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I hope this gets to you before you go in to the hospital! Wish I had seen it
sooner....First of all, GOOD LUCK!!! I know several people who in the last 5
years have had brain tumors removed (and all were 100% successes, so we will
all say what passes for prayers for you!!!)
As for the pump - here are some of the things I have written in the past,
having had several i hospital adventures, including a laparotomy last
year....it is ind of a mish mash and touches on a bunch of different
areas...hope some of it helps!
I stayed on the pump for both a virrectomy and he laparotomy (which is where
they slice you open from the middle of your stomah to below your navel and
dig around to find out what is wrong with you...in my case it was an absessed
appendix...I talked to the endo on duty (since i was in chicago) and to mine
in NYC on the phone AND to the anesthesia guy who agreed to let me keep the
pump. taught him how to adminster a bolus, but ONLY if I went above 200, and
we used a ratio of like 1 unit to 75 points (normal is 55-60 poins) just to
make sure they didn't over correct. i dont know if he corrected anything
cuz i came out a little over 200, but soon got myself back down as soon as
the drug induced fog lifted a little.
"make sure you are at a comfortable bg level for the 2-3 hours before the
surgery - check with your doc - probably 150-180 or so YMMV. Since you will
probably be fasting, make sure your basals are readjusted to
compensate....meaning you may have to lower them the day before and just
cover for highs - VERY CONSERVATIVELY. Don't over bolus for a high cuz you
won't be able to eat anything to bring it up! DONT FORGET the stress may
make you go higher!!
HOW long will you be unconscious? if more than a few hours, you should have
a dextrose drip, NOT a saline drip. Your body must have some sugar to work
and if it doesn't you will go into starvation ketosis. Find out how soon
you will be able to have juice of suck on dex tabs - AND BRING THEM WITH YOU
- they will not have them there.
Will you have someone you trust to test and bolus for you while you are
unconscious? I trained my sister how to do it and got permission to let her
in the recovery room after my vitrectomy - I was kinda out of it, but still
did the poking and squeezing...she aimed the strip for my hanging drop...told
me the number, then I told her how much to bolus...then I dropped back into
blessed valium and demerol induced la la land)
Bring all your own supplies and tell the nurse what the reading are IF they
ask (in my experience they only ask 3 times a day!!!), and IF they asked,
told them how much insulin I bolused...they asked ONCE in a week I think.
When they put me on glucose IV drip in the middle of the night without
telling me and my sugars soared, they got a reaming by my endo for not
telling me they had changed it - tee hee.
Make sure your diabetes doctor knows whats going on and he HAS to talk to
your attending physician.
OK, now - file this away: In a 1 litre bag of D5% there are 180 calories -
5% of that bag is pure dextrose - you can figure the CHO. In the 1 litre bag
of D2.5%, there are 85 calories. This is the so-called sugar water they hook
you up to on the IV. Drexler ordered the D2.5, but they put on the D5 by
mistake. I hollered about being put on sugar water until DREXLER 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 pee!!! Your body needs fuel and if you don't
get it from CHO, you will get it the BAD way - fats and muscles etc.
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 180 calories spread out over 10 hours. If you are at 250 rate,
you will get the whole 180 calories in 4 hours...and so forth. THIS IS
IMPORTANT TO KNOW SO YOU CAN REGULATE YOUR BASALS.
Then I had to drink the contrast stuff for the CT scan - they put it in Tang
so it tastes less like shit and more like rotten orange juice, but they have
NO CLUE how much tang is in it (one resident goes..."is there sugar in
tang???") So I drank it. ALSO NOTE: if you are having problems with your
kidneys at all - DON'T LET THEM DO THE IV CONTRAST in the CT scan without
talking to your diabetes doctor. The stuff you drink makes the test a little
less telling, but the stuff they shoot you up with is BAD for the kidneys.
well...i cant think of anything else
good luck nancy
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