Surgery, Post Op and the ER

Those silly doctors are quick! One minute you are laying in your hospital bed waiting for the OR Nurse to start your IV, and the next minute you have an IV, 10 vials of blood drawn and a team of doctors around you. When it starts to happen, it HAPPENS! I hardly had time to be mentally prepared. I guess its better that way....here is the low down on my surgery and how Diabetes has(mostly)cooperated!

CGM attached. A HUGE help. Surgery morning after nearly 2 full days without solid food I woke up with a BS of 65 although I temp basaled my way up to 170 the night before. I had no choice but to pop 2 glucose tabs and disconnect my pump for a bit. It all worked out fine. For surgery I set a temp basal of 40% (per the Anesthesiologist) and stayed from 110-150 during the entire 4.5 hour surgery. I ended up having endometriomas of both ovaries, but the suspected severity wasn't as bad as once thought. (HOORAY!) Just 5 one inch incisions were needed to get all the girly goods out! I also signed consent before surgery to give my girly goods to research focused on Endometriomas. (I thought this was pretty cool!) In all I had my Uterus, Cervix, Fallopian tubes, both ovaries and Appendix removed. I also needed a Cystoscopy for issues the Endo caused with my bladder. OUCH!

A surprising thing about my Anesthesiologist...she made a HUGE deal about me having T1 "Juvenile" Diabetes and was literally in Awe of someones choice to manage with an insulin pump. She kept saying how "uncommon" it is to see T1 Diabetes, especially someone that manages it while maintaining "great health." She went on and on about how her cousin was dx'd as a teen and is a total MESS. She kept saying how she believes being diagnosed as a child is the "key" to living well with Diabetes, because kids are so adaptable compared to teens. It was interesting to hear her babble on about "Juvenile Diabetes" (she was a supper bubbly talkative type) as she slipped me "something to relax me" into my IV. That was the last thing I remember, and I woke up in my room upstairs all nice and comfy! (hooray for avoiding the damn recovery room!)

I was up and eating dinner (STARVING!) 4 hours after surgery that night. My blood sugars were steady around the 160's which I was fine with. I didnt want to deal with low blood sugars with everything else going on. I felt pretty darn good until the anesthesia wore off completely. Im always reluctant to use pain meds, but decided the Morphine pump was my best friend within a few hours :) I was discharged the following day, just 28 hours after surgery. Never saw a blood sugar over 180 :) I did feel a bit nervous going home so soon...I guess I should have taken the option to stay another night...

Two hours after I got home my face felt hot. Hot eyelids. I thought maybe it was hot flashes. NOPE. I spiked a fever. (even after 600mg of Ibuprpohen was taken routinely since surgery) which made me realize they didnt even write me a script for preventative antibiotics! Why would they do that? CGM alarmed at 250. Corrections wouldnt budge. Ketones, HIGH. I know some degree of a raised temp is expected after surgery....but this was not good! Somehow seeing the high ketones instantly made me feel like crap. Funny how that happens!

Without much thought, I just said screw it! Im not going to take a chance on infection and DKA taking over. I didnt have the energy to deal with that possibility, so we went back to the hospital as recommended by my Endo. I waited about 30 minutes in the ER until I had cultures drawn and a chest xray. I was stuck in a secondary triage area in the back of the ER with just a recliner chair to sit in. No privacy AT ALL, surrounded by the war zone of all bad ER nights you could imagine. Yeah, I dont miss working in the ER at all, and RN's never fail to amaze me!

I still feel like the ER was the best place for me to be, I have a real fear of DKA and loosing control of my Diabetes even without this major surgery!

So, at this point my pump is set on a 50% basal increase and Im only going higher. My super awesome ER nurse came back to say it looked like a UTI may be the culprit. (Damn catheters) She started an IV and gave me some Morphine (even though I didnt really have any pain) some anti-nausea meds, and a big fat dose of Rocephin.

Within 10 minutes I felt weird. Just weird. Everything went quiet. I kept saying to myself that I hadn't felt this way earlier with Morphine AT ALL. I asked Josh to check my blood sugar as I started to feel a sense of panic. I was 230. I felt like my blood sugar was crashing. I felt like life was being sucked right out of me. I was thinking maybe the meds and fluids were freaking out my numbers. My chest tightened. I felt smoothered. I began to cry uncontrollably, sobbing, without notice. My tears burned my face, and tasted like acid. I told the Nurse my symptoms, and she said all my vitals were fine....but she could hear my panic. Then my pulse rate more than doubled in an instant. All I could hear was BEEPING BEEPING of the monitor, and Nurses running around me fumbling through drawers and calling for the ER Doctor. I was yelling for Josh to check my blood sugar (I wasnt even thinking allergic reaction!) and telling the Nurse to get me D50. I said it over and over and over, while telling her I wasnt sure that was what I needed. My body began to shake and tremor out of control. My legs were the worst, violently flying up, down and around. Talk about abdominal pain! I was SO freaked out inside. Totally aware of what my body was doing, and unable to do anything to help myself. The last blood sugar Josh took was a 180, and D50 was given almost in an instant. It never even occurred to me I was having an allergic reaction, it was a Hypo that I feared. Actually, I still dont really know what happened!

Josh and the Nurse took off RUNNING with me in my recliner chair down the hall to a REAL ER bed after Benedryl was given. I was crying out loud saying "I need more
D50, I need more Benedryl!!" all the way there while my body "seized." Josh threw me onto the hospital bed (seemed like it anyway!) while the Nurse zoomed around somewhere. When she returned she hit me with a dose of Ativan and I just pleaded for Josh to hold me tight while I shook. Suddenly I'd stop shaking. I'd think about the sound of a flat line, and a code being called in ER. I was sure sure I was going to die, or any second be in a Hypo coma. I kept saying in my mind "My girls need me, my girls need me." Then the violent shaking would start again. It seemed like an eternity that the shaking continued, although it was probably only 15 minutes or so. The Ativan knocked me out quickly. (Thank goodness) and I woke up the next morning at 6am. Blood sugar of 168.

I felt pretty darn good considering. I walked alot that day. I spent the day in bed with Maddison and Josh by my side. (Hannah had vball camp) I was kinda just there to get an IV dose of antibiotics I guess... The nurses kept asking me if I was ready to leave by the end of the day. SHEESH. I managed all my numbers and meals, mostly hanging out in the 130-180 range. At one point I hit 260 (after lunch!) so they called in the Internal Med doctor who questioned why I was "so high." How irritating! The nurses used my own BS readings for their logs, every 6 hours. I left the hospital that day, AGAIN about 28 hours after being admitted.

Today is day 4 post OP. I avoid the pain meds. Not much pain! The only pain I have is from the Dioxide gas still floating around my abdomen, chest and shoulders. My tummy feels like an aquarium with bubbles all around! Incisions are tender and my tummy is distended as though Im 7 months pregnant...but I feel pretty good! CGM is flat lining for the past 4 hours at a nice 146. I guess I should get on that and get my numbers down a tad since Im feeling better....-sigh- It would be so much easier WITHOUT Diabetes.

Thanks to everyone in the DOC for the well wishes! I survived all the chaos and apparently started an allergy list! NO ROCEPHIN for me!!! But yes on the Ativan!