advertisement

  1. This site uses cookies. By continuing to use this site, you are agreeing to our use of cookies. Learn More.

Things you need to know when heading to the hospital

Discussion in 'Stickies' started by WestinsMom, Oct 10, 2009.

  1. WestinsMom

    WestinsMom Approved members

    Joined:
    Mar 27, 2007
    Messages:
    3,137
    Maybe this should be a sticky? I think that the first trip to the hospital AFTER a diabetes dx is the most daunting learning experience ever. You thought it was hard to learn about diabetes. Well, now you know about diabetes and will soon learn that not many medical professionals know as much as you do. Here are my tips for heading to the hospital:

    Bring your own supplies- insulin, blood sugar meter and plenty of strips, pump supplies or syringes, blood ketone strips and meter (if you use them), snacks, glucagon, etc. Even pack a toothbrush and change of underware. You never know how long you will be there.

    Take notes- we all learned from another parent's experience last year that notes are a must. Keep a pen and paper right out on the side table so they know you are taking notes. I think it might keep them on their toes too.

    Remember that ketones need insulin! Westin has been hospitalized to treat high blood sugar and ketones and low blood sugar and ketones. Either way, they need insulin. The last time Westin was in the hospital it was after a shot of steroids. They wanted to admit us for the high blood sugar. When we got there, they wanted to wait for drs order to give insulin. I gave it to him anyway. Sometimes you have to take matters in your own hands.

    Call your endo and let them know you are there! This can be important to getting the proper treatment.

    Anything I have missed, please post it! :D
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,510
    Not sure I would agree with the statement that low bgs combined with ketones are best treated with insulin.
     
  3. Melissata

    Melissata Approved members

    Joined:
    Feb 19, 2009
    Messages:
    1,650
    The only thing missing is that you need carbs first in order to use the insulin for low bg and ketones.
     
  4. Seans Mom

    Seans Mom Approved members

    Joined:
    Oct 10, 2007
    Messages:
    2,279
    Ketones HAVE to be treated with insulin. Even with low blood sugar. Especially if the low blood sugar/ketone issue is from stomach virus or other illness. The hospital needs to put in a dextrose IV to get the blood sugar up enough to administer the extra insulin needed if necessary. Ask your endo if you have any doubts about treating ketones with insulin. :)
    I like the list, most important one I wish I had when we went was to call the endo MYSELF. I made the mistake of believing since we gave them the information at admittance that they were in contact with the endos office. They weren't. :mad::(
     
  5. Ellen

    Ellen Senior Member

    Joined:
    Oct 22, 2005
    Messages:
    8,240
    Have the endo write orders that you can treat with insulin, check bg, etc.
     
  6. joy orz

    joy orz Approved members

    Joined:
    Feb 7, 2008
    Messages:
    2,460
    If celiac is in the mix, it's helpful to pack your own snacks, and check EVERY plate that comes in. I can't tell you how many hamburgers came to Ava with wheat buns on them. :mad:
     
  7. Jen_in_NH

    Jen_in_NH Approved members

    Joined:
    Jan 12, 2009
    Messages:
    437
    Bring your own insulin. A lot of the hospitals (at least around here) have exclusive contracts with drug companies to only use their products. When Christopher was admitted last winter, he needed orders from the admitting doc to use his own Novolog, since they didn't have it in the hospital and wated to switch him to Humalog.

    Also, if you can talk to the admitting doc, ask them to write that you can dose insulin as you would at home. They were trying to get Christopher to eat anything, so we would order mac and cheese, bananas, etc. They wouldn't let us adjust upwards for the pasta, etc. The doc finally wrote an order to allow the parents to dose Novolog as done at home.

    Jen
     
  8. AlisonKS

    AlisonKS Approved members

    Joined:
    May 16, 2007
    Messages:
    2,391
    have someone come home and grab your childs favorite foods when they are well enough to eat-otherwise you'll be stuck there longer not being discharged because no one wants to eat splenda pears and grilled cheese that's been on the cart for hours. Also bring a scale, most hospitals use the usual 15 carb increments for foods, and with toddlers that is so not happening. If your toddler will only drink out of certain sippy cups-bring those too.
    When you are in the ER, make sure you have your endo's phone number, otherwise the hospital will call the pediatrician-this can take forever while the clock is ticking away. Some hospitals don't know that a pediatric endocrinologist will know more than a pediatrician, even if you are in the hallway screaming at them.
    Ask your pediatrician if they had a very sick child, which hospital would they bring them to? Go to that one if at all possible. If you feel like your child is not getting the care they need, demand a transfer. It will cost you more if you have sucky insurance but it is worth it.
     
  9. BrendaK

    BrendaK Neonatal Diabetes Registry

    Joined:
    Oct 29, 2005
    Messages:
    3,833
    Bring snacks. Or $$ for vending machines. I've lost a few pounds in hospitals because I have no cash for the vending machines and the cafeteria was closed!
     
  10. jilmarie

    jilmarie Approved members

    Joined:
    Jan 29, 2007
    Messages:
    773
    Just as an FYI, most people find Novolog and Humalog to be completely interchangeable. If they weren't, hospitals would probably have both of them on hand.
     
  11. hdm42

    hdm42 Approved members

    Joined:
    May 1, 2008
    Messages:
    1,297
    Very good point. We had the hospital pharmacy bring a Levemir pen up for us and claim it was Lantus. "Um, no it isn't." Luckily I had brought all our supplies with us and the pediatrician that admitted him was ok with me basically doing all his D care. We never even saw an endocrinologist in the 6 days we were in hospital.
     
  12. funnygrl

    funnygrl Approved members

    Joined:
    Nov 2, 2005
    Messages:
    2,324
    I wouldn't keep paper out so everyone knows you're taking notes. As a nurse, I know this is a turn off for many people. In our sue-happy society, it just scares people. I've had patients threaten to sue because their meal came up cold (something I have no control over) or because they don't like the color of the blanket (I didn't make this up). If we see someone taking notes, often we'll just avoid going in that room. In the ER, where nothing is really scheduled, that's just asking for long wait times and essentially to be ignored. Is it right? Of course not. But it is the way it is. You'll also cause everyone to treat you differently and definitely less friendly. Most nurses will do things like take off their name tag and not tell you their name if they see you are taking notes. I've even seen some nurses give a false name if asked (not something I agree with, but something I've seen happen).

    I also definitely wouldn't give ANY medication without letting the nurse or medical staff know. That's just asking for trouble.
     
  13. chbarnes

    chbarnes Approved members

    Joined:
    Jul 5, 2008
    Messages:
    1,215
    Many hospitals will permit patients to manage their own diabetes while in the hospital. It's a bit of a gray area for children, but I would continue to manage your child's diabetes until s/he was seen by a doctor and orders have been written. Generally, hospital staff do not know how to run an insulin pump. There are too many different brands. So, unless your child is admitted with significant ketones, you will probably be permitted to manage the pump. Of course, in DKA IV insulin is often given, so the pump isn't needed.

    Chuck
     
  14. hypercarmona

    hypercarmona Approved members

    Joined:
    Jun 18, 2007
    Messages:
    698
    I second this, and would add, if you are able to avoid it, do not let them start an IV insulin drip and don't let them near you with a syringe of "insulin" unless you actually saw them draw it from the correct vial. (Regular, Novolog, Humalog, Apidra, Levemir, are all clear liquids and look the same in a syringe.) The protocol is archaic and dangerous. The last time I was on an insulin drip three years ago, I was told that every one is given the same starting dose and that it works for nearly everyone except for the morbidly obese, there are no boluses and no extra insulin is given for meals---only after the fact to treat the resulting high. At my local hospital, the carb counts for the meals are given as exchanges, and it took an hour for them to find them for me, after I was finally able to explain to them exactly what carbs are.

    And no offense to the medical professionals and nurses on this board but every nurse I've ever met outside of an endocrinologists office, has absolutely no clue about diabetes, insulin, BG tests, carbs, etc. They carry the same misconceptions that the general public does, which makes them especially dangerous because the misconceptions are what they act upon when they are treating diabetics. I was told by an obstetrics nurse that I should be ashamed of myself because my BG was over 200 after eating a jello cup she gave me, as if I could do anything about it with the insulin drip I was on.
     
  15. Flutterby

    Flutterby Approved members

    Joined:
    Nov 11, 2006
    Messages:
    14,623

    Actually insulin is one of the few medications that MUST be checked by at least one other person, another nurse or dr. I found this out when Kaylee was in the hospital last year. Everytime they ever BOLUSED insulin, it had to be double checked, and by the third day there they were triple checking, and I was checking everything as well..

    if they let you continue to give insulin, thats great, but with ketones you need to make sure they don't leave it up to you completely, someone needs to be guiding you on how much insulin to give. We had an extremely horrible hospital stay last year.. with ketones 5.0+ they were having ME dose her insulin, I was trying, but with ketones THAT high no matter what I did I couldn't get them down.. I had to call the endo's office in the middle of the night to get instructions, because frankly the hospital had NO clue.. be an advocate for you child and don't be afraid to speak up if you see something going wrong. they almost killed Kaylee, I hate to think what would have happened if I didn't speak up.
     
  16. Gwyn

    Gwyn Approved members

    Joined:
    Aug 4, 2007
    Messages:
    928
    I second (or third:)) bringing your own insulin--and a keytone meter.

    When we were in for stomach flu last fall, our hospital couldn't give half units (they had disposable pens for insulin delivery) and they never gave DD any basal insulin. We asked about Lantus and they said we could not administer what we brought due to hospital regulations. But as time went on and no Lantus was ever administered, we we able to give her the insulin she needed. Also, ketones were checked with a pee stick--and infrequently at that.
     
  17. funnygrl

    funnygrl Approved members

    Joined:
    Nov 2, 2005
    Messages:
    2,324
    At my hospital is HAS to be another nurse. Apparently they don't trust the doctors or something. I had to give insulin once and couldn't find another nurse but a doctor was right there. I showed it to him and went to sign it off in the medical record. I put his name down as the cosigner, and the computer told me he wasn't an approved co-signer. :eek:
     
  18. RosemaryCinNJ

    RosemaryCinNJ Approved members

    Joined:
    Mar 9, 2008
    Messages:
    3,571
    I agree about bringing your own supplies....I made sure Amanda was only tested for BG using HER multi clix and NOT the harpoons they use at hospitals..they hurt more and make your childs fingers look terrible and long to heal..the (nurses) tried to tell me they had to use them..I told them "well use one on yourself then let me stick you with hers and see which one you like better"..they didnt say another word about it!!!
     
  19. Jen_in_NH

    Jen_in_NH Approved members

    Joined:
    Jan 12, 2009
    Messages:
    437
    They are pretty close, I know. But for the hospital here, they only have the disposable Humalog pens. Christopher was using a Novolog Jr pen, and they didn't have those. They originally wanted us to change to the Humalog pen, and try to play with the dosing, but finally agreed to let us use the Novolog Jr pen after they talked to his endo.

    They also only had Lantus. Worked out fine for us, but if you use Levemir, they wanted you to switch to the Lantus while you were there.

    Jen
     
  20. funnygrl

    funnygrl Approved members

    Joined:
    Nov 2, 2005
    Messages:
    2,324
    Yeah, no kidding. Everytime I've been admitted I've let them use their meter but used my own lancing device. Those things suck.
     

Share This Page

advertisement