Hypo

I think that there is something in the air, yesterday we went to two diabetics with critically low blood sugars. It's a job that we sometimes do, but isn't actually that common. The day before there were at least two others in our area, one of which was quite ill.

The first was rather simple. A woman found her husband collapsed in the living room, she called us and we quickly diagnosed and treated the low blood sugar. When we found him he was unconscious, sweating profusely and was rather ill looking. One injection and some glucose gel and an hour later the patient was playing with with his very cute doberman. We may have also been enjoying the friendly dog as well.

The second person was a young woman in the workplace. I felt sorry for her as she was surrounded by her work colleagues and it was impossible for us to move her to a more private area. She wasn't as low as our first patient although she was very sweaty and was acting as if she were drunk. Once more we managed to 'cure' her with some sugary drinks an a little time. She was mortified that she was ill in front of her colleagues. She had received some immediate help from her friends, one of whom was 'first aid at work' trained.

Neither patient wanted to go to hospital, and once their blood sugar was back to normal there wasn't much that the hospital would do. Traditionally these are the sorts of patients who refuse to attend hospital and are left behind by us ambulance crews.

Still it is nice to be able to help people in such a profound manner – it makes a nice change from people who aren't actually ill.

32 thoughts on “Hypo”

  1. I've been type 1 insulin dependent since I was a little girl which is essentially the reason that coupled with time & pregnancy I ended up with kidney failure. I fortunately still get the warning signs of a hypo so I've never needed medical intervention (apart from once on school camp when I wanted to be in bed rather than out on a midnight hike – it was of course faked, so I perked up a bit once the teacher got me back to camp and fed me). I always used to be upfront with employers and colleagues and have lost jobs over it. Back in the late '80s I was denied employment with a bacon packing company, they considered me an AIDS risk because I inject and supposedly I could infect the bacon! It's that kind of ignorance that makes people hide their condition.

  2. I agree that these are one of the most gratifying types of call. I'll be glad when I finish my intermediate and can do D50 IV Push, since as a Basic EMT we can only do oral glucose on conscious patients. Even so, it's still very cool to help someone who is so out of it, and to watch them come 'back to normal'. I had my first solo call to an old lady on a tour bus who was on the verge of losing consciousness. I had to work my EMT magic with an audience of 60 other concerned holiday makers.

  3. Glad its not just me. 2 night shifts, 2 hypos, 6 doors apart on a small quiet residentual street. Both travelled into hospital post recovery…… Why? Well, first one had a hypo, collapsed and # his NOF (broke his hip) and second one went hypo whilst cooking something on his hob. Was very very lucky that his neighbours heard his smoke alarm and called for help!

  4. I'm not surprised she was mortified! Showing any kind of vulnerability at work is not a good thing! No matter how nice the group of friends who want to help her, there'll be an office bully to say things like “why don't you just fall over again and see if anyone sends you home?”, and a manager watching like a hawk to see if her work performance can be said to have gone down at the next performance (pay) review.

  5. A little while ago we were having one of those days and very much looking forward to the last run which turned out to be not much different from the first.The first patient had been waiting for medication for 5 hours before she could leave the hospital and wasn't in the best of moods, having already spent 3 months in there, she couldn't wait to get home, second patient was in quite a lot of discomfort and didnt want to be on the vehicle any longer than necessary, promise to do our best, third patient had a carer waiting in the house for her who would have to leave soon and she didnt want to miss her, again promise to do best, my partner went in for the last patient, who hopped 'literally' on the vehicle and tapped me on the shoulder, 'Could you see that i'm off first please driver, i'm diabetic and due and injection'. With no desire to watch her go hypo i pleaded with the patron saint of empty roads and green traffic lights.

    You know those exercises you do on discrimination awareness courses were there's one life jacket and a sinking boat and you have to pick who gets it?

  6. I think it is the weather, my husband always seems to loose control of his blood sugar levels when the weather is warm….he is insulin dependent, his levels are more controlled in the winter.Most diabetics will refuse a trip to hospital if they can as they have to declare all hypos to the DVLA every 5 years for the driving licence issue. You will probably find the slip of paper you leave behind with the instruction of take it to your GP never goes anywhere but the bin

  7. I must say that I like doing Diabetic Hypo's. As it is one type of job where the patient is usually very thankful afterwards. Also you can see the difference that you are making.

  8. Tom – just to say (as have many before me) how much I enjoy reading your blog. Spent yesterday trawling the archive rather than concentrating on my desk job – it doesn't really compare to your day! Keep writing so that we paper shufflers can remain reminded of a world outside our desk area!

  9. hospitals can be so annoying for that… I know a diet-controlled diabetic who was in A&E recently with/for their partner and approaching time to eat something. They decided to attract the attention of a member of medical staff and explain that they were a diet-controlled diabetic and needed to eat something, and was this a good time to nip to the cafeteria?Staff members ignored the bit about “diabetic” and just kept saying to wait a while, the (particular doctor) would be round shortly and their partner would likely get moved to a ward, so it would be best not to go anywhere. The doctor in question didn't make an appearance till the next morning, it's a good thing my friend ignored the advice and ducked out to the canteen anyway when he started to feel ill.

  10. “it's still very cool to help someone who is so out of it, and to watch them come 'back to normal'.”That is the exact opposite job description of bar work – I only managed one shift in my youth, watching people getting stoopider and schtooopider as the evening progressed was hellish.

    Not that I don't have the odd glass myself, which I suppose makes me a hypocrite, but at least an aware one!

  11. My husband has not told any of his collegues in the office about his diabetes because he says there would be a lot of discrimination towards him over bonuses and promotion…….I have always told him to stop talking so much rubbish, not anymore, I was shocked by your comment that it does really happen other than the DVLA, it is so ridiculous! It is a condition not an illness, an AIDS risk!!! That really does take the biscuit!!!! i

  12. A thing to remember is that humans are hierarchical beasties – so any excuse to beat someone down and be “one up” – be it diabetes, red hair, skin colour, the “wrong” shoes… they (we) will be all over it like lemmings.EG, and with respect to all, if you don't think even this blog (which is written by and seems to feature a lot of very switched-on, cool people) is about status in the end, just check the recent post on the woman who didn't know she was up the duff (to use a medical term) and read the comments…

    Not making a case for it, or against it, just saying we all compare ourselves to others on some level and like to come out on top – doubly so where there's cash or other tangible status involved.

    JMO. ;o)

  13. Shhhh, dont tell anyone else, but sometimes they have a little stash of in the fridge of they give to diet controlled diabetics, often found in the discharge lounge or other departments.

  14. In 16 years doing A/E ambulance work I have only ever taken in three diabetic (due to hypo) patients. One was unreponsive to glucagon which was probaly masking an acute illness, and the others were alone at home and I did not feel it would be safe to leave them even though they had made a good recovery. (Training Officers cardinal rule…”always cover your arse…”)It is always good to see the dramatic effect that glucagon has when minutes prior to the injection the patient was either totally unconscious or fighting mad or behaving bizzarely.

    The look on relatives or friends faces when they recover is satisfying.

    Hypos, in general, are easy to deal with.

  15. Easy to handle when you are trained to, I have had to learn to duck fast when my hubby does Hypo, luckily he not a very good shot! It is very upsetting watching a loved on going through it.Did you know that you can get glucogon on prescription to have at hand if you have someone willing to administer it in case of emergency? We have a dose in our fridge next to the insulin. I know not all hypos happen at home but hubbies hypos are usually in the morning or over night….fingers crossed, not for a long time now. Obviously not a good idea if the arms and legs are being thrown around!

  16. Truly random events are more likely to be clumped together than evenly spaced apart. This goes against human intuition which is why we see “coincidence” and, combined with confirmation bias, “miracles” everywhere.Yes, I am a maths geek. 🙂

  17. Thank goodness the new disability laws now cover diabetes (so I've been told). Apparently you now can't be discriminated against – so long as you can prove it.Even so I'd dread having a hypo at work (also dread asthma). It's the thought of everyone standing over you fussing and flapping and gossiping about it afterwards.

    I really feel for that poor woman at work.

  18. I saw a chap getting shown out of the back of an ambulance with a bottle of lucozade and some jaffa cakes outside my house earlier so i don't think you are alone!

  19. the new DDA laws cover EVERY kind of disability. so as an Architect I have to place lightswitches were people both 3 foot high and 8 foot high can reach them. the DDA is great in principal but there are a great many occasions where the compromise position suits no-one. it does need at least to have an admission that not everyone can be catered for in every situation.

  20. If he's not on it already get your husband to talk to his doctor about the basal-bolus insulin regime. You take an ultra long lasting flat action insulin that covers you for 24 hours and then you just top up at each meal with a rapid acting insulin usually in pen form – it almost imitates how a functioning pancreas works. My BMs used to be up and down, usually low in the night but now I very rarely get any lows, just nice steady blood sugars. It took me a while to get used to shooting up in public but the pens are actually very discreet and you can inject through your clothes under the table if necessary.

  21. I don't consider myself disabled and as far as I'm aware diabetes itself isn't a disablity, maybe some of the complications like limb loss or blindness. Perhaps I should check it out I may be able to get a better parking space next time (kidding, mental face slap for being so shallow).As I was a mere 18 at the time of the bacon incident I wasn't savvy enough to do anything about it. It was a job packing bacon anyay, not worth making a fuss over – but if it happened to me now I would definitely raise the flag.

    When I was recruited into the MOD I declared all my illnesses and they hired me telling me that I would not be allowed to retire on ill health grounds as I was more likley to need to, I shall fight this if ever it becomes necessary. They have also been difficult over giving me time off to dialyse (which I didn't need until I'd been there for 6 years already, without a day off sick) which I'm very pissed off about so I work full time and spend about 15 hours a week travelling and dialysing to give them their pound of flesh.

  22. The Act covers people with long term health conditions “that has an impact on their day-to-day lives”So it also coveres people with cancer, multiple sclerosis and heart conditions, who may not consider themselves disabled (and I certainly don't).

  23. It's all very well if they come round nicely- it's the ones who kick lumps out of you as their blood sugar comes up you have to watch

  24. The DDA doesn't work very well because it isn't really enforced.If a disabled person encounters discrimination, they can't just ring up the disability rights comission and say “this happened! sort it!”. They have to find the time, energy and money (a lot of disabled people are short of at least one if not two of those) to get legal assistance, assemble a case, and go to court. They then have to fight against the legal team of the company… so if you encounter discrimination/lack of access/etc in (to use a random example) McDonalds in Smalltown, then you have to be prepared to take on the entire legal team of McDonalds Restaurants Limited.

    Would you try that? Or would you just cut your losses and go elsewhere?

    (and if MOD counts as “the armed forces” then they are exempt anyway and can treat you like any flavour of shit they choose.)

  25. A lot of people view the DDA as meaning “we've got to be wheelchair accessible” and leave it at that. In the simplest terms though, if something is at ideal wheelchair height then it is utterly inaccessible to anyone of average height who has trouble bending their back or legs.The solution is to account for both separately if they cannot be accounted for in one fell swoop. In much the same way as a supermarket has 10 disabled spaces and 200 regular spaces, so a row of payphones in a train station might have 3 at regular height and one low down, and a bank might have 7 regular cashier counters and one low cashier counter.

    It's preferable to have a catch-all solution if possible though, like light-switches at 4ft (where I can hit it from a chair or from standing) rather than at 5ft, and light-pull-cords that go all the way to the ground rather than being tied off 5ft in the air. The solution of the future would be remote-controlled lights, or motion-sensor lights.

  26. I've only taken 2 Hypos in to hosp. 1 was a bloke who knew he was diabetic but had never had an attack, after Glucagon he was so scared that he insisted he be taken in as we were obviously wrong and he wanted a doctor to see him and explain this “mystery” illness. Doc said the same thing as us 4 hours after he got there!!2nd was for a young lady who was on the cusp of unconsciousness but still aware. She could just about take Hypostop but vomitted it up but was still too conscious to give Glucagon. A&E let her go waaaaaaay down, gave her Glucagon and then when she came round did the usual milk and jam. Wish we'd been able to do it.

    BTW, Glucagon is an EMT protocol in some areas but not all.

  27. Part of the problem is the way the DRC are funded. They have about enough money to take 50-60 cases a year so with that limit they have to pick and chose which cases they take on.It's a very poor way for disabled people of all flavours to get justice and a number of employers realise this.

    As an ex-DRC employee I know that most of the staff there would love to be able to do just that, sort out all the injustice that is being inflicted across the UK. It was wearing to have to 'defend' a situation that you personally disagreed with whenever you encountered people's (quite understandable) anger at the lack of ability to engage in more cases.

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