CPAP use during/after medical procedures

[WearyOne]

If you're getting a medical procedure done and they use something like Versed (type of medication they use for certain procedures like colonoscopies), should you have your cpap with you? I don't know anything about this type of sedation, so I don't know if you're actually sedated enough to go to sleep (in which case, I would think you would need it). And those of you who have taken your cpap to use during/after a medical procedure (this type or after something that required general anesthesia) you just take the machine, right, not the humidifier. (Nothing against hospital personnel, but I would be concerned that they would end up turning the thing upside down with all the water in it, for those of us who have integrated humidifiers).

Oh, and as an aside, anyone here been given Versed, and if so, how was your reaction to it?

Thanks for your insight!

Pam

[Slinky]

Take your CPAP w/you, including the User's Manual (or Clinicians Manual if you have it). You won't need it during conscious sedation or anesthesia as you will be monitored by professional staff during the procedure. It is in recovery that you will need it. You should make the doctor who will be doing the procedure aware that you have OSA and use CPAP and will be bringing it w/you. If the procedure is being done at the hosptial, even as an outpatient, you should check w/the hospital first, a very few won't let you use your CPAP, many will want you to bring it in early to be checked by their engineering staff for safety in the hospital environment, most will just say okay, bring it. Even if the procedure is being done in the doctor's office or a stand-alone clinic or outpatient facility MAKE SURE THAT YOU INSIST ON SHOWING ONE OF THE RECOVERY ROOM STAFF HOW TO WORK YOUR CPAP! It is in recovery that you are going to be most vulnerable and in need of your CPAP. Perhaps ask that one of your family who knows how to operate your CPAP and fit your mask be w/you immediately and during your stay in recovery. apneasupport.com has a couple of really good links regarding CPAP and sedation/anesthesia.

I have had Versed for a colonoscopy. I'm one of the few who did have a reaction to it. I got agitated and then hostile. Versed is closely related to Valium. It is a benzodiazipine (??). Klonopin is in the same family. It is used as an sedating amnesiac during colonoscopies and endoscopies amongst other procedures. Most people do very well w/it which is why it is so popular for these type of procedures.

If you expect to be released the same day, no, I wouldn't take the humidifier either. However, if you expect to be kept overnight or for several days I would definitely take my humidifier and some distilled water w/me. You or a family member can see to its set up and disassembly to pack it up when moving to another room or released to go home.

[WearyOne]

Thanks, slinky. Hopefully, the test(s) I'm having next week will have good results, but if they don't, I'll probably have to have an out-patient procedure with Versed, and I was just trying to get educated!



Pam

[ozij]

What Slinky said.

Versed (in the US, and I think Canda) Dormicum in Europe, Israel , is the benzodiazepine Midazolam.
It has a very short half life, puts you to sleep in a second, and also causes amnesia of what happened before you took it - retrograde amnesia. Versed does not make you unconscious in the medical sense of the term - which is why the don't intubate you the way they do for real anesthesia. It is a sedative, not an anesthetic.

I asked who would be the nurse on duty on the day of my procedure (explaining I needed a cpap because "I don't breathe well when I'm not fully awake" -that gets everyone's attention much better that "sleep apnea", I wrote a letter when setting up the appointment for the procedure, set up a meeting with with the nurse for a day or two ahead of time, called on the day before the meeting to confirm she would be there, and then I went over and explained why | would need the machine, and made sure there was an electric outlet in the OR and in the recovery room. I told them I would have a friend along. I had a number of aims: to make them aware of my need for the machine, without its being sprung on them out of nowhere, to make sure they remembered me and that need, and to make them feel I was also considering their needs. I did a "show and tell" just before the procedure, I also made it very clear that the mask has to be removed from my face while the machine is still working when they move me from where the procedure was done to the recovery room. The nurses were quite interested.
I had a friend along whom I taught how to turn on the machine and fit the mask to my face, and to make sure the mask was on my face in the recovery room - and everything worked out fine.

Good luck with your tests!

O.

[Kiralynx]

Oh, this is a useful thread.... I've just gotten the word that I get a colonoscopy (or at least the pre-visit) for Christmas.

I've always been terrified of anesthesia, long before I knew or had any significant symptoms of apnea. (And let's not mince hairs here -- as far as I'm concerned, sedation is a form of anesthesia.)

It didn't get any better when, in 2001, I went in for a same day gall bladder removal and came out four days later because I could NOT wake up from the anesthesia.

I didn't appear to have issues with the cancer surgery anesthesia, but, based on what I now know is a linkage between my hip pain and the apnea, the level of hip pain I had while on a morphine drip -- and the fact that the O2 monitor kept going off, I suspect I was having a fair number of issues. (The nurses kept telling me I was knocking the oximeter off, and to be more careful -- I suspect I was desatting, the alarm would go off, and I'd jump and shift the oximeter, but because the events were so closely related, and because, when they put the oximeter back on me, the O2 was normal, they never twigged to what was going on.)

I recognize the usefulness of the colonoscopy as a diagnostic tool, but that doesn't stop me from gibbering in terror at the idea of anesthesia.

[Slinky]

Discuss your previous problems w/anesthesia and sedation w/your gastro PRIOR to colonoscopy and REMIND hin/her and all the staff the day of your scope as well. You should have your procedure scheduled at a hospital endoscopy department rather than a gastro's clinic or an outpatient facility w/o full resucitation capabilities. They might want to consider having an anesthesiologist present and possibly using Diprivan (propofol) which is a short acting anesthetic from which you recover MUCH FASTER than Versed or Valium.

[ozij]

http://www.sedationfacts.org/about-sedation-facts

http://www.sedationfacts.org/sedation-medication

O.

[Kiralynx]

Discuss your previous problems w/anesthesia and sedation w/your gastro PRIOR to colonoscopy and REMIND hin/her and all the staff the day of your scope as well. You should have your procedure scheduled at a hospital endoscopy department rather than a gastro's clinic or an outpatient facility w/o full resucitation capabilities. They might want to consider having an anesthesiologist present and possibly using Diprivan (propofol) which is a short acting anesthetic from which you recover MUCH FASTER than Versed or Valium.

Yes, one reason for scheduling with the doctor I am with (gastro group recommended by my oncologist, whom I trust) is because they are associated with the hospital where I had my cancer surgery.

<sigh> A friend of mine says I will probably scare the bejaysus out of the poor, unsuspecting gastroenterologist who's coming in to reassure a colonoscopy patient that it's all a perfectly normal procedure with nothing to worry about and finds a patient (and her husband) with (at present) four pages of questions and caveats.

[Kiralynx]

http://www.sedationfacts.org/about-sedation-facts

http://www.sedationfacts.org/sedation-medication

Thanks, Ozij... research is one way to deal with the sheer, unreasoning panic which hits whenever I think about this.

The prep's bad, too. I know how to accomplish it on my diet, but having spent 25 years with minimal control of my guts (and being told, "Oh, if it bothers you, just take a little Lomotil..." which made me even sicker), and then, in the last seven years, by rigid adherence to my diet, having achieved control, the notion of voluntarily swallowing something to induce violent diarrhea is psychologically traumatic.

Add my terror over anesthesia to it, and I'm not having a very good holiday season.

[bairdbeth]

I just had a heart catheterization and used the CPAP during my procedure. I never was asleep, but the anestheasiologist asked me "Do you use it evry night? Then we use it here as there is a chance you will fall asleep." After I had the CPAP on, one of the nurses asked if the anestheasiologist was going to put me on oxygen. She said "Why, with the CPAP her sats read 100%!" They also asked if I was sure my machine was on as it was so quiet! I have ankle surgery coming up and was told they would not do it unless I bring my CPAP with me.

[WearyOne]

Hey, thanks for all the great information. I'm not having a colonoscopy, but if I have to have this specific procedure done, she said it would be like what they use for a colonoscopy. HOPEFULLY, they'll be able to do the office procedure Monday (no type of sedation needed), and then I won't need this other thing done.

Pam

[Kiralynx]

HOPEFULLY, they'll be able to do the office procedure Monday (no type of sedation needed), and then I won't need this other thing done.

<fingers crossed for you>

And thank YOU for bringing the topic up, 'cause I got some top mark information I needed in order to prepare.

[Kiralynx]

I just had a heart catheterization and used the CPAP during my procedure. I never was asleep, but the anestheasiologist asked me "Do you use it evry night? Then we use it here as there is a chance you will fall asleep." After I had the CPAP on, one of the nurses asked if the anestheasiologist was going to put me on oxygen. She said "Why, with the CPAP her sats read 100%!" They also asked if I was sure my machine was on as it was so quiet! I have ankle surgery coming up and was told they would not do it unless I bring my CPAP with me.

That's impressive, too! And gives me something else to put in my notes for the gastro.

[Kiralynx]

OK, now I have a dilemma....

I saw the gastro yesterday, and he insists that "You'll be on oxygen the whole time, and we'll be right there so we'll wake you if you stop breathing." He apparently does NOT know much about apnea, and did not, to my perception, take the need for the CPAP seriously. He also insisted that the sedation they use is not like regular falling asleep, so there won't be any problem... except that it's Versed and Demerol, and Demerol, in the past has put me under like nobody's business.

Of course, I have this board to read.

So. Do I go along with what he says? Or do I show up for the procedure with CPAP and oxygen bleed connector sans humidifier in hand and insist on using my CPAP, even if the procedure is supposed to only take 15 minutes to 30 minutes, max?

Thoughts, anyone?

[Kiralynx]

bump