To expect more from the hospital

[florencerusty]

DD2 has been hospitalised (type 1 diabetic, 7th pregnancy no children at home, suffering from HG). Would it be too much to expect the obstetric/gynae team talk to the diabetic team and even worse for the diabetic team to talk to each other? Yesterday the consultant (diabetic) said he wants her to remain on the ward at least until after the weekend to try and avoid another heartbreaking outcome. To try and sort her levels (which totally behave of their own accord!). Today a Gynae doctor and a dietician (!!!!!!!!!!!!!!!! wtaf!) have tried to discharge her - this despite a major hypo during the small hours!!!!!!) I am fuming and so upset. I have buried a child, and will NOT bury another because of their stupidity. That said some of the staff are amazing

[amarmai]

so sorry for your dd . Could her gp intervene on her behalf as he will know what shd go on her chart to stop premature discharge - by a dietician??

[AdjustableWench]

So sorry . Is the HG the reason why her levels are all over the place? My (limited) experience with dieticians is that they often give VERY poor advice to people with diabetes.

There's some research on HG in type 1. This article, for instance, suggests a possible solution: www.ncbi.nlm.nih.gov/pubmed/17628816
(not sure how to link - sorry). Maybe ask the diabetes consultant about appropriate treatments?

I hope things improve in the very near future.

[LilaTheTiger]

Is there a diabetes nurse specialist at the hospital? There should be, and if you get her on side you'll have a great advocate.

[florencerusty]

The diabetes specialist nurse is very much on side and had been with us a long while during yesterday morning. She is totally in agreement that DD should remain in hospital and then various other hp's decide otherwise in her absence! She has tried all treatments for HG and nothing has worked - the strongest available had no effect :(
Thanks for your replies. Yesterday was a bad place. Today is marginally better however the sickness and level swings are having a bloody field day!

[IjustGotmy2016diary]

Very dangerous to discharge when she is that unstable. If they do again, ask them if they can personally guarantee her safety if she goes home.... they won't be able to and will probably re-think their decision.

Is she on a sliding scale?

[florencerusty]

Oh I am sure they make these random decisions when I am absent just so I cant argue face to face.
No sliding scale ... YET

[suchafuss]

So sorry for you and DD. Is she on an insulin pump? I was advised not to get pregnant until my blood glucose levels were within acceptable range. I was unable to get any kind of control until I got my pump, and couldn't get a pump until I had suffered a couple of serious complications.

[florencerusty]

No pump. Her glucose levels were stable and acceptable when she conceived as she had been told the same. We are off today for clinic appointments!

[suchafuss]

I hope it all went well. Could the diabetes specialist nurse support you in trying to get one at least for the duration of the pregnancy given her history? I know how stressful pregnancy is without the added stress of trying to control blood sugars. Also they could put her on a glucose monitor for a few days to check if there are any patterns to her highs/lows abd then adjust her insulin as needed.

[MrsBobDylan]

I'm guessing she needs to stay in because she needs continuous glucose/fluids via drip?I know how hard it is to manage a child with type 1 during a 2 day vomiting bug, so can imagine that HG makes controling the highs and low impossible without intervention which your DD can only get in hospital.

Could you just stand your ground and say that her diabetes team know she needs to stay in and refuse to go?

I also agree with suchafuss about the pump, particularly as it makes controlling the background insullin so much easier.

[florencerusty]

so yesterday we saw any number of doctors - first a diabetologist who said they will keep her in until the sickness subsides. followed by another diabetic consultant who says 'that will have to be reconsidered' (she is an old cow) and then her obstetrician who says he wants her home so she doesnt become institutionalised (in 4 months???) anyway for now she is still in and the sickness seems to have lessened, and the hypos have also eased - apparently todays doctor wants her home no later than thursday! I guess time will tell. They won't let her have a pump while her levels are unstable, don't ask me the logic in that one though.

[PerspicaciaTick]

Can you talk to PALS - they may be able to convince the medics to start talking to each other.

[florencerusty]

PerspicaciaTick

Blimey that would be revolutionary!

[PerspicaciaTick]

Well it worked (eventually) for my DMum when her exciting cocktail of cross-disciplinary ailments caused the system to grind to a complete halt. I liked to imagine PALS lady bumping heads together .
I really hope your DD gets everything stabilised soon to you both.