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Surgery and Sleep Apnea
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Post Surgery and Sleep Apnea 
I don't know if this the right place to post but I just want to tell the story of my mom, her sleep apnea and surgery.

My mother had a routine colonoscopy.  She did everything she was supposed to do prior to the procedure, including having it scheduled in a HOSPITAL not a surgical center due to severe sleep apnea.  The day before surgery she told the nurse that called for her history that she had sleep apnea, she told the lady that admitted her the day of the procedure.  She thought she was done telling people and no one else asked.

I talked to her pre-op nurse and asked if she was informed about the apnea and that mom had been experiencing some extra coughing lately.  She said she did NOT know about either but would make sure it was noted on the chart.  I expressed concern that the anesthesiologist know and was reassured that YES he would be informed.  

Upon my meeting her again in post op my first comment to her nurse was, "I don't like her sat rate (oxygen saturation rate) and her color is off."  The nurse reassured me that she was fine and that she was on oxygen for the low numbers.  I again expressed that the numbers should be higher SINCE she is already using the oxygen.  She kind of ignored me.  I was with my mom for about 10 minutes encouraging her to take deep slow breaths trying to see if I could get her sat rates up.  She was never over 92% even with nice deep breaths.  I again expressed concern.  

The next thing that happened is that we (my mom and I) could hear gurgling coming from her lungs.  I called the nurse over and she listened to her lungs and said they were clear and then asked me to leave (a new patient was coming in).  On the way out I saw that there were actually 2 more patients coming to post op and NO bays to put them in.  Less than 5 minutes later my mom is standing next to the nurse and is discharged from the hospital.

We drive home and I get her settled and make sure she has lunch.  She felt pretty good but was worn out (that colonoscopy prep is rough).  I go home and call an hour later she is unable to talk and her breathing was labored.

I call 911 while racing over there, she is admitted to a local hospital (not same one for procedure) with acute aspiration pneumonia.  I learned that she was never intubated during her procedure and they believe she aspirated vomit during the procedure.

Sorry for the LONG POST but PLEASE, NEVER let yourself be put to sleep unless YOU tell the anesthesiologist know you have sleep apnea.  I cannot stress enough how very important this is.  NEVER trust that the message will be given to him/her by your own doctor, the or nurse or the pre-op nurse.  We are all human and mistakes happen but this is one that NEVER has to.  NEVER assume the doc knows.  

This has been a scary and on-going ordeal.  She will need oxygen now for a while and there may even be some more permanent damage.  We now have many more test to follow but feel we are out of the woods as far as the critical period.

Thanks for listening and PLEASE spread the word.


_________________
~ElleMarie~ One day at a time, ARE YOU KIDDING ME! Sometimes it's just a minute at a time.



AHI 100 -Diagnosis June 2007-

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thanks for your warning, you might think of consulting a lawyer about your rights

Ironically I was given a general anasthetic before my apnea was diagnosed and although I assume I was snoring loudly my apnea wasnt noticed

at the other extreme my local hospital panics at the mention of apnea and has put me on a long waiting list to have minor surgery on skin cancer which normally would be done under a local anasthetic

again before my apnea was diagnosed ( by myself) I had another anasthetic there for eye surgery where eventually I slept while in recovery and again the snoring would have been loud but the apnea wasnt noticed or didnt concern anyone


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respironics comfort gell mask,resmed S6 lightweight CPAP, pressure 10 no humidifier
NO DOCTOR EVER ASKED ME IF I SNORED

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Anyone considering ANY medical procedure should read these two ASAA brochures:

CPAP use in a hospital or surgical setting.  An OSA patient's rights and responsibilities

Hospital Checklist for OSA patients.

Vicki



Last edited by Vicki on Mon May 12, 2008 10:32 pm; edited 2 times in total

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That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

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I had a pacemaker replacement, hysterectomy and a cardiac radio frequency ablation in the 6 months before I was formally diagnosed with sleep apnea. with all three procedures my sats were low and the nurses kept waking me up during the recovery period to breath deeper. that is one of the things that prompted me to get agressive with my doctor in getting the sleep apnea diagnosis ( I thought I had OSA based on symptoms, but I did not fit the typical mold of a OSA sufferer. - I am thin, female and relatively young) next time I need surgery I will make sure that all people caring for me know that I have sleep apnea, even if it means that I must have a family member with me at all times. thanks for the warning. Heidi


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Thank you everyone for your input on this forum.   Our 20 yr. old is facing eye surgery, and doctors are reluctant to proceed due to his OSA, and OHS problems and  risks of his heart  and lung problems.   He is upset because his strybysmus is causeing him to loose his sight, and wants to have the surgery.   You have helped us to understand rishks and procedures.

 thankyou[/b]


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As long as your doc knows and treats accordingly I would not have any fears at all.  In my personal case I felt that I received EXCELLENT care as my anesthesiologist never left the room, instead of putting me under then going to the next room, as is the norm.  He was quite vigilant and I had all confidence in him.  

We do NOT wish to scare anyone here just let all know of the necessity to SPREAD THE WORD everyone who is involved needs to know.


_________________
~ElleMarie~ One day at a time, ARE YOU KIDDING ME! Sometimes it's just a minute at a time.



AHI 100 -Diagnosis June 2007-

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Post Dunno 
I'm not sure that I snore or not.. I sleep with my schnauzers and they snore.. that more than likely don't count huh???lol


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ElleMarie, one would not normally be intubated for a colonoscopy because a general anesthetic is not used.  What they use is conscious sedation, a light sleep from which the patient can be easily aroused.  However, that situation is the very one that can cause trouble for those with OSA because there is nothing to keep the airway open.  That was certainly a scary situation and I'm glad your mother is recovering okay.

Btw, surely her stomach was empty before the procedure so why would she have vomited?  Maybe you should pursue an answer to that!

Lynn, why would sleep apnea be a problem when having minor surgery for a skin cancer?  Do they want to put you out for it?  I have had 5 minor surgeries for basal cell carcinomas  on my face and another on my arm and all I had was a local anesthetic.  The arm was done in the doctor's office, the others as outpatient surgery in a hospital.  No big deal.  But maybe yours is a bigger deal!

I should add that I don't have sleep apnea but that would hardly have mattered anyway seeing that I was wide awake!


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I told the anesthesiologist that I had SA when laying on the table for the colonoscopy..gotta tell ya...when I woke up i had never felt so good...no jokes and no laughing now!!!  I mean my head was clear, I was not a zombie for once.  BTW...it was not conscious sedation Frances...not all places do that for all patients.  

Next time I am going to write I have Sleep Apnea across my forehead...I joke but that is not a bad idea!


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Post conscious sedation 
It probably was, though, Mrs. RVW.  You don't have to be awake for conscious sedation, you just have to be wakeable.  The sedative most often used is Versed which also has an amnesiac effect.  You don't remember what happened when you were under the influence even if you were responsive then.

Frances (didn't sign in)


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Post Re: conscious sedation 
GuestFrances wrote:
It probably was, though, Mrs. RVW.  You don't have to be awake for conscious sedation, you just have to be wakeable.  The sedative most often used is Versed which also has an amnesiac effect.  You don't remember what happened when you were under the influence even if you were responsive then.

Frances (didn't sign in)


Our guest is correct.  There is no need for general anesthesia for a routine colonoscopy.  I had one a year ago and they indeed used Versed.  "Dream Cream" they called it!  A very bizarre experience as there is no drowsy, groggy recovery.  Just "POP" and you're awake!  

I also had a spinal cortisone injection last month (herniated disc) and they used the same stuff.  The doctors claimed they were talking with me during the procedure, but I have no recollection of it.  Very surreal.

On both occasions I mentioned my OSA to the anesthesiologists and both times they said "Thanks for letting me know, but it won't be a problem as we aren't taking you that far under".

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