Sedation and t1,am I overreacting?

I need to be sedated for colonoscopy. I also need some dental surgery. However I am stressed out over the idea so I have been putting both off.
I had surgery 20 years ago and I was horribly sick afterward. They told me t1s often react stronger to it.
That was before I had a pump and cgm. And they just let me run high before surgery.
I am very nervous esp since I have only short acting insulin. I hate being under anesthesia expecting someone will react quickly and properly.
One time in the hospital I had a nurse check my sugar w finger stick. It was 67. She immediately say oh my , you need insulin! And I said hold on I need sugar.
It’s that kind of quick action that scares me.
I get it that news articles get it wrong all the time. But when a nurse says that it freaks me out.
I told my dentist and he claims to know what to do, of course the doctor doing the colonoscopy should know.
Am I overreacting?

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I don’t think you are overacting at all! I have to be sedated Thursday for an angiogram. My paperwork says to take 1/2 dose of insulin since I’m NPO after midnight. I’m on a pump. I have different doses hourly, so not even sure how to do that!!

Surgery is scary. The colonoscopy at least shouldn’t last long. Are you going to be put under for dental surgery?

I always stay awake and I have been getting a lot of dental work done lately, dental surgery , a few teeth pulled and implants etc. I usually go in at about 130ish and do a temp basal reduction beforehand for longer appointments. For me and that isn’t the case for everyone I love to drop for any dental work or doctors visits. I have my reader with me and just check on it and I have been fine. A couple of years ago I did drop after a couple hours because of a hard to get out tooth surgery, I ended up at around 65 right after and I hadn’t thought it through that I wouldn’t be able to chew or suck so I was walking down to a little store to get some juice when I was sort of crashing. If I had had to I would of have chewed a gummy bear anyways.

I did start a thread on surgery and insulin as I found a lack of information at the time, it’s been a couple of years but here it is. It should help with some information.

The anaesthesiaist should call you before the surgery. Mention your illness last time, they should be able to give you meds that will help. Mine told me she gives it to all her type 1 patients because we’re prone to vomiting post anaesthesia. Unfortunately, I can’t remember what it was. It was something weird like a heartburn med.

I need implants. I’ve been avoiding it. They told me short acting anesthesia would be generally used. I cant imagine an implant being awake but maybe I should. I would just hate getting a new tooth just to wake up dead.

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My CDE went over the colonoscopy Dr.'s T1 instructions with me. We made some adjustments. I had no problems. I had to have a root canal last year. I took a small can of apple juice with me, but didn’t need it.

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@Timothy. In my experience, sedation is person specific and less about T1. Most of my D-friends do well on anesthesia. I however am the outlier in our group as I have anesthesia awareness and a super high tolerance level. I have surprised all but the last 2 gassers during surgery by holding a lucid conversation in the middle of a major multi-hour surgery when I should have been out for hours. I also emerge from under very quickly with little or no side effects.

Your experience will be based on your physiology. Previous sedations will help your gasser determine what will work best for you.

Best of luck with your upcoming procedures.

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Being awake for the implants was no big deal at all, I’ve now had 4 of them. The implants were way easier than two of the teeth being pulled that came out in pieces.

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I am a type 2, but in 10 years medication for conscious sedation has updated. I too had problems 10 years ago. My last 2 colonoscopies in 15 months where no problem post procedure. All procedures come with anxiety, take to your doctor. Good luck. Nancy50

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I’ve been having colonoscopies for over 20 years. First of all, they don’t use general anesthesia but, rather, what they often refer to as “twilight sedation.” Twenty years ago what they used for twilight sedation was actually stronger than what they use now, at least at my hospital. They used to use Versed, which took longer to recover from. Now they use propofol, and it’s pretty much out of your system very quickly after the procedure…literally within a half hour or so. Also, versed was known for making some people quite nausous, while propofol doesn’t seem to have that effect.

You should be able to keep your pump on, perhaps lowering the basal rate somewhat. I don’t blame you for being nervous, though. Here’s an interesting fact: when I was in a major Boston hospital for surgery, not one person in the pre-op room had ever seen a pump or knew what to do if I went low. Now THAT’S scary…major hospital knowing nothing. On the other hand, that same year in my local community hospital, everyone in pre-op knew what pumps were, how they worked, and what they needed to do if my bg dropped.

As for dental surgery, I’ve never had anything except local anesthesia for dental surgery, even when I had an implant.
My best advice would be to be as prepared as you can, discuss your fears with your doctor, and, having done that, try not to worry…I don’t know about you, but being anxious can make my bg drop like a stone.

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I kept my pump and cgm on throughout the procedure. One of the nurses was also T1 and she herself was wearing a pump which made me feel safer. She told me it was fine to keep both devices active. I did reduce the basal slightly only because I had not eaten since the previous evening and did not want to go low during the procedure.

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Good to know, Trying.

I’m prepping tonight for a double procedure: colonoscopy and gastroscopy. Haven’t even started the nasty stuff yet, but have been queasy all day from not eating. Tonight should be a barrel of fun - NOT!

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@Ruth4 Oh, yea, lot’s of fun!! Good luck tomorrow!

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I have had 2 colonoscopies. I go in about 120 to 150, Told the anesthesia doc that I am type I. They ask about blood sugars, For current bg they check my cgm.) I inform the anesthesiologist that I am on the pump. I told them that I turned it off, The procedure is for me about 1 to 1.5 hr. When I woke up I felt very cold and hungry. I was given saltines and juice. I asked for more before I even ate them LOL, Then doc talked to me about my results and I went home.

Many non endocrinologist are not very familiar with pump technology.
so be prepared to explain

In years past, I was told to take half the insulin the night before the surgery
and no insulin the morning prior to surgery My bg was 346 at the time of the surgery. The surgery was canceled due to high glucose. I have not done that since.

As far as dental work is concerned I am currently and have had a lot of dental work done. Yesterday, I had an extraction of a molar. Got 2 needles of lidocaine done in 30 min. Offered the relaxing gas but denied it.
Today, got a large cavity filled. Got lidocaine and was fine.
If you go to a regular dentist, the health history is relatively cursory.

I am currently being treated at a dental school so they are bit more particular.

Good luck. Best wish on a good report

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Call ur endo, I know this might be too late.

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You will be fine.

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My blood sugar rises as if I ate a piece of cake ant trying to calm down is very hard

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It’s not over reacting. Being put in a situation where you can’t feel a low or speak for yourself is scary stuff. I have had knee surgery, eye surgery, colonoscopy, and surgery for kidney stones. None of these procedures lasted longer than one hour. I take one half of my long acting dose so that I have some insulin on board. I also tell EVERYONE involved with the procedure that I am Type 1. I also ask that they schedule me for the first procedure of the day so I don’t have to wait until noontime for something to eat. The final thing is I ask that someone check my blood during the procedure and only do anything if I happen to go over 200. It won’t hurt me if I spend an hour in the 150+ range. I can get it down fast enough later. I have never had a time where they had to do anything.

It’s very scary but it can be done.

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Many anesthesiologists are getting more familiar with pumps and cgms, and is usually person responsible for your bg control while in surgery. For a long procedure, they can administer glucose and insulin via IV and do finger bg checks regularly, and may be open to checking your cgms.

Hi it’s me again. You are absolutely normal to be concerned about anesthesia and making sure every one knows about your T1. In the last couple of years I have had four hand surgeries and one hip replaced. It is the first thing I discussed with my surgeon. I insisted on keeping my pump and phone for my CGM. I let everyone who had anything to do with my care know that I could drop quickly and to keep an eye on my sugar. I am also sensitive to anesthesia and pain meds. The anesthesiologist always came in before surgery and I would let them know not to snow me. For my latest surgery the anesthesiologist was awesome. I woke up very quickly and didn’t have to be shook awake lol. Before surgery i started to drop and asked for some IV glucose. I was very nice but firm about my needs.