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surgery and the insulin pump
dgarner11 posted:
So I have to have surgery on my hand in a couple of weeks.

I would like to be prepared for my pre-op appointment and I'm not sure to handle the whole pump thing. I wasn't on the pump for any of my other surgeries so I have no idea if I should keep it on, take a pump vacation for that day and let them monitor my insulin/blood sugar.

I see my surgeon tomorrow and the pre-op nurse on Thursday, but I'm hoping someone here has some experience with surgery while on the pump


(also posted on the type 1 exchange)
MrsCora01 responded:
Sorry, but I never had any surgery while on the pump. From what I understand from other posters on other boards, they used to force you to take the pump off. Nowadays it seems that all they request is that you drop your basals during the surgery so that you don't go low. I remember when I was on mdi I usually took 3/4 of my nph (days before lantus) on the morning of surgery. Are they going to let you manage your own diabetes? I have been fortunate in that I have always been allowed the leeway to do that.

Will you be hospitalized or is it a day surgery?

Best of luck.

Lizzy19641951 responded:
When I had cataract surgeries done I just cut my basal a little and left my pump on. The same with my last heart cath. The nurses just checked my sugar before, during and after. As long as the basal rates are set right we are usually OK. Good luck.
DavidHueben responded:

I am certainly no expert on this subject (heck, I don't even use insulin), but I do recall this subject being discussed on this board several years ago.

As I recall, the decision as to whether a surgical patient was permitted to stay on the pump during the procedure (and hospitalization) was dependent upon several factors such as:

1. The technical capability of the surgical and post-op support personnel to care for a person on a pump. Some hospitals simply did not have the skills to do so. Thus, they placed the patient on injected insulin.

2. The length and complexity of the surgical procedure.

3. Hospital policy.

I am pretty sure the surgeon and pre-op nurse will be able to answer your question. Good luck with the surgery.

feelinghigh responded:
I never had surgery while using the insulin pump but, I have been in the hospital since and they made me take it off. No one in the hospital knew how to work it and I wasn't in any shape to monitor it myself. Actually, in a wierd way, it felt sort of a vacation for me to not have to monitor it.

Good luck with your surgery and keep us posted.
dgarner11 replied to feelinghigh's response:
thanks everyone. I talked to the surgeon this morning, he seems to think that I will probably turn it off (take it off) but its up to the anesthetist.

He said for the most part we don't want me going hypo on the table and they probably don't know how to work the thing either. I'll be able to put it back on once I'm eating etc again.

We'll see what they say Thursday and my pre-op, It sort of will be a vacation, let someone else monitor my blood sugar for a few hours lol.

I would even consider keeping it off for a few days after but, seeing as how I will have one hand incapacitated I'm sure pump will be easier than injections, may need hubby for site change help. Not sure how I'm gonna check my sugars either, I may have to start practicing arm testing.
feelinghigh replied to dgarner11's response:
Something you might want to consider is to bring your testing kit with you. Even though the nurses check your glucose very often throughout the day and night there is still a chance of you going low.

One of the nurses came in to check my glucose and at that time I thought to tell her that I don't always feel my lows. Well, when she checked my bg's it was 51.I felt fine but, she freaked out and ran out of the room to get some OJ for me.

Just something to think about.
auriga1 replied to feelinghigh's response:
feeling, this has nothing to do with surgery and the pump, but just a comment on how differently we react to lows. I should preface this to say that my sugar was very high at diagnosis and the doctor put me on insulin. I could start feeling the symptom's of lows when I reached 80. Guess my body had to go through an adjustment period. I've been in the 50's before myself, and was nearly incapacitated. Had to sit before I fell and my legs felt leaden. The sweat and shakes, turning red in the face was thoroughly embarassing. My mind was working overtime and I started the babbling. LOL. Just hate when that happens.

Has to be so scary to go low and not be able to detect it. Always need to be your own advocate when going into the hospital. Don't leave anything to chance or assume ANYTHING!

Good luck to you, dgarner.
dgarner11 replied to feelinghigh's response:
I will absolutely have everything with me (or put my husband in charge of it). I'm not staying overnight, its just day surgery, but just in case I will have all my testing stuff.

when I was in hospital to have my daughter, I was there for 2.5 weeks and they only tested me once with their meter, they always came and asked me what I tested and wrote it in my charts. I was in total care of my management except during the c-section. But I didn't have a pump at that point.
auriga1 replied to dgarner11's response:
Looks like you're in total control. Good for you. Day surgery is always good in that you won't have to worry about the staff.

I had an endoscopy and was put under anesthesia. Woke up and the nurse hands me some juice and crackers. Groggy and not thinking, I drank the juice and ate one cracker. Then as I became more cognizant, I told them I shouldn't have had that. It became glaringly apparent that someone didn't look at my chart and note that this patient was diabetic. I told her to take my blood sugar. That 4 oz. of juice and one cracker raised my sugar to 195 in a matter of seconds. Really aggravating.

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