Forced CPAP use in hospital?

whatrdreamsmadeof · Post by **whatrdreamsmadeof** » Tue Apr 17, 2007 5:49 pm

First, I wish you great success with your surgery, second, I too am a stomach sleeper and turn my head from side to side all night...that said, it's taken me 2 machines, one out of pocket, 15 masks, and tons of encouragement from the fantastic folks here on the forum. Im almost at the one year mark, and just now getting some greatly need relief. don't misunderstand me, I've got a way to go to get great treatment. Everyone here has guided me and held my hand along the way. I use the breeze dreamseal now, which I love and improves my treatment greatly. Prior to this mask 14 the Breeze nasal was o.k for me. It sounds as if you are putting your face in the pillow, and if that is the case, no mask will be good for you unless there is one I haven't tried or heard about. I use a small pillow I got at Big Lots, it only supports my head from the cheek back. I have claustrophobia, restless leg, and now I have to sleep in a brace that goes from my shoulder to the wrist...........what I'm trying to say is this is no walk in the park, but it gets better......if your willing to put in the work. Please know I feel your pain.........however a few bad falls, car accidents and the possibility of leaving those I love behind pushes me on.
The folks here.....push me on as well, they understand frustration, health issues, whining ( I do my share) and most of all they are compassionate and impart their wealth of knowledge graciously. They care ,and want you to have the best quality of life you can have. If you have been diagnosed with the need for cpap and don't use it your life will get marked worse that I can attest to. One week, one day can very bad for you Ultimately it's up to you, so except the help here and try not to fight this treatment so hard, after all if your drugged out in hospital and can, as a result tolerate the cpap why wouldn't you, just think, by the time you get released you may be adjusted to it,
My intention is not to offend it's to help, you make peace with this life enhancing treatment. I sincerely wish you the best...Ellen:roll:

blarg · Post by **blarg** » Tue Apr 17, 2007 6:00 pm

The feeling you're reading off our posts is a frustration. We'd love to help you with whatever cpap issues you have. Having trouble falling asleep? Too noisy? Feel starved for air?

The frustration is that it's been kinda presented like, "There's nothing anyone can do, it's just rough." when if there are specific issues, we'd honestly and truly love to hear about them so we can help you.

I certainly hope your surgery goes well, and please do keep us posted.

kteague · Post by **kteague** » Tue Apr 17, 2007 8:07 pm

Just like to suggest your ask your doctor for printouts from your card for your personal files. I'm just one of those folks who want to see it for myself.
Kathy

kered · Post by **kered** » Wed Apr 18, 2007 8:27 am

Thank you everyone truely for your concern and the warnings about cpap use and surgery. I actually had a Dr appointment yeaterday for some pre-surgery tests and was asking him about the cpap use and he told me about the importance of cpap use while being medicated for the pain for the days following surgery. So, guess there's not much to discuss with that. Also said I'm going to be in there probably 5-6 days so be prepared for some boredom.

whatrdreamsmadeof wrote: It sounds as if you are putting your face in the pillow, and if that is the case, no mask will be good for you unless there is one I haven't tried or heard about. CPAPopedia Keywords Contained In This Post (Click For Definition): breeze, CPAP

I actually don't bury it, I have my head on the edge and try to hang my node off the edge where this is no longer pillow. The Swift is pretty comfortable except for the fact that the tube tends to start digging in a bit into the mattress where my head lays since it is now off the pillow. That's where the Breeze is better because it doesn't have the long tube across the front, but the pillows are much more uncomfortable and seem to dig into my nose. I'm still seeing if I can adjust it and sleft with it last night with a coule extra pads on the front headrest to prop it out a bit.

And Blarg, my issues? Hmmm, I think they'd run out of space here - lol. Seriously though, besides apnea, I do have big problems just getting to sleep and staying asleep - I believe due to stress. I just don't shut down. I was just upped to Ambien CR 12.5 mg. Was taking Ambien 5 mg and it could still take me 1-2 hours to fall asleep and wake up wide awake hours later. If I don't fall asleep, yes, the noise gets to me as I listen to every breath. After awhile, I can't take it. And probably the other big issue is the comfort with a mask and being a stomach sleeper. I've tried switching to the side some but usually end up on my stomach. And the back is pretty much out. Tried one night and said I wasn't going to turn off my back. With Ambien I finally passed out after about 3 hours - woke up with a back ache, and I have back problems so I think that's definitely out.

Anyway, sorry to ramble. Thanks again everyone for your input.

P.S. I did have my profile filled out but couldn't find my username when I posted and now I noticed this smart board actually must have used my ip address or a cookie or something and said what I posted previously as so I posted under that this time. So I'm Guest111 too.

birdshell · Post by **birdshell** » Wed Apr 18, 2007 10:35 am

First, let's get this out of the way: I am so very sorry for all of your tough times. I don't know if you feel this way, but when I have gotten into those few times when there were a lot of medical issues of WHATEVER kind--it just seemed as if my body had suddenly turned and was working against me. My body betrayed me! This, after all I had done for it through the years!!!

The problem that I am sensing is that this is all just OVERWHELMING. Certainly, there are many of us who have been at that point in our lives, for whatever reason. I know that with my 10-11 surgeries, both inpatient and outpatient, that the whole medical profession was generally helpful and I was very, very thankful to have wonderful people doing their best for me. This was especially crucial when I had complications, although we ALL would have liked to avoid the complications in the first place.

So, if you have a great deal of trust in your doctors and the others who will be caring for you, that should be very reassuring. The small details may be different, but the big and important ones will be properly managed for you by the competent professionals.

Whenever we encounter something so overwhelming in its scope, whatever the area of our lives, we often tend to concentrate on the little things. It reminds me of the 80-20 rule; for so much of our lives, we spend 80% of our lives (our time) on 20% of the things about which we SHOULD be concerned. Is there any chance that this is the case with your CPAP--that it is the 20% portion of the problem, and therefore easier to handle?

If you wish, you may want to schedule an appointment with the anesthesiology department BEFORE your surgery; some hospitals do have a meeting scheduled during the pre-surgery visit, probably depending on the surgical procedure to be performed. However, if you are at all worried you may want to be sure that you see one of the anesthesiologists or anesthetists, preferrably the one scheduled for your surgery. This is definitely something that I would do.

Another thing that I would do if hospitalized again: I would see the hospital's nutrition department to arrange for appropriate meals. After my abdominal surgery, I was put on a liquid diet. Dinner one night was cream soup, which was apparently some cream mixed with bouillon. I do not usually complain about food, but this was really unappetizing. After 3 days, when the dietitian (RD) came to meet with me, there were many more choices available. Unfortunately, I was discharged before I got to benefit from more than one meal that the dietitian had planned.

Another time, my doctor ordered no dairy foods. This, it turned out, was to avoid the fats. A little skimmed milk or a pat of butter would have been SO welcome, and would have come in well under my allotment of fat a week after the cholecystectomy. (I was back in the hospital from a complication.)

Also, with the modern hospitalization policies, I was never bored when I had to stay. Anymore, you are generally impaired enough to be seriously unable to do very much (even read or watch TV) while in the hospital after surgery. One NEEDS to be seriously in need of hospitalization in order to even get a bed.

In my experience (which was before CPAP, which I have only used for a year) the pain medication pretty much had me knocked out the first day or so. I had the self-controlled PCA (Patient Controlled Analgesia) pump for a few of the surgeries.

This site has a great description of some of the procedures used to control post-surgical pain at the Cleveland Clinic, and is similar to those used at most other facilities, in my experience:

Click Here for Info on Pain Management After Surgery

The Cleveland Clinic site also has a number of other descriptions of what to expect with a surgery and a hospital stay; explore just a bit if you would like to read more.

Last, you may want to take a Chapstick (or other lip balm of your choice) for after the surgery in the hospital. After the surgery, having my mouth open for anesthesia, my lips were so dry! Asking for something at the hospital usually gets one a bit of Vaseline, which helps for only a very short time for me.

One addition: Many stomach sleepers find the Twilight NP (formerly called the Aura) to be extremely comfortable. Some deconstruct them, and some use them as-is, straight out of the box, so to speak.

Best wishes for your surgery, and know that you have our support. Please feel free to PM me should you have any other concerns with which I may be of assistance.

Sleep well and safely,
Karen

WearyOne · Post by **WearyOne** » Wed Apr 18, 2007 11:42 am

If listening to your breathing bothers you--it did me at first--buy a sound conditioner. It's a little machine that makes "white noise" to block out other sounds. I already had one to block my husband's TV in the other room at night, but it has come in very handy for blocking the sound of my breathing with the mask on, and the sound of the machine. If the machine noise bothers you, the sound conditioner will help, but you could also take a styrofoam cooler and put it upside down over the machine, of course leaving holes for the hose and air vent. I've heard the styrofoam thing really works.

My prayers are with you for your surgery.

Pam

Julie · Post by **Julie** » Wed Apr 18, 2007 12:21 pm

Kered - I can't PM you, so everyone's going to hear my story again... What I did is get a 4" deep slab of hi-density foam rubber (make sure it's been aired for a couple of wks to get rid of any chem. fumes) which is on top of my reg. bed. At the top end, I cut out a 4" wide x 3" deep channel going towards the bottom of the bed x 10" long. My head, on it's right side, is mostly on my left hand, but my nasal mask rests in the channel. It works for me because I use a Soyala FF, and a Comfort Select, which vent not right out from the elbow angle like most do (and would be blocked by the mattress), but from a place on the plastic that's not blocked in the same way. It's not a perfect set-up, but it works for me, and without that channel, I can't get comfortable at all in the masks and they don't seal properly.

Lulabelle · Post by **Lulabelle** » Wed Apr 18, 2007 6:11 pm

Good Luck with the surgery. I was in the hospital for a week about two months before I was diagnosed with sleep apnea. I look back and think I should have been diagnosed then, but no one even mentioned sleep apnea. They did have a pulse/ox monitor (I hope this is the right term ) on my finger. Just when I would fall asleep that would go off with an alarm indicating I was not getting enough oxygen, I fought with the nurses and doctor over that through out my stay. I thought of it as an instrument of torture. I believe they still use these and I would reccomend trying to use your cpap to avoid these same hassles.

I do think when you are on pain medication you sleep heavier and this is more dangerous to a person with sleep apnea. I hope you give it a try at least for the immediate post surgery recovery period. It does get easier. In the beginning (at least for me) it just seemed so overwhelming. The hospital stay could be a good opportunity to concentrate on adapting to the cpap therapy.

I hope I didn't sound too preachy, that was not my intent.

I hope you feel better soon!

tangents · Post by **tangents** » Thu Apr 19, 2007 8:04 am

If you'r still checking this thread, Kered, and I hope you are, read this information posted by Skygal6, in response to this article:
http://www.knoxnews.com/kns/local_news/ ... 70,00.html

Posted by Skygal6 on April 18 in the "This is Serious....." Topic

Hi all.....very sad article indeed. Let me see if I can clear up a few things after reading many of your responses and concerns. I am a fellow CPAPer and also a recovery room nurse. I deal with OSA patients everyday. I'll and tell you how we deal with patients with a history of sleep apnea or have certain risk factors which make them more at risk after having anesthesia and then narcotics for pain relief. Our hospital has instituted a prescreening questionaire which all patients fill out so we can predetermine who already has a diagnosis of OSA and then which of the other patients may have certain conditions which put them at risk (ie:treated for high blood pressure, snoring, known apnic spells, or overweight) This way we have some advance notice about these patients. Anesthsiologists also somtimes pick up certain indicators by their interviews with patients preoperatively. First, yes its very important to make all your doctors aware of your OSA history, and esp. your anesthesiologist. We have you bring your mask with you to the hospital and then will treat you with CPAP, APAP, or BIPAP while in the hospital esp. at night while sleeping.
If you have a general anesthesia (put totally out with a breathing tube down your throat during surgery), you will actually be on a ventilator type of machine during the surgery (thats what the anesthesia machine does) It administers certain anesthetic gases, as well as gives you ventilatory support while you are anesthetized.
Now after the tube is out and you are in recovery waking up you will be on various monitors including B/P, oxygen saturation monitor and heart monitor. We unitlize all of these as well as close physical monitoring to assure you are breathing well while you wake up. But another critical part of my job is to also control your pain from the surgery....we do this by giving narcotics (like in the article) We closely monitor all patients, but use special caution in our OSA patients. We then assess how the patients have responded and collaborate with anesthesia and the surgeon on deciding if the patient need continued close monitoring in our intermediate care unit (like an ICU step down unit) or maybe they are doing well enough to go to a regular post-op unit, but we then send them with central telemetry monitoring with oxygen saturation monitoring as well. Had the patient in the article had this type of monitoring post op, the fatality possibly could have been avoided. Where I see the problem laid in the woman in the article, was not only a lack of communication between the surgeon and anesthesia, but also no special monitoring was done on the floor while the patient was in that first critical 24hr period when you are still blowing off anesthesia gases and then also on narcotics. Many of our OSApatients get pain pumps to use for pain control after surgery, but then we also use these additional monitors for their safety while on these pumps ..Our patients will use cpap regardless what unit they end up on....to continue to receive good oxygen and positive pressure we all need when we have this diagnosis of OSA.
I recommend to anyone going into the hospital to always take their CPAP gear with them and let everyone know what their history involves so the medical people taking care of us can better do this with all the facts.
Hope this explains a few things and answers some questions.
Carol

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kered · Post by **kered** » Thu Apr 19, 2007 10:22 am

Yes tangents - thanks - I'm still watching, and from all the caring people here and my doctor I do realize that I have no choice and absolutely have to use my cpap after my surgery at least until I'm totally off the pain meds. The hospital did a pre-interview and said to bring my mask and have it documented that I am a cpap user. They said there will also be an interview with the anesthesiologist before surgery so it looks like they are on top of things. Next Thursday is my day and they say I'll be there at least 5-6 days.
Ed

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