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T1 Toddler to undergo general anaethestic

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Blissfool

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Help! My lovely little boy was diagnosed at the end of August with T1 - he is on a pump and we are just about coming to terms with managing things. But last week he started to scream in agony if he ate hot foot. Then sweet food. Now, any food. Luckily, i am still producong milk which, though not perfect, does give him some food/carb.

We got him in to see emergency dentist yesterday who said that he has to have two back molars out as they are infected and badly corroded (his teeth few through very soft and little enamel, have kept at bay but these last couple of months have given them plenty of sugars to feed on at night!)

She said he will have to be readmitted back into hospital and be put under general anaethestic this week. I am really worried, as he has hypos every day, and also has never had to undergo the fasting regime and is still traumatized by his last visit to hospital when he had ketoacidosis.

Meanwhile, his BM is going haywire, rising from around 4 to 20 in and hour, from 16 to 20 in 3 mintues when sleeping and then, if we up the basal or do bolus on the pump, it hits him really hard
and he goes down to the 2-3 mark.

I am very concerned about the general. I would have been anyway, given he is only 33 months and he has only just put back on his body weight. But the risks with the diabetes just terrify me. But they have given no alternative and as he is already terrified of hospitals and dentists etc. I know he wouldn't be able to be restrained, even if I were willing to subject him to it.

Help...anyone else gone through this?
 
You need to speak with your diabetes care team who should be able to give you some advice about how to handle this. I think you also need to explain the huge swings in blood sugar that your son is experiencing and they need to look at his pump set up and make some adjustments.

I'm sorry but I have no experience of diabetes with anaesthetics, maybe someone else will come along shortly to give some advice.

Why does he have to take a general, can they not remove the molars under a strong sedation? My son, who is not diabetic, had a molar removed when he was about 4 and that's how they did it, under a heavy sedation at a specialised dental clinic. It was over within half an hour, he was a bit groggy for a little while longer but it was much safer and quicker than a general. My son didn't remember anything of it, just the little needle prick and then a good sleep and waking up at the end of it.
 
I have no advice, just sending you hugs and a hope that it all gets sorted as quickly as possible.
 
Oh dear, your poor son, I can't advise about the anaesthetic except to reiterate what others have said about speaking to your diabetes care team about it.

As for teh BS swibngs, has it always been like that or only since the dental problems? Infections can make your blood sugars go crazy, if he was having lots of highs and lows like that before hand you should really look at getting his doses adjusted on teh pump as that's not right
 
Truly sorry to read what your little one is going through Blissfool, I can't begin to imagine what this must be like for you right now as a parent. Just hope everything goes well for your lad, and do take the advice from his diabetes care team who will hopefully have experience of dealing with children in similar circumstances to yours.

Good luck and best wishes!

Nigel
 
Hi,

I hope your little one is ok, thoughts with you all, I write this as my experience so I hope it's useful...

I had lots of operations at 9 years old for various reasons and all were under general anaesthetic, my mum said that I was ok, sugars quite up and down but I was deliberately placed on the diabetes ward so that the nurses could monitor me more closely. They put me on a sliding scale as well, I think its a mixture of glucose and insulin until I was able to go home, but if your son is using the pump they might just leave him with that.
As for the swinging sugars, again, i'll go with the other guys on her, infection, maybe increasing his basal just while he is ill might help.. but do call your diabetes team first and make sure.
I would suggest that as others have said, have a word with your diabetes team and double check the ward that your son will be going on and any other bits your worried about :)

Thoughts with you x
 
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