? re: fasting before procedures

When I have my ECT next week, they told me not to eat or drink anything after midnight the night before.  Which I know is very typical when you are having anesthesia.

However.  My appointment is at 11:30.  They would have said nothing by mouth after midnight if my appointment was at 8 am.  So that would mean nothing for eight hours before the procedure.  So if eight hours is all I need to fast, why can't I eat or drink up to 3:30 am the day of the procedure.  And yeah, I often am up that late 'cause I sleep something awful.

But another thing.  I have reactive hypoglycemia.  I think I will feel like total crap by 11:30 if I have not eaten in nearly 12 hours.  So I was wondering about having half a glass of milk or half a protein shake or something in the morning, like a few hours before the ECT.  Since I have no pyloric valve, it would not be in my stomach by the time of my appointment.  So why would that be a bad idea?  The PA that gave me my instructions does not understand how I have no pyloric valve, I don't think.  I think - well, I know, because she gave me a preprinted handout - she was just giving me the same instructions they give everyone.

So what do you all think?

Hey Kelly, I've had tons of precedures on my back where I have to get sedated, and lots of times my appt wouldnt be until 2:30pm, or so. They would tell me to go ahead and eat a light breakfast between 6 & 8am. Nothing heavy like sausage or a meaty breakfast casserole etc. If my appt was at say 8am, like you said they would say to not eat after midnight. And that was before i had WLS.  So I would definately think that for us a protein shake would be more than fine, because you know it'll be gone. I say go for it! By the way, I forgot one time my appt was at 1pm and I had already had a bacon, egg, and cheese bisquit late that morning, and I was fine! I, of course, dont know how you handle anesthesia though. I never get sick, and right when I wake up I jump right of the bed and walk out. Lots of people cant do that. But if you know you're good, do it, in my opinion. Good luck, and I think that its great your family is coming. It always feels good to have support.

I have been told both that some link or a small protein shake very early (e.g. 6am for a noon procedure) would be ok and have also been told that it would not.  I have faced this 3 times since surgery and have always asked the REASON for fasting.  The two times that the reason was simply concern that anesthesia or whatever would cause vomiting, I opted to disregard the fast and had half a protein shake 6 hours before (since there was no way it could make me ill at that point).  The one time they needed to do a lab test that required fasting before the procedure, I fasted.  I also warned them when I arrived that, because of my RNY and hypoglycemia, the fasting already had me shaky and lightheaded, and that I had not done something like that before and did not know whether or not I would pass out on them!  They did the lab test immediately, LOL.

Lora

I'm undiagnosed with RH but am pretty sure I have it

I was worried about this too when I had my surgery, but recently I was reading up on the RH and they several times seemed to mention that FASTING is not problematic.... I can't recall why, as that wan't my point of interest that time when I was reading the studies, but clearly stated was the fact that fasting itself is not an issue (and it wasn't for me)

I agree though.... 8 hours is all you need.... I try to clarify whenever I'm asked to fast because I know that if I go too long without drinking they'll have a hell of a time getting my IV started.

I'd have an emergency protein shake (RTD) or something like that available in case you crash, but I wouldn't deliberately go in to the procedure with food in your system. You can share your concern about blood sugars with them, or call them in advance for clarification too....which I'd recomend.

I'm definitely not going to eat.  But a glass of skim milk three or four hours before the procedure is not gonna be in my pouch by the time they do the procedure.  I may call them to try to clarify but I felt the PA I spoke to the other day did not understand what I was saying.  She just had this handout of printed instructions to give everyone.

I think the reason fasting is not necessarily a problem with RH is that RH tends to be a reaction (hence the term reactive) to eating too many carbs or too much sugar - causes blood sugar to crash.  But if I go too long without eating anything, my glucose does drop.  May not be RH technically then (I do have RH if I eat a carby meal) but it still drops really low.  I may just call Monday and ask what they want me to do if it drops.  I mean, I can't see going in there with a glucose of 40, and it has been that low before.  I could barely walk without passing out.  I had black spots swimming in front of my eyes.  It was no good.

That's a proactive way of looking at it.

They took my blood sugar before my surgery, after 18 hours of no eating, and 12 hours of nothing at all.... I was at 85. Though I think I did crash after that cookie I ate and shouldn't have.

Good luck with it.

Hi Kelly-

When I had my gall bladder taken out last October. I ate around 11 am. Felt really bad and went to the urgent care around 1 pm. I had emergency surgery at 3:30 pm. I told everyone that I had recently ate and no one seemed concerned. I was told by the anesthesiologist that he wasn't worried since I was post op RNY and my stomach was empty by then. Maybe call them and ask again if you could have something light? I know my blood sugar would crash if I couldn't eat for that long and that would be a whole other problem to deal with.

Good Luck
Liz

I'm gonna call.  I think the PA I talked to just didn't understand what I was saying about my pouch emptying fast, especially with liquids.  I'm  fine with no food.  I just want at least some milk or a protein shake.

My husband has been a brittle diabetic for 60 years.  It is always difficult when he has to be fasting.  He usually tries to vary his eating and evening insulin and gets an early appointment and takes something with him to eat.

I would think something liquid with protein and fat would be good for your blood sugar and like you said, it will be out of your pouch anyway.  They are probably most afraid of aspiration while you are sedated.

Best wishes.

I always try to follow doctors' orders -- that is, unless they just don't make any sense. 

It's probably just a preprinted sheet.  Maybe there's a chance something could happen- like vomiting with sedation - so to be on the safe side they tell everybody not to eat.
Call and ask what they say. 

For those of us who were blessed with common sense, we are obligated to use it--to make up for all of the poor souls who were blessed with little.   

Just to trying to make you smile....your posts have brought many smiles to my face since I began this journey a year ago.  Good luck to you!