Going to the hospital is something everybody avoids, but sometimes it happens. If you are a Type 1, there is probably a better chance that it'll happen, and to make it go smoother, it helps to plan ahead.
In my case, the last few times I was in the hospital, I accidentally learned a few lessons that have made later stays easier. While your doctors and nurses will do their best for you, just like everything Type 1, some of it is up to you.
1.) Have a bag of "diabetes necessities" ready to take with you. You might think "it's a hospital, they have insulin, syringes, blood glucose testing gear, etc. They'll take care of that." Not so fast. I've had lows in an ER, an ICU, a Cardiac ICU and a regular ward. None had glucose gel/tablets, etc. Also, they might test your blood an hour before a meal, if at all. Or if you are using a pump or CGM, my hospital doesn't stock infusion sets, sensors, etc. So I have a handy bag with everything I need (minus insulin - the hospital has it) that would keep me going if I were stranded on a desert island for a week. In some ways, a hospital is like a desert island if you have Type 1. Plan accordingly.
2.) Pack another bag of "extras." Like their fashion selections? Enjoy staring at a dead smart phone? Have dreams of brushing your teeth with your finger or do you look forward to washing your hair with hospital hand soap? In that case, you are fine. Otherwise, toss some traveler sized hygiene items, a charger and maybe a book in an old, unused backpack. Add a pair of baggy sweats (big sleeves to fit over IV lines, baggy to keep from getting tangled in EKG wires, etc.) and slippers, too. Being in a hospital isn't pleasant, but adding little things of your own takes the edge off the nastiness.
3.) Don't assume that they'll figure out your BG/carb count/bolus routine. They won't know your correction factor, insulin/carb ratio, or if they did, how to do the carb count and get the bolus right. That is on you (sorry - no breaks). That is if you are lucky.
In other cases, some unknown clairvoyant genius will decree that for lunch you need XXX units of insulin. The dutiful nurse will bring it at 11:00 but your lunch tray won't show up until 1:00. You will be tempted to laugh, say "show me my BG and the carb count" - resulting in your being labled a noncompliant troublemaker. Good. That's your job- to do your best to keep your BG tight so that everything they are doing to help you get well has the best chance of working.
Ideally, work it out with the head nurse and your doctor(s) on how your diabetes will be managed. If they come to respect your knowledge and expertise in managing it, they will (often) let you handle that part of your care. Keep them informed (just like you'd expect your doctor and nurse to communicate). Ask questions (will X or Y impact my glucose?, etc.). Use your meter and strips and check your BG like you normally would. Let the nurse know the results.
If you are on a pump, all bets are off. Some endocrinologists are good with them, others less familiar. Most doctors and nurses are aware they exist, but that is about it. A Continuous Glucose Monitor? Forget it. Last week I spent two hours explaining my pump and CGM to an ICU nurse. Other ICU nurses had seen maybe 1 pump in 5 years. Doctors (and children, for that matter) often fear or mistrust things they don't understand. Guide them along with a gentle hand.
4.) Try to remember that your Type 1 Diabetes is often seen not as a disease by itself, but a complication to whatever your doctors and nurses are trying to fix. This only applies if you aren't in for Type 1 itself (most typically DKA). Having surgery? Type 1 makes healing slower, increases infection risk, is another challenge for the anesthesiologist to work with, and makes the entire experience more complex. Sometimes symptoms of hypo or hyperglycemia get confused with symptoms of other problems as well.
5.) Be a patient patient. Dealing with Type 1 gives you more insight on how your body works and how complex it can be to keep it functioning. Most other patients don't have your insights, and that is how doctors are accustomed to approaching most patients. You have a chance to be a gentle teacher, mentor, collaborator and partner in achieving success. To do that you have to earn your doctor's confidence and respect. Done thoughtfully, and with them clearly knowing that you want to achieve the best possible outcome, then you have a chance of making the experience a positive one.
Managing Type 1 Diabetes in a hospital setting is a challenge both for people with diabetes and their health care providers. Working together, they can turn that challenge into a success, but don't forget that you play an important role.
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