Anesthesia Issues/3-6 Turbinate Red./Septoplasty Surgery

[49er]

Due to having concerns about anesthesia for various reasons, I had decided to seek an anesthesia consult before my my surgery and spoke with the head guy yesterday. I will be calling him again and will insist on a meeting even though he won't be happy.

One thing he said was that cpap isn't used in the recovery room. Unfortunately, because of my cognitive issues, I didn't follow up on that.

But it seems to me that if my ENT has no objection to my wearing an oral mask which would bypass the surgery site (and I realize he may), that simply doesn't make sense in light of my severe apnea. This guy acted like I was being a worry wort but isn't the greatest danger in the recovery room after the surgery when you have sleep apnea?

And just so folks know, I did ask him if I needed to talk to someone else about these issues or if I should discuss them with him. It seemed he didn't want to answer my questions and acted as though I should trust him because they have handled lots of apnea cases. Hmm.

He explained that if I had trouble breathing, I would be given O2. They could also tilt back my airway and use a bite block.

Are family members allowed in the recovery room as I would feel alot better if mine was there to monitor the situation? I know I would have to contact the surgery center but I am curious.

Would appreciate any comments on this.

The other issue is he said that my ENT allows MAC sedation which seems less risky to me. But he said that if my airway can't be secured, it wouldn't be an option. That is why I want to meet with him so he can make the determination. Sorry, I am not waiting until the day of the surgery to find out.

If anyone has had experience with this type of sedation, I would love your input in addition to what the anesthesiologist said about recovery room procedures.

And for folks who are wondering why I am pursuing this ahead of time, because of my cognitive issues that interfere with my being able to process information quickly, I don't want to be dealing with this on the day of my surgery when I am in already weakened state. Unfortunately, people perceive this as anxiety which isn't totally inaccurate but that is kind of misleading because of my need to have the information ahead of time so I can process what has been said and followup if necessary.

Thanks in advance for your help.

49er

PS - I seen the ENT on 2/25 for a preop appointment.

[Gparr]

I have had turbinate reduction surgery...and polyp surgery...and septoplasty surgery...as well as having my frontal sinus opened and cleaned. all 4 were done at the same time.

This was pre OSA diagnosis. I did not have any breathing issues (BTW I am considered moderate OSA) and as soon as I was coherent enough to ask for my wife, she was by my side from then on...and she said there were no issues.

On a side note...as much of a PITA it was to do all 4 procedures together...I can't believe how much better I could breath...smell and taste again.

Good luck...you will be fine!!!

[49er]

I have had turbinate reduction surgery...and polyp surgery...and septoplasty surgery...as well as having my frontal sinus opened and cleaned. all 4 were done at the same time.

This was pre OSA diagnosis. I did not have any breathing issues (BTW I am considered moderate OSA) and as soon as I was coherent enough to ask for my wife, she was by my side from then on...and she said there were no issues.

On a side note...as much of a PITA it was to do all 4 procedures together...I can't believe how much better I could breath...smell and taste again.

Good luck...you will be fine!!!

Thanks Gparr, that is reassuring. I am so glad the surgery helped you.

I don't want to get my hopes up but I so hope I can smell again. It is frustrating to not be able to.

Of course, the main goal is to be able to tolerate pap therapy. Any other benefits would simply be an unexpected surprise.

[Pugsy]

Family members aren't allowed in the recovery room...never have been as far as I know. There's just too much going on and they don't want family members in the way.

You know I had the MAC sedation with some sort of nerve block when they did surgery on my broken wrist. I had to sign a consent for general anesthesia "just in case" an open reduction with plates instead of just closed with pins was needed.
It wasn't needed. I was told the same thing..in recovery room you will be monitored very closely...this was with either anesthesia...and if the O2 levels drop they would take care of it.
The guy told me if all I needed was MAC then I probably wouldn't even need my machine in my room afterwards but to bring it just in case and have a family member know how to set it up just in case I ended up with general anesthesia and wanted to sleep more in my room. He said with MAC sedation I probably wouldn't be all that sleepy and he was right.

You won't be in the official recovery room all that long. You will be in better hands there anyway. An hour there, even with the drugs without cpap, is probably much safer than at home without the mask because it got removed prematurely.

[Gparr]

Pugsy...in the hospital that is correct...however I was in an out patient surgery center and they welcome family members in recovery...at least where I was.

[HerbM]

I have been in recovery rooms with my wife in both hospitals and surgical hospitals.

It was never a big deal. Sometimes not right from the first minute, but they usually call me when they get her to the recovery room and initial procedures completed.

Usually I get there before she is fully awake.

It of course depends on the surgical facility and the doctor(s) involved.

You can always ask.

[Pugsy]

My wrist surgery was in an out patient facility...no family members allowed in recovery room. They had to wait in my little "room" where I went to after I left recovery room.
I suspect that this option is likely up to facility to set protocols...since some people have got to go into recovery rooms.
So it looks like some will allow and some won't...and it's up to facility.

[49er]

Thanks everyone, I will definitely ask about the family member being allowed in.

And Pugsy, it is good to know that MAC is a possibility for me. And not being sleepy afterwards greatly appeals to me. I sure hope this will be allowed.

49er

[teleute]

Very interesting....never heard of MAC anesthesia before. Pugsy, what was it like? Did you feel conscious/awake? Do you remember much? I have had one septoplasty and am on the list for another (first one didn't quite "take" fully for some reason...they're also going to pair it with a turbinate reduction this time, which they didn't do last time), and am quite curious about this option.

Also, I don't use CPAP or have apnea myself (I'm here for helping out my husband...) - however, with everything I've learned, I've been very tempted to get my doc to let me rent a CPAP machine for a couple of weeks post-surgery and use an oral mask. I was *miserable* after my last surgery, since where I live is so dry. My nose was too blocked to breathe, obviously, and even with a humidifier in my room I'd wake up every 10-20 minutes with the inside of my mouth so dry I'd have to peel my tongue off the roof of my mouth - it actual got raw from all the skin I was losing. It was awful. The pain from the surgery itself wasn't bad, but I just slept so miserably that I had a much worse time than usual recovering. So yeah...the thought of something delivering humidified air directly to my mouth while sleeping sounds brilliant.

Sorry I don't have much to add here - I'm just very interested to hear about the anesthesia, and how the oral mask works for you post-surgery! Best of luck getting everything sorted out.

[49er]

Very interesting....never heard of MAC anesthesia before. Pugsy, what was it like? Did you feel conscious/awake? Do you remember much? I have had one septoplasty and am on the list for another (first one didn't quite "take" fully for some reason...they're also going to pair it with a turbinate reduction this time, which they didn't do last time), and am quite curious about this option.

Also, I don't use CPAP or have apnea myself (I'm here for helping out my husband...) - however, with everything I've learned, I've been very tempted to get my doc to let me rent a CPAP machine for a couple of weeks post-surgery and use an oral mask. I was *miserable* after my last surgery, since where I live is so dry. My nose was too blocked to breathe, obviously, and even with a humidifier in my room I'd wake up every 10-20 minutes with the inside of my mouth so dry I'd have to peel my tongue off the roof of my mouth - it actual got raw from all the skin I was losing. It was awful. The pain from the surgery itself wasn't bad, but I just slept so miserably that I had a much worse time than usual recovering. So yeah...the thought of something delivering humidified air directly to my mouth while sleeping sounds brilliant.

Sorry I don't have much to add here - I'm just very interested to hear about the anesthesia, and how the oral mask works for you post-surgery! Best of luck getting everything sorted out.

Thanks and best of luck to you too. Sorry your initial surgery didn't take. How frustrating.

If everyone agrees MAC anesthesia is the best option for me, I will definitely give a report. By the way, I had never heard of it either until the anesthesiologist mentioned it as a possibility.

Since my splints will be in for a week, that is why I am looking at the oral mask as an option. Interestingly, the thought of using it without surgery was not appealing. But somehow, knowing I won't be able to breath through my nose for a week sheds a whole different light on the situation:) I will certainly report on its usage if I go through with this.

It would definitely be worth you trying to rent a machine and use the oral mask. Ugh, waking up every 20 minutes, that doesn't sound like much fun.

49er

[teleute]

Awesome - I appreciate it!

[Pugsy]

Very interesting....never heard of MAC anesthesia before. Pugsy, what was it like? Did you feel conscious/awake? Do you remember much?

We always called it the "I don't care what you do to me" drug. It's actually a mixture of some stuff followed up with a good amnesiac drug so you forget anything unpleasant that might have occurred.

I was awake but I don't remember it.
The doc started with just a little...gets me relaxed and then told me "here's a little more and then I am going to do the nerve block"...the nerve block was a big needle deep in my shoulder area to essentially numb the whole arm... so I was awake for the nerve block part of things as I remember him doing it and remember thinking..."that didn't hurt at all".
So we wait a little bit and my arm starts to gain weight till it weighs about 100 pounds. which by the way lasted about 36 hours.
Then after it was good and numb and they were ready for me in the OR...the doc says.."okay, now a little more of the "I don't care what you do to me drug"...and that's all I remember but I was awake for the entire procedure.
The surgeon told me I spent the entire time talking to him and trying to get him to tell my husband that I would still be able to mow the yard on the riding lawn mower. He told me for some reason I was particularly fixated on mowing the yard...which for me is about 5 acres . He couldn't understand why mowing the yard was so important to a woman.

So I was awake for the entire procedure... I know I was but I remember nothing...I got a good dose of the amnesiac drug at the end of things I suppose.

It's not unlike what they give you for a colonoscopy or endoscopy...you aren't really asleep but you think you were because you don't remember anything and assume asleep....not the case...it's the drugs that make you think you were asleep.

Years ago we when I worked in the hospital and we would do procedures using those types of drugs...if the people knew what all they talked about under the influence...they would move out of state. And if you asked them about it afterwards....they would say it was a piece of cake and they slept through the whole thing and not for one minute were they actually asleep.

[teleute]

Hmmm....that actually dims my enthusiasm for it a bit. Thanks, though. Fascinating stuff!

[Rustsmith]

I went through a minor procedure at an outpatient surgery facility this week. They had my wife with me in the recovery room before I "woke" up. I know this because she told me. The amnesia effect of the medication wiped my mind for about 10 minutes after I regained consciousness (she tells me). All I know is that the first thing I remember was that I was completely dressed and the nurse asked me if I was ready to get out of bed to go.

As for the apnea part, I discussed this with the anesthesiologist prior to the procedure. He attended me during the procedure and I know (from others before I went in) that a nurse attended each patient (1 on 1) following the procedure until the patient was discharged. Since apnea was a potential side effect of the drug they used on me, they had an ECG, oxygen monitor and had me breathing oxygen during the procedure. I can therefore only assume that all that went well since at this point, I don't know anything more about it than what I am told.

[49er]

Family members aren't allowed in the recovery room...never have been as far as I know. There's just too much going on and they don't want family members in the way.

You know I had the MAC sedation with some sort of nerve block when they did surgery on my broken wrist. I had to sign a consent for general anesthesia "just in case" an open reduction with plates instead of just closed with pins was needed.
It wasn't needed. I was told the same thing..in recovery room you will be monitored very closely...this was with either anesthesia...and if the O2 levels drop they would take care of it.
The guy told me if all I needed was MAC then I probably wouldn't even need my machine in my room afterwards but to bring it just in case and have a family member know how to set it up just in case I ended up with general anesthesia and wanted to sleep more in my room. He said with MAC sedation I probably wouldn't be all that sleepy and he was right.

You won't be in the official recovery room all that long. You will be in better hands there anyway. An hour there, even with the drugs without cpap, is probably much safer than at home without the mask because it got removed prematurely.

Pugsy,

Regarding MAC, how did they protect the airway which I have read can be an issue with someone with apnea since you are supposedly breathing on your own unlike with general anesthesia?

49er