Blog Entries With Tag: surgery


Posted: Nov 25, 2014

I’d written earlier about going for pre-op for surgery (which has now been cancelled and moved up to January for some reason – so more time for me to dwell on … do I go for it / or not?).  At the time the pre-op team didn’t realize I was a Type 1 diabetic for some reason, and red flags went up when I questioned them what to do with my insulin pump regime.  Especially for my after care with 3 day hospital stay for recovery.  The pre-op doctor had said that they had 2 endocrinologists that understood how to work with patients with pumps.  That excited me to no end, as I’ve never had an endo/GP with that knowledge.  I’m self taught in most aspects of how I control my diabetes health, by keeping up with latest technology, discussing it with my medical team, and they allow me to self guinea pig myself with what I want to try.  I am my own boss behind what I do with my health care for diabetes – but sometimes it can get exhausting – but I refuse to give into burnout from diabetes. 

Fast forward, I arrived at the clinic in the Lakeshore Hospital.  The diabetic clinic was a small place, with patients waiting (during the time I was there - one guy was glugging water like he was a fish out of water –  sprinting to the loo to pee like a horse – sadly the door does not have good sound barrier …. uhhhmmm – diabetic out of control with their ???).  I asked the receptionist, out of curiosity sake, if patients were able to share their pump/blood glucose information via Internet to their office (I use Diasend with my Animas pump).  I think she was almost embarrassed and a few of the staff members behind her as well, when she said “No”.  Oh, Oh, …. I’m thinking to myself … am I wasting my time coming to this clinic?   I looked around at various info on walls and in the hand out sections … everything … geared for Type 2 diabetics.  Hot flash started due to panic mode at that point.  I am ready to run out of the hospital!!

Hour and half later, sweating like a pig due to being dressed for cold weather (and that day we were experiencing unusual high temps of 18C in Montreal – ovey) – I see the endo.   She gets down to asking me my history.   My saying how long I’d had Type 1 diabetes seemed to floor her and at that point I wish I’d said … I’ve only had diabetes for 15 years, which she had thought I’d said when I’d told her I was coming close to year 50 of diagnosis (I joked about applying for the Joslin award – I was nervous at this point – white coat syndrome as usual).

Then we got to my insulin regime.  I told her I was currently on MDI (multiple dose injections) – but planning to go onto pump again on December 1st since I thought I had figured out the right dosage for my basal portion of my insulin regime with Levemir.  She seemed puzzled by my not taking the same amount for each meal (I explained it depended on the blood sugar (BG) reading at the time, my I:C ratio, ISF ).  I asked her if she understood what TDD meant?  A term used in the pumping world for Total Daily Dose … she did – but she didn’t seem that interested. 

At this point, I knew I was not seeing an endo with full knowledge of pump experience (as she spoke to me – I slowly undid George Michael’s battery cap, and slunk him iaway for future use).  She admitted that not many people use insulin pumps, and that even the largest diabetic centre in Montreal isn’t as well.  For my upcoming surgery, she does NOT want me on my insulin pump but to stay on the regime I'm on at present.  She wants me on my current regime but RN's will be under my orders … if I am with it …  otherwise they will follow the protocol the endo has written out - which scares me .... on the order form she has put down that I take 4 units of NovoRapid for each meal – which I told her could send me into hypo land if a) I had a low blood sugar; or b) I didn’t eat all the food on the tray).  Gulp.

This is obviously not the United States of America – where I’ve heard from other insulin pump users going into surgery, sometimes wearing a pump.  There are no CDE’s able to help you manage your health … not at least in Quebec where doctors are Gods.  No pharmacist or CDE can help assist you in your health regime – so you suffer while you await to see a specialist.

Wait though, there is some good out of this visit.  She wants to see me in February, and she is actually going to be testing me for celiac disease, which is common among Type 1 diabetics.  I had asked previous doctors for this test, and they’d look at me like I was off my block.

 

The other thing that was interesting about this so called “pre-op” visit.  My feet were examined by her doing a few tests which she says should be done every year for diabetics by a doctor.  I have NEVER EVER had my feet examined by a doctor.  She was amazed at the sensitivity of my feet, ability to still feel (I joked about not wearing socks with sandals, only as a child with my parents did I have to do that – memories of being made fun of by American kids at a beach in Maine one year will never be erased from my sponge brain).  IIf I’d known she was going to do this, I would have washed them.  Luckily, she said my feet were in amazing shape …. again the emphasis was due to how long I’d been diabetic.  It’s like … what … am I supposed to have dinosaur looking feet or ????

Yes, I’m scared.  I want to cancel the surgery even more so now.  Time to write a letter to my surgeon.  I must stop procrastinating!

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Tags: surgery (1) hospital (1) endocronologist (1) CDE (1) pump (1) insulin (1) Diasend (1)
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Posted: Nov 17, 2014

The-sea-of-time by Kyle Bean - http://www.kylebean.co.uk/

If any of you read my posts on Facebook or Twitter, you’ll have noticed that I’ve been going through some little health problems that are compromising the control of my #diabetes.  It’s nothing serious, just the usual “woman” issues that occur as we get on in life. 

Just last week, I went for a pre-op for a partial hysterectomy ( 1-2 hours of slice ‘n dice time for my surgeon and moi).  It’s to remove some large fibroids in my cervix that over the past 30+ years HAD (and I stress this with caps) become painful.  When I finally saw the gynecologist (gyno) back in June, I was a bleeding mess (menses lasting up to a month), slightly anemic due to blood loss, along with discomfort from pressure of fibroids against the bladder, I was exhausted (thyroid problems weren’t helping there).  I’ve always thought I had a bladder built like a truck driver; I can go on forever without having to take a wee.  Not so anymore, pressure of fibroids … hmmm, you want that truck load of bananas to arrive still green … pick another driver.

While she’s down there in the nether regions, due to my age, she’s going to remove the uterus since I’m at the age where I’m too old to have a kittens.  Recovery time of 4-6 weeks.  I’m fine with that, with diabetic mastopathy surgery back in 2009  – I was back on my feet faster then a speeding bullet.  Though this maybe abit different with the act of sitting on the throne and pushing out a load of crap!

What initially lead me to write this #dblog (aka my online diary that some people read) was after the blood work/EKG.  The RN, who after going instructions for what I was to do the night before surgery, etc. told me …   “that was it.  You are free to go home”.  I then stupidly asked the RN, “what about my insulin coverage for diabetes on that day?”  I told her I’d be probably back on the pump at that time since I’m on a break from it due to not having greatest control of #BGNow.  Hormonal issues with peri-menopause have increased my TDD (total daily dosage) to …. 60% and I was having infusion site issues with larger doses of insulin!!!  Really, it’s like I’m a T2D (Type 2 diabetic) with insulin resistance – and no – with my #dblog post in October – my endo refuses to allow me to take metformin to help control this resistance - urrrhhhh.  Sadly,  I don’t see my GP until end of January 2015 to see if she’ll consider allowing me to try this out (she was the one that allowed me to go onto Synthroid since my endocronolgist aka endo had refused).  I also explain to the RN, that in past surgery’s my endo signs papers to allow me to take full control of my insulin regime once I’m conscious.

So, the RN decides I will need to talk to a doctor at this point.  A short wait of an hour (I was catching up on a few English newspapers that I don’t receive where I live in Montreal – I was in heaven – reading about local stuff) – I get to see the doctor.  He goes over my medications, tells me to stop a few before the surgical date.  He asks me what my #BG (blood glucose) average is.  I tell him the story of my recent roller coaster ride with the #BG.   The only good thing about my telling him this …. I’m now maybe going to see one of the two endo’s that understand pump technology, but … and this will be hard for me … I’m supposed to keep my lips zipped on the fact I already have an endocrinologist (who sadly does not understand pump technology and is just my pimp for prescriptions).

On top of all that’s swirling in my sponge brain, is the hospital I went to.  It has not got the greatest reputation and I personally avoid it at all costs (though according to one #PWD (person with diabetes) – it’s improved).  BTW, I detest hospitals, white jackets.  I’m probably not alone in this statement, especially when it comes to medical staff not understanding the complexities of #diabetes and those of us on an insulin regime that maybe is not by their “book standards”.  I’m self-taught in what I do with both MDI (multiple dose injecting) / insulin pumping, due to being unable to find help where I live.

So now after all of this scribble, I am now in peri-menopause since August, no more keeping Protecter & Gamble’s stock up with purchasing sanitary supplies (that we get taxed on in Canada of 15% ovey!! – what a bloody rip off).  Anyway, I wasn’t expecting was to go into peri-menopause, and guess what?  No more discomfort, pain.  According to what I’ve read, fibroids shrink at this point in time, which does not necessitate having surgery. 

So, I’m on the fence post whether I should just cancel the surgery, or go ahead.  What would you do in my case?  Preserve your stomach for future MDI and infusion sets (while I healed from the 4-6” incision there will be less real estate for me to play with)?

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