Monday, April 11, 2011

Speechless and Furious

Warning: this could be a long one. I have posted a few times in the past couple of days about some issues Vince is having in keeping his blood sugar under control. This is the first time in 31 years that he has pumped himself full of insulin, on the hour, way more than ever "prescribed"' and the sugar remained high with no explanation. Well, it seems after a trip to the ER, and loads of tests all showing up negative, we figured out what was wrong. Thanks to a great ER doctor who took 10 mintues to look at my husband.

About two weeks ago Vince visited our family doctor for some wheezing problems. She went over all of his medical history, asked again how long he has been Type 1, and took down his medications. She proceeded to say, after examining him, that he must have developed asthma and prescribed two inhalers to him. One inhaler was a steroid, Flovent, to be taken two puffs, twice a day. The other was albuteral sulfate, Proventil, to be taken a few times a day at first, and then only as needed. So for the last two weeks, he followed the instructions he was given and the wheezing stopped and all seemed to be well. On Friday, about 72 hours ago, his sugar began to creep up to the 200-300's, and he couldn't get them lowered. This is very unlike him. He has always been able to control his highs when they happen, even when he is sick with a virus. So we did a site change about 3:30 Saturday morning. Saturday evening we decided to try another site change to a brand new location (his back) and got out a brand new vial of insulin. By Sunday morning, we knew something very bad was going on. He has never been this uncontrolled, ever. We called the Endocrinologist Sunday morning, and he said it sounds like an absorption issue. He said try a higher temp basal or try using the insulin pens for an injection in addition to the pump and see if that makes a difference. Throughout the day on Sunday, we continued to pump him full of insulin almost on the hour. He ate a sensible dinner. For this dinner, he would have normally taken 15 units of insulin. He instead took 35 units in hopes he could control the carbs he just ate. Two hours after dinner his sugar continued to rise, but at a faster rate. This is when we got out his insulin flex pen from the refrigerator and he gave himself a regular injection of another 10 units. We decided to wait one hour and if that injection did not work, then we would call the doctor again and ask if we should go to the ER. So at 8:30PM, we phoned the Endocrinologist and he agreed we had done everything possible and that there must be something seriously wrong like an infection of some sort. Keep in mind, aside from feeling crappy from the high sugars all weekend, Vince had no signs of any infections or other problems. So I gathered up a site and sensor change supply kit, (in case they made him remove his) and off we went to the hospital. We checked in just before 9:00PM. They got his vitals, checked his sugar and took down his list of medications. When Vince told him he was going to take some more insulin, they said okay and recorded it on his chart, but mumbled something to the affect of, "it's probably not doing anything but go ahead, since you probably know better than us" Keep in mind these were just the triage nurses. Vince and I both knew that even though the numbers weren't not going down, the insulin was stopping them from going to a severely high level. As we waited in the waiting room for the next 5 hours, they took all of the broken arms and flu patients and insisted we needed to just wait. We were getting livid at this. People would wait 1 hour and would get taken right back. We just sat there hour after hour thinking Vince must have an infection, kidney failure, or even worse: we both thought maybe it could be cancer! We didn't know each of us thought this same thing until later when we joked about how we were freaking out at the unknown of what was wrong. When you know all is well, you can only laugh right? A quick side story, while we were in the waiting room watching the people come and go, and walked in what appeared to be a Type 2 patient in a weak episode who lost her meter at home. She came in saying she was having stroke symptoms, and it turned out she was having a low episode and was being "silly" from it. Made us chuckle to see it and know she just had to get some OJ, which she did, and then walked out. Anyway, about 1:30 or 2:00 AM we were taken back and we explained what had been going on and said that the Endo told us to come in. They did blood work, urine check, chest x ray, EKG, and checked his entire body for any possible infections that we missed. They looked over his medication list and came across the Flovent inhaler. They asked when Vince had started using this, and we explained the wheezing from two weeks prior. They proceeded to tell us that people with Type 1 cannot be on steroids for an extended period of time, since, unlike Type 2's, they cannot fight against the raise in blood sugars. They explained that over the past two weeks, the steroids had built up in his system, and when that happens in a Type 1 Diabetic, it can cause the blood sugars to soar high with little chance of control, no matter how many units of insulin you pump into your body. We couldn't believe his family doctor would ever give this to him. I even asked her and the pharmacy about 3 times each, if this medication was okay to use with all of his other meds. This is something I always ask over and over because you never know...she assured us this was safe for him to take with the other medications and failed to mention he would end up in the hospital from it. So the ER doctor gave him a bunch of IV fluids and said that should help. We had no clue how but hey, if it helps, then go for it right? I asked if they were going to admit him, as they mentioned before they realized what was wrong, but they said no, since there is nothing they can do until the steroids are out of his system. They sent us home and said give it until Tuesday, tomorrow, and the steroids should be out of his system by then, and the sugars should go back to normal. Here it is Monday afternoon and they are already improving. 

I had asked the ER doctor what Vince should take since he is wheezing and needed the inhaler. He said the second inhaler that was given to him, Proventil, was much more safe for Type 1 Diabetics, and that he should only use that one. So...needless to say we will now be shopping for a new family doctor, and will not be seeing Mrs. Idiot who could have put Vince in kidney failure if it wasn't for us dosing him with insulin every hour for the last 72 hours. We were furious that she was so dumb to prescribe him this medication. Lesson learned, never completely trust what the doctor says.


  1. OMG! Oh Sandy, what a horrible thing to have happened. I pray Vince feels better soon and you both get some rest.

    Are you going to tell the GP doc what happened?


  2. Glad to hear everything is ok! Had a similar situation with Joey last year. Gotta love doctors. Haha

  3. Yes we are actually never going back to that doctor. We both see/saw her. We are going to the other docs in the practice for now and then will eventually switch to a different practice all together. That should not have happened. She should have known better.

  4. and people wonder why I am cynical about the medical industry!

    I am so sorry, Sandy, that you and Vince had to go through this

    However, as DW has said over and over in her blogs,

    if we don't take control, there is no control

    it is so difficult to trust today
    thank goodness that the ER doc understood!

    ER docs are hit and miss
    sometimes they are great
    other times they are not

    I find that often they care so little about follow up
    that they are more honest than "regular" docs

    then again.....

    there are no good answers.

    can you get some sleep?????

  5. How awful. Really do hope that you get some sleep tonight . . . sounds like you both need it! The thing about Type 1 diabetics "not being able to take steroids" is more than a little upsetting for me. My husband has been on prednisone since his kidney transplant several years ago, but at least we were told it could make his sugars go high. It is a low dose, but it does have an effect (I think) in many ways. Some of his doctors will try to say that 5 milligrams a day shouldn't make a difference for him, but it obviously does. This is part of his anti-rejection medication for his transplanted kidney, so he has no hope of ever getting off it.

  6. I agree, ER docs are hit and miss. I guess we got lucky in that department.

    Lilly, yes, just be careful. Low dose is probably different plus this was an inhaled version of the steroids which I think MIGHT make a difference. I don't know but apparently it is the cause of this big mess.

    Well it is 930PM so I think it is time to rest up for work tomorrow
    Ahhhhh uggghhh

  7. I am so mad at the ER you went to! I have taken my husband in a couple times in three years of marriage for lows that we can't get to come back up and a stomach flu that wiped him out. The second they find out he is diabetic they take him right in. The only thing that ranks higher at our ER's is a heart attack or stroke. Shame on them for not taking diabetes seriously! You and your husband will be in my prayers!

  8. What a sorry to hear that you two had to go through this. good job, batting for your man...we are our best and our hubby's best advocates. HUGS

  9. how freaking annoying. scary. exhausting. our family doctor didnt diagnose diabetes in my baby, or bacteremia in my daughter. weve been shopping around for a new doctor who isnt so incompetent. not having much luck. glad the numbers are improving. your gut tells you when things arent quite right. releived to hear you decided to go to the ER.

  10. OMGOODNESS!!!! How did I miss this post Sandy? This is horrible.

    I am so sad and mad that you two had to go through this awful experience. How are his numbers now? How long did it take for them to get better?

    That definitely shakes your confidence in the Health Care System...doesn't it?

    Love to you and Vince.

  11. Hey reyna, the last time he took the inhaler was Sunday morning. They said he should be better by Tuesday. His numbers are better now. Mid 100's...still slighty crazy but getting better every day now. He is going to the doc (a different one in the office) tomorrow cause he is wheezing again, so we need to find out what he can take that is safe. I am sooo mad at that doctor. What a flipin idiot!!!!!!!