RE: somewhat disappointed
Most people who get sleepy from a spinal in the recovery room actually drop off for a very short time, if at all, and usually because the adrenalin has worn off more than anything else, so they naturally drop off, but it is usually for so short a time that the need for a cpap is trivial, given the small chance that anything could actually occur that could damage you in that situation, and you are being constantly monitored as well, often with an O2 cannula still providing some supplemental oxygen, and if not, then your sO2sats are still monitored and a nurse is checking up on you every few minutes or less. We are talking a few minutes on the average, and the wake up is rapid. There is no strong opiod effect on the airway if you nod off post op from a spinal or local, so if there is a an apnoea event, you will wake up as you would normally, unlike if you are in recovery from general anaesthesia. Here the risk is higher, because the lingering effect of the anaesthesia may prevent waking upon apnoea events, and the recommended practice is either to retain intubation or provide some other form of support until the patient is fully awake and extend the monitoring time. For GM's case, monitoring is all that was needed, same for Rose. Notation would have been made in the chart for both of you, and in big letters at the top of recovery chart for the recovery nurse, or a flag or sticker. Before the op, in the op, after closing you up before transport and in the recovery room, there are checklists that the entire team has to go through verbally confirming everything. This is now SOP in both the US and in my country, and has been proven to cut down any complications or other problems, including mortalities, by a massive amount. So, if it was noted that you had apnoea and required a breathing device, then believe me people were aware of it every step of the way. The nature of the anaesthesia would have determined if you would need additional precautions beside extended monitoring and maybe supplemental O2 or not. Granted, smaller and older hospitals in the US may not be fully up to speed on the checklists yet, and HMO hospitals may be especially lax (I cannot tell you how much I loath the cost cutting bottom line methods of HMO systems in the US), but the checklist procedure is now fully establish in the US and will be found in most facilities these days. After all, if it spares problems, it spares insurance costs, even if it takes a few more minutes of the team's time.
I agree that a little reassurance goes a long way, and there, the bedside manner of your docs could do with an improvement. Maybe a lot - it costs only a titch of time, and saves a ton of anxiety.
As for the elevated blood sugar in GM, it was most certainly taken note of, monitored and a few extra precautions laid on that would not be seen by the patient, but honestly, would it have been even possible to wait for the sugar to normalise, given the current life situation and procedure needed by the patient? If the surgeon and the gas passer saw no greater danger in this, then there was no greater danger in it. The biggest problem in such cases is wound recovery, normally, not surgical complications, and a (very) minor risk of Ketosis. So wound maintenance is the real trick here - I usually suggest Keli-med crème in such situations. Vitamin-E crème or peanut oil also work a treat, but first the wound must close fully and be dry on the surface. So correct bandaging and infection protection is essential.
(This post was last modified: 08-23-2015 01:37 PM by DocWils.)