Surgery and Possible Lows

I have a couple of questions I hope somebody can help me with. I am scheduled for an outpatient surgical procedure in a little over a week. It is about a 2-1/2 hour drive to get to the medical center (my sister will be driving). I am not to have anything to eat or drink after midnight but I am not scheduled for the procedure until 1:30pm. 1st question: how do I keep from going low? I am on MDIs--split dose of 5u Lantus each and Novolog for correx and to cover carbs. I am real nervous about not eating/drinking for that amount of time. They told me to contact my doctor for instructions, which I will do, but I know from experience that what I can learn from you guys has much more credence than what I will get from the doctor. Because of financial constraints I am not currently seeing my endo so will be calling my primary. Any suggestions? 2nd question: Because of the length of time without eating/drinking and the long drive to get there, do you think it would be better to go the day before and spend the night? We will not be driving home after the procedure, plan to spend the night there. Need to be making reservations real soon and need to figure out whether to make them for 1 night or 2.

I had this same situation last fall. The hospital doctor told me since my surgery was not until the afternoon, I could eat something light, no later than 6:30 a.m. that day. he also told me not to include any protein in what I ate. My surgery was scheduled for 1:30 and my surgeon actually ended up running late. My surgery didn’t actually start until about 4:00 that afternoon. I did actually go low and I told the girls at the desk in the waiting room that my sugar was 69 and I needed to treat it with glucose tabs. They went in the surgery area, asked the doctor, and he said not to treat it with glucose tabs. Instead they immediately took me in the back and gave me an IV to treat the low. I don’t know what to tell you to do about the travel arrangements. Sorry. Good luck with your procedure!!

Thanks Carman. Having worked in health care for years the first thought that came to my mind was an IV of dextrose. That is one of the reasons I thought about going the night before so that if I did go low I would be able to get somewhere and get help instead of being out on the road with no options.

You know I have no answer for that. All my drs have always made my surgery in the mornings b/c of fallng low (I do it ALOT) I would suggest the idea of staying near the hospital over night would be a good one.

I would stay the night before. I had a belly button hernia and went low before and they just gave me a little IV. LOL After it was over I just drank juice, in little amounts.

My experiences : having had 2 surgeries since 1983 diagnosis , once in 1984 , mastectomy and 2006 broken wrist ( same day in , same day out ) and both were performed early am …would it be possible to ask to have yours re-scheduled for an earlier time in day and resolve some of your concerns this way ? Just a thought .

I would definitely get your GP’s opinion on this… but I am scheduled for a surgical procedure on my pancreas in 2 weeks. The pre-op instructions said that if you’re on insulin to take 1/2 your normal dose the morning of surgery and nothing to eat or drink., Not sure how that works with Lantus, as I’m on Novolin NPH and take it twice a day. So the morning dose will be half of normal. Also, if your procedure isn;t until afternoon you may be able to have something light early in the am, ask them. Mine is at 8am and was told nothing after midnight. Also you could test extra on the way to surgery and before it. And tell them in pre-op your situation and to keep checking.
I guess if you can’t afford to stay both nights the night after might be better. Its a good thing your sister is driving you there, I guess you kinda have to have someone take you. Does she know how to notice and treat lows?

Have you ever done any basal testing? That would help to know if you drop low without eating. Since you have a week, you could do a test run to see if you would drop low.

I have had several surgeries (including one major surgery) in the afternoon and only had a problem with being low once – and I was at the surgery center when that happened and that was pre-basal testing. I also travel several hours to get to what I call real doctors so I never schedule stuff for first thing in the morning. Once I learned about basal testing, I never cut back Levemir for surgery and don’t plan on it now that I am on the pump either. When I had my cataract surgery, I ended up taking several units of Apidra on the way there because of DP and stress. The nurses were flipping out when they found out I had taken insulin

Thanks everyone for you input. You have been a big help.

The last surgery I had they stopped my Lantus the night before any adjustments were done with novolog but we did not adjust until after surgery.

Hey Sarein,
I hope your procedure went well, without any complications and I hope you’re recovering nicely