Anesthesia and sleep apnea

Margaretm wrote:If this is off topic, please forgive me and maybe someone can direct me as to where I can ask.

I have been using a BiPAP for going on six years now, use it every night (can't sleep without it if power is out) and according to the sleep clinic, it's working. I am faced with the situation of possibly needing surgery in the next few months. I have to have a minor procedure under anesthesia/sedation and if the biopsy is positive, will need major surgery (hysterectomy).

I have heard, and my gyn confirmed it, that sleep apnea patients are at higher risk with anesthesia. He said if I have to have the surgery, it will be a difficult one and that the risk is considerably higher with sleep apnea.

Your GYN is full of crap.

When you're under for surgery, you'll be intubated, (tube down your throat) so you *can't* have apnea... plus, you'll be on a respirator.

When you come out, you'll either be using your machine, or the anesthesiologist will stick a 'nasal trumpet' up your nose into your airway to keep it open while you're in recovery (that's what they did to me last summer when I went under general anesthesia.

Just tell your gas passer about your condition ahead of time, it's nothing he won't have experienced.

However, if you REALLY want special attention: https://www.youtube.com/watch?v=fE2KDzZaxvE&t=10m57s

Margaretm wrote:If this is off topic, please forgive me and maybe someone can direct me as to where I can ask.

I have been using a BiPAP for going on six years now, use it every night (can't sleep without it if power is out) and according to the sleep clinic, it's working. I am faced with the situation of possibly needing surgery in the next few months. I have to have a minor procedure under anesthesia/sedation and if the biopsy is positive, will need major surgery (hysterectomy).

I have heard, and my gyn confirmed it, that sleep apnea patients are at higher risk with anesthesia. He said if I have to have the surgery, it will be a difficult one and that the risk is considerably higher with sleep apnea. This has me scared out of my wits, to the point of not even wanting to do the biopsy. (I am also diabetic, adding more risk) Is there anyone here who has had surgery and how did it go?

Margaret

For a minor office procedure I had with propofal, I was fine. Piece of cake and no apnea-related issues.

With a short outpatient hospital surgery that required anesthesia, no problems while under, but some problems in recovery. I'd doze off, stop breathing, and they had to keep waking me up, but then I'd doze back off again. But it wasn't that long until I was able to stay awake. So for this you might want to ask if you can bring your machine just in case. I know it's a short time as an outpatient, but it might be something to consider. This procedure was a gynecological biopsy, which sounds like what you are supposed to have.

Due the the results of the biopsy--precancerous cells--I had to have a hysterectomy. I made sure everybody, and I mean everybody, knew about my sleep apnea. At the hospital I was in, they provide the machine and the patient provides the mask. No problems in surgery...but major problems in recovery. They could not keep me awake but for a few seconds before I'd go back to sleep, at which point I stopped breathing. After a while of that, they put me on CPAP. That didn't help much, so then they switched me to BiPAP, which I'd never been on before. After a while, that helped enough that they were able to move me to a room. (Mind you, I don't remember ANY of this. Only what I was told later and what the hospital records indicate.) I ended up on the cardiac floor (or something like that) as opposed to the floor you would normally go on after a hysterectomy because of my breathing issues. Stayed on BiPAP the rest of my time there, which was only one overnight stay, plus oxygen until the next day. (Reading the hospital and nurses notes on this was very interesting to say the least. I always request a copy of my medical records from tests and surgeries.)

I don't say all of this to scare you, but to make sure you're prepared. I believe with most general anesthesia you will have a tube down your throat. So it can't collapse and cause an apnea. From my own experience, recovery is where problems might occur, so especially if you end up having the major surgery, make sure EVERYONE that will be involved knows about your apnea and that a machine is ready for you in recovery if needed there.

For my hysterectomy, the type of surgical procedure my doctor used--robotic-assisted (De Vinci)--it was not a huge deal. Not a piece of cake, but not a huge deal either. There are several different ways the surgery can be done. I hope you don't have to have it, but if biopsy results indicate a need, then please get it done. For me at least, walking around with the symptoms I was having plus never knowing if my pre-cancer would turn into cancer was something I was not going to do.

Margaretm,

When I had a septoplasty in 2015, I was scared to death about mishaps. I met with an anesthesiology resident ahead of time to discuss my concerns and she was very reassuring. To make a long story short, I sailed through the surgery and woke up very quickly in the recovery room without even being put on the machine.

You'll do fine.

49er

PS - I realize your surgery is alot more major than what I had. But my point is I worried needlessly about what could go wrong.

TASmart wrote: I was anesthetized less than 1 year ago and I came out fine.

Same here. I told all the medical staff that I had sleep apnea and they assured me they would monitor my breathing and I would be fine. They were right.

xxyzx wrote:
1 in 5000 dies from the anesthesia

100% of SA patients will die (eventually)even if they use a CPAP.

xxyzx wrote:

TASmart wrote:Xenophobic too. IS it your contention that the ability to speak english is required to practice medicine? Here or there or anywhere? But I have never encountered any Dr. while here in the US that did not speak English at a passible level. I wish college professors were held to the same standard.

======

more libtard insults and lies from one of the bullies

logical not xeroanything

i speak english
the doctor and i need to communicate perfectly not passibly

any doctor who has trouble with the language is dangerous to patients

english is supposed to be required to practice in the usa to get a license
but that is reading and writing not speaking and hearing which is harder

I have seen no evidence on this forum, nor others you have been banned from, that you can communicate perfectly in English nor any other language. By the way, injecting foreign language comments into a conversation in English is not the basis for clear communication either.

What is the English competency requirement in the Medical Licensing Exam? You can quote the actual chapter and verse for clarity.

TASmart wrote:What is the English competency requirement in the Medical Licensing Exam? You can quote the actual chapter and verse for clarity.

I googled and can't find such a requirement. That's because there is no such requirement. Now, if someone actually finds such a requirement, please post.

I am not a doctor, but I have worked in the medical field for over 30 years. Trust me when medical facilities take sleep apnea VERY seriously. They should specifically ask you if you have sleep apnea. There should be a questionnaire that you fill out before hand and I have never worked anywhere where anesthesia was going to be used where the anesthesiologist does not meet with you before hand. Even if you have filled out a questionnaire REMIND YOUR MEDICAL TEAM that you have sleep apnea! Trust me, they are VERY careful! I have had numerous surgeries--a lot in the past year for eyes and cancer, and they have specific forms that go in your chart that address sleep apnea. They put a alert sticker on your chart.

Please don't postpone needed surgery because of having sleep apnea. You have a medical team standing right there with you who knows how to do surgery on people who have sleep apnea. Think of the high percentage of people who have sleep apnea. They have dealt with thousands.

I have faith you will be ok!

XXYZX,

You are new here since the last time I was here regularly. I saw warnings about you from people I know and trust. I chose to judge you on my own observed actions.

The ONLY thing you said which was worthwhile was "Make sure you meet the anesthesist before you go to the hospital"

Your comments about death rates, and money-making were not only unnecessary, they were cruel. The original poster is worried and needing information to make appropriate decisions. She does not need stupid, vicious, panic-mongering.

What the original poster needs is a concrete plan. She should:

1. Talk with both surgeon and anesthetist about her concerns.

2. Make sure both surgeon and anesthetist understand about her need for her machine. Her surgeon should write this, along with her prescription information into the orders for her surgery. The orders should include a requirement that there will be a machine available in Recovery for her, as well as her own machine (which a family member may need to bring and set up) for the remainder of her stay. Depending on hospital regulations, they might require her to use a hospital-provided machine while she is there, in which case, her family member can take hers home and set it up to be ready for her return.

3. To accomplish part of #2 above, she needs to be sure a family member knows how to take apart and set up her machine for her. She can pack her machine herself before going to the hospital, but it's always worthwhile for someone else to know how. And she may not be awake enough when she is brought up to her hospital room to set it up, and make sure she gets her mask on. In special situations, it is wise for one to have a fully-informed family member to advocate for one.

4. Make sure the family member can assist her in getting the machine taken apart and packed upon her departure for home. I would recommend clean filters to go to the hospital, and another set of clean filters when she comes home.

How do I know what kind of a plan is needed? Because I have been in the original poster's shoes.

I'm a cancer survivor. Cancer changes a person in ways no one who hasn't been there can fully understand. It is a terrifying experience.

It was the more terrifying for me because the only time I had had general anesthesia prior to that went badly. I did not know enough to advocate on my own behalf in advance. What was supposed to be same day surgery resulted in four days in the hospital, with me unable to wake up, unable to stand up.

Going into the second surgery, I was beyond terrified. A minor surgery came close to costing me my life. I was facing a major surgery, which my surgeon admitted was complex. At that time, it was not known that I had apnea. The original poster has an advantage here: her issue IS known.

My life depended on the surgery. The cancer I had has a high cure rate if caught early. If it is not caught early, it can spread. There was no time for me to dither about my fears.

I met with the anesthetist. I explained my concerns. We went over procedures, and he stated that he appreciated my bringing them to his attention, as there were a number of things he could do to make matters safer for me.

I came through the surgery with no issues.

And the reason I came through was because I was pro-active on my own behalf. I was out of bed in half the time of the previous minor surgery. I healed well, and I am now coming up on five years cancer-free, that is, the five years required to be declared cancer free, plus an additional almost five years.

Six months after the surgery, I was diagnosed with apnea. Clearly, both my surgeon and my anesthetist knew what they were doing, and were completely able to handle it. BECAUSE I brought my previous issues to their attention.

So ALL the original poster needs is a concrete plan of action, and appropriate information on which to base that plan. Your blathering and declarations against anesthesia could cause her to hesitate. That delay could cost her her life.

And that, Mr. XXYZX, is beyond unconscionable.

Actions such as yours cost a dear friend her life.

I do not wish ill on anyone. However, if that which you do results in ultimate good for those with whom you interact, then do I wish the same for you. But if your actions are out of spite, malice, prejudice, or stupidity, then do I hope that you will receive the same in return, in three times threefold measure.

In some hospitals/offices in some countries, the anesthesiologist/anesthetist is/are assigned the day of, on rotation--so having a chat just before may be fine. The place may be run like an assembly line, but it may be difficult for them to predict who will be needed where and for how long that day in order to make that assignment in advance.

In my case, before a minor procedure, I simply asked him to write down that I had OSA and that 10 cm H2O ought to be enough to keep my airway open in all stages of sleep. I then added, "I know you don't need that information for during the procedure itself, but could you please make sure you put that information where it wouldn't get missed by anyone, in case something rare goes wrong and I'm out for a few days?" He took that opportunity to explain to staff why I had worded things the way that I did. Hearing him restate it in agreement with my wording gave me more confidence in his understanding of the sleep-breathing condition.

xxyzx wrote: everything i posted was useful information.

No. It was not.

Deliberately posting information which is frightening is NOT helpful.

May you receive what you deserve.

jnk... wrote:In some hospitals/offices in some countries, the anesthesiologist/anesthetist is/are assigned the day of, on rotation--so having a chat just before may be fine. The place may be run like an assembly line, but it may be difficult for them to predict who will be needed where and for how long that day in order to make that assignment in advance.

In my case, before a minor procedure, I simply asked him to write down that I had OSA and that 10 cm H2O ought to be enough to keep my airway open in all stages of sleep. I then added, "I know you don't need that information for during the procedure itself, but could you please make sure you put that information where it wouldn't get missed by anyone, in case something rare goes wrong and I'm out for a few days?" He took that opportunity to explain to staff why I had worded things the way that I did. Hearing him restate it in agreement with my wording gave me more confidence in his understanding of the sleep-breathing condition.

JNK,

That's a really good way to word it.

And, if the anesthetist repeats it back to you in slightly different phrasing shows that s/he did understand what you said, and knows how to handle it.

Definitely confidence-building.

Thank you for the responses. Most of you have been very reassuring, one response is troubling. Someone mentioned Propofol. That is what they use here, according to my gyn. The Michael Jackson drug. (he said he doesn't know why on earth that dr used propofol on MJ)

According to the literature I was given to read, I will have to attend a pre-op clinic no more than 3 months before the procedure. I have done this numerous times in the past (before my apnea diagnosis but I probably had it back then) and always met with an anesthetist (though not usually the one I'd have for the surgery). I did have to fill out a questionnaire about medical issues/history and it asked about apnea. The literature said to bring my machine to the hospital, I assumed it meant for people who were to be admitted after but will ask at the pre op clinic, especially since it might be difficult to do. (I don't have anyone to bring it in for me)

Kiralyn, thank you so much for all your suggestions and for your long post. I'm so glad you beat your cancer!

I have to stop typing now as my hands are sore. (CT, arthritis and trigger finger in 2 fingers) I wanted to address everyone who replied, but I just can't. I do appreciate all your suggestions and words of advice and encouragement.

Margaret

Once I had discussed my concerns with the anesthesiologist, there were no problems.
The only glitch was that the hospital I was in put me on a diet for T1 diabetics (very high carbs),
--even though I had INSISTED on a low carb diet, which I need to keep my T2 blood sugars in a healthy range.
Knuckleheads! Never going back to that stupid hospital!

Aspirin can kill you too... it depends how you take which dosage, how often you do it, with what other meds, etc. etc. Propofol is used all the time for day surg procedures all over. M. Jackson's MD was criminal in that he allowed Michael to take (or gave him) amounts not prescribed at all for ... sleep(!) on top of who knows what else or how much, but please don't let it worry you re regular hospital monitored work. They shouldn't have named the med in the media as it needlessly scared so many people. Just dumb.