Pre-Op, Type I Diabetic and Nervous

[tweters]

Hi everyone, I am new to this list. I am scheduled to have surgery with Dr. Ranjan Sudan at Duke in Durham, North Carolina. My surgery date is January 26th.

I am very nervous about my surgery. I am a Type I diabetic and do not know anyone in my situation. I am scared about handling the low sugars immediately following surgery. Anyone that has some knowledge about this who could give me some advice, would be greatly appreciated. No one seems to be able to tell me what to expect, including my Endocrinologist or surgeon.

I am also having irrational fears that I will not lose any weight. How do I get over that?

My partner had her surgery back in August and has done exceptionally well and has already lost 120 pounds. So I do feel that I know what I am getting myself into. I know most of the requirements and guidelines by heart. I know that Amy used to love to eat carbs and does very well not eating them any longer. I have to admit, I am a CARB JUNKIE!!! I am nervous that I will not be able to give them up. I have heard several people talk about detoxing from carbohydrates and saying that after the surgery they just don't want them anymore. What are your experiences with your favorite pre-op foods? Do you miss them? Do you crave them? Does one or two small bites fix your craving?

Thanks for letting me rant and thanks in advance for any feedback you can provide. I look forward to getting to know a lot of you throughout my journey.

[Deleted]

Dec 23, 2011 14:01:39 GMT -5 tweters said:

Hi everyone, I am new to this list. I am scheduled to have surgery with Dr. Ranjan Sudan at Duke in Durham, North Carolina. My surgery date is January 26th.

I am very nervous about my surgery. I am a Type I diabetic and do not know anyone in my situation. I am scared about handling the low sugars immediately following surgery. Anyone that has some knowledge about this who could give me some advice, would be greatly appreciated. No one seems to be able to tell me what to expect, including my Endocrinologist or surgeon.

I am also having irrational fears that I will not lose any weight. How do I get over that?

My partner had her surgery back in August and has done exceptionally well and has already lost 120 pounds. So I do feel that I know what I am getting myself into. I know most of the requirements and guidelines by heart. I know that Amy used to love to eat carbs and does very well not eating them any longer. I have to admit, I am a CARB JUNKIE!!! I am nervous that I will not be able to give them up. I have heard several people talk about detoxing from carbohydrates and saying that after the surgery they just don't want them anymore. What are your experiences with your favorite pre-op foods? Do you miss them? Do you crave them? Does one or two small bites fix your craving?

Thanks for letting me rant and thanks in advance for any feedback you can provide. I look forward to getting to know a lot of you throughout my journey.

We have at least one Type 1 that is post-op. Let me see if I can find her and direct her to you ;D

[dianarr]

I was type 2 diabetic before surgery. I didn't have low blood sugar after surgery, mine was high. I really think this is something to talk to your surgeon about in detail.
Another thing would be going to their support group before surgery and talking to everyone there.

[Paula]

Im not a Type 1 diabetic (not a Type 2 either), but I totally get where you are coming from as far as being a carb junkie goes. Im fighting that same battle pre-op as well. I was a carb junkie when I had my RNY surgery in 2000, so I can tell you that it will get easier for you as far as carbs go after your surgery. I did great. My biggest problem was letting the carbs come back into my diet again. I know its going to be one of those things Im going to have to really work on because I think that is a trigger for me. Let too much carb in and it just becomes its own little monster that continuously feeds on itself with a voracious appetite.

I think everyone must have those worries that surgery will not work for them. After all, we've probably tried every diet or suggestion known to man anyway...and nothing worked. What helped me was not setting a specific weight number in mind that would define my success or failure as far as weight loss post-surgery goes. While Id love to be in the 180lb neighborhood, that might not be in the cards for me. But what I am looking for is doing whatever I can to make myself healthier than I am right now. Try (if you can) to look at it maybe in those terms and then make sure you are happy and celebrate each little bit that comes off. Remember that its a marathon, not a sprint Each great journey begins with only one little step.

Its perfectly natural to be nervous before your surgery. And you are doing the right thing by expressing your worries and seeking advice from people who have been there and done that. I wish you peace and good wishes in the time up to your surgery and well beyond

[sherbearmama]

My brother is a Type 1 diabetic--he avoids carbs at all costs. His diabetes is so bad that he as an insulin pump implanted into him. He's not heavy and has never been so, but he knows that his body will have to work harder and that he'll need more insulin if he eats even a few grams of carbs a day. When he goes to Chanukah or Christmas parties, he brings his own food and doesn't touch what's there because he knows it's a slippery slope and that bad habits for a type 1 diabetic will eventually kill him. He seriously knows EXACTLY how many carbs he's eating a day.

This surgery--the DS--is a great lifestyle for a diabetic of any type. Even if you DON'T do it, you MUST start living the same sort of lifestyle. PLEASE consider changing you eating habits now--even before surgery. It'll be so worth it. We all care about you and want you to live a healthy life--surgery or no surgery.

:-) Sheri

[smokinstella]

Well considering you wont have to deal with dumping thats a good thing. For lows I would try things like apple juice concentrate if you have any lows. then its a small amount that would be a clear liquid and easier to get down. Or you could take glucose tabs and desolve them in water and sip that down but I really think the juice concentrate will be your best bet or maybe honey. I am sure your Blood sugars will run on the higher end due to the trauma of surgery for a bit after. I know for my daughter any pain and she is running in the 200's in no time. Maybe also see if you can get CGM if you dont have it already so that you might be able to see if your headed down before you really are so you could start sipping juice before you get really low. You should also do some basel testing before hand to make sure that your basels are set where they need to be. You should also ask your surgeon how they are going to handle your insulin needs while your in the hospital. Will they have you on an iv drip or will you be able to wear your insulin pump if you have one, or will you be using MDI. Also ask if you will be able to use your own meter and strips while in hospital since the hospital machines are freaking blood sucking vampires.

[sherbearmama]

Dec 23, 2011 16:23:35 GMT -5 smokinstella said:

Well considering you wont have to deal with dumping thats a good thing. For lows I would try things like apple juice concentrate if you have any lows. then its a small amount that would be a clear liquid and easier to get down. Or you could take glucose tabs and desolve them in water and sip that down but I really think the juice concentrate will be your best bet or maybe honey. I am sure your Blood sugars will run on the higher end due to the trauma of surgery for a bit after. I know for my daughter any pain and she is running in the 200's in no time. Maybe also see if you can get CGM if you dont have it already so that you might be able to see if your headed down before you really are so you could start sipping juice before you get really low. You should also do some basel testing before hand to make sure that your basels are set where they need to be. You should also ask your surgeon how they are going to handle your insulin needs while your in the hospital. Will they have you on an iv drip or will you be able to wear your insulin pump if you have one, or will you be using MDI. Also ask if you will be able to use your own meter and strips while in hospital since the hospital machines are freaking blood sucking vampires.

I'm not sure what my numbers are now--but since surgery I've definitely had low blood sugar levels. So, per my doctors orders, I've been drinking apple juice (nothing citrus this early out), chewing candy, and I take glucose tablets in the middle of the night and in the morning. I'm only type 2 but this whole drastic weightless thing (21 pounds in two weeks) has really thrown my level for a loop. At the hospital (as expected) my levels rose and I needed insulin shots. But they came in with a little prickly thing and checked them manually, and checked them regularly. If they know you're Type 1 they should be all over that the entire time you're in the hospital. At home, my biggest challenge thus far is to get in enough nutrition because the low blood sugar makes me shaky and nauseous. So I'm doing my best to get some calories in where I can. But I'm almost always sipping on Gatorade or apple juice to keep my levels at the norm.

[sandyv63]

I can't help you with the Type 1 diabetes, but as for the carb addiction and the fear of not losing weight, I promise you cannot beat this surgery. Early out you won't want to eat. Trust me on this one. Even when your appetite returns, one or two bites of anything and you will be done. I mean completely, totally DONE. I am 6 weeks out and I can't eat more than the quantity of one hard boiled egg. One bite more and I am horribly uncomfortable. Not uncomfortable like you feel pre-op with a regular stomach; this is a different feeling and you will be motivated to avoid overeating post-op because it feels so awful.

By the time you can eat relatively normally, you'll be off the carbs for so long and you will have gone through the 'food tastes like crap' stage so that the carb addiction will be conquered. It will be at that point where you need to decide whether or not you want to allow that addiction to come back or not. BTW, by then you will have lost some significant poundage and that should motivate you to continue to live a low carb life.

[jenntype1]

Hi Tweters,
I'm the Type 1 SHales mentioned. I had my DS 2.5 years ago. You are going to love it! I had a lot of insulin resistance on top of the Type 1, and the DS resolved all of the insulin resistance. I started at 350 and am now 185, which was my surgeon's goal for me. Truth be told, if I had really worked hard at avoiding carbs, or wanted to now, I could drop another 10, but I frankly just don't care. I am very happy with my health and my weight now. My A1c is 6.1, I can move around easily and enjoy life chasing my 8 year-old. Having the DS was the best thing I ever did for my health, even more than going on an insulin pump (although that is a very close 2nd).

Immediately after surgery, the endo nurse practitioner at Baptist (in Nashville) put me on 1/5 of the basal rate I had been on. (If you're not on a pump, that would be 1/5 of the Lantus dose you're on). It worked very very well. My blood sugars were eerily steady at 100 for several days post-op. Once I was eating food, my basal rates crept up some, and are now at about 1/3 of what they were pre-op.

Of course you'll have low blood sugars on occasion, but early on they are pretty easily treated with non-acidic juice or, if you can stand it, that horrid glucose gel. Anything that you can swirl around in your mouth that contains sugar is good, because sugar gets absorbed in the mouth.

As for the carb cravings--I didn't have horrid ones pre-op, but I also considered 50 carbs per meal as not a lot. My perspective on that has changed! Initially after surgery, you really don't want to eat much, trust me. The battle is getting in enough fluid. Definitely do the protein shakes, you need them for speedier healing and fluids.

Please feel free to PM me if you have additional questions, or I'm happy to answer them here.

Dr. Sudan is a great surgeon from all I hear, so I think you'll have a great experience.

Best,
Jenn