Like others, I've had procedures where I kept my pump and my CGM. The gas-men (anesthesiologists) loved my devices. I would lower my basal by 50% depending on how long the procedure.
I beleive both John Walsh, Pumping Insulin and Gary Scheiner, Think Like a Pancreas, address this issue. Perhaps you could bring those pages in with you at the next apt pre-surgery.
The problem isn’t the surgeon it is my family doctor that doesn’t have anything to do with taking care of my diabetes. I don’t understand why he gave these instructions since he doesn’t take care of my d. If it would of been my endo she would have had me decrease basal before surgery and then after go back to normal settings and do a correction if needed.
By washing his hands of it, the surgeon is complicitly involved in the poor decision making of the GP. They monitor your BG while operating and if it’s flying up, which seems likely if your pumpless, they give you IV insulin. I think the general tendency is that surgery will make your BG go up a bit, carbing stress or whatever. It’s much easier to manage this with a pump. You shouldn’t have to write off control to put it in the hands of a doctor whose approach will be super primitive.
Not to mention that they seem to prefer a glucose-heavy IV drip for hydration!
Don't let them give you IV dextrose, whatever you do. Make sure they are only using plain saline.
No way in the world would I give up control for 26 hours for a 30 minute surgery. You should be the one controlling this. Actually you KNOW what your endo would do. Dropping the basal 50% etc. So why don't you take control.
Hope all goes fine.
Thats goofy. I wouldn't do that. What drugs do they plan to give you during surgery? The last time that I was 'incarcerated' in the hospital, they ran my bg around 250 to 350 and wouldn't give bolus for meals. I stopped eating completely, but I was trapped there for four days, due to a bad seizure. My mom smuggled Humalog into the room to try to prompt me to eat, but the Doc found out and yelled at her that if he found insulin in the room, he would ban me from having guests. It sucked. You need a game plan, my friend. I think it is frequent hospital policy to run diabetic numbers super high. Sounds like they might be making this a nice, safe surgery for themselves, and a fairly dangerous one for you.
Basal, you can buy legally, without an Rx. This is a good idea. Make sure you adjust appropriately before the surgery or you should cancel it.
Ooooh, thats bad. They can give normal saline. Are you sure they will do insulin IV? This sounds unlikely to me.
Called my soon to be new endo this morning to see if he will advise surgeon and also trying to make an appointment before surgery on Thursday. After sleeping on this last night and getting madder and madder about the whole situation I decided to get a new family doctor. Keeping the surgeon because he is the best in the area for this surgery. If I get to the hospital and I don't like what I'm hearing I'll walk out.
I hate hospitals and there under-educated staff.
Here is a good solution to your dilemma. Write this letter to your surgeon and send a copy to the hospital administrator etc. There is no reason you should have to disconnect from your pump or that your control should suffer because they're too imbecilic to handle it.
Things are looking up! Got in to see new Endo this morning and he is redoing pump orders. My new endo is a T1 also. I think we are going to be a good fit. My stress level has gone way down. Feeling Good!
Congratulations, that's the way to advocate for yourself because nobody is going to do it for you. I hope the surgery goes well and you heal quickly.
??? I think you're mistaken. Lantus and Levemir are both prescription.
Did you mean Humulin-N? Yes, that's available without prescription, and it will work, but it's a poor substitute for the long-acting analogs.
I feel like they are wanting me to go in a coma so they can make more money off of meI doubt that.
Your experience clearly reflects an irrational hypo-phobic legal-defense mindset that is all too common in medicineIrrational? I think that a bit unwarranted.
Terry, are you familiar with the cost of malpractice insurance premiums for ANY surgical specialty? The hyper-litigious culture of our society is responsible, mostly, for these sorts of adaptive behaviors.
I've seen it all first-hand. My Dad (now retired) is an internist -- nothing exotic, pretty much garden-variety with a typical patient load and mix. He never faced a malpractice suit in his career, thank God.
Regardless, over my childhood and early adulthood, the malpractice premiums soared many-fold, and the behaviors and standards of practicing medicine changed along with it to be what we all now call, "defensive medicine".
I remember when a large part of my Dad's day was doing housecalls, a thing of the past now. So much has changed, and while a litigious society is not to blame for all of it, it has played a big role in making medicine the paranoid, filthy expensive service it is today.
Great! There is no reason for you to disconnect your pump. Maybe you can lower basal if needed. When I had a colonoscopy in August the instructions given to me said not to disconnect your pump if you use one and not to use fast acting the morning of the procedure if on MDI. I ended up lowering my basal and running a bit high for the test due to sedation. I was also happy to hear that they used plain saline for the iv/hydration/meds.
I will be staying connected to pump for surgery with a -20% basal rate 2 hours before surgery and 2 to 4 hours after surgery. I am OK with these instructions.
Good for you! Report back on how you do.
This discussion has served to make me angry all over again about my Endo practice decision that pumpers have to "surrender" their pump in hospital (I am hoping that doesn't mean surrender your meter as well). Insisting that using IV insulin - R insulin at that - and nowhere near the frequency of testing I do is adequate fires me. What is so hard for an RN to deal with a pump - the hard work (i.e. setting up the factors and rates) is already done. And we all know that better controlled bg's enhance the healing process. GRRR!
I was thinking, back when I was with the police department the obvious things like foreign languages spoke were registered with HR, as well as things like beekeeping, familiarity with snakes etc. That way we coud call on people with the expertise as needed. Even having pumpers on staff be available to "carry out Dr's orders" on a pump would go a long way. Like many of us here, I am not happy about tossing my good control out the window for "their" convenience and conventions.