Question:
I was just diagnosed with severe sleep apnea--2 wks prior to open rny and
it has complicated matters so much! I am glad to be aware that I have it but now I don't know what to do about pain relief. My doctor uses the morphine pump and although I am supplying him with all the information on my case, I am afraid I will push the pump too much and medicate myself to the point I won't wake myself up when I don't breath. I am getting a cpap today and the setting is 12. Does anyone know if this is terribly high and would hurt my new sutures after surgery? I have asked people in the sleep lab, my doctor, and every seems to kind of "glaze over" when I state my concerns. Now I am coming to the "experts"--all of you. Please any advice would be appreciated. What did most of you with sleep apnea use for pain control after surgery at the hospital and at home? Did you use your c pap at the hospital and at home? Or just at home? Thanks I am so confused! — [Anonymous] (posted on November 10, 2000)
November 10, 2000
w/the pump of pain meds. they make is so you can't over medicate yourself.
they make is so you only get so much and at certain intervals of time. My
was every 10 min. I could get more. But I didn't need it. so they took it
out. Good Luck to you...you can also state your problems to the
anestesologist and see what he has to say. Actually he has to know anyways
b/c sleep apnea can affect the general anestesia and stuff. He needs to
know as well.
— Alison B.
November 10, 2000
w/the pump of pain meds. they make is so you can't over medicate yourself.
they make is so you only get so much and at certain intervals of time. My
was every 10 min. I could get more. But I didn't need it. so they took it
out. Good Luck to you...you can also state your problems to the
anestesologist and see what he has to say. Actually he has to know anyways
b/c sleep apnea can affect the general anestesia and stuff. He needs to
know as well.
— Alison B.
November 10, 2000
I also had sleep apnea when I had surgery about 7 months ago. I had been
diagnosed about 11/2 years before that. My c-pap was also set on 12, which,
I believe, is relatively high. I DID take my c-pap to the hospital with me
as per my instructions. I used the c-pap when I slept & the first few
days after surgery when I was still on oxygen, they ran it thru my c-pap so
my oxygen would also be supplemented while I slept. I had no problems,
whatsoever, with my c-pap, my sleeping, or my medications either at the
hospital or later, at home. However, as I lost weight quite quickly right
after surgery I found that I was having trouble sleeping with my c-pap
& after several days, I discontinued using the c-pap. I have now been
off the c-pap for about 61/2 months & am sleeping great....Well, wish I
were sleeping longer, but that's another story.... LOL! I am hoping you've
gotten more info about your sleep apnea & c-pap by now, but in case
not, let me mention that once you have the c-pap on, you WON'T wake up due
to not breathing because the c-pap will insure that you DON'T stop
breathing. That's what it does; it keeps your airway open so you don't stop
breathing while you're asleep. The c-pap won't affect your sutures in any
way. As was mentioned in the previos post, it's impossible for you to over
medicate yourself. The pump will be set to only give you a certain amount
of medication within a certain amount of time. The only other thing I want
to mention is you might consider renting a c-pap instead of purchasing one,
as many of us previous sleep apnea sufferers have found that with the
weight loss after surgery, we no longer have sleep apnea &, therefore,
no longer need to use the c-pap machines. See, you can just relax a bit; it
will all be fine!!
— Kathy W.
November 10, 2000
Everything's ok!!! You will be able to handle this with no problem at all.
My sleep apnea was diagnosed almost a year prior to the surgery and I was
using a CPAP machine, also with a 12 setting. 12 is considered moderate
and will pose no issues for you in the hospital. Sleep apnea is also a
major WLS comorbidity, so in a way it will work for you, not against you,
especially if you had any insurance hassles. First, let me tell you that
using the CPAP changed my life dramtically. It was truly a blessing to
finally have REAL sleep and not worry whether or not I was going to fall
asleep at the wheel or at work. For those who have not had it diagnosed, I
highly recommend tending to it. Undiagnosed, it can cause tremendous
strain on your organs and can eventually kill you. So I congratulate you
on diagnosing the problem. Some tips at the hospital: You will have to
take your own machine in. The hospital does not provide these machines for
use. Label it well to be sure it doesn't "walk off" somewhere.
I know how expensive they can be. I could not use it the first night I was
in the hospital because of the tube down my throat, but this did not
concern me. I was so groggy, and I didn't need to worry about being
terribly alert. I wasn't going anywhere! In order to use your CPAP at the
hospital, someone will need to certify it. It's just a formaility. They
want to be sure that it checks out electric and safety-wise. While in
surgery, give your CPAP to your family member/friend who will be waiting.
On the second night after my tube was removed, I did use my machine - no
problems whatsoever. They even hooked up my oxygen tube to the mask
itself. As far as pain meds, don't worry! I had a morphine pump and it
was never a problem. And just to ease your mind - it is not possible to
overmedicate yourself. The pump is set to a certain level automatically
for a certain time period, and after a certain point, no matter how often
you press the button, nothing more comes out! IF YOU HAVE NOT DONE SO
ALREADY, BE SURE YOUR SURGEON AND ANESTHESIOLOGIST (SP?) ARE AWARE OF YOUR
DIAGNOSIS. Sleep apnea patients do need special attention when they put
you under, but it's nothing they haven't seen hundreds of times before and
nothing they can't handle. Also, some sleep apnea patients take longer in
recovery to come out of the anesthesia, so inform your waiting visitors so
they don't worry. When I got home, I used my CPAP machine for 3 more
weeks, and I have never looked back since. I am 6 months post op and have
lost 84 pounds. No more sleep apnea, among many other good things. Hang
in there - you'll do great. And honestly, having sleep apnea does not
complicate things a bit!
— Paula G.
November 10, 2000
I got my C-PAP in 97 set at 15, my surgeon had me get another sleep study
as a pre-op test and I now have a Bi-PAPset at 20 insperation and 15 om
expration. My surgeon told to bring m machine and head gear and that I
would have to spend my first night post-op in intensive care as a
precaution. I have had many people tell me that they could not ever sleep
with that mask on I tell them that I can't sleep without it. Get your
machine and use it. By the third night I was able to use it all night long
and could nit remember the last time I had gotten that much rest in one
night.
— MARK N.
November 10, 2000
Hi,
I too have C-pap at a setting of 12. It can go up to 20 so I'd say we are
right in the middle. When I had my surgery
(1 month ago) I opted for an epidural for post-op pain control. It works
for approximately 80% of people, and it was great for me(no pain). It is a
better choice than morphine pump for those with sleep apnea. My surgeon put
me on oxygen in the hospital instead of cpap as he did not want to blow
forced air into my new stomach in case I breathed through my mouth. When I
went home I went back to cpap. Whether you are on epidural or morphine
pump, they will put a pulse ox on your finger to monitor your O2
saturations. If you do stop breathing and your sats drop below 90% an alarm
will go off, if that does not wake you up, a nurse will be in to do it for
you. I just made sure they knew about my apnea and they took care of
everything else. They are experts and know what to do. Just make sure they
are very aware. I was on liquid pain meds when I came home, but really did
not need it very much. The epidural stayed in me in the hospital for 3
days and by the time it came out most of any pain I would have felt was
gone. I did not waste any energy fighting pain and being worn out from it,
and thus I had lots of energy to walk, walk, walk in teh hospital and at
home.
— claire C.
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