Pool_1

"Case 104800," Blake had his head down shaking disapproval, but not for the last remarks, but what he knew would follow. The gallery sensed that and muted. Doctor Katherine Mulvaney stood up and began with, "They killed her. Those bastards killed her. You want me to sugar it, Milty?" The case number didn't add any mystery, everybody knew at least something of this one, but the floor was the floor and M&M was M&M. Process took over. "Hmmmmnnnghhh. This beautiful eight year old female," Mulvaney blinked hard stiffening into the ritual as a family photo of a beaming and vibrant young girl was projected, "was first diagnosed with juvenile diabetes ten months ago. "She was admitted here in coma in ketoacidosis heralding the onset of her diabetes. She was quickly stabilized, under control, and lucid within one hour of admission. Her provider," which was obviously, again, Amerimed though not named, "denied her admission here and demanded transfer to Bethdale General." A group groan was allowed do play itself out. We offered our diabetic nurse educators as there are no endocrine services, let alone pediatric endocrine, at Bethdale. A call from a floor secretary there asked what insulin sliding scale she was to go home on, based on our two hours of contact with her." More collective groaning made further presentation impossible until it was settled by Blake. "She was, of course, initially on her honeymoon," medical jargon for the more forgiving diabetic state seen shortly after it first presents and which may be abruptly followed by difficult control. The implication was that things as seen shortly after onset are at their best and may well worsen. The signs and symptoms of change need to be recognized and dealt with. Medication needs, specifically insulin types, dosages and schedules, vary and counter measures will have to be taken by family or even school