I had a minor op earlier this week that involved being knocked out for a while. It was nothing too serious and I will definitely live, but it’s amazing how much brain power the diabetes side of things took up.
I had to fast from midnight before my op at 6 am. From previous experience being first on the operating list is a definite bonus that comes from being pancreatically challenged. I was allowed water between midnight and 6am, then nothing from 6am onwards. Tough decision one – reduce the overnight basal or not? Logic says avoid hypos when fasting at all costs so reduce insulin and ride those highs. But I’d prefer to go into surgery at a reasonable level, I don’t like the idea of all that extra glucose surging around while my body is trying to recover.
Decision: stick with normal basal rate, I usually wake up between a 5 and a 6 and I think the stress of the op will push that up. Back that up with the safety net of setting the alarm for 5.30am so I can do a test and if I’m too low, I can take some apple juice before my “drink nothing or die” deadline of 6am.
Result: wake up at 5.30am as a 6.6, trending slightly upwards, decide that’s pretty safe when combined with the boosting effect of stress and the fact that I always rise a bit when I get up.
7.30am – blood sugar now around 9 and holding steady. Any other day I’d put in at least 0.4u to bring it down a little but I sit on my hands and do nothing.
8am – having agreed with the anesthetist that I’ll manage my diabetes as I’ll only be knocked out for around 30mins, reassure them that I’m an 9 and spend the next 5 minutes explaining the wonders of the pump and CGM, neither of which they’ve seen before. I’ve turned all the alarms off on the CGM, and clipped the pump on my hospital gown right next to my sensor so they shouldn’t hear a peep out of it during the op. My final brief to them is that if there are any problems diabetes wise, please consult the husband (I suspect they would completely ignore this request, but I have to make it to give me confidence, I don’t like the idea of leaving diabetes in the hands of surgeons and anesthetists, lovely as they are, they’re not great at diabetes).
9am – come round, take painkillers, check CGM. I’m a 10. Celebrate that nothing went awry diabetes-wise and take some insulin to start bringing that 10 down a bit, especially given I’ll be doing nothing for the rest of the day. In my mind I can see all those glucose molecules laying out the welcome mat for infection and slow healing.
So, all in all it was thankfully uneventful from a diabetes perspective. I’ve spent a very quiet week doing nothing very much more stressful than taking painkillers and watching daytime TV whilst constantly increasing basal rates to compensate for lack of activity. Surgery must be so much easier without diabetes.