post-operative care and diabetes

[ezap]

My mother (75yrs) goes in for a bilateral mastectomy and axillary lymph node dissection tomorrow morning (July 17th) ; it is scheduled as an outpatient procedure. She has type 2 diabetes that has been under control until just recently. Presently her blood sugar levels have been consistently elevated (fasting = 13-16). A few days ago she started taking Metformin to try to start lowering her blood sugar and there has been no change. I understand that high blood sugar levels are associated with higher risk for infections and complications and that Metformin is sometimes associated with lactic acidosis when taken just before/after surgery.

My concerns:
- is it safe for my mother (75yrs) to take MetforminHCL the day before and day after surgery?
- What can I do to help if/when her blood sugar goes too high?
- When (at what blood count) does it an emergency?

[japdip]

Diabetes aside I do not believe it is appropriate for your mother to have this procedure as an outpatient.
I feel very strongly about this and would NOT stand for it for my mother or anyone else of your mothers age and with her medical problems.

If there is any way possible that you can object, PLEASE DO SO .... this is not adequate medical care.

[ezap]

Thank you for your thoughts & caution - we were told if we arranged for a hospital bed for the night we'd have a much longer wait for surgery and even then it would almost certainly be cancelled at the last minute.

My mother was out of surgery at 4pm and we had her home by 7pm yesterday. She just started sobbing when she woke up after surgery... right away we had a quick lesson in emptying the drains of blood & lymph fluid and we had to ship her home. Yes, it does seem a little on the barabic side. It seems like a big responsibility to monitor her condition and empty the drains for the blood and lymph... this is how it works with universal healthcare in Canada. I'm just glad my brother & I could be tere to help her, I can't imagine how people manage who don't have the help, or can't take time off etc.

On the bright side, she seems to be doing well. She is not in pain and moving around to the best of her ability  - she is scared of being still for too long - and possibily getting a blood clot or swelling in her arms.

We are all exhausted... it's not over yet and our fingers are crossed that she heals well.
Her blood sugar levels have been between 12 -17.5 .... and she doesn't show any symptoms of  dangerous hyperglemia.

[japdip]

Sorry, I didn't know the health care situation; your story makes me feel VERY fortunate indeed. I'm so happy she got along well and especially that you two were there for her. Now you know why I am so against the "drive thru" mastectomies that are being done these days in some areas. It's wonderful that she wants to be up and around. I'm guessing that she had removal of a number of lymph nodes in the axillary area .... if I am correct she should not get too active with that arm. Blood clots are a concern but not in the arm or in any way associated with the mastectomy but primarily dealing with the legs and inactivity. There are prescribed exercises that one can do after surgery. The American Cancer Society has video tapes that they loan / or give to pt.s that are quite good. I don't know if this is available in your area or not ... you might check it out. They are simple exercises but a big help in regaining normal range of motion. Thanks so much for letting me know how things went and tell you mother I think she has a couple of "good kids". Regards to you all ......