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[IP] Re: Glucose during surgery question
In a message dated 9/6/01 4:27:12 PM Eastern Daylight Time,
email @ redacted writes:
<< how do they know how much to give you and do they tell you how much is
in there? Also, to carb count it, would it be 4 grams of carb per .....
I am having knee surgery in two weeks and although my
orthopaedic surgeon says they "always" use glucose (but couldn't give me a
reason why) my endo (who is at Joslin btw) included in his letter that
fluids NOT include glucose.
Also, if anyone can answer the carb question that would be useful if I do
need to adjust for this.
- -------------- >>
Jackie, Claire had major surgery in May. Her pump was disconnected while she
had 2 IV lines--one with insulin and one with Dextrose and the fluids. The
paed Endo calculated the rate of insulin she would need according to the rate
the IV was running and I was amazed that it worked so well. So the IV
insulin functioned like a basal amount in the pump. As her bgs started to
creep higher after the surgery (lots of stress on the body), I just had the
nurse crank up the rate of insulin infusion .1, similar to increasing your
basal rate. Claire had only been pumping two weeks at that point, but my
knowledge of basals and boluses helped me decide when to move it up--the
nurses certainly didn't know what to do. You can calculate the carbs in the
IV fluid quite easily, but you need to know at what rate they are putting it
into you. The percentage amount of dextrose is printed on the bag.
Usually once you are eating or drinking they take the IV line out. So if
you are keeping your pump on during surgery, increase your basal for the
amount of dextrose per hour and then adjust up or down depending on how your
body reacts to all the stress. But the insulin infusion is another option,
depending on how long you will "be out of it". Claire could not take any
fluids for several days, but when they finally had her drink about 4 ounces
of apple juice, the nurses were shocked at what it did to her bgs. They
really had no idea what happens to a Type 1.
Barbara, Mum of Claire 7
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