I am coming down with a virus that is going around, and at the same time I am stressed out over changes in my employers health insurance. To add injury to insult (no pun intended), I am going in for surgery on friday - to remove some pre cancerous tissue from my back.

 

I am already using about 30% more insulin (since thursday) - what am I supposed to expect happen after the surgery?

 

I am a new pumper, and have not gone thru any of this before..

 

Any insight/experiences are greatly appreciated!

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Anders, I haven't found that my various surgeries had any effect on my BG unless steroids are involved. YDMV. Hope you get rid of the virus soon!
My experience has been like pup's. While my insulin needs usually increase slightly before surgery, colonoscopy, etc., it seems come down quickly after surgery or the procedure. Last winter, I had some minor surgery done and before surgery, my numbers were up and I increased my basal to cover; however, within an hour after surgery, my numbers fell very quickly and I ended up low before leaving the hospital. My guess is that I'm much more stressed because of anticipating the surgery, but once over, I settle down quickly. In these circumstances, my doc always tells me not to worry about a couple of days with slightly higher numbers. Stressing about the blood sugar only makes it worse. This is not the case if steroids are involved. You certainly have several things going on that will cause stress.

Also, I've had really good luck with the anesthesiologists when I've had surgery since going on the pump. While the doc doing the surgery is clueless sometimes, the anesthesiologists haven't been. I usually put my pump in a baby sock and pin it to the outside of the hospital gown. That way everyone knows its there. Plus I talk to the anesthesiologist prior to him putting me under and my expierience has been that they always ask me what my basal is, if I've changed it in anticipation of surgery, etc.

Good luck. I hope everything goes well and you feel better soon.
I needed considerably more insulin after an appendectomy 10 years ago. I was a new pumper then and don't remember now how I handled it, but I was certainly high post-op for a couple of days. In general, when I'm sick and seeing highs or on steroids and seeing crazy highs, I increase my basal by 10-30% and run it there until I see my first two lows in a row. Then I assume my body is responsive to insulin again.

Any time you go in for surgery, it may be helpful to have a letter from your endo stating how much or how little control over your pump management and blood sugars you are to have. During that appendectomy, I was not told that they removed my pump and had it locked in the nurse's station. I had to call a doctor to come fight with the nurses to let me take over my own insulin management in the days to follow (which may have been why I was running so high).

By contrast, after my c-section last year, I was allowed full control over my pump and meter throughout my hospital stay. Hospitals have come a long way, but it pays to have your wishes in writing.
Thanks for the information - fortunately my procedure is an out patient thing, so I should be in and out of there within hours - but still, I appreciate your input - and it may be very useful for someone else :)

Sickness and stress definitely affect blood sugars. Both increase gluconeogenesis (body making its own sugar to dump into your blood) so you need more insulin for that. It's tough to say how much because that all depends on the sickness or level and type of stress. What I've found very helpful is low to moderate exercise like walking for AT LEAST 30 minutes 2 to 3 times a day because this will help reduce some gluconeogenesis and help with insulin sensitivity that might go down due to higher glucose values. Don't know anything about surgery itself, but if the surgery is stressing you out, take a walk before you go in. Good luck.

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