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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 ..... 
ummmm ????
   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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