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Diabetes and surgery

Discussion in 'Parents of Children with Type 1' started by curediabetes14, Sep 20, 2011.

  1. curediabetes14

    curediabetes14 Approved members

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    So they have scheduled my dd's orthoscopic knee surgery for next Thursday the 29th at 7:30. Does anyone have any pointers or things to expect. This is our first surgical experience. I am so nervous about this. The doctor said that she would be in a great deal of pain and the rehab will be excruciating.

    Thanks for any advice and the prayers.
     
  2. Beach bum

    Beach bum Approved members

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    Contact your endo. They will most likely want to draw up orders for the surgeon to follow, and possibly have a plan for rehab to. We had to have orders for a minor procedure.

    Good luck, I hope everything goes well and she does experience too much pain.
     
  3. Caldercup

    Caldercup Approved members

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    I agree -- have the endo team draw up the orders.

    With my son's two outpatient surgeries, we asked them to use a saline IV rather than a glucose one.

    Get your endo team to give you advice on managing BGs with the pain. Some kids react by going low, others by skyrocketing BGs.

    Good luck!!
     
  4. ashtensmom

    ashtensmom Approved members

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    I don't know what insulin she's on but I know that apidra is not compatible with dextrose or lactated ringers. U might need to check not use dextrose anyway because it is the "sugar" one. Have the onus on yourself to check the iv bags. I have heard of so many med errors. It is better safe than sorry.
     
  5. TheFormerLantusFiend

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    If she's not allowed to eat for some hours before the surgery, you may want to reduce the basal a bit while she's not allowed to eat, and to correct slightly less aggressively.
     
  6. lamia

    lamia Approved members

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    I hope your daughter will be fine and get well soon.
     
  7. hdm42

    hdm42 Approved members

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    Definitely talk to your endo team. When Campbell had an endoscopy (outpatient procedure), the surgical team wanted orders from the endo. They let me handle it all, but they wanted it in writing for his file.

    One other suggestion is to talk to the anesthesiologists about putting anti-nausea drugs in the drip as they're finishing up. We did this with both my boys and it made a big difference in how they came out of it. They both felt pretty good once they woke up, and there was no vomitting. It can include a steroid, but I told them I'd rather deal with a known steroid high than the unknown of vomitting. They also gave us zofran for him to take at home if he felt sick later.
     
  8. sarahspins

    sarahspins Approved members

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    How are they doing the anesthesia? When I had my knee surgery done (I was close to the same age), they actually just gave me a spinal and lots of twilight sedation so I don't actually remember anything but I was never completely "out" (I did fall asleep after surgery for a while in recovery, but I wasn't unconscious or anything, just very very tired). I didn't have D at the time of my knee surgery, but I've had dental work with similar sedation several times since and I just ran a little higher (140's) and set my pump at 75% basal) and I was just fine... I did run a bit high after (and I was conservative about correcting), but I never had any lows.

    As far as the IV, none of the analog insulins can be administrated in LR or dextrose... it's not just an Apidra thing. I wouldn't worry one bit about the kind of insulin she receives through her pump - since it's not going into her IV. If they have to give IV insulin for some reason they will use regular.

    I hate to scare you (though it seems your daughter's doc has already given you a head's up), but my knee surgery (I tore ACL, MCL, my medial meniscus, and shredded part of the cartilage behind my kneecap) and recover was one of THE most painful experiences I've ever had.. at just 15 I proclaimed it had to be worse than childbirth, and after having had a 9lb+ baby with no drugs, I have to say I'd rate my big baby as maybe a 6 out of 10 (aka "slightly more than uncomfortable"). After knee surgery was an 11, and the CPM was torture. Injuring the knee originally (I dislocated mine) didn't hurt as much.

    Stay on top of the pain meds even if she "feels fine" - it's easier to keep pain under control than to deal with major breakthrough pain when it's not controlled. Her knee will probably be loaded up with lots of local anesthesia which can take a long time to wear off after surgery, usually a day or longer for some, but mine wore off after only about 4-5 hours, and they kept telling me that it couldn't have, and I shouldn't have been in so much pain already, but I definitely was! She'll probably feel just fine immediately after surgery, but when the pain kicks in it can be pretty bad... however it will be uncomfortable before it really registers as pain.
     
  9. pianoplayer4

    pianoplayer4 Approved members

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    I had cateract surgery a year a go, I was still on shots then so we reduced my lantus the night before and I had a snack at 11:45 uncovered. that morning the antesiologist (sp??) talked to my mom, she said if I 'looked' low she would test me, and if needed they could give me a glucose drip. I ended up on the low side all day, they did have to do the drip, but I wasn't in any pain, I hope it goes well for your daughter! I'll be praying for her:cwds:
     

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