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Healing after surgery

Discussion in 'General Discussion' started by Riley's Mom, May 13, 2015.

  1. Riley's Mom

    Riley's Mom Approved members

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    My 17 year old daughter is scheduled to have a lumpectomy on May 29th. She will be 5 months in to her T1D diagnosis. I've read that cuts and things take longer to heal in diabetics - is this true even with fairly good glucose control? She will be having a phyllodes tumor removed that is about 2.5 cm in diameter plus at least 1 cm margins under general anasthesia. It will be a pretty decent size scar. Anything I need to be aware of otherwise with surgery?
     
  2. Sarah Maddie's Mom

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    Ok, banish from you mind the notion that Type 1s heal any differently from others. It's a myth and it's not relevant to an otherwise healthy, "well managed" type 1.

    Of greater concern is how you might want to adjust your insulin dosing to avoid lows during surgery and immediate recovery and how you might address the highs that may come after due to the stress of the "injury". I'd give a call to the endo/ CDE before hand and seek their suggestions.

    Good luck!
     
  3. Riley's Mom

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    Thank you Sarah! That is so good to hear! And yes, I will def contact her endo for instructions on all of that! We are trying to get the Dexcom by then, but our insurance is being a pain...
     
  4. Snowflake

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    I agree with Sarah re getting instructions from endo on T1 management before, during, and after surgery.

    My daughter had adeno-tonsillectomy last year that involved a post-op overnight stay, or about 36 hours total in a recovery ward.

    A few things to be aware of, although these might differ from surgeon to surgeon and hospital to hospital, and on length of surgery/recovery. First, the surgical scheduler gave us a pre-surgical bg range and told us the operation would not proceed if we were out of range. Because the surgery had been very difficult to schedule, I was up most of the night before trying to keep her right around 140 so we wouldn't risk sacrificing our appointment to a number that the surgeon thought was too high or too low. The scheduler gave us the first appointment of the day so that we wouldn't be playing that game too long in pre-op.

    Second, even though the ENT surgeon and the endo both supported us parents managing dd's bg and her pump during recovery, the hospital's nursing staff told us that they had to do pokes on their own meter (which looked like they dug it out of a diabetes museum!) something like every two hours during the 36-hour post-op stay, and they also wanted us to revert to the pump settings that the endo had given the hospital weeks before the surgery. We ended up letting the nurses do their own pokes (even though it was pretty sleep-disruptive), but they did ultimately give us control over pump settings and bolus decisions.

    My bottom line advice is to ask the surgical staff and hospital if there are any protocols around T1 management before and after surgery and, assuming that you will be with your child the whole time, to seek as much control for you or her over T1-related decisions as possible. Also, if the hospital requests it, I'd make sure that her endo's care plan regarding Novolog/Levemir dosing is as fresh as possible before surgery.
     
  5. Wendy12571

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    Okay I have had multiple surgeries with type 1 diabetes. Some have been without the pump some have been with the pump. I would first make sure the endo writes orders for the hospital to follow pre and post surgery. I actually just learned the import of post op instructions during last surgery. Basically the pa said ah just test her two more times after surgery. Endo and I was under impression was going to be admitted to hospital after but surgeon decided to let me go home that night. If on a pump make sure the endo has updated pump settings or insulin suggestions.
    Now when not on the pump a general rule was to lower the basal insulin night prior to surgery. I would talk to endo on this. If on the pump I would also talk to the endo. I found after all the surgeries I healed faster then the surgeon expected. My blood sugars were not optimal for the final one and was pretty much healed when they removed the staples The incision for the last surgery was fairly large and on the stomach. The biggest tip I have is get the endo to write orders for everything.
    Wendy
     

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