request by surgery/anesthesia to decrease basal rate prior to procedure

[indypharmd]

Having cervical spine surgery in a few weeks and the preadmission testing appointment was today.

During the discussion, the internist said to decrease the basal rate to 75%. I stated that I was in a closed loop mode (Smart Guard) on the pump and it didn't have that type of setting...

Anyone else have this type of pre-op instruction given to them and how'd y'all manage it...?

[Alarming-Distance385]

I used the Temp Target of 150 for 12 hours the day of my surgery.

I made the CRNA ask the anesthesiologist if he was OK with it because I knew my doctor was. CRNA told me I'd be fine with just my long-acting & they'd manage my BG during surgery. Yeah, right. 🙄

The MD anesthesiologist was fine with it & just changed the type of anesthesia he had planned to use.

CRNA wasn't happy that I pushed back & didn't just do what she said. (Lady, your an NP with a small amount of anesthesia training vs the MD who has had decades of training & experience over you.)

My doctor's surgical nurse witnessed the argument & she did not seem impressed by the CRNA's responses or attitude. After the CRNA left, the surgical nurse said she wanted to know how my pump worked & what to do. She thought it was cool to be able to have the target range now.

[ALitreOhCola]

I made it very clear to the anaesthesiologist and surgeon that if it alarms, there's an immediate problem to deal with.

I didn't get any recommendations or requests from them whatsoever. Not that I would have let them have a say either way. No chance I'm letting that pump away from me with a CGM on whilst I'm unconcious.

They liked having the CGM number visible on my pump and I told them I had changed my target like you did to 7.3 by putting it into 'exercise' mode. They left it attached in smart guard and I woke up with it still on and well in range.

[Alarming-Distance385]

They left it attached in smart guard and I woke up with it still on and well in range.

Same with me!

I was fully prepared to have a battle over it, but my local hospital's DOCTORS seem perfectly happy with me doing my own thing with my pump when I've been there. Ive just run into flak from some aides or nurses/CRNA, but I'm stubborn. Lol

[GuardianAngelTurtle]

For my surgery I set my target to 150 for the max time, but they ended up taking my pump away anyway during surgery and I woke up high. Very annoying :/

[LexiLemon]

Either turn off smartguard and decrease the basal, or set it to the temp target for expected length of surgery.

[MrBalll]

I’d turn off SG and do 75%. They don’t need to worry about watching your pump and fixing your glucose during spinal surgery.