Surgery and CPAP

[DanceDiva26]

I know these are not SleepyHead reports which I will learn later. Titration study showed that 8 cm compensated the oxygen desaturations in REM. I'm a bit unsure about the reliability of that 57% oxy desat number. (Had heavy fingernail polish on both nights with oximeter monitor on. (1st Dr. appt. on a Wed, his office called late Friday with a Sunday cancellation. Jumped at the chance to take it. Office closed all weekend, no prep instructions, tech didn't remove polish.) Still, very worrisome. Surgery in 5 days.

I've had many surgeries in the past (in fact just had general anesthesia in June), but this is the first with knowledge of apnea and a CPAP. Sometimes ignorance IS bliss. Had I not known of the breathing/oxy desat issues, I'd just be thinking..."let's get this going and done with!". But now.....

I've read past board posts re: surgery and CPAP and taken the required steps re: notification to anesthesiologist, recovery room nurses, labeled machine with my settings, etc. Any other last minute tips to optimize preparedness? Bribe a nurse to ENSURE mask on in recovery room?
Any tweaking to further optimize? Do I need to buy a dang oxygen tank?? Sorry. Nerves.

If nothing else and this works, at least I've learned how to use imgur and get some images posted.

My heart is pounding and I feel lightheaded today. Not normal for me and I'm not attributing it to CPAP in any way. It's just jitters. I've actually been pleased with CPAP therapy in the 10 or so days I've used it. 0% leaks again and .5 AHI last night with 6:54 hours sleep, only 1 bathroom break. Love the P10.

[Pugsy]

Don't worry about when you are in the hospital or even the recovery room.
You will be watched really closely when in the recovery room and you will be wearing a pulse ox...and if your O2 drops they will be right there to deal with it. Most likely you will be prompted to wake up because that's what they do in the recovery room anyway. I don't know if your doctor will want to bother with cpap in the recovery room...that's something you can talk to him about and if he makes the order they will do it but you will just about have your own private nurse sitting right by you in the recovery room and if you run into trouble they can fix it and most likely they will also have you on added O2 in the recovery room.

Now once in your hospital room...that is of course different and make sure you have it all set up and ready to go.
Should you doze off and not anticipate it they will again have a pulse ox on your finger and if it drops too low the bells and alarms will go off and they will wake you up rather quickly.

[Grace~~~]

Now once in your hospital room...that is of course different and make sure you have it all set up and ready to go.
Should you doze off and not anticipate it they will again have a pulse ox on your finger and if it drops too low the bells and alarms will go off and they will wake you up rather quickly.

Hello OP, DanceDiva26 and Pugsy.

Good wishes for DanceDiva and a question for Pugsy? (or anyone who knows?)

~~~regarding the scenario quoted above but from a different perspective.

If an undiagnosed person who has SA were in the hospital and that *bells and alarms* kept happening would the hospital be able to give a diagnosis from just that information without a sleep study? Assume it was some 'worst case' type scenario where someone was being monitored in Intensive Care for a few weeks? Do you think that would be at all similar or equal to a sleep study test for determining Sleep Apnea?

[Pugsy]

If an undiagnosed person who has SA were in the hospital and that *bells and alarms* kept happening would the hospital be able to give a diagnosis from just that information without a sleep study? Assume it was some 'worst case' type scenario where someone was being monitored in Intensive Care for a few weeks? Do you think that would be at all similar or equal to a sleep study test for determining Sleep Apnea?

No, they wouldn't be able to actually diagnose based on low O2 alarms but it should raise enough concern that someone does some thinking and asking about it.
In reality it probably won't get done. My brother had to have 2 colon surgeries...his O2 alarms went off all night to the point he just took it off so he would sleep. He snores something awful and I personally have witnessed his stopping breathing from OSA events.
Now I don't know for sure if it was never brought to my brother's attention or not....it might have but he has his head stuck so far up his ass in denial that he wouldn't ever admit it to me if they did.

But no...observing desats all by themselves won't earn a person an OSA diagnosis. Too many other things can cause low O2 for someone give that diagnosis without further investigation..like a sleep study.

[Grace~~~]

That is great to know Pugsy.

Thank you.

I hope it's like a day in the spa, DanceDiva26.
Something to make you more PERFECT.

[DanceDiva26]

Pugsy, I guess I knew all that intellectually (Dad was a surgeon and I always had an extra "advocate' watching over me, but no more)....just 'really 'feeling' it today....Thank you once again Pugsy, for helping to lessen my jitters.
And thank you too Grace for putting the spa image in my mind...a very soothing thought.

And oh, Grace? You have a great stream-of-consciousness going on ....and while your stream may not always penetrate my stream....on the occasion it does, I experience a paradigm shift and think...."Yeah! That works! Right on!" All the best to you, Grace.

[Okie bipap]

When I had knee replacement surgery in 2014, the nursed noted my blood oxygen level was dropping while I slept. The doctor that did the morning rounds was a pulmonologist. He arranged for me to have an oxygen concentrator when I was discharged from the hospital. I was directed to use oxygen when I slept. He scheduled me for a sleep study. When I followed up with him after the study, he said I need to have a titration study. At first, I refused because of the experience I had during the sleep study. The mask they put on me did not fit properly and I had a large, red sore spot on the bridge of my nose. I agreed to do the follow up titration study at a different sleep lab. Thankfully, we have several in the local area. He ordered a bipap machine and all associated equipment, but Medicare would not authorize the purchase because the doctor did not document a face to face meeting where we discussed sleep apnea and the dangers it poses before my first sleep study. I found a different sleep doctor and repeated the whole process again before I was finally able to get a bipap machine. The whole process took around 10 months during which I was using supplemental oxygen every night.

[Grace~~~]

Thanks DanceDiva26 ~~~

I'm that fringe element of the 'stream' that doesn't exactly eschew punctuation but instead thinks it's my friend and playmate? *I* don't however have an invisible whale that came with my cpap ~~~ and I laid in bed all lonely the other night listening for one and was really jealous of you!

In my memory the whale is blue but I don't think you told us that?


Okie Bipap ~~~ Ten months sure does seem like a lot of time for them to take?

I wonder if that is a common time frame?

Of course I realize that a bi pap is different than a cpap/apap.
Was that part of the reason it took so long?

That is a horrible story about the sore from the mask too.
You'd think they would have all the special pads and such to make sure that
didn't happen.

[D.H.]

Make a special packing list for your CPAP ahead of time. This will avoid last minute screw-ups like forgetting the power-cord, forgetting the mask cushion, etc. Also, this list will come in handy when you travel.

[3dmark]

I had surgery a couple of months ago. Because of my sleep apnea, they required me to stay overnight. I was really glad I did. I was using my own machine in the hospital overnight. My SP02 levels dropped whenever I drifted off, triggering the alarm. Eventually they added an oxygen feed right into my own machine's line, which solved the problem. Next day once the anesthesia had properly worn off, everything was fine.

I was pleased that everybody understood about sleep apnea (the nurses, surgeon, anesthesiologist), and were able to deal with it with no fuss.

[49er]

I stayed overnight after having deviated septum surgery as a precaution by my ENT. I honestly think I would have been fine having the surgery on an outpatient basis but to be honest, I was glad he was cautious at the time.

Unfortunately, I was forced to use the hospital's machine (long story) so they had a machine ready for me in the recovery room. But apparently, I woke up very quickly and it wasn't necessary.

Had a hard time using the machine in my room which is another long story.

Anyway, my point is Pugsy is definitely right about your being watched closely and you will be fine. But I do understand you being nervous as I definitely was. Now that I have had the experience of having surgery post apnea diagnosis, if god forbid, a similar situation occurs, knowing what to expect will be greatly helpful.

Best of luck.

49er