[freebird]

ok so we talked vitamins and liquid vs pills, now i have to ask about my daily meds. i have a hard time getting them down now and also i read that you take pills one at a time 5 mins apart. i take 12 pills in the morning 6 at lunch and 8 at bedtime, it's gonna take up most of my day just getting my pills down. plus some of them are needed at full strength to work for me. for example i get up at 5 am to take pills that help me to wake up and stay awake, i take them at 5am and go back to bed until they start working which is around 6:30 or 7am. if i have to take the last one at 5 am then i have to get up before 4am? Doc can dexadrine and trimipramine and glyburide all be crushed into powders and swallowed that way in one or two mouthfulls with water or my protien shakes? i know talk to my dr. but i can't see him for awhile and i'm starting to get worried about it

thanks

[fr1endly2]

I think this is something very important to discuss pre OP with your surgeon. LISTING everything you take, how much and possibly show
your surgeon the size of the pills your required to take...and let him
see how this will be worked out!

GOOD LUCK! this is one for the doctors
love ya

[DocSanae]

As lisa says, that's going to be something that you and your dr will have to decide. I do suppose it's possible to crush them and mix them into your protein shakes, or other liquids during the liquid stage, but there's going to be the question of how much will be absorbed, and if any changes in the chemicals happen if they are mixed into something else. I can understand how this issue will worry you, since they are all necessary medication to keep your daily life controllable.
Even if you can't see your dr personally, is there any way you can contact him, and ask? Like fax, email, etc?

Hope you get all the answers you need, and everything works out.
((((((((HUGS))))))))))

[freebird]

i'll be seeing the sleep specialist this month, and will ask him about the two that are narcolepsy related, and when i see my dr. on the 17th i'll ask about the one i take to control my diabetes.
i guess i was wondering how others have handled this if they had problems or not
thanks i will be asking the dr.s

freebird

[DocSanae]

Hmmm, diabetes medication. Now, of course, you'll have to do as your dr says, but just for info, since my speciality is diabetes.

When I have patients who need major surgery, I have them switch to insulin prior to the surgery so their blood sugar level can be closely controlled, and keep them on it until their sugery wounds are healed. After that, depending on how well the patient has done, and on how well they are now receptive of using insulin, I keep them on it, or switch back to oral medication if that's what they prefer, and their control is fine.
When they have to operate on diabetic patients, most surgeons who know what, actually ask us to switch and control the patient with insulin until they are sure the patient is healing well. There's a rapid acting insulin now that you can use immediately prior to your meals (instead of the conventional 30 minutes before), heck you can even use it mid-meal if you've forgotten before, which should make blood sugar control easier for patients in your shoes.

Well, you'll have to go whatever way your dr says, but if he brings up switching to insulin, keep what I've written here in mind for reference.

Good luck with everything!

[freebird]

thanks Doc, Ok another question about diabetes and yes i know what my dr. says goes but out of curiousity until i can get there,

for the past 3 weeks my sugar levels have not gone lower than 8. They haven't been any higher than 9.7, i know that normal is between 4 and 5 and before this i have had them for about 7 months under 7. I know that stress and illness can cause the levels to go high but i don't think i've been any more stressed than usual and yes there have been days i haven't felt well but mostly i've been ok. i'm on glyburide at 5mg, two twice a day. again i'll say i know i need to talk to my dr. but until i can get to him do you have any advice or knowledge you could share about this? i know my surgeon won't do the surgery if you don't have controlled levels, do you know how long for?

I'll keep in mind the insulin and discuss that with my dr. when i get to see him just curious in the mean time

thanks Doc.

[DocSanae]

You have been sticking strictly to the diet recommended by the nutritionist/dietician, haven't you? And your total intake is below what it was before you started controlling your diet in preparetion for your surgery, right? Then it is likely that it is due from pre-op stress, especially with the paper mess that you are having to deal with, now.

You'd be surprised how much stress can make a difference in your sugar level, I was with one of my patients not too long ago. She had an issue with her husband, was going through divorce when I first started seeing her. Her sugar level was high from the beginning, but before I was able to put her on enough medication to bring it down, the husband fell ill, and there was no one but her to take care of things. Her sugar level that had just started to come down, went back up again, and stayed there. I figured I'd have to put her on insulin, but she asked to wait until she could get everything about her hubby straightened out, place him in a nursing home (living by himself had become out of Q) and then getting the divorce. It took her a couple of years, but once everything was set, lo and behold! Now her sugar level is below 120--that's below 7 for you--and her A1C has come down to 7 on the same amount of medication as before.

As for what your surgeon will require. The recommendation by ADA (American Diabetes Association) is for your sugar level to be below 126--7 for you--at the time of admission. There's no reference about how long prior to, so so long as the sugar level just before you are admitted is there, it'll probably be fine with your surgeon. For reference, the Japanese Diabetes Society recommneds fasting BS below 130 and A1C below 6.5, but all of the surgeons I know will operate at A1C 7.5 or below.

Hope you get through your paper mess soon!

[freebird]

Thanks Doc
I went for a minor surgery awhile back where they didn't use anesthetic just a sedative and my blood sugar was at about 8.4 or 8.5, the nurse said that would make sense because of being nervous and stressed about the surgery, so i'm wondering about what you said about the level of admission. If i am stressed and anxious won't it be higher than normal?
Yes i have been following the nutritionists diet plan and doing the medication as perscribed. i guess i could be more stressed than i realize and i fiqured out just recently that perhaps i'm in a bit of a funk about the paperwork stuff.
I'm sure it will all work out.

thanks again

[DocSanae]

Originally Posted by freebird

I went for a minor surgery awhile back where they didn't use anesthetic just a sedative and my blood sugar was at about 8.4 or 8.5, the nurse said that would make sense because of being nervous and stressed about the surgery, so i'm wondering about what you said about the level of admission. If i am stressed and anxious won't it be higher than normal?

That's one of the reasons I switch my patients to insulin pre-op. It's easier to control the blood sugar, and the dose can be adjusted in accordance with your blood sugar level that you self monitor. With pills, the level of blood sugar can not be controlled as minutely.

[Pillows]

I cannot imagine having to take that many pills post op right now. I have a hard time with my 6-7 pills plus 3 calciums. I hope that you and your surgeon figure out a good solution to this. Good luck.
Janae