Health Scare - Why We Have To Be Better-Educated than Dr's (x-post)

 I'm a VSGer, but wanted to share this here since my mom had had R&Y. She's doing much better now compared to when I originally posted this...but it's been a trying weekend, & could have been prevented had her doctors been better informed...

My mom is fine right now, spending the night in the hospital for observation, but the reason she’s there in the first place is why I’m sharing this. Once the ER doctor found out my mom was diabetic and post-RnY, he called an endocrinologist. My dad knows my mom’s whole medical history. It turns out about 2 months ago, her endocrinologist prescribed a new medication while taking her off the metformin. She told me the name of the med, which I believe is pronounced Buterin but I’m not 100% on it. It is an extended release injection to aid weight loss. How many red flags are there for you in that sentence? My dad got past telling me ‘extended release’ and I freaked out. Well, Mom had lab work done 2 weeks ago, and her A1C was double the normal level, so her PCP put her on Humalog (insulin) twice a day. The ER endo told my father that the Humalog was depressing her blood sugar levels because the amount prescribed was too much, and the extended release med from the old endo was keeping her from eating what she should have been eating. So she wasn’t eating enough to maintain normal blood sugar levels because she had no appetite, and the Humalog was depressing her ‘normal’ sugar levels – but they were just looking at the A1C’s.

My mom’s a smart lady, but her mistake was trusting two doctors who both know she had surgery but are poorly informed about her surgery. The PCP has been her doctor for nearly 50 years, and her former endo has a reputation as a pill-pusher. The ER endo (who she asked to be her new endo, and they did the paperwork to make it happen) has told her that the first order of business is to get her blood sugar stabilized, and next is to have her meet with the entire bariatric team to get a medical plan. My mom’s been compliant with her post-op bariatric plan except for the exercise component. She didn’t feel comfortable with the old endo after he took her off metformin, and had called her bariatric surgeon to tell her of the concerns. Turns out, my mom was smack dab in the middle of a referral process to get a new endo, but this scare expedited it. She trusted her instinct in asking for a new endo, but she trusted both the old one and the PCP and it could have honestly killed her today.

It’s a sobering thought. I know I have always made it a point to make sure that my doctors all have copies of every blood panel or test I get, and for someone with a fear of needles, I’m neurotically obsessive with getting my labs and making sure the levels are right where they should be. My mom’s been like that, too, but one little slip…one instance of trusting two doctors over her gut, was almost fatal. Please, please, please, remember that we know our bodies better than our doctors ever will. Even though they’ve gone to med school for decades to be good at what they do, it is still our job to be the best-educated on what goes into our bodies. I am so glad my mom is refusing to see her old endo and that her surgeon’s office is aware that he was (in my opinion) negligent in my mother’s care (OMG, extended release, I am STILL baffled by the fact that he’d think that was a good idea for someone whose stomach is the size of an egg). I’m even more glad that I still get to take her for her birthday lunch next week, and she’s here to celebrate her next birthday.

Ummmmm............. Insulin can be long term extended release.  I am on lantus and that last 24 hrs. with a peak of 12 hrs.  Different medications act differently in different individuals and many different reactions can happen.  We take a chance everytime we take something new and sometimes we can have reactions on something that we have taken in the past.  This goes for anybody with or without WLS.   Diabetes can be very difficult to treat and as we age it can get more difficult.

I sorry that your mom had a bad reaction.  Hopefully, the docs can assist with good management of her diabetes.

Nobody was testing her blood glucose levels as she started insulin on a daily basis if not more frequently?

I'm betting this injectable is Byetta. Its for diabetes and it does aid weight loss. But the surgery interrupts the hormone signals involving the gut which is why a lot of people can discontinue their diabetes medicines shortly after surgery.

I'm on it and can't imagine being on it after surgery because it really packs a wallop. I'm not even sure that you can be on insulin and Byetta at the same time. There is a similar injectible medicine that you definitely can't be on.

When she was not eating and still taking insulin--wasn't anybody monitoring her blood sugars? At least once a day? Didn't anybody warn her about this? She should have had at least one training session with a CDE- a certified diabetes educator to learn how to us insulin and what to do when you are sick, not eating, exercising, etc.

Your right byetta and insulin is not use together.  Another injection symlyn, which is very similar to byetta is use with people that used insulin...........and there is another that starts with a V but I can't remember the name right now.

Victoza.

The pharmacists at my Wal-Mart were very careful to make sure I was not on insulin before they handed over the Victoza the first time. Asked me more than once. I always get them filled at the same place.

If she has been going to the same pharmacy--or even the same pharmacy chain--their computer should have caught it even if the docs and the pharmacists missed it.

If on an electronic record (the same system) that system should not have let the second prescription go through either. Both hospital systems have a full copy of my presciptions and over the counter meds in their systems including vitamins etc.

I have multiple safeguards. What went wrong here so it can be avoided in the future?

I'm so glad your mother is doing so much better.