pre-op question/insulin pump user

 I am preparing for surgery. Just received approval letter for GB-RNY yesterday. BUT... My endocrinologist just quit her practice on very short notice. I am on an insulin pump which I have used for 3 1/2 years since my pancreas is shot. My surgeon wanted to go ahead and do the surgery and just put me on sliding scale regular insulin shots after surgery because he thinks I will not need insulin at all after surgery, but there is no way to know. I hope he is right. Anyone out there had any experience with this? 
My gut feeling is to wait until I can get on board with a new endocrinologist that can be available to walk me through the transition if needed. I also have thyroid problems, so my thyroid medication may need to change as well. I am very disappointed in the possible delay because I was all set to have the surgery in July. Now, I may have to wait until September. My primary care Dr. has already told me she will not do pump management. I am a Type II but my pancreas is burnt out,so that is why I am on insulin. I am vacillating whether or not to wait.... been a long journey thus far and do not want to lose my momentum.
I am not asking for medical advice, just feedback and wondering if anyone else has gone through this...

thanks
p.s. this is also posted on RNY site... DPFlorida

Type 2???

I was also on an insulin pump...my nut and nurse told me to leave it at home but my gut feeling was not to do that. Glad I didn't.

I had my surgery on the 24th of Jan 2011 and it wasn't until the 1st of Feb that I finally took off my pump...even then I was still using insulin until the 11th of Feb.

I DID cut my basel rate in half based on past experience (wore mine thru numerous surgeries from 2002 to 2011) and then kept a close eye on it. I also placed it so that the cannella was attached way below my stomach and had them place the pump itself on my leg so that it was not in their way.

I also told my surgeon it was there...he was fine with it.

Liz

Yes, type 2
But my pancreas is shot. According to my former endocrinologist.
I did not wear my pump during my last surgery... my sugar went sky high from the stress.
I just have a feeling it will do the same.
My real dilemma is whether or not to delay the surgery due to the fact I have no back up for any questions about the adjustments to my basal rate, insulin sensitivity and carb to insulin ratio post surgery... 

If your PCP is not willing to help, I would delay til you have an endo on board.

I didn't have one but my PCP was willing to help me and I had been a pumper for quite some time...plus I had gone thru other surgeries, etc where I had some of the same issues. I had a UPPP with a tonsilectomy that kept me on a liquid/soft food diet for about 2 weeks back in 2002...just after I went on my pump...I just followed the same instructions as my endo gave me for that one.

When my middle of the night blood sugar readings started hitting 50 after my DS for 2 nights in a row, that's when I took my insulin pump off and never put it back on. I did monitor my blood sugars VERY carefully and used injections of my novolog to correct any highs.

But yeah, if your PCP isn't on board, I would delay til you do have backup.

Liz

Thanks for your insight! 

Glad to be of help. :)

Liz

 Get an endo! I have been a pump trainer for years and have put people on pumps who have had bariatric surgery. With RNY people often do come off of insulin quickly, but everyone is different and you will definitely need multliple adjustments after surgery if you still need insulin - easier to do with a pump than with shots. Surgeons do not have the experience to manage insulin - sliding scale regular insulin is not an option I would choose. If you cant find an endo quick enough can you find a CDE who is willing to work with you and adjust your insulin? There are many CDEs out there who know more about adjusting insulin and pumps than most endo's  do - I have worked with MANY endo's who cant manage insulin. I have found that bariatric surgeons tend to give you the best case scenario which is not always realistic. Studies do show resolution of diabetes after RNY even before any weight loss, but I know that if there can be an exception then that is where I usually fall. Good luck!!!

Hijack...

Which pump company? Mine was an Animas pump, unfortunately not the newest one but was also due for an upgrade this year which I don't need :)

I did donate all my excess supplies to my endo's office...as long as it was all still sealed, they had no issue accepting it.

Liz

The practice that your endo left from doesnt have another for u to see? Can they recommend someone to u? Some hospitals have hospitalists (drs who only see people in the hospital). U wouldnt even see your personal endo while admitteed... maybe that is how the hospital will be that u are going to and u wont have to cancel.