It is time, Tuesday 11 am, I am just in front of the
admission guy getting ready to be admitted for a knee
surgery after 9 months of continuous pain because of meniscus disc tear in my
right knee. Nurse is preparing me for the one clock pm surgery and a little conversation started
between us .
Me: I am a T1 diabetic and I definitely do not want any glucose,
lactose, fructose to be given to me while I am asleep in operation.
Nurse: Sir; Doctor will decide that but I believe it is a protocol and
it cannot be changed unless Dr. Said so; not you.
Me: No; it can be changed and I already agreed with surgeon to get
non lactated saline solution only if required – it is just a 30 mins surgery
and I insist. She called the nursing supervisor who came and started to argue
with me and then he noticed the insulin pump and asked what this?
Me: insulin pump
Nurse: Insulin pump!!!
Yes insulin pump
What kind of insulin you use in it?
Me: Novorapid.
Nurse: (assertively): So I think you will have to wear it off during surgery.
Me: Nooooo - I do not have to - it is only giving me basal insulin______
Room was suddenly filled with 4 nurses listening to this crazy guy talking about basal insulin and pump.
Nurse: Even basal insulin only – you will have to take it off sir.
Me: No I will not. Because it is my basal insulin instrument.
Another Nurse: What is basal insulin.
Me: It is the insulin that keep my body working - it is required to facilitate inlet of glucose to cells that needs energy - another word to match the work of Glucose secreted by my liver to serve all involuntarily movement’s energy requirement inside body like digestion, breathing, kidney filtration.
Another Nurse: Sir you are so inclined in medical information, How do you know all this?
Well I am an educated T1 diabetic who learn and take care very well of my version of Diabetes and here is my book about Diabetes (always carrying some copies).
Me: insulin pump
Nurse: Insulin pump!!!
Yes insulin pump
What kind of insulin you use in it?
Me: Novorapid.
Nurse: (assertively): So I think you will have to wear it off during surgery.
Me: Nooooo - I do not have to - it is only giving me basal insulin______
Room was suddenly filled with 4 nurses listening to this crazy guy talking about basal insulin and pump.
Nurse: Even basal insulin only – you will have to take it off sir.
Me: No I will not. Because it is my basal insulin instrument.
Another Nurse: What is basal insulin.
Me: It is the insulin that keep my body working - it is required to facilitate inlet of glucose to cells that needs energy - another word to match the work of Glucose secreted by my liver to serve all involuntarily movement’s energy requirement inside body like digestion, breathing, kidney filtration.
Another Nurse: Sir you are so inclined in medical information, How do you know all this?
Well I am an educated T1 diabetic who learn and take care very well of my version of Diabetes and here is my book about Diabetes (always carrying some copies).
All went well and now time for anesthesia to be injected; at the same time
Nurse was measuring my blood sugar and it was 91 and she conveyed
that to my surgeon who was shocked and said
that is Hypo or going to be Hypo soon and you are advised to eat some sweet
to raise up your BS before we start - it is accepted to be 180!!!
What!!! 180 - 180 my
ASSSSS.!!A lot of arguments - they fed up with me and finally called hospital endo; who said the same thing but I kept on talking and managed to convince him that my basal insulin is well adjusted and the enlite sensor is on and it will cut the basal immediately if any hypo happened and that I am fasting so the sensor reading will be very close to BS reading plus there is no bolus to cause any possible hypo and that I had no HYPO incidents since long time because I am in LC diet and I am following the law of small numbers of Dr. Richard Bernstein which minimized the chance of Hypo occurrence, etc…
Endo said: Fine, looks like he knows what he is saying and practicing
very well. IT IS OK for me – “talking to the surgeon” you can go head and start
the procedure.
Finished the 50 mins Arthroscope peacefully with no glucose
taken (only non-lactated Saline as I requested), pump on, no hypos. everyone was happy and content.
The whole day after surgery I was talking about diabetes
management with nursing staff who were really eager to learn and I was also
happy having the chance to spread the word again and again.
T1 diabetic planning to have a surgery- watch yourself. It is a huge challenge for those taking diabetes for granted and don't learn!!
Take care.
Comments