Thursday, February 26, 2009

I Need Your Help, What Would YOU Do?

OK dBlogville, need your advice, as I’m ready to go medieval on someone whose taking care of my mother and yes, it’s totally diabetes related.

As I’ve told you before, my little 113 lb mom was diagnosed with t2 a few months back and put on Metformin once a day – lowest dose possible.

Now, normally her fasting b.s are only about 20 points higher than they should be, but since she going to have a surgery that had a high risk of infection, her docs decided to nip her slightly elevated blood sugars

Cut to last night – 7:30 PM. My mother calls me and says:

Hey Kel – guess what? They took my blood sugar and it was 250 – I wouldn’t let them give me insulin – I didn’t want another shot of anything.

Internal Voice: WTF, WTF, WTF, WTF!!!! Why not just tell me your having lunch with Serial Killer & stab me in the heart with a two-by-four????! She’s never been over 133 and visions of DKA started dancing in my head…but then, something made me ask the following question:

Me: Mom, when they took your B.S, had u washed your hands??

Mom: I always wash my hands when I go to the bathroom.

Me: That’s not what I asked. Did you by any chance have some chocolate or some Big Red Gum and just wipe your hands clean or did you get up and REALLY wash your hands?

Mom: Ummm, no.

Me: OK listens to me mom. Go wash your hands and don’t eat anything. I’m calling your nurse at the Nurses Station and asking her a few questions. If she comes in and takes your b.s again & it’s high, you have to take the insulin. If not – then we won’t worry about it.

Mom: I don’t want a shot.

Me: (Very exasperated) Listen to me mom – I know your veins are collapsing & your feeling like a pin cushion – I totally get that, but the insulin gets injected in the fatty tissue – not your vein – it won’t hurt as much and you won’t turn black and blue (OK – maybe I lied) but in order for your knee to get better, your blood sugars have to be perfect – or you won’t heel properly and your doing SO well.

So she promises me she’ll wash her hands and we hang up. I call the front desk and ask to speak to my moms nurse. They put me on hold for 10 minutes and finally Brenda the Nurse Practitioner from hell gets on the line.

NP from Hell: Yes, what can I do for you? (Can I just mention that she sounded really condescending?)

ME: I’m Marjory Kunik’s daughter Kelly and I just got off the phone w/her. What’s the story with her 250 blood sugar? She’s never been on insulin and her blood sugar is never over 130 = tops 140’s. She refused insulin, correct?

NP from Hell: (In the most irritated and are you f’ing kidding me voice ever): Your mom had a b.s of 250 and refused medication. This is a rehab and we cannot force the patient to take any meds they don’t normally take.

Me: I understand that – but,... I wonder if she had washed her hands - this was quite sometime after dinner, correct? I know she has chocolate in her room – she might have just popped a Hershey’s kiss and the remnants of said chocolate Kiss may have actually caused her high b.s. She’s never had such had such an elevated b.s in her life!

NP from Hell: Sugar has nothing to do with high blood sugars (yes –idiot banshee’s exact words, I kid you not!) and I swabbed her finger with alcohol.

Me: (Trying not to verbally annihilate her over the phone) Well, I’ve been a type 1 for 30 years and I’m also a Diabetes Advocate and beg to differ with you. Sugar, olive oil, anything on the hands can absolutely cause a false reading – articles have been written on the subject – go ask a CDE about it, I'll wait. Look, my mother barely eats as it is – hence the reason she has a bit of chocolate in her drawer – the woman only weights 113 lbs for god sakes. IF this is a TRUE high blood sugar, I want it dealt with Paula, immediately, and if not - thank God she refused the insulin – Does the name Sunny Von Bulow ring a bell? I want you to retest within the hour.

NP from Hell: I plan on going in at 10.

Me: Paula, I need you to do me a favor and go in at 8:30 - PLEASE.

NP from Hell: FINE.

Me: Thank-you Paula I’ll check back with you at 9.

SO, basically I’m fuming at this point and those of you who were privy to my Tweets and FaceBook status last nite can attest to that fact.

8:15 my sister calls and I fill her in – she calls my mom.

9:00 my mother calls me and says: Hey, guess what? They took my blood sugar and it’s 140. Washing my hands must have REALLY helped!

Me: Thank God. Listen – you must scrub your hands every time they check your blood sugar, OK?
Mom: OK – Good night, I love you!

Me: I love you mom, goodnight!

Cut to this morning - her blood sugar was 111.

Me – I've been checking in all day and blood sugars are text book. I've talked to her nurses & told them that they must call me if her b.s is over 150 and to make sure her hands are washed with soap and water before they test.
My sister met saw her today and sat in on a cumadin meeting with my mom and her team this afternoon - I haven't talked to her since this morning so I'm not sure what she said about last night.

Me, I still wanna kill Paula,Nurse Practitioner from Hell. I found her actions and attitude incredibly irresponsible and potentially lethal and I plan on discussing in excruciating detail during the meeting we have tomorrow with her doc's.

Any suggestions on How I should deal with the Dr’s regarding Paula, Nurse Practitioner from hell almost killing my mother or do you think I'm overreacting??


Cara said...

I would talk w/ her doc about it. It's not safe. Someone that is that newly diagnosed would feel like total CRAP at 250. Heck, I feel like crap at 250. They would know. And if there's a reading that doesn't match up w/ how she feels, they should retest!
I retest all the time. And I've been at this for 23 years. Not every patient would refuse medication...and then where would they be???
ICU, that's where!
I say talk w/ the doc as soon as you can.

meanderings said...

I agree w/ Cara and - - -
Keep notes, copious notes - a running daily diary of what you see/hear from your mom. This way, when you need to speak with the doctor or whomever, you're able to pull out your notes and site the day/time and incident that you need to talk about.
And, since she hasn't had insulin before, there's no reason it should be on her drug list. Have it removed.

Crystal said...

I agree with Cara.
Talk to the doctor directly. Possibly ask to change nurses while suggesting she get REtrained.

Sugar has nothing to do with high blood tests??? WTF?
The Reason we test our Blood is for the Sugar content! DUH!

You are not over-reacting.
Take a breath. You AND your mom especially are doing just fine. She learned from a seasoned T1 and her refusing the insulin was crucial.

Hang in there Kelly!! My best to you both as you get through this.....

Kassie said...

It sounds like you handled it really well. Did you speak with the nurse again at 9? Had her tone or attitude changed?

If the nurse had swabbed her finger, she was following protocol by offering insulin for a 250 - granted, you know that 250 feels like crap and that your mom was unlikely to be that high. But the nurse(s) know T2, post-surgery and 250 was feasible.

Now, if she did not actually use the swab, she'll never admit it.

I would talk to her docs about a safer protocol for her - whether it's calling you, or not considering insulin unless she has two high blood sugars in a row, or some other combo.

I would tell them - or someone - that the nurse was less than pleasant.

And I would drop off an article about the importance of cleaning your hands before checking your blood sugar.

Scott K. Johnson said...

While not exactly scary looking, I do possess some physical hugeness. That, and I know a ninja...

Let us know and we'll go open a can on her.


k2 said...

Cara -
EXACTLY - thanks I took advice!
Mom is now off the insulin sliding scale ;)

Colleen -
I have a notebook and quoted it yesterday when I spoke w/ the Nursing supervisor. First I asked what she thought of my mom's blood sugars (Wonderful) then I asked about the 250(she couldn't explain it.
Then we talked about handwashing and bloodsugars. Guess what ? She had no clue about that & is now talking to her staff about it!

CP -
Thanks for your support girlfriend! Breathing deep and starting to see the light of day.

Kassie -
Thanks for the advice and support.
I discussed b.s protocol and the less than pleasant attitude, and now the whole handwashing bloodsugars issue is being taught to the staff. I will print out an article for the though- great advice - thanks again!

Scottie J
WOW, my very own Enforcer & Ninja protection team - this chick greatly appreciates it!


Diane J Standiford said...

You are NOT overreacting. Research has proven that patients who have family around get better care. COMPLAIN--LOUDLY, I would have a mtg with person who runs the facility about b&*() Paula. I would tell Paula, if anything happens to my mother due to any of your actions I will hold you personally responsible. I get very tough. I could give you many examples of similar things happening to aunt Vi and me! Be TOUGH.

k2 said...

Diane -
So happy to see your reply!
You'd be proud - I was tough,& didn't mince words!

Jim F said...

Well Kelly, to be honest I can't really help you on how to "Best" handle nurse Rachet. That's because I am not a very diplomatic person. I can though say that I can relate with idiot health unprofessional's, (This is not a slam on all health professionals) having had to deal with them myself on my father's behalf before he passed away. Lets just say that after repeated trips to the hospital and them just sending him home over and over, I finally paid them a visit and, ummm, things got fixed.

Best of luck with you and your mom and again the two of you are in my prayers.