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[IP] Surgery and an insulin pump??? LONG

Hope wrote:

> If anyone knows anything about surgery and wearing an insulin pump 
> I would appreciate some info.  I  just found out that I have to have a > 
> hysterectomy.  I was just wondering if anyone could give me any info 
> on what to expect regarding placement of my infusion site, and anything 
> else that may help with knowing what to expect during or after surgery.  

Sorry to hear about the impending surgery...but we can help...I had a
vitrectomy with pump in 1995 and a laparotomy in February of this year...at
which time, thanks to this group, discovered my legs as ideal insertion

If you have to swim thru a sea of interns, residents and students to get to
speak to your attending BEFORE the surgery, do it - no nurse or assistant will
take this person;s place...and if you have to get ugly - DO IT.  Make sure
your diabetes doctor knows whats going on and make sure he is in on the
discussions with your attending.   Make sure you talk to the anesthesia
person...tell him what you want your sugars to be...150-250 maybe but YMMV).
Tell him if you need insulin you want it through the pump, nOT through the IV
- show him what to do, if he is receptive to learning...BUT - hopefully, your
basals are set and you can get through the surgery without the medical
professionals MESSING with your diabetes

If you are keeping your pump and I hope you are...make sure your basals are
working well in advance...they will tell you  not to eat the night before
probably... Both surgeries I tested all night (for the laparotomy, they were
in there all night trying to get me to drink this crap to clean out my
intestines so I was awake anyway...) so conceiveably, ideally, when you arrive
in the morning, you are on the high side of normal...better to be a little
high than low.  Will someone you trust be going with you?  teach them NOW how
to test your sugar and administer boluses while you are out.  I had my sister
in with me in recovery for the vitrectomy - I couldnt see, but she held the
strip up to my finger after I poked it...and read the number...then I walked
her through giving a bolus - in between barfing from the anesthesia...

If no one personal is going, find a nurse or student who will be with
you...WRITE DOWN what they should adminster is you are between x and x...Be
sure to go in with a FULL reservoir and a nice clean healthy site - You dont
want to have to change that while you are on morphine...I promise...Also,
bring your own meter, and strips - the hospital will charge you $$$ to do it -
then check you bill to make sure they didnt bill you for them.  Also bring dex
tabs cuz hospitals dont stock them and your own insulin and stuff...

Now file this away:  they will be putting you on IVs, and standard operating
procedure (pardon the pun) is sugar water and it comes in a couple of
varieties: D5 or D2.5 - the D stands for dextrose.  Depending on how long you
will be on the IVs, you may or may not need to need this...I was on IVs for 6
days - a week before in the hospital while they thought I had diverticultis,
and than another 6 days before and after the laparotomy to remove my abscessed
appendix, so I needed to learn my stuff...you may be different.

In a 1 litre bag of D5% there are 190 calories - 5% of that bag is pure
dextrose hence the name - so then you can figure the CHO.  In the 1 litre bag
of D2.5%, there are 95 calories.  For my vitrectomy, I had saline, but when I
had my laparotomy this year, they tried to put my on the D.  I was very
difficult and turned the IV off when the nurse left the room...until my
DIABETES doctor reminded me that your body needs APPROX 150 grams of CHO to
function (YMMV).You need that much to keep from going into STARVATION KETOSIS.
Your blood sugars will read normal, or low, but check yer urine!! Your body
needs fuel and if you don't get it from CHO, you will get it the BAD way -
fats and muscles etc. and you will spill  KETONES a bad thing even if your
sugars are normal.

You have to figure out how much you are getting - Look at the flow rate on the
IV machine - if it says 100 - that means you are getting 100ml per hour, so a
1 litre bag of IV  is gonna last ya 10 hours...If you are on D5%, you will get
that 190 calories spread out over 10 hours.  If you are at 250 rate, you will
get the whole 190 calories in 4 hours...and so forth.  THIS IS IMPORTANT TO

If they are planning to do a CT scan - make sure your diabetes doctor knows
and let s them know if your kidneys are compromised in any way - the IV
contract they Inject you with is BAD fo ryou if your kidneys are like
mine...the kind you drink isnt as good for the results of the CT scan but you
have to weigh that with your diabetes doctors advice.

I could go on and on...it is truly a learning experience...if you want more
information, let me know..

*-)=B xoxx~~~~~~[507]          which indicates....my blood filled eye, my cute
grin, my long neck and droopy boobs, then my lovely scar around my belly
button, and my trusty 507 currently attached via long tubing
Insulin-Pumpers website http://www.insulin-pumpers.org/