In case you were wondering, the post title refers to me having surgery and me being on a pump rather than me attempting to operate on my pump!
After nearly a year of loving being on a pump I’ve found an uber downside
I have a frozen shoulder and after 2 years, a vast amount of pain, numerous cortisone injections and a load of physio, it hasn’t got any better. The doc has therefore decided to do ‘manipulation under anaesthetic’ and a ‘capsule release’ to try and sort it out. I’m ok with this, I know it’s not going to be very pleasant in the short term but hopefully I’ll finally get the use of my arm back and so it’ll be worth it.
The pump related uber downside bit is that I went to my pre admission appointment earlier this week and though usually the procedure is day surgery, they’ve decided that because I’m on a pump I’m ‘complicated’ so they’ll have to admit me the day before, take me off the pump and put me on a sliding scale drip. After the op the next day, I can go back on the pump but they’ll monitor my bg’s hourly and won’t discharge me till they’re within range and remain stable which they say may mean keeping me in another night. Boo!
I had day surgery under a general for retinopathy last year when on MDI and they were happy for me to take half my Lantus the night before, not take my humalog or eat anything and monitor myself so I didn’t need to go in before or stay after.
Anyone else on a pump had a general for something and have any experience of this?
That sounds painful @Bellebe, I hope they manage to sort it for you.
I’ve had a couple of 30min ops under a general in recent years. For each one I’ve kept my pump on and agreed that I’d aim to be about an 8 with no active insulin prior to the op (I suggested this approach, they weren’t coming up with anything other than a sliding scale). I’m not sure how long an op they’d be happy with this approach for.
Do you know if the pump is the problem, or if they just refuse to do any diabetic as a day case? If the pump is the problem you could always try a bit of basic education – personally I can’t see any reason other than ignorance why you’d operate on someone on MDI as a day case but not someone on a pump. Or if they’d be comfortable doing you as a day case if you were on MDI, you could choose to go back onto MDI yourself for a couple of days. That does seem like a huge step backwards though.
Re staying in until you’re stable – I’ve discharged myself a couple of times when I’ve been comfortable that the only issue keeping me in was diabetes and that was something I could sort perfectly well at home rather than in hospital. You just need to sign a form to confirm that you understand you’re a foolish and irresponsible patient who has chosen to ignore the doctors who obviously know best.
Hi @Bellebe so far no opps with a pump (touch wood!) however I helped in a research project re hypo’s and the effect it has on your heart. The heart consultant had to be in control of my insulin requirements so I was taken off the pump and put onto a sliding scale so they could make me hypo. That in its self pushed my b/s up as my stress levels increased. However, once back to normal about1/2hr later I could go home.
I suppose in a way what I am trying to say is
a) If you suffer with stress and it effects your b/s it may be better for them to monitor your dose.
b) Who will be testing your blood?
c) Do you want a nurse/doc messing about with your pump??
d) What does your diabetic team say ? can they not talk to opp doc?
e) From another angle pregnant diabetic mum’s who are on the pump are encouraged to keep the pump on them but what do they do if an emergency section required?
Hello @Bellabe I had both shoulders released and manipulated at the same time about 3 months back. I was admitted the night previously and stopped my pump at about 7 am to have a sliding scale. I’m glad I did as after capsular release surgery on both shoulders I could hardly move let alone operate my pump. I stayed on the sliding scale until the next morning and was in hospital for 3 nights. It does feel like going backwards swapping a pump for a sliding scale but keeping my pump running was not an option given to me. I hope the surgery helps you out, frozen shoulders are so painful and not being able to lift your arms really limits you. Good luck with it and I hope you get some useful movement back in your shoulder.
Blimey @Megs – both at the same time?! Respect!! How are you doing 3 months on?
a) I do, so it may be
b) I don’t actually know specifically – I shall therefore ask! (during the op I assume the anaesthetist?!)
c) Er no.. actually, I don’t think I do …. whilst at the pre admission appointment one nurse who spotted my pump (which I wear in an mp3 pouch/sportsband thing around my ankle) actually asked “is that a prison tag or something?”…. I’d def prefer that she stay well clear!!
d) the only DSN with pump experience at my hosp is on annual leave! Back in tomorrow apparently so I’ll be on the phone for her advice first thing.
e) good question!… I have no idea!! Do you go under general for a c section though?? Being kiddie free (thus far) I have no idea about these things, but wouldn’t mind finding out before I start thinking about babies/giving up my freedom/sleep/cash/etcetc (!)
@Alison – more than happy to confirm that I understand that I am a foolish and irresponsible patient who has chosen to ignore the doctors who obviously know best on numerous occasions, so this certainly won’t be the first time!
I’ve just had day surgery today under a local anaesthetic, no concern was raised about blood sugar levels although I did say I was well controlled.
I did have a long chat about diabetes & pumps during the operation – they were surprised! Several asked if they could see it which being both a proud pumper (& in a open backed surgical gown) was hard to refuse.
I think I was the first pump user they’d seen which is strange since they were based at the hospital which is a pump advocate!
I did get a lot of paranoia from the doctors about infection because I’m a diabetic, which is a new one on me does anyone know if there’s any truth in this?
@furrypaul glad you survived, hope you’re all fit and well now.
Pumps are a real mystery to most medics outside the diabetes team (and I suppose why shouldn’t they be, they’re not particularly common and if your job is to operate on people you’ll see them very rarely).
High BGs increase the chances of infection, and also slow down healing/make it harder to get rid of any infection. All that sugar makes for a tasty place for infection to feast. In the mind of Drs who’ve once read a paragraph in a textbook on diabetes this translates as “all diabetics are a hotbed for infection” which isn’t strictly true. If it’s controlled there shouldn’t be an issue.