Friday, November 27, 2009

Recap: Virtual Endo Consult

Originally posted December it is again, for your viewing pleasure. Especially relevant after a humongous T-Day meal.

Press "1" if you're experiencing a health question or concern.

Press "2" if you'd like to speak with a nurse(sometime in the next month.)

Press "3" if you'd like to schedule an appointment.

1. Hello, this is your virtual endo speaking, how can I help you today?

-My blood sugars are whacky.(A)

-I have another D concern.(B)

-I'd like to know the results of my latest & greatest
a1c test(C)

-I'm bored, and I just wanted to know if you would
tell me again if avoidance of that box of KK donuts
will absolutely add another 5 minutes to my life or
if I just go ahead and live it up.(D)

-How much is this consult going to cost me??(E)

2. You have reached the message box of EMT-B Heidi.Please leave your name,email,and credit card number + we'll get back to you asap.Thank you.Sorry if you expected to reach a real doctor,that ain't happening. But if it makes you feel better,someday I will be a nurse,if you plan on sticking around that long.

A. Press (!) if you're over 600 mg/dl
Press :-((((( if you're under 40 mg/dl
Press :) if you're perfect
B. Choose your concern:
A1. Complications
B1.Insurance Woes
C1.My Neighbors Cat
D1.Everything else.

C. ER, yes. Ok, now enter your Medic Alert number...

D.Dude, KK is ALWAYS worth it.That's not the ADA line,but its what you wanted to hear,right? So go ahead and bolus well,don't let D dictate your life.Just remember,all things in moderation.

E. It all depends.So far,$10 per word,or a measily $2000+. Keep reading.

(!) So you're high.Wayyy too high,as you well know.How long have you been this way?
!1 under 2 hours
!2 2:4 hours
!3 4 + hours

!1Check ketones..troubleshoot pump.Take injection immeadiently.Recheck ketones+ bg, in a couple hours.
Drink tons of fluids.

What are you now?
J1moderate ketones,250 mg/dl
J2trace ketones, 200 mg/dl
J3moderate ketones,300 mg/dl

J1 You're not out of the woods yet.Keep drinking fluids,sugared as well as plain,to replenish calories.Take additional boluses,as needed.

J2 You're fine. I don't care if your stomach is throbbing fit to beat the band,ketones are nasty little buggers + thats to be expected.You're out immenant danger. Plus,you probably just have a little stomach virus.(its always a stomach virus!)Nothing for us to waste our valuable time over.

J3 Take more insulin.NOW. Go back to !1

!2 Repeat J1,call if bg not coming down.
!3 Go to the ER(if ketones not coming down).That's assuming you're still conscious.

A1-B1. Worried about complications,yes,we feel your pain.America is eating itself to death,T2 and T1 is on the rise,and many people can't even afford basic meds.
Keep your chin up,and do the best you can, that's all we can say.

C1 So,your neighbors cat does its business all over your front bushes?It very likely may have diabetes.See if you can get a dipstick reading off it..and if its positive,you have your answer right there.

2C- 00000000000001
Your latest a1c was 7.6 Keep it up,you'll get there.

D1 I wasn't aware there were any,thought I'd covered it pretty well. Press "3" to schedule an appointment,we should obviously talk about this.

#3 Ok, you wish to make an appointment. How soon?
O.Sometime in the next week
W.SOmetime in the next month

N.You're in luck!we have an appointment for you in 10 minutes.Would you like to accept this appointment?
Y or N
Yes-I can make it
No-That isn't enough time to get out of the house,much less to your office.

O. Sorry,nothing available.Switching to W...

W. Thank you, your appointment is scheduled for Dec.24 at 4:45 PM.Have a nice day,and we look forward to serving you!

A:-(((( Eat, eat,and eat.Call us back when you're able to hold a rational conversation(assuming hypos don't resolve) You should really reduce your basals by 0.2 h/hr and your bolus ratios to 1/20. And no, you're not having a second honeymoon.Nor are you turning into another Halle Berry.You're a type 1,and there's obviously a reason for this.

A:) Perfect, huh?Enjoy it while it lasts,because it won't. Please press "2" if you wish to share with the medical community your secrets for a persistantly euroglycemic state.We're all dying to know.

See,there's nothing to be an endo..very predictable.I know what they're going to say before they say it.I know what they should say&don't and vice versa.Even when you're down(bg wise)you're not really "down."(ketones)But its ceased to be a concern,since your bg is now fine..

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