Wednesday, 15 August 2012

Hypo Awareness Week!

It is Hypo Awareness Week this week, which seems to be a new thing, and I've had a couple of throughts knocking around my head about the subject in general. Part of the week is about educating healthcare professionals working in secondary care about hypos, what they might look like, what to do if you find someone hypo, etc, and it got me thinking about a couple of things, which I'm going to actually going to split into two posts, because I can ramble on a fair bit... ;)

1) Hypos in hospital

I've had two experiences of being hypo while staying in a hospital, and they were quite different from one another.

The first was while I was participating in a study.  The study part had ended, but I was hooked up to IV insulin, and they were continuing to monitor my blood glucose levels over night (part of the study protocol as I was instructed not to take my lantus the previous day).  I woke up at some point in the wee hours, and I knew I was low.  They had just taken a sample to test, and I was still in that sleepy/hypo groggy stage where I was deciding what to do when they came back and asked how I felt. I replied that I was pretty sure I was low, to which they responded "your BG reading is 2.8"

By this point I was fully awake, and ready to grab some skittles and just get on with it (as you do).  I knew I was low but it wasn't a particularly bad one, so I wasn't bothering that much, other than being slightly frustrated that I couldn't just get up and treat it.

The nursing staff, however, pretty much went into panic mode at this point.  They asked me what I wanted to treat the hypo (fair enough), so I asked for some juice if they had any.  They gave me a glass of orange juice and four biscuits, and then asked me if I wanted a couple of slices of toast and a cup of tea.  I drank the juice, ate one of the biscuits, and then explained (while hypo) that if I ate all of the stuff they were trying to give me, my BG would end up skyrocketing.

They were very nice, and very concerned, but oh man, it's so hard anyway to avoid overtreating a hypo without someone trying to force food on you! I was also surprised, as the study was diabetes related, that their night staff were not better educated on how to treat a hypo.

The second experience occurred while I was in short stay for a liver biopsy.  I'd had the biopsy, and was in the middle of the six hour bed-rest-and-observation period.  During this, they take your blood pressure and heart rate every 30 minutes to make sure you're not bleeding to death.  At one point, I'd just checked my BG and I was a little bit on the low side, so I'd had some jelly babies and was waiting to come back up.  The nurse popped in, measured my BP and heart rate, and stopped to comment that my heart was racing (I believe it was 135 bpm at that point...) She asked if I could feel it, and I explained that yes, I was aware of it and it was because my BG was low.  She looked at me and said "so I guess we should get you something to eat then?"  I said that I'd already had something, and said "ok" and left.

I'm in two minds about this.  I'd insisted on having my pump and meter and being able to monitor myself, as I had the last time, but they were meant to be recording things like BG etc.  It's part of the reason I said I wanted to manage my diabetes by myself, because I'm always vaguely terrified that I'll end up with someone who doesn't understand what's going and will do something wrong.  While I wanted to manage my own diabetes, they were still meant to be monitoring/recording data, and the fact that none of this occurred, and the nurse's lack of attention or concern about the fact that I was low (simple things like: how low are you? What have you taken? I'll check back in ten minutes) worries me, and did nothing to relieve any concerns I have about ending up unconscious in hospital with no control.

So I've had two experiences of being low in hospital, and they were pretty much opposite ends of the spectrum.  One was a panicked over-reaction, and the other was a worrying under-reaction.  As a result of this, I'm really pleased to see hypo awareness week, and I hope that it improves the way taht hypos are dealt with in these situations.

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