cpap & hospitals

[Catnapper]

Thanks from me too, ozij. I had that spinal thing when I had bilateral total knee replacement. I was awake through the surgery, but drugged enough not to care. I like that better than general anesthesia.

This time on Wednesday, I will have general anesthesia for breast cancer - expecting to have sentinel lymph node biopsy, then lumpectomy, followed eventually by radiation. Sounds like a busy morning.

[ozij]

Sounds like a busy few months for you, Joanie .
My best wishes to you for a speedy recovery - I hope the radiation therapy will get rid of any possible remainder of cancel cells.
Remember to take things easy and give your body all the time it needs to recover. I know (from a friend) that radiation can be quite exhausting.
O.

[nobody]

I had surgery last year and was told to bring the CPAP. They didn't put it on me and after I woke up I was gasping for air in a panic. Now I'm having surgery at another hospital in a couple weeks. I talked to a nurse there about this, she said they don't put it on unless my oxygen goes down. I don't know how to make them understand that I'd rather not have that happen because usually then I come awake in a panic and try to get up NOT GOOD RIGHT AFTER SURGERY!

[gasparama]

Thanks from me too, ozij. I had that spinal thing when I had bilateral total knee replacement. I was awake through the surgery, but drugged enough not to care. I like that better than general anesthesia.

This time on Wednesday, I will have general anesthesia for breast cancer - expecting to have sentinel lymph node biopsy, then lumpectomy, followed eventually by radiation. Sounds like a busy morning.

I hadn't realized that you had cancer. I'm sorry if I missed your message in another post. Please let us hear from you as soon as you are able. As Ozij said, you are really going to have a busy morning. It sounds like your doctor is on top of things.

I was diagnosed with endometrial cancer in February. However, when I saw the oncologist, he said that my cancer couldn't be properly staged because no lymph nodes were removed. At least my CA125 eventually normalized. I'll be starting radiation in June.

Jane

[Elbysmom2004]

I know this response is a little late but better late than never I guess. I was being sarcastic in my earlier post saying that it was encouraging. I remember being in labor with my twins and after I got the epidural I was able to sleep (about 6 hours into induced labor and I ended up laboring for 25 1/2 hours before a c-section). The nurse kept coming in and waking me to tell me to take a deep breath and breathe because my pulse ox was going too low. Never once did she mention to me (or the dr) to see my PCP for possible sleep apnea.

[Kiralynx]

This time on Wednesday, I will have general anesthesia for breast cancer - expecting to have sentinel lymph node biopsy, then lumpectomy, followed eventually by radiation. Sounds like a busy morning.

Indeed, it does. When you have a chance, look into CoQ10 (CoEnzyme Q10) and breast cancer... I'm not saying to do it instead of traditional therapies, but it can be a valuable adjunct to those therapies.

[Kiralynx]

I was diagnosed with endometrial cancer in February. However, when I saw the oncologist, he said that my cancer couldn't be properly staged because no lymph nodes were removed. At least my CA125 eventually normalized. I'll be starting radiation in June.

Jane,

Wonder what it is about February? I was diagnosed in February of 2008 with endometrial. They did remove lymph nodes with mine, which has resulted in issues with lymphedema.

I see my oncologist next week. So far, she has not recommended radiation or chemo for me, thank goodness.

[gasparama]

I was diagnosed with endometrial cancer in February. However, when I saw the oncologist, he said that my cancer couldn't be properly staged because no lymph nodes were removed. At least my CA125 eventually normalized. I'll be starting radiation in June.

Jane,

Wonder what it is about February? I was diagnosed in February of 2008 with endometrial. They did remove lymph nodes with mine, which has resulted in issues with lymphedema.

I see my oncologist next week. So far, she has not recommended radiation or chemo for me, thank goodness.

From what I understand, it your cancer is Grade I and the nodes are negative, the pelvic wash is negative and cervix and ovaries are negative along with a normal CA125, then that's the end of the treatment. I belong to a gynecological cancer forum, and your experience seems to be what others have had. Sigh, I wish my surgeon had checked on the nodes. Are you still having the edema. My onc. said that it's actually a small percentage of the women who have that side effect and that it does get better for most of them. (I hope we're not hijacking this thread.)

[Kiralynx]

From what I understand, it your cancer is Grade I and the nodes are negative, the pelvic wash is negative and cervix and ovaries are negative along with a normal CA125, then that's the end of the treatment. I belong to a gynecological cancer forum, and your experience seems to be what others have had. Sigh, I wish my surgeon had checked on the nodes. Are you still having the edema. My onc. said that it's actually a small percentage of the women who have that side effect and that it does get better for most of them. (I hope we're not hijacking this thread.)

I believe mine was grade 1+ -- out of the endometrium, and into the uterus itself, but apparently no further. Nodes were negative. Because of my size, my surgery was unusually long and complicated -- 5.5 hours. My oncologist realized she hadn't done the pelvic wash after she'd closed, and wasn't going to reopen. Nothing has been mentioned on the CA125 since then, but I've been told all my labs were negative since then.

Ironically, it was my oncologist who first raised the question of apnea -- and my answer at that time was, "No I am not, to the best of my knowledge." Five months later (and after my last appointment with her), I was diagnosed. I must remember to ask her if her question was a general surgeon's question, or something she observed.

I must also remember to mention to her the fact that when I was in the hospital after the surgery, the alarm on my oximeter kept going off, and the nurses scolded me for "fiddling" with it. My suspicion -- now -- is that I was desaturating, the alarm would go off and wake me, and by the time they got in to adjust the thing, I was awake, and my SPO2 was just fine.

I see her next Thursday, and should get my test results about a week after that. I get edgy when the tests come up, worrying about if they'll find something THIS time.

[Hermit]

I too was told to bring in my cpap. I had a second total knee done this April. The only way I saw my cpap installed was when I installed it!!!!!!!!!! they tell you to bring it yet I think they don't know how to put it on and turn it on. All they had to do in my case was put my mask on the machine did the rest.Well perhaps the next time they'll learn. I ended up on the heart floor due to a flat ekg for just over 3 minutes.Now they come by the room and ask if I have enough water for the humidifier.They sure learn the hard way.

[restless RT]

I am a respiratory therapist and I was just diagnosed with OSA and put on a cpap at home. I have to say that we RTs are not really up on the use of home cpap machines. As a therapist I would like the patient's to bring their cpap machine from home and for them to be able to use it themselves. We have so many people come to the hospital who use cpap at home and don't bring it with them, they don't know their settings they use. We're suppose to figure that out. Then we have to use one of our machines that are really not nearly as nice as the home units, we also only have a limited amount of them. We use them on critically ill patients as bipap mostly to try to prevent the need for mechanical ventilation. Then when they're needed for that they're all set-up on home cpap patients because they left their units at home. Now as a patient using cpap at home I see the importance of bring your own machine with you to the hospital. My machine is so much better than the ones we have at work. You need to also know how to use it or havew someone with you who does. The RTs at our hospital stay really busy and sometimes fixing someone's cpap that they normally do at home every night is low on the priority list. Don't expect us to know what your setting is...we don't. I admitt that we are not as educated on home cpap as we could be, but in a hospital our job is mostly critical care...not home care. If you want your cpap you need to bring it and be able to operate it yourself or have someone who can.

[Mist]

Yike, Elbysmom. What is encouraging here to you? This is all pretty distressing news to me, and I just don't get it.

I think by looking at the smiley at the end of the sentence she was being sarcastic.

This is a bit distressing to me as I will be having a gastric lap band in September.

Hopefully since my sleep center AND bariatric program are all tied to the hospital I will be in more capable hands.

However, I will be making great noise at all pre-op appointments that my CPAP is to go on as soon as the breathing tube comes out.

[plr66]

The RTs at our hospital stay really busy and sometimes fixing someone's cpap that they normally do at home every night is low on the priority list. Don't expect us to know what your setting is...we don't. I admitt that we are not as educated on home cpap as we could be, but in a hospital our job is mostly critical care...not home care. If you want your cpap you need to bring it and be able to operate it yourself or have someone who can.

Thanks very much for your candid and forthright input here, R-RT. Comments about what you have said are not made toward you personally, but toward the entire insanity of this kind of thinking in the hospital community. I just continue to be astonished and bewildered that OSA and XPAP treatment are brushed to the side as "fluff" when one of us is being hospitalized. I am unable to breathe properly without my cpap, but nobody on staff sees that as an issue?? I have no other words at the moment.

[elader]

She must not have understood the concept that you quit breathing with sleep apnea and with a closed throat the air and oxygen just don't make it to the lungs. It seems pretty basic to me, but she is a nurse, so what do I know? I am not a medical professional in any way.

My brother, who is a cardiac surgeon explained this to me recently: When you're on 100% oxygen, the hemogolobin in your blood is saturated far above the usual, and can carry enough oxygen to your brain, even if you're not breathing so well. He added that there are times during cardiac surgery that they have to disonnect people from the heart/lungs machine for as long as minute - but because their blood is properly saturated, there's no problem with that. I had never thought of it like that - but it makes a lot of sense. 100% oxygen is not like an oxygen bleed, when the oxygen is just supplemental.
O.

Well sure, you might be at 99.9 percent instead of 95 percent but the physical disruption of breathing followed by the rapid increase in pulse and blood pressure will still occur if you stop breathing for 2 minutes. Its not the O2 level in your blood that triggers the breathing response, its the CO2 level. That does NOT change if you are on O2. I just don't entirely buy it from a physiological perspective and no disrespect to your brother intended, but I doubt that your average cardiac surgeon (incredibly skilled in his area of expertise) knows a great deal about sleep and apnea. Probably the anesthesiologist would be more on top of it.

[ozij]

From the Encyclopedia Britannica:

http://www.britannica.com/EBchecked/top ... =ref537196

Control of breathing » Chemoreceptors
One way in which breathing is controlled is through feedback by chemoreceptors. There are two kinds of respiratory chemoreceptors: arterial chemoreceptors, which monitor and respond to changes in the partial pressure of oxygen and carbon dioxide in the arterial blood, and central chemoreceptors in the brain, which respond to changes in the partial pressure of carbon dioxide in their immediate environment. Ventilation levels behave as if they were regulated to maintain a constant level of carbon dioxide partial pressure and to ensure adequate oxygen levels in the arterial blood. Increased activity of chemoreceptors caused by hypoxia or an increase in the partial pressure of carbon dioxide augments both the rate and depth of breathing, which restores partial pressures of oxygen and carbon dioxide to their usual levels. On the other hand, too much ventilation depresses the partial pressure of carbon dioxide, which leads to a reduction in chemoreceptor activity and a diminution of ventilation. During sleep and anesthesia, lowering carbon dioxide levels three to four millimetres of mercury below values occurring during wakefulness can cause a total cessation of breathing (apnea).

Elader, you seem to assume there is a buildup of CO2 in person after anesthesia, which will cause a struggle to breathe against obstruction.

Cardiac surgeons work hand in hand with aensthesiologists and heart-lung machine operators. They are a team.
Anesthesia is not sleep. Nor is it diving.
O.