Nikki had another sleepless night.  The Doctor’s orders require the hospital to administer all medications.  I think this is the CYA addendum to the Hippocratic Oath that the malpractice insurance companies have added.  It’s easy to understand for most people.  And they certainly don’t want to be accidentally double dosing medicine.

Because Nikki is diabetic, these rules require the hospital to deliver insulin as prescribed by an algorithm. This method likely works for the vast majority of patients. Not our girl. The original orders were for 2.5 units (mG?) per hour. We know the algorithm doesn’t work for Nikki so we had them drop it to 1.2 units per hour. We still thought that might be too much.  Guess what? It was.  Within 2 hours her glucose level dropped from 229 to 79 – at the reduced delivery rate.  79 is low.  But when it’s at that level and dropping that fast, we’re lucky we caught it.  Imagine how fast she would have dropped if she had been receiving double the dose based on the algorithm.

This was after a couple of conversations with the attending physician who was adamant about her using the chart. So we had the insulin drip suspended and had to passionately convince the staff that she would be better monitoring on her own using the Omnipod delivery system.  She’s been using this system for years.  While nothing is perfect, she’s been able to understand the nuances that work for HER. The Doctor may not have been too happy with her as we also had to encourage them to re-administer her anti-rejection drugs after she threw them up about 20-30 minutes after taking them.

The Doctor did agree with the self administered glucose monitoring as long as the nurse was OK with checking Nikki’s blood sugars every hour.  Imagine being woken up every hour when you haven’t slept much in the last 2 days, you haven’t eaten in over a day, and you’re nauseous from the pain and the medications.  Oh, and they stick your finger with a needle.  Now go back to sleep!

Once again, the staff, and especially the nurses have been great. We’ve been very happy with the care on the entire 6th floor our last couple of trips here.

She did nap for a bit today.  But she’s still in a lot of pain and is nauseated. She was able to take down 1/2 a PB & J sandwich and a little bit of chicken noodle soup.  She had to stop eating the soup because she thought it “tasted like she was eating a bunch of ground pepper”.  After tasting it myself, I thought it was one of the blandest soups I’ve had in a while.