The Pressures of Figuring it all Out

When it comes to the medical community, sometimes I feel alone in dealing with my diabetes.  I feel like we are often left to be our own doctor and to figure things out by ourselves when blood sugars run high or low, or when illness strikes.  It really upsets me.  The nurse on the phone was giving me instructions for an upcoming surgery, and she told me that I should refrain from taking any insulin the morning of my scheduled surgery.  

As a person with Type 1 diabetes, I knew that was not likely the case.  I knew from past experience that I should always have some sort of background insulin in my system to avoid high blood sugars, or worse, diabetic ketoacidosis.

I questioned her about it, and she stated “You are going to be fasting and having surgery, you aren’t going to be eating anything”.  I explained that even during an illness like the stomach flu when I am not eating, I require some sort of background insulin to keep my blood sugars from soaring.  She finally relented and said that if I wanted to take any insulin, I should speak with my doctor to get the proper dosing information.

I thought that sounded like a good idea so I contacted my regular doctor.  He was on vacation.

No problem, I thought, I’ll check with the Endocrinologist I visited a couple months ago.  Though I was a newer patient of his, I figured he could advise if I should take a long lasting insulin injection prior to my surgery, and how much would be safe.  I received a call from his nurse but she said that because I’d only seen him once and he didn’t have much information about me as a patient, that he couldn’t give me the information I’d requested.  

My heart skipped a beat as serious panic set in.  What on earth was I supposed to do?  I was on the verge of tears as I pleaded with the nurse for some information because the surgery was the very next day and my regular doctor was out of the office.  She said he would give me some general advice on what he’d recommend, but that it would not be specific to my insulin dosing.  I knew that it was likely because of legal reasons, but I felt so alone.  

His advice worked beautifully, and I was grateful to have had it, but I was surprised, and a bit hurt that I was more or less on my own.  Though he was a new doctor for me, I’ve gone to this same medical office since I was a young child.

I’m sad that after more than 20 years with Type 1 diabetes I still go through moments where I simply don’t know what to do.  Diabetes is always requiring attention and thought.  It’s hard to have diabetes and feel like you have to constantly try to master it, always striving for perfection but never quite getting there.

I made a list for my husband for after my surgery in case he needed to give me my insulin.  It explained how much insulin I take each day as background insulin, and the insulin I need when I eat.  It also noted correction doses based on my blood sugars.  He has never given me a shot.  I made the list very bold so that he wouldn’t accidentally inject me with an astronomical amount of short acting insulin instead of the long lasting insulin which has a much higher dosage.  I put rubber bands on the box of long lasting insulin to make sure it is obvious what insulin is being grabbed.  He said he didn’t think he’d need to inject me, and that I’d be fine; but I wanted to be prepared just in case.  He was right and though I was thankful, I suppose in a weird way I was somewhat disappointed.  I would have loved to have given away the responsibility, even if only for a little while.


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