Opinions please - am I nuts??

I had surgery on my middle ear a little over a month ago (a cyst was removed)--outpatient but still very invasive (a slice down the back of my ear and was intubated for the procedure). My ENT said not to use my cpap until a month afterwards. I went to him after the 4 weeks and he said I could start using it again. He said it's healing but I have infection so have drops to put in for 7 days. I told him I use an apap and he seemed not to know what that was. I told him my numbers have gone as high as 17 and I'm afraid if I use it, I might do damage or blow out the ear drum. I'm to go back in another 4 weeks and I've opted not to use the apap until I know it's good and healed. Quite honestly I can't tell any difference in my energy or sleepiness since not being on it but I do plan to start again after it's healed. Does anyone think I'm doing the right thing - I mean what would you do?? Thanks to all - I appreciate any input.
Kathy

Babbie wrote:I had surgery on my middle ear a little over a month ago (a cyst was removed)--outpatient but still very invasive (a slice down the back of my ear and was intubated for the procedure). My ENT said not to use my cpap until a month afterwards. I went to him after the 4 weeks and he said I could start using it again. He said it's healing but I have infection so have drops to put in for 7 days. I told him I use an apap and he seemed not to know what that was. I told him my numbers have gone as high as 17 and I'm afraid if I use it, I might do damage or blow out the ear drum. I'm to go back in another 4 weeks and I've opted not to use the apap until I know it's good and healed. Quite honestly I can't tell any difference in my energy or sleepiness since not being on it but I do plan to start again after it's healed. Does anyone think I'm doing the right thing - I mean what would you do?? Thanks to all - I appreciate any input.
Kathy

Personally speaking, I don't blame you for being cautious especially with a post-operative infection.

Although the air from the xPAP should only go into your lungs, it has to traverse your throat where the eustachian tube exits from your inner ear. Any increase of pressure there could exacerbate problems with the healing process, and your pressure peaks at a pretty high level (17).

Since you don't seem to be noticing a marked difference in your energy level, I agree with your approach of waiting until you are well-healed and infection free.

Are you concerned about being off APAP? If the doc knows what CPAP is and feels it is OK to use-you could set your machine to CPAP with a lower set pressure that would take care of most of your apneas (if it doesn't go to 17 often). I would probably be very cautious too-and I'd be concerned about being off CPAP. Also agree with going with how you feel-one suggestion-monitor your blood pressure-if it is going up think about doing CPAP at a lower pressure. If you do start using CPAP at any pressure and have pain-turn the machine off.

Thanks, guys. I guess I just needed someone to tell me I'd doing the right thing. I know going without the cpap therapy is NOT good but I feel that until I know for sure the ear is all healed up, I'll do without. Yes, I'll keep an eye on the blood pressure but so far things are fine. I'd really hate to do any damage. What's that old saying about trying to help one thing but hurting another?? That's kind of my situation. Anyway, I appreciate your input.
Kathy

I had to be off cpap for a couple of weeks due to a severe sinus infection. I didn't feel sleepy for quite awhile, but I discovered I had started making mistakes at work again. (This was one of the major problems before therapy). Boy, was I glad to get back on cpap!

This is a case where you *have* to do what your doctor says. No one can gainsay your doctor's advice.

While an ENT might not be familiar with XPAP, he is probably familiar with barotrauma to the ear - ENTs see scuba divers and snorkelers who have various ear problems all the time. So, although he might not know what a "Xpap" is, he should know what the issues are of having your throat pressure slightly over ambient and getting a positive pressure in the middle ear are and how that might affect his surgical repair.

But, well, I know that when my pressure goes above 12, it might cause me to feel like my ears are gonna "pop", (in other words, pressure above that tends to open the tubes that connect the throat to the middle ear) so were it me, well, I might talk to my doctor about temporarialy reducing the high number on my APAP to 10 or 11. BUT THIS ADVICE CANNOT APPLY TO YOU because everyone is different! When I started with CPAP even 8 caused me to get air at pressure into my middle ear with the concommittant discomfort - after a while I learned how not to do that.

The good news is that, based on my SCUBA experience, the middle ear rebounds quickly from "clean" pressure related trauma (trauma that is not caused by infection). The eardrum seems to heal stronger (and end up very slightly less flexible) after a rupture than it is before the break. This is based on ENT lectures about scuba medicine.

I'd want to be back on some xPAP therapy as soon as possible, and I'd be happy that my ENT approved me and I'd watch for feelings of fullness in the ear - if there were no full feelings, I would not worry much. Again, that is me.

All of the above advice is good..........and as for the name of your thread......the answer is.....YES.....if you are one of us. Good luck, get well......

hi--

i would probably call my sleep doc and ask what he says about using the apap under the circumstances. if he says no problem, then i would use it. you may have unrealistic fears because of some medical or biological info we all know nothing about.

i'm not saying you are wrong. the sleep doc may agree with you. then i would lay off apap and go back on his/her schedule. but i prefer not to invent medical problems if they are not really there.

that doesn't mean you're crazy.

caroline

I think your concern is legit. You have in essence a wound that has been put back together. What are the changes of getting an air embolism due to increased pressure in that area You could ask your doctor for use of a pulse oximetry just to keep track of your oxygen level while you are off the xPAP.

Once again, thanks for all the replies and different opinions. I've not started back on it simply because there is still a feeling of "fullness" in there, like it's still not quite open. I know some may think that I'm just using this as an excuse for not using the cpap but it's not. I have no "sleep doctor" - my regular MD wrote the script out to the girl who is a respiratory therapist and she's the one who I call when having a mask or machine issue. You guys are pretty much my support system and I've learned a lot on here. I go back to the ENT in a couple of weeks and I'm hoping by that time it will be healed more and the fullness gone and I'll go back to using (the cpap that is!!). I know I'm being paranoid about not wanting to do any damage in there. I guess I was just concerned when the ENT didn't know what I was talking about!!
Kathy

Babbie-
I get sinus infections everytime I get a cold. I was told by my equipment provider not to use the machine during those times...she said that the pressure could spread the infection deeper into the sinus cavities. While she is not a doctor, the logic makes sense to me. Perhaps this also applies to your post surgical ear infection.