A Dose of Dr. E: Don’t Let Your Doctor Kill You If You’re Having Surgery

  1. Ed Beberman

    Great info as always. A must for anyone going into surgery. Thanks.

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    Glad you brought up the subject of surgery…very important issue and I still have a lot of questions. Hospitals do not seem to have specific protocols in place for Diabetics. Even bringing up the question of glucose verses saline IV induces puzzled faces. Lots of awareness/updating still needed!

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    Thank you for increasing our awareness and your insights into before and after surgery issues.
    Is there a best way to have these insights inserted into a personal medical file to be accessed in an unplanned/emergency surgery?
    TCOYD is such a wonderful resource!

    • Thanks for your comment, Nicole! I would suggest writing up your personal information, your concerns, what you would like to happen in terms of communication with the surgeon and anesthesiologist early and ask your HCP (or his or her staff) to put it into your medical records. Many systems use EMRs and it is easy.

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    Great topic, very informative. I am a T1, had surgery in 2017. That head of the surgery dept., told me to call my Endo and follow his protocols for surgery. He didn’t seem very concerned at all. I was appalled at how little the nurses on 2 different floors knew about diabetes. They can’t even take your sugars without leaving bruises on all of the fingertips. One of the floors was supposed to be the “Diabetic” floor!

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    I had quadruple, open heart by-pass surgery last November. The surgical team was amazing in helping me to manage my blood sugar. My pump and CGM were running right up to the surgery. They brought in the resident Endo from the start and they got me back on my pump as soon as it was safe for me to manage it. It took a day or so to adjust new basal rates for the ten days I was in ICU, but I healed well and the overall care was great.
    The biggest problem was my lungs not responding well and my having severe asthma post surgery that caused me to gag at anything in my mouth. So I initially did not each much. I agree with the surgeon in the video, the post surgery stress RAISED my BG and I was initially on almost double my normal insulin, even without eating.

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      Hi Bob, thank you for sharing your story. It’s encouraging to hear your surgical team was on top of everything, and we’re happy everything went well and you had such great care!

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    First of all, Dr. Edelman– where’s your G6?! You’re still wasting your time with fingersticks?

    A year ago, I had trigger finger release surgery in both hands (because they occurred simultaneously, could this have been a potential musculo-skeletal effect after 30+ years of diabetes? Nobody was able to confirm this for sure).

    In reality, the surgery was very short– I was to be knocked out only for about 30 minutes. However, I felt that it would of course be helpful to the anesthesiologist to have my Dexcom available for them to refer to during the surgery.

    I was told, “We don’t need your CGM in the surgical suite. We confirm blood sugars with fingersticks”.

    I said, “Yes I understand, but the CGM can alert you as to whether I need a fingerstick.”

    They said, “We prefer not to handle patient’s hardware in the surgical suite. Your device might be misplaced while you are being transferred between beds. Plus, this unfamiliar device could be more of a distraction than benefit.”

    I was stunned that the anesthesiologist, who is the doctor in charge of making sure all of the patient’s levels are stable during the surgery, would turn down the opportunity to use a device that gives live blood sugar readings. It’s absurd– but that’s the reality.

    You might luck out and get a baby doctor who is aware and interested in learning about new technology, but the reality is that if you’re dealing with an established anesthesiologist that has been doing this work for decades, they’re not likely to want to get to know the new technology, no matter how unbelievably helpful it could be to the successful performance of their job.

    • Thanks for your comments, Adam. No one can answer the question of simultaneous trigger finger occurrence with 100% assuredness, but most likely the cause. I had 3 trigger finger repairs but not all at the same time. Two of my three trigger fingers were my middle two fingers…I thought it was fitting since I used those two middle fingers quite a bit to tell folks how I felt about them…especially while driving on the freeway!!

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        Hahaha, Dr E … that’s why my 2 “bird” fingers blew out too 🤣👍. Had surgery on each, two years apart, by 2 different surgeons. The first one done by a hand specialist in Santa Barbara, and I had no problems with surgery or recovery, and had an excellent result. The second was done by a local ortho, and it was a disaster. It’s been 10 months, and I still can’t straighten my finger. I went back to the first surgeon for an opinion, and after reviewing the surgical notes, and examining my hand, he said trigger finger surgeries in diabetics are unpredictable, and that it wasn’t unusual to have two different results.

        • Trigger finger surgery isn’t super easy and some situations are more difficult than others, but I would ALWAYS go to a hand specialist.

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        Dr E….you crack me up! Must be all of that easy commute traffic in San Diego😁

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    Dr E, I’m just watching this now. Saw the one posted a few weeks ago, before your knee surgery. Hope you are healing quickly. I learned about steroids being given during surgery in that video, which came in handy, when I had abdominal surgery 2 weeks ago. During surgery foe Breast Cancer 9 years ago, the hospital wouldn’t use my pump, and my bg went over 450. (probably had steroids) The high BG, led to. an infection and then they removed the implant as a result. So, after reconstructive surgery, I ended up with a hernia, which was repaired 2 weeks ago. I wish others in the Medical field would listen and learn how to prevent infections by having someone trained in pumps, there to help. I had that during my last procedure, and my TIR, was 90%, even after a steroid. T1 for 68 years, and Mom of 3. I’ve seen a lot. Also had trigger finger repairs, probably due to my sign language for traffic and my spouse on occasion.

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      Haha! Love your sense of humor! Thanks for sharing your experiences…sorry for your earlier ones, but glad your last one went well. Hope more hospital systems get on board.

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