He’s well known to everyone on my unit. A diabetic for many years who has no concept of proper blood sugar control. On top of the diabetes, he’s a drug addict. During previous hospital stays, drugs have been found in his room and he was once found puffing on his crack pipe in the shower. Frequent room searches have become the norm when he stays with us now.
He has paid the price for his addiction and poor blood sugar control. Earlier this year he lost one leg just below the knee. Before the end of the year I suspect that he will lose the other one. Of course he has no insurance, so the hospital picks up the bill for all of his hospital stays and the staff is forced to deal with his verbal abuse, crass jokes, and non-compliance. I can honestly say that this is one patient that I loathe above all others.
I go into his room to check his evening blood sugar. He’s being unusually pleasant. No demands for snacks or pain medicine. No comments about the previous nurses “nice tits”. Perhaps he’s turning over a new leaf? His eyes look a little hazy and he seems a little out of it. I have my suspicions that something else is going on. The results of his blood sugar check pop up on my glucometer. 27
“Fuck.”
I run to the med room and grab a syringe of dextrose. I push the full syringe into his IV. This stuff works like magic when someone has a low blood sugar. I notice an immediate change. He becomes more alert.
“Fuck dude! What happened?” he asks.
“Your blood sugar got really low, “I reply. “Can you tell when your sugar gets low?”
“Sometimes.”
“Well, you need to call when you feel it getting low. I’ll get you a snack.”
I order him a snack and recheck his sugar. Up to 158. Awesome. I look through the previous nurse’s documentation to try and figure out what could have caused his sugar to drop so low. He’s had a habit of dropping low during the last few nights. I call the intern and let her know what is going on. I suggest that maybe a change in his insulin regimen is needed and she promises to pass the information off to his primary doc in the morning.
The next morning a search of his room is conducted while he’s gone to CT. A bottle of regular insulin and a couple of syringes are found among his toiletries. The asshole has been giving himself extra insulin on top of what we’ve been giving him. He fancies himself an expert in blood glucose control. I hold back the desire to point out the fact that he’s lost one leg and several toes due to his poor blood sugar control. His insulin is confiscated.
“You sure you wanna take that away from him?” I ask the oncoming nurse.
“Of course, why wouldn’t I?” she asks.
“He’s much more tolerable when his blood sugar is in the 20’s.”
We laugh. We have discovered a wonderful new tool: personality control through hypoglycemia.
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