Patients often assume their caregivers have told them everything they need to know about their illness or condition and what the patient needs to do to properly manage the condition in the future. Caregivers often assume some other caregiver has already told patients everything they need to know. Such assumptions can leave patients without important information and lead caregivers to mistakenly label patients non-compliant! (A label I detest, by the way!)
I cannot count the number of patients with diabetes who have lived with high blood sugar levels for many years because they've never been given the knowledge or tools to achieve good diabetes self-management. One patient, for example, told me he took his long-acting insulin only when his blood sugar was high. I explained to the patient that if his blood sugar was not high, it was because he took his long-acting insulin! No one had ever asked him how he took his insulin, so he didn't realize he was doing it wrong. (By the way, long-acting insulin that is taken once a day should be taken at the same time every day, and the amount should remain the same day after day regardless of the blood sugar level, unless the physician changes the daily dose.)
When I ask patients how they treat low blood sugar, they often describe to me a treatment that is far from ideal. For example, some patients treat low blood sugar with peanut butter. When blood sugar is low (below 70) it must be treated with a FAST-acting carbohydrate. That means a food that contains no protein or fat to slow down digestion. Peanut butter is mostly fat and protein, so it is a poor choice when quick action is needed. However, once the blood sugar is recovered and is above 70, peanut butter makes a great snack to help stabilize blood sugar. The point here is that patients often don't know what they don't know. They don't know they are doing something that either hampers their blood sugar management or might even be downright dangerous.
So what is the solution? If you are in the hospital, take advantage of the experts! If you have conditions such as diabetes, kidney disease, chronic digestive problems or morbid obesity, ask to see a dietician. You can describe your diet to that expert and ask if what you are doing is the optimal approach. If you have diabetes, ask to see a certified diabetes educator. Not every hospital has one, but if your hospital has a diabetes educator, you can describe your self-management routine to that expert and make sure you are doing the right thing and that you haven't created any inappropriate habits due to lack of information or a misunderstanding. If you have had a heart attack, ask to speak to a cardiac rehab nurse. Other experts in the hospital include the physical therapist, occupational therapist, speech therapist, pharmacist, and social worker. There is no charge for their services, and they can answer your questions and teach you what you need to know to carry on safely at home after discharge.
As I mentioned earlier, patients often don't know what they don't know. A good approach is to simply ask your nurse and other experts, "What do I need to know about this illness/condition/disease? How can I best care for myself and avoid a return trip to the emergency room?" Caregivers love to answer questions, and they enjoy teaching patients, so don't be stingy with your questions! Let your caregivers, and especially the experts, help you get smarter so you can be safer!
