I should probably be catching up on sleep but it’s so quiet at home that I can’t relax and I feel I need to get some things off my mind as my mind keeps whirring.

This Christmas has probably been one of the worst. Lonely, isolating and frightening. My mum went into hospital last night (25/12) with Diabetic Ketoacidosis and what struck me most is how difficult it was to get any help. I know not to expect much from out of hours medical care but what happened I think was verging on negligent.

My mum has been vomiting for the past week or so and I got a prescription for antiemetics as we all assumed it was down to a sickness bug, maybe it was initially. She wasn’t able to keep the antiemetics down and then on Saturday (22/12) she complained of feeling dizzy and fell and hurt her shoulder. My mum is notoriously difficult in trying to get her to go to the doctors. Initially there was nothing visible but she now has a huge bruise on it and A&E said its probably a soft tissue injury (they said they’d x-ray it but I don’t know if they did) and became increasingly confused and in pain as well as still vomiting. The past few days have been so stressful. Yesterday, the confusion got worse and I decided that I needed some advice despite certain people telling me to leave it till after Christmas.

I initially rang the Crisis team as they have been involved in the past with my mum’s care and they confirmed my view that the confusion is medical and not psychiatric and told me to phone the Out-of-Hours (OOH) doctors. The OOH doctor eventually rang me back, asked to speak to my mum who was at this point incoherent. He asked me take a blood sugar reading which was 17.6 mmol and told me that he didn’t think it was anything to do with Diabetes and that I ought to phone the Crisis team, though I thought -bearing in mind that the blood sugar reading is basically on fasting for several days, that is a very high value. He then said bring her to the OOH practice and I said that I’m going to struggle to do that and that I need someone to see her urgently. He eventually agreed to arranging patient transport with an up to a 6 hour wait. It transpired, after I read the letter OOH written to A&E containing a transcript of the phone call that he had refused to send a doctor out for safety reasons due to her illness which I will stress has never caused her to be violent or abusive. I’m actually disgusted and appalled that a) he did this without asking me if she was violent/abusive and b) and more importantly- tried to fob me off by telling me it was more likely to be a psychiatric problem than a serious medical problem. I’m just astounded. When we eventually arrived at the OOH practice, there was another doctor and he was very concerned and she was sent to A&E immediately. They confirmed in A&E that it was Diabetic Ketoacidosis (DKA) and she was moved to resus, she had a high level of ketones in her blood and was started on fluids to correct the dehydration, sliding scale insulin, glucose and potassium. Mum has had DKA before, so once they started treating her I was a bit more relaxed and I cannot fault the care of A&E or the ward at all, they have been excellent.

A&E was interesting on Christmas Day. Before I arrived I thought I was having a terrible day, and yeah I was but coming there showed it wasn’t just me. There were hundreds of patients sick or injured. While I was waiting outside resus I saw an elderly lady being brought in and she looked in a bad way, they were doing chest compressions as they were bringing her in and she was intubated. I recall at that time thinking that it didn’t look good and I hoped she wasn’t alone, some time later the resus doors opened again and I saw that she was no longer there and had evidently passed away. Her husband was there and everyone was so sorry, you could tell they genuinely meant it. I thought, how terrible to lose your loved one especially on Christmas day and I was struck by the dignity he showed. Christmas day is something that I associate with spending with your loved ones, a time for family for most.

My mum’s still poorly but she should get better eventually. It’s not the easiest time of year for things like to happen at least from a practical side of things rather than sentimental. I’m exhausted but the world doesn’t stop turning and there are things that need to be sorted out. I am angry with myself for not realising sooner and I feel like it is all my fault, I feel like I’ve failed her as her carer.

Posted with WordPress for BlackBerry.


3 thoughts on “Christmas

  1. kerri says:

    Sorry things aren’t going so stellar, Simi. What type of diabetes does your mum have? I know things must be super stressful, but I am happy that you knew how to act to get her the care she needed and were able to advocate for her. How is she doing today?

    PS. Not sure if my first comment came through, oops. Feel free to delete one if they both came through.

    • Simi says:

      Hi Kerri, thanks for your message.
      They are unsure what type of Diabetes she has, she is managed on long acting insulin (Levemir) and tablets (Metformin and Glimepiride). She was diagnosed a few years after starting antipsychiatric medication and then in 2010 was started on Insulin as the tablets+diet method had little effect, her HBA1C test values have been very high. It’s possible she may have some kind late onset type 1 diabetes as it is quite unusual for type 2’s to end up on Insulin. And she’s had 3 episodes of DKA all within the last 5 years, DKA doesn’t happen very often in type 2. She had Gestational Diabetes when she was pregnant and I had to be born early because of it.

      I went to visit earlier and she is still confused and has now been catheterised. The good news is she no longer has ketones in her blood, but she is still being sick and they cannot give her antiemetics because she reacted to the IV Cyclizine they have given her. They said they have to wait until she has started eating etc to see if this episode has been managed and they think she has some kind of viral chest infection which precipitated this.

      Hope you had a lovely Christmas. xx

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