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[IP] Re: surgery and the pump

** Reply to message from insulin-pumpers-digest:

> Date: Tue, 22 Sep 1998 11:58:05 EDT
> From: email @ redacted
> Subject: [IP] Surgery and Pump
> I am having surgery next week and I would like to ask how surgery affected
> your diabetes on the pump.  My endo wants me to reduce my basal rate for the
> a.m. to 0.5.  I am rethinking his advice.  My BGs are perfect in the a.m. on
> my present basals that vary from 0.6-0.8. during the morning hours.  I am
> considering leaving my basal rate the same.  I am thinking that with the
> excitement ( this is probably a poor choice of words) of surgery, my BG will
> go up.  I know it goes up alot when I participate in a 5K or 10K race.  Any of
> you who have had surgery with the pump, what was your experience?  Did your BG
> go up or down?  Did you reduce your pump basal rate?  ellen

I had emergency surgery last January resulting from a very nasty
Charcot-complicated compound fracture of my ankle --- actually two surgeries in
three days --- in a hospital in northern Wisconsin.  The anaesthesiologist
handled the insulin dosage details:  he didn't have much experience with it, but
he had a lot of intellectual curiosity and was a quick learner.  For the first
surgery he had me remove the pump completely --- he and the surgeon didn't want
to have to deal with a hypoglycemic reaction during surgery, and felt a
temporary elevated bg was preferable.  For the second surgery, he had me set the
pump at 50% the previous evening (this is a Disetronic where temporary rates are
set as percentages) based on the previous experience, and then as they were
rolling me into the OR he said "OK, set it at 100% now."

What was more interesting was the adjustments I made following surgery: for a
week or two I was running it at 120-140% of the usual basals, and then that
crept down to 110-120%, and finally after a few weeks to plain old 100%.

I think you find that the medical team quite reasonably wants to err on the
side of high blood sugars rather than possible hypoglycemic reactions.

Richard G. Larson,  Professor,       Dept of Math., Stat., and Comp. Sci.
U. of Ill. at Chicago,  851 S. Morgan St, M/C 249,  Chicago IL 60607-7045
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(312) 996-8616   email: email @ redacted    homepage: http://www.uic.edu/~rgl/
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Insulin-Pumpers website http://www.bizsystems.com/Diabetes/