Diabetes on the gurney – by Helen May
Diabetes is with me 24-7, 365 days of the year. And 366 days on a leap year (if only I could have one day off every 4 years). This means that it is with me whatever I do: travel, gym, holidays, eating out with friends, climbing, a night in the pub, … And that includes when I have to do less fun things like washing up, laundry, work, cleaning, … and going to the hospital.
I think of myself as healthy. OK so I have a chronic disease called diabetes but, weirdly, I don’t think of that as an illness: it is just part of me. However, over the last few years I have experienced another little problem which has caused more frustrations than major impact on my life. As a result, I recently had a minor operation. It was only day surgery so I was in and out within a few hours. But, I had to have a general anaesthetic so it was treated seriously. And my diabetes came with me to the hospital.
Whilst the surgery was not major, it was still a little daunting and adding diabetes to the mix, added to the dauntiness (or should than be “dauntlessness”?). My concerns were split into two categories: how would my blood glucose levels be affected by the surgery (including the preparation for the surgery) and surrendering the management of my diabetes to someone else whilst I was under general anaesthetic.
I prepared myself and the hospital staff as much as possible beforehand. At my post op, I told them I had diabetes so they did more tests (apparently an ECG is not normal, but having diabetes puts me more at risk so I was checked). Once I passed these tests, the date and time of the operation was discussed. I was not allowed to eat five hours before turning up at the hospital. To be honest, I am not sure how much having diabetes makes a difference to feeling hungry but it gave me the chance to express an opinion. The appointment was set for 12:30 which gave me a chance to have some breakfast before 7:30.
Normally, I eat my breakfast as I start my working day reading emails at 8:45. So I had to get up early and to eat some jam on toast. Might not sound very exciting but it was my Mum’s homemade strawberry jam on homemade spelt and rye toast. Knowing that would be the last solid that was allowed to pass my lips for some hours, I was conservative with my insulin: better to be running too high and have to take a top up later than to have a hypo, need some sugar and have to postpone the surgery.
Following a normal morning of work where I had a deadline to meet (with no motivational award at the end), I drove my boyfriend to the hospital. This was the start of me having to let go a little – I would not be able to drive for 36 hours after having a general anaesthetic, so I couldn’t just leave the car outside to drive myself home after the op.
I passed all the pre-checks with the nurse. My blood pressure was slightly high but I was nervous and it wasn’t too high. My heart rate and blood glucose (BG) were fine. I had a chat with the consultant who was going to do the surgery and the anaesthetist. This last guy was the important one when it came to the diabetes. I checked he was going to keep an eye on my BG – he would take at least one reading every hour. He questioned me about my pump. He asked me where it was: I had put my canula in my lower back out of the way and kept the pump in a strap around my chest … again to keep it out of the way: and he confirmed that it would be giving me insulin all the time and there was no need for him to intervene.
Then it was time for the operation. I don’t remember much after the nurse confirmed I was there for the correct operation and I was “plumbed in” to make sure my heart rate and blood pressure were being monitored, and the anaesthetic was administered.
Next I knew, I was waking up in recovery, my BG was checked again and I was fed some fruit juice to bump it up a little as it was now 4.2. My heart rate was was checked again … it was a little lower than most, but that was explained by me being fitter than most.
After a cup of tea and sandwiches, I was discharged with some pain killers (which, luckily, I did not need) and a reminder not to drive.
I was glad this operation was planned. But my experience gave me the confidence, if I needed an unplanned one, the healthcare professionals know how to manage diabetes during the surgery and my diabetes should not get in the way. My BG was not adversely affected and I was surrounded by people who understood diabetes, if there was a problem.
Based on my experience, I’d advise anyone having planned surgery to:
- Make sure everyone involved with the surgery knows you have diabetes
- Run your BG a little high whilst fasting beforehand
- Take spare supplies with you to the hospital (although I changed my pump set at home on the morning of the operation, I took a spare set with me in case there was a problem)
- Make sure your BG is checked before the op, during the op and when you wake up … and any other time you want
- Don’t worry too much – you’re unlikely to be the first person with diabetes in the operating theatre.