Fasting blood sugar test and ‘rude’ laboratory staff

Iren and her mum, Mrs. Asahde, hurried up the stairs quickly. She glanced at her watch and exclaimed, “Wow. 9:45! We are so late! I hope they will attend to us.”

“Ah! They better attend to us o. We shouldn’t do all this wahala for nothing. At least, we have a good reason for being late.” her mum responded.

They met the laboratory attendant as soon as they got in. “Good morning sir. I’m here for a test.” Iren said, stretching out the request form to the laboratory attendant.

He collected the form and looked at it. ‘Investigation required: Fasting blood sugar.’ He shook his head. “I’m sorry but you can’t run this test anymore today. You’ll have to come back tomorrow or at another time that is convenient for you.”

“Why?” Iren asked.

“Because it’s a fasting test, and it’s past the time for it. We don’t take any fasting samples after 8 a.m.”

“But I still haven’t eaten anything. As a matter of fact, I haven’t eaten since 6 p.m. yesterday so there’s no big deal.”

“You haven’t eaten for almost 16 hours. That even makes it worse.”

“Hmmm.” Iren sighed dejectedly.

Mrs. Asahde who had been quiet since they got there spoke up. “Young man, let me explain the whole thing. You see it isn’t our fault that we are late. We are coming from Saki town which is two hours away, and our car broke down along the way. We set out since 5 a.m. so that we could be here for 7a.m. run the test, and then see the doctor at the 2 p.m. clinic. She’s going for surgery soon and the test is part of the requirements.”

“I’m sorry ma but ko le work.”

“I beg your pardon?”

“Oh, please forgive my manners. I often forget that not everyone understands my language.” he said with a slight smile. “I mean it can’t work. Those are the rules. No fasting samples are taken after 8 a.m.”

“Ok. It’s alright. Let’s go mum. We’ll explain to the doctor.” Iren said.

But Mrs. Asahde was not having any of that.

“Na wa o! Don’t you even have the milk of human kindness?!” she blurted out. “With all I’ve explained, you are still saying you can’t. If we even check well, I’m old enough to be your mother. So you mean to tell me that if your mother was standing here you will be telling her this story about rules? Can’t you even consider us for the stress we’ve been through?”

The young man was taken aback. “Ummh, I’m sorry for all that, ma, but that is the rule…”

“Heeeeeeee! Children of nowadays!…” Mrs. Asahde shouted as loud as she could, turning to face the people behind them. “…especially all these hospital workers. They are just so inconsiderate and rude. If not for condition would I be here? Nonsense! My God will judge you.”

Iren was highly embarrassed and just wished she could disappear. Or that the floor would open up and swallow her. She tried dragging her mum away but she wouldn’t budge. In less than five minutes, the area was crowded. Mrs. Asahde sure knew how to pull a crowd.

“Please excuse me madam. I need to attend to the next person.” the lab attendant said, trying to remain calm.

“Can you see that?! Can you see what I’m saying? Did you hear what he just said to me? You’re very rude young man! Very rude!”

“Don’t mind them. That is how they behave! Very uncaring people.” someone said from one end of the waiting room.

“Don’t waste your time. Just report him to SERVICOM for wrong behaviour so that he’ll learn a lesson.” another person yelled.

A middle-aged man with a dimple in each cheek walked toward them. He flashed a set of brilliant white teeth as he spoke, “I’m the head of the laboratory. What seems to be the problem, madam?”

“Ehen! Thank God. I’ve been explaining to this young man that we need this test today but he said we are late and he’s giving me attitude.”

“Well, so sorry for that madam but if I understand correctly, you are almost two hours late for a fasting blood sugar test right?”

“Yes. But that is why we were pleading with him to assist us.”

“This is pleading? Interesting. Well, the truth is that it is not his fault; the test isn’t done after more than twelve hours of fasting because the results may not be accurate after that.”

“I don’t understand you.” Mrs. Asahde said.

“This is the way it goes. When you eat, the food gets broken down into its smallest constituents and released into the blood. Carbohydrates are broken into sugars, proteins into amino acids and so on. So soon after eating, your blood sugar levels rise. But it is dangerous for the blood sugar to remain perpetually high, and the body can’t use all that sugar at once so it has to save for the rainy day. Therefore, under normal circumstances, the body should release a hormone called insulin that would drive that sugar into the body’s cells and store them. This would make the blood sugar levels return to a normal range after a while. Are we together so far?”

“Yes.” Mrs. Asahde nodded.

“Cool. When someone is asked to do a fasting glucose test, it is to estimate how well the body is producing insulin, and also if the body’s cells are responding to it. If the body is not producing enough insulin, the person may have type 1 diabetes. And if the body is not responding well, the person could have type 2 diabetes or be on the way to developing it.”

He paused for a bit and then continued. “So how does this correlate with the fact that you can’t do your test now? There is a range in which the blood sugar level be. If it goes below that, someone can go into a coma, and even die. So if you haven’t eaten for a long time, another set of hormones go to the body’s stores to get glucose back into the bloodstream to maintain that level. These harvesting hormones are what makes it possible to fast for a day or even days at a time. So if you’ve been fasting for more than eight to ten hours, when you run a fasting blood sugar test, those hormones would have caused your blood sugar levels to be higher than what it should be for a fasting test. Your doctor could then wrongly think you are diabetic or pre-diabetic.”

“Ohhhh.”

“And for those that are already diabetic, and on treatment, it could make your doctor wrongly think that the dose of the drug you are using is not enough. Then they increase the dose which could cause the blood sugar too low. And that is very dangerous. So that is why we wouldn’t be able to run your fasting test now.”

“I see.” Mrs. Asahde nodded. “Thank you very much for this explanation. That young man should have just told us this in the first place instead of just saying rules, rules, and rules. Please teach all these small children so they will know how to handle things like this.

Iren glanced at the laboratory attendant when her mum said that. He was fuming.

“I understand you, madam, but sometimes there just isn’t enough time to explain to everyone.” the head of the laboratory said in his defense.

“Mummy, just apologize to him and let us go.” Iren said.

“No be only apologize. If he knew his onions would we have gotten to this point? C’mon, let’s go jare.”

Iren rolled her eyes. ‘I’m so sorry.’ she mouthed to the attendant behind her mum’s back. She was sure glad they were leaving the scene.

Lexicon

*do all this wahala – pidgin phrase meaning ‘go through this stress’.

*SERVICOM – A unit responsible for reviewing service delivery in government institutions of Nigeria.

*No be only apologize – pidgin phrase loosely translated as ‘I see no reason to apologize.’