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Changes in OR Protocol Ease My Mind
October 20, 2009
Surgery went well and I now have three new medicines — two that can cause diarrhea and one that can cause constipation. So far, they seem to be striking a balance, albeit an uneasy balance, such as you would experience trying to stand on a ball. With grease on it.
Also, for a few days there, my husband was changing my diaper twice a day.
Wait! I can explain! By the time I got home from the outpatient surgery, I had bled through the dressing. Following instructions to call the doctor if the blood spot was larger than a 50-cent piece (if anybody remembers those), I called the doctor. He said to put something very absorbent over the dressing and hold it on with an elastic bandage. Hence, the diapers. On my foot.
How about a handy Heloise-type hint thrown in here? Peroxide removes blood from things like, oh, your recliner’s footrest that you plopped your foot on before noticing blood had soaked through the dressing. Just pour some peroxide on the blood, it fizzes up, and you blot it with a cloth or paper towel. You can’t tell the footrest had ever been besmirched. The inside of my air cast is another story, but I cleaned up most of it.
Aside from sleeping a lot for a couple of days after surgery, I feel OK and the doctor says I’m doing well. The bottom of my foot is somewhat bruised up, so it’s difficult to walk (i.e., hurts like a sonuvagun), but that will get better with time.
When the doctor’s scheduler told me I would be going to a new place for the surgery, I did my usual “I don’t wanna go to a new place! They won’t know how to take care of my diabetes during surgery!” rant. I mean, just when I get used to one place and have some confidence that the folks there know what they’re doing, they stick me in a place I’ve never been to before.
It didn’t help when a nurse asked me how much insulin I was taking or had in me or something like that. I didn’t understand the question until the woman who was there to do an EKG asked, “What’s your basal rate?” Then the nurse didn’t know what that was.
“She doesn’t know much about diabetes, does she?” I asked the EKG woman after the nurse had left the room.
“Oh, she just doesn’t know about pumps,” EKG woman replied. “We don’t see too many of those in here. I had an in-service on the pump about a year ago.” She paused, then added in a stage whisper, “When I got my pump.”
The nurses who would be in the operating room during my surgery came in to introduce themselves and to check out my vital signs and were excitedly fascinated by my continuous glucose monitor. They’d never heard of a CGM, so I gave them a “tour” of it.
“Wow!” one said. “That will come in handy during surgery!” And her colleague agreed.
It was looking better.
Then, something happened that I haven’t experienced in years: The anesthesiologist came in to see me. Of late, I’ve only seen them in the holding area in the surgical suite.
It was also my first female anesthesiologist.
Anyway, she, too, was fascinated by the CGM — and it came in handy when I was able to show her that my blood glucose had been holding in the 80s for the past four hours. I told her it would alarm if I was nearing hypoglycemia and showed her how to suspend delivery on my pump. She agreed to leave me alone unless I started going low. And she did: I went in with my glucose in the 80s and came out with it in the 90s.
I was happy that people understood and wouldn’t jack my blood glucose sky-high. And my husband was happy, too. Oh, not about my diabetes care. No, he was happy because there was a recliner in my room. He expressed his extreme pleasure by falling asleep before I was taken to surgery.
It was a far cry from a surgery I had in 2000, when the anesthesiologist didn’t understand how an insulin pump worked — he knocked me out when I was trying to explain it to him, and I woke up with my blood glucose in the 300s.
Now, all I have to do is redo all of my basal rates. I had them perfectly balanced before the surgeon got rid of the infection in my foot. Later that day, as expected, I began to slide toward hypoglycemia. I still am and will be until I have my basal rates refigured.
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