Hospital stays.

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Janetfairlie

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I am a patient at Guys and long term pump user. I need to go in for surgery in a couple of weeks and just wanted some advice. Whenever I have been admitted to hospital since becoming diabetic I have been hooked up to glucose and insulin which is painful and stressful. As I am on a pump and Libre 2 is there a possibility that this could be avoided? Thank you in advance.
 
I don’t use a pump but I imagine it’s not that different to injections in that it depends on what kind of surgery it is, how long the recovery is, how your blood sugars respond to the procedure and to any medications given for recovery, and whether you will be capable of running the pump and making any adjustments needed whilst you’re recovering, or whether you’ll be too out of it after the anaesthetic to control it yourself. Do you have any more background you’d like to share?
 
Welcome to the forum @Janetfairlie

I have had a variety of operations, mostly day cases, and it has always been the anaesthetist that determines whether I was able to stay on my pump. for these shorter operations they were happy to let me stay on the pump.

My most recent one was last year and I was on a closed loop system so the pump was automatically adjusting my insulin every 5 minutes. It was a two hour op, and the anaesthetist agreed to leave me on the pump, I showed him how to put in a BG if it asked for a callibration and agreed that if any other alarms went off he would switch me to the insulin/glucose drip (previously called sliding scale).

For longer surgery they put me on the drip and to be honest I was very pleased not to be concerning myself with checking the pump, especially as I as throwing up afterwards.

My message would be to talk to the surgeon and if possible the anaesthetist before hand, although they don’t always know who the anaesthetist will be until on the day. However you will meet them, and the ones that I have met have been happy to have their work done for them by my pump. The Libre or CGM also gives them the information they need to monitor what is happening.

I hope that that helps.
 
My daughter had her appendix out when she was 7 and they insisted on putting her on a sliding scale, then sometime the next day they finally took her off that and allowed me to put her pump back on and resume control. I think the issue is that general hospital staff don’t know a great deal about diabetes and the chances are they won’t understand how to use your pump and will want you on some sort of insulin delivery system they can control, at least while you are having the operation and until you have recovered from the anaesthetic. That’s a good idea to talk to the team first and see what the options are.
 
I have had a couple of surgeries since starting pumping and I would agree with @Inka - it's up to the anaesthetist. My surgeon initially said I would need to remove the pump but I was lucky enough to have a great anaesthetist who asked a few question about what the pump does and agreed he would monitor my blood sugars, leave the pump to run (as long as it was out of way of the surgery) and top up with glucose or insulin via his drip if necessary. It wasn't the surgery and pumping went well.
It has the added advantage that when I came round, I was in charge of my insulin whereas I have heard other people with Type 1 having their insulin pens taken away from them only to appear at meal time.

In short - ask and, if they say "no" ask again.
 
Had surgery on knee last year, as experienced pump user & long term diabetic told staff would just manage own condition, all they asked for was bg readings & insulin doses at mealtimes.

Kept pump on during surgery just on normal basal rate, made sure bg was stable prior to going into theatre.
 
Came to see me before my knee op and told me they'd put me on a scale. Fine said I - what hourly rate? 2 units per hour. Good God - why do you think I'll need 5 times as much insulin? - so I argued and they grudgingly it seemed to me at the time, agreed to 1u/h. Pain relief, 2x oral paracetamol twice a day so I needed a basal rate of 300% until after I got home and established more frequent paracetamol for a week after which I could start reducing the rate - but it took a couple of months to get back to pre op doses.

I think they must have some sort of norm in terms of rate/hour cos when I had my hysterectomy I was completely out of it for 2 days and I found out eventually that Oh yes - I'd been mega hypo! - no wonder they were all so ruddy happy when I eventually resurfaced OK ....
 
Janetfairlie said:
I am a patient at Guys and long term pump user. I need to go in for surgery in a couple of weeks and just wanted some advice. Whenever I have been admitted to hospital since becoming diabetic I have been hooked up to glucose and insulin which is painful and stressful. As I am on a pump and Libre 2 is there a possibility that this could be avoided? Thank you in advance.
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When I needed surgery, I just showed the anaesthetist my pump and sensors and she said oh fab that saves me a lot of hard work, thank you.
They had a copy of the basic operating instructions in my notes and everything was fine.
Ask to speak to the anaesthetist via your consultant's sectary if you are concerned.
Good luck with your operation.
 
I had day surgery a couple of years ago, and my experience was much like the others. The anaesthetist was happy to go with the pump and CGM - saved him a lot of bother.
 
Yeah - when they later had to trim the wire that they'd fixed my kneecap back together with via day surgery - they were more than happy with my pump too.
 
trophywench said:
Yeah - when they later had to trim the wire that they'd fixed my kneecap back together with via day surgery - they were more than happy with my pump too.
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How long did it take you to get back to full mobility after that which I assume you did, can you actually kneel down on the knee now.?
 
Nope in answer to part 2 - but there again, how low, because if it's eg on a chair or the bed for some reason, yep but if it's lower like the back of the bottom shelf of a kitchen cupboard - or wiping up a wet splash on bathroom/kitchen floor - for get it. More to do with getting down there and back up again - but like no way would I dream of expecting the hinges on the kitchen base units' doors, to stand up to my body weight hanging off em. All 18mm carcasses - but MDF absolutely ain't solid mahogany!
 
trophywench said:
Nope in answer to part 2 - but there again, how low, because if it's eg on a chair or the bed for some reason, yep but if it's lower like the back of the bottom shelf of a kitchen cupboard - or wiping up a wet splash on bathroom/kitchen floor - for get it. More to do with getting down there and back up again - but like no way would I dream of expecting the hinges on the kitchen base units' doors, to stand up to my body weight hanging off em. All 18mm carcasses - but MDF absolutely ain't solid mahogany!
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So kneeling down weeding looks like it might be off the agenda then.
 
Well - things that sometimes come through the door or are included inside eg caravan club or NT magazines do have 'kneelers' to use in the garden which should certainly help either of us - I just haven't found one to buy, yet. I should fully imagine, should I bother to visit a garden centre - I might have LOT more luck!

@Leadinglights - BUT - what's wrong with your knee? - a smashed patella they had to put back together like a jigsaw with not all the pieces whole so they had to find all the tiny shards and get them out and bin too, is nowhere anywhere near eg a planned knee replacement or half knee replacement, or any other different knee problem. Surgeon did say I had no tendon or cartillage probs evident so that was good. I didn't like his sidekick who got the latest Xray up, looked at it and opened the conversation with 'You'll get arthritis cos people always do when they do this!'

I immediately responded with 'Frankly - at this moment I am a lot more interested in how my broken patella is actually fusing together again, as it's the very first bone in my body I have ever broken in my life and if I do get arthritis or rheumatism at some point in the future that's a bridge I can only cross when I get to it, surely to God! So - how IS it healing?' Bloody doom monger.
 
trophywench said:
Well - things that sometimes come through the door or are included inside eg caravan club or NT magazines do have 'kneelers' to use in the garden which should certainly help either of us - I just haven't found one to buy, yet. I should fully imagine, should I bother to visit a garden centre - I might have LOT more luck!

@Leadinglights - BUT - what's wrong with your knee? - a smashed patella they had to put back together like a jigsaw with not all the pieces whole so they had to find all the tiny shards and get them out and bin too, is nowhere anywhere near eg a planned knee replacement or half knee replacement, or any other different knee problem. Surgeon did say I had no tendon or cartillage probs evident so that was good. I didn't like his sidekick who got the latest Xray up, looked at it and opened the conversation with 'You'll get arthritis cos people always do when they do this!'

I immediately responded with 'Frankly - at this moment I am a lot more interested in how my broken patella is actually fusing together again, as it's the very first bone in my body I have ever broken in my life and if I do get arthritis or rheumatism at some point in the future that's a bridge I can only cross when I get to it, surely to God! So - how IS it healing?' Bloody doom monger.
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I fell down 3 steps off a step ladder and ruptured the patellar tendon and fractured the head of the tibia so had surgery to screw the bit of bone back in place and repair the tendon. Three and a half months ago now, the surgeon said it had healed well and I'm still having physio. The knee has full bending but is still quite stiff and I'm not confident about going down stairs forward yet, I have started walking a bit further each day and doing the exercises.
I was a bit despondent about the slow progress but the consultant said don't under estimate the severity of the injury.
Cov and Wark Hospital have been pretty good.
 
Janetfairlie said:
I am a patient at Guys and long term pump user. I need to go in for surgery in a couple of weeks and just wanted some advice. Whenever I have been admitted to hospital since becoming diabetic I have been hooked up to glucose and insulin which is painful and stressful. As I am on a pump and Libre 2 is there a possibility that this could be avoided? Thank you in advance.
Click to expand...
I had an emergency admission to hospital while on holiday last year. I use a pump and Libre2 and the cardiac team were happy to let me self manage. They didn’t seem to know much about pumps so asked a lot of question. I think they were happy to let me manage my diabetes and I was glad they did!
 
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