PIG Meeting: 18th March 2021
55 year old male for ACDF for neck and arm pain.
- Type 2 Diabetes Mellitus – recent HbA1c 10.7%. Patient variably compliant with insulin therapy
- HbA1c discussed with surgeons. Agreed to defer OT for 3 months to allow optimization. Noted that patient did not have myopathy with urgent indication for surgery.
- Patient abusive on phone when told. Hung up phone multiple times on nursing and medical staff in clinic.
- Patient also threatening GP clinic for sharing HbA1c data with Perioperative staff.
- Difficult situation.
- Patient in denial about significance of chronic disease.
- Emphasised the importance of decision made in consultation with surgical team. There may be surgical indications to perform surgery in patients not ideally optimized from the diabetic control.
- The use of a guideline written in consultation with Endocrinologists provides support for clinical decision making.
- Discussion with patient liaison officer. Requested their assistance with management of patients complaints and concerns.