nervous about blood sugar during surgery

[minah009]

Ok, on March 11th I'm going for outpatient surgery to remove a nodule from my breast. The surgery is scheduled for 1:15pm and I have to start fasting at midnight. I'm worried about my blood sugar levels because my fasting numbers are always higher than any other time of the day (around 140) and they continue to go up until I eat. I usually limit my morning carbs to 15g and eat protein (hard boiled eggs or some lean ham) and then my sugar levels for the day are stabilized. If I can't eat until after the surgery I'm worried about what my sugar levels will do. I know I'm going to be a wee bit emotionally stressed and I'm guessing the surgery will up my physical stress levels as well. I'm bringing my meter so I can test right after I get out of surgery (I won't be having general anesthesia but I will be sedated) but what should I consider to high for a blood sugar level? I only take Metformin so if I'm too high I can't even correct for it. I am planning on eating as soon as possible after the surgery but that's a looong time to go without getting any food to help level out the blood sugar. Does anyone have any suggestions?

~Mariah~

[morrisma]

Make sure the surgical team is aware of your sugar levels so they can monitor it during the procedure. They will probably give you insulin if levels are too high.

Good luck,
Mike

[lorelei]

If they know you are diabetic I'm sure the surgical team will want to keep an eye on your BG. With higher BG risk of infection goes up, and they will want to make sure that doesn't happen. So I strongly recommend discussing your fears/concerns with your surgeon, or their staff. I'm sure they'll be happy to talk to you about it.

Good luck with the surgery. I hope all goes well for you.

[Holly]

I'd discuss this with the surgeon/anaethetist. It could be that since your surgery isn't till afternoon - they could consider allowing you a light breakfast very early in the A.M. especially in light of it not being a general anaesthetic. Our guidlines became much less stringent in the paediatric population after research was done proving prolonged fasts didn't make a significant difference.

[JadeMonkey]

I'm surprised they're not doing yours first thing. My doctors and people at the hospital have told me they try to schedule diabetics first (well, after those with latex allergies or other special circumstances) to help out with the fasting/blood sugar issues. Maybe they can move you up on the list for the day?

I'd definitely make sure everyone is very aware you're a diabetic. You don't want to take any chances that the surgeon or someone else in the room doesn't take that into consideration. I doubt it will cause you any problems but you just want to make sure. :)

-Jade

[Kim_in_TN]

I had an outpatient surgery this past Summer. The nurse at my pre-op appointment told me to eat a big spoonful of peanut butter before I went to bed. I'm not sure if this is what you should do or not. Do you have a pre-op check up with your out-patient surgery facility? I had several tests done and had to answer tons of questions. This is really what you need so the nurse can alert everyone of any special needs you might have!

Good luck with your surgery!

[Alice]

In some cases, liquids are allowed...you just need to check with your medical team. I would go so far as writing something on my arm...but that's just me!

[TomB]

Try to relax, Mariah, because stress can add another variable to your glucose level. At last count, I think I've had 12 angiograms during which I accumulated 9 stents and an overnighter. Either myself or my wife made darn sure that the nurse who looked like she knew what to do was made aware that I was diabetic. But after that, there was little in common between any two procedures on how my insulin was handled. Too many variables.

Common practice for all these procedures is to lay around for an hour or so getting hydrated through an IV. During that time I always had a finger poke and the type of IV sometimes got chaged, depending on what the glucose was. I've had regular saline but I've also had a bag of glucose and a bag of potassium hanging over my head. And I've had my big toe poked during an angiogram and the IV bags changed again. I've been out of the cath lab in under an hour and home that same day but I've also had a six hour stint and put in the CCU because I told the doc I wasn't paying him for overtime.

You might feel a lot better if you called the hospital and talked to the nurse in admitting. Tell her the same thing you wrote here. Get her name and ask what kind of snack would be ok. They don't want to take a chance on you asperating which would probably be a lot worse than having high glucose numbers for a day. Also ask her what you should expect for your procedure. The more you know, the more comfortable you'll feel.
Best to you,
Tom

[Jan B]

Mariah,

I had a similar surgery several years ago. In case you are more worried about the nodule than your possible high bg . . . I'm sending you peaceful and encouraging thoughts that it will all be fine. I was, and I hope you are too.

[minah009]

Thank you all for the advice. I have pre-op lab work and an EKG set up for March 3rd and then a pre-op appt with the surgeon on the 7th. I will talk to him and go over a plan in case my blood sugar gets high. I did get paperwork from the hospital today that I need to fill out and send back. There was a section about specific concerns so I will mention my blood sugar concerns there as well.

Jan B: Im actually not as worried about the nodule as I was before. I decided on the surgery because the consulting surgeon I saw said he wouldn't do a needle biopsy because if it came back negative it wouldn't be confirmation that everything was ok. He said it was small and in an odd position so there would be a chance of the needle missing the nodule. He said if I declined the surgery he would check me every 3 months until it either disappeared or got larger. So i decided being a wee bit worried for a few weeks is much better for me than totally freaking out every 3 months with repeat mammograms and ultrasounds. Thank you for thinking of me.

hugs 2 you all,
Mariah

[owlyn]

My experience has been that they make sure you don't get low. I'll bet you a dollar that they hook you up to a 5% glucose drip no matter what your BG is, and you come out of the procedure with your BG somewhere between 200 and 300, if not higher. If that happens, don't sweat it- you can always bring the BG down.