Having ACL surgery - any advice?

I've had a lung operation and gall bladder operation. I always thought positive before going under and told myself to listen to the doctors and nurses and do what they tell you. Think of pleasant things, to take your mind off of the operation, as much as you can. Good luck. You'll do all right.

McSleepy wrote:Because of the knee, I can't imagine a very comfortable sleep (I can't sleep but on m y stomach). I'll probably be forced to sleep on my back for at least a few nights, and that's when I have central apneas. I don't think any change in my machine settings would help - higher pressure is considered conducive to central apneas; being on my back, I'd probably have to reduce the pressure a bit, if anything (not to mention all the aerophagia I get if I'm not on my stomach, even for a few minutes, at 9.6/15 cm H2O).

Damned if you do. Damned if you don't. Either way, you're damned.

Good thing it won't be more than a few nights.

Can you plan on sleeping in a recliner while you are recovering? Or at least get a wedge pillow to elevate your head if you have to sleep on your back.

So, I saw the surgeon yesterday and the operation is scheduled for Friday morning. He prescribed Lorazepam for before the surgery (one 1mg pill at bedtime) and Oxycodone for the pain after the surgery. I don't intend to take the Lorazepam more than three times (Tue, Wed, Thu), although I'm still debating if I should maybe only take a pill the night before. Anyway, has anyone had trouble breathing under CPAP with any of these medications? I will have to adjust, depending on how I feel after the surgery, and see if I'll be able to sleep on my back (possibly with elevation). I'm not worried about getting enough rest - I'll be taking days off work, and I work from home, anyway, so it's not like I'll be exerting myself much, and I could nap anytime. I'm only worried about experiencing prolonged and frequent apneas (which I never have since I got the S8), which would be rather annoying. I'd like to be able to reduce the pain at night so I can sleep, but if the analgesics would mess with my sleep, that's not going to work.
McSleepy

My Achilles surgery in October resulted in my "diagnosis" by the anesthesiologist that I have sleep apnea. She sounded a little put out at me for having it but I didn't know. You will have an interview with an anesthesiologist prior to your surgery so be sure to let that person know about your sleep apnea and they can compensate for it during your surgery. I had planned on having a block in my knee but it did not work so I got the general. Even if the block had worked you would have anesthesia and one reason is so you won't hear the sawing and drilling going on as the surgeon works on you. I had bone cut off and I tell you I would have had a major panic attack if I had thought I was going to hear anything. Even with untreated apnea I took the same pain pill and I guess it didn't kill me but looking back on it, it was pretty scary! I was in a lot of pain after my surgery and I can't imagine not taking the pain meds. I don't know why you are on medication prior to the surgery though.

PS Re your wife's surgery. I don't really remember a lot after my surgery but I was given medication for nausea and that also could have affected my memory.

I was given Oxycodone after surgery to fix my broken wrist last summer.
I also had to sleep entirely on my back (not that back sleeping is particularly bad in my case) due to the splint and later cast on my arm.
Even with 2 pills of Oxycodone at bedtime it didn't seem to make much difference on my reports.
Maybe a slight increase in pressure (using APAP) than I normally might have seen and maybe a very slight increase in AHI. Very slight increases which could have happened anyway.
It wasn't nearly as exciting as I thought the reports might be with the opiate in my system.
Still well below acceptable range AHI and maybe a handful of "centrals" which simply could have been flagged due to "awake" events because the first few nights I didn't sleep all the greatest. Mainly because I couldn't move around as much as I normally did and my back gave me fits.

I am a small woman who normally is pretty sensitive to these type of meds, so I thought I would see some huge remarkably ugly report.. It really was a non issue. The Valium in small doses is even less of an issue. I have taken it also (long time ago).

Just take the meds so you can rest as well as can be expected and let the machine do its job.
You will be fine. Good luck.

Just got home from a scope job on my torn medial meniscus (sp?). Anesthiologist told me he had control of the world's best CPAP while I was in the OR. Now home and hope to control discomfort with ibuprofin. You will come through OK>

Thank you, so much, everybody! Your reassurance is very helpful.
McSleepy
P.S. The Lorazepam is for pre-op anxiety, I only plan to take three 1mg pills total (one on each remaining night before the surgery). By the way, I went to a hypnotherapy session today, and for someone who doesn't believe much in such things, it worked quite well.

Just 1 pain pill last night to take a little edge off before sleep. AHI this morning 1.0 in 8.3 hours of sleep. Took a pillow for between my knees during side sleeping and under while on my back. Ice packs, ibuprofin, elevation, PT, compression socks, and rest today. You will do well. Hold on to good thoughts.

Thank you for the feedback and for the reassurance!
McSleepy

msla:
anesthesiologist really LIKED the S9 Autoset?
Yess!

chunkyfrog wrote:msla:
anesthesiologist really LIKED the S9 Autoset?
Yess!

Nope, He thought his equipment would handle my apnea very well. It must have since I am still kicking. We did not need to unpack the S9.

Just to let you know: the surgery went very well, I had no issues, the anesthesiologist was very understanding, although I think he did what he intended to, anyway. I went under about two seconds after he gave me "some oxygen" and woke up about three hours later feeling great. Then I started getting cramps (not acute, cutting pain) and got scared and increased the Oxycodone dosage - even though it was still under the maximum, it turned out to be a big mistake. Actually, it was the full-leg brace that was putting pressure on my knee and causing all that, but I didn't know it until I overdosed a bit (nausea, inability to digest food) and, probably in combination with my inability to get real sleep in any other position than flat on my stomach, it gave me a nasty panic attack last night (more than just intolerance to the machine as I've experienced a few times before). I've throttled down the Oxycodone to the minimum and hope to get better soon. I saw the surgeon today and he said it all looks great and I should start rehab this week. I like his optimism and I'll just do what he says.
Typing on the laptop is not very comfortable, but I hope to be able to get up and sit a desk soon, anyway. Thanks again for your support!
McSleepy

The problem with these drugs is that sometimes you don't remember when you took the last one,
and then you take the next one too soon--way too soon.
I never want to do that again!
I hated that feeling. The spinal block was much nicer.
If I could have had that, I might have had more kids.

it sounds like you have really good advice on this thread.
I just second the advice to make sure you insist on time with the anesthesia person. make sure you write on every possible form that you have osa and use a cpap. sometimes this means filling in "other"
If you think you may stay overnight be sure to bring your own cpap machine etc.
I had minor surgery last summer and was only expecting propafol but once the surgery started I manifested signs of discomfort and they had to intubate me for general because I also manifested apnea signs. All of this was unexpected to me. It was a little scary to wake up a lot later than expected and not feeling so great. The worst part was that the anesthesia person was called away before we finished the interview and so I was unprepared. But I had written OSA all over the forms and talked with the surgeon about it previouisly. It would have been fine if I had expected any of this and had had the opportunity to discuss it. So I say INSIST on discussing it all with the anesthesia person. It will help your peace of mind.