Thursday, September 8, 2011

I Think I Liked You Better When Your Blood Sugar Was 30

A few nights ago, a friend of mine gets an older gentleman from the nursing home- he's cold to the touch and acting kind of like someone who just took a bunch of Benadryl and is trying to stay awake. Medics tell us his blood sugar is in the 30ish range but they couldn't establish IV access, so it's still that way. He gets the doctor in there and we get to work on an IV- dude is a little ball of scar tissue, unfortunately. His EJs are pretty much useless from as many times as they've been stuck, but I managed to get a neonate IV in his wrist, and push an amp of D50 in that bad boy. Woot! Poor guy's rectal temp was about 96, so we also got him hooked up with a little Bair Hugger action and he started to turn around a bit.
He started looking around and was talking in kind of a pleasantly confused way. He knew who he was, but that was about it- he kept referring to my teammate as "my son" and smiling at him. I get him some warmed fluids and go back about my business with my other patients. About a half hour later my friend rechecks his blood sugar and finds it's now only in the high 30's- I run into the room with him to try and find another IV site for a D10 drip as he's giving the second amp of dextrose. Just as he is finishing up with pushing the med, they guy sits right up and asks me what the hell I'm doing. I explain that his blood sugar keeps dropping and that we're going to try to get another IV to give him some dextrose continuously. I then ask if they're giving him Insulin over there at the nursing home.
He scoffs. "Well. OBVIOUSLY, or I wouldn't be here, would I?"
I explain that there are multiple medications for diabetes besides Insulin, to which he responds with, "Oh. Really. And you couldn't figure out that Insulin was what they were giving me? You're a little special, aren't you?"
So, then my friend decides with the mental status change and junk that he should ask his orienation questions again. "What's your name, sir?"
"What's wrong sir, you seem upset?"
"I AM upset, because that's a STUPID ASS question!"
I then make a last ditch effort to explain the state he presented in, to which he responds by rolling his eyes and turning away in a manner similar to a 13 year old girl. I take this as my cue to exit.
I hear screaming coming from the room about an hour later and walk in to find him waving the urinal around and yelling about how he got the sample we keep bothering him about. I thank him and take it away. He squints at me and crosses his arms and says, "and where have YOU been?"
"I've been taking care of my patients", I tell him. "I was in here earlier helping your nurse, the guy that's been in and out of here checking on you, but it seemed like I was getting on your nerves so I thought I'd step out for a while." He stares at me for a minute and says, "You know what?" What? "You're a typical woman. That's what you are."
I just busted up laughing at this point. What else could I do? I always thought people were easier to deal with when they were lucid, but I guess not always.


  1. How hysterical! "You're a typical woman" Love it.

  2. What the heck! You just can't keep all the patients happy huh? At least you got a good laugh over it.

  3. I prefer a vented patient on a propofol/versed/fentanyl drip most days.

  4. Well now you know why they let his bs drop so low!

  5. I like people much better with a little PRN propofol... Titrate to a Ramsay of "Shut the F up."

  6. Just discovered your blog and am enjoying reading some of the archives. I was initially very confused by why you were giving D50 for a blood glucose of 30, until I remembered that the US and Canada use totally different systems for measuring blood glucose and in the US a blood glucose of 30 wouldn't be ridiculously high. :D