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[IP] Re: Strep Throat.....Ugggghhhh!!! 2nd POSTING--surgery and kids

I would say that there is no "normal" thing with the pump and surgery and 
kids.  It will all depend on the endo who is in charge of your child's 
diabetes during surgery.

Claire has had several major surgeries, 3 hour operations  The first 
pre-diabetes, the next pre-pump which was a real nightmare and the third 3 
weeks after starting pumping.  For the last surgery, there were 3 doctors 
involved: the plastic surgeon, the anaesthetist, and the endo.  The endo 
called all the shots (pun intended) and would not allow the pump to remain on 
during surgery and follow-up.  This same endo had turned us down for a pump 
and I had taken Claire elsewhere to another hospital and Endo to get a pump, 
which happened quite quickly.

  I checked her bgs when the anaesthetist came out to meet us just before 
taking her in to surgery.  He was totally amazed by the One Touch Ultra and 
returned shortly after to ask if he could take the meter with him into the 
operating room, as he said the one they had to use was pre-historic. Insulin 
was started with the IV pre-surgery, the endo calculated the rate without 
consulting me, but it was very close to her basal rate, with a bit extra for 
the dextrose in the IV.   You can easily calculate the carbs in the dextrose 
in the IV solution by observing the rate that it is being infused. The amount 
of carbs is fairly low per hour, but does add up over time, so has to be 
accounted for.  And the stress of surgery will likely increase bgs, this may 
not be an immediate effect.
        Claire could not take anything by mouth for a couple of days, not 
even water, and was quite heavily drugged, so the IV was essential and I 
ended up being quite happy that she was not connected to the pump.  I just 
kept checking her numbers and instructing the nurses when to crank up the 
rate of insulin infused, just like you would do a basal increase.  When she 
was ready to sip on juice, I put the pump back on and the IV came out.  
Necessary to get out of the hospital, but not so good for pain relief as she 
had been on morphine or something through the IV.  

       Tonsil surgery is routine and quick, I would think.  But you would 
have to ensure in advance what the doctors will allow regarding the pump.  At 
one small surgery for ear tubes, the anaesthetist would not even allow a bg 
check with the meter, he insisted on a blood draw from a vein and sent to the 
lab, pre-OR!!!  In any event, keep the pump running until the last possible 

You can write me if you have any questions. 

Barbara, Mum of Claire 8
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