Diabetes Talking

Question:

The British NHS is now close to finally setting in place the National Service Framework for diabetes care. Up to date information is constantly posted here http://www.doh.gov.uk/nsf/diabetes/ Ratty — ratty at diabetes.flyingrat.net Diabetes pages http://diabetes.flyingrat.net

Response:

The British NHS is now close to finally setting in place the National Service Framework for diabetes care. Up to date information is constantly posted here http://www.doh.gov.uk/nsf/diabetes/ Ratty

Yippee !!!!! Well if only two of things I have had a quick browse actually get done and done properly then diabetis care will have vastly improved in my book. The two things I am refering to are from the service models and are the Pregnancy & diabetis Module plus Care of people with diabetes on admission to hospital. I gave birth to a baby girl last December (an early picture of her is on the web page) and was lucky enough to have almost the sort of care described in the Pregnancy & Diabetis section (The locally agreed protocals were outdated and not open to interpritation at 10.30pm as I as leaving the operating theature.  Also the communication wasn’t always prompt and effective even if it was just a note in my file telling the midwife I didn’t need a special schedule regarding food during labour as this had been covered in detail with me and I did actually know what I was doing, Honest!!!). But on the whole it was great to be able to go to one place and have my needs seen to.  In fact I usually had to see my diabetic specialist before the obstrician as a matter of course so that obstrician had the very latest information regarding my diabeitis to work with.  Ok my appointment’s usually took 2-3 hours but at least my notes were up to date and everybody knew what was going on (most of the time).  I also had access to a specialist diabetic nurse every day of the week who would either contact my specialist on my behalf and inform me of what was discussed (often less hassel for me) or arrange for me to see my specialsit in between clinics. The clinic also had a diatecian and a vistisng physiopheripst. A friend of my Mothers who has diabetes and was pregnant one county over had to go to two separate clinics and often found her notes hadn’t managed to travel between the two in time for her next appointment so never knew what was going off and found it all very stressful. Then I entered the labour suite and it all fell apart  There was no special schedule or protocol in my notes regarding food during labour (quick panic).  I explained what I had been told by my team and had some very doubtful looks from the midwife’s.  Eventually they tracked down a member of my team who confirmed what I had been saying so that could be put into my notes and the world was yet again safe.  To cut along story short I ended up having an emergency caesarean at about 9.30pm on December the 18th 2001.  My daughter was born at 10.18pm and I left theatre around 10.30 -10.45pm.  Upon a discussion started as to whether to put my on sliding scale insulin.  I pleaded that as a Type 2 diabetic who had only been on very small does of insulin (4 units actrapid with lunch & 6 units Insultard with tea) I really didn’t think this was necessary.  But protocol states that’s what you do to a diabetic after a caesarean so that’s what happened. Next they arranged to transfer me to the labour ward having explained I was on sliding scale.  The ward agreed to take me and my family was sent home. I was on the ward for about 20 minutes before they decided they hadn’t got the staff to deal with testing my blood ever hour and adjusting my drips accordingly and also to test my babies blood and cup feed if necessary. Back down on the labour suite I actually had a very good night with the midwife who had assisted with the caesarean as it was a slowly night and I was her only patient.  We discussed how silly me being on sliding scale was as I started of on glucose which put me high after an hour so was switched to insulin which then put me low etc.  In the end as soon as my specialist diabetic nurse was in the midwife phoned her to ask if I could be removed from sliding scale.  She asked why I’d even been put on sliding scale in the first place and of course I could be taken off it.  My midwife stopped the sliding scale without permission from the Doctor on duty and prepared to get told off.  Luckily the Doctor agreed with the Midwife and all was ok. Then I was transferred to the ward where I was asked whether I had my own insulin and if they would need to test me.  My daughter received lot’s of care relating to having a diabetic mother (not all of it I was happy with) but no-one thought to tell me I could order diabetic alternatives to puddings.  When I did finally discover I could (about 3 days later) and proceeded to order a diabetic pudding, the domestic asked the nurse’s who it needed to be given to and was told thee wasn’t a diabetic on the ward and it must be a mistake so just put it out for anyone to eat.  Luckily I overheard this and manage to save my dessert and correct them.  They were slightly surprised to discover the had a diabetic on the ward. Now I don’t like the idea of everyone making a big issue of my diabetes but sometimes it’s necessary for people to be well informed and when I’m in hospital recovering from an operation is one of those times in my book Also my notes while I was in hospital were documented very poorly and my daughter lost an alarming amount of weight which caused my community midwife to actually arrange an appointment with the Ward Sister to complain about my stay.  She basically got told ‘Opps’ So if they managed to actually do those two things and integrate them where applicable then I will be one of the happiest diabetics around as I am considering doing it all over again in a couple of years What do other’s like about it and why ??? Morgana

Response: