Post Operation - Temporary basal?

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martindt1606

martindt1606

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Relationship to Diabetes
Type 3c
Scheduled to have an operation within the next week or two.

It will be the first since they took away my pancreas and therefore also the first where I have an insulin pump and where I go into the operation as a diabetic.

Last time I ended up in Intensive Care due to excessively high blood sugars => ketones because the post op care didn't register my new found diabetic status. This time I'd like to make sure they (and I) are prepared.

The operation this time should only take around 6 hours and I expect to be on Morphine for a few days and in hospital for 5 to 7 days.

Anyone got any views on how the op will impact my insulin regime? My DSN has suggested setting the temp basal at 4 times current levels to start with. Does this seem reasonable?
 
You will need more due to inactivity and healing processes etc, but it's hard to say how much! When my daughter had her appendix out I just kept doing correction boluses and setting higher and higher temp basals until we found a level that worked. Good luck, hope it all goes well 🙂
 
Will you be on the pump or a sliding scale?
 
Haven't discussed sliding scale. I was hoping that once I was conscious I'd be able to take control which means using the pump. I remember last time I would get pain killers and food and sit there waiting for insulin - not good when I'd never had insulin before. This time the insulin stays with me.
 
Can't really help with the insulin martin, but I hope that all goes well for you. Will you be 'with it' enough to be able to get your doses sorted if you're on morphine? I was told if ever I have to go into hospital to ask to see the diabetes team so they can keep an eye on me - not sure if all hospitals do that though.
 
These days, it is written that they must agree a Care Plan for us, so we know exactly who will be doing what when with our diabetes!

I usually throw up for about a week after a general, take forever to come round and really feel like death itself for quite a while after, so I wouldn't want control of it for quite some time - as long as I have my meter so if I do feel like I care again, I can test and if I wasn't happy with what my meter was saying, demand my own stuff.

I'm not sure what they do about stuff like that now, they don't really like you having any personal possessions or money with you at our hospital as there are no locks on the lockers, stuff does get stolen and they won't take responsibility for any of it.
 
Hi Martin

I had a long operation last year but wasn't allowed to keep my pump running during surgery as the anaesthetist preferred a sliding scale.

The sliding scale was kept running for 24 hours after because I was sick and the morphine caused me to have weird hallucinations. When I did re attach my pump I only needed about 120-130% basal rate. I waited until I was able to start using it and gauged it from there. I didn't have a set idea of what I might need, just worked it out as I went along depending on blood glucose levels, pain and sickness.

Make sure it is somewhere accessible after surgery as one time mine got locked in the drugs drawer and I could hear it alarming but couldn't get to it, the nurses told me I would have to wait as the ward was too busy. I had to have a rant to get it released.

Good luck, I hope your surgery goes well.
 
Flower said:
Hi Martin

I had a long operation last year but wasn't allowed to keep my pump running during surgery as the anaesthetist preferred a sliding scale.

The sliding scale was kept running for 24 hours after because I was sick and the morphine caused me to have weird hallucinations. When I did re attach my pump I only needed about 120-130% basal rate. I waited until I was able to start using it and gauged it from there. I didn't have a set idea of what I might need, just worked it out as I went along depending on blood glucose levels, pain and sickness.

Make sure it is somewhere accessible after surgery as one time mine got locked in the drugs drawer and I could hear it alarming but couldn't get to it, the nurses told me I would have to wait as the ward was too busy. I had to have a rant to get it released.

Good luck, I hope your surgery goes well.
Click to expand...

Just heard that I have to go in on Sunday to be monitored before the op so looks like sliding scale is on the cards. Last time I was fine on morphine - it took away the pain but didn't seem to have any other impact. I intend to get back on my pump ASAP - last time was a nightmare it wasn't unknown for my pills and insulin to arrive 30 minutes after the meal arrived when I shoudl have both with the meal. hospital food isnt that good luke warm its even worse stone cold.
 
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