A complicated Extraction!

1 Jun

(A fantastic guest blog from Amanda Burrell about the experience of her son who has Type 1 Diabetes when he recently had to have 8 teeth removed – Grumps).

Type 1 diabetes, complicated at the best of times especially when just a parent trying you’re best to look after your child, then add a bit of surgery into the mix :0( !!!  Makes for a very interesting and exhausting couple of days for child and parent.

My little boy of 9 years old was told he needs 8 teeth removed , I can’t help but blame the diabetes a little (though it’s probably more bad luck), the hypo’s and sugary drinks and sweets to bring him back to his normal levels have taken their toll and his teeth are paying the price sadly .

He’s had so many abscesses the surgery couldn’t come quick enough, we never knew how complicated this could be for a diabetic!

Week before surgery our fantastic diabetes team arrange to see us to do a care plan , no food after 8pm , water till 5am then nothing till we get to ward at 7 , sounds easy except when you need food and insulin and trying to explain to a 9 year old no you can’t have a snack tonight it isn’t :0( My little one eventually goes off to sleep the night before surgery at a BG of 13.2 and I pray for no hypo tonight like the previous 2 nights as this can put the much needed surgery back , 2am check and we are at 10.2 phew no hypo in sight thank god !! but as all parents of type 1s know this can change very quickly .  We get to 7 am 13.2 BG, bit high but we’ll run with it as no insulin to be given.

A worried little boy sits on his bed with the anaesthetist explaining to me that he may go high because of the stressful situation and adrenaline (big factor in it), I knew nothing about this, I’ve prob been told but there’s so much to take in with caring for a diabetic child   you can’t blame me for not absorbing that one. Ok so we are now at 7.30 am  and he’s scheduled 1st on the list ( one plus of being a diabetic , apparently you are always 1st on the list) anaesthetist  says to check BG , 19.3 !!! Woahhh how, where, why he’s not eaten since 7pm the night before, then oh yes this could be what I’ve just been told, its stress related. I do still think if a pre-med is offered then take it as my son may of not got so stressed to begin with , they did say they could of given him one too grr !!

Dr says give 1 unit of insulin to correct, he’s on a 1-3 correction regime, I know and you know this won’t bring him down enough but I don’t say as I’m sure the DRS know what they are doing, I should have spoken up and things may never of got quite so out of control to begin with high BG levels!

Surgery done, anaesthetic went well, my little boy minus the bad 8 teeth is in recovery where I’m waiting for him. .

They do BG; yep we are now at 23.9!!! Surprised, NO!!! Three more units of insulin given to my already very tearful , scared young man :0( but the staff are great with a lot of compassion and assure me it will improve , little did we know over 25 finger prick tests and 10 insulin shots in less than 8 hrs. much was going to be the same .

The staff were fantastic on the ward and at no time did I have any complaints about my sons care. They were eager to get my boy eating as soon as possible which bless him isn’t easy minus the 8 teeth but with BG still rising he needed to eat and have insulin, by 11am his BG was at 29.1, he has now had quite a bit of insulin as he also now has had something to eat too all be it bread and butter.

I think what has shocked me is how my son is having to continuously have finger prick tests and more insulin but the levels don’t  drop by much and when they do with in 2 hrs. they were climbing  again , so amazed how stress and surgery effects the body and more so in a diabetic , thank god at this point there was still none of the  dreaded ketones which we’ve grown to hate .

The highs stayed with my son and eventually although at 25.5  BG he was allowed home because of no ketones and the diabetes team will take over + he was one keen boy to get home back to his Xbox ;0) more testing , more insulin and still he remains high , I can remember thinking just before bed I bet he has ketones by the morning as let’s face it we all know continuous highs eventually will do this :0( I found it much more comforting to have him with me overnight especially with the continuous testing .

Highs all night :0( no drop below BG17 and by the next morning  day after surgery 25.6 still and the dreaded ketones too have appeared 1.6 :0( Still blown away by how my little boy’s body has reacted to surgery and stress I again have learnt so much so will be much more knowledgeable if by any chance he has surgery again .

I know that the ketones meant he needs insulin and his diabetes nurse is quick to return my call and pay us a visit.

BG still running at 20.1 but we have managed to get the ketones down now even though he still remains well out of range for his BG.

The comforting thing in all this is my son who has remained quite smiley throughout it all though complaining of sore fingers bless him from all the testing .He really is a star and as I’ve said on many occasions most adults would complain about what he’s endured over the last couple of days !

My son is slowly healing and slowly the BG are dropping only then can we hopefully get back to our normal which isn’t the same as most people’s normal but it’s a type 1 diabetics normal.

Lesson learnt here, when your diabetic child has surgery although we may think we know what to expect, expect the unexpected!!!!

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3 Responses to “A complicated Extraction!”

  1. oceantragic June 1, 2013 at 2:40 pm #

    Great information about the surgery, stress and BG levels. Thanks for writing it.

  2. Rosie June 1, 2013 at 8:43 pm #

    I’m quite surprised at your son’s treatment here. I’ve had a couple of operations in recent years and have always been put on the ‘sliding scale’ (like a pump I think) even though it was not major surgery (in and out of the operating room in less than an hour and home the same day) and my blood glucose levels were under good control prior to going into hospital. This kept my blood glucose levels nice and steady whilst I was in theatre and had no major problems later in the day. Maybe you could ask about this if your son needs to have any other surgery (though fingers crossed he doesn’t!).The last thing you need to worry about when having surgery is high sugar levels!

  3. Brett Sweet August 27, 2013 at 1:06 pm #

    Thanks for writing your story and the information. After reading I thought I would share my experiences and to say that I have noticed this too.

    I am a total believer that stress alone and especially when combined with a surgery can have a dramatic effect on blood sugar levels. Im naturally a anxious person so any important date/events etc. my sugars can spike. I have also had multiple eye surgeries from diabetes and have noticed large spikes in blood sugar even after 12 hour fasting. My latest surgery had a few small complications so it didnt go smoothly and by the next day I was in the hospital with Ketoacidosis and never did get a solid reason as to why I got so sick.. Im sure it affects everyone different like everything else about Diabetes. I have never been on a pump. Im 31. was diagnosed at age 10.

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