Having Major Surgery...Have Questions

SleeplessinBradenton · Post by **SleeplessinBradenton** » Sun Oct 15, 2006 7:44 am

I just found out that I need a complete hysterectomy and it will be done Nov. 1. (Age 54 - postmenopause)

Should I be concerned about the apnea issue? What have your experiences been with being under anesthesia for approx. 3 hours?

I was diagnosed with sleep apnea last Nov. and got the machine in January of this year.

Can I/should I take my own CPAP machine to the hospital with me? I will be inpatient for approx. 2 days. I think that I should....

The mask I currently use is a Respironics ComfortGel and tape my lips closed nightly. That is working out pretty well (after months of frustration!), but I am thinking that for the hospital I should have a full-face mask so I don't have to deal with the taping. What is your advice and what full-face would be the best to use?

Thank you for any help!

Goofproof · Post by **Goofproof** » Sun Oct 15, 2006 8:29 am

I just came from having a Defibrillator put in three weeks ago, You will need to inform the Dr.s of the XPAP, It will be needed for the surgery and your stay the FF Mask is a good idea. Also you will need a O2 adaptor. I didn't think about that, and the hospital had to find me one.

They are finding it's best to use the XPAP with patients that require it, but the words not out there 100% so it's up to us to see its done. Good Luck on your surgery. Jim

I use a Comfortfull 2 and a F&P431, but my numbers are best with the Comfortfull 2.

kteague · Post by **kteague** » Sun Oct 15, 2006 9:42 am

I knew that post surgery it is important to use xpap. Jim, when you said "for the surgery", was that referring to procedures when one isn't intubated or were you speaking of the recovery room? I just accompanied a friend with OSA to a surgical procedure and wonder for future reference if I have the right understanding.
Kathy

birdshell · Post by **birdshell** » Sun Oct 15, 2006 11:13 am

I had a chat with an anesthesiologist when my mother had an intubation anesthetic for knee surgery. I had just gotten my CPAP and had read about telling the medical people if one is having surgery.

He assured me that for intubations, anesthetists and anesthesiologists are trained to look for any OSA problems and consider them during the surgery. Whether that is ALWAYS done, or not, is a question I cannot answer. However, through many surgeries neither my mother nor I were diagnosed and had no problems with the anesthesia.

Any anesthetists or anesthesiologists out there?

Bamalady · Post by **Bamalady** » Sun Oct 15, 2006 12:11 pm

I had a procedure done about 3 weeks ago, told everyone I had Sleep Apnea, and took my machine to the hospital. Their 'treatment' for the Apnea when they put me to sleep was to give me oxygen through a Nasal Canula. They kept giving me oxygen until I roused up enough to ask for my machine....about 3 hours later. I have to have another procedure in about 3 weeks, similar to what I had before. I have sent the following Guidelines to my Dr. I'm not sure how they expect someone to benefit from Oxygen delivered through a Nasal Canula if one's airway is blocked.

http://www.guideline.gov/summary/summar ... oc_id=9308

From what I have read, the concern is that the meds given to put a patient to sleep can affect the signals the brain send out to make sure we don't die when we stop breathing.... putting those signals to sleep as well.

Snoredog · Post by **Snoredog** » Sun Oct 15, 2006 12:13 pm

I would make it a point to tell your anesthesiologist again when they stick that needle in your arm.

I usually say: hey doc, I have sleep apnea, keep my airway open will ya until I wake up. They may even put a tube in you to keep it open.

Bamalady · Post by **Bamalady** » Sun Oct 15, 2006 12:40 pm

Snoredog......I did say again that I had Sleep Apnea in the OR room. The anesthesiologist's reponse was something like this: I have worked with a lot of Sleep Apnea patients. I give them oxygen.

Then I was out. Now I am trying to correct matters before I go in again. I even suggested they consult the Doctor at the Sleep Center which is part of their hospital. I don't know if they will???

Goofproof · Post by **Goofproof** » Sun Oct 15, 2006 1:01 pm

My implant was done with a local, I was only supposed to be out for 5 minutes, while they checked the implant. They had to send to my room for my machine and then they had to send for a O2 adapter. Something must have went wrong because I was out for 30 minutes. I could tell because I had the card in....... The timeline on the card showed a rise in pressure for 30 minutes, when I was out.

The anesthesiologist's wasn't competent enough to inject novocaine, long enough to see it you were breathing. This was supposed to be painless, she could have taught the V.C. a few tricks. Jim

Bamalady · Post by **Bamalady** » Sun Oct 15, 2006 1:19 pm

Jim....that sounds awful! I don't do well with Novocaine myself, but I let them know in a hurry! And I won't let them continue until I am comfortable. There is another med that can be used if you don't respond well to Novocaine, but I don't remember what it is off hand.

OSAGuy · Post by **OSAGuy** » Sun Oct 15, 2006 1:50 pm

Had surgery about a month ago and was also "out" for over three hours. I spoke with the Dr. and Anestheseologist about it. All said they were not concerned about the sleep apnea during surgery, as the anestheseologist knows how to handle it during surgery. They did want me to bring my APAP with me, as they wanted me to be on it in recovery (was able to do on an outpatient basis). They also suggested that I bring an oxegen adapter or they could provide one (I bought one myself for much less than they charge). Don't know what happened during surgery but had no problems in post op. when I woke up. The only problems I had was when I got home, as I was on a strong dose of Hydrocodone for a week, as I did have difficulties during that time. Once I got off the pain medication it was fine. The issues I had when I was on the meds at home probably wasn't as severe as I thought it was - Just not getting the good results I was accustomed to. My only suggestion is to keep the Dr. and your Anestheseologist in the loop regarding your sleep apnea.

birdshell · Post by **birdshell** » Sun Oct 15, 2006 2:03 pm

I just had a colonoscopy a few weeks ago. It was routine, but my hematologist sent a letter outlining the procedures and things that they need to have on hand in case of an emergency.

The doctor was a very thorough one; and EVERYTHING was perfectly ready according to the hematologist's instructions.

Possibly the sleep doctors (pulmonologist or ENT or neurologist or...) should send out letters for their patients having surgery.

The surgeon's office may not check, but the OTHER office sends these out pretty routinely, or at least in my case.

Maybe we should carry a copy of said letter, too? I'm going to have to ask for one from my hematologist.

So, let us review: we will now carry our driver's license, medical card, medical alert card,list of meds, list of docs, passport, birth certificate....And I wonder why my purse is heavy. Guys, forget the thin wallets and get ready for wallet-induced back pain from the weight and sitting with the thickness.

Ms Piggy · Post by **Ms Piggy** » Sun Oct 15, 2006 6:20 pm

I was told that some hospitals require one of their departments to check your equipment a few days prior to op. also that it is usual to meet with the anesthesiologist prior to surgery when he will ask you questions and want to know what was given to you, and your response etc, at previous ops - it seems to be unlikely that you will be able to get a report from him afterwards but he will want to know any info you have regarding any previous ops., so it's worth asking can you have a report from him after, regarding problems or lack of same. ask Your surgeon regarding an appointment to meet with him.
The correct proceedure in some places is that your equipment is to go into the op theatre with you, in case it's needed. I was told by my sleep Dr. that I was to use my equipment prior to surger if I was sedated prior to and, of course, to use it afterwards, if it's not on when you wake up insist you get it immediatley.
It does add a little more stress to the whole experience I found, but don't worry. best wishes.

Ms Piggy · Post by **Ms Piggy** » Sun Oct 15, 2006 6:24 pm

I was told that some hospitals require one of their departments to check your equipment a few days prior to op. also that it is usual to meet with the anesthesiologist prior to surgery when he will ask you questions and want to know what was given to you, and your response etc, at previous ops - it seems to be unlikely that you will be able to get a report from him afterwards but he will want to know any info you have regarding any previous ops., so it's worth asking can you have a report from him after, regarding problems or lack of same. ask Your surgeon regarding an appointment to meet with him.
The correct proceedure in some places is that your equipment is to go into the op theatre with you, in case it's needed. I was told by my sleep Dr. that I was to use my equipment prior to surger if I was sedated prior to and, of course, to use it afterwards, if it's not on when you wake up insist you get it immediatley. I would try to take as little pain meds as possible once you get home, they have you up and galloping round the halls as soon as they can, in a day or two.
It does add a little more stress to the whole experience I found, but don't worry. best wishes.

NightHawkeye · Post by **NightHawkeye** » Sun Oct 15, 2006 6:50 pm

SleeplessinBradenton wrote:Should I be concerned about the apnea issue?

YES!!! The first thing you need to know is that apnea is not a problem during surgery but it is a serious problem during recovery. A number of apnea patients have died during recovery because they were still drugged, their survival instincts to breathe did not kick in, they were not on their CPAP's, and no one was monitoring them.

Anesthesiologists, after losing a few CPAP patients, have apparently taken all of this to heart, so you should be in good hands while the anesthesiologists are watching over you. Sadly, the same cannot be said for the rest of the medical community.

You need to make sure that you are put on CPAP immediately after your intubation tube is removed, and that a relative or close friend is with you at all times after surgery until you are awake and fully alert again. Depend on your health care practitioners to do this only if you're unconcerned about living through the experience.

SleeplessinBradenton wrote:Can I/should I take my own CPAP machine to the hospital with me? I will be inpatient for approx. 2 days. I think that I should....

YES!!!

Best of luck with your surgery, SleeplessinBradenton.

Regards,
Bill

Bamalady · Post by **Bamalady** » Sun Oct 15, 2006 7:16 pm

Birdshell...... I had to laugh at your list, and it's true! And here I thought my purse was heavy because of the change that accumalates.

Maybe I'm missing something here, but it seems that it would be such a simple thing to make sure that a person with a diagnosis of Sleep Apnea had their machine with them the entire time they were out as Jim did. Why do it any other way? Less stress on the person and less monitoring by staff seems a good thing to me. I just wonder what happens if a person has problems during surgery?

Having Major Surgery...Have Questions

Having Major Surgery...Have Questions

Xpap and surgery

Surgery

Re: Having Major Surgery...Have Questions