[Previous Months][Date Index][Thread Index][Join - Register][Login]
[Message Prev][Message Next][Thread Prev][Thread Next]

[IP] Inexperienced and Scared

Harold writes:

> I have been on..pump since March 1999 and I am far from being
> an expert.  I'm scheduled for surgery in 10 days and my concern is
> dealing with the fact that the surgery is being performed at a VA
> hospital where there are no doctors or staff that are familiar with the
> insulin pump.  

First of all, I bet you would be hard pressed to find ANY hospital where the 
doctors or staff are familiar, let alone comfortable with the pump.  In this 
regard, YOU are the expert, so it will be up to you, and hopefully your endo, 
to TRAIN those who will be responsible for your life.  It takes a little more 
effort and time, but the control you CAN maintain, is WELL worth it, and the 
better your control during and after surgery is vital to your subsequent 

> recent posts....has increased my uneasiness about all of this.   

better to be prepared...don't be worried - just take advantage of the days 
you have left to insure you are comfortable once that anesthesia starts 

> How should my wife or I handle the staff regarding their ignorance of 
> this device?  

Call your attending, who will be covering you while you are there....go over 
everything with him, and get written approval from your endo - keep a copy of 
this with you at all times.  Also, fin dout who your anesthesia dude will 
be...sit down with him and give him pumping 101...show him how to deliver a 
bolus, and how to suspend, and that is ALL.  Give him written instuctions on 
what to do while you are unconscious...Discuss the bg range you will be 
shooting for....it is suggested you do NOT aim for 80-120 during 
this...better to aim, say 140-200...WRITE down what if any, correction should 
be given, ie "if my bg is 140-200 do nothing.  if my bg is 200-250 administer 
X units"  and BE CONSERVATIVE with this bolus...better to be a little high 
then even slightly low....

> doctor instructions that I remain on the pump but I don't know if they
> will honor my request.  

get it in writing and they have to.  You may have to sign a release.  How 
long are you gonna be in surgery?  how long before you can sanely monitor 
your own levels>  If your wife or a family member plans on staying for the 
duration, train them how to do a finger stick, and give them the same bolus 
instructions as you do the anesthesia guy.  

Read my previous post entitled HOSPITALIZATION, or one from last FEb called 
Hospital 101 as to how to deal with the IV fluids...if you are NOT going to 
be eating fr a while, you WANT IV glucose...just be aware of what 
concentration and flow rate

TAKE ALL YOUR OWN equipment and dex tabs.  I can virtually promise you that 
the hospital will not have anything you need, INCLUDING insulin.  Test 
whenever YOU feel like, and often is better.

Stress may raise your basal needs...test OFTEN the 12-20 hours before your 
actual surgery...lower your basals or put in temps

It CAN be scary, and you MAY feel like your care is gonna be compromised by 
the fools who are in charge of your life, but KNOWLEDGE is power.  Even if 
you are unconscious, make sure you have someone ther who isn't!!!!  I fought, 
and got permisison to have my sister in recovery with me following my 
vitrectomy.  I did the finger poke, and she aimed the strip at my hanging 
drop...then i walked her through delivering a bolus.  Even after my more 
vigourous laparotomy, i had my aunt there telling me what my bg was and me 
slurring out what amount of a bolus I needed...

> Is this really something I should worry about? 
yes, but NO...if you are prepared.  I fear beng run over by a truck  not cuz 
I wear holey underwear, but if Iam knocked out and can't tell anyone how to 
take care of me!!!!  I am not normally a control freak, but when it comes to 
my diabetes, I think i'd rather be dead than take my chances with stupid 
doctors and EMTs

> he doctor told me that they give diabetics glucose prior to surgery 
> to keep them high so they won't bottom out.  

tell him you don't mind an IV drip of dextrose, but you MUST know the 
concentration and the rate so you can adjust your basal rate.  you do NOT 
need a huge dump of sugar...the reason they do this maybe is cuz they are 
assuming most diabetics are on NPH or Lente which has such erratic 
peaks...there is no point in maintiang your bf at 140-200 for the previous 24 
hours if you have to come out of hte surgery at 450 becasue they were 
"scared" you might bottom out.

> Am I making a mountain out of a molehill? 

no - you are the mountain...make the moles come to you for training (then 
send them a bill for the in-service)


I want to be prepared so any advice would be great!

Harold Lyssy

for HELP or to subscribe/unsubscribe, contact: HELP@insulin-pumpers.org
send a DONATION http://www.Insulin-Pumpers.org/donate.shtml