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[IP] Surgery Fears

Hi Joanne,
     My pumping daughter Claire had major surgery one year ago, not long 
after starting on the pump.  The endo in charge said she preferred her to use 
IV insulin, rather than staying connected to the pump.  At first I was 
unhappy with this, but in fact things turned out very well.  
     I did like the fact that I didn't have to worry about "site failure"--we 
were new at pumping and not too experienced.  Also Claire could not take 
anything by mouth for well over 48 hours, not even water, so I didn't have to 
worry about bolus insulin, only basal rates.  This probably won't be the case 
with you, but if they start wanting you to drink right away, you can stick 
with water or sugar-free pop.  
     The endo calculated the IV insulin drip rate and I was surprised that it 
worked so well.  As her numbers started to creep up about 10 hours after 
surgery, I just had the nurse turn up the rate on the IV.  This was the same 
thing as you would do with your pump.  As I recall, they started with a rate 
equivalent to .5 an hour, Claire's regular basal was .4 an hour.  She was 
also getting dextrose in another IV and I did calculate the carbs in this, 
based on the IV drip rate, it wasn't hard to do.  I think that her after 
surgery IV basal rate needed to maintain bgs. went up to .7 for about 36 
hours, including about 5 carbs an hour from the dextrose IV.  She was on 
morphine for pain.  
     Often an IV insulin is preferred because if you turn off the IV, the 
insulin action stops almost immediately in your body.  The anesthetist came 
and asked me for our One Touch Ultra bg meter to use in the operating 
room--he was quite enthralled by it, said the one they had was a prehistoric 
version.  I checked Claire's bgs just before they took her into the operating 
room, and that was when I disconnected the pump.  The IV line was already in. 
     I hope this helps a little bit.  Good luck 
Barbara, Mum of Claire 8
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