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[IP] Wisdom teeth

    I had my all four wisdom teeth pulled right before Thanksgiving and it all
went relatively well.  I had it done under conscious sedation.  My diabetes
doc, who by the way is an internist, not an endo, suggested I decrease my
basals by 50% for the whole day of the procedure.  I knew that was going to be
a nightmare, as my basals are pretty finely tuned.  I did drop my basals back
by 50% the morning of the procedure though to bump my BG up so it would be in
a safe range to be sedated.  I went in with a BG of 146 and came out with a BG
of 254.  I cranked my basals to my higher basal range after the surg, since I
figured that the stress, pain etc would increase my insulin needs.
    The biggest problem I faced after the surg was nausea and ketones.  I was
testing my BG about every hour and ketones every time I peed.  I took a ton of
extra insulin for the ketones and made sure to keep myself hydrated.  The oral
surgeon called me at the end of the day to see if I had eaten anything solid
and of course the answer was no!  I was barely keeping fluids down, but she
said solid food would settle my stomach after swallowing so much blood.  My
dilemma was that everything I was taking medication wise had nausea as a side
effect, and we all know ketones can exacerbate nausea, so it was no fun.  I
ended up not taking any pain meds after throwing up the first dose of codeine.
I did keep the PenVK down, and actually had some phenergan suppositories
called out, so I could eat something solid.
    The first day was the worst.  The very next day I felt a whole lot better.
I was up and about and eating soft foods.  Each day progressively was better
than the last.  The other problem I had was that being diabetic, they couldn't
or chose not to give me the steroid they usually give to most patients to keep
the swelling down, so I did have quite a bit of swelling, even for keeping my
face iced the whole first day.
    Anyway, I survived the whole ordeal.  In hindsight I would not have
dropped my basals, since the elevated blood sugars along with everything else
just contributed to the ketone/nausea problem.  Had I been able to keep the
BG's down the ketones may have been less of a problem.
    Good luck with your surg, I'm sure it will go just fine.  Just remember,
even though you may feel like crap right after the surg, it does get better
and you will survive!
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