Unraveling Health and Emergency Care

Ann Bartlett Health Guide
  • This is part of the series, Misleading Gallbladder Diagnosis Leads To Better Diabetes Management


    After my January ER visit, life was normal again. I was back running and I had added 2 to 3 days of yoga per week.  My body was lean and fit.  My diet was good, but I noticed that heavy foods, like red meat, or foods that were fried, along with beer bothered my stomach giving me acid indigestion.  When I talked to my GP about it, she thought it was "diabetic stomach," a condition that occurs when the nerves die off in the walls of the stomach, causing reflux and indigestion.  Puzzled, I asked why I didn't have neuropathy anywhere else and the answer was that it could start anywhere.  When I talked to the endocrinologist, Dr. H, about it, she agreed, because this was part of my not having control over my diabetes.  She labeled me a "brittle" diabetic. In addition, I noticed my skin yellowing and I asked Dr. H for her advice.  She informed me that it was probably due to liver disease.  According to her, most diabetics develop liver disease and she prescribed a medication that would help slow the process.  However, the medication had some negative side effects on the kidneys.  With all the anti-acid and acid reflux drugs I was taking, my diabetic stomach was no better.  I thought if this other drug had adverse effects on my kidneys, why mess with an organ that isn't having a problem?! Discouraged and disheartened, I just focused on my fitness, hoping I could change my condition.

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    In June, a month before my fabulous 4th of July dinner, I was walking with a friend of mine and we were comparing hands.  She remarked how incredibly yellow my hands were, so I shared with her what the doctor had said.  I told her that I had not started on the liver med, because it seemed wrong to be taking a drug that would have negative side effect for something that had not been officially diagnosed by a blood test or scan. I shared that if I had all of these side effects from not having taken care of myself, why wouldn't I feel it in my exercise and see signs of retinopathy? Apparently, I had everything else for advanced stages of diabetes decline!


    Finally July 5th hit and the seriousness of all that had been staged over the years was rearing its very ugly head.  I drove myself over to the doctor's office.  My regular doctor was off, so I had another doc take a look at me.  He palpated my stomach asked if anything hurt and I told him no. I had no physical pain, just throwing up and unable to keep anything down.   He was pretty sure I had a case of food poisoning from my fabulous 4th of July dinner.  I did not have ketones and my blood sugar was in the 180s.  So he sent me across the street to the hospital for an IV drip for a few hours.  My follow up for the next couple of days was rest and to drink clear fluids until I felt better, and if I could handle it, bland crackers or rice.  I spent the day curled in a chair, watching movies and sipping chicken broth.


    By 5 am the next morning, I was vomiting again - only there was not much to expel.  I had no solid food for almost 48 hours. This time, I told my husband, something is wrong and did not feel like food poisoning.  So he drove me over to the ER and they hooked me up to an IV again and asked if I had any pain.  I told them a little in my back, near my kidneys.  They gave me a large dose of morphine and phengren for the nausea, and noted that I had been in for food poisoning and this was probably just carry over.


    The ER doc was less interested in my case, and more interested in finding out how she could get an invitation to Boston Marathon to work the finish line medical area (I was wearing a Boston Marathon jacket when I came in).  My husband and I have worked at the Boston Marathon for 10 years.  We always work the week before the marathon helping with elite athletes and then on race day, we work the elite athlete recovery area and medical. With all the morphine, I was having a hard time keeping my eyes open, let alone sharing information about the Boston Marathon. When I asked why they had given me morphine in the first place, no one would answer me.

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    When I dosed off, the ER doctor left me alone.  About 30 minutes later another doctor came in to assess me.  There  had been a shift change and he was taking over my case.  He asked a few questions and decided to send me for a scan of my abdomen.  After he looked at the CT scan, he asked if I had ever been to a gastroenterologist, I told him no, and he casually said, "You might want to check in with one next week."  He signed the release forms and I left for home.  I had no referral name and no indication that I was heading into a serious problem.


    What I would have done differently:

    1)    I'll be honest with you: if you can avoid ER care, I would!  Too many potential mistakes, because too many unknowns for the doctors.  They don't have your history and they often have a busy job. But if you are suffering with ketones and physical decline, don't wait for your doctor.  A better way to help yourself is to get to the ER for that big drink of water through an IV. Your recovery is faster and your body will thank you with more easily managed diabetes!


    2)    I have a friend who copies all of her records from the doctor's office, in case she has to go to the ER.  And, of course, she has never been in an ER!  In the front of the file is a list of prescribed  mediccations that she is currently taking, followed by pages of her medical history. 


    I think an entire file to hand to ER staff may not be helpful.  But having a list of 5 or 6 key things they need to know about you is a great idea! For example, list thing like your type 1 diabetes, medicine allergies, food allergies, recent surgery, previous days blood glucose log and current medications.  It gives them a point of reference and offers them information quickly.  Talk with your regular doctor about what 5 key things they think are important and develop your list together.


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    For more, read: Poor Diabetes Management: What I Had To Learn the Hard Way and

    Misdiagnosed Gallbladder Issue Leads to Better Diabetes Management


Published On: March 09, 2009