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cpap and surgery
#1
cpap and surgery
I had surgery at the beginning of this month and was rather shocked when the surgery center staff sent my cpap machine out to the waiting room with my family.

Both my PCP and my sleep doctor stressed how important it was that I take the cpap machine with me because I would absolutely need it after they extubated me until I was fully awake.

Has anyone else had surgery / sedation without their cpap? Is it at all reasonable to assume that I didn't need it? I'm very curious about all of this and would love to hear your experience with cpap and surgery.

Thanks,
SSA
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#2
RE: cpap and surgery
I was put under with profofol for a colonoscopy. Anesthesiologist monitored vitals.
Profofol is like a switch, they push it, you're under, they stop and in about 5 minutes you're wide awake.

I was first dx'ed with OSA when working up for surgery. That doc insisted I be on CPAP.
After the workup -- I elected not to have that surgery.

I did spend a few nights in the hospital in 2010; and they used their machines that are much more elaborate than our home machines.
They can set things like %O2 in the flow. An RT was assigned to me during my stay.


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#3
RE: cpap and surgery
I have had regular colonoscopies since 1999 when I was diagnosed with Colon Cancer. My longtime surgeon passed away and the most recent doctor I went to asked on the general questionnaire if I had ever been diagnosed with OSA. I thought it was an odd question and didn't know why I would be asked that. At the time I had not been diagnosed but admitted I entertained the idea that I might have it. They didn't much care unless I was diagnosed. I had the scope and all was well. I never go to sleep with that sedation anyway. It always amazed my first surgeon that I could repeat comments made during my scope and could remember things. I don't have to go back for 5 years. I have graduated to the regular colonoscopy schedule now instead of every 2 years. Now I am approaching 5 year mark since Breast Cancer diagnosis. Looking forward to putting it all behind me!
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#4
RE: cpap and surgery
I had my gall bladder out last August. When talking with the anesthesiologist before the operation, he looked in my mouth and asked if I had OSA. At the time I wasn't diagnosed with it yet, but told him I was in the process of getting it checked out. He said he'd keep me on the lighter side of being put under. It was perfect for me; when they hit the brake on the bed in the recovery room I woke up completely. It was the best nap I had ever had!
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#5
RE: cpap and surgery
Just my thoughts here?

I have had the following surgeries after being on my dream machine:

3 different knee scopes - out-patient,machine left at home, no instructions about it.
Nose Surgery - out-patient, machine left at home, not to use it first 48 hrs after.
Throat Surgery - out-patient, machine left at home, no use for 12 hours after.
Total Knee replacement - in-patient, machine came with, not used until in room.
Shoulder surgery - out-patient, told to bring machine in case they kept me, used as soon as was at home.
Total Hip replacement - in-patient, machine came with, not used til in room.
Multiple PEs (two different times) - in-patient, machine brought in, no surgery, used ASAP.
Kidney Failure - in-patient, wife sent home to get machine, not allowed to close eyes (watched) until machine was hooked up. No surgery.
Anemia - in-patient, wife sent home to get machine, not allowed to close eyes (watched, different hospital) until machine was hooked up. No surgery.

It seems the more recent, the more strict the policy about OSA, sleeping, and sedation. Prior to my TKR in 2009, I never spoke with the guys knocking me out, or anything special due to my OSA.
But, starting with my TKR in 2009, a separate APPT with the knock-out team, and a release by sleep Doc (and heart Doc) were required prior to surgery. All but one knee scope were complete knock-me-out and wake up in recovery. One scope was a 'spinal block' (yuck).

My three most recent visits (2 different hospitals), flagged my room with signs warning that I was OSA, and *MUST* have dream machine on when eyes closed. - last visit also flagged me for "30 minute mask checks", and they verified the high leak alarm was turned on.

The above was over the last 9-10 years, at four area hospitals around the Akron/Canton area of Ohio.
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#6
RE: cpap and surgery
For most surgeries, other than day surgeries, you will be intubated and OSA events are eliminated. But you will want that CPAP in the recovery room or your hospital room. Even if you have oxygen, it isn't going to do diddly for OSA events other than help your O2 levels.

Most hospitals have policies in place for patients who bring in their own equipment. Usually this is just having either someone from maintenance look at it for safety or have someone from RT check it over. Their policy should be listed. If it is not, just contact their patient services or something similar and ask about it. That's what I did. I just wish I could remember what the answer was! LOL

When I had my tonsils out at age 25, they released me two hours early because my snoring was bothering the other surgical patients. My first colonoscopy, same thing. My second one, I didn't think to bring my CPAP with me, basically because I assumed they would send me home early again. Instead, they used a different drug that had me awake much better than the first time. I was also intubated the second time. I think they had made a note on my official charts or something 'cause they were ready for the snoring monster!
PaulaO

Take a deep breath and count to zen.




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#7
RE: cpap and surgery
For me it was quite funny - two different times I remember waking up in the recovery room with a nurse telling me to breath~! Was hooked up to an Oximeter with an alarm set for (something??) whatever, and I kept setting it off, so they'd yell at me, then I'd fall back asleep and set it off - had the tube in my nose - tried explaining it would work better in my mouth (HEHE), and to turn it up - LOL!!!

But ya, never understood why I wasn't on my PAP in recovery...
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#8
RE: cpap and surgery
One thing I have wondered is why when we are diagnosed does the machine not come with something that we wear to identify that we have OSA so if there is an emergency, it is visible to the medical personnel so they can do whatever treatment necessary with the information that we have OSA (or whatever our diagnosis is).
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#9
RE: cpap and surgery
Because it is called freedom of choice. Just like a person who has diabetes or has a pacemaker or some other much more serious disease or condition. It is up to us to choose if we want to notify emergency personnel of our conditions.

The thing is, in an absolute emergency where we are unable to communicate or are unconscious, more than likely we have been intubated. Meaning there is a tube down our throats. This is done in many cases just to keep the airway open and eliminate one more thing going wrong. In case surgery is necessary, one less thing to take care of before hand. In a situation such as that, OSA is not a problem.

It becomes more of a problem during recovery when we are breathing on our own and not being watched as closely. That's when the CPAP will be needed.

I have a bracelet and necklace from Medic Alert because I have multiple conditions. My OSA is not listed on the back but is listed with the company and is available if they call.
PaulaO

Take a deep breath and count to zen.




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#10
RE: cpap and surgery
When I had my back surgery a year ago, I was told to bring my mask and only my mask as they would be able to hook it up to one of their machines. They RT came up to the room and said it wouldn't fit any of their machines. Seeing as I was only going to be there for one night, they put a remote O2 sensor on my finger and said we would make a decision if the numbers went south. Seeing as I had the head of the bed pretty much in a recliner position (and didn't really doze off all nite) it wasn't a big deal. I don't know how many of the NY Times crosswords I did that night, I was awake every time they came in to do vitals. My nurse told me the lowest my 02 got was 92%. So in a nutshell, in my case, it was a waste. The mask stayed in my bag all night. Talked to my surgeon the next morning and he said he wasn't surprised.

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