Andrea, that must have been a horrible experience for you. Yet, going
to the ER was probably the right thing... They may have saved your
life. Unfortunately, the nurses and other personnel in attendance did
not really know what is going on with diabetics such as youself.

By leaving when you did, you may have also done the right thing. It is
hard to say. I cannot imagine continuing to have an IV dripping
dextrose when your BG is 165!

Thank God, you are OK...

Will,T2

Andrea,

First off, sorry to hear that you had to go through something like
this.  Insulin to food is a delicate balance and unfortunately these
kinds of hypos can happen.

Secondly, IMO what you did was wrong.  I put part of the blame on you
and part of it on this newsgroup.  No one in particular here, but the
overall impression here about how hospitals and doctors don't know
anything about diabetes and will give bad treatment.  So someone like
you reads all this and goes into an ER or a hospital loaded for bear
and ready for them to be incompetent.  Big mistake.  And your actions,
again IMO, were also the wrong ones. They have their procedures for a
reason and for you to decide to play doctor and remove the IV was
dangerous and foolish.

I hope you feel better now and will act differetnly if you ever find
yourself in this situation again.  

Best,
Kurt

Andrea, what a horrible experience. I know very little about type 1
diabetes, but I hope you're feeling much better today.

--
Cheri

Andrea2 wrote in message ...

For gawd sakes, get a couple of glucagon kits and have your husband and
friends learn how to use them.  then you can skip the ER.

What is WRONG with diabetics that they don't know this most BASIC
information??

dave

On Wed, 15 Mar 2006 18:37:35 -0800, Andrea2
<andrea6192001nospam@yahoo.com> Huffed and Puffed the following into
the madness of usenet:

actually they did give you the correct treatment.  However they should
have called an endo and OBGYN for a consult as to how high to bring
your BG back up.  The observation period was to make sure you did not
go hypo again.  Which is a very real possibility.

Some things you should discuss with your pregnancy team:
Splitting your meal time insulin.  Taking half or less at the
beginning of the meal and the rest at the end of the meal to insure
that you actually eat the whole meal.  Adjust the second half of the
dose according to what you actually finished eating.

If a severe hypo occurs like that again, provide you in writing the
exact recommendations of your pregnancy team.  How to treat it, how
high to bring the BG back up.  How long to stay under medical
observation after the BG comes back up.  And contact info for your
team's primary doctors in the case of an emergency.  Carry this with
you at all times.  Also if you have a wallet put a card taped to your
driver's license instructing medical personnel to look for the printed
instructions in an enveloped marked In Case of Medical Emergency.

Make sure your husband and your friends and family know where these
instructions are and that they must be followed in the case of an
emergency.

What you describe is a typical reaction to a severe hypo.  I've been
there too many times.  And the ER does usually want to bring your BG
up well above where you want it right now because of the pregnancy.
Without direct instructions from your medical team signed by your
doctors "every" ER will follow the same pattern of treatment as that
which you received.

You need to be aware of the "loss of consciousness" that you
perceived.  What actually happens is that you do not actually pass
out.  You go into a black out something like an alcoholic would
describe.  You are up, mobile and talking and responding.  You may or
may not appear to be behaving strangely.  But you will have little to
no memory of the event.  In this state diabetics have been known to
get behind the wheel of a car and drive, some without injury or
accident others causing severe accidents, injury and even death, and
some mistakenly getting pulled over by the cops who assume they were
driving under the influence and may even be attempting to flee arrest.
As a result of that last one, some diabetics have been arrested and
put into lock up without receiving proper emergency care, some have
died in lock up.  Others were forcibly brought to the ground by
various means.  One I saw on a TV medical show was chased down as he
ran away from the cops and EMTs on foot and had to be tackled and
forced to accept help.  Another a few years back was pulled over after
several miles of a "low" speed chase, had his drivers side window
smashed out by the cops and a police dog set on him through the window
as the cops opened the door and dragged him out and to the ground.
Because the police thought he was under the influence and claimed he
attempted to run them down after they pulled him over.

You also need to have a sit down with your husband because in this
state, you could actually attempt to reduce medical help in the ER and
want to check yourself out.  You could appear to be normal.  You
should agree with your husband on a course of action to take in such a
situation and that should include not allowing you to leave before
your BG is tested and comes back at a level your Endo/OBGYN team agree
is safe for you and the baby.  Your husband has to be prepared to
argue with you and refuse your wishes if you are hypo.

My loved ones have no problem getting in my face and shouting at me
and ordering me to do what I need to do when I am hypo and refusing to
accept help.  Sometimes that is the only way I will respond correctly.
They know what level my BG has to be before they relax this stance.

It's frustrating, and somewhat frightening when sit back and look at
it from the outside as if this happened to someone else.  But you need
to do so, in order to get a clear picture of the risks you were in.

Glad your doing better now.  and seriously, discuss splitting the
dose.  Half at the beginning of the meal and the remainder, adjusted
for what you actually ate at the end of the meal.  This will go a long
way in preventing hypos.

Nausea and vomiting was the culprit. Glucogon would be the ideal antidote
for that rare situation where you've injected and then vomit everything you
eat and are in danger of a serious low. So sorry to hear what you went
through.

Andrea,
            I hope you are feeling better now.    you are diabetic
then you should always keep some glucose kits & insulin tablets with
you, as anytime your Blood glucose level can fluctuate.
you can to gather more information on diabetes like first aid
treatment for such conditions, excercises to control diabetes. just
visit the following link:-

http://medical-health-care-information.com/encyclopedia/d/Diabetes.asp

I'm also a diabetic & through this website i got quite good
information.

take care

Leena Rose

Andrea,

So sorry you had to go through such a nightmare.

What strikes me is that your experience embodies the underlying basis of
Dr. Bernstein's advice. "Small inputs make for small errors, large
inputs make for large errors."

It is tough, verging on impossible, to correctly estimate the carb count
in a restaurant meal such as the one you describe. A potato can be
anywhere from 10 to 30 grams of carb. Unless you bring a gram scale with
you to the restaurant you aren't likely to know where your particular
potato fits in.  Same with the ear of corn and the roll.

When I was in my weight loss diet phase and measuring everything I
bought a bunch of baked goods from local eateries and weighed them. A
bakery "blueberry muffin" could weigh in anywhere from 6 to 9 ounces!
None of them was anywhere near the 2 ounces that is the portion size
that nutritional software assumes.  For example, my software gives 27
grams for a generic blueberry muffin (weighing 57 grams or 2 oz). But
the actual carb count on a Dunkin Donuts muffin (based on its weight on
my home scale is something like 103 grams. It is also worth pointing out
that the count given on the company's web site assumes that the muffin
weighs less than the real muffin weighed too!

So even ignoring the additional problem of throwing up, the difficulty
of matching your fast acting insulin to the estimated carb count of your
restaurant meal is enormous.

Then there's the problem of nausea, on which I can speak authoritatively
as I was nauseated almost daily for all 9 months of my second pregnancy!
In fact, my doctor told me at one point, only half jokingly, "Your
diabetes is controlled because you can't keep any food down."

So the practical solution for you might be to do several things.

1) Avoid  eating a lot of carbs in situations where you can't get a good
fix on how big your portion really is.  At the restaurant have the meat
and salad, and only a bite of the potatoes and a quarter of the roll.
Cut your insulin down to where it is low enough that if you don't end up
keeping things down your body can handle the resulting low and if you do
eat there aren't enough carbs in the meal to shoot you disastrously high.

If you are already on the verge of low before the meal and could be in
trouble if the meal didn't stay down you might also rethink what you are
going to order and keep the carb count of what you plan to eat lower
than usual so that, again, if your food doesn't stay down the insulin
doesn't cause an emergency.

2) Try breaking your nutrition into smaller meals so that you never have
inject an amount of insulin that is enough to put you into a severe hypo
if the food doesn't match it.

If you only ate a max of, say, 25 grams of carbohydrate at any one time
but did it six or seven times a day, you might be able to avoid the huge
doses of fast acting insulin. And that way if you don't match the food
to the insulin the result won't be so upsetting.

Eating a lot of smaller meals also helps with the nausea and was what I
ended up having to do when I was pregnant with my second, just dribble
in small bits of food all day long. As you get bigger, this tends to be
what you have to do anyway as there isn't as much room for much of
anything but baby in your abdomen!

Hope this helps!

--Jenny

http://www.phlaunt.com/diabetes  Diabetes Info

http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
Sugar Under Control