Diabetes mellitus and being an anesthesiologist

Specialties CRNA

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Hello. This isn't really a CRNA question, I guess, although it's somewhat related. Sorry if I'm breaking any rules.

Anyway.

I have diabetes mellitus. I have not had any hypo or hyperglycemic shocks for about seven years. I exercise regularly and eat a fairly healthy diet. My serum glucose levels are in the normal homeostatic range. However, I am never 100% confident about my body.

I am planning on becoming an anesthesiologist. I would like to get some opinions on that. I understand that anesthesiology is a very taxing physical and mental job, but I am exceptionally determined. The only thing that I could foresee ever even remotely affecting my path to being an anesthesiologist and my experiences post ex facto would be my diabetes mellitus.

One of my teachers has suggested that I become a general physician, or atleast some speciality where surgery would be minimized. I accepted this advice, but I still deeply desire being an anesthesiologist.

Any thoughts, feelings? Anybody know any nurses or doctors with diabetes mellitus?

Thanks in advance for any input.

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Anything is possible. Don't let diabetes get in the way of your dream. Sounds like you have a pretty good handle on things now, just keep it up and I think you will be fine. You may just have to carry snacks in your pocket and check your sugar more often in times of illness/high stress, but then again you'd have to do that with any other job! Good luck!

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One of our cardiologists has insulin dependent diabetes. It's a pretty taxing job with all the office hours, hours in the cath lab, and being on call regularly. He does well for the most part...also follows a healthy diet and exercises. He tends to go high if he gets out of range, and everyone can always tell by the way he acts. They tell him he really needs to check his sugar, which he does since he knows this happens, and can then adjust his insulin pump. No major problems.

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I agree with the above posts. Even if you are on a long case, take some snacks in your pocket and have a small glucometer available to you. You can always check your sugar when you need to. As far as being a student, that is the only thing I would think would cause a little more problem areas. Studying anesthesia means you'll spend lots of hours studying, being at the hospital, and you'll have to make a concentrated effort to get enough sleep and continue exercising and eating healthy. I think it will be easier once you're not a student and have more of a set schedule to expect with your job. I wouldn't let it stop you though, if you really want to pursue anesthesiologist go for it!

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I have Type I Diabetes myself and I am applying to CRNA school this fall. I think you should do what your heart tells you. In many ways obstacles in life make you stronger, more determined, and more willing to reflect on how those obstacles have made you a better person. I would recommend getting an insulin pump if you can afford it (if you don't already have one). It has made my life as a nurse soooo much easier. I often take the most unstable patient in the unit and am unable to leave the room without someone watching out to even have a bathroom break yikes :). I never have any problems. Don't let this obstacle hold you back from your dreams...use it as a stepping stone. Go for it!

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I think it would be possibly dangerous to be an anesthesiologist doing main OR work with Insulin dependent diabetes....

There will be times where the patient is so sick that for 3,4 or even 8 hours you don't even have time to sit and think about peeing, let alone checking your sugars.... Especially if you go into private practice where you may not have other anesthesia folk to break you out...

In my opinion, I would choose another field where you have regular down time... It sounds like you are interested in anesthesia, but are you even in med school yet??? i would suggest going to med school first, and finding out what you enjoy the most (it might not be anesthesia).... then try to find a specialty that incorporates the things you enjoy and are good at...

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I think it would be possibly dangerous to be an anesthesiologist doing main OR work with Insulin dependent diabetes....

There will be times where the patient is so sick that for 3,4 or even 8 hours you don't even have time to sit and think about peeing, let alone checking your sugars.... Especially if you go into private practice where you may not have other anesthesia folk to break you out...

In my opinion, I would choose another field where you have regular down time... It sounds like you are interested in anesthesia, but are you even in med school yet??? i would suggest going to med school first, and finding out what you enjoy the most (it might not be anesthesia).... then try to find a specialty that incorporates the things you enjoy and are good at...

I have to disagree, I have had type I diabetes fro the past 35 years, never once have I been in a situation I felt unprepared for. I spent years SCUBA diving, went camping, took long hikes, worked in situations where no help could be expected. Of course I have worn an insulin pump since 1985. I suggest that someone interested in the field get a pump and carry glucose tablets with them in the OR. Blood sugar can be checked, and most of us with diabetes can certainly recognize a low BS before it is too late. At worst if one really has no rescue medication, the pump can be suspended avoiding a crisis. Most of us can also recognize when blood sugars rise without constant monitoring and appropriat action taken there also. It all depends on how badly you want what you want.

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okay.... wintermute has got a point... a pump is ideal...

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Thank you everyone for your input. This has helped immensely - I feel a lot better now.

Tenesma: I am, sadly, not in medical school yet, still in college. But I can't wait - even though I know it's going to be a grueling 8 years of agony and ecstasy and strange happenings in deserts and peeing blood and communicating with the dead. Or something.

I am currently very interested in anesthesia, but you're right, I should go to med school first before I set any speciality in stone.

This thread has brought up another very interesting topic - the insulin pump. Currently I do not have a pump and I just inject my insulin the old fashioned way. The pump makes me nervous, probably because of a lot of false preconceptions of it I have. I am afraid for silly reasons... like, I am worried that the motion of my body would be affected by the pump (ie, would I still be able to do crunches?)... and other stuff like that. I know very little about the pump. My best mental image is of a hockey puck hewn into the side of my stomach with a bunch of buttons sticking out.

Trauma and WntrMute, could you tell me what the pump is like? If it would be a true help to me even in the very least, then I will fight to get one.

Thanks once again, everyone.

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This thread has brought up another very interesting topic - the insulin pump. Currently I do not have a pump and I just inject my insulin the old fashioned way. The pump makes me nervous, probably because of a lot of false preconceptions of it I have. I am afraid for silly reasons... like, I am worried that the motion of my body would be affected by the pump (ie, would I still be able to do crunches?)... and other stuff like that. I know very little about the pump. My best mental image is of a hockey puck hewn into the side of my stomach with a bunch of buttons sticking out.

Trauma and WntrMute, could you tell me what the pump is like? If it would be a true help to me even in the very least, then I will fight to get one.

Thanks once again, everyone.

I worked with a girl who has an insulin pump and you wouldn't have even known she had it if you didn't know it. I also know of a couple of physicians that use the pump and it looks just like a beeper on their belt.

Seems like it would be worth it to look in to them. Best of luck to you.

Sprout :nurse:

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Thank you everyone for your input. This has helped immensely - I feel a lot better now.

Tenesma: I am, sadly, not in medical school yet, still in college. But I can't wait - even though I know it's going to be a grueling 8 years of agony and ecstasy and strange happenings in deserts and peeing blood and communicating with the dead. Or something.

I am currently very interested in anesthesia, but you're right, I should go to med school first before I set any speciality in stone.

This thread has brought up another very interesting topic - the insulin pump. Currently I do not have a pump and I just inject my insulin the old fashioned way. The pump makes me nervous, probably because of a lot of false preconceptions of it I have. I am afraid for silly reasons... like, I am worried that the motion of my body would be affected by the pump (ie, would I still be able to do crunches?)... and other stuff like that. I know very little about the pump. My best mental image is of a hockey puck hewn into the side of my stomach with a bunch of buttons sticking out.

Trauma and WntrMute, could you tell me what the pump is like? If it would be a true help to me even in the very least, then I will fight to get one.

Thanks once again, everyone.

Well, First I would like to respond to the fears associated with having a Type I diabetic in the OR. It is very important that experience has taught me that I have gone for 12 hrs without eating and never had a problem because of my insulin pump. I have worked shifts as long as 18 hrs and never had a problem and often rotate shifts and done on call. Only you know your body and as a diabetic you have to decide what you think is safe. I think that shots make life very regimented...you have to eat three meals a day, can't skip snacks, risk hypo or hyperglycemia at inopportune times. I work out regularly and I was also worried about situps etc. The pump sets offer a flexible plastic cannula that moves with your body. You don't even feel it. You change the set every 2 to 3 days and can adjust your basal rates to your metabolic needs. Shots don't allow this. It's hard to consider the idea of having something attached to you all of the time, but it is the best thing I ever did. Most of the time I'm not even aware of it. It's like a part of me. It is very small, about the size of a beeper and comfortable. It has offered me a normal life and opportunities that I would be unable to experience otherwise. Hope this helps.

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"the pump makes me nervous, probably because of a lot of false preconceptions of it i have. i am afraid for silly reasons... like, i am worried that the motion of my body would be affected by the pump (ie, would i still be able to do crunches?)... and other stuff like that. i know very little about the pump. my best mental image is of a hockey puck hewn into the side of my stomach with a bunch of buttons sticking out."

i must first say that i don't have personal experience with a pump,but 2 of my close friends have had pumps for about 10 years. the actual pump looks like a beeper which you wear on your pants like a beeper. pump is maybe a bit larger than a beeper, but easily fits in the palm of your hand. connected to the pump is clear tubing and the catheter is inserted into the abdomen. the catheter is somewhat pliable, so it is not like a 27g needle permanently in you.

i don't know about exercises (crunches). i am sure there are ways to do it and modify cath. positioning so that it is more comfortable while at the gym. there are many pro athletes who wear a pump and still train (blonde male olympic swimmer from usa comes to mind - but cannot remember his name:chuckle ). talk to your endocrinologist.

maybe this is a stupid question, but ask if you could do a trial run at the gym with just the catheter inserted - take it slow those days and concentrate on how it "feels" while you are working-out. this way you can mentally answer any of your brain's hangups (should i do that, what if it hurts) so that if you do get a pump, you won't be worrying all the time. .... just a thought.

it is a natural response to be fearful of the unknown...bet you weren't "pumped" about giving yourself shots when you first got diagnosed huh? (sorry for the pun).

christine

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