Anesthesia and sleep apnea

[Goofproof]

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

======

propofol is safe ***IF*** the anesthest is attentive and watches the numbers all the time

too often they are tired and busy trading jokes with the operation doctor
or they are merely incompetent

nothing is safe if they are not watching and you stop breathing so they adjust the ventilator

Mikey probably put it in the wrong hole. Jim

[Gryphon]

To the OP a lot of posters have said it very well. Have your machine with you and or make sure you have your pressure settings available so a machine can be set up for you in recovery if needed. If you can have a friend or a family member who has exsperiance with your machine and how it is setup.
Even with the initial procedure you'll have people monitoring your breathing and oxygen levels. I was just in for surgery 4 months ago and even though I went with a local they still monitored my oxygen levels and checked my ploodpressure regularly through out the procedure. I had a very minor thing done but I had multiple people there making sure I was ok.


And now....

Xxyzx.... Didn't we have this chat already?

I thought we already talked about this thing called tact, and how quoting statistics at people is generally useless and usually mean and insensitive.

PS: I'll break my general suggestion of quoting statistics only to correct yours. Your numbers are way way off. For general anesthesia the accepted mortality is less than 1 in every 100,000. Your number, you insisted on repeating like 5 times in your posts, is about 20x worse then reality. [ I'll accept that I could be wrong as well, but the 1:100,000 figure came up on at least 3 different medical sights about dealing with surgery.] Only reference to 1:5000 was from 40 years ago. So if you were being operated on 40 years ago it was more dangerous.

Since you insist that your information was needed for the OP to make an educated decision about her choices it would be nice if the info you provided was actually true.

For someone who thinks the whole medical system is made up of nothing more then money grubbing scam artists you seam to tell people to see doctor's a lot.

Any time someone's real life experience divers from your perspective one of your frequent suggestions is to tell them to go see a mental health doctor. As if to completely undermine and dismiss anything that isn't how you see it as a sign of a mental condition.

I think you should take your own advice. You really should go and have a long talk with a mental health professional and ask them why your so angry and why you have this uncontrollable urge to lash out at people on a online help forum. You could, and will argue, that we're all bullys and we're being mean to you so your defending your self. But I'm thinking that a lot of your reactions to criticism are way over the top and need to be toned down a lot.
If you want to argue your point of view I have no problems with that but you need to keep your head on strait and not go off the deep end raving and calling people names.

To win a debate you have to change my point of view, convince me your right and show me why. Your arguments are usually very one sided and lacking in convincing facts. When that doesn't get the reaction your looking for you start calling people names.

There is almost no one left on this forum who thinks anything you say is creditable. I say almost, only because we keep getting anonymous guest posts that defend your actions like a sort of personal cheerleader. Those posts might be a bit more creditable if they came from registered members but, I digress.

Once again. Please learn how to argue your point sensibly. And if your going to continue to post unhelpful insensitive statistics at people who are strugling or needing advice then at least have the decency to research them and not pull them out of your backside.


Gryphon

[TASmart]

To the OP a lot of posters have said it very well. Have your machine with you and or make sure you have your pressure settings available so a machine can be set up for you in recovery if needed. If you can have a friend or a family member who has exsperiance with your machine and how it is setup.
Even with the initial procedure you'll have people monitoring your breathing and oxygen levels. I was just in for surgery 4 months ago and even though I went with a local they still monitored my oxygen levels and checked my ploodpressure regularly through out the procedure. I had a very minor thing done but I had multiple people there making sure I was ok.


And now....

Xxyzx.... Didn't we have this chat already?

I thought we already talked about this thing called tact, and how quoting statistics at people is generally useless and usually mean and insensitive.

PS: I'll break my general suggestion of quoting statistics only to correct yours. Your numbers are way way off. For general anesthesia the accepted mortality is less than 1 in every 100,000. Your number, you insisted on repeating like 5 times in your posts, is about 20x worse then reality. [ I'll accept that I could be wrong as well, but the 1:100,000 figure came up on at least 3 different medical sights about dealing with surgery.] Only reference to 1:5000 was from 40 years ago. So if you were being operated on 40 years ago it was more dangerous.

Since you insist that your information was needed for the OP to make an educated decision about her choices it would be nice if the info you provided was actually true.

For someone who thinks the whole medical system is made up of nothing more then money grubbing scam artists you seam to tell people to see doctor's a lot.

Any time someone's real life experience divers from your perspective one of your frequent suggestions is to tell them to go see a mental health doctor. As if to completely undermine and dismiss anything that isn't how you see it as a sign of a mental condition.

I think you should take your own advice. You really should go and have a long talk with a mental health professional and ask them why your so angry and why you have this uncontrollable urge to lash out at people on a online help forum. You could, and will argue, that we're all bullys and we're being mean to you so your defending your self. But I'm thinking that a lot of your reactions to criticism are way over the top and need to be toned down a lot.
If you want to argue your point of view I have no problems with that but you need to keep your head on strait and not go off the deep end raving and calling people names.

To win a debate you have to change my point of view, convince me your right and show me why. Your arguments are usually very one sided and lacking in convincing facts. When that doesn't get the reaction your looking for you start calling people names.

There is almost no one left on this forum who thinks anything you say is creditable. I say almost, only because we keep getting anonymous guest posts that defend your actions like a sort of personal cheerleader. Those posts might be a bit more creditable if they came from registered members but, I digress.

Once again. Please learn how to argue your point sensibly. And if your going to continue to post unhelpful insensitive statistics at people who are strugling or needing advice then at least have the decency to research them and not pull them out of your backside.


Gryphon

Well worded and nicely constructed gryphon. But if you think this will have any impact on xxyzx.....ya gotta be shitting me.

[Margaretm]

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!

I would seriously question that hospital's qualifications. Diabetics (both type 1 and 2) have to watch their carb intake. So sorry that happened to you.

[svofan1]

...I did have a quintuple herat bypass in Sept 2013...I was diagnosed with sleep apnea (93 ahi per hour) 3 years later (2016)....on that surgery I was under for about 12 hours since it was an "on pump" procedure..I recalled I was intubed...still here.....
Good luck and relax all will be fine..God will be with you as it was with me..

Ralph L...

[Goofproof]

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!

I would seriously question that hospital's qualifications. Diabetics (both type 1 and 2) have to watch their carb intake. So sorry that happened to you.

Just got out of a 36 hour hospital stay, I'm type two, take 200 units of mixed insulin daily. They put me on a no salt, no sugar, no taste diet. They stopped my insulin.

I was 160 when I went into the hospital, 290 when I came home, had 3 cups of tea, 2 oz of boiled chicken, a small mashed potato w/gravy?, a roll no butter. A sandwich of diet bread and a piece of ham loaf that had been passed around the kitchen to read the newspaper thru. 6 hours sleep in a 48 hour period. I took my cpap with me and used it. I took my insulin kit too, but never used it. Last time they fed me, but used too much insulin for the food, this time I wasn;t going to let them kill me. Hospitals are for dying! Jim

[Margaretm]

I almost cancelled the procedures (there are 3 he wants to do). Worrying about this is consuming my mind 24/7. I'm used to sleeping 8-9 hours a night, now I'm getting 4-7. So, a week ago last Friday, I called my gyn's office to cancel. His secty spent 20 mins on the phone with me and convinced me to talk to him. She was going to see if he could call me over the weekend while he was on call but booked me in for the following Wed. in case he couldn't. He was too busy but needed to change my appt to this Wed due to his schedule being too tight and wanting to be able to take the time I need to talk about it and answer my questions. The secty was really good and she said he has no problem doing this and would much rather me go in and talk to him rather than sit at home and stew about it and then end up cancelling.

He is really nice and I'm very comfortable with him, so I am not worried about his competence or anything. Just freaked about the procedures, and about being trussed up like a turkey for them as I have arthritis in hips, knees and one foot plus chronic back problems. And really scared about what if I need major surgery, what if they refuse saying I'm too high risk, in which case I'd rather not know the biopsy results.

Anyone here have multiple risk factors for surgery under general anesthesia? I have lots - I'm a fat chick, I have apnea, diabetes and I think "obesity induced hypoventilation syndrome" basically meaning I don't breathe deep enough and don't get enough oxygen, though I've tested at 95-98% at rest. (It is improving, I've made changes to my diet and I'm noticing less shortness of breath and I can stay on my feet longer) Anyone else have more than one of these and had majory surgery?

Sorry to be such a pain about this but reading the responses has been helpful.

PS. Also, anyone who's had propofal, did it wipe out your memory of what happened in the OR? I've read it will do that and do not like that one bit. If I gotta be semi awake, I wanna remember what happened. (Last time I had general, I had versed which does the same thing and it took years for me to remember saying "give her versed", I also had a panic attack coming out of it and am antsy about the versed causing that)

[Julie]

Actually, from the sound of it, you're quite like very many patients these days... arthritis, diabetes and other similar conditions are rampant and yet many, maybe most of those routinely have surgery every day and a big proportion of them also have apnea, half of them undiagnosed. Don't worry at all - the anesthetists aren't stupid and you'll have 02 going the whole time in any case. I've yet to hear of anyone dying on the table from apnea because they weren't diagnosed or because the anesthetist was not told about apnea. And I worked my entire life in hospitals (Montreal and Toronto).

[Margaretm]

Actually, from the sound of it, you're quite like very many patients these days... arthritis, diabetes and other similar conditions are rampant and yet many, maybe most of those routinely have surgery every day and a big proportion of them also have apnea, half of them undiagnosed. Don't worry at all - the anesthetists aren't stupid and you'll have 02 going the whole time in any case. I've yet to hear of anyone dying on the table from apnea because they weren't diagnosed or because the anesthetist was not told about apnea. And I worked my entire life in hospitals (Montreal and Toronto).

Thanks, Julie! From my research, it seems the risk is after the surgery, not during. What spooked me about being rejected for hysterectomy if I have cancer was reading about a treatment used on women who cannot have surgery due to medical conditions. I probably read too much! I'm sure doctors are sick of patients going in saying "I( read on the internet that...." LOL. I try to not do that to them, though my gyn (who I've just started seeing) seems to be impressed at my knowledge of the body. He was talking about fat tissue and estrogen and asked me if I knew the connection and I said "fat stores estrogen" and he looked astonished and said "How did you know that??" Well, I read a lot lol.

[ru2on]

Interestingly it was during. A routine surgical procedure that my sleep apnea was discovered. On the specialist report there was a highlighted note from the Anesthetist saying that this patient had continual obstructed apnea throughout the entire procedure and needs to see a sleep specialist. Which I have and subsequently been diagnosed with severe sleep apnea and am finally getting some beautiful sleep with a cpap..All thanks to my Anesthetist

[49er]

MargaretM,

I have cognitive issues and propofol caused zero problems when I was twice put under anesthesia the past few years. My procedures weren't as extensive as yours but I was still worried I would be very susceptible to worsening effects. I worried needlessly.

Forgive me if I have mentioned this but I was told by anesthesiologists as two different hospitals to skip taking the Versed that is routinely given as pre op meds for anxiety prior to surgery. So that is something you might want to consider and instead download some type of calming podcast like meditation to listen to while waiting for your surgery.

I also asked that medications be minimized which was done. The downside was in one situation, I woke up with pain but it was quickly alleviated.

Anyway, I did very well and I know you will also.

49er

[Margaretm]

MargaretM,

I have cognitive issues and propofol caused zero problems when I was twice put under anesthesia the past few years. My procedures weren't as extensive as yours but I was still worried I would be very susceptible to worsening effects. I worried needlessly.

Forgive me if I have mentioned this but I was told by anesthesiologists as two different hospitals to skip taking the Versed that is routinely given as pre op meds for anxiety prior to surgery. So that is something you might want to consider and instead download some type of calming podcast like meditation to listen to while waiting for your surgery.

I also asked that medications be minimized which was done. The downside was in one situation, I woke up with pain but it was quickly alleviated.

Anyway, I did very well and I know you will also.

49er

Thanks. Thing is, they never gave me the versed until I was out. I have had six surgeries in my life and have never had any sedative prior to them. Maybe they don't do that here in Canada?

[Julie]

Again, I doubt if Canada has anything to do with it... just diff. approaches by diff. doctors (and/or hospitals) to diff. procedures and conditions. Every place is different, even in one city, and every patient is different in ways only their doctors know, so tracing motivation, etc. in one case (without having asked docs about it) will be hard to do.

[Lucyhere]

Interestingly it was during. A routine surgical procedure that my sleep apnea was discovered. On the specialist report there was a highlighted note from the Anesthetist saying that this patient had continual obstructed apnea throughout the entire procedure and needs to see a sleep specialist. Which I have and subsequently been diagnosed with severe sleep apnea and am finally getting some beautiful sleep with a cpap..All thanks to my Anesthetist

Before my relatively minor surgery, I mentioned sleep apnea to the Anesthetist. When I spoke to him a few days later he said he saw no signs of it and that I should probably have another sleep study. I also had propofol and had no problems. Used in the hands of a competent doctor, propofol shouldn't be a problem. What happened to Michael J. scared people needlessly.

Much good luck, Margaret. I know you'll be fine!

[kb4mdz]

MargaretTM -

I'll give you my recent experience with surgery. Type: Bunionectomy, right foot. Last month, October 2017.

Consultation with the surgeon several weeks before I was given a whole stack of paper to be done ( some bloodwork to be ordered 30 day of procedure, for example) and such.

I was asked if I used CPAP/had OSA, I said yes, and it was duly noted for my chassrt.
For day of surgery I was given a list of things to bring with me, and that included my CPAP machine. (including ID so they knew it was me, and my spouse to be there & drive me home.

So my pre-op chart specifically said I use CPAP, and I did bring my machine.

Within the hour before surgery I/we met with the anesthesiologist, he already knew from my chart I use CPAP, and I repeated it for his benefit. (BTW, the drug was Propofol; wonderful stuff, I can see why MJ liked it. There' s a little macabre jokeing in that statement, but it's true. It puts you under fast, you come out fast, with no seeming ill effects, brain resets to almost exactly where it was when you went under. Some people pick up conversations right where they left off when they went under.)

Wife & I were also emphatic with the anestheiologist that I tend to wake up slow. (in hindsight, that may have been because my previous major surgeries were before I wa diagnosed. Right now, that's my story and I'm sticking to it. )

So: check with other members of the medical team that's to do your surgery. Esp. your anesthesiologist. You should even make an office appt. with him/her a couple weeks before the surgery and bring up this exact issue and say you've heard some conflicting information. I'd quietly mention what your ob/gyn said, and let the anesth. decide whether it's worth his trouble to 'educate' the ob/gyn.

My results: Very good. Waking up in recovery room was uneventful, surgery was a success ( I have only 2 more weeks off work before I go back.) Life i good.