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If you have had surgery while living with T1D, were you able to choose the person who managed your T1D during the procedure? If you have had surgery multiple times, please answer for your most recent procedure.
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I didn’t get to choose who would manage bc the anesthesiologist was in charge but I thoroughly explained (with written directions) and I had someone “follow”. There was an issue with Dex not working due to equipment interference but they just did finger sticks.
Didn’t choose-Kaiser-but my anesthesiologist was type 1.
When I had surgery 4 times I left my pump on. For 2 of those surgeries I used Omnipod Dash. The other 2 , I used my Medtronic 770g. The results on Dash were different that the 770g.
I had slightly better control on my 770g.
I was able to wear my pump and CGM. The CRNA assigned to me had no issues with me keeping it all on for the procedure.
No. I was allowed to wear my pump. There was never any discussion about having a special person there to manage my diabetes. I hoped that someone there would do that.
I use a pump so as long as I was in range I just let it ride and alerted them if there was a problem what to do
I had knee replacement surgery in 2013. My surgeon let me use my insulin pump for my diabetes management. Everything went well.
I had an endoscopy, which was short but I was under anesthesia. They wouldn’t allow my cgm, said it was a quick procedure. Afterward I saw on the info from anesthesiology I was listed incorrectly as having type 2 diabetes and I have type 1. Not a doctor so I’m sure the protocol may be normal but it made me very uncomfortable and I am not getting the colonoscopy ordered yet, because of this
After I fell and broke my hip, the ambulance medic recommended a certain hospital. I said ok. Surgery was delayed 4 days. They let me keep my pump and CGM, provided they control my insulin dosage. They let my bG numbers go/stay high and would not be swayed by my arguments or intervention from my own endocrinologist at a different hospital. It was a very distressing 4 days. Fortunately the surgery itself went well.
I had cataract surgery, which is a relatively short procedure, and managed my own T1D. I showed the staff my CGM and informed them that I’d reduced my basal rate for the necessary time.
When I’ve had surgery each time the medical personnel tried to get me to let them manage everything and requested I remove my pump and CGM. I said I keep these things and control things myself or there will be no surgery. I have won the argument each time so far.
I had two lung surgeries and both times, the nurses and doctors managed my diabetes and delivered the insulin. Honestly, I was fine with that – I had too many other things to worry about at the time!
Most recently I was able the keep my pump and self manage. That was not the case years ago.
It was general anesthesia to remove all 4 wisdom teeth. I checked my bs before I was put under, and diabetes wasn’t an issue. (though I did lose five pounds, from only eating “soft” food after – soup, jello)
In both cases, the anesthetist was the default person. I had no choice in the system and it’s wrong.
Cataract surgeries 19 years ago–They were before I was on a pump and noone ever questioned me about what to do but I trusted the surgeon and the crew and the hospital. I was awake and mostly aware the whole time (lightly sedated).
Carpal tunnel surgery #1 around 6 weeks ago: I was awake and aware the whole time so there was no need to have anyone else manage.
I just had surgery April 4, better be my last one for breast cancer. Not able to chose who managed it during the surgery, the anesthesia nurse did. Asked to please keep my tSlim X2 and G6 on.
It has typically been the anesthesiologist and I had to explain the cgm and pump.
As others have said, it’s always been the anesthesiologist in charge. Fortunately, I have been allowed to keep my pump and CGM. I’ve explained to the anesthesiologists how they work but I’m never sure whether they really understand or pay attention to my CGM. One nurse told me I’d better not allow any alarms because they would annoy the surgeon.
Every time I’ve had surgery or been in the hospital my Endo has said “let her manage her own diabetes.” I take a relatively small amount of insulin and the standard 5u dose would have been way too much. Now it’s me and my pump. I tell the anesthesiologist my basal rate in case anything should go south.
Other – I managed it myself after a collaborative dialogue with the orthopedic surgeon. He recognized and honored the fact that I am a well-controlled seasoned T1 PWD and a diabetes care specialist RN. He consulted and cleared it with my endocrine provider and the procedure went well with smooth sailing.
During my C-section, my husband was in charge of keeping track of my glucose levels via the cgm. I kept my pump on me, and my husband knows how to operate it
I had surgery at Univ. Of Washington in Seattle. They have exceptionally good teams of Endocrinologist along with the nurses who managed my T1D during my last surgery.
I’m jealous. I’m in Portland Oregon, maybe I can go there for any surgeries
Usually, the person managing my blood sugar was part of the surgery team. For short procedures, I kept my pump on and the anesthetist kept an eye on my blood sugar.
With my last major surgery, which was for my shoulder I knew that the anesthesiologist would be the one managing my diabetes during surgery. I talk to her office several times prior to the surgery to explain to them about my pump and CGM and to alert her about my history. The day of the surgery just minutes before I was taken in. The anesthesiologist came to introduce her self and she was totally clueless that I had type, one diabetes or that I had talk to her staff at all. I tried to show her how to follow my blood sugar on my just calm receiver, but she really wasn’t interested. My blood sugar was a bit high prior to the surgery and we discussed whether I would take a bullet through my pump or whether she would give me IV regular insulin during surgery. She apparently did do fingersticks once or twice during surgery and gave me some insulin twice but and cautious amounts as I explain to her how sensitive I was to insulin. This was a very stressful situation that was totally unnecessary. With my recent colonoscopy, which I had to have done twice the nurses were clueless about type one diabetes, insulin Pumps, CGM’sbeing, and just let my husband and myself manage it. they thought that the pump would just take care of everything with no monitoring or input from myself.
I coordinated my management by bringing my CGM receiver into the operating room and discussing the screens with my anesthesiologist
Two surgeries. Both times, discussed with the anesthesiologist and they handled my blood sugar regulation.
My first time for major surgery followed by 3-day stay was appalling, D-wise. I was on basal-bolus MDI but they didn’t want to let me manage my own insulin and were going to use R/NPH and the old sliding-scale crap. I had to dig in my heels and they finally relented. Since then I’ve ALWAYS had my endo contact the hospital and make arrangements ahead of time. Hospitals are all over the map in terms of how they deal (or don’t) with T1. Super important to know this and plan in advance, at least for scheduled surgery.
I wouldn’t say the person was my choice. But, in talking to the person I was introduced to that would be managing my diabetes during the surgeries, I determined they knew what they were doing after hearing my instructions to them.
When the hospital had my endo on staff, I could select. Years later in another state, they had no endo on staff. Everybody with T1 got the same treatment (sliding scale of needles). I refused it and continued with the pump.
I got to educate the anesthesiologist before the procedure so he could follow on my CGM and advise the surgeon.
Being an inpatient – no matter the reason – is my biggest nightmare. My Kaiser health plan policy is for T1D inpatients to give them our pump, CGM and meter! This policy comes from the head of the Endo dept – so trying to get a staff Endo to help is useless. (as an aside, the chair of the Endo Dept retired, perhaps – from my lips to God’s ears- the policy has changed. The do perhaps 4-6 fingersticks a day, use NpH/R insulins, and sliding scale. It’s hazy if they bolus for meals, so I guess I won’t be eating. The target bg is way too high – don’t they know that high bg’s impede healing? Supppsedly on the “third floor” of the hospital inapteints can keep their gear – I am presuming it’s the maternity ward. But I don’t know. 40+ years with T1D, and my TandemX2 with Dexcom integration has resulted in A1C’s in the mid-5’s for years, and although I do get rogue numbers, I am TIR (my range – 60-15) 95+% of the time. I’ll be damned if I let them screw me up.
You go girl! When I had a hysterectomy they almost killed me. I almost passed out going to the bathroom but normal for me after surgery. They said I might be bleeding internally (new interns) and might have to return to surgery. I said just give me something to eat. They gave me OJ and a bagel (can you believe that)! So I told them I was going to inject insulin – at the time, 12 years ago, I was using pens. They freaked out and said I was forbidden to do that. I said well if you are giving me a dam bagel and OJ, I need insulin. They then brought me a needle with 12 units of insulin in it! I told them that would kill me. They said, OK, then but you have to take it all by the end of the day. I said: OK and then proceeded to get dressed and when my doctor showed up and was told all of this, I said get me outta here. I had asked him prior to the surgery if he had dealt with diabetics before and he laughed and said of course. Well…NOT
The anesthesiology team (2 doctors) surprised me while I was gowned on the table about to go into the operating room for orthopedic surgery and told me to turn my pump off. “We won’t give you candy!” they laughed. GRRR
On the bright side I was allowed to use my pump and CGM in the hospital during recovery. That’s worth a million.
BTW I had never met them before so never had a chance to address the pumping insulin question.
This is a confusing question, if you are asking if I was able to chose the medical professional the answer is no, not possible at any surgery I have had in 70 years. If you are asking if I was able to partner with the anesthesiologist, the answer is yes, and until was in agreement with anesthesiologist and the surgeon before surgery on how T1D would be managed I would not go into surgery. And I have has medical personnel removed from my management staff pre surgery when I felt they were not going to be a safe medical professional to be participating in the pre, during and post surgery.
Many years ago I was taken by ambulance to the ER where I was admitted and put into intensive care for about a week. The hospital assigned an endocrinologist for my T1D care and I really liked him. After discharge I made a followup appointment with him and gave the clerk my insurance card. She replied that the doc didn’t accept ANY insurance. OMG, I thought, how am I going to pay his bill? I went through medical bankruptcy because of the enormous bill. Hospitals know which insurance a patient has and should assign an endo who accepts that plan. What a nightmare! I do not think that this is allowed anymore. My insurance plan offered this doctor a big portion of his bill but he refused the payment. He wanted every single penny. He might have been a good doctor but he was not a good human being.
I had a similar experience with my last colonoscopy. I was told ahead of time that the facility was covered by my insurance but not all doctors might be. I naively thought they would TELL ME if they wouldn’t be accepting my insurance. Anyway: afterward I discovered the anesthesiologist didn’t accept my insurance. I fought it and won because Florida does not allow a certain type of billing – can’t remember what is is called now. But I fought the damn insurance company and doctor and won. Haven’t had another procedure since then but if it isn’t an emergency, before I go under I am going to question each doctor in the room before they touch me!
I wasn’t fully out, just laughing gas for a single wisdom tooth removal. It was a fast procedure and therefore could support myself during that small amount of time.
I managed my own care with my doctor’s approval.
Didn’t get to choose who managed my T1D care, but had a long discussion with the person who did about not putting me in a sliding scale and doing I:C ratio as well as my correction factor. I was MDI at the time but could overhear there was another T1 in the next room in a pump and I asked why he gets to manage his and I want being offered the same.
I maybe should have marked “no” but I marked “other” as I never asked if I could choose who would be monitoring my blood sugar. I was able to wear my pump and CGM during my colonoscopy. I set my pump on activity “exercise” to keep myself from going to low, but I was surprised my blood sugar level went from 160 at the beginning of my colonoscopy to 127 at the end of the procedure. So much for the pump striving for a higher blood sugar number.
Unplanned stents and was allowed to keep my pump and manage my own insulin and I was fully alert. – I did not receive any anesthesia
As many have said I am able to wear my pump and use CGM for the last few surgeries.
I chose other. I suppose I am the one in charge, even though I am not conscious during the events.
Depends on the type of anathesia and anathesiologist.
I never thought to do this or ask about doing this!
Before recent ankle surgery I had a 40’ chat w/ person I thought was anesthesiologist & that we were on same page. Yes, I would not have to remove CGM after all. Yes, I would take same basal doses of Lantus. BUT bg during surgery was abnormally high increasing risk of infection. Sure enough I got MRSA! Though my osteopenia has not worsened (proven by x-rays), orthotic surgery dept assumes all diabetics have osteoporosis and need extra thick plates. Result? Small persistent scab very slow to heal, MRSA, delay of physical therapy. Obviously Endocrinology does not communicate with Orthotics. And Orthotics usually only sees diabetics who need a toe or a foot or a leg amputated. I’m so disgusted, I’m going to quit present provider. Lucky me, there are two other providers in town with much better diabetes treatment reputations. I’ve had colonoscopies, an endoscopy, lens replacement, dental surgeries with light or local anesthesia where I was in full control of bg levels and NO problems ensued. And these were successful BEFORE I had a CGM!
It varies on which hospital/city/province you are in for your surgery. If you are in a well-managed health care provider system you often get service from well-trained professionals. Other times it is your own knowledge you must rely on to get safely discharged.
I meant to answer yes. I’ve always spoken with my anesthesiologist and we agreed on what to do. I would use a temp basal rate most likely. I’ve had multiple surgeries and never relinquished my pump and always had good outcomes.
Yup. and they 100% IGNORED the instructions and refused to obey the written orders for an lethally obscene amount of time (days) after the procedure too.
Multiple surgeries and have done it all by myself.