Wednesday, August 23, 2006

Taking diabetes management into my own hands

I didn’t realize that I had done this until after I had actually done it. I have been managing my diabetes on my own since I was diagnosed essentially. But what I did today I think is the definition of being a patient-advocate. This is sort of minor, but I think it exemplifies how we simply have to be aware that doctors know best, but don't always know me best.

As you’ll see from my last post, I’m having surgery tomorrow. I was nervous enough about managing my sugar level when they initially told me that the surgery likely wouldn’t be until late morning. The physicians’ assistant didn’t seem to know much about diabetes. Example, when I told him that my fasting the morning of my original appointment was 85, he seemed to think that was “low.” I don’t remember his exact words, but he said something to effect of not wanting me to be “that low.” I don’t want to bad mouth the doc on the eve of the event, but 85 is pretty darn good in my book. Seems like it’s almost right smack dab in the middle of exactly where I should be. But anyway, I digress.

So someone from the doctor’s office called today to ask a bunch a questions (which I had already answered, by the way, but why not be thorough) like if I had a family history of cancer or stroke or diabetes and all that stuff that I’ll likely get asked again tomorrow. (But, again, thoroughness is good.) She told me where to park and asked if someone was coming with me and told me about not eating after midnight. And, oh, by the way, the surgery is at noon. Ok, Ok, sounds good, see you tomorrow.

Waaaaaiiiiittttt just a stinkin’ minute. If I don’t eat after midnight, which will actually be not after 10 p.m. because that’s when I go to bed, and the surgery isn’t until noon, that’s more than 12 hours since I’ll have eaten. Even NOT being on insulin I just don’t think that’s such a swell idea. I can’t just not eat.

So I called the doctor’s office back and spoke to one of the physicians’ assistants. She told me that it’s marked on my chart that I can’t eat because “you wouldn’t want to throw up during surgery.” Well, no, I wouldn’t, but I’m not going to be under general anesethesia, I countered, I’ll just have a local and probably some versed. Surely I could eat a piece of toast around 6 a.m. I mean, that’s a full six hours before the surgery. No, she insisted, nothing to eat. But since I can have clear liquids until 6 a.m., I should have 6 oz. to 8 oz. of regular soda or juice before then, she told me.

I’m really, really nervous about going low, I told her. And with soda or juice, I'm nervous about an eventual crash. Well, if you’re feeling “a little weird” you can always come in early and we can put you on an IV. Well, sure, because I could just hop right over…your office is 45 minutes from where I live. **big sigh**

So, the plan is that I’ll probably not have such a sensible dinner (which wasn't the original plan), take half my Lantus tonight, skip the Metformin in the morning, have my Sprite at 6 a.m. (Yuck!), get ready, drop No. 2 off at her first day of preschool (Mom, is it a school day, yet??), and high tail it to the doctor’s office where we’ll likely be about 45 minutes earlier than they told me to be. Hopefully, this will help us get started sooner than noon, which they told me might be likely if I show up early.

The Mr. wants to know if I’m taking him out to lunch afterwards. Ah, yeah, and I’ve already got Steak N Shake on my brain. I'll probably eat one of everything. Can't tell you the last time I went more than a couple of hours without eating.


At 6:23 PM, Blogger Scott K. Johnson said...

Wow - that is a long time for fasting!

It sounds like you were able to work out some kind of plan - even though the sound of Sprite for breakfast sounds pretty gross.

You'll have to fill us in on what you do eat afterwards!

At 8:10 AM, Blogger Lyrehca said...

Good luck with your surgery! I've had a few now, and because I was always stressing my "insulin-dependent diabetes" before surgeries, I've always been the first procedure of the day, which helps with the delayed food issue. But with my most recent procedure, I was told I could treat a low with a clear (not red) juice. The red is just to ensure no one thinks there's internal bleeding somewhere. So I think you'll be OK with a Sprite breakfast (although there's also apple or white cranberry juice if you want a change). And I recall eating a few Life Savers before a major surgery a few years back and everything went fine. Keep us posted!

At 4:29 AM, Blogger Michael Kurniawan said...

Good luck for your new blog!

- diet for diabetics -


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