Our Lady of Georgetown

Our mission trip to the Georgetown clinic was the first of the week. Similar to last year, the Georgetown clinic was very, very busy. Many people had been there from an early hour and were waiting their turns to be seen by our team and the district doctor.{{more}} Everything flowed smoothly, and near the end of the morning a woman was brought in by one of our local colleagues.

“Emergency here, doc,” he said, “blood sugar of 32!”

Seeing the woman being unsteady on her feet, we began scrambling for some glucose tablets to give her, thinking her to have a low blood sugar. Thankfully, something stopped me before we gave her any glucose tablets, and I asked, “32 low blood sugar?”

“No” came the reply,” 32 HIGH.” Then I realized the reading had been given to me in mMol/dL, which is the unit of measurement used on most meters in St. Vincent and the Grenadines. I was used to another measure, the mg/dL used in the United States. When you convert from one to another, a conversion factor of 18 has to be used. So, this woman, instead, had a very high blood sugar, which converted to 576mg/dL in units to which I was accustomed. 576!!!!

Needless to say, she was NOT given any glucose tablets! Instead she received a dose of insulin right away and was given lots of water to drink while we examined her and spoke with her family. As it turned out, this woman swore she had been taking her diabetes tablets, but when I searched through her records it seemed she was in the hospital every month for high blood sugars. I asked her to tell me the absolute truth, if she was taking the pills or not. She said she was. Then, I replied to her, they are not working and you need to be treated with insulin instead.

This is where the melee broke out…

“INSULIN???No, I can’t tek no insulin!!!”

I spoke with her daughter who again said “no, she can’t tek no insulin!”

I kept asking, “why not?” and all I kept being told was “no, I can’t tek no insulin” or some variation of that statement. When I kept asking, finally, an answer came from the woman: “I don’t want to give myself any shot and I don’t want my daughter giving me any either.” However, she would take the shot from a nurse.

This was most distressing to me. Let me tell you something. please listen, everyone: ANYBODY WITH WORKING HANDS AND DECENT VISION CAN GIVE THEMSELVES AN INSULIN SHOT. Even small children with diabetes give themselves shots. All you need is to learn the proper way, THEN JUST DO IT. I am tremendously grateful to all of the community nurses in St.Vincent and the Grenadines who act as good neighbors and actually swing by someone’s house to give those people insulin. BUT, all of you patients need to take responsibility and do it YOURSELVES. If you learn, then the medication can be given at the same time every day, and you will not have to go to the clinic to receive it, or wait for someone to come to your house. This is part of your taking control of your health.

So, stop backing away and step up to your responsibilities. Learn to give yourselves your own insulin, please.

Until next week, stay safe and healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com

Medical Director Endocrine Care Group

www.endocrinehelp.com

Tel: 843-798-4227