eldin raigmore wrote:Not sure what thread this should go in; I decided on this one, perhaps incorrectly.
I had baryiatric (I know I'm misspelling it; I think my spelling ought to be the correct one) surgery a week ago yesterday morning.
I'm doing just fine now.
Didn't see this earlier, but I also wish you a speedy recovery!
But I was in the hospital a day longer than plan because I had to be intubated and spend the first 24 post-op hours in ICU.
I slept through all the excitement, though. When I recovered consciousness I was peeved by the tube and by having both my wrists bound, but that didn't last long, and after I was extubated and my right wrist was unbound I felt fine.
Okay -- this explains the sign language proposal in the other thread! A little personal experience here. I guess between us (you patient me nurse), we've got both sides covered, then.
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Here's what happened (I'm just assuming someone is interested):
I have sleep apnea and high blood pressure.
Not a good combination, to be sure. I'm sure we all hope this procedure will help get you to the point where neither of these will so much of a concern!
I was my surgeon's second procedure that day; his first patient had multiple procedures and complications and the surgery went on for two and a half hours longer than planned.
It happens. I certainly don't mean to be flippant -- but sometimes things go wrong, and the next person in line has to wait. It's never a pleasant wait; and I certainly hope your hospital had some kind of liason that could let you know what's keeping your surgeon away!
Hospitals put a lot of fluid in surgical patients pre-op.
They certainly give "some" -- without knowing how much you got, it would be difficult for me to say whether or not you got "too much" or whether or not the amount was appopriate.
Keep in mind, though, that you had nothing to eat or drink since midnight the night before -- and most people do not wait til 1145pm to bolt down that last steak and potatoes with a couple litres of coke! Most people come to the hospital already fasting a good twelve hours. If the case before you is going long, then you'd easily be pushing 15 hours without so much as a sip of water. The amount of fluid they give you will be determined at least in part by your size as well as time -- it may seem like a lot, but think about how much you'd normally drink between six am and noon -- for me, that could easily be 64 + ounces of fluid. I will say it is always a bit of a heartbreak to have to deny someone a sip of water when they're pretty clearly dying of thirst; or to listen to them beg for a chip of ice to suck on. But eating and drinking before general anaesthesia is a strict no-no. The alternative is extremely horrible: when you put things in your stomach, you turn on all that acid production. Normally this is not a problem, but with the medications they give to you -- muscle relaxants especially -- all that nice acid will just flow right up your esophagus and down into your lungs. Acid and lungs don't get along very well. And, being asleep and completely relaxed, you would have no defense against that -- you wouldn't be able to cough or swallow or anything. And it would just sit in there for hours. Bad joss all around.
So I had 2.5 hours' worth of extra fluid in me when I went under.
I'm hoping they asked, during that time, -- or that you had the sense to ask! -- if you wanted to go use the bathroom! We like to avoid urinary catheters as much as possible (best way to avoid a UTI is to not introduce anything up anyone's urethra if at all possible). But there are other factors that might indicate one in your case.
Having sleep apnea, I reacted to the anesthesia by stopping breathing.
That's as expected.
Everyone stops breathing once they start with the meds. But that's what the tube and the ventillator are for: they breathe for you. Sleep apnea certainly makes the process more dangerous: all the extra tissue in the back your throat falls back and makes it much harder for them to see your airway.
Most people's blood-pressure goes up when they stop breathing.
Yes. Other medications are given to stabilize blood pressure. Obviously, some folks react differently, or have a more extreme reaction!
Since I was already hypertensive, my blood-pressure really skyrocketed.
Since I had more fluid in me than was planned for, this pushed fluid into my lungs and I started getting pulmonary edema.
Also, I began to go into
diastolic heart failure and/or
congestive heart failure.
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Sorry to hear all that! It's always a sad thing when someone goes in for a surgery designed to help them become healthier; and they end up with another bad problem in stead! That's the scariest thing I've heard you say yet! I hope that you took your b.p. meds that morning (usually hypertension patients are on some kind of diuretic -- that would have helped get rid of some of the fluid); I would also hope that they would have given you something for fluid management during the procedure as well.
Apparently they extubated me one time that I don't remember. My sister, who went with me, says that I woke up (which I think probably overstates my state-of-consciousness at the time).
Yeah. "Waking up" can mean several different things, and being fully conscious and aware really isn't one of them! There are certainly differenlt levels of awareness -- some of your parts may be more aware than others; there are also the effects of medications to think about. If they kept you intubated, they probably also kept you pretty well narcotised. You would have been pretty oblivious to everything. What your sister describes is probably your
body kind of waking up. Well before a patient can understand and follow commands, you might have squirmed around a bit, maybe tried to lift your arms up, maybe kicked your legs a bit. Eventually, even when some part of your mind was able to process and follow commands (like "open your eyes" or "open your mouth") You (the person we can actually talk with) might still be quite unaware and would not remember. So yeah, some part of you "woke up", but You might still have been wandering other paths somewhere!
They say I got very agitated because I was still on the verge of pneumonia with the fluid in my lungs so I was re-intubated and knocked back out.
Could be. That could certainly exacerbate. Some people, as I said, react differently to medications; some anaesthesiologists have a little less finesse than others. It is an art as much as or even more than it is a science. Waking up agitated is pretty common -- some people wake up just as smooth as new milk, they pop their eyes open and start talking just as if they never went to sleep (before falling asleep again for another while!); other people wake up swinging their fists and literally trying to jump off the bed. Most people fall somewhere along the continuum in between.
Then I woke up in a lot of discomfort, not because of any of that, but because it felt like the damn urinary catheter wasn't working.
Yep. They are not designed for comfort, really. One effect of having a catheter shoved up there is that you feel like you have to pee all the time; and other is that you can't!
With a tube between your vocal cords you can't make a sound; with a tube between your lips nobody can read your lips.
I don't know of any sign-language where a speaker never needs to move at least one hand; anyway I don't know how to speak a sign-language, though I've been interested in Ameslan (American Sign Language, similar to Danish SL and French SL rather than to British SL).
So the ICU personnel would bring me a pen/pencil and a notepad.
But I couldn't see what I was writing; besides, you can't write very much or very well when you can't move anything above your wrist.
So they never understood what I wrote.
They really should have tried to explain things better, and perhaps a little more frequently. Especially as you were regaining consciousness.
At least they frequently did things to let me know they were still there. I didn't even have a call-button; if they'd been behind my back and silent for too long I'd have panicked. But they didn't let me panic, and that situation (intubated and both wrists bound and no call-button) didn't go on for hours.
That's good at least! I'm sure they had your wrists strapped to keep you from reaching up to grab the tube; and they probably wanted you to be a little more awake before undoing the straps. Even when still not-quite-back-among-the-living, awakening patients can still hear and can still understand. I think they perhaps could have done better to explain and reassure, verbally, even if you aren't quite able to talk or communicate effectively.
Ah! I see later you describe what procedure you had done: I've never seen a "sleeve gastrectomy", but understand what you described. That's pretty major, even if it's laparoscopic.
Of course, you don't need me to tell you this is really the opening salvo; that many bariatric surgery patients regain lost weight; that the road ahead is not easy; etc. It may or may not be much consolation, but I'm sure everyone here will keep you in mind, will pray for you and hope you win the fight in the end!
Hope this helps understand some of the reasoning on the Other Side!
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