Undiagnosed OSA

[pemoha]

My father probably has had sleep apnea all his life, he is now 79 yrs old. Three years ago he was hospitalized with a light stroke and confusion he was then diagnosed with sleep apnea. It was found he had a heart murmur, copd and chf. He was put on cpap, never could get used to air blowing in his face. He was sent to rehab hospital for therapy and to get him used to cpap, he refused to use it. He is now in the hospital , he fell out out bed Monday, we could not wake him up, we had to call the paramedics.
The confusion has worsen and the dr told him that he has to get on the cpap, it is a must, if he wants to live. I stayed at the hospital with him lastnight and the respiratory therapist put him on bipap. I made sure it stayed on him allnight. He had most of the night periods of quiet sleep with the bipap. My cousin is with him tonight to give me some rest and I told him not to let him take that mask off. My father is so set in his ways and I doubt he will use the cpap when he gets home but if I have anything to do with it if I have to stay up all night, make sure he used it.

[JimH]

How did your Dad feel the next morning after sleeping with the Bipap? Hopefully he may have noticed a difference. It's hard to get people of older ages to sleep with a machine. I hope he slept well with it tonight. Good luck!!

[sleepy gal]

It's encouraging that he slept well in the hospital while you were there. Hopefully he will feel the difference himself and continue to use it ( with support and encouragement from you and other family members). Support from the doc and an RT would probably be really helpful as well.

Good luck.

[pemoha]

Thanks for all the support. The doctors don't want to have to intubate him and put him on the respirator, so they are trying the bipap for a few days, while they do tests for high c02 in his blood. They had to restrain his hands so he wouldn't take the mask off.

[Barb (Seattle)]

I have a question. Did he have any type of wish about medical care, or a Living will, etc?

[pemoha]

Yes, that all have been taken care of. Why do you ask?

[Barb (Seattle)]

Yes, that all have been taken care of. Why do you ask?

well....you say he was confused and a little obstinate about CPAP, so I thought maybe he will get to a point that he wouldn't want medical care is all. Hope all is going well now {{{hugs}}}}

[Janelle]

Since the mask is probably the biggest effect on compliance with CPAP why wasn't he given the option of different masks, like a nasal pillow that wouldn't blow air on his face!??? I can tell you from being on this forum for the last 8 months that if that mask is uncomfortable, causes sores on his nose or forehead from being improperly fitted or leaks all the time or hurts anywhere else, he DEFINITELY will not use it when he gets home. Who would?

[pemoha]

In the hospital, they don't have nasal pillows. Plus he is a chronic mouth breather. They give I guess you would call it the institutional nasal mask by Respronics, it looks like the comfort classic but its not. I was thinking when he gets home, i would get him the comfort curve.

[IllinoisRRT]

I am just speaking from experience on this, so bear with me...
BiPAPs in the hospital are very likely to be different from BiPAPs as discussed here. In the hospital realm, "BiPAP" has a backup rate- it is considered noninvasive ventilation. This is usually something last-ditch before intubation, and often used instead of intubation for someone who has a DNR order (although I always had issues with that because it does have a backup rate, but that's besides the point). If he's on it now and they're monitoring his CO2 levels, it is likely that he is on it for respiratory failure. That's a whole different ballgame. I think it's great that he has family to stay with him through the night. Is he receiving supplemental oxygen as well?
When I worked at a hospital we also had very generic masks, but I'm surprised they don't even have a full face mask to give him- would that make things worse? We didn't have lots of different styles of masks, but we did have nasal and full face, as well as chinstraps.
I hope that everything goes well, feel free to PM me if you have any questions.

[Sleepless on LI]

Christine:

I wanted to say hello, first, and tell you how impressed I was at your knowledge in the field.
Secondly, my son just graduated with his BS, did a pre-med course of study, but majored in RT. He just passed his licensing exam and is now an official Licensed Respiratory Therapy Technician (as the Office of Professions called it on his license) and will soon be taking the exam to become a RRT. He went to SUNY Stony Brook University here in NY and got a job with Stony Brook University Hopt. He starts his training tomorrow for two days in the hospital where he'll be working and then he starts on his 3-day-a-week, 12-hour-a-day shift. They said the first two weeks, he will be observing, although he did two years of clinicals and took so well to it that the RRTs and doctors in the hopt. told him when he was a junior that he technically didn't need the next year, he did so well.
In any event, he has decided to give Respiratory Therapy a try first, before decides if he wants to take the MCATs to do Anesthesiology.
Any advice before he embarks on this journey tomorrow?

[IllinoisRRT]

Pemoha,

How are things going with your dad?

[pemoha]

Thanks for asking. He has left the hospital and is spending a couple of weeks in a rehab facility before he comes home. They have him on the cpap and the oxygen level has come up. I realize that it may not last, from your previous post. It's my dad and I have to have hope.