I survived trigger thumb surgery, my blood sugar not so much

This is riding home from the surgical center around 11 am on the subway yesterday. All in all, the surgical procedure lasted about 13 minutes. Of course having what they call twilight anesthesia (anesthesia lite), I was entirely unaware. After the numbing agent wore off yesterday there is pain which I’m treating with naproxen and tylenol. It is less painful today. And I’m using ice to prevent swelling.

But here’s the clincher. Yesterday around noon my blood sugar started rising and hovered at 170 mg/dl all day no matter how much insulin I took. All day and night I was injecting small amounts of Humalog which didn’t make a dent; but did keep my blood sugar from rising further. At first I thought it was the stress effect of surgery, but by 5 pm I assumed they snuck a steroid into the IV because the stress effect wouldn’t last that long.

At 8:15 am this morning, waking at 149 mg/dl, I called the surgical center and a kind nurse told me all the medications they gave me. She identified, sure enough, that one of them was a steroid to counteract expected inflammation. Even though the anesthesiologist and her assistant both introduced themselves to me before the surgery, neither thought to tell me I would be getting a steroid that would raise my blood sugar.

The mind bending thing about this is I had to identify myself, my conditions, my medications three times before the surgery and no one thought to tell me to expect a blood sugar rise. To me this constitutes “medical error.” What I can take away from this is if I’m having any kind of medical procedure to ask specifically if they will be giving me anything that can raise my blood sugar. If you want to know how to deal with a steroid blood sugar rise, here it is.

A half hour after I spoke with the nurse the surgeon called me. Obviously he’d been told I had called. He confirmed the steroid and said it’s protocol for procedures like I had. So while I’m blown away no one told me about the steroid, I will also tell you that having both the nurse and surgeon talk with me immediately was the part of healthcare that’s too often missing; I felt cared for. And that, goes a long way toward healing.

4 thoughts on “I survived trigger thumb surgery, my blood sugar not so much

  1. I am so happy you got through the surgery. I am also so pissed off that a steroid was snuck into your treatment. Problem: we can’t just ask if we’re being given anything that’ll raise blood sugar because too many medical people don’t know that steroids raise blood sugar. (Or maybe if they do know, don’t think it’s important or significant.) Another thing to look out for is dextrose in saline drips when getting hydrated in the hospital. There’s more. I learned the hard way to get a “note from my doctor” before going to the hospital. So I could order food to feed myself healthily as opposed to the hospital’s high-carb “diabetic diet,” and to manage my own care. (Last time I was in the hospital staff insisted on giving me insulin injections rather than me doing it.)

    • I have told the husband more than once should I ever end up in the hospital he has to advocate for me, and prime has to be that provided I’m in my right mind, I manage my blood sugar. But, still, for a top notch place not to think to tell a person with diabetes, particularly type 1, that there is a steroid in their IV, is not just unconsciounable, but unfathomable. Thank you for sharing.

  2. Glad you got through the surgery successfully. I have to say Riva, those high numbers are a daily thing for me even without steroids. But I understand your frustration with the doctor and hospital staff.

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