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somewhat disappointed
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GrammaBear Offline

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Post: #11
RE: somewhat disappointed
(08-23-2015 03:06 PM)me50 Wrote:  
(08-23-2015 09:22 AM)GrammaBear Wrote:  I recently had a surgical procedure in a hospital setting. Prior to the surgery date I had a phone interview with the surgery department and I indicated to them I have severe sleep apnea and use a cpap machine. I assumed that information was enough for them to be aware of any possible breathing problem. And yet when it came surgery time, there was no mention of any cpap machine or accomodation for the sleep apnea. Is it not the anesthesiologist job to monitor the breathing? I can't speak for anyone else, but when I lay flat on my back I do have trouble breathing. Obviously my procedure is done and over so nothing bad happened. I had a spinal anesthetic and I don't know if that affected how I was breathing. I was not completely unaware, but at that point I was too sleepy to say anything. Is there something I need to make my doctor aware of in this respect? Has anyone else experienced problems in this way?

glad to know that you did okay through your surgery. you are braver than I am. I won't let them stick anything near my spine! welcome back

For me, a spinal was the lesser of two 'not-so-great' choices according to the gas-passer. These guys/gals are responsible for making sure the patient does well during the surgery. You know how the anesthesiologist always ask you 'how wide can you open your mouth'? It turns out that, for me, I can't open my mouth wide enough for the gas passer to do the intubation safely without damaging my front teeth. He flat out told me, "I think you would be safer having the spinal - are you on board with my decision"? I agreed with him because I've had one before, some years ago, with good results. A spinal sounds worse than it really is to someone who hasn't had one. I had only a mild headache afterwards and the recovery nurse gave me something in the IV to help that. Me brave?? Nah - not on my best days. Smile
08-23-2015 04:00 PM
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GrammaBear Offline

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Post: #12
RE: somewhat disappointed
DocWils ~

I know you have stated before that it is you who are lucky to have your patients come to you for medical help. From a layman's point of view, it is people like me and others who are the fortunate ones to have benefit of your knowledge and your kindness in sharing that knowledge.

Thank You....Merci
08-23-2015 04:11 PM
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DocWils Offline

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Post: #13
RE: somewhat disappointed
You're welcome, GM. But please stop, I don't like blushing and I don't take compliments all that well. Once is most assuredly enough.

BTW, my general feelings about spinals, if they are well administered (here that is most times), is that the greatest dangers is blisters on the heels - it takes a few hours for the stuff to wear off and leave your legs, but you are awake in your bed, and without realising it you are moving your legs a lot, mostly back and forth, so the heels can get blistered on the bed sheets without you realising it or feeling it - I always tell the patients to roll up a towel before the op and store it in the side table by the bed, and once back in the room, to put it, or have the nurse put it, or a pillow, under the achilles tendon to keep the heels from touching the bed clothes. And a pillow under the knees, too. Just more comfy, unless it is a knee operation, then, no to both.

For the most part I prefer to not use full narcosis if at all possible, since the recovery is complicated by the anaesthetic a bit - the patient goes through mood swings and that doesn't help much. On the other hand, if it involves a lot of banging and hammering or sawing, better put them out, less scary for them...... six of one......
08-23-2015 04:31 PM
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trish6hundred Offline

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Post: #14
RE: somewhat disappointed
Hi GrammaBear,
Glad you came out ok from your surgery, WELCOME BACK.!

trish6hundred
08-23-2015 04:39 PM
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YTN3rd Offline

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Post: #15
RE: somewhat disappointed
I am glad this story didn't end in a horror story. But at least if something bad happened to your breathing you would be in the best hands to help. Kinda silly this kind of info was not jotted down or used in any way though.
09-16-2015 03:34 AM
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GrammaBear Offline

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Post: #16
RE: somewhat disappointed
P.S.......At my post-op checkup, the surgeon gave me a post-operative report which I read when I returned home. The report says that I had a "general" anesthesia when in fact, to the best of my knowledge, I did not. Later that week I contacted the surgeons office and was told that I must be "mistaken" and that all of the doctor's surgical patients receive a general anesthesia. I gently pointed out that I don't believe it did because in one place on the report it does say spinal and in another place on the report it says general. This went on and on for several days when finally the surgeon 'found' what I was referring to in the report and said "You're right" - you did have a spinal and I will need to file an amended report and will send you a corrected copy which I have yet to receive. It pays to read the operative report I guess.
09-16-2015 08:15 AM
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DariaVader Offline
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Post: #17
RE: somewhat disappointed
(09-16-2015 08:15 AM)GrammaBear Wrote:  P.S.......At my post-op checkup, the surgeon gave me a post-operative report which I read when I returned home. The report says that I had a "general" anesthesia when in fact, to the best of my knowledge, I did not. Later that week I contacted the surgeons office and was told that I must be "mistaken" and that all of the doctor's surgical patients receive a general anesthesia. I gently pointed out that I don't believe it did because in one place on the report it does say spinal and in another place on the report it says general. This went on and on for several days when finally the surgeon 'found' what I was referring to in the report and said "You're right" - you did have a spinal and I will need to file an amended report and will send you a corrected copy which I have yet to receive. It pays to read the operative report I guess.

It's amazing that they are not more careful than that, but then so resistant to the patients input. Having that in your report could lead a later physician to mistakenly think you have shown a good tolerance for a general previously, when that was not the case. Good catch!

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
09-16-2015 10:00 AM
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GrammaBear Offline

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Post: #18
RE: somewhat disappointed
(09-16-2015 10:00 AM)DariaVader Wrote:  
(09-16-2015 08:15 AM)GrammaBear Wrote:  P.S.......At my post-op checkup, the surgeon gave me a post-operative report which I read when I returned home. The report says that I had a "general" anesthesia when in fact, to the best of my knowledge, I did not. Later that week I contacted the surgeons office and was told that I must be "mistaken" and that all of the doctor's surgical patients receive a general anesthesia. I gently pointed out that I don't believe it did because in one place on the report it does say spinal and in another place on the report it says general. This went on and on for several days when finally the surgeon 'found' what I was referring to in the report and said "You're right" - you did have a spinal and I will need to file an amended report and will send you a corrected copy which I have yet to receive. It pays to read the operative report I guess.

It's amazing that they are not more careful than that, but then so resistant to the patients input. Having that in your report could lead a later physician to mistakenly think you have shown a good tolerance for a general previously, when that was not the case. Good catch!

It is my thought that the surgeon may not have appreciated me finding that honest mistake and I most certainly cannot afford to "annoy" this doctor. If I do then she will tell me to "take a hike". In my previous conversations in the office with her I've received the impression that she doesn't want the patient to question her judgement. I feel as though I am between a rock and a hard place....not really a comfortable place to be.
09-16-2015 12:16 PM
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DariaVader Offline
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Post: #19
RE: somewhat disappointed
(09-16-2015 12:16 PM)GrammaBear Wrote:  It is my thought that the surgeon may not have appreciated me finding that honest mistake and I most certainly cannot afford to "annoy" this doctor. If I do then she will tell me to "take a hike". In my previous conversations in the office with her I've received the impression that she doesn't want the patient to question her judgement. I feel as though I am between a rock and a hard place....not really a comfortable place to be.

I hear ya! My experience shows surgeons in particular to be just a leetle more godlike than the rest of us

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
09-16-2015 12:32 PM
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DocWils Offline

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Post: #20
RE: somewhat disappointed
(09-16-2015 12:32 PM)DariaVader Wrote:  I hear ya! My experience shows surgeons in particular to be just a leetle more godlike than the rest of us

Of COURSE we are!

Mostly, though, we are simply really busy and really tired, and by my age, in serious pain and mostly ready to go under the knife ourselves (I know one orthopaedist who does a roaring trade just doing hip, knee and back surgery on other surgeons - he won't see anyone in the general public, and frankly has no time anyway, he is so in demand), so we tend to get a bit snippy when challenged. And we've answered it all before anyway, and forget that new patient hasn't heard it all before. And we run our ORs like real martinets.

Admittedly that is happening less and less as ORs are run more as teams of which the surgeon is only one member, even if he is nominally the quarterback, but nowadays we actually have special coaches to run us in drills in simulated ORs for emergency situations and every day situations to help us function better as a team. And yes, I was one of the people who suggested this, but I wasn't the only one, and it is run by another department. It is being introduced in the US as well, so far as I know, and is very successful here, in France and in the UK. A far cry from the days when Matron was the battleship that ran the whole thing and kept all of us, even us big headed surgeons, scared. I had one back in the day who could freeze your blood with just one baleful eye and a clearing of the throat. Oh, I hated the days she would be in my OR.......
09-16-2015 06:27 PM
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