I have had several surgeries in the past few years and brought my continuous glucose monitor (CGM) into the operating room with me. I’m never really certain if it gets looked at or not, but now with the technology of being able to “share” data, at least I know a loved one is able to see my blood sugar and perhaps tackle someone if I hit a 60!
I thought this blog post was an interesting perspective on how much a surgeon DID rely on Ryan’s CGM…
Does anyone have any blood sugar/surgery stories or insights?!
Before my daughter’s most recent major orthopedic surgery, I met with her anesthesiologist and discussed her Dexcom CGM system at great length. He agreed to be in constant communication with me via telephone throughout her surgery, and followed my instructions on what to do based on her at-the-moment BG. I’ve heard many more stories of not-so-great experiences from other parents, however. I suspect that the anesthesiologist was willing to agree to our particular arrangement because I am also a physician and have had training in anesthesiology, so we were able to “speak the same language.” I was pleasantly surprised when the anesthesiologist came around a few more times during my daughter’s hospitalization because he was fascinated by and wanted to learn more about her diabetes “tech” (her pump, CGM) and he even printed up some medical articles for me to read that he thought I would find interesting.
I remove it or at least turn it off. I do a verbal hand off to the anesthesiologist. I remind her I am a type 1, I show the attached devices and tell them from the tieI go under, that they have the control. I remind them I want it well controlled. I say I have faith, but I expect them to manage blood sugar at least as good as I do.
I have found the same thing… More often than not, the OR/ER crew are always fascinated with the technology and want to learn more. In my mind, ORs should have giant display screens to monitor bgs at all times!
I know I am in great hands, but I still get nervous every time I go under! I worry they will forget I have diabetes. Once, they let me write it on my forehead! Lol!
The only thing I have had done where I was sedated recently since D was a colonoscopy. They had never seen a dexcom and they were interested but since the procedure was only about 15 minutes they didn’t use it at all. I can’t remember what I did with it during, if I took off the receiver or not, I think they put it somewhere for me and gave it back to me when I came to. I had nurses/anesthesiologists monitoring me and checked my bg before etc. so all went well. I let my bg run high for the procedure. The prep was a true nightmare and I’m not sure how I made it through that.
Once after I woke up during a cardiac catheterization in deep pain. Yet I was frozen and could not speak or move. The doctor bent over to me and said, Rick you are experiencing a heart attack, which we caused with this procedure., Ride it out and it will pass soon, it is not doing damage this is the result of stressing your heart muscle in a way it does not like.
It was a terrifying expirence; I could do nothing about it, and I was even unable to scream. Of course, I survivied, the stress was applied to find the issue with my heart and today I have three stents, and the repair of the AV fistula is complete.
But at that moment, I truly had placed my life in someone else’s hands. I could do nothing expect to ride it out. What that taught me was that once you are under, you ar in their hands. You either trust them, or you don’t. You will make it or you wont, and no amount of extra preparation is going to mean one darn thing.
What a scary experience… It’s terrifying feeling helpless, unable to control or even guide what is happening to our bodies. Sometimes I feel a helpless anxiety similar to the terror of surgery when I am stuck on plane, camping in the backcountry, even at times being the passenger in someone else’s car…All instances where I am not necessarily in control of the situation. This type of anxiety all came with diabetes. That horrifying feeling of “what if”… I can’t get to my insulin, we get stuck, I forgot glucose tabs, etc…
Surgery offers those of us living with diabetes the bonus of an added layer of anxious!
Thank you for sharing your story!
I am involved in a type 1 clinical trial that involves quite a few surgeries. And the past 2 I hand off the CGM reciever and the endo watches it during the procedure. First surgery I rode right around that 180 mark which was where they wanted the blood sugars which happened due to the hard work getting those basals set right. Last surgery I went in a little higher than I wanted but a little insulin and things ran smoothly. If your basals are set you should be able to go all day without any problems. But than those stress hormones may kick in. Just when you think you have it, you don’t. I think with the right medical team, his technology is a game changer!
A few years ago I broke a tooth and it had to be pulled. I chose to get an Implant and chose an experienced dental surgeon. The Dentist said he would be doing the surgery under local anesthesia and my wife, who has several decades as a dental assistant, told me i would be fine. I suspected afterward that he chose the local after I had explained that I was a T1d.
One of the first things I did when I was seated for the operation was to explain to everyone I saw what the Dexcom was and how it worked in simple terms: no beeping-all is ok; 2 beeps-still ok; 3 beeps-ok but getting borderline; 4 beeps-call 911. I should add that my wife was nearby and she and the surgeon had worked together earlier. And, I was always conscious.
It took only an hour and a half and I had no IOB and had worked my BG to a steady 150 before the start of the procedure; all was well with nary a beep.
I recently had my bladder and prostate removed with a new bladder made out of my intestines. It was a robotic surgery that lasted 10 hours. I put my pump and CGM (Dexcom) on my thighs to avoid the sugical area. I was lucky to have a RN with type I that the docs tasked with monitoring my BG level. All went well and I stayed steady throughout the procedure. My wife also monitored on her iPhone (really cool). In recovery they kept coming in to give me a insulin injection and each time I refused. I did cut back on my Basel rate for surgery and afterwords since I was not eating for two days. Overall, BG managed.
@Bob_McAdams Wow. I didn’t even know such a surgery was possible. I hope recovery has gone well and you’re doing OK. I’m glad you were coherent enough in recovery to keep them from giving you insulin!
Yes beast my recovery has been great and I’m free of cancer. The surgery is remarkable in that the robot does a lot of it. Called DaVinci. I was back at work 6 weeks from surgery. I know my healing was aided by keeping my BG under control. Having a CGM made all the difference. Thanks Bob
I had emergency surgery last year to place 3 stents in a blocked artery. I was wearing my CGM with my pump. When the anesthesiologist talked with me before the surgery, I told him about my CGM and how it could be helpful to him in assessing how I was doing during the surgery. He listened carefully in order to learn how to read the Medtronic pump. Twice during the surgery when I was in a “twilight sleep” he tapped my head to report my numbers and asked me if they were good. I was really amazed and happy to respond that they were indeed perfect. I then went back to sleep. When I later awakened in my hospital room, my glucose reading was perfect. Anesthesiologists can learn how to use CGM readings, if they are motivated to do so. If there is not a diabetes “team” available during a surgery, insist on teaching the anesthesiologist how to read one and have remedies available to address glucose issues.
My daughter’s last orthopedic surgery was her first with T1D. Her brilliant (and easy-on-the-eyes) anesthesiologist remained in contact with me throughout the surgery via mobile. Even checked in on her twice during her post-surgical hospitalization. Like all good physicians, he was all about the learning. He even did some literature searches about CGMs and printed up some studies for me. (I hope he is single…)
My medical advice: Find a very good surgeon. Find a great anesthesiologist.
No to CGMS in theatre, because I’m paranoid about getting electrocuted! I’ve had 3 hand surgeries in the past 2 years, two under general anaesthetic, one last week under local.
I am not actually a huge fan of CGMS, I hate being nagged by my pump, but I now use Freestyle Libre and love it. I find it quicker to track and more accurate than Medtronic.
I wore the Libre sensor last week and the surgeon used bipolar diathermy. No shocks, no destruction of the sensor.
By keeping my levels nice, I have healed almost completely, although my surgeon suggests another week before I start aikido training again, he doesn’t want his pretty scar disrupted…
I am not so sure about mono polar diathermy used in more major operations. I have actually zapped myself while performing a Caesarean, and it hurt (had a tiny hole in my glove).
I really cannot be bothered sorting out the physics of it all, but can someone with more cleverness than I possess at the moment ascertain if the current would travel to the sensor? If properly earthed with a sticky plate?
[quote=“rgcainmd, post:16, topic:53887, full:true”]
My daughter’s last orthopedic surgery was her first with T1D. Her brilliant (and easy-on-the-eyes) anesthesiologist [/quote]
My “recent-divorcee detector” just started blasting like a klaxon
The receiver runs on a 3.6V rechargeable lithium battery, and the transmitter attached to your body contains two coin cells in series at 3.2V.
I can assure you with 100% absolute confident that you are no more in danger of electrocution from these devices than you are simply handling an AAA battery while you change them in your TV remote.
I have worn mine into the operating suite. I’m an adult educator, so I created a Quick Reference card so they knew what to do if it alerted to a low. Very specific instructions, especially because I was half conscious. I also provided a treatment they could use. Worked like a charm.
