June 16, 2008

Post Surgery: I'm Doing Great!

I had my surgery last Tuesday and I'm doing very well, but I'm supposed to rest and not use my arms much, so I'll keep this brief.

I asked my surgeon what blood sugar they prefer in someone with diabetes and she said "Under 200" which is pretty appalling. I explained my outlook and she was very supportive of my low carb diet and blood sugar targets. I asked her if I needed to eat more carbs during the healing phase, and she said, "No. The low carb diet is an excellent diet for healing."

I'd been eating very low carb with lots of colorful veggies and greens for the three weeks before surgery and have continued with that diet for the past week.

At the hospital I tested at 88 mg/dl on their meter at 7 AM which the nurse thought was dangerously low. I explained it wasn't and that I had not used any basal insulin that morning. They promptly hooked me up to a lactate drip so they could raise my blood sugar.

I made a huge point to the anesthesiologist about my insulin sensitivity and made it clear that if they had to lower my blood sugar, using a typical Type 2 insulin dose could literally kill me. (Which it could.) I'm still alive, so she must have listened.

The surgery lasted three hours. They told me after the surgery that my blood sugar had gone up to 139. It dropped back into the 90s by the time I went home.

I'm currently using my usual basal insulin but almost no meal time insulin as I am eating only meat, cheese, greens, LC veggies and lots of berries, and that keeps my blood sugar between 95 and 115 most of the time. I'm trying to get about 100 g of protein a day, which is about right for my weight. I don't want to screw around with insulin shots at meals if I don't have to because the pain drug slows digestion and it is hard to know when the food will digest.

But I'm on the mend, everything is going really well, and I'm really enjoying taking time off from doing all the stuff I usually do.

I'll leave you with this fascinating piece of diabetes research published in this past months edition of the journal, Diabetes Research and Clinical Practice:

Dietary Breads: Myth or Reality

Someone finally decided to see if the so called glycemic index works for people with diabetes. Here's what they did:

"One hundred twenty one type 2 diabetic patients were randomized into three groups as whole wheat, wheat bran and rye bread groups. Each group ate 100 g of bread with water with in 10 min. Blood glucose measurements were made at every 30 min in 2 h. Insulin was measured at fasting and at the second hour in the patients who do not use insulin. The same processes were repeated on the following day, with white wheat bread for each group."

Here's what they found:

"No significant difference was found in either glycemic or insulinemic effects between four types of breads when compared to each other. (p = 0.093 for glycemic effect and p = 0.297 for insulinemic effect)."

In short, "healthy" whole grains raised blood sugar as much as white bread.

Show this article to your doctor!

19 comments:

The Old Man & His Dog said...

Best wishes. Get well soon.

k2 said...

So happy to hear that your doing great after (and before ) your surgery!

Keep positive, keep motivated, and keep your plate loaded with those colorful fruits and veggies!

Sending positive energy in your direction!
k2

renegadediabetic said...

Good to hear you are doing well. Wishing you a speedy recovery.

About the bread, I found that whole grain products are bad enough for my blood sugar and I don't even want to try it with refined grain products. Drs. Mike & Mary Dan Eads describe whole grain as sugar with a little fiber. It's not enogh fiber to make a difference.

I did find I could tolerate one slice of low carb bread per meal. But that stuff is so dry, one slice really isn't worth it.

Anna said...

Glad to hear your surgery went well and you emerged without horrific BG stories.

In the US, it is unfortunate that "whole grain" is the term used for ground whole grain products. In the UK, at least they use the term "whole meal", so one knows grinding is involved. Technically, whole grain *should* mean the whole intact grain kernal, which has a very different effect on BG than whole grain flour (which I consider to be "pre-chewed").

It's really sad how many otherwise intelligent people are duped by this "whole grain" marketing. But it's as if they leave their intelligence at the grocery market door. And the brownish colored breaded marketed as "wheat bread". Sheesh. Unless another grain is specified, all bread is "wheat" bread, even Wonder bread.

I'm still trying to figure out how "flourless" bread is made. It must be crushed or ground to a certain degree to expose the starch so it will bind.

Jenny said...

Anna,

You're quite right about the confusion between "grain" and "meal."

At the hospital, when they needed to give me something to eat to see if I'd recovered from the severe post-anesthesia nausea, I asked for a saltine. The nurse was horrified and told me that since I had diabetes I needed the slice of whole wheat bread.

I explained that there was 1/4 the carbs in the saltine than the toast, thank you, and to their credit they brought me the saltine which I ate with no problems, allowing them to send me home.

Denise said...

Sounds like you are on the mend. Keep up the good work!!!!

George said...

Good to hear things went well.

Colleen said...

Good wishes for a speedy recovery!

Alan said...

Gald to see you are OK, I hope you heal quickly and well.

I couldn't get past the abstract; if you have the full text I'd be fascinated to see what peak post-prandials those type 2's hit after 100gms of bread in 10 minutes.

Cheers, Alan

Jenny said...

Thanks for all the good wishes!

On the bread article, only the abstract is free, but it tells us enough to be valuable. In some journals the full text becomes available after 6 months, in others never. Not sure how this particular journal works.

Boz said...

Very glad you came through the surgery ok. I recently had knee surgery and was fortunate to know everyone involve very well, since my wife is a surical tech. I told the nurse anethetist to not worry about my glucose unless it got below 70. He agreed, since he figured I live by my meter and know what I can handle. I went in with a 92 reading, and stayed around that the whole day. So care and listen, some don't.

Richard A. said...

Arginine does wonders for wound healing. Use the key words arginine and wound healing on the internet to see what I mean.

Jenny said...

Boz,

I knew I was going home as soon as I was stable and not having to stay at the mercy of the nurses, so I figured it wasn't worth pitching fits over.

My bg has running a bit higher than usual, partly because I was pretty spaced out this past week and occasionally forgot my basal shot. But now a week later the bg is falling back into line.

The slowing of digestion caused by the pain meds really makes it tough to cover meal time carbs, so I mostly avoided them. I was fortunate that I'd recently read someone else posting about precisely that issue, so I was forwarned, which was very helpful. But I was zonked enough I don't think it would have been a good idea to try any bolus shots. So my Sweetie pretty much fed me eggs, cheese, greens, meat and blueberries for a few days.

Even now that I've been off the pain pills for a few days my digestion seems to be really slowed down and my stomach empties very unpredictably. They tell me the effects of the anesthetic can last up until 3 weeks.

Anne said...

Good to hear you are home and all went well in the hospital. Best wishes for a quick and uneventful recovery.

If nitrous oxide was used, it can deplete stores of B12. A PubMed search brings up many hits on this. My father, a physician years ago, put B12 into the insulin of all his diabetic patients.

Jenny said...

Anna,

Thanks for the tip! My B-12 levels were checked a while back when I was on metformin and they were quite good. The multivitamin I am currently taking has a good amount of it.

Sarah said...

Glad you're on the mend! And many thanks for the link to the bread article.

Cindy Moore said...

Good to hear you're healing well!

Love that the doc said low carb was a good healing diet! I of course agree with her! Protein is what's needed to heal and most low carb diets are a bit higher in protein.

Nicky said...

Glad you're doing so well! Hope you're continuing to be a patient patient and following your recuperation orders : )

Learning points for me; it's possible to retain reasonable bgs during surgery, and anaesthetic can have an effect on digestion up to 3 weeks afterwards. Thanks!

Pubsgal said...

Just wanted to add an anecdote here. My mom had heart surgery recently, and I was interested to see how closely they monitored her blood glucose levels, even though she does not have diabetes. Surgeons at her hospital recognize that the stress on the body from surgery raises blood glucose levels, and that keeping the levels in normal range promotes better healing. (Her surgeon has his patients' blood glucose levels maintained in the 70-125 range; some of the other surgeons go for even more strict control.) She was on a diabetic food plan most of her stay; nurses monitored her blood glucose levels around the clock, and they administered insulin when it went above 125.