A Night in Hospital with CPAP

[Muse-Inc]

I have my spare machine and a complete set of what I would need...

Great idea! Will pack my backup as if someone else was picking it up for me in an emergency.

[RocketGirl]

RocketGirl I was following along after a hiatus. First the shock of the news and then the relief of seeing that your heart is not just good but provably good. Please let us know how the chest pain proves out. My brother had chest pains a few years back. They finally told him it was strained muscles and that his heart was just fine. They did tracers and found no blockages. None of us knew at the time about sleep apnea. However, we now believe he had the familial CSA that my mom and I have. That may have caused damage somewhere that threw a clot or something. Unlike you, he was very overweight, I'll guess somewhere above 280. About a year after the chest pains, he decided to loose the weight. Between March and September, he had lost 65 pounds with weight watchers and one day after a walk, dropped with a heart attack and they were unable to revive him. I have no idea if his chest pains were a true warning sign or not. He was my little brother and I miss him a lot.

Hi Mr Bill - thanks so much - I will report back once more is known. For now, I have a whole series of specialist visits scheduled to check on possibilities ranging from ulcers to intercostal chondritis and everything in between (and I've got direct orders to de-stress. But no instructions how!)

I am so sorry to hear about your brother. I won't say I know how it feels because everyone is different, but I certainly can relate. I am the last surviving in health of my family. It is a sad place to be.

[john5396]

reading this thread reminded me to update my In Case of Emergency entry on my cell phone.

I understand that emergency personell now look at the cell phone before looking at the wallet because they are more likely to find needed information there.

I now have on my cellphone and entry that identifies my immediate family from my contact list. To that, I have now added a statement that I haver Sleep Apnea, with a CPAP pressure of 9.

Hopefully, my phone can speak for me when I can't.

[Bazinga]

I spent the night in hospital yesterday after having bilateral foot surgery. I learned that it is this hospital's policy to keep OSA patients in overnight for observation due to increased risk of apnea and oxygen desaturation. Fair enough. Like a good CPAP user, I brought my gear.

I had done some research about the effects of general anesthesia post-operatively on OSA patients...pretty scary. So I had my general anesthesia late in the day, and was given Dilaudid for pain , as I have many opioid intolerances due to severe nausea. They were being very careful to titrate up to effect in very small doses. I appreciate that. Once on the surgical floor, I was receiving the proper amount of injectible hydromorphone to keep me fairly comfortable, and yet not "snowed" or feeling doped. I was breathing well.

I will add, interestingly enough my surgeon saw me after in Recovery and said I could go home that night. He was not aware of the protocol to keep apneics overnight. But the nurse and anesthesiologist told me that I was staying, as this was an anesthesia department rule.

So, bedtime comes and I don my gear. As I am drifting off to sleep, I notice that I keep waking up with a gasp and with the feeling I am holding my breath. This is not obstructive apnea, but central apnea, as my CPAP machine is doing its job nicely to keep my airway open.

After two hours of this fitfull snoozing, I turned on the light and checked my data on the machine display. My sleep doc had told me as long as that number was under 5 AHI, I was OK. So imagine my surprise (well not really...) when I saw that my AHI was 220!!! I believe this was a combined effect of the residual anesthetic in my system and the opioid narcotic pain medicine.

I called the nurse, and told her my story. Bless her heart, she really was trying to understand, but looked at me as if I had three heads. She said she thought that the CPAP machine would alarm if I stopped breathing and it would take a breath for me. I explained this machine is not like a ventilator in that regard.

I skipped a crucial detail earlier: Though the very reason I was being kept overnight was for observation due to increased risk of oxygen desaturation and apneic events, there was no pulse oximeter on my finger. I should have caught this being a healthcare professional myself (a nurse practitioner) but it had been a hectic night waiting for a bed, dealing with extreme pain and nausea. Also, I was breathing fine while awake.

I then asked her for a pulse ox to wear during the night and the alarm set to ring if my sats dropped below 90. She was very happy to comply. She also put me back on oxygen which made it so I could not use my CPAP. So I slept on my side (a neat trick after foot surgery) and hoped for the best. I continued to awaken over and over with the alarm sounding and extreme desaturations displayed. Needless to say I did not sleep much. I was terrified of dying in my sleep.

The reason I bring this up is because we need to be our own advocates in these situations. I feel as though I could have quietly died last night and there was nothing in place to monitor my breathing post-operativelY I believe I will suggest that both the physicians and nursing staff be made aware of this potential danger. I do not know if I will have these episodes again tonight as I am still taking pain medicine for severe pain.

I also think it would be a great idea if my ResMed machine had the option of an alarm to wake me up for central apneic events. I do know there is an optional pulse oximeter that can be purchased and monitored by the machne, but I do not know if it alarms audibly.

Thanks for reading this. I think it is an extremely important topic that deseves attention from the CPAP community and also healthcare professionals working in the post operative areas of hospitals and clinics.