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Re: [IP] pump management during surgery



I am a Canadian citizen who just had surgery in Detroit MI.  Prior to my 
surgery, my US surgeon was adamant that my pump would come off and that I 
would not put it back on until I was home from the hospital.  I was 
terrified.  I paid out of my pocket to have an Endocrine consult at the 
hospital in question prior to surgery where it was agreed that I would have 
an insulin drip (IV) during surgery and once awake and alert could put my 
pump back on.
Once I arrived for surgery, the anesthiologist wanted to take my pump off 
and said that the insulin drip would be hooked up in the OR.  I told him 
that I didn't believe him.  (up to this point nobody was listening to my 
pump concerns AT ALL)  He said they would just leave my pump on then, and 
only take it off if I went terribly low.  This was a change of plans that 
was told to me as I was being wheeled to the OR.  My surgery was abdominal, 
and had I known this, I would have moved my site to my arm or leg.  As it 
was, it was dead centre in my stomach and I knew this was going to be a 
problem, but there was no time to move it.

I woke up with my pump removed and no insulin drip.  The surgeon was trying 
to move me to ICU as they "could not regulated my BG"
I was in terrible surgical pain and having had no pump (and thus no insulin) 
for 5 hrs, my BG was 428.  I demanded an Endocrine consult STAT.
Endocrinology came and wanted to start me on NPH.  I refused.  I had worked 
out a basal rate of 80%, promised that I would not do any correction boluses 
without consulting with them, and had a family member there to take my BG 
every hr if I was unable.  We had a little chart as I said we are Canadian 
and so we did the conversion so it made sense to all.  My helping family 
member FYI was my 13 year old son who is amazing in his knowledge of 
diabete.  After MUCH convincing, the Endocrinologist agreed and within 4 hrs 
my BG were 108.
The next day I had about 5 Endocrinologists in with me, amazed at my BG. 
They have not waivered, and my surgery was April 22.

I'm sorry for the long post-the reason I am telling this story is because I 
think it is CRITICAl that we advocate for ourselves.  Do as much as you can 
ahead of time to research and prepare.  Stand firm in your insistance to 
have your pump.  I later did get an apology fromt he surgeon, who called my 
"knowledge of my medical condition and determination to stay on top of 
things, refreshing."

While I still had nurses who wanted me to shut my pump off because I went 
low, I held firm and as a result am helaing wonderfully from major surgery. 
I realize I sound awful tough and mean, but I am really a very nice person-I 
just refuse to put my health in jeopardy because of someone else's ignorance 
and/or arrogance and unwillingness to admit that they don't know.

Good luck!!
Loree
----- Original Message ----- 
From: "C" <email @ redacted>
To: <email @ redacted>
Sent: Saturday, April 26, 2008 11:35 AM
Subject: [IP] pump management during surgery
>
> I will be having knee replacement (one knee) surgery in May.  I know the 
> topic
> of pumps and surgery is in the archives but  I don't  know how to find the
> topic.I tried and tried.  I am more anxious about  my pump than the 
> surgery.
> Could you please share what your endos had you do and how it worked out . 
> And
> did your anesthiologist listen.  Thanks Charlene
> .
.
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