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[IP] Donna: Cataract surgery


Your questions about surgery are not silly at all.

Here's an opportunity for you to educate your medical team on the benefits
of pumping ;-)

Surgery actually can be managed quite effectively when you are on an
insulin pump.

Make sure your basal rates are well established. You should be able to do
this surgery with minimal changes in your pump routine, if your basal rates
are settled.

Fasting for the blood work was no problem for me, and is easily done with
the pump (if basal rates are correct).

The recommendation to shut your pump off the night before surgery is really
not necessary, and is probably based on management techniques for folks
taking NPH and / or multiple injections. I'd argue this one strongly with
your health care team. There are numerous folks on this list who've had
surgery while wearing their pump. Since you use only short acting insulin
in the pump, there should be no problems with managing your BG levels
before, during and after surgery. You can adjust as necessary.

I left my pump on during my cataract surgery, with no problems. I use a
Disetronic, and clipped the pump case to a wide elastic "belt" which I
received with my pump. Trying to find a decent location for the pump is
something you might want to consider in advance. I'm not terribly shy, but
I realized when the nurses wanted to know where my insulin was coming from,
they'd get more of a show than they expected <vbg>.

Prior to the operation, I taught the nurse and anesthesiologist how to stop
and disconnect the pump (just in case). This made them very comfortable.
The "gas man" was actually very relaxed when he realized I was pumping,
since he felt I was in control of many of the variables which typically
caused him concern (BG levels, need for carbohydrates, insulin levels,
etc). I felt since I was doing a part of the job for him, I should get a
partial refund. Not !! <vbg>

The one thing you may need to "battle" on is the IV solution they will want
to use. I think my IV contained 5% Dextrose. I did *not* need this, since
the pump let me maintain normal BGs during surgery. As it was, I reduced my
basal rate, just to be "safe". Combined with the Dextrose IV, I was high
when done with the surgery, but able to bolus down quickly. At the time, I
had no idea IVs came in non Dextrose "flavors". In retrospect, I would have
wrestled with them on this one and fought for an IV which had no added

I was awake during the entire procedure, and actually found it interesting,
not the slightest bit uncomfortable. The surgery team did have to ask me to
stop telling jokes, though. Apparently, it's tricky to operate on someone
when you're laughing. Well, how was I supposed to know? They also asked me
to warn them if I needed to sneeze ;-)

Surgery can be a bit unsettling, but pumps can take a lot of the worry out
of it. Talk to others, you will hear some variations on this theme. The
general consensus seems to be that pumping helps a lot during procedures
like this.

Remember, YMMV - Your Mileage May Vary (but things should work fine).

Bob Burnett

mailto:email @ redacted

Insulin-Pumpers website http://www.bizsystems.com/Diabetes/