Surgery/Anesthesiologist comments/death of nurse

[Vallan]

I wanted to make a few comments and share some things I learned today. First I'm on day 7 of therapy I think. I've had some 13-14 AHI numbers, and decided to bump up my min and max pressure. (from 10 - 13 to 10.6 - 13.4). I'm guessing that is why I had AHI's 0f .3 on day 5 and day 6. [sure, everyone should be given dumb machines so they have no clue. I'm also so impressed with my required 10 min followup appt with the sleep doc where he has no data so we can talk about how I'm doing and he can use my compliance date to provide me with valuable insight. ok..rant off]

What I wanted to share with this wonderful community is the following:
1) I had surgery today, took my cpap with me. No probs, everyone was great and they gave me a special wrist band that said apnea. My Anesthesiologist told my wife "he was difficult to intubate. If you let us know in advance next time, we can be ready for that". My sleep doc said I had a narrow throat. Maybe others with OSA have the same problem, so it might be worth mentioning.

2) My recovery nurse told me to be sure and get my CPAP machine on as soon as I was in bed. She worked with a nurse that died at home after her surgery because she didn't have her machine on, and she knew better. WOW! I got mine all set up when I got home and was waiting for my wife to get back with my hydrocone. The morphine shot I got at the hospital was wearing off, and I started to drift off waiting for her to get back. Not good. So if you have to be on pain meds or muscle relaxers, please be very careful and get masked up before you pass out! I bumped my autoset up so my min was my cpap fixed pressure from sleep study and max was top end of my prescription, so 12 - 15. I'll be leaving it there as long as I'm on the meds.

Take care fellow hosers and merry christmas.

[PST]

1) I had surgery today, took my cpap with me. No probs, everyone was great and they gave me a special wrist band that said apnea. My Anesthesiologist told my wife "he was difficult to intubate. If you let us know in advance next time, we can be ready for that". My sleep doc said I had a narrow throat. Maybe others with OSA have the same problem, so it might be worth mentioning.

This is a factor that is sometimes overlooked in discussions of OSA and surgery. The airway characteristics that incline a person to sleep apnea can also cause difficulty inserting an endotracheal tube for general anesthesia. If the anesthesiologist and surgeon know about OSA in advance, they can consider that in planning the type of anesthesia to use, and if a general is still the best plan, prepare for the possibility that intubation will be more difficult than usual. I've reviewed thousands of medical malpractice claim files over the years, and I cannot recall ever seeing a case in which the failure to use CPAP after surgery caused a serious injury (not that this isn't a possibility to be guarded against). What I do see a couple of times a year are injuries caused by unsuccessful or traumatic intubations, and often in these cases one allegation is that OSA should have tipped the doctors off to the potential for difficulty. As Vallan's anesthesiologist said, it's best to inform the medical team in advance, not just on the day of surgery.

[ozij]

it's best to inform the medical team in advance, not just on the day of surgery.

Worth repeating. And repeating again.

O.

[gasp]

Vallan, this did bring up something I hadn't thought of before. My husband should know how to put my headgear on me and seat the mask. What if I was injured and couldn't do it for myself or was in the hospital? Thanks for the post.