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Re: [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

This depends on your hospital and your surgeon--you may have to 
fight.  I've been lucky in that our community-owned hospital (area 
population about 100,000) is relatively pump-friendly, and I've had 
surgery there 3 times on the pump--gall bladder, total knee 
replacement, and partial mastectomy.  Ask your surgeon where he wants 
the set and the pump.  If they try to insist on a glucose drip, be 
able to tell them how much a ml of solution will raise your blood 
sugar with the pump and have some idea of how fast your blood sugar 
will rise without the pump.  My blood sugar rises about 5 mg/dL for 
each g carbohydrate, and a 5% glucose drip is 5 grams per 100 ml, so 
100 ml of IV fluid (a bag is 1000 ml) is enough to raise my BG by 
about 25 mg/dL  Going without the pump I can go up by 100 mg/dL an 
hour without a glucose drip, but an insulin drip is chancy because my 
sensitivity is around 100--1 U of insulin can drop my  BG by 100 
mg/dL.  Being able to quote this kind of information for your 
particular case may decide the anesthesiologist that he'd rather you 
just kept the pump going.  And definitely talk with your pump 
doctor--if possible get him/her to talk to the surgeon and 
anesthesiologist.
Biggest problem I've had is the hospital food, which is not 
diabetes-friendly even though they put what is purported to be the 
carb count on the menu.  They rather obviously use the old exchange 
diet and guess at the portion size.
-- 
Sue Ann Bowling, North Pole, Alaska
http://climate.gi.alaska.edu/Bowling/Bowling.html (professional--retired)
.
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