surgery with type 1

[gambi]

I'm a pretty healthy indiviudal, I just have diabetes. My last AIC was not great, 7.4% but I attribute that to the learning curve with the pump. Now I have a CGMS and am starting to obtain tighter control (only 3 readings so far this month abouve 200! and I always correct when it does go high). Diabetes and low thryoid are the only health problems I have.

So anyways my heart health is good but I'm wondering if my endocrinologist will not clear me for surgery with an AIC that high, I will be going under local anethesia.

What do you all think? Honestly I would be more concerned about my heart health that my AIC prior to surgery. But I would like to know what you all think.

[solox316]

I had a surgery about 6 months ago, under local anesthesia as well... My surgeon didn't ask much about my a1c, he just asked that I really watch and make sure I wasn't close to low beforehand, since I couldn't eat. They monitored my glucose during surgery. This was only a 90 minute or so proedure though, removing an enlarged lymph node from the neck...

[Dewey]

I think that as long as you continue to take care of yourself, you should be alright in terms of surgery & healing.

Do you mean you're going under general anesthesia (where you're asleep)? If that's the case, just be sure to communicate with the doctors about your needs before hand. I did that & even as they were putting me under (for sinus surgery), I reminded them I didn't want Decadron (steroids) and I reiterated to them not to be alarmed because my pump might beep every now & then. They were cool with things & everything turned out well. I did wake up with a higher sugar level, but was able to bring it back down with a bolus.

If you're doing local anesthetic, you should still be awake & able to communicate with the doctors if needed (of course, depending on what type of surgery you're having - if it's dental, that may be a different story ;)).

[xMenace]

I doubt A1C is even considered. It's a short term event and they really only care you going hypo. My last time in I told them the pump would keep me steady and they believed me. They left me hooked up and let me control it.

Years ago when I went under, they raised my BGs over 10 before surgery.

[notme]

I had surgery I my feet last year. I had it done once in Sept and again in October under general anesthesia. Before surgery, my doctor did an untrasound on my legs to check for circulation and all went well. My A1c (although it wasn't checked) wasn't perfect.

Not to worry, just have your surgery and try to keep your blood sugar in good control before and after the procedure.

[gambi]

I think I will be under a local and geneal anesthesia, the nurse said I will be awake but out of hit. The doctor and nurses have experience with diabetics and know how to use the pump and all that, so I think I'm pretty confident that they will be able to control my BG. I will have to fast and the surgery will take about 2 hours.

The last time I went to the endo she said my A1C was good, I guess for someone not even a year out it is decent but I have room to improve my 7.4% It was my GP who had a problem with it.

I also had an EKG, the first one came back slightly abnormal, the second came back slightly abnormal but in a different way. My GP said if I didn't have diabetes she wouldn't be so concerned, but since I have it you can never be too careful. So I will see a cardiologist on Tueday, I get to run on a treadmil with sensors, how fun. It's probably just there machine. I was also told my a nurse I work with that thyroid conditions can cause heart palpatations and that is probably what through the test off. Oh well. I probably should start seeing a cardiologist once a year anyways, right?

Thanks everyone for putting me at ease!

[Richard157]

xMenace gave you good advice. If you have tested your basals and they are working then leaving the pump attached and working during your surgery should take care of you nicely. I have heard of pumps being disconnected before surgery and the patient being very high after the surgery. Don't let that happen. Of course you don't want the pump for MRI's, etc but those should not be happening during your surgery. Good luck!

Richard

[gambi]

So had my surgery on Friday. (It was cosmetic, nothing to do with diabetes). I was told not to take metformin at night, which I did not. I woke up at 5:30am and was 108. So I turned off my pump until I got to the doctor's office. Right before surgery was 102, my normal basal from 3am-10am is .7 then drops down to .55. My endo had told me to leave my basal going as is during the surgery. They told me to keep my pump off during the surgery. So started at 102 no insuling from about 6-11am. Oh yea I had to fast all night. THey told me the highest I went during the surgery was 139. Oh course wouldn't you know that's the first thing I asked when I woke up!
Then while in recovery they tested and I was 202. So I connected back up and took a correction. I looked at my CGM and saw a slow creep up from about 100 to 200. So I came home and ate and went up to 300 about 2 hours after lunch. So I wanted to get down quick so I tried Blue Sky's method of injecting into the arm muscle. Got down to 160, then ate dinner and took correction was 116 after dinner.

Now I've been hanging out in the 70s for the past day or so. Isn't that bizarre? I thought I would be much higher. I can really exercise as I'm too sore. But I am eating a lot less and resting.

It's odd how much less I eat when I don't exercise. Not that I would EVER stop doing that. It's about 60 outside and it's killing me not to be able to run!!!

But anyway I was really concerned that my numbers would be higher but surprisingly they are not.

Just goes to show how crazy diabetes is!

[kgm0612]

Glad everything went well for you. I wish you a speedy recovery!

Wow.......less than 2 months before the "BIG DAY". Are you ready?

Karen

[JediSurfer]

Don't beat yourself up over a 7.4% thats not bad at all. "normal" non diabetic range is 5-7%. And we are far from normal. You will be fine. Just remember the people on this site with 5-6% are a very small minority in the diabetic world.

[Gary_W]

Don't beat yourself up over a 7.4% thats not bad at all. "normal" non diabetic range is 5-7%. And we are far from normal. You will be fine. Just remember the people on this site with 5-6% are a very small minority in the diabetic world.

Whilst I aggree that 7.4% isn't bad, according to Wikipedia, the 'normal' range is 4% - 5.9% and 95% of all non-diabetics will fall into this range. From what I gather, every 1% rise above 6% gives you a 40% greater risk of long term complications, and if you can get down to 6% (without lots of highs and lows which apparantly also get you and is where I fall down) then your risk of complications should be minute. I can't find the reference for that one, but I've read it on here several times. The Wikipedia link is here, though.

Glycosylated hemoglobin - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Hba1c#_note-2)

As for the surgery, it's becoming increasingly fashionable to do surgery when avoiding general anaesthesia these days irrespective of other health issues. But when you have got other health issues / age issues / obesity etc etc then local regional anaesthesia looks even more attractive. Our local hand unit proudly states that it never puts a patient out. Lots of knee replacements done under local as well at the same hospital. The more advanced places will do a nerve block using ultrasound guidance. In fact, they'll do a couple. They will do a short(ish) acting block for the duration of the operation. If they're doing your hand, they'll typically be whacking the needle in your neck for that (or occasionally under your armpit depending who's doing it :) ). The reason they block so high up is that you'll have a tourniquet on your arm for the duration of the operation, and that is seriously painful when it's been there for a bit... Then they'll put another block in your forearm a few inches south of your elbow. This block is longer acting and will give pain relief for a good 24 hours after the op. Better for the patient as you can rely less on opiates following the proceedure and typically go home earlier for that very reason.

Gary

[MinimedPumper07]

i am having surgery and will choose general anaesthesia because its eye surgery and that freaks me out...