Support vs Advice...I have some concerns

By Nick1962 Latest Reply 2013-01-13 06:44:34 -0600
Started 2013-01-09 11:57:49 -0600

In the past we’ve had discussions regarding what we post here on this “support” site, and when it crosses the legal/ethical boundaries between giving “support” and giving “medical advice”.

In a recent post, we made some assumptions and gave support/advice based on what turned out to be an incorrect assumption. It was a simple mistake of not knowing whether the poster’s BG numbers were mg-dl (US) or mmol-l (Canada). Many responded correctly by stating “seek medical advice”, which would have been accurate if the number posted was either mg-dl or mmol-l (although, were it mg-dl, I suspect the post would have ended zsdklrjghisajddh;ncvjah;sioas as their face hit the keyboard and passed out). Some however responded with support/advice that would have only been appropriate if it were mg-dl. An easy mistake for sure. Luckily someone picked up on the little mix-up and thankfully, things turned out OK and we learned a valuable lesson. From now on we post which it is, mg-dl or mmol-l.

Could this confusion have been avoided? Sure. Had the poster not posted anonymously, we probably would have picked up on it sooner (most of us know where everyone’s from by now, even if they’re not on our friends list). Had the poster added “mmol-l” there would have been no questions. Not the poster’s fault – heck we’ve been throwing BG numbers out without disclaimer as long as I’ve been here.

I might be making a mountain out of a mole hill, but I can’t help wonder “what if”. What if this had been a first time poster who really didn’t know any better. I know, you’re probably saying “Nick, most diabetics know this”, but that’s not the case. When I was diagnosed I was only told what “range” I should be in, and never told what to do in case of highs and lows, let alone what was considered high or low. Honestly, if on a Sunday someone told me to eat an orange if my BG was 240 (mg-dl), I would have believed them. The unfortunate thing is, more people are coming on board here with the same lack of proper medical education.

So my question is multi-part: if we (even mistakenly) supported/advised someone with high numbers to consume sugar that caused a medical emergency, what kind of liability would we put ourselves (and the site) under? Are there things we can do (aside from the already good suggestions) to prevent this in the future? Am I indeed making a mountain out of a mole hill here?

Love to hear your thoughts.

45 replies

jimLE 2013-01-10 14:02:48 -0600 Report

no you by all means aint makeing a moutain out of a mole've made a great point you pointed out newbies dont always know when they join here.then there's the ones who's been here for how ever long they been here.they dont always think of that simply because its common knoledge.but yet you did make a good point all the same.i beleave a person should post mg-dl or mmol-l in the subject,just to avoid confusin or what ever.and some way to learn is froma honest mistake.especily when no one gets hurt.

Nick1962 2013-01-10 15:32:59 -0600 Report

You know, I’ve used a drafting (drawing) program for about 20 years now. Along the line I’ve “tweaked and personalized” it to fit my habits and increase my efficiency. Even though I hunt and peck to type, my left hand plays the keyboard like a piano while my right works the mouse like the shift in a Ferrari.
Someone called me recently to assist them in learning the same. You know I couldn’t do it without actually sitting down at the computer and forcibly looking at what I’m doing. To make matters worse, all those “tweaks” I made (like assigning “C+enter” to be “copy” instead of “circle”) weren’t on their machine so I had to wrack my brain to remember all the default commands. After about an hour of zero productivity I really had to step back and examine things from a totally different perpective. Good thing I did too because one of my command “tweaks” was to assign the key “Q” to be “save” instead of “quit”. Hitting Q+enter would have seriously ruined his day.

Tony5657 2013-01-10 10:47:40 -0600 Report

Thanks Nick!!!!!!!!!! Your concern is legitimate and valuable. A huge {THANK YOU} comes from me. You're not making a mountain out of a mole hill. We don't want anyone hurt needlesly.
Tony5657 in New Braunfels, TX

Nick1962 2013-01-10 13:19:25 -0600 Report

I can’t help but think about what prompted the warning on my wife’s hairdryer “warning: do not use underwater” (and other seemingly silly warnings). Don’t know that anyone here is quite at that level, but you know someone, somewhere tried it with disastrous results.

Just Joyce
Just Joyce 2013-01-11 12:49:44 -0600 Report

Nick, common sense isn't so common any more. I am sure someone has tried that. Years ago there was a dish detergent I think it was called Sun Light had a lemon on the front of the bottle with a lemon scent. Several hundred people got sick from making lemonade out of it. Tried to sue the company and lost. Label said dish detergent. Why try to make lemonade out of it and drink it?

Set apart
Set apart 2013-01-10 05:51:36 -0600 Report

Nick you're so right I've learned so much on DC, but as I remember when diagnosed two days later finding DC I didn't even know what the acronymn BG stood for! There's so much with D that you have to learn and are constantly learning! I believe like you most of us here offer guidance based on experiences, but there are so many issues where we do have to go to our medical team!

Nick1962 2013-01-10 13:40:51 -0600 Report

Yup, I agree. I guess my personal lesson here was even though I might be "experienced", that doesn't necessarily make me "qualified".

MAYS 2013-01-09 21:30:35 -0600 Report

Knowing that there are other systems of measurement used throughout the world and knowing that a blood glucose level og 20 (usa standards) would render a state of confusion on an individual prompted me to ask the poster where was she located, in order to help someone (in life) we must ask questions as well as go by what is being given to us first hand.

I am glad to see that the young lady is doing well after her ordeal.

In the past i have posted the conversion chart for universal and u.s. measurements of blood glucose levels for reference, as well as many other charts and tid bots of information that i assume will be helpful at some point and time.
There is so much to learn and no one has all of the answers but we try to help one another, and that is all that we can do!

Once again, this is a great and much needed discussion, thanks for posting this.

jayabee52 2013-01-09 22:46:35 -0600 Report

Yes I agree Mays.

However if she was at a 20 mg/dl it would not be the time to play "20 questions" it would be the time to take action. And that is what many of the early posters, including me, thought. This discussion and that discussion has awakened me to the need to be more careful and to ask more questions before sounding off about a particular Blood Glucose (BG) reading.

MAYS 2013-01-10 07:09:12 -0600 Report

James, I understand your point, but in any situation instead of "20 questions" we might want to reduce that number to "10" or "5" to clarify the situation somewhat…LoL.
This has been a learning experience for everyone involved, there is no reason for anyone to feel ashamed, we may not be medical professionals but our compassion as humans kicks in at times and we can't help wanting to help others.
Collectively (as a group) we may guide one person in the right direction, save one life, or help to make someone's life a little easier, and that is what helping others is all about!
There is hope for us after all, as humans!…Lol.

Just Joyce
Just Joyce 2013-01-11 13:08:51 -0600 Report

While I agree with you and James, instead of playing 20 questions which is what I hate, why not ask one question. Have you contacted your doctor? Saves time and makes the person responsible for his/her health care.

Nick1962 2013-01-10 14:00:45 -0600 Report

I'll agree, I think all of us here are somewhat "wired to assist" - else why would we be here.
It also seems to be kind of a “rotating” membership – the old timers teach the newbies, and the newbies step up. Since this whole social networking/support thing is fairly young when you look at the diabetic community (and us older folks), it will go through an evolution of sorts. I guess the whole point of my post was to maybe find ways the evolution stays on the right track.

GabbyPA 2013-01-09 20:09:30 -0600 Report

When I first started coming here in 08, I did a lot of that. I didn't know very much and made similar assumptions. Thankfully there are knowledgeable folks here that can usually stem the tide. But it is true. In the discussions we are not experts and cannot be viewed as such. We are sharing our opinions and experiences and I suppose finding a way to make that more clear might help.

Asking questions of the poster can be a vital part of that process. Hopefully they are active in the discussion to answer what questions are asked.

Nick1962 2013-01-09 20:21:50 -0600 Report

Yeah, I have learned to step back and make sure I have the right info first. And I like the use of your word "active" there. So often I see what I call "drive-by's" - folks just looking to confirm or deny what they've been told. Fortunately though, sometimes it opens up dialogue between us here and ends up a learning experience in the long run.

Just Joyce
Just Joyce 2013-01-09 19:04:10 -0600 Report

Nick I don't think you are making a mountain out of a mole hill. You have valid points. The response the person got was based on the fact information was left out. This is what happens when people want help but fail to give all information. Suppose this person was in this country and called an Emergency Room and left out the fact they were Canadian. They would have treated the call as an emergency only to learn the person was high instead of low. Which is why medical advice should not be given on this site. But that is my opinion.

Nick1962 2013-01-09 20:16:17 -0600 Report

Luckily Joyce, in this case, US or Canadian, the number was way out of whack either way and deemed medical attention. I don't mind saying i had a little panic attack when I first read it thinking "20? No way the poster is going to be concious to read any replies".
Like Mays aptly said though, it's a fine line between support and medical advice, and often the reciever determines which it is.
Slightly off topic, but related, even the lines get crossed n the medical community. I had to get some spinal steroid shots. On all the forms, and during each visit with the ortho, diabetes comes up because steroids are known to cause high numbers. Well, I tough out 3 different spinal injections, and each time, after the procedure (with the same doctor and assistant) the assistant offers me 2 hershey's kisses, which I promtly put back on the counter saying I'm T2. Funny thing was the elderly volunteer in aftercare remembered very clearly about our discussions about alcohol swabs, proper hand washing and drying and discounting the first drop of blood and the effect on numbers these have.

Just Joyce
Just Joyce 2013-01-11 13:05:40 -0600 Report

Nick I didn't come close to a twitch of a panic attack. I was wondering why not CALL THE DOCTOR? Not everyone knows what to do. However, in the time it takes to boot up your computer, type your question then wait for a response, you could have contacted the doctor.

The other night I was in Pogo in my favorite room playing with my favorite group of people. One of the players said she had just finished a bottle of wine to celebrate her birthday. She had been drinking the wine on and off all day. About an hour later another player came in to join us. The woman drinking the wine said she had been hyper for the past week and was having trouble sleeping. The person just joining us said take to benedryl tonight before bed and it will help you sleep. I said DO NOT do that as did a nurse in the room. We told the woman who told her to do this that our friend had been drinking wine. The nurse explained what would happen if she took the benedryl and told the woman who told her to take it that she has seen her give out medical advice that could possibly harm people and to stop doing that. In the mean time the nurse said she gets the person in private chat and tells them what to do.

This is why I only follow the medical advice my doctor gives me. I learned the hard way that juice will cause my blood sugar to rise too fast and too high so if I asked what to do about lows on this site, the typical response would be to drink juice. No one knows a persons medications, dosage or other medical problems so this is why medical advice should never be given.

Nick1962 2013-01-11 13:29:28 -0600 Report

Well, to cut the poster some slack, it was 6:00 on a sunday night, and chances are they weren't feeling the high. But you're right, a call to the ER would have been more appropriate. Another lesson learned.

MAYS 2013-01-09 18:50:39 -0600 Report

Such a great topic, and here are my thoughts, hmmm…
I believe that there is a very thin line between support and advice!

That should be determined by the person receiving such information, there is a little bit of both within one another and caution should be taken so that one isn't mislead by either.
Discussing what is said and written with your doctor(s) and/or medical team is beneficial to your health, a little research won't hurt, after all no matter what advice, or support is given unto you, "YOU" are responsible for your health and well being!

Questions can be asked, and answers given but remember this, most people won't ask a question if they know the answer to it, and "Yes" people do come here to this site for advice and support, treating them with courtesy and respect should be a requirement, after all "No one" here knows everything, and we all can learn something about anyhing / everything!


Nick1962 2013-01-09 19:48:40 -0600 Report

Can't disagree with that. But underneath your response, do i hear you telling me basically "poster beware" and that anyone looking for advice here should be aware that what they get may not be accurate or even possibly unhealthy? I guess that would ease my mind a bit regarding liability issues and maybe I should relax a bit.

MAYS 2013-01-09 21:13:05 -0600 Report

Nick, I just believe that a person has a responsibility to themselves to ask questions of, and to do a little research themselves based on the information that they are seeking as well as being given…no one is more resposible for "self" than themself!
Maybe (to be on the safe side when posting) we should state that " We are not medical professionals, and/or in my opinion " prior to posting a discussion or comment…we must protect ourselves so "poster beware" may be needed as well as "reader beware" or at least "do your research"…all in all this is such a wonderful site and concept.
It's always better to be safe than sorry, or at least it should be!…You can relax

GabbyPA 2013-01-09 20:12:06 -0600 Report

The expert advice would come from our "ask the expert" section. The discussions should never be seen as expert advice, but the sharing of experience and opinion. You are right though, we who are posting need to make sure we are reading carefully what the original post is about and ask for fill in questions.

Nick1962 2013-01-09 20:24:34 -0600 Report

Ya know, until recently I didn't even know there was an "ask the expert" section. I'm sure like a lot of folks I came here looking for only what I wanted to find and discounted the rest.

GabbyPA 2013-01-09 20:27:42 -0600 Report

True for many. There are a lot of great things offered here. And with the new changes coming, I am sure there will be even more. Explore. There is much to be discovered.

roxiekb 2013-01-09 12:34:58 -0600 Report

I believe in talking to my doctor or dietician for advice if I have any questions regarding my numbers. You definitely do not want to eat an orange if your sugar reading is 240. I only do that when I am below 86 which seems to be my do something low number but everyone is different and should seek advice from their medical team. I also did a lot of reading on internet and books and completely new cookbooks. Out with the old and in with the new. Education on this disease is the best course.

Just Joyce
Just Joyce 2013-01-09 19:06:20 -0600 Report

Roxie I totally agree with you. The problem is some people will not educate themselves. They find it easier to ask someone else. If you have health insurance, Medicare, Medicaid or pay out of pocket, why not ask your doctor for medical advice. They are being paid to help you.

Nick1962 2013-01-09 18:27:41 -0600 Report

I fully agree that education is necessary, and preferably from qualified medical professionals. What scares me though is that because of the internet, we here at DC have at times become the first place many look for that education. Not that its a bad thing, but like the example in my post here, i think there's some potential for something bad to happen.

Just Joyce
Just Joyce 2013-01-09 19:01:11 -0600 Report

Nick that scares me also. People look to the internet for cures for acute problems when they should be talking to their doctors. In fact a doctor should be consulted for all medical advice. What scares me is that someone is going to tell someone to do something and the person is going to be harmed. People should never give medical advice for several reasons:

A. They are not a medical doctor
B. They don't know the persons medical history
C. They don't know what medications the person takes or how it will react to OTC medications or supplements
D. They don't know if the person is telling the truth or is even accurate
E. Someone is going to get harmed or will die

People simply don't get the what works for me may not work for you at all concept.

Nick1962 2013-01-09 19:59:32 -0600 Report

Joyce, I recently had to "investigate" the cause of a ceiling collapse in a school. Luckily it happened over a break period and no one was in the school, but as it turns out the ceiling was installed by well-meaning parents, all of them talented, but none had any construction training beyond do-it-yourself TV. The instructions on the packaging for the ceiling (that ugly 2 foot by 2 foot tile and grid stuff) never addressed how many lights were allowed in the system or even that the system had to be screwed and hung from structural members.
I know it's not just us here at DC, and that's exactly how things like building codes get developed - someone gets injured first. I'm worried we (well, and social media in general) are starting to get to that point where we need to adopt some form of "codes" or risk injuring someone through our own inexperience.

Just Joyce
Just Joyce 2013-01-09 22:31:22 -0600 Report

Nick where I use to work a bannister broke and a woman fell and severely broke her arm. The Chief Operating Officer couldn't figure out why the maintenance guy kept screwing it in and the screws kept popping off. I said because there is no stud to screw to because the studs are not centered properly. She didn't believe me till a professional told her they had to put the studs in correctly. She asked me how I knew. I said because my father worked in construction his entire life and taught us how buildings were built.

I agree social media is the culprit and people need to be careful about what they are asking and the responses they get.