Читать книгу 50 Things You Need to Know about Diabetes - Kathleen Stanley - Страница 11
Оглавление4 How to call your doctor for help
There will be days with unexpected troubles, days when you need to get some advice from your health care team about your diabetes care. The doctor’s office is the place for getting accurate medical advice. It may be easier to ask friends or neighbors (or the Internet) for health advice, but they may unknowingly provide you with misinformation, or worse yet, provide dangerous suggestions, which could cause further problems. Here is some good advice for when you need some help.
DISCUSS THE GROUND RULES
Ideally, as part of your initial visit, you should have been given information from your health care team about when to contact them, your responsibilities when doing so, and when interventions are up to them. If you have not received this information, plan to ask these questions at your next visit:
At what levels do you want me to treat high or low blood glucose on my own?
What number should I call when my blood glucose gets really high (for example, higher than 350 mg/dl)?
What number should I call for help when my blood glucose gets really low (for example, lower than 50 mg/dl)?
When should I call other health care professionals instead of you?
Should I call you if I experience any hypoglycemia, or just moderate to severe episodes?
Should I have a glucagon emergency kit?
Should I check for ketones? If yes, when?
What steps should I take if I have positive ketones?
What steps should I take if I can’t take my diabetes medication (going to have a dental procedure, employment physical, having vomiting, etc.)?
What steps should I take if I run out of medication?
What steps should I take if I can’t reach your office for a diabetes problem?
Who will be taking my after-hour calls? What are his or her professional qualifications? Do they have access to my medical history if needed?
When should I go to the hospital if I can’t manage my blood glucoses on my own?
To which hospital should I go if I need emergency help?
WHEN TO CALL
Typically, you will want to notify your health care provider at once if:
You run out of medication
You are running a fever (for more than 8 hours)
You are unable to eat (nausea, vomiting, diarrhea, other) for more than 6 hours
You have missed more than one dose of diabetes medication
You are spilling moderate (or greater) ketones, or cannot clear trace/small ketones
You have symptoms of diabetic ketoacidosis (DKA) if you have type 1 diabetes
You are having “runaway” high blood glucose levels for a few hours (starting at 200, then moving up to 300, then going to 400. Do I hear 450?)
EMERGENCY SITUATIONS—TAKE ACTION
If you are experiencing symptoms of a serious health problem, such as a serious injury, possible heart attack or stroke, or possible DKA, do not call your doctor’s office. Have someone take you to the nearest hospital or call your local emergency response center immediately.
HOW TO CALL
Find out what phone number to use for office hours and after hours. Some offices have a “triage” system where phone emergencies are called in and someone is appointed to call you back. Some offices have an automatic voice messaging/prompt system, which allows you to access someone by selecting a certain choice, even in emergencies.
DON’T WAIT
If you have been experiencing problems with your blood glucose for a couple of days, don’t wait until Friday night to call the after-hours support person. You may end up being connected to someone who is not familiar with your history and not associated with your regular crew. Don’t get mad if they require additional information (asking question upon question) from you in these situations. They are trying to do their best to make the right assessment of the situation, and they need your cooperation to get the right information.
THE EMERGENCY ROOM IS NOT A SUBSTITUTE FOR YOUR REGULAR OFFICE VISITS
It is important to stay on course with regular visits to prevent problems. If you run out of medication because of your lack of planning or knowledge of self-care, the emergency care center may cost you a fair amount of money, and you may still be referred back to your usual health care professional when they open the next day. Therefore, plan ahead for prescription renewals, attend classes to learn how to deal with problems, and keep regular appointments to avoid a Saturday-night trip to the local emergency room.
BE PREPARED TO ANSWER QUESTIONS
If you do need to call your doctor, be ready to answer the following common questions:
What type of diabetes do you have?
What is your current blood glucose?
When was the last reading (blood glucose) taken, and what was it?
What medications did you take today?
What medications are you taking for your diabetes management (actual name, dose, and timing)?
What have you eaten today? Can you hold down food?
Do you currently have a fever? For how long?
What is your pharmacy’s name and phone number?
What is your insurance company and policy number? (If you have secondary insurance, you will need the information on both.)
What are your symptoms and complaints?
Do you feel you need an appointment, or just need to ask a question?
What available phone number can you be reached at? (You may want to give a backup number of a family member or a friend if the information is urgent. Keep the phone on and available to receive the return call.)
If you feel you need to go in for a sudden visit, have you arranged transportation so that the appointment time can be made accordingly?
MORE RESOURCES TO EXPLORE
BOOKS
Diabetes A to Z: What You Need to Know About Diabetes—Simply Put, 5th edition. American Diabetes Association; Alexandria, VA. 2003.
YOU—The Smart Patient: An Insider’s Handbook for Getting the Best Treatment, by Michael F. Rozen and Mehmet C. Oz, with The Joint Commission. Free Press; New York, NY. 2006.
