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Knee Surgery

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paul.johnson

Well-Known Member
Relationship to Diabetes
Type 1
Hi All,
Quick question about insulin and surgery.

I am due to go for a cartilage op on my knee on 23rd, never been in hosp since type 1 diag.
What happens about the nil by mouth 12 hours before and insulin injections and afterwards ?

Do your blood sugers go high for the op
thanks for any info in advance
 
I can't answer your question Paul, as it's not a situation I have been in, but I'm pretty sure quite a few of our member have - hopefully they will see this and respond 🙂 I'd recommend asking your DSN for advice. Good luck with the op! 🙂
 
When I had a knee op a few years ago I insisted on a chat with the surgeon first to discuss the whole diabetes care thing and he brought along the anaesthetist who was very reassuring. He was going to monitor blood throughout and was going to effectively drip feed me insulin as I needed it.
I did though have a panic when I tested my blood just before going down and it was about 3.4 and he said he’d pump some glucose in instead!
Was quite high when I came round, but that was easily managed
I think talking to the team is key, so your DSN should be your first call, I suggest
 
Don’t know if this helps but might put your mind at rest. I had ketamine infusion therapy for pain . It lasts 6 hours and why kids pay for ketamine I will never know. You our totally out of it hallucinating really frightening experience. But the one thing I was aware of was the nurse coming regularly to test my blood sugar. If I was low I was given glucose. (So I was told). I was totally incapacitated as you probably will be so rely on the angels to keep you from the dreaded hypo. Good luck with the op.
 
Depends on a number of things - is it GA or epidural, what insulin therapy are you on, etc etc. If you are using an 'all day one jab' basal insulin eg Lantus, you need to know whether to take it, and if so, how much, the night before the op, for starters. Is it 'Day' surgery, or what? You may be put on a 'sliding scale' (insulin pump operated by anaesthetist during op) or you may not, depending on how long the procedure is likely to take.

I had a hysterectomy in the hospital that was the main regional BUPA knee clinic. After about 4 days I said to the sister Oy - I want a word with you! Every day I see strapping young, fit blokes coming in here, and every day I see em after you lot have done your stuff on em going home again - and every man jack is either on crutches or in a wheelchair! Thought you were sposed to make em better!

Some of the beds had squeaky wheels - it was disturbing trying to recover after a major op, with the constant parade past my door - I mentioned it to my consultant and she told management who got the maintenance team in to sort it. Nurses said after they'd been moaning about it for years to no avail - but it makes a difference when a paying guest complains! I told them to report back that I was appalled it had taken me to say something to get something done and that I thought it was illustrative of poor show from Management ! Would have loved to be a fly on the wall.
 
I’ve been nil by mouth for twelve hours several times for odds and sods. I was at the time on Lantus plus Humalog, and I found from experience that reducing the long acting by 2/3 worked best, then wing it from there. My guess is that you will get an epidural - they do that for hip replacements these days, so apart from the actual surgery, just carry on as normal. They will be quite happy if you just test and inject, though the anaesthetist will be keeping an eye on your BG during surgery and correct as necessary.
 
Thanks trophywench for info and mikeyB,
I'm on Lantus and novo rapid so will probably jab basal at midday before and see what they say.
Havent a clue if they are knocking me out or not,i see BUPA pre op team on Monday,My knee has a cartilage fold in it apparently,had it all my life.
But working on aircraft kneeling crawling etc etc has caused wear over 40 years lol. so they tell me..
 
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