Diabetes and Surgery

Nutrition

Diabetes and Surgery

In 2011 I was in an accident in Melbourne, Australia where I had to be taken under for a trauma surgery to my jaw. It may sound like blasphemy, but when I was in the OR bullpen (I am sure there is a more appropriate name!), the anesthesiologist kept asking if I could remove my insulin pump and the entire site. (A pump site is a band-aid like adhesive where a hairlike need is inserted into the skin so insulin could flow into the body).

I obliged. I didn’t want to take it off because I knew for one, my backside is one of the best spots for my pump. Getting a good site that absorbs the insulin efficiently, for me then, was not a quick process. Above all, I had fasted for far too long, was not thinking entirely clearly and was in severe pain despite the medication I was on. I did not want to twist my body in the needed fashion to put in a new site. Also, I assumed I had to manage to get a new site myself because this method of controlling my blood sugars was not common in Melbourne (a commonwealth country where the government funded the medical supplies). Lastly, I didn’t see the need to remove the whole site. The doctors wanted to remove it to prevent a bed sore or bed wound. But I knew I was a healthy 20-something, and the surgery was not anticipated to be an all-day event. So the anesthesiologist and I met in the middle. He took my pump, and I left on my site.

My blood sugars were checked throughout the 4-hour surgery, and I am guessing the range was flexible, but I did not have insulin administered at all during that time. I have a vague memory late that evening in post-op, of my Certified Diabetes Educator running into my room asking for my glucose reading because the pump removal was against her orders. Sure enough, I was loaded with ketones, which thankfully recovered, but I was honesty scared for my life. How could this top-level trauma hospital in all of the country, let alone state, miss this? The doctor did call me after I was discharged to acknowlede the mistake.

While this story has more details, and I will spare them. The important thing is it is an example of a moment (and not the only one in the decades I have had type 1 diabetes) that I felt alone, without a team that I fully trusted to care for me entirely.

As a newly diagnosed 8-year-old, as a growing teen, as a new college student transitioning to an insulin pump, as a soon-to-be mom monitoring blood sugars throughout pregnancy (2x) like a hawk, I’ve met with many health care professionals shedding loads of advice on how to best manage my disease. Many of those tips are still with me, but there were occasions I thought, “I wish they knew how to do this 24/7, 365 and would reconsider what they are asking of me.”

What I am getting at, and perhaps you can relate, is do not hesitate to advocate for yourself and create your "diabetes village." This can be a diabuddy (I have many thanks to DiabetesSisters PODS meetings, local organizations and social media like the #DOC). But this village should also include health professionals that can give you guidance when the answer isn't obvious. I am more than willing to connect too. Having a village is crucial on the journey of living with diabetes emotionally and therapeutically. After all, diabetes is far more than a game of counting carbs and drawing up a dose of insulin or medication or manipulating a diet to fit the need.

Don’t hesitate to reach out, and I wish you the best health, today and the many tomorrows.