recent heart cath and use of bipap

[girlsaylor]

Hi all,

I know I haven't been on much, but maybe this info will be helpful to those with OSA.

Recently I had a cardiac cath, which turned out fine. The hospital experience was very good too. My doc and his staff were fully aware of my OSA plus arthritis and fibromyalgia. So, breathing support and pain medication post-cath were high priority. I brought my bipap machine to the hospital as instructed. However, it was not allowed in the cardiac cath lab. The anesthesiologist refused to begin until the hospital's respiratory person arrived and hooked me up to the hospital's bipap. The doc decided on conscious sedation, and everything went perfectly. Due to the entry into the artery in the groin and manipulation of instruments, that area had to be protected so it wouldn't re-bleed, so I was flat on my back for 8 hours. The nurses made sure I had my bipap at bedside in my room immediately. They were allowed to plug it in, but not allowed to set it up, per hospital regs. I set it up fine, as my nurse handed each item to me as I requested, and she placed it on the bedside table, handed me my mask and I was good to go. The issue of being immobile was a tough one, although I was permitted most all of my medications prior to the procedure early in the morning, including my pain meds for Fibro and Arthritis. I did have a period when they had to give me some pain meds (groin area very tender), and my doc had slipped up on that one. The cardiac cath patients have standing orders for all manner of narcotic pain relievers, however, I am allergic to everything they had standing orders for. My nurse put in a call to my doc, and I had to wait, in pain. Argh. But then my physician's nurse assistant came down the hall, was hailed down, and immediately arranged the order for Toradol, which is rarely used. The wait was worth it, as I was soon much more comfortable. I was irritated that anybody should have to wait for pain medication under these circumstances, and I'll be sure to fill out my hospital survey noting that one.

But all in all, the staff was totally knowledgeable and prepared for the need for extra measures for my OSA. Hope this is reassuring for others who may someday find themselves in the hospital. The one thing I would stress is to have a strong person with you as an advocate. I would not have been in pain for so long afterwards had somebody been able to be there to remind the doc that I needed special orders for pain meds. My DH had to go back to work (brand new job), and I have nobody here in town.

girlsaylor

[Pad A Cheek]

Hey Girl Saylor I had wondered where you were off to. I am so glad that although you had to undergo a hospital stay you were taken care of (mostly) well. I am glad that is behind you now and you are on the road to healing. I was glad to hear that they were careful with your OSA needs while you were there. I know more and more the information is getting out that sleep apnea is an important condition to manage for all who have it.


I wish you great sleep and sweet dreams.

Karen

[6PtStar]

I went through that a year ago. It turned into a horable experance. They kept messing thing up and I had to stay flat of my back for 18 hours, also none of my drugs, food or Insulin for the i8 hours. They found one blockage and put in a stint. Did not give me an option as to whether I wanted to do the awake thing while they worked on me. Only had O2 while I was on the slab. I am also alergic to the drug that they give to thicken the blood so I had to lay there until the blood thinner was filtered out of the body. Would not let me have my cpap until I could move around and not disturb the clot. I dozed off twice on my back and my Pulse Rate would drop to 35 and the monitor would scream and wake me up and bring the nurse. My back hurt so bad from laying flat for the 18 hours and the Doc only authorized Tylenoil III which almost did nothing. I found out he authorized Morphine for heart pain and I finally told the nurse my heart was killing me. I did wink at the nurse when she put it in the IV. While the hospital was understanding about the sleep apnea and using my cpap but I really think the Heart Doc does not have a clue. when I was allowed to get up I was allowed to call my wife and she brought my cpap and the nurse helped her hook it up. I could have something to eat but since it was after midnight all the had was a box lunch (2 pc bread, one very thin slice of ham, a squeeze packet of mayonase and a package of bear grams) but the pharmacy was closed so I could not have any insulin. My sugar level the next morning was 212.

I really think many of the speciality Docs do not understand OSA and are making very little effort to learn about it since it is out of their relm of their practice. JMHO!

Sound like your experance was a bit better than mine, congratulations. I am going to have to think long and hard before I go through another one of these.

Jerry

[rested gal]

I really think many of the speciality Docs do not understand OSA and are making very little effort to learn about it since it is out of their relm of their practice.

Amen, amen, AMEN!!! And of all the specialists who OUGHT to be aware of what OSA does to the major organ of their chosen specialty....the heart...cardiologists and cardiac surgeons should certainly be making the effort to get themselves up to speed about Obstructive Sleep Apnea.

EVERY person who has an appointment with a cardiologist or a neurologist should be given an Rx to have an overnight recording pulse oximeter test at home....whether "sleep apnea" is suspected or not. Across the board.

A pulse oxi test for everyone would cost too much?
How about the cost of ICU when that preventable heart attack or stroke happens? How about the cost of recovery and rehab?

DMEs don't have that many pulse oxi's to give out?

Hey, doctors, DMEs, and insurance companies....best get in gear and start looking for OSA NOW. The baby boomers are aging. A tremendous increase in heart attacks and strokes is just around the corner.

Better start screening NOW for OSA.

Family doctors... you, too.

[Slinky]

Glad to hear your heart cath and hospital experience went so well, GirlSaylor. It would seem like it would be more your cardiologist's fault than the hospital's that there was a delay in getting you the proper pain relief tho. I've heard and read that Toradol is an EXCELLENT pain reliever but it is an injectable NSAID and I can't "do" NSAIDs. *sigh*

Boy, Jerry, I sure am sorry that your heart cath experience was so lousy!!! I sure don't blame you for thinking twice about agreeing to another one. I sure would find another cardiologist to do the procedure if I did have to undergo another if I'd gone thru what you did!!!

[kteague]

Girlsaylor,

Good to hear from you. Glad your procedure turned out ok - thanks for the update.

Kathy

[girlsaylor]

I've missed you guys and the support you give. It's been a wild time, but getting a little more settled. I'm trying to help somebody else on another board right now, who needs cpap help. Trying to get that person to come here, where the experts are. I couldn't answer her questions comfortably.

Boy Jerry, I also am so sorry your cath experience was so awful. We just hafta get the word out. Guess to the medical community also, as it's obvious they aren't keeping up.

girlsaylor

[6PtStar]

girlsaylor and slinky, you think that one was bad. That was No.2. I really can't believe I let then do #2. The first one was before I knew I had OSA. Remember I said I was alergic to the drug they used to thicken the blood after it was over. The first one (10 years ago) went well, no blockage that was bad enough to do any thing about. Until in the recovery room they shot me with the thickening agent. I was supposed to go home from the recovery room. I went into defib and heart stopped. I woke up 4 hours later in a hospital room.

Now you know why I LOVE hospitals!

Jerry

[luckylinda]

I've heard and read that Toradol is an EXCELLENT pain reliever but it is an injectable NSAID and I can't "do" NSAIDs. *sigh*

Sorry girlsaylor and 6PtStar about your nasty experiences!

I have become allergic to all NSAIDs and am frightened about any possible surgery in the future. I had to recover from surgery to reattach my Achilles tendon to my heel on Extra Strength Tylenol. I broke out in hives from Vicodin, vomit from codeine.

Slinky, any advice?

[Snoredog]

boy I tell ya, I'd NEVER let them do one of those on me again, the risk is simply too great with all this MRSA running rampant, now a days there are other imaging techniques that are just as effective and much less invasive (color nuclear, ultrafast CT scanning, even ultra sound is improving by leaps and bounds).

I had mine back in 2000, it was $21,000 for that procedure then, can only imagine what it costs today.

Oh they like doing them, they are a BIG money makers for the hospital and doctors, think it was reported last year that procedure was the most unnecessary procedure being performed in modern medicine.

[girlsaylor]

Good points raised. The MRSA thing is very scarey indeed. Unfortunately, some people's body build (top-heavy women, as one example) makes for problems with the non-invasive imaging techniques available. A skewed result, more often than not. In my situation, the cath was the best choice. I agree it shouldn't be performed as often as it is. But sometimes it really gives the information needed much clearer and expediently. I cannot perform the stress test due to the lung problems I have. Never will be able to do that one due to permanent lung damage. Just gotta move on from here. Luckily no MRSA problems (this time)!

girlsaylor

[ksp]

Luckily no MRSA problems (this time)!

girlsaylor

What is MRSA?

[BarryKaraoke]

What is MRSA?

http://en.wikipedia.org/wiki/MRSA

[ksp]

Thanks Barry