2 questions

[SueEK]

Hi all, I know both of these questions have been discussed before but can’t find the answers.

1. Could someone give me the link for the best way to finger prick, am having problems recently getting blood and am bruising each time, don’t know why, don’t normally have this problem, thanks.

2. On pre-op assessments what bg level are they looking for, do they do HbA1c for this? I have seen that ops have been cancelled because bg too high. PS do you normally take your own food in?

Thanks for your help. Sue x

 

[AndBreathe]

Hi all, I know both of these questions have been discussed before but can’t find the answers.

1. Could someone give me the link for the best way to finger prick, am having problems recently getting blood and am bruising each time, don’t know why, don’t normally have this problem, thanks.

2. On pre-op assessments what bg level are they looking for, do they do HbA1c for this? I have seen that ops have been cancelled because bg too high. PS do you normally take your own food in?

Thanks for your help. Sue x

Sue, this is a Diabetes UK clip demonstrating testing:

Vis-a-vis your query around pre-op. They generally are looking for 68 or lower, due to the increased risk for wound healing and so on if higher. The figure of 68 can be side-stepped where the need for the op is very urgent and the risks of delaying outweigh the risks of going ahead.

Thankfully, my only op post-diagnosis I was able to go home the same day, so I ate the rubbery sandwich, as a means to get home. Had I been staying longer, I would certainly have had some things with me.

My OH and I often joke about bringing each other emergency food parcels should we end up in dry dock.

Goodluck with it all, if you're having an op soon.

 

[SueEK]

Sue, this is a Diabetes UK clip demonstrating testing:

Vis-a-vis your query around pre-op. They generally are looking for 68 or lower, due to the increased risk for wound healing and so on if higher. The figure of 68 can be side-stepped where the need for the op is very urgent and the risks of delaying outweigh the risks of going ahead.

Thankfully, my only op post-diagnosis I was able to go home the same day, so I ate the rubbery sandwich, as a means to get home. Had I been staying longer, I would certainly have had some things with me.

My OH and I often joke about bringing each other emergency food parcels should we end up in dry dock.

Goodluck with it all, if you're having an op soon.

Thanks very much, my HbA1c should be fine then but I shall be in between 4-11 days, probably more the latter, also it is 25 miles from my home so getting family to bring food may be difficult. Am concerned as have read they do not seem to cater for diabetics at all and will need all the healing powers I have. Even if they allow me to keep some things in the fridge I won’t be able to get up to get them so I’m not sure what I’ll do.
I’ll have a look at the video and thanks again, Sue x

 

[AJLang]

Hi Sue I’m sorry that I can’t give a specific answer but each time I’ve had a general aesthetic they’ve wanted my BG to be in quite a tight specific range immediately prior to the operation, something around 5-10 but I can’t remember the specific numbers. It’s probably best to check with whoever does your pre-op assessment.

 

[Flower]

Hello Sue,

At my most recent operation under GA I was told to get an HbA1c of 6.5%/48mmol/mol for the surgery to go ahead. That was just my hospital but I imagine the requirements will be there or thereabouts for elective surgery.

These guidelines may help, downloads on the right hand side https://www.diabetes.org.uk/profess...y-and-elective-procedures-improving-standards

 

[SueEK]

Thanks @Flower and @AJLang, did they give you a blood test at your pre-op or did they go by your last HbA1c result.
Do you have any tips on the food problem, sorry to be a pest 🙄🙄

 

[Flower]

I was sent for blood tests including an up to date HbA1c by the pre assessment clinic. I was so sick after GA I didn’t eat for a few days but I took in my normal hypo treatments with me.

Can you make a list of small portable meals from your normal foods that could be brought in by family/ visitors for you as a back up in case the hospital menu doesn’t have good choices for you.

 

[trophywench]

With me the last time they gave me a phlebotomy appt immediately after the pre-op to have an HbA1c test as the last one they had at that hospital trust was 18 months previously since I don't go there for diabetes things, but this was to remove the metalwork they'd put in my knee when I broke my patella over 12 months previously and I was still seeing that consultant 12 months later as still having trouble with it as the barbed wire entanglement was migrating although the breaks themselves had healed quite well - apparently my chap was quite good at doing bony jigsaws LOL

No idea what my A1c was either time but the first time I was admitted via A&E anyway and operated on the next morning so they didn't have much choice really then. Both would most likely have been in the low 50s I expect since that was my norm anyway.

Being Type 1 I have a lot more leeway with food - so that was just as well since there was never anything whatever low carb on offer - salad was only an option twice whilst I was there and I fell for it both times - awful, tough leaves, 2 slices of cucumber and the same of tomato! Never any fresh fruit. A desertspoon of veg and lumpy mash. No 'plain' meat or a slice of cheese or eg mashed tuna or even a jacket spud. No yoghurt ever. All sandwiches made with thick sliced white. Absolutely vile and TBH 1950s school dinners were far more appetising since I actually liked mashed swede! LOL (1960s school dinners were great, freshly cooked that morning from good ingredients by interested cooks on site)

 

[Ljc]

Since 2015 I’ve had a few hospital stays and I found the none of the menus diabetes friendly even though they say they are.
Apart from the salads were ok
Breakfast consisted of porridge, cereals or toast .
Dinner, apart from the salad was all carby
Puddings were 😱
Tea. Was soup , a sarnie
No fresh fruit at all, very little veg either.
Fortunately for my last hospital stays I was already on insulin so I could deal with the carbs .

At your pre op appointment you could ask about availability of a special menu but tbh I don’t hold out much hope.

 

[SueEK]

I was sent for blood tests including an up to date HbA1c by the pre assessment clinic. I was so sick after GA I didn’t eat for a few days but I took in my normal hypo treatments with me.

Can you make a list of small portable meals from your normal foods that could be brought in by family/ visitors for you as a back up in case the hospital menu doesn’t have good choices for you.

Thanks for the info Flower, will have a think and speak to the team when I see them next. X

 

[Ralph-YK]

Hospital did a finger prick test the morning of my procedure (as an outpatient!). They didn't ask about HbA1c. I had a local anaesthetic and was awake all the time.
It could depend on the procedure you're having done.

 

[AndBreathe]

@SueEK - When I had my pre-op assessment, I was asked bout my diabetes status. The nurse doing the assessment was a bit befuddled by my status of "Diabetes Resolved", and asked, as I was having bloods drawn anyway, if I'd like a A1c thrown in, as it had been a few months since the last one.

I gather if your latest test was recently, they sometimes go with that.

This is quite and old document (2016), but I don't think the 68 has changed since then.

https://www.diabetes.org.uk/resourc...ine 2015 - summary FINAL amended Mar 2016.pdf

The reason I'm so confident in that is I was involved in some discussions about a piece of research being set up to try to pick up those with high A1cs earlier in the process. Folks turning up for their pre-op assessments then being turned away is much more common than it should be, and causes such disruption to the hospital lists, and usually immense disappointment to the person awaiting their surgery.

 

[SueEK]

Thanks all for your replies, as my HbA1c is fairly low it shouldn’t be a problem from what you said, I hope. Am more concerned now regarding the food but will try and talk to the consultant and his side kick about it, haven’t actually seen any good reports on food for diabetics in hospital. However I’ve been told by my surgeon that it is a major op, fairly long stay and in an area that is notoriously slow to heal (and that’s without having diabetes) so will try and push those comments.
Thanks again and if you have any ideas about food that would be great x

 

[Nick Cliff]

Prior to my Prostate removal last year at pre-op my HbA1c was 54 and surgery went ahead.
Food at Eastbourne hosp was acceptable. I took some oatcakes in with me which were handy when I needed food and it wasn't mealtime.

 

[SueEK]

Prior to my Prostate removal last year at pre-op my HbA1c was 54 and surgery went ahead.
Food at Eastbourne hosp was acceptable. I took some oatcakes in with me which were handy when I needed food and it wasn't mealtime.

Oh that’s good to know Nick thanks. Out of curiosity did you ask if they could adapt your meals?

 

[Nick Cliff]

@SueEK I didn't ask them to adapt my meals but did tell them I was diabetic. Fortunately the impact of my diabetes is not severe and I figured that there would be sufficient choice for me to get by for the couple of days I was in. Nick.

 

[TheClockworkDodo]

When R was in hospital recently the first day he was given nothing to eat, the second and third days he was given only stodgy carbs, and by the third day when they gave him a salad and a yogurt, he was too nauseous and uncomfortable to eat them, so it does seem to be a bit hit and miss - so definitely worth discussing the issues with your consultant beforehand, and having as many friends/family members as you can prepared to bring you in food parcels as often as they can, I should think, distance allowing.

When I was in hospital (with DKA) R brought in all my food, but that was because of my food intolerances rather than my diabetes - there wasn't anything on the hospital menu I could actually eat except for bananas. He came in once a day around lunchtime and I ate the fresh things he'd brought, like tuna and tomatoes and (my citrus-free) yogurt, while he was there, so they didn't have to survive all day in a hot hospital, and kept the less fresh things, like peanut butter sandwiches and cereal bars, to eat in the evening (then got the hospital banana for breakfast). Not much help to you diabetes-wise though, because I didn't have to restrict my diet to diabetes-friendly things, as they were pumping me full of insulin at the time.

I do know the woman in the next bed to me was type 2 though, and she was trying to get them to bring her the carby puddings from the menu and they were bringing her yogurts - so not all hospital staff are clueless!