Need advice from Type I's

I am scheduled to have open RNY on November 9, 2004. I've been Type I for 26 years and I have an insulin pump. Did any of you actually wear your pump during the operation? Being a Type I diabetic, does anyone regret having WLS? Are you disappointed with the amount of weight lost? Has it made life with diabetes even more difficult?

Dear LoLisa, Hi. I am a type 1 insulin dependant diabetic. I had lap RNY in June of this year and had severe complications. I was in the hospital for about 6 weeks, endured three surgeries, went into severe ketoacidosis, developed pancreatitis etc. It was not fun. I blame most of it on the surgeon and hospital not having specific protocols dealing with a post-op type 1 diabetic. Our insulin needs, and delivery along with our nutritional requirements are quite different from a type 2 diabetic and little is known about these things. In hindsight, I wish that I had the lap band rather than the RNY. I honestly do not know why I chose this gastric bypass, I think that because the surgeon and hospital that I went to did more RNY surgeries and kind of promoted it more. With lap band, if there were major complications down the road (who knows in 10 years), it could be easily reversed. The RNY is lifetime. My insulin requirements have greatly decreased, my A1c has gone from an 8.4 to a 5.7. I still take 4 shots a day, humalog 3 units at each meal and 12 units of lantus a bedtime and I honestly have to test my blood more frequently. I now test about 6-8 times a day. Since I can eat only a tiny amount per meal my insulin requirements have dropped dramatically but I will still need to inject insulin my entire life. Luckily, if my blood sugars become too low, I am able to take a few sips of orange juice and have never had a problem with the sugar content nor the acid in the juices. I started at 256 lbs. and am now about 178 pounds or less. The weight is coming off but you still need to exercise a lot, drink tons of water, take vitamins, and eat very little.I do not do the protein drink regiment but I eat three healthy meals incorporating healthy carbohydrates in small amounts for insulin metabolization. After a year or two people really have to exercise and diet a lot still to keep the weight off. For some months you may feel nauseous and just crummy. I am happy that I am losing the weight but at what future cost, I do not know. Lab work must be done frequently to make sure that you're not starving or becoming anemic etc. Again, good luck with your surgery!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Sincerely, Carol

Hi Jolisa, COngratulations on your upcoming surgery next week! I've been an insulin dependant diabetic for 10 yrs and have been using a minimed insulin pump for 2 yrs now. Before sugery I was taking bet. 100-125 units of Humalog a day, now 7 1/2 months PO, its averaging 45-55 units of Humalog a day! I, fortunately, did not have any problems with my Open RNY or my stay in the hospital. I also was fortunate to stay in ICU for 5 days due to my surgeon wanting me monitored with my diabetes and I'm so thankful to have had the 1 on 1 nurse care. However, my blood sugars were a little erratic being high and low which kept me in there as well. They used dextrose to control the lows and I was very diligent in testing my own blood sugars and relaying it to my nurses and endocronologist. I think its very, very important to have your endo follow your care while in the hospital and especially the first 6 wks following surgery. My insulin requirements after surgery dropped to about 20-25 units as I was on liquids and puree the first 4 wks. Once on soft foods your insulin requirements will begin to change. Its a learning process for sure. To answer your question, No I wasn't allowed to wear my insulin pump and YES, I am so happy I had this life saving, health recovering surgery! I haven't felt this great since being dianosised with Type 1 diabetes and I'd do it over again in a minute~ Best wishes for an uneventful surgery and a quick recovery. Feel free to e-mail me if you have any questions. Wendy 275/189/150

Hi JoLisa: I've had type 1 diabetes for 24 years and had open RNY in May. I'm thrilled now that I had the surgery. Had you asked me about it in the 4-6 weeks after the surgery I would have told you that I regretted it and that I was miserable! I developed diabetic ketoacidosis, (DKA), when I got home from the hospital, (1 week post-op), I went to the hospital, but wasn't diagnosed with DNA, (I had no idea and my surgeon and his staff had no idea because my blood sugars were fine) They hydrated me, keep me in the hospital for a week, then sent me home. A week later, (about three weeks post-op), I got sick again. Thankfully the ER doctor figured out it was DKA and was able to treat me. I spent another week in the hospital, and I've been fine since I got out. My endocrynologist would not let me leave the hospital until I could consume 75 grams of carbs a day. That's a lot when you can barely eat. I got most of it through apple juice mixed with water. I think this surgery can work for people with type 1, but you have to be aware of the great risk of DKA. I've lost 59 pounds in six months and I'm so glad I had it done. Weight loss is slower with type 1's because we have to eat some carbs, but it does work! I have a pump, but wasn't allowed to wear it during surgery. Good luck Michelle

I, too, am a type 1 and while I have not had my surgery yet, I was told well in advance that I would not be allowed to wear my pump during surgery and probably for a while afterward. Unfortunately, I am no longer a pump user, period, at this time because I went into severe DKA right before Christmas and spent six nights in ICU. I was scheduled for Feb.2 but had to postpone until April 13th because both my PCP and Endo said I needed to recover from my near death experience befor going through surgery. It scares me to death about post op DKA, but so many have no problems. My surgeon assures me that he will stay on top of things, but has not mentioned a stay in ICU. Maybe I'll mention it to him. Anything that any of you other Type1 post ops can share would be greatly appreciated. Jeannie