My assertiveness paid off in hospital – by Alyssa
Last Year I had to have a minor operation on my foot which required general anaesthetic. I was worried about things because I didn’t want the hospital to take my pump and continuous glucose monitor (CGM) away and put me on a sliding scale (a drip of insulin and a drip of glucose). I had to go into the hospital early so that the nurses could help me with fasting and make sure I never went hypo.
When I got to the hospital I was shocked by how little knowledge the hospital staff had about Type 1 diabetes. I was on the orthopaedic ward, so most of their patients were older, but they should have at least known what an insulin pump is in case they get a patient with one. They told me that I had to keep them right, because they didn’t know how to work an insulin pump, let alone a CGM, but they didn’t put me on a sliding scale. I convinced them that I could control things myself, and if things are going wrong, I would let them know.
My blood sugar was brilliant the whole night. in the 6-7 range, but at that time I always dropped in the morning because my background insulin rates weren’t correct. I put a temporary basal on to try and stop this drop, but in the morning at around 9am my pump got a ‘low predicted’ alarm. I swiftly alerted the nurses of this, but they had no idea what to do. I couldn’t treat my predicted low orally as I was to have a general anaesthetic later in the day.
The nurses took 20 minutes to call a doctor and ask his advice, at which point I had dropped to 3.8 and was getting increasingly scared. They came into the room and put me on a glucose drip to bring my blood sugar back up, but I was not impressed by how they handled this time sensitive situation.
I was taken down for my operation at around 2 0’clock, still wearing my insulin pump, but had a glucose drip in just in case. In the room before the operation, they had a woman who had more knowledge on insulin pumps who came to talk to me, so she could advise the team who were with me on what to do.
I luckily knew the woman who came to talk to me! Her young son got his insulin pump training in the same group as me, so she knew exactly how my pump worked, but I had to advise her about how to work the CGM during my procedure. They left my pump unclipped next to me so it was easily accessible and the team could see what my blood sugar was during the procedure, which was very reassuring to know.
When I came around after the operation, I was told that my pump had suspended my insulin because it thought it was hypo. The nurses said that they tested my blood sugar and it was in range, so it was my CGM that was inaccurate. I don’t know why that happened, because it is usually really accurate, but it must have been to do with the anaesthetic.
My blood sugars were good during the fasting before the operation, apart from the blip in the morning. It was shocking to see how little knowledge the ward had of Type 1 diabetes, and if I hadn’t been assertive and taught them about it, something could have happened. I made them change the plan to suit my individual needs, but some people might be too afraid to do this, and that is concerning if the staff don’t know the facts.
I am pleased to report that my operation was a success.