasnt due till supper at 6 oclock

Personally I would not have eaten the food without the insulin, hungry or not. Secondly I would have asked to see the ward manager and made a formal complaint about withholding your Insulin. I would have then got up and walked out.
If you are still in then don't give the pen back when you next inject. Solves a lot of problems. 🙂

 

[SB2015]

How are you doing now @brisr949
I hope that your levels are now back in target and that they are letting you manage your insulin.

With the treatment that you have received, unless there are other issues you would be better managing your diabetes at home, applying correction doses as necessary.

 

[mikeyB]

I always take my own insulin into hospital for that very reason. The same applies to Creon, which is even worse understood.

 

[Lanny]

That wouldn’t work for me at The Causeway Hospital! When I was admitted May 2017 they took all of my big bag of meds off me & locked it in the top drawer of my bedside table. All of the patients being admitted have their meds locked up too & the nurses come round & administered the meds, including my insulin, unlocking the drawer to give them to me!

 

[Inka]

@Lanny When I was in hospital they told me all meds had to be locked up for safety, but I just asked for a key, which, after a bit of fussing, they gave me.

 

[Pumper_Sue]

That wouldn’t work for me at The Causeway Hospital! When I was admitted May 2017 they took all of my big bag of meds off me & locked it in the top drawer of my bedside table

I always refuse to hand over my meds due to the major C ups made in the past. Lat year I ended up in hospital and was expecting a 24 hour stay but due to an infection in there for 3 day after which I walked out. Major c.up regarding my meds which like Adam I had run out of and the pharmacy seemed it ok to remove a life saving med from my prescription so I considered it far to dangerous to stay plus not being fed for 3 days as no gf food available I had had enough.

 

[everydayupsanddowns]

It is stories like these which make me worried about any hospital stay. That and the less-than-ideal figures and outcomes in the National Diabetes Inpatient Audit.

I would press hard for access to your own medications @brisr949 - and quote the NICE guidance if they resist. Your diabetes management is clearly being adversely affected, and your health is being put at risk.

 

[Carlos]

My hospital experience during an overnight admission for something not related to diabetes was not great either, in just about 24 hours they managed to mess up my levels to the point of needing four days to get back on track after going home.

To this day I still can't believe the level of ignorance the nurses and duty doctor displayed.

 

[Inka]

I had a planned hospital admission (for giving birth) and I got my consultant to write up my diabetes plan in my Notes in advance - ie I wouldn’t be taking my pump off, I’d be doing my own insulin, etc etc.

Not that I’d have let them take my diabetes stuff anyway, but having that in my Notes was reassuring.

 

[trophywench]

Well yeah - I've only been admitted once in recent years when I smashed a kneecap - tripped up when walking over a speed bump that we've driven over shedloads of times - friend said I was obviously walking too fast! ) so I was completely compus mentis whereas Bris was an emergency admission in DKA, so different. However - he'll now be bed blocking so the quicker they let him home the better for all concerned.

 

[MarkGeordie]

My biggest concern when I was admitted to hospital for 8 days about 6 years ago for something not related to my diabetes was when they came to do a BG check in the afternoon and it read 2.6 and she just walked away and said she would be back in a few hours. I was like “excuse me are you going to treat my hypo?”, she replied “what do you mean ?”. I was gob smacked that she was walking away and thought it was normal.

I ended up asking to speak to the nurse in charge, as well as telling her what she needed to do to help me.

 

[brisr949]

Thanks for all the great replies, im home now, managed to get discharged this morning so home now and very glad for it. Feel so much better being back in control of my meds.
Adam.