I am getting GI surgery in a few weeks and I am concerned about managing my diabetes while I am recovering in the hospital.
Before I was on the pump I was in the hospital for a few days and the nursing staff didn't know how to manage my diabetes. Fortunately I was alert and able to tell them what I needed. But I am worried that this time around, post-surgery, I won't be alert enough to manage my BGs and general pump maintenance. Has anyone been on the ping in the hospital while recovering from surgery? I would love any advice on the best way to deal with this. I am anxious about this on top of the major surgery and its a lot to think about right now!!
This used to drive me crazy, but I've come to realize that modern insulin dosing isn't taught to most healthcare providers. I've seen a few research studies in the last few months showing that patients with tighter glucose control healed faster so some hospitals are beginning to get up to speed. But expect to have to patiently work with the nurses and doctors who help you in the hospital.
They probably won't let you keep pump on while you're under anesthesia, and will put you on an insulin drip so they can monitor. Don't expect to have tight control on the insulin drip... just know if will be for a day at the most and it's better since you'll be incoherent.
Nurses can only do what is directed by your chart. Once you're able to test and dose, your doctor will need to write in your chart that you will administer your insulin and you'll be able to reconnect the pump. You may consider cutting back on both bolus and basal in the weeks post surgery. Take your own meter and test a lot since the stress of surgery and different medications can do funky things to blood sugar. I also take snacks/glucose tablets in the hospital, just in case I have a low.
Once the nurses see that you're well monitored they'll probably let you alone and just ask to test your blood or may ask to chart any boluses you give. Hope everything goes well for you.
The most important thing is to emphasize your concern. Tell your doctors and your nurses that you are diabetic, and that you are on an insulin pump. I was able to keep my pump on during my last surgery and was fine under anesthesia. The stress of a surgery will generally raise your bg a bit more than usual but that’s normal. While you are under and in recovery any CNA can should be able to check your blood sugar and be able to determine what you need. You may want to give them a range that you feel comfortable with your bg being in. You should also have a family member with you that knows what to do if your bg is not in range.