Tuesday, January 8, 2013

Who Nurses the Nursing Student?

It's only the second day of nursing school and I've caught a cold! But that doesn't mean I can stay home and rest, so I loaded up on zinc lozenges and hand sanitizer and went to class.

Like I mentioned yesterday, I've made some new friends at school and it is inevitable that new friends ask questions about my diabetes. So I thought I would share how I answer some of the innocent questions that curious friends ask.

  • "Is there anything I need to know, if you have an emergency?" 
Yes, there is a glucagon injection in my backpack. If I am unconscious or unable to take sugar by mouth, you should use it immediately, then call for help. However, I have had diabetes 27 years and never needed to use the glucagon injection. 

  • "How does your pump work?" 
It is connected to me via a subcutaneous catheter, that I change about every 3 days. (I love talk to other nursing students, because they understand the terminology!) The pump delivers a base rate of insulin continuously and when I eat I program a bolus of insulin to cover the amount of carbohydrates in my meal. If I am being a compliant patient, I also wear a continuous glucose sensor, which transmits my blood glucose readings to the pump every 5 minutes. The sensor is a separate subcutaneous electrode and it's a really big needle to insert it, so I don't like to wear it. 

  • "How can you tell if your blood sugar is off?"
I test my blood sugar frequently, like 6-10 times per day. If I am feeling weird, usually I will test to confirm my gut feelings. When I am low, I get really fatigued. And when I am high I feel sluggish and short of breath. I like to explain highs like this; think of your blood having the consistency of egg whites, when the blood sugar is high, the blood get polluted with sugar solutes and becomes more like elmer's glue. How would you feel with glue running through your veins? 

  • "So you can eat whatever you want?"
Yep, although somethings I avoid or save for special occasions; like pizza.

  • "Why pizza?"
Because of it's high fat content, pizza is problematic for most people with diabetes. The fat causes a delay in blood sugar spike, so I can pretty much go without a meal bolus for pizza for the first few hours, but around the 6-8 hour mark, my blood sugar will spike very quickly and take hours to come back down. But, there are ways to "plan" as much as possible for the spike, so I can still enjoy pizza.

  • "Ugh! Why are you having pizza for lunch? Now, you're making me nervous!"
Because I am evil, no not really, just to prove that I can. (For the record 8 hours after my pizza, I was 54.)

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