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Post surgery levels

Discussion in 'Insulin Pump Forum' started by Picci, Apr 14, 2018.

  1. Picci

    Picci Type 1 · Well-Known Member

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    I had shoulder surgery on Monday, I opted for a nerve block to avoid GA and slower recovery.

    The day went as well as could be expected and luckily my bloods were of acceptable level.

    The flowing day the nerve block had worn off and I was in intense pain and due to running 13mmol I introduced a a 20% TBR which helped a bit.

    Spoke to my nurse on Wednesday who said to keep running the TBR for as long as needed and like we know, I was told it was the pain causing the highs.

    I'm now day 5, pain has eased but I'm still running the 20% TBR but bloods are never below 10mmol.

    My nurse is ringing on Monday to see how things are but I'm tempted to increase my TBR further 10%from 120% to 130%.

    I'm a new pump user and have yet to get my basal rates tuned, and now this is just causing more frustration

    Shall I increase the TBR?

    I just want some moral support the worst pain is over and I'm not seeing good numbers.

    Thanks in anticipation, Christine
     
    • Hug Hug x 1
  2. Deleted Account

    Deleted Account · Guest

    I had surgery last year and, thankfully, experienced little pain. However, my body was still repairing itself and dealing with the trauma of being cut open.
    It took a couple of weeks of increasing my basal by 40%.
    During this time, I tested, tested, tested to make sure my basal was not too high.

    We are all different and have different surgery. But, remember your body is repairing even when you feel no pain.
     
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  3. Picci

    Picci Type 1 · Well-Known Member

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    Thank you for sharing your experience @helensaramay I may indeed follow my instinct to increase further. My nurse never seems bothered about 10mmol, no doubt she'd say that's fine, but it's not fine, since starting the pump 5th March she's only concerned about eliminating hypos, which we have! I can't wait to just get on by myself, I disagree with a lot of her advice. Anyway, I'm derailing my original post!
    Christine x
     
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  4. Books1

    Books1 LADA · Well-Known Member

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    Did you bump it up and has it helped?
    Frances
     
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  5. Picci

    Picci Type 1 · Well-Known Member

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    Hi Frances @Books1 I bumped it up to 130% and I bolus with and additional 20% (Health event thingy!) it's keeping me a steady 6mmol ish....... I'm on loads more insulin, I can't believe it! Speaking to my pump nurse tomorrow.
    Hope you're OK Frances xxx
     
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  6. Chas C

    Chas C Type 1 · Well-Known Member

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    Hi @Picci hope you feeling better soon. When I had my hips done I had to bump up to 180% for one hip and then for second hip 200% for about 2-3 days then dropped back down to around 120 ish for maybe a week more or so. It will vary person to person but not unusual.
     
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  7. Books1

    Books1 LADA · Well-Known Member

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    That sounds nearer to where you want to be. Hope speaking to your nurse was useful - just remember that it's your t1d and although the medics know some stuff they're not always the experts on all aspects specially pumps.
    Take care

    Frances
     
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  8. donnellysdogs

    donnellysdogs Type 1 · Master

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    You dont actually have to wait to take control-providing you have gained knowledge...

    A lady here helped me in my first weekwith adjusting and by the time I saw dsn and consultant that week later they were gobsmacked but happy that I had support from a fellow pump user...and was allowed to carry on pretty much providing I did basal tests that I was doing. I could prove my knowledge, had exact records to prove everything carb counted, exercise, sleep, waking and food.
    I hadnt even read any books such as pumping insulin etc. Just had incredible support from a person here phoning me.

    I also went on to do the same with another few people -one used to visit our home on a Sunday...and a couple by phone as well.

    I no longer use a oump due to my body blocking cannulas.. but I know that I gained enough confidence to adjust my own doses from phonecalls and could pass that knowledge on as well... if you make small adjustments and have the correct reasoning and action for making adjustments and results are improving then you are taking control... and thats what you need to do.

    My nurse and consultant were good and they knew from talking by myself at appointments that I had grasped the ins and outs and wasnt just doing what the lady had suggested to me...
     
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  9. Picci

    Picci Type 1 · Well-Known Member

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    That's good to know @Chas C thank you.
    I'm a week and a day post surgery and still on the TBR of 130%. It feels like it's going to switch to a permanent basal rate
    Christine
     
    • Hug Hug x 1
  10. BUZZ

    BUZZ Type 1 · Member

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    Omg I'm waiting to have shoulder surgery and just read your post.... Mine is GA and I am dreading it as they are taking me off my pump until after the op. I dread to think what my levels are going to be post op. How you're recovering well
     
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  11. ickihun

    ickihun Type 2 · Master

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    I'm very interested in your post.
    Ive had to double my basal and bolus insulins but I am hugely insulin resistant.
    I'm led to believe it takes about a month for mine to settle down after infection and iron deficiency anaemia are resolved.
    I'm still waiting. I've added weight due to no exercise in a week of immense back pain as Tramadol stopped working.. again.
    I'm awaiting a date to see bariatric surgeon but the wait will be used to sort out iron deficiency and have good blood pressure and the best hba1c I can get.. considering. I did have a 48 but I know will be more like 80s due to illness, worry and high bgs from tweeked insulin which hasn't worked.
    Just starting to walk again, now.
     
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  12. Deleted Account

    Deleted Account · Guest

    Is it your choice to be taken off the pump?
    During my surgery last year, I remained on the pump at all times (including in the operating theatre).
    Initially the surgeon was concerned about this but I spoke to the anaesthetist and convinced them it would be better ... and there was nothing stopping him take control if he was concerned.
     
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  13. crashinduction

    crashinduction Type 1 · Member

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    I’ve recently had shoulder surgery and found just the same. I had really high insulin requirements for several days afterwards, even worse after the nerve block wore off.
    I’m in a slightly different situation as I’m an anaesthetist. I advised my colleague giving me the GA/nerve block to leave my insulin pump & G4 CGM on which is by far the best solution. Not all anaesthetists will be that familiar with pumps/CGM’s but with a bit of explanation, will quickly learn and probably be happy. They will all understand the concept of the devices though.

    Your body goes into a state of surgical shock post op due to the trauma of the operation, which is attenuated by the block (although still present) There are lots of hormonal changes that occur including release of adrenaline and cortisol which elevate your BM’s for several days. Once the surgical site settles down, the hormonal increases will settle too, although post-op pain will also increase your BM by a similar process.

    BM’s of 10 to 13 aren’t unusual for a few days afterwards and probably not be that harmful and just need an increased BR until they settle. Regular pain relief and BM monitoring is the key.
     
    • Like Like x 1
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