So worried about my mum

ChrissyR

Member
Messages
12
hi, Just hoping for some advice. My mum is in hospital after a stroke 2 weeks ago. I can never remember what type of diabetes she has but she's insulin dependant and has had it since she was 55 (she's not 85).

Since she's been in hospital her blood sugar levels have been all over the place, at times dropping as low as 1.4 and at other times rising to 24. They have been letting her eat anything including puddings. She does need to put weight on as she now only weighs 6st 10 but not sure she should be allowed to eat absolutely anything.

They are adjusting her insulin every day depending on her levels. They have even had to give her insulin during the night when her levels have gone through the roof. Other days they give her a biscuit at bedtime because she is so low. Its such a mess at the moment. They are now talking about discharging her early next week and I am panic stricken. For a start she is not going to be able to do her own injections any more as she is so shaky and I have never done them. Dad used to help but he died a few months ago and since then she seemed to be coping ok with it until the stroke.

If they send her home how will we know what dose of insulin to give and when, its so scary.

Any advice would be greatly appreciated.
 

jayne15

Well-Known Member
Messages
115
Hi express your concerns to the hospital team and request a district nurse referral they should support your mums discharge in terms of insulin, you could also request that she is assessed by the hospital diabetes team so that they can review her current regimes.
 

ChrissyR

Member
Messages
12
Thanks for the reply. The diabetic nurse is visiting her in hospital but nobody can confirm that someone will be going out to her home to sort the insulin out. They say they have asked but there has been no answer. They say they hope that something can be sorted out.
 

jayne15

Well-Known Member
Messages
115
Hi go to the hospital pals team they will support you, they cannot discharge your mum without the correct support it would be an unsafe discharge. you can also contact the discharge team or the district nurse team to discuss your options there is a huge care in the community infrastructure these days so try not to worry, if you are not happy with the arrangement simply refuse to take her home until adequate provision is in place. Also look into 'continuing health care' as your mum may be eligible for this funding.
 

martwolves

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Can't a district nurse help with this? Daft as it may sound, being 36, I can have a district nurse do my testing and dosing if I wanted to. It's wasteful and needless in my own case though.
 

ChrissyR

Member
Messages
12
Thanks for your replies, I really appreciate it. As far as the district nurse goes, they say they are pushing for it but its not definite. I will ask for contact details for the discharge team and district nurse and see what they say.
 

Tracey167

Well-Known Member
Messages
309
Type of diabetes
Type 1
Treatment type
Insulin
Hi ChrissyR

Keep on at them i think you have to these days to get things done, even if you get on there nerves it obvious you mum will need help when shes discharged especially after having a stroke. Hope it all goes well for you and your mum makes a speedy recovery.

tracey167
 

ChrissyR

Member
Messages
12
Hospital have said that the district nurse can only visit once a day so someone else will have to do the other injection. It appears that someone will have to be me. Ive never done it before and am terrified of doing something wrong, even if I dont have a problem actually giving the injection what about knowing what to do if she goes high or low.

The diabetic nurse at the hospital has asked me to go in tomorrow morning so she can show me what to do which apparently involves injecting a cuddly panda! This means that the first time I actually inject my mum will be in her home with no supervision. I told them I cant believe that this is acceptable but they said the only other alternative, if I dont feel able to do it, is to find mum a placement which is not going to happen under any circumstances. So looks like its down to me and I have never been so scared in my life.
 

iHs

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Messages
4,595
ChrissyR said:
Hospital have said that the district nurse can only visit once a day so someone else will have to do the other injection. It appears that someone will have to be me. Ive never done it before and am terrified of doing something wrong, even if I dont have a problem actually giving the injection what about knowing what to do if she goes high or low.

The diabetic nurse at the hospital has asked me to go in tomorrow morning so she can show me what to do which apparently involves injecting a cuddly panda! This means that the first time I actually inject my mum will be in her home with no supervision. I told them I cant believe that this is acceptable but they said the only other alternative, if I dont feel able to do it, is to find mum a placement which is not going to happen under any circumstances. So looks like its down to me and I have never been so scared in my life.

Hello Chrissy

Im hoping for your mum's sake that she will be ok using twice daily injections and not multi (MDI or basal/bolus).

Injections using an insulin pen are so so easy to do. All you do first of all is put a glass cartridge in the pen barrel, screw it together and then screw on a pen needle at the bottom. Turn the dial at the top of the pen to prime the needle so that insulin comes out the end of the needle and then turn the dial at the top of the pen to the required number of units of insulin and then gently push the needle into your mum's bum or arm. Its no problem at all and you will be surprised that there isnt much to it.

Insist on an insulin pen with glass cartridges filled with insulin and not a disposable syringe. Disposable pen needles are available in various lengths and a 4mm pen needle is very short and very thin. Your mum wont even feel it.

Try not to worry........... you'll be fine with the injections. The only real problem will be making sure that your mum eats the correct amount of carb in her meals. If she needs supervision with this, can you stay with her or maybe she could live with you?
 

ChrissyR

Member
Messages
12
Thank you so much for your reply. Apparently she cant have the pens because she has porcine insulin and not humulus (hope ive spelt those right). They did try her on humulus a few years back but she had a reaction to it. I was hoping for the pens because ive heard theyre so much easier.

Sorry for not knowing much but could you explain multi (MDI or basal/bolus). I have asked for help with her diet but theyre so laid back its difficult to get the information I need. Where is the best place for me to find out about carbs etc? I realise it sounds bad that I dont know much about all this but up until her stroke, although shes 85, she has managed her diabetes really well to Ive never really got involved. I wish I had learnt all this a lot earlier.

We are in the process of buying a new property and mum is coming to live with us but it will probably take quite a while for everything to go through.

Im so grateful that this forum is here as I dont know where to turn at the moment.
 

iHs

Well-Known Member
Messages
4,595
Chrissy

Animal insulin is available in vials and cartridges. Look at the website http://www.wockhardt.co.uk/products/searchresults.asp

There are 2 insulin pens that can be used with the animal Wockhardt cartridges - the Autopen and all Elly Lilly pens as the cartridges are the same design. If you telephone Wockhardt, Im sure someone will be able to advise you on pens that will accept their cartridges.

MDI or basal/bolus is where a slow acting basal insulin is injected once or twice per day and a fast acting bolus injection is done to eat meals containing carbohydrate. The amount of bolus insulin needing to be injected is calculated using an insulin to carbohydrate ratio like 1u for every 10g carb. Some diabetics need to alter the ratio to enable blood glucose levels to remain within safe limits and so frequent blood glucose tests need to done. Its a bit complicated.......

Twice daily injections are easier to comply with but dont give people the freedom to eat whatever amount of carbohydrate that they want at any one meal time, instead twice daily injections mean that people eat set amounts of carb at each meal time as the insulin releases its action over a 12hr time period and as long as people dont overeat or undereat, bg levels remain at stable levels.

Carbohydrate levels in food can be found out using a search engine but most packaged food will contain info on carbohydrate content per 100g weight although sometimes its listed per item. Its important for your mum to eat food with the correct amount of carb in it otherwise her blood sugar levels will either go too high or be too low causing her to go hypo.

I think you will need to make an appointment with your mum's doctor or diabetic specialist nurse to discuss her diet and blood glucose testing to keep her well.

Dont worry if you get stuck and need help..... good job for forums :thumbup:
 

ChrissyR

Member
Messages
12
Thank you so much, you cant imagine how grateful I am for the info youve given me. I am meeting with the diabetic nurse in the morning to learn how to do the injections so will ask about diet while Im there.
 

iHs

Well-Known Member
Messages
4,595
Using a syringe to draw up insulin from a vial is also not hard but pens are better.

The way I did it years ago was take a disposable syringe and pull down the plunger to just slightly more than the amount of units of insulin needed. Then holding the vial in one hand so that its upside down (you may possibly need to shake the insulin first if its a cloudy one) push the syringe needle up into the vial membrane (the rubber bit) and then push the plunger up so that air bubbles will be injected into the vial and will rise to the top of the insulin. Next bit is slowly pull the plunger down to about 10u. There will be an air bubble but dont worry, just quickly push the plunger back up to the top again and the bubble will go into the vial. Then gently pull back the plunger again and this time there shouldnt be any air bubble; just insulin. If there is a bubble, just push it up into the vial again and gently withdraw until youve got the correct number of units. Withdraw the needle and then its ready to inject.
 

ChrissyR

Member
Messages
12
Thanks again for the info. Have been over to the hospital and the diabetic nurse now thinks that she can get the pens for mums insulin. She is trying to get one today and a supply of the vials so hopefully by tomorrow when mum is discharged i will have the pen rather than the syringes - anything to make the process easier!
 
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ChrissyR said:
Thanks again for the info. Have been over to the hospital and the diabetic nurse now thinks that she can get the pens for mums insulin. She is trying to get one today and a supply of the vials so hopefully by tomorrow when mum is discharged i will have the pen rather than the syringes - anything to make the process easier!

hi Chrissy I hope everything goes well for your mum when she is discharged. Have you thought of the In hospital Social Service department? as they may be able to help you with advise, support or to point you in the right direction of another organastion. You won't have anything to lose by asking.

Good luck and make sure you take care of yourself too.

Best wishes RRB
 

ChrissyR

Member
Messages
12
Have been to the hospital this evening and been informed that the District Nurse cant take Mums case on as they dont have any free slots. This will be the case for the forseeable future. There just seems to be nothing I can do about it as they are going to discharge her tomorrow. I had to agree to do one of the injections to get her home so now am obviously going to be expected to do both. Things are just going from bad to worse.
 

Mr Happy

Well-Known Member
Messages
231
Before she leaves make sure you get to speak to a diabetes nurse, ask for all the pamphlets they have and a blood glucose monitor and test strips. They also will have log books for you to writing levels and doses down. Keep this and a food diary so you can see when and what makes your mum high and low. Try not to panic and over correct if she is high or low (at such a light weight changes are likely to be erratic).

Also, get a contact number for a diabetes nurse at your local doctors and ring them whenever you are worried. Its the responsibility of the nhs to provide a level if care, ensure they do.

Finally, remember to give yourself a pat on the back. Many people wouldn't do what you are, you will be making your mum proud!

Sent from the Diabetes Forum App
 

jayne15

Well-Known Member
Messages
115
Chrissy that simply inst good enough- you need to get pals to support you with this (every hospital as a pals team) you should only take this on if you are happy and confident to do so. ask if there is a Hospital at Home team available to support you. your mum and you have every right for the correct level of support.