"Diabetes care as a surgical inpatient"

In December I had Eye surgery at Gartnavel Hospital

12:30-12:45pm - Removed insulin pump before theatre as advised by anaesthetist who had asked earlier that morning if I was on lantus. I had informed them that I would have no insulin in my system once my pump was removed. I said I do not use lantus or any other background insulin, only Humalog via insulin pump. I was assured that they would check my blood sugar during surgery and inject actrapid insulin when required.

4:10pm – Came round from anaesthetic, my eyes were completely covered and I had no sight at all – as expected.

I was vomiting violently.

Struggling for breath.

Shaking & trembling.

Extremely hot and thirsty.

I asked what my BG was. They didn't know. They tested and it was 11.9

I asked what insulin I had in theatre. Nurses didn't know. They said it wasn't in my chart.

I asked them what my ketone level was. Nurse said they didn't have anything to check ketones.

I explained where they could find my personal BG & Ketone meter and test strips. Ketones were 1.0

I kept asking nurse to find out how much insulin I had in theatre. I had my pump off for 4 hours by this time. I needed to know how much insulin was in my system and if I needed more.

I continued to vomit, shake, struggle for breath, feel hot and thirsty.

I asked nurse to check BG again, it was 12.3

Asked them to check Ketones again, they were 1.6

I told nurse I needed insulin to combat ketones but needed to know what time and how much I had been given since taking my pump off.

Nurse said my notes indicated I was not to get my insulin pump back on until I had eaten some toast.

A) I was not able to keep water down so knew I would not be able to eat toast.

B) I didn't know how I was going to be able to work my pump as I could not see!

I told nurse I wouldn't be able to keep food down until I had got rid of ketones and that I desperately needed insulin.

4:50pm - Anaesthetist came and told me I had no insulin since taking my pump off as my BG had been stable in theatre. I told the anaesthetist I had no background insulin working and that I still need insulin even without food.

I was asked if I wanted my pump back on and I said yes as I just wanted insulin in my system as quickly as possible. I knew with my pump on then at least my basal rate would be running and it could potentially stop DKA.

Anaesthetist gave me my pump and I attached it to my canula in my tummy. The anaesthetist asked how much insulin I needed to bolus.

I explained to her how to give me one unit. I was scared of going low (no hypo awareness) and by this time didn't trust that I would be looked after properly. I was still being sick, struggling to catch my breath, very hot and very thirsty.

6pm – BG 12.6 I begged nurses to please get a diabetes specialist. I was now really scared to try and explain to a nurse how to bolus more insulin using my pump. I was also really scared to not bolus insulin. I had an intense fear by this time of both DKA and Hypoglycemia. I had no vision and could not monitor my BG and Ketones by myself. I had to rely on someone else to do it for me.

Nurses couldn't get hold of Anaesthetist to find out what to do. I was still being sick etc. Eventually someone from Queen Elizabeth University Hospital called and said I was to be put on a sliding scale and moved to the ward.

7-8pm Eventually arrived in the ward. Starting to feel slightly better. Was told to take my pump off, which I did. BG 12.2 Ketones 0.7

It seemed to take a while to get the sliding scale started so I connected my pump back into me until it got started.

I felt more confident by this time because my sister, daughters and son were with me now. They could check my BG and ketones!

I asked a number of times how a sliding scale worked but no one gave me an answer. I had no idea how long the insulin that was going into my veins took to work or stayed in my system.

I had to fight to get my daughter to stay overnight in the hospital with me. I was terrified of Hypoglycemia with no awareness. I couldn't see. I didn't feel safe at all.