Back ground Info: RNY 2008 No complications No side effects, No issues
Upper GI in June showed all is well
New Cpap (Bi level) with pillows 5 days ago.

Last night I (and this is gross) I  threw up in my mouth, hot acidy stuff, burning my throat. While I was asleep. I woke up with it coming into my mouth. I had not eaten anything at bedtime, nothing unusual that day or evening.

I know I will be talking to Doctor at some point but what do you folks think? Ever heard of this?

 I don't have the answer but I can't wait to hear (read) it.. I did the same thing about 5months after my RNY. It only happened once but it FREAKED me out!

I know, freaks me out too. I'm like, can I choke on this if it happens again.

Just a wild guess, a hietal hernia (not sure if I spelled that correctly), its a weakness in the upper stomach valve that can cause a leakage and acids to drip into your throat while you're laying flat. Like I said, wild guess, but I dont think that would show in radiology unless you were laying flat. But go to your dr, I'm not one lol. Hope you get it resolved.

This was no drip, it was a gulp (yuk, I know gross)

Oh wow, that doesn't sound right, definitely need to sed your doc, I wonder if pressure from your cpap has anything to do with it? Id like to hear what happens just in case I ever have that problem.

you know, I thought that too. My first call is going to be to the Cpap rep.

Do you take meds? I've found taht I get acidy reflux only if I've eaten something extra acidic, or taken meds which all taste awful with reflux.

my reflux was never cured by RNY... but the acid part of it was. I only get ACID reflux when I've consumed something yuck... or acidic. even vitamins can give me an uncomfortable reflux

i've taken the same meds for 7 years but i did just start taking more vit D. First dose was yesterday (this happend last night). OMGoodness, you may be on to something. I went from taking 1000mg of vit D a day to 15,000 and my first dose was yesterday. I wonder if that is it? Not something I ate because I didn't have any out of the ordinary foods for last week. I actually was deeply asleep when it happened. Do you think it could be the new dosage of D?

I'm a new post op...almost 3 months, but I have had this happen several times before surgery.  I was told to take prilosec and prop up my bed on blocks or sleep with a wedge pillow.  This could also be symptoms of a hiatel hernia.  unfortunately I never really got a definitive answer, although making the small changes....propping up with a wedge pillow, taking 20mg of prilosec, and not eating after 7pm, cutting back on alcohol consumption and spicy foods seemed to help.  I definately know the scary feeling of it all...I was brought out of a deep sleep by throwing up all over myself....it was not fun....sorry I can not be of more help...just hope a dr. has a better answer for you.

hmmm  what are the symptoms of a hiatel hernia?

Im not entirely sure, they told me after my surgery that I had a bad one and they repaired it. I was 19 at that time. I remember always having something burning at my throat, but given that I have severe post nasal drip which is always draining, I dont know how much stuff was acid and how much was sinus drainage. I just know I was spitting out piles of yucky stuff out every morning, and since rny, its been greatly reduced. But see up until that point in my life, sick, or dr visits just wasn't an option, between football, band, and county weld off for high-schoolers, I had so much on my plate, that I just ignored everything going wrong with my body, boy have I paid for that.

Vitamin D isn't likely to make anyone throw up.  I took 50K IU of dry D3 daily with no issues in 2 years time.  DAVE

 Sounds like you aspirated in your sleep. This happened to me a number of times before I went on my bi-pap. Essentially, you stop breathing for long enough that your system does anything it can to wake you. You may need to have your settings adjusted.

Do you know how to check your AHI stats on your machine?

That does make sense. I just got the Bi Level Cpap so I do not yet have any pressure settings. I will need to send in my SIM card so they can determine my adjustment needed. They said I am now on the lowest level. I not only do not know how to check my AHI stats, I don't even know what that is?

 Ah, yes, that's very likely it. if you need a bi-pap, you probably have quite severe apnea, and if it is at it's lowest setting, you are down around a 5 ish, so you will still stop breathing a lot.


AHI is Apnea/hyponea indicator. It is the average number of not breathing, or not effective breathing you have per hour. It is the primary way you can tell if the pressure setting you have is efficiently working. You are always looking to get your AHI under a value of 5, but as low as possible. Have a search online for the manual to the machine you are using, it should be pretty easy to check.

Once you have your pressure adjusted properly, you will probably need to get it adjusted every few months as you rapidly lose weight. As you go, signs that your pressure needs to be lowered are:

Mouth leaks: waking up to find air rushing out your mouth,
Waking up belching or with discomfort in your pouch from swallowing air
Sinus irritation unrelated to a cold or infection.

My pressure started way up in upper severe at 18, and is now down to 5... I should be off it soon, if I can take off a bit more weight!

Best of luck,

Mo

How do you determine what level to have your machine adjusted to and who makes that decision. Do you need to do a new sleep study in order to get off the machine?

Technically, yes, you're supposed to have it evaluated by sleep study and adjusted with the supplier, but here I'm only covered for one every two years. I did it myself, lowering it point by point whenever I would have high pressure symptoms ( for me it is a specific form of rhinitis) and monitoring my AHI to make sure I was still in happy range. 

Eventually, when that wasn't working for me (rhinitis wouldn't clear, huge mouth leaks) even when I dropped pressure until ahi rose above 5, I went back and had a sleep study, turned out that one or two pressure down made my apnea worse, but four down, made it perfect.

LOL, I'm a doctor but not a med student. And I'm not a pulmonologist so I can't really address your CPAP, but are you wearing it at all now? 

How long was your last food intake before bedtime and how much/what?

Anyway here's my recommendations:

1) See your doctor, but in the meantime:
2) get a wedge pillow or elevate the head of bed 15% with cement blocks (That's the best way)
3) Avoid acidic foods, fats, caffiene and alcohol/carbonated beverages - esp before bedtime. And no smoking ( probably you are doing all this already, but it's part of the treatment).
4) Don't eat 3 hours before bedtime. If you must have a snack, make it really light; like some yogurt.
5) Using multiple pillows may make the GERD worse, because you tend to slide down on them and that increases intrabdominal pressure.

Talked to the cpap guy yesterday, he is unaware of anyone having this happen as a result of the machine. He did say that he supposes it is possible if I swallowed too much air but he has never encountered that. so today I am asking my PCP.