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H continues improved, no more 'dementia' symptoms. But today he wanted to go to the hospital, suspecting a small stroke. At the ER they would not let him have even a glass of water, much less food. We told them he is diabetic and had not eaten for hours. They promised to bring a 'box lunch' but it never showed up. At every step or request for anything, it was 'we'll ask the doctor' -- then the person would disappear and never come back. He wanted to take his own insulin (pen inject) but they said "WE never give insulin under X BG."

This was not a big city ER with a lot of drama. During the hours we were there, only two other patients came into the area. Several pretty nurses had time to pop in and out several times to pet his cute service dog.* Maybe we should have nagged each one every time?

This sort of thing has happened at other hospitals. He is in ER for hours not allowed any food or drink. No real reason for it, just 'policy says we have to ask the doctor' and they never get back. Sometimes one of them eventually apologizes and says it was seriously wrong of them.

In his own medical purse/kit he has his own insulin pen; morn/noon/evening/night meds (heart stuff, anti-depressant, etc). No drink to take his meds with. After many requests, a nurse brought him some crackers. Luckly he carries 'jerky' sausages in his kit too. With that, he dared to give himself an insulin shot. Finally later anohter nurse brought him a 'box lunch' with a surprisingly good cold sandwich.

I guess I need to keep another emergency hospital kit in both cars, with picnic food, drink, cell phone charger, etc. Stuff he doesnt' want to clutter his kit with. Trouble is, he doesn't want the car 'clulttered' either. Duh. Have a little briefcase at home packed with such stuff, including underwear etc, but forgot to take it today; I didn't think they would want to keep him.

It just seems weird that we would have to sneak this stuff in. Dunno what would happen if they caught him using or eating what he brought himself.

I know in some cases, maybe as default, these restrictions would be reasonable. But in his case the restrictions are a big problem. How do other diabetics deal with this?


* His service dog is a medical alert who tells him when his blood sugar is too high or too low, so it is okay for people to pet the dog.

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Thanks to all, more later. Just a quick report now.

He was kept in the hospital for 2 nights for tests. He just called and said:

"The verdict was a small stroke, and no more rice."

Me: "No more rice?! Why not?"

Him: "No more MRI's. Because of the pacemaker."
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I would check the blood sugar of your loved one and then give insulin depending on the sliding scale. Afterwards, tell the nurses you did it, what can they do? Then they HAVE to work within your parameters.
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Do you remember "Terms of Endearment?" Debra Winger needed her pain meds and Shirley McLain started out nice and ended up screaming at the top of her lungs!

The ER has reasons to tell you not to do something, but you never got an answer. Sometimes we have to forget our "nice girl" training to take care of our loved ones or ourselves. Yes, ask again every time the nurse comes in. Yes, follow the nurse out and politely inquire when she will ask the doctor and when you may expect a reply. Obviously, if every room is filled with screaming bloody patients, you sit down and shut up. If they don't seem busy, become a squeaking wheel.
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Key words: "suspected a small stroke". If something MAJOR had happened in ER and they needed to get to the OR, they don't want ANYTHING in the stomach, as they can aspirate when under general anesthesia. Those safeguards are in place for a reason - diabetic or not. No food = no need for insulin = should there be a need for surgery, we are covered. They're not doing it to be jerks - they're doing it for a reason.
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Oh, the parents came by ambulance, so there was no triage. Still it took all day for both trips to this ER.
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I never thought about insulin in the ER, though I did give my mother her crackers one time when she needed something to eat. This hospital has a bad reputation in Birmingham, so I was happy to change to another. I was only in the ER there twice, but I was unimpressed. It was the worst ER I had ever seen.
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Look up the hospital complaint dept or patient-family rep, or any kind of feedback thing they have going. If there is no medical reason to deny a hungry person food they should be getting that OK for you in a reasonable time. On the other hand, they would have wanted him NPO for any procedure they might have done if he actually had a stroke.
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continued: Patients who walk into an ER under their own power are often set aside for observation to see if the complaints pass. On the other hand if the EMT's or MD's indicate a critical situation, things happen quickly.
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High sugar level can mimic dementia, they will talk nonsense. What was the dog doing? Surely he tested his blood sugar at home before going to the ER, was it high? If he wanted to go to the ER I would first make sure his sugar level was correct. If it was high, I would suspect that was the problem and not give a lot of credence to a self-reported stroke, unless there were additional symptoms. If I did think it was a stroke, I would call 911 immediately and call the MD as well. Patients who walk in to an ER under their own power
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JessieBelle,

Good for you with your mother! Bad reaction to going without food or insulin is a DEFINITE thing that you know will happen. "Maybe there is some relation to what she came in about" -- is a MAYBE.

Have the staff ever caught y'all using your own food or insulin without permission? What did they say? Would they try to take his kit away?
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JessieBelle,

Woops, I tried to click "Helpful Answer" and hit "Report this Post" instead! That's how tired I am.

It's not like one long wait. It's several nurses who come in, promise to do something -- then never come back. Actuallly the doctor showed up soon after we arrived, talked with H, sent him for a scan, etc. Naturally reading the scan etc would take a while.
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I can understand the hours-long wait. Some hospitals have ERs that are poorly staffed and very inefficient. The one my father and mother have visited in the past was terrible. One could spend all day in an ER, seeing a doctor or technician for only a few minutes during that time. My mother has now switched hospitals, though she still thinks she wants to go to the old one if needed.
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I take two kinds of insulin. One is slow acting and I take that at bedtime, without eating. The other is fast-acting and I take that before a meal. I would not take the fast-acting without having food in sight -- to take it and not eat would definitely cause hypoglycemia. I have gone many hours without eating, for medical procedures, with no harm. I would not take insulin during that period.

I would not take insulin if all I had to eat was a few crackers, and I don't think jerky would add enough carbs to change that.

The fact is that managing diabetes can be complicated and I don't blame the ER for not wanting a patient to eat or use insulin until the doctor has evaluated the situation. Presumably there may be something seriously wrong -- that is why the person is in ER after all -- and it is unknown at this point what the treatment may require. You thought you knew what it might be and you thought food wouldn't interfere with the treatment (and you may have been right) but they really have to have a professional opinion,

I accompanied a young man who had attempted suicide to an ER. He kept hollering for water. No one would give him any until the doctor saw him. It may seem cruel but the rules are intended for the patient's safety. This man was miserable for a few hours, but he did survive -- which was the goal of the ER.

If the dog can sense high or low blood sugar levels, I'd wait for the dog's reaction. H was in a great place that could have quickly dealt with either situation, if it arose. Or, not having a dog, I would take my own blood sugar reading with my meter, and if it was approaching a dangerous number I'd call in the nurse at that point. Unless it was at a danger point, I'd relax and wait for the doctor.

I try to avoid ER for myself or my loved ones, but sometimes it is the best (or only) option. I accept that the experience is not likely to be pleasant. I accept that the rules might not seem to apply.

The last 5 times in an ER (with other people) the wait to be seen was less than half an hour. What really puzzles me in this post is why the wait was so long for a suspected TIA. Were they dealing with a major traffic accident that came in just before you? Was their regular ER doctor sick and they had to find someone else? Just what was going on?
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My mother is diabetic. I always have emergency supplies with me -- glucose tablets, glucose gel, crackers, water. If her sugar dropped, what the ER said would carry no weight with me. We can get stuck in there for hours when we do have to go -- it seems ridiculous. I wouldn't let her go into hypoglycemia because they have "rules." My own personal rule is not to put someone in a little room for an hour in an ER without even checking on them. I mean, it is an emergency room, right?
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