Psychiatric Treatment of Hypoglycemia

At home, I awake to the cool of an open window, and snuggle into my blankets.

The hospital is overheated and I sweat a lot.

It is spring and the first sound of the day is birdsong.

On inpatient psychiatry, Unit 3-6, the windows do not open. 

I touch a finger to the electric controls of my bed and rise to look at the green—green, green—of the trees fringed in early leaves.

In the hospital I have a manually operated hospital bed.  I press the call-bell.  The head of my bed is six feet away from the intercom.  The nurse asks what I want.  I say “Bed up, please.”  She says, “I can’t hear you.”  I reply, “Then come to my room and talk to me.”  She replies, “I’m busy,” and shuts off the intercom.

This is the beginning of Unit 3-6’s discrimination on the basis of disability:  first, I am not close enough to the intercom; she says she can’t hear me.  But, oh, then she hears me, doesn’t she?  Then “she”—a faceless, nameless person who cannot be held accountable—shuts me down.  An able-bodied person can walk to the nurse’s station, can see and identify the person she’s talking to, and wait patiently and persistently until her needs are met.  I am left alone in a room with only an intercom, which they shut off.  I am out of sight and they can put me out of mind.  This is the experience of being disabled.

On the first Saturday morning, April 20, I awoke around 6:00 a.m. (night shift) knowing I was about to have a diarrhea attack and needing help to get to the bathroom.  I pushed the call bell.  The nursing station turned it off without asking what I needed.  I pushed the bell again.  Again, they turned it off.  I pushed it a third time.  A third time they turned it off.  I had a bowel movement in bed.

Driven by shame and adrenalin, I made it to the bathroom and expelled an enormous quantity of solids, liquids and gases.  I pushed the bathroom call bell.  Most accidents and crises occur in the bathroom so the bathroom call bell is always answered promptly.  R.N. Amber and (I think) Megan (probably an R.N., too) appear and ask what I need.  I say, “Clean sheets.”  They strip the bed and leave.  I know that if I don’t get flat—immediately—I’m going to fall off the commode, so I make a bee-line for the bed and drop down on the bare mattress.  The nurses have done no nursing assessment and I am too sick/confused/disoriented, etc., to know what they need to know.

Amber and companion return.  Amber asks if this is a hypoglycemia attack.  I shrug, not knowing.  She does not check my blood sugar.

On Tuesday, I had taken ten times the therapeutic dose of long-acting insulin.  Normal glucose is 100-120.  During the Tuesday-Wednesday night, on the Observation Unit, I had a hypoglycemic crisis in which my blood sugar dropped to 65.  The nurse stepped to my bedside and asked if I would eat and drink.  I nodded yes and immediately was given a cup of apple juice, a ham and cheese sandwich, and an endless supply of other food and drink.  The nurses did not leave me unattended for about an hour and did finger-sticks (blood sugar checks) every fifteen minutes until all my fingertips were punched black and blue.

On Thursday morning (the night shift) on 3-6, I woke up knowing something was terribly wrong and made a dash for the bathroom.  I was soaked in sweat, lights were flashing inside my head and my body was screaming major fucking crisis.  I had a bowel movement, pushed the call bell, and rolled off the commode onto the floor.  (Always take yourself down while you still have some control; don’t wait to fall.)

The staff came.  It probably was Amber in charge, though I didn’t know that at the time.  Finger-stick.  Blood sugar 65 again.  They bring me glycogen (?) whilst having big discussions about how I came to be on the floor.  Glycogen tastes awful.  I suck up about half the tube then ask for orange juice.  They only bring me 4 ounces.  I ask for a straw.  Then to have my head raised.  With grossly low blood sugar and flat on my back on the floor, I am directly the staff in how to care for me because they can’t figure it out themselves.  They are psychiatric nurses.

They intend to put me back to bed.  No, I say urgently, I’m going to have another bowel movement.  I am assisted back on the commode.  Here we have the entry of Matt, who later will become a major player.  He’s a “counselor,” i.e., a therapy aide, and about the size of a refrigerator only slightly taller.  He stands in front of me, we clasp forearms, matching hands to elbows, and he lifts me.  Always and in all ways, Matt lifts me.

So I poop again and then am put back to bed.  The bed is a standard psychiatric bed:  a wooden box with a foam mattress pad.  There is no place to hang my catheter bag so it is usually lying on the floor.  Instead of moving me to a hospital bed, they pile six pillows behind me and give me pretzels to eat.  They are so dry that I can’t swallow.  After the little glycogen, less juice and virtually no pretzels, they check my blood sugar again.  It has gone all the way up to 67.  The nurse starts to leave the room.  I ask her not to leave me alone.  She says, “You’re in bed, and I have sixteen other patients.”  Most people are in bed when they die.

Somehow, someway, I get more juice and another finger stick.   The nurse says my blood sugar is now 70 and, according to the protocol, I’m all right.  In forty minutes, they will come back and do another glucose check.

I am 66 years old and have multiple illnesses, including uncontrolled diabetes and kidney failure.  I have been using an electric hospital bed for fifteen years and an electric wheelchair for ten years.  Forty-two hours ago I overdosed on a long-acting insulin.  With a glucose of 70, I am now being left alone in a psychiatric bed.

The only call bell is on the other side of the room.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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