Fingers Crossed

[masonbason63]

Yes the title is loosely used I'm now 1 week off yet again for my first knee op, everything is now in place for day surgery next Friday, I have had to battle to convince them to let me stay on my pump using a TBR before, during and after the procedure. It finally fell into place when I had to go back yet again to see the annethetist and convince him to operate using a spinal block and not a general, yippee, but everything is hanging on the swabs I've had taken for MRSA which has held me back for the last few months so fingers crossed.

Just wondering has any others been given this whilst on a pump and also what's the rough sort of recovery time? .

 

[Spiker]

When I had my cataract op I had to convince them to let me use my pump but the diabetic ward in the same hospital was on my side.

The new NICE guidelines just published for T1 also encourage this if possible so cite the guidelines.

Good luck Mason!

 

[ann34+]

Yes the title is loosely used I'm now 1 week off yet again for my first knee op, everything is now in place for day surgery next Friday, I have had to battle to convince them to let me stay on my pump using a TBR before, during and after the procedure. It finally fell into place when I had to go back yet again to see the annethetist and convince him to operate using a spinal block and not a general, yippee, but everything is hanging on the swabs I've had taken for MRSA which has held me back for the last few months so fingers crossed.

Just wondering has any others been given this whilst on a pump and also what's the rough sort of recovery time? .

I was not on the pump at the time, but re recovery time from a spinal injection - i had one, and not a GA, when i had screws put in to repair a broken hip, recovery time short, as you only have to wait for any sedative to wear off, and to be able to feel your toes before being wheeled back to the ward. I had not much sedative, and was wheeled up in not much more than half an hour. Another possible advantage - though the epidural may feel as if it is gone, it seemed, for me, to stop much pain for more than 24 hrs, if same for you, you may not need any (or just a little) pain medication afterward. If you had had a general you would probably have needed a lot. Just my experience, i imagine everyone is different. Hope all goes well.

 

[masonbason63]

I was not on the pump at the time, but re recovery time from a spinal injection - i had one, and not a GA, when i had screws put in to repair a broken hip, recovery time short, as you only have to wait for any sedative to wear off, and to be able to feel your toes before being wheeled back to the ward. I had not much sedative, and was wheeled up in not much more than half an hour. Another possible advantage - though the epidural may feel as if it is gone, it seemed, for me, to stop much pain for more than 24 hrs, if same for you, you may not need any (or just a little) pain medication afterward. If you had had a general you would probably have needed a lot. Just my experience, i imagine everyone is different. Hope all goes well.

Thanks Ann34+
That was the answer I was hoping for, but as you say every ones different I'll have to wait and see

 

[masonbason63]

When I had my cataract op I had to convince them to let me use my pump but the diabetic ward in the same hospital was on my side.

The new NICE guidelines just published for T1 also encourage this if possible so cite the guidelines.

Good luck Mason!

Completely Spiker and I when I had both cataracts done they didn't bat an eyelid about the pump so to speak !

 

[AndBreathe]

Yes the title is loosely used I'm now 1 week off yet again for my first knee op, everything is now in place for day surgery next Friday, I have had to battle to convince them to let me stay on my pump using a TBR before, during and after the procedure. It finally fell into place when I had to go back yet again to see the annethetist and convince him to operate using a spinal block and not a general, yippee, but everything is hanging on the swabs I've had taken for MRSA which has held me back for the last few months so fingers crossed.

Just wondering has any others been given this whilst on a pump and also what's the rough sort of recovery time? .

Masonbason, I can't comment on your core question as I've never had the experience, but I just wanted to wish you well for the coming days, and through the op. I know you've had what seem like so many knock-backs with this, so it's great to hear of your progress.

Keep us posted on how you get on; maybe with an update to this thread? That would also add to the search potential of the forum, should anyone else have the same query?

I'll cross my fingers for you next Friday.

 

[CarbsRok]

When I had my cataracts done I told them I was keeping my pump on There was no objection at all.

I'm due a sinus op in the near future which is an hour under general so will have a nice little chat with the knock out man

 

[masonbason63]

When I had my cataracts done I told them I was keeping my pump on There was no objection at all.

I'm due a sinus op in the near future which is an hour under general so will have a nice little chat with the knock out man

Hi CarbsRok, yes I had both of my careracts done a couple of months apart without losing the pump so I was very pleased, the op on my knee was meant to be under a general but when I saw annethetist yesterday he was more than happy to give me a spinal block and he said I could keep pump on no problem but said they wouldn't have been to sure under a general.

 

[CarbsRok]

Hi CarbsRok, yes I had both of my careracts done a couple of months apart without losing the pump so I was very pleased, the op on my knee was meant to be under a general but when I saw annethetist yesterday he was more than happy to give me a spinal block and he said I could keep pump on no problem but said they wouldn't have been to sure under a general.

Having sensors as well might swing it say's me in hope

 

[Spiker]

Thing is that the theatre staff can't be expected to know how your CGM or pump works, how to read it, what to do if it alarms etc. So really they need you to be conscious and able to do all the thinking and talking.

 

[CarbsRok]

Thing is that the theatre staff can't be expected to know how your CGM or pump works, how to read it, what to do if it alarms etc. So really they need you to be conscious and able to do all the thinking and talking.

It's the anaesthetist who is solely in charge of that dept so there should not be a problem......... ie leave the ruddy thing alone and if I go low give some IV glucose. In all honesty though the Animas pump is idiot proof so a highly qualified anaesthetist should be ok besides new NICE guidelines say pumps can be left on

Copied from guidelines

1.14 Care of adults with type 1 diabetes in hospital
Blood glucose control

1.14.1 Aim for a target plasma glucose level of 5–8 mmol/litre for adults with type 1 diabetes during surgery or acute illness. [new 2015]

1.14.2 Establish a local protocol for controlling blood glucose levels in adults with type 1 diabetes during surgery or acute illness to achieve the target level. [new 2015]

1.14.3 Use intravenous in preference to subcutaneous insulin regimens for adults with type 1 diabetes if:

• the person is unable to eat or is predicted to miss more than 1 meal or
  
  
• an acute situation is expected to result in unpredictable blood glucose levels – for example, major surgery, high‑dose steroid treatment, inotrope treatment or sepsis or
  
  
• insulin absorption is expected to be unpredictable, for example because of circulatory compromise. [new 2015]
  

1.14.4 Consider continuing the person's existing basal insulin regimen (including basal rate if they are using continuous subcutaneous insulin infusion [CSII or insulin pump] therapy) together with protocol‑driven insulin delivery for controlling blood glucose levels in adults with type 1 diabetes during surgery or acute illness. [new 2015]

1.14.5 Use subcutaneous insulin regimens (including rapid‑acting insulin before meals) if an adult with type 1 diabetes and acute illness is eating. [new 2015]

1.14.6 Enable adults with type 1 diabetes who are hospital inpatients to self‑administer subcutaneous insulin if they are willing and able and it is safe to do so. [new 2015]

Delivery of care

 

[masonbason63]

Well had my knee op on Friday, what a performance I was told nothing to eat from night before and could sip water up till 2 hours before admission at 7am as I would go down first due to my medical conditions and diabetes, 3.20 pm I went down in the end after threatening to walk and make an official complaint, I just felt ill with no food and water. How could they leave a type 1 for so long is beyond me and they wonder why people have problems

Good old pump it played a blinder, all that time bloods were between 6 & 6.5 excellent even with stress.

Op went well, but unfortunately I do need to have a new knee got back to ward at 5.20 so much for day surgery. And they didn't tell me with a spinal you lose bladder control so ha ha I wet the flipping bed after about an hour, but the nurses were so so good but it was a different story with the night staff when it happened they left me in it all night

I can't believe how little the nurses on the ward knew about type 1 unbelievable! Even the experienced ones didn't know the basics, I think it was because it was an orthopaedic ward but no excuse, they all were fascinated by the pump and only 2 nurses had heard of them. They all thought you plug it in then it self calculated your doses and done your bloods as well, I enjoyed educating some of them on pumps and type 1 " I felt I was in control of my situation "

The staff were excellent "apart from the night staff " and I'd not asked for the diabetic menu which was agreed and my bloods stayed perfect throughout the stay.

Happily at home in control

 

[ButtterflyLady]

Well had my knee op on Friday, what a performance I was told nothing to eat from night before and could sip water up till 2 hours before admission at 7am as I would go down first due to my medical conditions and diabetes, 3.20 pm I went down in the end after threatening to walk and make an official complaint, I just felt ill with no food and water. How could they leave a type 1 for so long is beyond me and they wonder why people have problems

Good old pump it played a blinder, all that time bloods were between 6 & 6.5 excellent even with stress.

Op went well, but unfortunately I do need to have a new knee got back to ward at 5.20 so much for day surgery. And they didn't tell me with a spinal you lose bladder control so ha ha I wet the flipping bed after about an hour, but the nurses were so so good but it was a different story with the night staff when it happened they left me in it all night

I can't believe how little the nurses on the ward knew about type 1 unbelievable! Even the experienced ones didn't know the basics, I think it was because it was an orthopaedic ward but no excuse, they all were fascinated by the pump and only 2 nurses had heard of them. They all thought you plug it in then it self calculated your doses and done your bloods as well, I enjoyed educating some of them on pumps and type 1 " I felt I was in control of my situation "

The staff were excellent "apart from the night staff " and I'd not asked for the diabetic menu which was agreed and my bloods stayed perfect throughout the stay.

Happily at home in control

Glad it went well and you are back home and in control

I would make a complaint about the night staff not attending to you as they should have. I'd have thought on an ortho ward they should know this happens with a spinal. Just appalling. Some people could be at risk of infection or a painful rash from this. And it's a loss of dignity which is against patient's rights. If your complaint helps improve things for other patients then it's worth the time it takes.

Wishing you a good recovery.

 

[ann34+]

Well had my knee op on Friday, what a performance I was told nothing to eat from night before and could sip water up till 2 hours before admission at 7am as I would go down first due to my medical conditions and diabetes, 3.20 pm I went down in the end after threatening to walk and make an official complaint, I just felt ill with no food and water. How could they leave a type 1 for so long is beyond me and they wonder why people have problems

Good old pump it played a blinder, all that time bloods were between 6 & 6.5 excellent even with stress.

Op went well, but unfortunately I do need to have a new knee got back to ward at 5.20 so much for day surgery. And they didn't tell me with a spinal you lose bladder control so ha ha I wet the flipping bed after about an hour, but the nurses were so so good but it was a different story with the night staff when it happened they left me in it all night

I can't believe how little the nurses on the ward knew about type 1 unbelievable! Even the experienced ones didn't know the basics, I think it was because it was an orthopaedic ward but no excuse, they all were fascinated by the pump and only 2 nurses had heard of them. They all thought you plug it in then it self calculated your doses and done your bloods as well, I enjoyed educating some of them on pumps and type 1 " I felt I was in control of my situation "

The staff were excellent "apart from the night staff " and I'd not asked for the diabetic menu which was agreed and my bloods stayed perfect throughout the stay.

Happily at home in control

Hi, masonbasin, good that your pump worked well - not so good that you have to go back for a new knee. Believable that nurses on the ward knew little about Type one,..some years ago i found that many staff did not know much about type one, either - I had hoped things would have improved since then, as i have to go back for another fairly major operation sometime. Regarding the spinal, not sure whether it could be partly to do with the skill with which it is administered, especially as you were not warned in advance? I did not have the problem, and no-one warned me it might occur.

 

[ButtterflyLady]

Hi, masonbasin, good that your pump worked well - not so good that you have to go back for a new knee. Believable that nurses on the ward knew little about Type one,..some years ago i found that many staff did not know not much about type one, either - I had hoped things would have improved since then, as i have to go back for another fairly major operation sometime. Regarding the spinal, not sure whether it could be partly to do with the skill it is administered, especially as you were not warned in advance? I did not have the problem, and no-one warned me it might occur.

It might pay to ask about bladder control before your next surgery, as if it's likely to happen again, they might use a catheter instead? I've had a catheter overnight after surgery and having it removed was not painful, but it might be more painful for men, so not really a good option. Worth asking about though?

 

[AndBreathe]

Well had my knee op on Friday, what a performance I was told nothing to eat from night before and could sip water up till 2 hours before admission at 7am as I would go down first due to my medical conditions and diabetes, 3.20 pm I went down in the end after threatening to walk and make an official complaint, I just felt ill with no food and water. How could they leave a type 1 for so long is beyond me and they wonder why people have problems

Good old pump it played a blinder, all that time bloods were between 6 & 6.5 excellent even with stress.

Op went well, but unfortunately I do need to have a new knee got back to ward at 5.20 so much for day surgery. And they didn't tell me with a spinal you lose bladder control so ha ha I wet the flipping bed after about an hour, but the nurses were so so good but it was a different story with the night staff when it happened they left me in it all night

I can't believe how little the nurses on the ward knew about type 1 unbelievable! Even the experienced ones didn't know the basics, I think it was because it was an orthopaedic ward but no excuse, they all were fascinated by the pump and only 2 nurses had heard of them. They all thought you plug it in then it self calculated your doses and done your bloods as well, I enjoyed educating some of them on pumps and type 1 " I felt I was in control of my situation "

The staff were excellent "apart from the night staff " and I'd not asked for the diabetic menu which was agreed and my bloods stayed perfect throughout the stay.

Happily at home in control

I’m so pleased you’ve had the op you have waited so long for. It’s a shame you’re going to need a new knee. Is that going to be in the near future or as the knee deteriorates further?

To look on the bright side; when it comes to next time, you will be far better informed , in terms of discussing your diabetic needs at pre-op meetings, and also to be able to have discussion about bladder control, assuming you would opt for an epidural again. Could it have been useful to have tried emptying your bladder every couple/few hours, even without the usual urges? Just a thought.

Whilst nobody likes to make a fuss, I do believe that you need to raise the fact you were left in wet bed clothes overnight. If you were infirm, or prone to ulcerate, that is a sure-fire potential to increase your chances of bed sores. Some things are tolerable for an overnight stay, because your focus is on just getting out, but when your knee is done, you are likely to be an inpatient for around 5-7 days, so you don’t need a repeat performance. Perhaps you will have the opportunity to give this feedback at your post-op appointment, with your Consultant?

I know it’s a different op, but my neighbour had a full hip replacement op using an epidural a couple of years ago and was absolutely fine. She just loaded up her iPod with her favourite music and sang her way through it. Personally, I’m hoping she didn’t sing out loud, because I’ve heard her sing!

I hope your recovery goes well.

 

[masonbason63]

Glad it went well and you are back home and in control

I would make a complaint about the night staff not attending to you as they should have. I'd have thought on an ortho ward they should know this happens with a spinal. Just appalling. Some people could be at risk of infection or a painful rash from this. And it's a loss of dignity which is against patient's rights. If your complaint helps improve things for other patients then it's worth the time it takes.

Wishing you a good recovery.

I'm in a good frame of mind about all the day staff they were brilliant, so I'm a bit reluctant to make a complaint as I don't like persecuting two night staff, I know leaving me was totally inexcusable, I feel I might do it annonomosly about the ward night staff and say that in the complaint. I would like to know what you think?

 

[ButtterflyLady]

I'm in a good frame of mind about all the day staff they were brilliant, so I'm a bit reluctant to make a complaint as I don't like persecuting two night staff, I know leaving me was totally inexcusable, I feel I might do it annonomosly about the ward night staff and say that in the complaint. I would like to know what you think?

Up to you, whatever you feel comfortable with. I just think it's poor, they should know better.

 

[masonbason63]

I’m so pleased you’ve had the op you have waited so long for. It’s a shame you’re going to need a new knee. Is that going to be in the near future or as the knee deteriorates further?

To look on the bright side; when it comes to next time, you will be far better informed , in terms of discussing your diabetic needs at pre-op meetings, and also to be able to have discussion about bladder control, assuming you would opt for an epidural again. Could it have been useful to have tried emptying your bladder every couple/few hours, even without the usual urges? Just a thought.

Whilst nobody likes to make a fuss, I do believe that you need to raise the fact you were left in wet bed clothes overnight. If you were infirm, or prone to ulcerate, that is a sure-fire potential to increase your chances of bed sores. Some things are tolerable for an overnight stay, because your focus is on just getting out, but when your knee is done, you are likely to be an inpatient for around 5-7 days, so you don’t need a repeat performance. Perhaps you will have the opportunity to give this feedback at your post-op appointment, with your Consultant?

I know it’s a different op, but my neighbour had a full hip replacement op using an epidural a couple of years ago and was absolutely fine. She just loaded up her iPod with her favourite music and sang her way through it. Personally, I’m hoping she didn’t sing out loud, because I’ve heard her sing!

I hope your recovery goes well.

I couldn't have discussed the fact about diabetes etc at the four pre-assessments I had for this op and each time I spoke to the aneathatist I was told I would be seen early in the day I was 3rd on list late pm ridiculous!!!.
They've said knee will be done sooner rather than later so I will definitely push for being 1st on list and yet again explain everything to them again.

In the ward knee replacement they like you out 3-4 days max and hips which I'll need eventually 3-5 day which I can cope with as long as I know. They have you out of bed next day on the ward I was in and I think that's brilliant, it's not the stay I mind it's being taken as not an intellectual person who doesnt know how to look after themselves which I most certainly am especially my health.
As to the bladder control after the hours I waited I couldn't of had any left in me but if I was warned it would have better the day staff cleaned me up straight away keeping my dignity at all times, I would have the spinal every time for an op now best thing since sliced bread felt brilliant at all times during and after op when I was in recovery watching people who'd had the same op under general some were very poorly.

Next time bionic knee !!

 

[AndBreathe]

I couldn't have discussed the fact about diabetes etc at the four pre-assessments I had for this op and each time I spoke to the aneathatist I was told I would be seen early in the day I was 3rd on list late pm ridiculous!!!.
They've said knee will be done sooner rather than later so I will definitely push for being 1st on list and yet again explain everything to them again.

In the ward knee replacement they like you out 3-4 days max and hips which I'll need eventually 3-5 day which I can cope with as long as I know. They have you out of bed next day on the ward I was in and I think that's brilliant, it's not the stay I mind it's being taken as not an intellectual person who doesnt know how to look after themselves which I most certainly am especially my health.
As to the bladder control after the hours I waited I couldn't of had any left in me but if I was warned it would have better the day staff cleaned me up straight away keeping my dignity at all times, I would have the spinal every time for an op now best thing since sliced bread felt brilliant at all times during and after op when I was in recovery watching people who'd had the same op under general some were very poorly.

Next time bionic knee !!

Please don't get me wrong, I'm not suggesting you hadn't tried to achieve the best care, but sadly it didn't go quite right, by the sounds of it. Keep us posted and we'll send you the positive vibes for the next chapter of your knee saga.