I am told that some people have normal blood sugars but I’ll believe it when I see it. As far as I can tell, everyone is either too high or too low.
Recently, I saw a lady who was an expert in the latter. She presented with her third hypoglycemic episode of the day. EMS was called out each time, where they would find her about as responsive as a tree stump. She would quickly normalize after getting some D50 run through an IV, and being unable to stomach yet another run to her house the medics finally managed to talk her into being seen in the ER.
I looked up her old records. She had fourteen visits for hypoglycemia in the past year and a half, managing to simulatenously beckon Death with one hand while staving him off with the other. Through medicare she had a family doctor, diabetic educator, and home health nurse but despite access to these resources she was unable to grasp basic elements of caring for herself, like knowing the name of her medicine or how to check a glucose level on her own.
I dutifully went through some diabetic educational stuff with her and her daughter and then left her to complete my fancy 21st century medical treatment: dinner.
A short time later the next chart hit the to-be-seen rack with a clunk. I pulled back the curtain and who was sitting there but the low sugar lady’s daughter, who just five minutes before I had been in a calm discussion with. Now she was complaining of one week’s worth of right shoulder pain, with a longer history of similar pain on the left treated, so she said, with narcotics by another ER up the road.
No, you can’t have any vicoden.
Speaking of this lady, I know how to solve America’s ER crisis, and all it would take is 25 bucks or so.
April 14, 2008 at 10:03 pm
Yeah, yeah, a co-pay. Dream on, brutha.
Come on K, Yes-We-Can! Ok, maybe not.
April 15, 2008 at 1:08 am
It’s hard managing diabetes when you’re smart. The poor stupid people don’t stand a chance. Seriously, it sounds like this lady needs to add a psychiatrist to that tax-payer-sponsored medical team.
What she really needs is assisted living but she’s unwilling to go.
April 15, 2008 at 6:16 am
Looks like the daughter has a similar condition, wading in the shallow end of the gene pool.
Bet the daughter’s working on getting disablity for her injured shoulder.
April 15, 2008 at 3:24 pm
it’s nice to know that we’re all in the care of such compassionate caring people.
April 15, 2008 at 9:46 pm
Back in Atlanta, when I was working ground EMS there, we had a “Treat and Street” policy for such events.
Barring any unusual circumstances, for a insulin dependent diabetic with hypoglycemia, we’d start a line, give the D50, wake ‘em up, make them something to eat, watch them eat it, and let the patient stay at home.
Medicare even paid for these calls. Cheaper than shelling out a couple hundred dollars for an ambulance ride and an ER visit.
Those patients on oral diabetic meds were always transported. Longer acting drug and all that.
April 16, 2008 at 10:07 am
Jeff- the problem is even without oral meds, and insulin like Lantus lasts 24 hours, and an insulin like Levemir or NPH lasts 12. If they took too much of this insulin, they’re likely to go low again. If it’s the short acting insulin they took too much of, yeah, that’s a good policy.
April 16, 2008 at 1:32 pm
I don’t get it…what’s your $25 solution? Were you really subtle, have you discussed it in previous posts, or is it obvious and I’m just slow on catching on?
April 17, 2008 at 1:57 pm
It’s subtle, but Nurse K nailed it in the first comment.
April 17, 2008 at 2:24 pm
“Come on K, Yes-We-Can! Ok, maybe not.”
HAHA
April 18, 2008 at 8:04 pm
My copay is $50 to been seen at the ER. Seems about right. Although the $50 tetnus shot and antibotics over a long weekend sucked.
$25 would be great!
April 19, 2008 at 5:27 pm
$25…
Does a gun really come that cheap?
May 3, 2008 at 6:00 am
Kal!You read my mind! I repeatedly mutter at work ,” I have a list ,YOU are now on it, now where is the gun”.
November 1, 2008 at 10:38 pm
You folks crack me the heck up!!! The sad thing is I think I see most of these same people in my restaurant every few days. Small world hm?
And Madam Yvonne, I think there needs to be a universal list of idiots/assholes/etc. that should be refused service in any type of public establishment.