Brain Angiogram Procedures:Pre and Post While On the PUMP; I have questions

Hi all, I have been away from the DOC a few weeks; school just started and I have been really busy.

I have been seeing a new pain management specialist for my back problems and repeated consults with my neurologist for the episodic diplopia ( double vision)., tingling and leg/foot pain. lower back pain, tightness. that may or may not be associated with diabetes. The vision problem is intermittent and is not bothering me at all at this time.

Other things are, though, but I am hanging in there. I have had two MRI's in the past two weeks of the brain and the cervical area of my spine A lower back bulge of the spinal cord was found, as well as some abmormalities with the basal ganglia ( ganglion?) in my brain. My neuro says that he wants to do a brain angiogram to rule out vascular weaknesses that may cause an aneurysm ( No Brett Michaels incidents for me!!). As a result of the second MRI with the dye,he has ruled out MS as a cause for the diplopia and the pain problems.. I am assuming that the foot and leg problems are diabetic-caused in nature, but maybe so ,maybe not They come and go in severity, from very mild to so painful I have to take pills to get some sleep . and then am very groggy in the a.m., sometimes on and off fatigue throughout the day....He is concerned about the brain "abnormalities".. so I am due for an angiogram on Wednesday, September 22.

I wanted to know if anyone has gone through this procedue as a diabetic on a pump.. I understand about the catheter and the dye through the femoral artery ("ouch") and the sedation needed.. I just wanted to know how to manage it on a pump .. Do I disconnect during thisprocedure? I know I am not to eat any solid foods and only clear liquids for 8 hours prior to the procedure... but am I to go out shots and remain "untethered" for several hours after? I would prefer to stay on the pump and have my blood sugars frequently monitored, but would that be too much to ask?. Can I wear My CGM?. I will be sedated and unable to manage my own blood sugars..My neuro's medical secretary had no answers to these questions, told me to call the endo.. Just got this info about the scheduled angiogram on Friday, so I have not been able to directly contact him...

So again, Has Anybody out there in TuLand ever had an angiogram on while on a pump?.. I am beginning to think that we pump users are so rare that procedures have not been established to tell the doctors that order this test? Maybe a call to the Vascular Radiology Dept. at the hospital where it will be done will help me.. Suggestions?

l so appreciate your prayers and concern...

God Bless

Go Bucks ( OSU)


P.s. There IS some Good news Latest A1c down to 6.6, aiming for 6.0 by the end of the year. My Opthamologist, as is quite usual for the past 25 years that I have seen him., found no signs of diabetic retinopathy in my eyes at yesterday's appt.

Gosh Brunetta, I’ve not had any similar experience aside from MRI’s
I think a lot of the answers would depend on the type of equipment used,
and the expected length of the procedure. If they are putting you under for <3 hours,
I don’t think it would be worth the stress of trying to figure out what to do
For shots. Your end would have the better understanding though

You will be in my prayers, and please keep us informed! And
congrats On the eye report!

Hi Brunetta

First of all congrats on the excellent A1C!!! That’s awesome! Im sorry to hear about the pain in the back and legs. I know how frustrating that can be.
Although I have never had an angiogram, I have been present for a few dozen. Im a CRNA also known as a nurse anesthetist. Im generally the one that would provide the IV, administer the sedation, and monitor vital signs during and for a little while after the procedure.

Here’s some important things to know:

  1. You will be asked to stop taking blood thinning drugs including OTC drugs(aspirin, motrin, aleve, etc.) 48 hours before the procedure.
  2. I know you are a type 1 diabetic but if for any reason you are taking metformin or glucophage, you will be asked not to take them for 48 hours before the procedure as well.
  3. You will be asked(a million times lol) about any allergies to iodine.
  4. No contacts, glasses, earring, dentures, necklaces, hairpins, etc. are allowed. Be prepared to remove everything.
  5. You may be called a few days ahead to come in for an ekg, if you haven’t had one in a year. This depends on the doctor and the anesthetist.
  6. You already know not to eat anything after 12 the night before.

Here’s what to expect before during and after the procedure:

  1. When you get there you will need to sign a form giving permission to do the angiogram and a separate form giving permission to use the Iv contrast(you will be asked 6 more times about iodine allergies lol)
  2. The nurse will give you a gown and show you to a place where you can change.(Bring socks so your feet don’t get cold, no panty hose or nylon).
  3. After you change the nurse will take you to the procedure room, where you will lie on a flat table. This is where you will meet your anesthetist(9 times out of 10 it will be a CRNA, don’t worry we are well trained lol).
  4. You will have a blood pressure cuff placed on your arm, a pulse oximeter on your finger, and this is when the anesthetist will ask about your diabetes and any medication. Explain to he/she that you are wearing your insulin pump and cgm. I have no problem with my patients wearing an insulin pump. It helps me and it helps them, so it’s a win-win situation. The procedure doesn’t last that long, typically around an hour, so if for some strange reason your anesthetist or doctor doesn’t want you to wear it(unlikely), you can have it given back to you immediately after the procedure. The nurse will check your blood sugar before and several times after the angiogram so don’t worry! You have every right as a patient to express your concerns about your bg! You cant request to have it checked at any frequency that you want, all you have to do is ask!
  5. Next you will be given an IV, local anesthesia to numb the groin area, and that’s when you get the sedation medicine(probably Fentanyl (a narcotic) and Versed (Midazolam),a tranquilizer). You won’t remember what happens next, lol.

Just remember, that your blood sugars will be monitored and you can wear your pump. The actual procedure that you will be sedated for is only about an hour. The recovery period last 6-8 hours but you will be awake and though you won’t be allowed to check your own bg, you will be able to ask the nurse to check it as often as you would like. Most of the time, if everything goes great, you will be given something to drink and a small snack about 2 hours after the procedure(they won’t starve you lol).
Angiogram has come a long way, the biggest improvement is the iv contrast. You will feel warm all over but the nausea and other side effects rarely happen anymore. I hope this helps some and if you have anymore questions feel free to ask.
Good Luck and you will be in my prayers!

Thanks so much,Lavetta, for your quick and thorough reply… You have answered just about all of my questions You know as a CRNA you were just the right one to know all about this procedure…Thanks to God for putting you in the right place at the right time…You Go Girl!!!

God Bless,

Thanks so much for your concern Jacky, U R a jewel. I will keep you all informed as to the outcome.

God Bless,

BTW, Lavetta
This sister’s hair is in hundreds of little braids… Must we and my young 22 year old hairdresser cousin, who put them in, take them out before the procedure?..All that I had planned to do was wash my hair the day before

God Bless.

You are very welcome!!! I’m glad I could help some. God always knows just what to do and who we need : ))

BTW, Error: the of the angio gram date is September 22 , a little less than two weeks,

You wont have to take them out, trust me! lol A lot of patients worry about their hair so it’s normal to ask but it wont affect your hair!

That’s great!!! Thanks Again!!

God Bless,

Wishing you all success with the procedure.

Please be very clear with your doctors, techs & nurses that you want your pump. In addition to speaking with them, have a copy of your instructions added to your file. This may not be a problem with a procedure, but many people have to do battle while hospitalized about managing their diabetes themselves.

Great work on your A1c. Happy for your great eye report!

Best Wishes and much love to you. Please keep us posted. Love ya xo

Thanks so much Gerri and Robyn, for your encouragement and suggestions. It means a lot to me.

God Bless,

Brunetta I just got off the phone with my boss and he confirmed what I said. You can wear your pump with absolutely no problems! I’m not sure what kind of CGM you wear but that may be a problem with the MRI technology. It won’t affect the machine or your results but it could mess with your transmitter. He said Dexcom is the only one he has had experience with and the gentleman wore it on his arm. Check with your CGM company to make sure you won’t have any trouble with yours. It may not affect it at all, or if you wear it lower on your body(stomach, back, thigh) the frequency won’t reach it.

I will call Medtronics, Lavetta, about the CGM aand ask the questions. I wear the CGM on my lower sides, or on my big ol’ butt, nowhere close to my head…but I do not want to tear up the transmitter,so I will call to make sure…Thank you, sweetie, for going out of the way to get this info for me. You are an angel!!!

God Bless,

It’s no problem at all! If you need anything or anymore questions come up, feel free to ask!

Wow Lavetta - you are a breath of fresh air with all your experience. So happy that Brunetta can go in with all the knowledge you have shared with us.

Way to go Brunetta on your latest A1C!!! Keep up the good work. Sending you many ((( hugs ))) from Sackets Harbor (if you read my latest blog - I’m “marooned” in the US of A for abit - while Jenna’s Journey has her diesel tanks cleaned out ). I’m hoping to be back home in a few week, it’s a 5 day journey back by water to get to our home port - and I’m hoping the winds are kind to us (and we have no after effects of Hurricane Igor).

I read your blog ,Anna. I see you chose to get back on the pump for a while. How is it going today? You are an inspiration as a survivor of cancer as well as remaining a long-time sucessful competitor turned champion in the daily diabetes duel we all endure… I always enjoy reading your blogs, comments and discussions. Very informative and uplifting…

Stay safe!! I will keep everyone in TuLand posted on the Angiogram.

God Bless,


I was worried for you, but Lavetta eased my mind too. Good luck with your procedure; I hope the results are favorable, and congratulations on your A1c!


Hello Brunetta:

How can we help you dear lady??? Endo would be one route.

Pump & CGM companies respectively would be the other. Both companies will be able to tell you about the safety issues re: the mechanical pump aspect anyway.

Have you caught Spike aka Dave? His wife should know the answer to this one as you know… both an RN and pump user too.

Considered calling the CDE at the hospital doing this proceedure? Might be a good call…

I’ll post this around some places see if we can find you an decent answer?