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Re: [IP] Report on surgery

Jenny had her wisdom teeth out in June. We discovered that the week she was
on pain meds (Percoset) she required much less insulin that she anticipated.
Lots of lows. Stress raises glucose levels and she wasn't stressed that


On 7/31/07, Jan H. <email @ redacted> wrote:
> I had surgery on my Gortex Loop in my forearm today - to stick the 15g
> needles into for dialysis treatments. A few notes of interest:
> The nurse told me most of the pumpers will take their pumps off. I asked
> if
> they remove the pancreas from a non-DMer before surgery. She looked at me
> rather funny. LOL I said, "Don't touch my pump! ;-) At that moment I was
> 211. I had taken 0.6u to take it down to about 160.
> When I talked to the anesthesiologist (Dr. Musunuru = moose-en-oo'-roo) he
> told me to take care of my DM myself since I have had it longer than he is
> old (57 yrs) and knew more about DM than he. He said I should leave the
> sleeping part to him. I told him I really appreciated that.
> When the nurse asked me what I wanted for pain (much later after a prior
> morphine injection) I chose Vicodin and said I needed food with it. She
> asked, "Do you?" DUH! If you don't want to throw up, you do. Pain meds do
> a
> number on an empty stomach.  Nursey didn't know that? hmmmmm  She gave me
> some soda crackers.
> When I had the other part of the loop repaired in May, I threw up 5x and
> was
> in a lot of pain, and swelling. I have none of the afore mentioned -
> hardly
> any discomfort except how visible the large white gauze wrapping around it
> and the bands around my right wrist, keeping me conscious of it. PTL!
> I broke 200 late in the afternoon (194). I corrected after each one. This
> evening I upped my basal from 0.7 to 1.0 since the Vic could raise me. I
> am
> now 166.
> Got a lightbulb moment the other day. They usually ask us to take 1/2 the
> amount of insulin the morning of surgery (or basal). I got to thinking
> that
> our TDDs are a total of basals and boluses. Well, if you leave off the
> boluses for no food, that IS 1/2 of the daily total. The basals are set
> for
> normal days (or as Michael says: "Vanilla days"), so not eating after
> midnight requires no boluses, therefore running basals only IS half of the
> total. It's an automatic cut. We go through a lot to set basals - the
> stress
> and injury of surgery raise my BG and I need the insulin to cover it at
> best. If I would cut a basal, my BGs would be too high and hinder healing,
> Not good. YMMV
> Some of my list of physicians:
> Musunuru
> Hrisomalos
> Theocaredes
> Kezei (Kay's eye)
> Straneiro
> Jan - T-1 11/50 http://tinyurl.com/hqsk2  - http://tinyurl.com/z4j5f -
> http://tinyurl.com/er5c3 including evolution of pumps
> .
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