I'm having minor surgery next thursday. It's early in the morning. Anybody have any good advice? I'm worried about going low. Will someone be monitoring my blood sugars? Of course I'll be asking my doc at my pre-op but thought I'd ask for some real world advice too
I've had two, umbilical hernia (innie turned into an outie when I was heavier...they fixed it) and a cyst in my armpit was excised. Neither was huge, both GA. I have a pump and CGM and did ok getting my BG ok, I think I drifted a bit low before the cyst one and just had some jelly beans and smarties and don't seem to have thrown up or anything like that (I guess that's why they don't want you to eat? I dunno really...) and it went fine. Having surgery early is a huge advantage w/ diabetes. They also had me talk to the anesthesiologist and they were both pleased and had no concerns. I think they have a meter and will just use that if they feel it's necessary, or maybe every however many minutes.
I'm sure if you tell them that you are a diabetic they will most likely be checking your blood sugar to make sure that you don't fall low during surgery!
This really will depend. Is it really minor such as outpaitent? And you should ask your endo for advice managing your blood sugars, not necessarily the doctor doing the surgery (who may be clueless about diabetes and simply want you in the 300-500 range to avoid a low). If you are conscious, you can certainly test and treat and it should not be a concern. If you will be put under your endo will probably advise you to reduce your basal beforehand, perhaps to 50-75% of normal. If you are being put under, you will be asked to be fasted. If your basal is not set properly and you go low if you fast for too long then further adjustments (down) may be necessary. In the end, the best advice is likely to come from your endo.
here are some more discussions on surgery
https://forum.tudiabetes.org/topics/surgery-and-type-1
http://www.tudiabetes.org/group/omnipodusers/forum/topics/omnipod-and-surgery
https://forum.tudiabetes.org/topics/do-nurses-test-blood-glucose
https://forum.tudiabetes.org/topics/583967:Topic:252727
Brian is correct, although I use my own good sense instead of endo advice. I have a good example. I had some dental surgery where I was out, and I wore my pump and CGM. Before I went under, I explained how the devices work, how to read my BGs, turn off alarms, treat a low, etc. I also provided a reference card I made. Surgery took longer than they thought. CGM alarmed and the doc and assistant panicked. Brought my husband in and he turned off the alarm, explained what to do. I might have been communicating with a washboard.
Even with some cataract and foot surgeries, all outpatient, I had to oversee the D. I raise my BG the night before so I do not go low before or during the surgery and have to eat or drink anything. That has worked out OK so far. I can correct later.
My favorite hospital story: I was hospitalized overnight for swelling in my throat. Middle of the night, I went low. I asked for juice and was told I could not eat or drink anything, doctor's orders. I went ballistic and threatened to get up, rip out the IV and find a coke machine. They finally got permission to give me some juice after another 45 minutes. If I remember, I tested at 45. Really nonsensical.
GOOD LUCK with the surgery.
Sort of the same reaction on my part. Basically I take things a little high the night before, I like to show up around 160 to 180 tell them i am diabetic first thing, and make sure they understand at some point that either they or i have the BS. The IV can and they will give you dextrose if you go low so long as they knwo first thing they have it or you have it things will run smoothly.
Unlike some other posters I want them to carry the load especially if I am going under or will be a little sedated. Obviously if I am fully sedated they have to carry the load. I disconnect my CGM if the darn thing goes off in surgery the doctors freak out and I dont need or want that.
My big advice. the very first thing I do when I show up is say I use insulin get your meter I want a BS. I also do that last before I drop to never land in surgery. Get me a BS. They always accommodate me, and it sets in their mind, that this is their responsibility now. Incidentally it is the anesthesiologist who controls it so if one if present I talk to them about it as well.
Post surgery in the hospital, I insist the doctor write an order for a low. Chances are i will still be hooked up to an IV so it is easily done. If I am not I go for ice Cream or dextrose tabs. They keep ice cream on the floor. so it is always a good idea.
Like spock i have dipped below my low threshold in the hospital and they are not willing to bend a single rule if you are low. Its crazy so try to get an order in writing if you can, if not the middle clot int eh tray will hold tabs and I think have a half dozen in there makes sense. Hey a guy needs to be ready just in case.
Good luck
Rick
Don't worry about it. You will be very closely monitored while under anesthetic and even if you do not take insulin, you will get some. Surgery puts a strain on the body so they will use insulin to keep you safe and in range.