Friday, 19 February 2016

My tonsillectomy

I had my tonsils 3 weeks ago on Wednesday. It's not common to get your tonsils out as an "adult", I put it in quotation marks because at 18 I still don't see myself as an adult! Regardless, I'm not a child and so it was a big decision for me to make to get my tonsils out, a tonsillectomy is the most commonly performed surgical procedure and while relatively simple, it can go wrong, as can any operation unfortunately. However, I was willing to take the risk and after being told multiple times by the GP that I had to "have tonsillitis over 5 times a year" in order to get a referral, we went private. I'll spare the details of what exactly the problem was with my tonsils, but let's just say they were very cryptic and had big holes in them, and would bleed often and they were just a bit of a mess! My surgery was scheduled for February 3rd 2016, and I was excited for it, but also a little bit nervous.

As always, diabetes has to be considered in every single thing I do. I've never had an operation, let alone had an operation with Type 1 Diabetes in tow. I contacted my diabetes team(s) (I'm in the middle of transitioning and so I'm still under the care of my current diabetes team, but also being encouraged to contact the adult team with questions etc.) for fear of the anaesthetist not being totally clued up on Type 1. On the night before my surgery the hospital called and told me to disconnect my insulin pump at midnight...erm? I said ok but after wards it dawned on me that that is not a good idea. Anyway, I did disconnect it but I just took lantus to keep me covered- they told me to disconnect it to stop me from going low, but I suppose don't understand that my insulin pump is my only source of insulin for my body and so disconnecting it would send me way too high. In the morning I woke up with a blood sugar of 12.9 and I didn't touch it because I thought of it as, I'm safe from going hypo. We arrived at the hospital at 7am and the nurse checked my blood sugar, it was still 12.9...apparently this was an issue, that me and my mum weren't told about.

The anaesthetist came in, asked if I had disconnected my insulin pump etc. and then said that my blood sugar was a bit on the higher side, which I knew, but I assumed it would come down once I was on the saline IV or whatever it was, and I assumed I would be put on a sliding scale. Basically there was a lot of miscommunication and I wasn't even sure if I would be able to keep my insulin pump on during the operation. Anyway, my blood sugar needed to come down and it was about 7:30am at this point, with surgery scheduled for 8:00am. I said to the anaesthetist, can I not just correct on my insulin pump? My blood sugar was not going to come down by just watching it. He said "no no hold on let me talk to the surgeon" This wasted a good 15 minutes, 15 minutes that I could have corrected my blood sugar in and they could have been on the way down. So the surgeon comes in at about 7:45, and says "We can't operate on a blood sugar over 12" So my question at that point was: "Why were we not told this?!" I could have corrected my blood sugar that morning when I woke up and it was 12.9, and by the time 8:00am came round it would have been corrected. Grr! They finally told me to correct on my insulin pump...and gave it another 15 minutes. All of the odds were against me, I was nervous about the impending surgery, anxious about my blood sugar not coming down in time...all of which are emotions that can raise my blood sugar.

At around 8:00am the nurse came in and checked my blood sugar: 12.6. Argh! They had come down 0.4 in half an hour. She left, and the anaesthetist and the surgeon both came skulking in and basically said they can't do the operation. The surgeon had a clinic at 9am apparently, and so he had to go. We asked if it could be done later in the day and he said no because he does one operation on a Wednesday morning and then goes to his outpatient clinics. At this point, both my mum and  I were incredibly frustrated at the lack of communication and just lack of understanding it seemed about my blood sugar...I didn't feel at ease about it in the slightest to be honest. So, I didn't actually even have any words for what they just said, I was angry and just feeling a bit teary about it really, we had all worked ourselves up for this operation and were ready for it to be over and done with, I had already arranged 2 weeks off work, my mum took the day off of work to come with me, I was all ready in that hideous gown and in fact the surgeon and the anaesthetist etc. were all ready for the operation too...apart from my blood sugar, it wasn't feeling quite ready, obviously. In my frustration, I felt the need to show it, (hehe) so I got up and I went over to the cupboard and I got my clothes out and I got my coat out and put my things back in my bag (all while the anaesthetist and surgeon were both still in the room trying to apologise and suggest arranging the surgery for another day) and then, they asked me if I wanted tea...TEA? I wanted my tonsils out, I wanted that operation over and done with I didn't want tea. So I said no thank you, and continued my packing, I refused to sit there looking like a fool in that hospital gown any longer. I just felt so silly having got ready for the operation and then for them to not be able to do it just made me feel like even more of a fool.

They left, and I think my mum and I were a bit gob-smacked that I wasn't going to have the operation that day. Someone should have made it clear that my blood sugar had to be 12 or under for them to do the operation. That should have been communicated to us. My mum said she had to go outside to get some fresh air, and then said to check my blood sugar quickly out of interest to see what it was: 10.4! It was a perfect level for the operation. So when my mum went out into the corridor she saw the surgeon and the anaesthetist still standing outside discussing what they could have done better and what they should have done etc. and told him my blood sugar. Miraculously, he turned around and said "Ok I'll do it, I'll just cancel my clinics for this morning". By this point I was already dressed and ready to go- I had my shoes on, I had my clothes on and my bag was packed. I was ready to leave. Suddenly my mum runs in and said that they're going to do the operation and to get ready! Probably within 15 minutes I was asleep. I've never been put to sleep before and I was so nervous about that before hand, but because it went from not having the surgery to then having it, I didn't have time to get nervous about being put to sleep and I just went with it and was just glad to be having it done in all honesty. When I was laying on the bed to be put under, they let me keep my insulin pump on, and I don't even remember falling asleep, I just remember getting dizzy and my last thought and my last sentence before I fell asleep was: "Make sure you don't let me go low..." and that was it.

I woke up in the recovery room about an hour and a half later. My pump wasn't attached to me however, I'm not exactly sure what happened in terms of my insulin during the operation...I had it on at first but who knows why they disconnected it. Regardless, my blood sugars were perfect during the operation. The surgery was an emotional roller coaster really. Throwing up blood when I first woke up was not nice at all, and being practically forced to eat a dry jacket potato really was hideous, I couldn't swallow properly because my uvula (that thing that hangs down in the back of your throat) had ballooned 3x it's normal size and so swallowing food meant swallowing my uvula at the same time. My throat was also very dry, and I believe it was still waking up from the anaesthetic to be honest, I had to swallow twice because my swallowing mechanism just wasn't strong enough. I left the hospital at about 4:00pm that same day.

And the recovery process started! My blood sugars were amazing for the 2 weeks that I've been recovering. It was hard on the days where my throat was especially painful because my blood sugars really hovered on the lower side and I went low on a couple of occasions and the last thing I wanted to do was eat anything. Drinking fizzy drinks like lucozade wasn't an option either because it would have burned my throat, the same went for apple juice etc. Thank goodness for Twister ice lollies! Also, thank goodness 1 million times over for my wonderful mum, she helped me so much and she is just brilliant in every way!

I'm incredibly glad that it is over, and that my throat is beginning to feel and look like a normal throat again.

-Ellie


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