A lot of patients in outpatient neuro are diabetic. It's not surprising because a lot of them are here because of stroke. And most common causes of stroke are all the cardiac risk factors such as hypertension, obesity, sedentary lifestyle, etc.
So what I want to say... to myself, is that watch your patients' response to exercise very carefully.
Like the patient I worked with today, he is diabetic, had a stroke, doesn't eat breakfast, doesn't monitor his blood sugar very well, really needs extra attention everytime when exercising him.
His vitals were all fine coming in, and all fine after circuit training. He did look a little tired, but he gets tired pretty easily, and complained about mild headache. I knew he only ate a little before he came here, so I asked if he wanted to eat some snacks. He said he had snacks in his bag. He said no, he is fine.
So we moved on to balance training; and then he started feeling lightheaded, blacking out during balance training. My CI was very assertive. Made him sit down, gave him orange juice and cookies, and told him "please eat that for me." Took his blood sugar afterwards to make sure he is fine. Ended the session early.
There were so many signs and symptoms indicating pt might have low blood sugar. I didn't take any actions because patient said he was fine and wanted to continue. Here shows why clinical judgement is important and we can't always believe what patients tell us.
Learned a lesson.
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