Surgery Risks

Andy12z

Newbie
Messages
2
Hiya

I am type 2 (under control with medication), hypertension (under control with meds) and obese.

I need to have surgery under general anaesthesia soon, and whilst there is always risks with general, my consultant has stressed that I am at high risk of problems during surgery, including serious complications and ultimately death.

Now I am fully aware that it's their job to say that, but surgery is my only option to regain some kind of life, and he has encouraged me to go for it. I'm sure that he wouldn't agree re surgery if I was likely to end up adding to his morbidity statistics :)

I know that research shows that obesity in itself raises risks, but the real risk raisers are obesity+hypertension+diabetes. Since I am under control with meds does that reduce risk or is it just the basic fact that there isn't any mitigation when you are diagnosed with all 3?

I am going to my GP surgery and speak to the nurse practitioner re this as she will have my specific info in front of her.

Thanks for your time and any reply
 

DCUKMod

Master
Staff Member
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14,298
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I reversed my Type 2
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Diet only
Hiya

I am type 2 (under control with medication), hypertension (under control with meds) and obese.

I need to have surgery under general anaesthesia soon, and whilst there is always risks with general, my consultant has stressed that I am at high risk of problems during surgery, including serious complications and ultimately death.

Now I am fully aware that it's their job to say that, but surgery is my only option to regain some kind of life, and he has encouraged me to go for it. I'm sure that he wouldn't agree re surgery if I was likely to end up adding to his morbidity statistics :)

I know that research shows that obesity in itself raises risks, but the real risk raisers are obesity+hypertension+diabetes. Since I am under control with meds does that reduce risk or is it just the basic fact that there isn't any mitigation when you are diagnosed with all 3?

I am going to my GP surgery and speak to the nurse practitioner re this as she will have my specific info in front of her.

Thanks for your time and any reply

Whatever your op, and however tricky, I think it's safe to say that the better your control leading up to your op the better. What, if you don't mind saying,was your last HbA1c and your day to day levels?
 

MargaretR

Well-Known Member
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125
Type of diabetes
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Tablets (oral)
Hi Andy,
I’ve got the same risk factors as you, plus oedama (swollen ankles) and taking drugs which depress the immune system and have had both knees replaced in the last 18 months. Before the first one I had the same discussion about high risk as you, and I had to be done in a hospital which had a high dependency unit. I was home in 3 days, and everything was fine.
I had the second one done, initially everything was fine, and I was home in 3 days. Then things got a bit complicated because they gave me a drug to prevent blood clotting which worked a bit too well, and I ended up back in hospital. But that had nothing to do with my risk factors, and I’m absolutely fine now. Pain free and more mobile than for years.

I did try and get my blood pressure, blood glucose, and weight down before the op, and also had massage to shift the fluid in my legs.

So, I knew the risks, but went ahead. It worked for me.
 

Andy12z

Newbie
Messages
2
Thanks both for the replies :) much appreciated.

The surgery is to remove 2 discs in my spine. If it doesn't happen then it's only a matter of time before I become paralysed from the waist down, and have double incontinence. And, at 49 I'm still young and want to get back to my job and being useful.

I don't know my last levels exactly it was around 6 and it has never been suggested to me that I should check my blood myself.

Since diagnosis a year ago I have lost 4 stones and since I am currently basically bed ridden, having to eat horizontally since I can't sit or stand for more than a few minutes at a time, I'm still losing as all I'm eating is salad veg, well mainly.
 
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EllieM

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As you're new to the forums, I'm going to tag at @daisy1 to give the standard intro to diabetes talk, as the standard dietary advice from dietitians tends to have some glaring defects for T2s. (Apologies if you already know this stuff). And the advice for T2s not to blood test appears, to many of us at least, to be a cost cutting measure by the NHS, rather than an outcomes for the patient based measure. The fact is that many of the T2s on this forum have successfully used diet to attain normal blood sugars while reducing or eliminating their diabetes meds.
Now I am fully aware that it's their job to say that, but surgery is my only option to regain some kind of life, and he has encouraged me to go for it. I'm sure that he wouldn't agree re surgery if I was likely to end up adding to his morbidity statistics :)
You'd think so, wouldn't you? Don't you wish they'd quantify those risks, rather than say "high risk". (I still remember accompanying my 12 year old daughter as she went for a general anaesthetic to have her broken arm fixed, and her doctor insisted on telling her she was at a small risk of dying just before she went under.)

Since I am under control with meds does that reduce risk or is it just the basic fact that there isn't any mitigation when you are diagnosed with all 3?
Well, I'm not a doctor, but I'm sure that the statistics re blood pressure and diabetes are mitigated by good diabetic control and blood pressure meds. (Or put it this way, I'm sure the statistics are going to be worse if your blood pressure and blood sugars are sky high :))

Good luck, whatever you decide. Maybe the doctor is trying to encourage you to have your affairs in order (ie up to date will) in case you're one of the (hopefully very few) unlucky statistics? More likely, though, he legally has to tell you this stuff so that he doesn't get sued if there's a bad outcome.
 
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daisy1

Legend
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@Andy12z

Hello Andy and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 

MargaretR

Well-Known Member
Messages
125
Type of diabetes
Treatment type
Tablets (oral)
I’ve remembered some more that I left out of my post above. In the health authority I’m in we have a pre op assessment up to 3 months before the op, which is an hour of having everything checked by a nurse. Certainly in one of mine my blood pressure had gone a bit high, so she sent me to my GP to get it sorted.

Everything is checked again on admission, and if any of the markers are too high, then they will either remedy the situation or say, no, not today
You will also have a long chat with the anaesthetist, who is influential in deciding whether to go ahead.

So there are lots of checks in place. And they do have to make sure that you are aware of the risks, hence the scary chat that you got. I had that too.

Margaret
 
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david1968

Well-Known Member
Messages
409
Type of diabetes
Type 2
Treatment type
Diet only
I had surgery last week and one of the things they did at my pre-op assessement was to check my HbA1C.

They also went to great pains to make sure that I understood what I was having done and the possible outcomes - I think it's simply part of the procedure that they have to go through.
 

Daibell

Master
Messages
12,652
Type of diabetes
LADA
Treatment type
Insulin
Hi. I think you will find that with well-controlled diabetes and blood pressure you will not be adding any risk from these conditions. Just make sure the anaesthetists and surgeon know about the diabetes. They will check your blood sugar etc before the op. I've had a few ops and the medics have been very good and methodical.
 

libs

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Thanks both for the replies :) much appreciated.

The surgery is to remove 2 discs in my spine. If it doesn't happen then it's only a matter of time before I become paralysed from the waist down, and have double incontinence. And, at 49 I'm still young and want to get back to my job and being useful.

I don't know my last levels exactly it was around 6 and it has never been suggested to me that I should check my blood myself.

Since diagnosis a year ago I have lost 4 stones and since I am currently basically bed ridden, having to eat horizontally since I can't sit or stand for more than a few minutes at a time, I'm still losing as all I'm eating is salad veg, well mainly.
Hi Andy I was in your position in January for same surgery but my diabetes was not well controlled sailed through the op out the next day wound healed well back to working from home after 2 weeks and back full time after 4