JUST BACK FROM THE E.R.

I just got back from the E.R. after yesterday's battle with HYPOGLYCEMIA. After my neighbor called 911 at 2:00AM because I yelled at her to do that, since I was on the floor of my apartment thrashing about with the Forces of Life and Death. The Paramedics arrived and asked if I wanted to go to the hospital. Since I had drunk a good quantity of Maple Syrup and my Blood Sugar was now 65mg/dl where previously it was 40mg/dl. I decided against going to the hospital. They would have given me Glucose I.V. and taken my blood. These things I was doing myself minus the Glucose I.V.
What happened was when my BloodSugar was 40mg/dl, I decided to make Crepes with Maple Syrup to raise it up. However, Time was not on my side. Yes, I began eating the Crepes w/Maple Syrup, but next found myself on the Kitchen Floor with my plate smashed doing battle with the Forces of Life & Death from the Hypoglycemia. It must have gone down to about 20mg/dl. Since I now have Hypoglycemia Unawareness, the Falling of my BS is very quick,
Before the Paramedics left, I tested my Glucose and it was now 86mg/dl. We all felt assured that things were OK. However, an hour later my L Hand began to swell. I immediately put ice compresses on it and knew that it was related to the Fall. Since the EMT people had already left, I decided to go to the E.R. in the morning after sleep.
While waiting in the E.R. Waiting Room I heard someone coughing and sneezing. I turned in the direction and again saw that the simple implement of a tissue or handkerchief was not used to cover the nose and mouth. The person looked like a Fellow American. So it shows, that All People,including Americans (based on my comments of yesterday in the TUBERCULOSIS article) can display low class, base behavior, not caring about others or themselves.
Back to the E.R. The results of the Xray revealed a fracture of the Radius on my L Hand. So I have to wear a Soft Cast for about 6 weeks. The irony about all this as I told my Physician and Nurse is that all the long years I spent in Martial Arts, I never incured a Fracture, However my Battles with staying Alive from Hypoglycemia related to Diabetes caused more Pain (Emotional & Physical) as well as Fractures in comparison.
Eventhough I ended up staying 8 hours in the E.R. from 4:00PM to 12:00AM, Dr. Kaplan who was the E.R. Attending and Dr. Gulotta , the Orthopedic Resident were great as were Thomas and Mei my E.R. Nurses.

TUBERCULOSIS

Today in New York City, the temperature was around 50℉ so I decided as usual to go to Farmers' Market for more great Food for the week. The best way of getting there for me other than biking is the Subway. I boarded the train which was fairly empty (it was around 1:00PM). At the next stop however, a woman wearing a face mask gets on and sits close to me. I immediately moved to the other end of the car. It was not long before another woman who was already seated began expectorating her phlegm into her used coffee cup. Having had worked at Columbia University School For Public Health at one time and having a healthcare background before I entered the Food Industry, I again moved my seat to a Safer part of the subwaycar.
I do know that there was a time when anyone who had a communicable disease or a respiratory infection and was coming into this country would be quarantined for the good and safety of all.
Is it no wonder that there has been an increase in Tuberculosis in New York City. There exist now entities that look like human beings who when the need arises to sneeze or/and cough it is done openly without using a handkerchief (foreign substance to many) or tissue to cover the nose or mouth. This is so that their germs and poor habits can be openly shared with others in close proximity. I once saw someone who resembled a human being (outer form only) expectorate on the floor in the Lobby of Bellvue Hospital. I am sure that this "wholesome activity" is going on in other cities as well. Afterall, isn't it more important to show "Foreigners" how accepting we Americans are of all who come to our Shores, despite being "Blown-Up" as we were on 9/11/2001?

DON'T YOU DESERVE THIS LEVEL OF CARE?

When I was on the Insulin Pump some time ago, I still would have severe hypoglycemic reactions. All the more so, since I now had what is called "Hypoglycemia Unawareness". A condition due to lack of sufficient norepinepherine levels that act as an early warning system for low blood sugars.
There is a hospital in New York City that every once in a while will advertise on radio as to 'how great they are' by saying in a very Pompous Uptight/Upper Eastside/Snobby Woman's Voice, "Dont you deserve this level of care"?
Well since I was affiliated as a patient with this hospital, I decided to go to their Emergency Room. The day before I had dropped to the floor along with my floor lamp and awoke about two hours later because of the "Hypoglycemia Unawareness". Not only did this result in a loss of consciousness, a loss of my floor lamp, but heavy contusions on both legs which caused "open cuts" resulting in skin infection. Since Medically this is considered an Emergency, I naturally went to the ER of this supposedly great hospital. It was about 5:00PM when I was admitted into the ER where still wearing my Pump and after having seen the On-Call physician in the ER who suggested an alteration in my insulin settings and a dressing for my wounds. Since I was still laying on the Stretcher-Bed waiting for the Dressing to be applied by Whoever, I decided as I often do, to check my Blood Sugar. It was 40mg/dl....I was going into another Hypoglycemic Event and those Idiots who supposedly know all about Emergency Care, did not seem to know that a person who has Diabetes and is wearing an Insulin pump, is in need of FOOD!!!! Especially since it was now 7:00PM and I had been in the ER since 5:00 PM without any food.
I then got up off the Stretcher-Bed, approached the ER Physician who had seen me and said in a very loud voice so others would hear me as well, that I was Hypoglycemic and needed food. I also showed him the reading on my meter to confirm what I had said. I am glad I embarrassed him. I did get my food and later thought to myself as I left the ER as to why there is much Litigation within the Medical Profession. Could it be that the thousands of unnecessary deaths in hospitals due to negligence and stupidity is the reason?
Don't You Deserve this Level Of Care?

ONE OF THE MANY WORSE SCENARIOS FOR THOSE WITH TYPE 1 DIABETES

This goes wothout saying fellow persons with T1DM......do everything you can to try to stay out of hospitals as an in-patient.
A number of years ago, I had to undergo an operative procedure. As many of you know, all patients who are admitted for any surgical procedure must have an IV placed. This allows for easy access to administer medications quickly via a vein. It is especially useful if a person is not allowed "anything by mouth" and again it is a very quick/reliable way to adminster medications.
So, when I was admitted, the IV nurse places a solution of D&W in my vein in order to "keep it opened" in case different medications are required. Being proactive and never giving up self-autonomy, being able to think for myself, I said "I think you should use NaCl instead. Otherwise the D&W (Dextrose & Water) will cause my glucose to become very elevated. This is in spite of the medical personnel knowing in advance that I have T1DM (Type 1 Diabetes Mellitus). Afterall, an intake form is always required for all patients where their allergies and illnesses are listed. After consulting with the Resident and Attending, the IV solution was quickly changed to NaCL (Sodium Chloride). It is blunders like this which account for many many mistakes which affect the patient and his outcome. Another reason why litigation is so prevelant in healthcare.
Another time and in a different hospital, I required surgery on my eye. The RN assigned to me after the surgery was told to put "Liquid Tears" in the eye that did not have the surgery. The eye that did have the surgery, had sutures around it so I was not able to open it until removed.
So what do you think happens? She enters my room with the "Liquid Tears" and proceeded to apply it to the eye that had the surgery and which I could not open anyway due to the sutures. In my post anesthetic state I still was able to tell her WRONG EYE!!!
The lessons to be learned from all of this (I have more stories to tell), is NEVER NEVER GIVE YOURSELF UP TO DUMMYS AND INCOMPETENCE. It is you who are in charge of your body and no one else. Afterall no one is going to feel your pain if a mistake is made. Even those who wear WHITE make mistakes. Ask any Attorney who practices Malpractice. Don't ever "sell yourself short"!! Intelligence and good judgement are not exclusively given to those who wear white. I am wearing a teashirt(white) right now as I am writing, but I still know more about T1DM than many Fellows in Endocrinology.

WHAT IS STARBUCKS GOOD FOR?

Many of you would automatically think of coffee. Since Starbucks does have great name recognition, there would be no other reason to associate the company with anything else. But wait, Starbucks has other things that are even better than coffee. Besides, their coffee is not a good as it use to be. Some of the reasons for this are that the volume of stores cannot and does not (in my opinion) keep the same quality control when it comes to the roasting of their beans. The Barristers and "others" who work for the company are not as good as once were. They seem to be people who are there to fill vacancies and nothing more. The emphasis appears to be on marketing and real estate purchasing compared with good quality and knowledgeable service. In the beginning when Starbucks "came on the scene" here in New York City, the coffee was great as compared to the cheap quality coffee that was coming in from Columbia at that time. Starbucks, since it was the "new guy on the block", had to prove itself and establish a following willing to pay more than .50¢ for a cup of coffee. They did this by having well-trained Barristers and great Roasters to handle designated areas within the city.The small number of Starbuck stores established in the city at that time enabled the fresh roasting of coffee beans to be available to each store with care and quality control. Not the case now.....there are too many stores and not enough qualified people involved with the company as once was. Basically, Starbucks has grown too big and in the process has lost quality of coffee and service."Too big to be managed effectively". OK now that I have said my little critique on Starbucks, I will answer the question posed.
Taking many insulin injections throughout the day has some risks. Since I always carry my Flash glucose meter with me in a pouch that I clip to my belt, I can always monitor my blood sugars. When I am outside (the street), I need to be able to access a place where I can either give myself a bolus if my bs is too high or take someting sweet if the opposite is true. Since I am no longer on the "Pump", I carry my insulin pen with me all the time as well. Behold Starbucks!!
How great is it to be able to sit at one of the tables and do a 5 sec. check of my blood sugar?
If my reading shows "Hyperglycemia", then all I have to do, is to walk about 15ft. to the bathroom in Starbucks and take my fast acting insulin there.
If the contrary holds where I am feeling irritable, irrational, disoriented (normal states in New York City by all) and my glucose meter shows a "Low Number", then all I have to do is again walk about 15ft. to the sugar counter and open a few sugar packets to swallow. Nothing could be easier and I did not even have to drink their horrible coffee. And if you are feeling romantic, you could always sit next to someone who you feel attracted to. All this without spending a dime. Oh, one more thing.....If you are "out and about town" and in need of going to the bathroom, there is always a Starbucks to be found (these days) on every corner. Starbucks has become a stationary ambulance for those with Diabetes that also sells coffee. Thank you Starbucks for assisting all those with Diabetes.