One of the interesting challenges facing type 1 diabetes can be the variability of daily life. Many Online Diabetes Community members have written articles on preparing for travel and vacations. The new variable that I just faced revolved around the need for surgery. My daily routine includes the use of an insulin pump which is coordinated with my blood glucose meter, a fitbit and a Dexcom G4 CGM. As part of the Hospital protocol’s I started with a Perioperative review. My reporting of my CGM made for some interesting discussions.
The Perioperative review did discover another issue that would require an examination during my scheduled surgery stay. Ok. Listed under the comments of the Pre-Anesthesia Instructions was to leave the insulin pump and Dexcom unit in place. Good!! Use Glucose tabs as needed after Midnight for scheduled surgery on Tuesday August 9th
As a type 1 diabetic for over 50 years and a Joslin Medal holder, it was my sense that the entire surgery team appreciated the ability to monitor my glucose levels through my Dexcom unit to be very helpful. Their only concern was that the unit was marked as my personal unit. It was.
I, for the most part monitored my blood glucose and maintained my CGM values which were shared with the nursing staff during my four day visit. As a Dexcom volunteer, I was given the opportunity to share my thoughts and feelings regarding the additional help and assistance of the implementation of a CGM in my diabetic care routine with various members of the hospital staff.
Now, the unexpected challenge. After surgery and a day to stabilize, the decision was made to perform a CT scan. Both my insulin pump and my Dexcom unit have 24 hour phone lines. I placed calls and was informed that both pieces of equipment should not be near a CT or MRI machine,. I was prepared to change my inset line after two days, but was not prepared to change a CGM sensor. Both were removed and the CT tests were completed. A CGM sensor was replaced and my family brought a replacement sensor to the hospital. However, right after the CT test the nursing staff took a blood glucose which hit over 400. I found the greatest challenge to be the continual monitoring and the ability to change temporary basal flows to be a major assistance during my stay. It made no sense to me to attempt to figure out what was causing a rise in blood glucose levels. Just respond as quickly as possible.
I found the hospital had a major plus for a diabetic patient. I was supplied with a menu and ordered meals. The food service staff had knowledge of the fact that I was a diabetic patient and had a set of maximum carbs for three meals and an evening snack. They let me know when I order too much! The true help came when the meal arrived with the counted carbs! The opportunity to plan ahead for my meal bolus was not attempted by me and delivery time of ordered meals was dependent upon the time of day.
Now, I am recovering at home and looking forward to returning to a less challenging environment. The IV lines with fluid and meds are gone! Surgery and the recovery period can bring a set of challenges that as a diabetic we normally do not face. I am thankful for all of the assistance of a great hospital staff and look forward to a return to normal activity.