Horror story Options

[gigem99]

This was written by Manxman in another topic and moved here by the moderators.


Moderators, you have my permission to delete this post if it is too shocking in nature, but it contains some valuable info. for any Diabetic. Yes, another long story from the new old guy. This is how bad things can get-------- and I'm still here.

In September of 1998, I had a heart attack (M.I.). didn't know what it was at the time, but I knew I should get it checked out. I scheduled a doctor visit, and asked him to use his EKG machine on me. The test strip clearly showed the evidence of an M.I. I drove directly to the hospital up the street, and my doctor called in a colleague Cardiologist (my doctor was a Nephrologist) to take over my treatment. I was treated with Angioplasty and had four stents placed in two arteries. Keep in mind that Diabetics are usually not good candidates for Angioplasty because their arteries that cause heart attacks are usually not strong enough for Angioplasty to work. Bypass surgery is usually used. I lucked out.

Last paragraph is the beginning of a horror story that involves poor medical judgment and medical malpractice. If you are squeamish, stop here.

The cardiologist had been originally trained and educated in Iran. Somehow, he was not aware that the use of beta blockers with Diabetics is very dangerous. He casually mentioned as he gave me the Rx for "Lopressor":
"You may have less obvious symptoms of hypoglycemia". Should have said: "Your hypo symptoms will VANISH. This is dangerous! You must test at least six times per day, and never drive without testing first!".

A year goes by while I slowly get over my fear off dropping dead and begin exercising again, and because of my reduced activity, there were no problems of hypo episodes. Until Sept. 9, 1999. We had the worst thunderstorm that the Central Coast, CA area had seen in over 20 years. I was watching news reports of the freak weather on TV as my wife left for the grocery store to get some dinner supplies, and our two Wolf Hybrid dogs were going absolutely crazy with the lightning flashes and cannon-fire sound of constant thunder. I got up to open the front door to watch the fireworks, and a combination of passing out from un-felt hypoglycemia and two, 100+# dogs milling around my legs resulted in an open, spiral, tib-fib fracture of my left leg. I remember sliding down the wall, looking at my left leg, and thinking "Oh crap! Now I have two knees!" before passing out completely. My wife came home, found me laying half out of the front door, looking senselessly at the lightning, and called the paramedics.

Worse things ahead--. A surreal ambulance ride through the mountains at rush-hour in blinding rain and constant lighting hits and I get to the hospital- Dominican Hospital in Santa Cruz, CA. All local forum members take note!!!
The on-call Orhopedic Surgeon was Dr. Daniel Spiegel. I made it crystal clear to him that I am a Diabetic, and off I go to surgery. I asked him to please not keep a glucose drip into my veins overnight without very careful monitoring and insulin if necessary overnight.

I wake up the next AM, and know instantly that my BG is off the charts. I buzz for the nurse, point to the bag of Ringer's Lactate running into my arm and tell her that it must be taken away immediately. "Oh, I can't do that without doctor's orders" she says. I said "do it now or I will while you go get your BG meter. My blood sugar level is high enough to put me in a coma!", and then I projectile vomited completely over my body and off the end of the bed.

She did remove the IV, needed to try three BG meters before one would register- the other just said "High" with no scale. My BG was 923. Oops! My bad.

More bad news. The doctor makes no comment at all about the lack of proper treatment overnight, but says that my tibia could not be pinned for proper alignment because the previous tibia fracture from 8 years previous had been set to crookedly, a pin in the new fracture was impossible. Also, his practice is not covered by my health insurance, so I would need to find post-op treatment in the San Jose area in my own network. Probably the best news so far- this guy would probably kill me.

More bad news. Between the ambulance and the hospital surgical treatment, the open fracture became infected with one of the three bacteria species that normally kill surgical patients. You know about strep, and staph. What I got was pseudomonus. The enormously high blood sugar that built up overnight in the silver-dollar size wound cause by the broken tibia punching through the lower leg had provided the most perfect growth media possible.

After leaving the Santa Cruz hospital (fortunately), I wound up needing six more hospital stays in San Jose (O'Connor Hospital), requiring four more surgeries and two stays for IV antibiotics for infection. One of the surgeries was a femoral artery bypass to aid in increasing blood supply to heal all of the other damage, and I had to wear an external fixator for fourteen months. Also had to see the best non-union Orthopedic Specialist in Northern California at Stanford Medical Center.

More bad news. The bacterial infection in my tibia is unkillable without amputation. Fortunately, the antibiotic Ciprofloxacin (Cipro), keeps the infection from growing- kind of like suspended animation. I will need daily doses of Cipro forever, or until the leg is amputated. Guess which choice I made? I can no longer run or jump, but I walk without a limp. I walk a lot!

So everybody, if you think that you have a nightmare experience, this is just one of mine. Fortunately, the worst one (so far). Maybe the pump and later a CGM will prevent any more.

This post has been edited by Manxman: Today, 02:50 PM

[Manxman]

Thanks for moving the story Tom. I have 16 healed fractures, and each one has a story. Not all of them came from hypo episodes. If you live long enough, damage accrues, Diabetic or not.

[Manxman]

P.s.

The foregoing was a graphic learning experience, and cured me of the belief that you are safe as a hospital patient. I neglected to mention that, in the six hospital stays for all of the further leg treatment, I insisted on taking care of my own BG tests and insulin needs. The nursing staff was pretty peeved at this, but the four specialists who were treating me, and knew of the circumstances that brought me here, overruled the nursing staff's objections. I made sure that the infection status was not dependent on the schedules and over-worked conditions of employees. It was in my hands alone.

[Lindsey]

I haven't experienced the horror story that you have in regards to blood sugar but, I too insist on managing my diabetes when in the hospital. Often I am in the hospital simply to receive assistance with pain management thus, I still have the mental capabilities to manage my diabetes.

I simply do it because I believe that I know myself, my diabetes, and my body's reactions a WHOLE HECK of a lot better than some nurse on their 12 hour shift. No disrespect to nurses because I LOVE nurses and they have an incredibly difficult job but, it just simply isn't possible for them to be experts in something that I live with everyday.

[Linda B]

I also insisted I be allowed to leave my pump on and manage my Diabetes when I was hospitalized for a hysterectomy 4 years ago.
The nurses kept filing in from all over the hospital asking to see my pump and for me to explain how it worked.
I stayed remarkably stable throughout the entire hospitalization.

Linda B.

[Manxman]

Lindsey,

I am glad that you have the correct attitude (for your own safety's sake). What I found distressing as a long-term hospital patient was that meal times were not at the same times during each day. They could arrive any time, plus or minus up to an hour, but that made no difference to the arrival of the nurse with the meds, including insulin. Now what sense does THAT make?

What helped me during this time was that I was using a Jet injector, and not needle injections. This was also prior to the existence of Humalog or any other rapid action insulin. I used Regular, and when delivered by Jet injection, it worked about 30% faster than needle injections.

So, with the erratic and high BG levels being caused by the leg infection and total inactivity, the faster action of the insulin and the more complete absorption of it that is normal for Jet injections gave me a lot more benefit than relying on other people. Infection control made it imperative that I maintain a BG level as low as was safe, and that was very hard to do. Would have been impossible without looking out for myself.

[Lindsey]

Exactly. I would mention the problem of meal times and med times to any and all nurses that would listen and they would explain it as a systemic problem and most didn't feel it was anything they could change. They would go ahead and make med rounds and had to do so at a certain time to get meds to everyone but this didn't correlate in any way with the kitchen who would start their processes independently of the med rounds. Then after the meals were made it was then up to another set of people to deliver them. With this lack of coordination it would be impossible to expect the process to work in conjunction of one another...which is exactly what I found to be true and why I just went ahead and took the reins of my diabetes while in the hospital.

[Arlene S.]

In February of 2007 I stepped down from a curb on to black ice and sustained a trimalleolar fracture of my left ankle which required surgery and the insertion of a plate and nine pins. I was told that if I didn't have the surgery I would never walk again but if I did I could lose the foot or die because I'm diabetic. (Great choices, huh?) But an MRA showed that I had "non diabetic circulation" so I was good to go (five days later). My orthopedist (an alarmist who turned out to be a sweetheart) listened intently when I told him about my pump (I'd been pumping for 14 years) and the CGMS I'd been using for a little more than six months. (My endo had said, "Don't let them bully you into taking off your pump and sensor.) Before I could even ask my surgeon if I could wear it during the surgery he said he wanted me to do so. I had a spinal with no additional sedation and was awake during the more than two-hour surgery. I showed the anesthesiologist how to use my system. He and all the OR nurses were fascinated. I'm pretty sure they did extra checks during the surgery but I felt in control.

During my entire 11 days in the hospital I used my own meter and checked my own BGs. A nurse came around to get the information.

The only time I removed the pump and sensor was when I had the MRA. That was an interesting experience. The orderly who wheeled me down to the Imaging Division was late and when we arrived the technician said, "You're late. We had to take the next person." I said, "Okay, but I wear an insulin pump which is up in my room and if I have to be without insulin very long I could go into a coma." They took me immediately.

[Manxman]

Another member has "Diabetes, the thinking person's disease" in their signature. Your story doesn't have the negative warnings that mine have had, but yours illustrated the importance of staying in personal control of every aspect of your hospital stay that is possible. Doctors love educated, prepared patients. As a Diabetic, if you are not a thinking person, you are a statistic, eventually.