A little panicky...a question please...

My heart is in my throat. I apologize if something like this has been posted before. A quick search on the forums turned up a few posts but nothing looked quite like my situation.

I am scheduled for a VSG this coming Monday and have been on a pre-op diet for 9 days now. My diet is protein shakes, clear liquids, and V8/tomato juice.

Last Friday (day 5 of diet) I had an annual checkup with my PCP and got some bloodwork done. I had no idea they had a lab on site so hadn’t been fasting—I had some coffee (with literally a splash of fat-free ½ & ½ (finished the carton, been drinking black coffee since)), V8, and part of my first morning shake but the nurse said to do the bloodwork anyway.

Well, the office called today and told me my fasting glucose was 141 and they want to do a 2-hour gtt.

I told them I can’t do it before the surgery because it’ll mess up my pre-op diet (I have worked DAMN hard on this diet and refuse to screw it up). But then after surgery, I still won’t be able to do it because I won’t have the capacity for that nauseating drink. The nurse is going to talk to the doctor and see what he wants to do.

I also went in for pre-admission testing at the hospital this morning. THEY drew blood too but I’m not sure if there was a fasting glucose test in there or not. There were certainly enough vials for it. If my fasting glucose comes back elevated from this morning’s testing, is that something the surgeon would cancel the surgery for?

I’ve had elevated blood sugar before, but it was at a “keep an eye on it" level. I also had gestational diabetes (diet-controlled) to add to the mess. And my dad died from complications of poorly managed Type 2. So it’s in the family and I’ve got a history.

I am panicking right now that they might cancel my surgery. After all this work on the diet, making plans to be out of work for a week…I mean, isn’t the surgery supposed to HELP patients with diabetes? What would they do? Postpone it while putting me on meds or something until an A1C comes back within a reasonable range? The office did say they may have me do an A1C before surgery…

Should I call my surgeon’s office and tell them? Should I wait and see what happens with my test this morning? Should I just crawl into a hole and cry? I’m crying anyway…

Thank you.

I know the idea of postponing surgery is horrible, but I think it is important to tell your surgeon and get all the bloodwork information you can. You and your surgeon may decide that a different wls would be more appropriate for you in the long term. In the big picture this is just a blip, but your health is the most important thing. Best wishes!

Thank you for your reply. I did let them know but haven't heard anything back. My guess is they are waiting for the results of this morning's bloodwork.

Even more alarming was the call I got from the office telling me the nasal swab they did this morning came back positive for MRSA. (!?) So now I've got a tube of goop to apply up my nose twice a day for the next 5 days. Lovely. But at least they didn't say they were postponing because of this.

I am praying they don't postpone because realistically, I can't afford another week off wor****il the end of June. The thought of stopping the liquid diet and then doing it all over again...ugh.

Of course, if it happens, it happens. Nothing I can do about it even though I'll kick and scream and cry (privately, anyway). My health IS the most important thing.

Hopefully I'll get some good news tomorrow.

Thanks again!

 I just had the surgery on Monday 4/16.  My doctor wanted to make sure my sugars were in the 150 range during the surgery.  Prior to be rolled in i was at 148.  I rolled my insulin pump (i'm type 1) in under my hospital pants.  There has to be a better option for testing you that doesn't preclude you from having the surgery.  I would make sure your sergion is in the loop.  Again my experience is that my diabetes was in good control prior to sergery but better control after.  If sure you will see the same.

That one blood sugar reading was elevated, but not in a particularly dangerous range at all. (Some days I'd kill for a 141 fasting blood sugar....)    It may be important to know what your body does postprandially (after eating).  You should certainly be able to do a glucose tolerance test before surgery because what you are consuming is all liquid anyway. 

I know this is all new for you and you are not wanting to lose your surgery date.  Frankly, I'd be surprised if you did if all you have is mildly elevated blood sugar.  You are not running up in the 300-400's, so this could be very manageable.  Also, if any medication or other intervention is needed, there's some time for that to work.

One of the most important things is to be sure your surgery team knows about these developments.  They are your partner in this, so they need to know what you know.  They are pulling for you too, so they can give you the best medical advice about what is safe and what is not. 

Good luck!   

Thank you everyone! I am feeling so much better tonight. Got an email from the surgeon's nurse that said, "EVERYTHING WORKS OUT" and went on to talk about pre-op antibiotics at the hospital Monday morning. NO mention of blood sugars. Either my pre-admission testing numbers came back fine or they don't consider my 141 to be an issue. Or both.

Now I just have to make it through these next two days.

oops, I wrote my reply without reading the whole thread -- I see that things have resolved for you.

Blessings on you as you approach surgery.