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VRII and back to pump

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SB2015

SB2015

Well-Known Member
Relationship to Diabetes
Type 1
As they will be doing X-rays during my forthcoming operation, I expect to end up on VRII. Even if I stayed in my pump and they were happy to disconnect and hide it for the X-ray I would still have to remove my sensor, so it would be manual pump, which I would prefer to VRII (sliding scale). I am hoping to speak to the surgeon and/or anaesthetist before the day, but usually I end up meeting them on the day.

If I am on VRII and switch back to my pump am I right in thinking that there needs to be an overlap time?
Does anyone know how long?
I emailed my consultant who is unfortunately away on holiday. I am left with a DSN who is certainly not familiar with my pump!! Panic rising as the day approaches.

I hate anyone else managing my diabetes!!!
 
If it helps, I had a CT scan a couple of weeks ago and told there was no need to remove my pump.

Just a suggestion but can you not get longer tubing so your pump is well out of the way same with sensor have it where the xray wont be in the way?
 
Thanks Sue

I do have some with longer tubing so if the anaesthetist will let me stay on the pump that would be great.
 
When I had surgery, I had only met the surgeon before the day.
He was not happy with me keeping my pump.

On the day, I met the anaethetist. He asked me some questions about how my pump worked. We agreed he would be able to leave it be. If he detected my blood sugars rising or falling, he could manage it by adding insulin or glucose via the drip.
He was perfectly happy for the pump to remain attached (and out of the way) so the surgeon was also happy.

This was about 5 years ago when pumps were less common than now.
 
Hope the conversation goes well and puts your mind at rest @SB2015
 
helli said:
When I had surgery, I had only met the surgeon before the day.
He was not happy with me keeping my pump.

On the day, I met the anaethetist. He asked me some questions about how my pump worked. We agreed he would be able to leave it be. If he detected my blood sugars rising or falling, he could manage it by adding insulin or glucose via the drip.
He was perfectly happy for the pump to remain attached (and out of the way) so the surgeon was also happy.

This was about 5 years ago when pumps were less common than now.
Click to expand...
I had the same conversation with the anaesthetist a few years back and also provided the basic operation manual for the pump.
The lady was more than happy as most of her job was done due to the sensors being used as well 🙂
 
Thanks All. I shall go armed with the various suggestions and prepared for either outcome.

I spoke to a friend who is an anaesthetist who confirmed that where possible they would prefer us to continue with our pumps. He explained that where X-rays are involved they are very directional, and simply covering the pump and sensor with a lead apron, well away from the operating area should be sufficient protection. He welcomes any system that avoids any possible errors creeping in.
Now I just need to convince the anaesthetist on the day.

I am nil by mouth after breakfast so plan to raise my target level before breakfast to avoid any possibility of hypo before I go in. I shall make sure I change my cannula in the morning and if allowed to stay on the pump calibrate before I go down to theatre, and hope that those precautions avoid any issues.
 
Er, you don't use metal cannulas do you?

No idea what you're having done and don't need to know - but just be very aware that having an incision to your body and then the 'rummaging about inside you' will absolutely have the same effect on your body as if you've been hit by a train - ie major trauma - so you might need one helluva lot more insulin post op - but for how long? - can't tell you that, depends on your body - please make sure you have your very own blood ketone monitor and strips with you as well as your BG meter.
 
I spoke to the surgeon yesterday and he confirmed that he will not be using any X-rays, and will use an alternative diathermy as my sensor is metal. He is then happy for me to use my pump during the operation. Now it is just up to the anaesthetist.

Thanks for the reminder @trophywench. I hadn’t thought to take in ketone strips. Last time I ended running at 200% for a couple of days, so I may well have to switch from sensors to manual. Humphrey will start alarming if the delivery is very High for over 7 hours. This will be a learning curve for how the sensor copes.
 
All went well and I staid on my pump for the op. I explained how to put in a Bg if the pump asked for it, and the anaesthetist said if it asked for anything else he would disconnect and switch to VRIII.
woke up still on pump and with a Bg 5.5

once home I needed a lot more insulin so switched to manual mode and used TBRs Up at250% at one point. Glad I had spent time familiarising myself with this when I first used this pump.
Went back into aut mode this evening.
 
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