Surgery
Question:
Thanks. I had a nebulizer which is albuterol, the same as Ventolin right before the procedure. Not enough for me, but I am a lot bigger than a two year old. I hope his CT scan came out okay. I have a hard enough time to get my 11 year old son to have his blood drawn. Kathy from Iowa
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>I had sinus surgery back in July. I was asked to take two puffs of Ventolin >prior to the general anaesthetic and had absolutely no ill after effects >what-so-ever. Provided the anaesthetist is aware of the asthmatic condition, >he/she should be able to keep things well under control.
Same thing happened to me last February. Like yourself, no problems. "With Confidence in our Armed Forces – with the determination of our people – we will gain the inevitable triumph – so help us god." Franklin Delano Roseveldt, 8 december 1941
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With all your complications, I suggest you *insist* on talking to the gas passer ahead of time. -S- – Hide quoted text — Show quoted text – > I am also set for a hysterectomy and appreciate any info on anesthesia. When I > had the D & C (about a 15 minute procedure) they put me under completely and I > came out of the anesthesia in an asthma attack, that is coughing. A quick > nebulizer treatment when I was conscious took care of it. They said it was from > taking the breathing tube out. > I also have reflux, which is an indicator for a general anesthesia as opposed > to local. And I have a genetic blood clotting disorder (Factor 5 Leiden which > means I am more likely to clot) which means after the surgery I go on low dose > molecular heparin (Lovenex) shots to reduce the likelihood of clotting. The > Lovenox shots means no epidural since that combination could result in a clot > and paralysis. > It is hard here to talk to an anesthesiologist ahead of time. > I want the general but do not particularly want to come out of the anesthesia > in a coughing attack. This time I could shake the stitches out. Any comments? > Kathy from Iowa
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My son had a CT scan earlier this year and he had to be put out under general anesthetic to do it (He is only 2). I had to administer ventolin to him 20 minutes before he had the general. He was only out for 40 minutes. He came out of the anesthetic fine. He had no asthma problems. Debbie – Hide quoted text — Show quoted text – > I am also set for a hysterectomy and appreciate any info on anesthesia. When I > had the D & C (about a 15 minute procedure) they put me under completely and I > came out of the anesthesia in an asthma attack, that is coughing. A quick > nebulizer treatment when I was conscious took care of it. They said it was from > taking the breathing tube out. > I also have reflux, which is an indicator for a general anesthesia as opposed > to local. And I have a genetic blood clotting disorder (Factor 5 Leiden which > means I am more likely to clot) which means after the surgery I go on low dose > molecular heparin (Lovenex) shots to reduce the likelihood of clotting. The > Lovenox shots means no epidural since that combination could result in a clot > and paralysis. > It is hard here to talk to an anesthesiologist ahead of time. > I want the general but do not particularly want to come out of the anesthesia > in a coughing attack. This time I could shake the stitches out. Any comments? > Kathy from Iowa
Response:
I had sinus surgery back in July. I was asked to take two puffs of Ventolin prior to the general anaesthetic and had absolutely no ill after effects what-so-ever. Provided the anaesthetist is aware of the asthmatic condition, he/she should be able to keep things well under control. ned – Hide quoted text — Show quoted text – >My son had a CT scan earlier this year and he had to be put out under >general anesthetic to do it (He is only 2). I had to administer >ventolin to him 20 minutes before he had the general. He was only out >for 40 minutes. >He came out of the anesthetic fine. He had no asthma problems. >Debbie > I am also set for a hysterectomy and appreciate any info on anesthesia. When I > had the D & C (about a 15 minute procedure) they put me under completely and I > came out of the anesthesia in an asthma attack, that is coughing. A quick > nebulizer treatment when I was conscious took care of it. They said it was from > taking the breathing tube out. > I also have reflux, which is an indicator for a general anesthesia as opposed > to local. And I have a genetic blood clotting disorder (Factor 5 Leiden which > means I am more likely to clot) which means after the surgery I go on low dose > molecular heparin (Lovenex) shots to reduce the likelihood of clotting. The > Lovenox shots means no epidural since that combination could result in a clot > and paralysis. > It is hard here to talk to an anesthesiologist ahead of time. > I want the general but do not particularly want to come out of the anesthesia > in a coughing attack. This time I could shake the stitches out. Any comments? > Kathy from Iowa
Response:
I am also set for a hysterectomy and appreciate any info on anesthesia. When I had the D & C (about a 15 minute procedure) they put me under completely and I came out of the anesthesia in an asthma attack, that is coughing. A quick nebulizer treatment when I was conscious took care of it. They said it was from taking the breathing tube out. I also have reflux, which is an indicator for a general anesthesia as opposed to local. And I have a genetic blood clotting disorder (Factor 5 Leiden which means I am more likely to clot) which means after the surgery I go on low dose molecular heparin (Lovenex) shots to reduce the likelihood of clotting. The Lovenox shots means no epidural since that combination could result in a clot and paralysis. It is hard here to talk to an anesthesiologist ahead of time. I want the general but do not particularly want to come out of the anesthesia in a coughing attack. This time I could shake the stitches out. Any comments? Kathy from Iowa
Response:
Heart attack, bypass surgery, broken leg.. and I had to be firm about taking my own medicine (Type 2) and my own testing (daughter brought in my kit) plus the usual arguments with the diet (Jello?). As with restaurant and banquet food, you can scrape off the sauces, butter on the vegs is ok, and skip the desert. Plain piece of bread will keep starvation off… You have to be in control.
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> In general, posters report: > a. Most will demand (non-negotionable) that they use a 5%
glucose IV during the surgery and often for some time afterwards. I went into surgery with Ringer’s iv, this was fine by the surgeon and anesthesiologist, no argument and they understood my reasons and concerns, but somebody (probably in recovery) changed it later to dextrose when I couldn’t argue about it due to being unconscious. "Next time" I’ll insist on a different approach. Maybe if it’s put in writing on my chart, instructions from the doctor….. > b. Staff tend to hate low bG. They think anything around 200 is
great. Hypo’s or lows are feared, high bG is an acceptable alternative. And they may refuse to believe it if you say you are well-controlled. One of my nurses certainly didn’t — she all but called me a liar when I said my #s were higher than normal for me (in a fasting state, yes even after surgery, I’d had other recent experience!) — I blamed the dextrose iv, she insisted it was a very slow drip and couldn’t be the cause. So how come my #s dropped beautifully as soon as the iv was out!?!. > c. Your PCP or the surgeon can write "orders" on your chart which
give you the freedom to to take some post-op control of your bG. (Post-op only) I was able to get up sometime in the evening after 8am surgery; I tested without telling anybody. Also, when the nurse (well, some kind of assistant, anyway) came around for an "official" test, she didn’t object when I insisted on using my own lancet and meter, although she did say she had to do a test on her meter too. But at least I was spared the usual excrutiating nurse’s stab. I don’t take dm meds, so didn’t have a problem with that aspect. And once I got rid of the damned dextrose iv my bg #’s went back where they belonged. > d. Hospital kitchens often have strange ideas of "diabetic diets".
IMHO, "diabetic diets" in the medical field are designed for T1’s who can overpower almost anything with added insulin. Aside from being starchy-carby, one of my meals included canned peach — with syrup — and Real Apple Pie. Neither of which I have seen on "diabetic diets". But the apple filling was at least soft enough for me to swallow, even the peach was too hard (this was after thyroidectomy), and the bits of chicken in the mountain of rice was also impossible, tho I was able to extract a couple of grains of softer rice. > The pre-admit nursing staff "ordered" me to leave my meter and insulin at home.
Nobody said anything to me about any of it. And nobody inspected my property either; it was all put in a big bag which my mother held onto (for security) until I was in my room, after that I had access to it all. bj
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To me the best thing that you can do is make sure your numbers are and remain in non diabetic range. This should help and make sure they dont give you any glucose in the IV. Good luck. Hope all goes well and you let us know how you are doing Loretta America will stand strong and always be the home of the brave and the land of the free..
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. .snip. . . > d. Hospital kitchens often have strange ideas of "diabetic diets". >IMHO, "diabetic diets" in the medical field are designed for T1’s who >can overpower almost anything with added insulin. >Aside from being starchy-carby, one of my meals included canned >peach — with syrup — and Real Apple Pie. Neither of which I have >seen on "diabetic diets". But the apple filling was at least soft >enough for me to swallow, even the peach was too hard (this was after >thyroidectomy), and the bits of chicken in the mountain of rice was >also impossible, tho I was able to extract a couple of grains of >softer rice. . .> >bj
bj’s hospital food experience was similar to my G.D. co-worker who lost memorable diet fights at a hospital in another city. She is still amazed at a kitchen which regarded sugared- desserts as suitable for a diabetic diet. My G.D. co-worker’s experiences are noteworthy for this group. She is the Superintendent of a small chemical plant. She can be very firm and very focused and very loud and very persistent. However, she won some battles but lost the war. I never was offered a nominally sugared-food. However, after receiving an entree with mashed potatoes accompanied by a bread pudding dessert I stopped believing the sugar-free descriptions. . .not that they might lie, but that they might not fully appreciate the need to separate the sugared and sugar- free. Regards Old Al (T1 since 94, 38 units H + U via 4 injections daily) A retired engineer who shares his experiences
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I am new to this group, but have been reading for a while all your posts. They have given me a lot of help. Thank you all! I was diagnosed Type 2 exactly three months ago today and have found out that it is a good probability that I will have to undergoe abdominal surgery for an obstruction. My questions are – is there anything I should do before the surgery to improve my odds of a better recovery and is there anything after surgery to speed up my recovery? Anything you can suggest would be greatly appreciated. LadyMJK
Response:
Keeping your BG at non-diabetic levels is the best way to ensure your healing. High BG slows healing and provides a welcome environment for infections. If that means insulin for awhile, so be it. Best of luck with your surgery. Jennifer – Hide quoted text — Show quoted text – > I am new to this group, but have been reading for a while all your posts. > They have given me a lot of help. Thank you all! I was diagnosed Type 2 > exactly three months ago today and have found out that it is a good > probability that I will have to undergoe abdominal surgery for an > obstruction. My questions are – is there anything I should do before the > surgery to improve my odds of a better recovery and is there anything after > surgery to speed up my recovery? Anything you can suggest would be greatly > appreciated. > LadyMJK
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I had surgery more than once. The key to good recovery is your Doctor. One day before the surgery l had all tests and took prescribed antibiotics The morning of the surgery the diabetic doctor work with the anesthetist and installed a sugar monitor and an insulin infusion pump for the duration of the surgery. After surgery monitoring is imperative and your food and insulin have to be adjusted accordingly. In my case, I stayed four days at the hospital. Ultra fast insulin like Humolog and Novalog are not recommended before, during and after surgery. The last two surgeries (upper jaw advancement and vestibuloplasty) I had I entered the OR at 07:00 am and was in the recovery room at 11:30 am. Both operation were a success. As for the upper jaw advancement I grew new bone in a in short time to weld the bone incision (1/4" gap between the sawed off jaw). The second surgery took place 4 months after (vestibuloplasty). They removed a 5" X 7" piece of skin from my left thigh last March. Today I can hardly notice where they took the skin. It grew back nicely and next summer it will not show at all. Not all Doctors take the time to do that procedure. Today the medical science and the Doctors knowledge have come along a long way. However, the diabetic shall monitor is own health. Antibiotics were
– Hide quoted text — Show quoted text -> Keeping your BG at non-diabetic levels is the best way to ensure your healing. > High BG slows healing and provides a welcome environment for infections. > If that means insulin for awhile, so be it. > Best of luck with your surgery. > Jennifer > I am new to this group, but have been reading for a while all your posts. > They have given me a lot of help. Thank you all! I was diagnosed Type 2 > exactly three months ago today and have found out that it is a good > probability that I will have to undergoe abdominal surgery for an > obstruction. My questions are – is there anything I should do before the > surgery to improve my odds of a better recovery and is there anything after > surgery to speed up my recovery? Anything you can suggest would be greatly > appreciated. > LadyMJK
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>I am new to this group, but have been reading for a while all your posts. >They have given me a lot of help. Thank you all! I was diagnosed Type 2 >exactly three months ago today and have found out that it is a good >probability that I will have to undergoe abdominal surgery for an >obstruction. My questions are – is there anything I should do before the >surgery to improve my odds of a better recovery and is there anything after >surgery to speed up my recovery? Anything you can suggest would be greatly >appreciated. >LadyMJK
You are about to embark on an "interesting" research project: "just how does your hospital handle diabetics in their surgical system". There have been a multitude of posts on the subject; the practices of individual hospitals vary all over the map. In general, posters report: a. Most will demand (non-negotionable) that they use a 5% glucose IV during the surgery and often for some time afterwards. b. Staff tend to hate low bG. They think anything around 200 is great. Hypo’s or lows are feared, high bG is an acceptable alternative. c. Your PCP or the surgeon can write "orders" on your chart which give you the freedom to to take some post-op control of your bG. (Post-op only) Oral meds are tricky but control of your own insulin and your own testing is possible. Note that sound medical opinon opts for injected insulin for non-insulin using T2’s to get through abnormal situations. You may be able to convince one of your docs to set up an injection regime that keeps you below 200 if you get too high. If so, they will probably use Regular and NPH which will be quite slow to act. d. Hospital kitchens often have strange ideas of "diabetic diets". IMHO, "diabetic diets" in the medical field are designed for T1’s who can overpower almost anything with added insulin. My experiences: Most surgery is traumatic enough to send your bG soaring. After my hip surgery, I about doubled my insulin, cut my food drastically, but still cycled between 130 and 200 most of the time. (When I left, the staff remarked that my bG history was the best they had seen in a surgical case.) The pre-admit nursing staff "ordered" me to leave my meter and insulin at home. I said "sure thing" and had my spouse bring them anyway. The first thing I did when I woke up from anesthesia in the final rooms was test my bG. You need a spouse or S.O. to pull this off best, though any accomplice can bring your stuff in when you are finally cleared for general visitors. I was testing every two hours. They would have tested every 4 hours. Most of the hospital kitchen carbs were fast carbs. I was cynical enough to avoid their sugar-free offerings unless they were in original packaging. I had a G.D. friend who spend 5 weeks in labor under drug- induced semi-paralysis. She reported constant losing battles with the hospital kitchen in an attempt to get a reasonable diet. It’s been five years since the episode and she still has a sense of amazement over the episodes. I just minimized my food intake for a few days. Most U.S. adults can go quite a few days without food or on zero carb. It’s a royal pain but what about this disease isn’t? Regards Old Al (T1 since 94, 38 units H + U via 4 injections daily) A retired engineer who shares his experiences
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Hi, I have to have a couple of teeth extracted under general anasthetic in a couple of weeks. I’m Type 2, no meds. Is there anything in particular I need to watch out for? I understand that healing times can be slower for diabetics. Is this true even if my BGs are under reasonably good control? — Cheers, John Carney. Melbourne, Australia Type 2, DXed 13 Sep, 2002. Diet & Exercise.
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> Hi, > I have to have a couple of teeth extracted under general anasthetic in a > couple of weeks. I’m Type 2, no meds. Is there anything in particular I need > to watch out for? > I understand that healing times can be slower for diabetics. Is this true > even if my BGs are under reasonably good control?
Well, an antibiotic started before the op would go a long way in preventing an infection. Usually only needed to start an hour before but with a general and needing nil by mouth for x amount of hours before the op perhaps after might be ok. It is your right to ask for the antibiotic even if the doctor doesn’t think it necessary.
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> I have to have a couple of teeth extracted under general anasthetic in a > couple of weeks. I’m Type 2, no meds. Is there anything in particular I need > to watch out for?
Probably not. If you were taking insulin, the usual requirement of not eating for several hours prior to being given general anaesthetic might be a problem, but I can’t see it causing trouble for you. Of course, the usual caution applies — make sure your dentist and anaethetist are aware of your diabetes. That said, I think general anaethetic is used quite often where local anaesthetic would suffice. I’m usually quite sensitive to pain but had no trouble having my wisdom teeth extracted under local anaesthetic. But YMMV. Colin Percival
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> > I have to have a couple of teeth extracted under general anasthetic > in a couple of weeks. I’m Type 2, no meds. Is there anything in > particular I need to watch out for? > Probably not. If you were taking insulin, the usual requirement of > not eating for several hours prior to being given general anaesthetic > might be a problem, but I can’t see it causing trouble for you. Of > course, the usual caution applies — make sure your dentist and > anaethetist are aware of your diabetes. > That said, I think general anaethetic is used quite often where > local anaesthetic would suffice. I’m usually quite sensitive to pain > but had no trouble having my wisdom teeth extracted under local > anaesthetic. But YMMV.
I’m sure my mileage *will* vary 
My oral surgeon says they’ll both be tricky extractions. I *really* don’t want to know. Thanks 
— Cheers, John Carney. Melbourne, Australia Type 2, DXed 13 Sep, 2002. Diet & Exercise.
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- Hide quoted text — Show quoted text -> Hi, > I have to have a couple of teeth extracted under general anasthetic > in a couple of weeks. I’m Type 2, no meds. Is there anything in > particular I need to watch out for? > I understand that healing times can be slower for diabetics. Is > this true even if my BGs are under reasonably good control? > Well, an antibiotic started before the op would go a long way in > preventing an infection. Usually only needed to start an hour before > but with a general and needing nil by mouth for x amount of hours > before the op perhaps after might be ok. It is your right to ask for > the antibiotic even if the doctor doesn’t think it necessary.
Thanks for the tip, ozgirl — Cheers, John Carney. Melbourne, Australia Type 2, DXed 13 Sep, 2002. Diet & Exercise.
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>I understand that healing times can be slower for diabetics. Is this true >even if my BGs are under reasonably good control?
One thing to consider is the possibility of infection. I don’t know about extractions, but when I had a medical procedure the doctor gave me antibiotics as a preventive measure because of my diabetes. — remove "spamtrap" for e-mail
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Im going to see a surgeon on Monday to talk about surgery I will be having that Friday to either remove the left lobe of my liver or just the parts with the tumor on it, depending on what the biopsy says. Is there any questions related to diabetes that I should ask? Should I make him aware of my diabetes, or does it not affect the surgery at all?
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He absolutely needs to know about your diabetes. It can affect surgery. I really hope things go well for you. — c website http://www.plazaearth.com/philo
– Hide quoted text — Show quoted text -> Im going to see a surgeon on Monday to talk about surgery I will be having > that Friday to either remove the left lobe of my liver or just the parts > with the tumor on it, depending on what the biopsy says. Is there any > questions related to diabetes that I should ask? Should I make him aware of > my diabetes, or does it not affect the surgery at all?
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> Im going to see a surgeon on Monday to talk about surgery I will be > having that Friday to either remove the left lobe of my liver or just > the parts with the tumor on it, depending on what the biopsy says. Is > there any questions related to diabetes that I should ask? Should I > make him aware of my diabetes, or does it not affect the surgery at > all?
The doctor has to know everything, including what meds you are on as some have to be stopped up to 3 days before. Ditto smoking. He will order blood tests, hopefully your bg’s are in control, my father in law had to wait 3 weeks in hospital for a severed thumb op til his bg’s were closer to normal.
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Hi, You must tell your surgeon about your diabetes, you dont say whether your type 1 or 2. But either way, it is very important. I am a type 1 & was not allowed insulin the morning of my surgery, & my test was getting low the morning of the surgery, (it was day surgery). So the doctors told me to come into the hospital earlier & they gave me a sugar drip etc as I couldn’t eat. Your surgeon should tell you every little detail about what you need to do, what medicine to take & when to take it etc. Also, you need to tell them as they may ask you to stay in the hospital longer due to complications that may arise after surgery. Make sure you don’t leave the hospital until you are fit enough to have food (no nausea etc). I was in for day surgery & was told usually they are in & out within about 2 hours after surgery. My surgery was the first for the day at 7.30am & I didn’t leave the day surgery unit until 9pm as I felt too nauseas to eat, & didn’t feel comfortable with going home as it was. Also, if you are on your own, make sure you get someone to look after things at home. Ie: clearing the letterbox & feeding animals & plants etc. The last thing you want to do after getting home from hospital is to do all that kind of stuff … even worse, to come home & find something "missing"/ stolen. Good Luck, Hope the surgery goes well for you Bex (type 1 & veteran of surgeries hehe) "Don’t Hate Me Coz I Have Opinions, Hate Me Coz You Don’t Know Me"
– Hide quoted text — Show quoted text -> Im going to see a surgeon on Monday to talk about surgery I will be having > that Friday to either remove the left lobe of my liver or just the parts > with the tumor on it, depending on what the biopsy says. Is there any > questions related to diabetes that I should ask? Should I make him aware of > my diabetes, or does it not affect the surgery at all?
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> Im going to see a surgeon on Monday to talk about surgery I will be having
that Friday to either remove the left lobe of my liver or just the parts with the tumor on it, depending on what the biopsy says. Is there any questions related to diabetes that I should ask? Should I make him aware of my diabetes, or does it not affect the surgery at all? The surgeon will need to know EVERYTHING about your medical situation. Not just diabetes, but any drugs (Rx or OTC) you take, including any supplements. Pre-op testing will include things like metabolic panel & any particular-to-your-condition tests, and since you’re diabetic perhaps also dm-related tests. They may also require an ekg — I once had to have one only 4 months since a previous one, since the hospital required one within 90 days. When I’ve had surgery as a diabetic, they were insistant about scheduling me for first-in-the-morning. I also requested "no-dextrose" in my iv going in to surgery — I don’t need it. Unfortunately, at some point the Ringer’s got replaced with dextrose, and did exactly what I knew it would — elevated my bg & kept it up, not real high, but why should I have to put up with that? Next time (if there is a next time), I’ll take stronger measures. But this is something for you to consider & consult your dm doc about too — how will your bg be managed while you are "out". You may find that a hospital’s idea of food suitable for a diabetic has nothing to do with yours. Liver-involvement may also affect diet — you may want to discuss this thoroughly with the doctors _and_ the hospital food department. Some places are better than others in how much choice you’re given. Be sure that you have it written in your chart that YOU will control your diabetes (if you will). I don’t know what your op entails, but unless you’re really "out of it" you should be able to do your own testing/dosing if you have your stuff with you — although the staff may still want to test you with their meter (I recommend you do your own lancing for them if possible — they can stab *hard*!). You may also need to discuss with your endo, diabetes educator, or somebody, about any changes you may need to make to your dm management due to the stresses of surgery, possible dietary changes, reduced activity, etc. That’s all I can think of right now. Good luck. bj
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You MUST tell the surgeon everything. Including the meds that you take plus vit. and aspirin. If you are taking Metformin (glucophage) you should stop taking it for at least a week. This med affects the anesthetic . Ira glucophage 500mg twice a day I AM IN CONTROL AGAIN!
– Hide quoted text — Show quoted text -> Im going to see a surgeon on Monday to talk about surgery I will be having > that Friday to either remove the left lobe of my liver or just the parts > with the tumor on it, depending on what the biopsy says. Is there any > questions related to diabetes that I should ask? Should I make him aware of > my diabetes, or does it not affect the surgery at all?
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Yes , and you MUST BE SURE that the anastheologist ALSO knows exactly all about your meds…so there is no fatal conflict between your meds and anasthesia !!! tim – Hide quoted text — Show quoted text – > You MUST tell the surgeon everything. Including the meds that you take plus > vit. and aspirin. > If you are taking Metformin (glucophage) you should stop taking it for at > least a week. This med affects the anesthetic . > Ira > glucophage 500mg twice a day > I AM IN CONTROL AGAIN! > Im going to see a surgeon on Monday to talk about surgery I will be having > that Friday to either remove the left lobe of my liver or just the parts > with the tumor on it, depending on what the biopsy says. Is there any > questions related to diabetes that I should ask? Should I make him aware > of > my diabetes, or does it not affect the surgery at all?
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seems that I have developed an incisional hernia after my hysterectomy. Since it has begun to effect my bowels, I am to be booked for emergency surgery shortly. Anyone out there have a similar problem or know anything about recovery time, restrictions, etc. Tenia PS Mad as hell!!!
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Don’t know much, but see if there is someone that does "laproscopic" surgery. I’m not even sure if I spelled it right, but it is the practice of working remotely through a small incision. It is supposed to reduce recovery time to under a week, as opposed to 4 to 6 weeks with the old fashioned open’em up technique. Do a search on it and you will see several surgical centers around the country that specialize. > seems that I have developed an incisional hernia after my hysterectomy. > Since it has begun to effect my bowels, I am to be booked for emergency > surgery shortly. > Anyone out there have a similar problem or know anything about recovery > time, restrictions, etc. > Tenia > PS Mad as hell!!!
– Bruce T. Wilson Christian / AANR Frame-Up Photography San Antonio, TX http://frameup.home.texas.net (2 Tim 1:7 KJV) For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.
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