[IPp] Re: surgery - tubes in ears

[email @ redacted]

Hi Linda!
       Has Adam not had tubes before?  You will find that it is a very, very 
simple and fast procedure.  
       Claire has been having tubes put in since she was 8 months old.  I was 
worried that first time, but found that it was finished before I had time to 
go down and buy a coffee and get back upstairs.  Her tubes would sometimes 
not even last the 6 weeks until check-up, so she has had them replaced a lot 
of times.  
       The last time she had them put in was about two months before we 
started pumping.  As she was diabetic she was scheduled to be first in the 
morning.  I was worried about being low overnight and not allowed to treat, 
though I think you can give clear fluids (apple juice) 3 hours before--check 
on this.  So I gave a bit less bedtime insulin.  The worst thing was that the 
anesthetist insisted on getting a bg from the lab before the procedure!!!  
Well, Claire is frantic about blood draws from a vein, so this was very 
traumatizing.  Then, the docs, nurses, etc were all waiting to go ahead at 
8:00 am and had to wait for the bg from the lab.  I told them I could give 
them the number in 30 seconds (pre Ultra one touch), but they said No, no.  
Ha-ha, so they waited and waited.
       Anyhow, in my experience they have never put in an IV for ear tubes.  
The amount of general anesthetic is very tiny, and the kids are awake within 
1/2 hour.   I would think that the best thing to do is to just leave his pump 
on, running at the usual rate.  Check his bg just before he goes in, and let 
him run a bit higher than normal.  You would definately want him to wake that 
morning a bit higher than normal, as you don't want him low.  However, if you 
check in the early hours and he is a bit low, you can just suspend delivery 
for a bit of time to bring him up a bit.  The pump makes it so much easier.  
       If the docs want the pump disconnected, that is no problem as the 
amount of time is so short.  Just hook him back up when he comes out.  
Typically the kids are a bit groggy and want a big cuddle.  Then the nurse 
brings a popsicle or juice for them to have.  With a pump this is fine--you 
can just bolus for the things.  
       Claire has also had major surgery twice since having DM.  It was a 
nightmare on injections, but not quite so bad with a pump.  With the pump I 
left it on until the moment they were taking her into the OR at Sick Kids in 
Toronto.  I checked her bg when the anesthetist came out to meet us--he was 
so fascinated with the One Touch Ultra that he came back a few minutes later 
and asked me if he could keep it with her in the OR.  Said the one that the 
hospital used was from the dinosaur age!  LOL  Then we disconnected the pump 
and they were going to start the glucose IV and the insulin IV in the OR.  
The endo calculated the rate of insulin infused and it worked extremely well. 
They checked her bgs every hour during surgery, which was about 2+ hours in 
total I think.  Bgs started to rise with the surgery stress about 7 hours 
later.  Rate of IV insulin was just notched upwards at my suggestion as 
required.  Sick Kids nurses were quite relieved that I handled all bg 
tests--the intensive care nurse did not like the idea of being responsible 
for them.  Thus at 4 am I had to troop down from my bed on the 7th floor to 
the intensive care unit, do the bg and then go back to bed. 
       I know that all hospital things can be worrisome, but I can reassure 
you that Adam's ear tubes should go really smoothly.  And his ears will be 
much happier for it!  You should look into getting custom ear moulds made to 
keep out the water.  I think you need the doctor's Rx for these and then you 
get them fitted by the audiologist--ask around about it, even some ENTs don't 
know about these.  Cost about $60, our insurance covers them.  They are most 
helpful with summer and swimming season coming up.   
       Currently Claire has a hole in her ear drum, has been there for a year 
now.  The tubes are long gone.  Nothing works to fix it up and the infections 
can play havoc with bgs.  It doesn't respond to antibiotics as it is not in 
the inner or middle ear.  ENT has now tried Gentian Violet, an old-fashioned 
remedy.  

Good luck and you can always ask me anything else you might like to know. 

Barbara, mum of Claire 8  (in BC now)
> Hi, I have not posted for a while, I usually just read. Adam, who is 7, and
> on the MM 508, is getting tubes in his ears for reocurring ear infections,
> on Friday, May 14th. He will be in the hospital, under a general anasthetic
> (sp??) and I was wondering how other families handled surgeries and not
> eating, did they get put on a glucose IV?? Thanks for any info!
> 
> Linda, mom to Adam, 7, pumping MM 508 for 3 years!
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