Sleep Apnea & Anesthesia When Having Surgery and Thank you

[Schnauzers 5]

This is a long post but I need some answers and to fill you in on what is happening with me.

I am 67 and have cataracts and recently saw my eye specialist and got new distance sun glasses and clear distance but they did not help, and now trying to read street names and signs on the right or left is impossible until I am at the intersection or stop sign. I went back to see if the prescription was correct and the doctor fit me in to recheck me. He also had a topograhy done on my corneas which have been ruined by voluntary Lasik I had 13 yrs ago this past March. So he showed me the picture and the circles like a target board or bulls eye, are wavy all under and thru my cornea. That along with my right eye ( blue eyes)has Aides pupil which is a neuorological oddity where they think a virus got to my eye and spine when I was in my thirties and it causess the pupil to no longer or barely react to light or dark. Apparently doing cataract surgery they go thru the pupil but with me, it never dilates enough to do so even with drops. So he said doing surgery might not help my vision after I go thru all that and I could LOOSE an eye! WHAT? OMG! I never heard that before. Previously he said his associate is good at figuring the right prescription for such Lasik type eyes. Now he says it is very risky! BUT if I don't have it, I will eventually be blind. No option is a good one. If I did have at least my left better eye done;which scares me, I would want to be under anesthesia but I have sleep apnea so how does that work? They sometimes give a local but I am sure for me, If I ever choose with wise counsel to have surgery, I would want to be asleep. Meantime, I am devestated about the odds of me being blind in a yr or two . I live alone with 5 Schnazuers and just the recovery would make it hard to care for them, being blind I would not be able to work to support myself let alone my dog family. Sleep apnea is no big deal compared to this! So I plan to call to see the associate doctor to see what he thinks. A man of few words I am told by a friend who had him do glaucoma surgery. I need answers and info to try to figure how to maintain my vision to function and continue to groom dogs and drive to the client. So again, IF I ever risk surgery how will they deal with the sleep apnea. I hear it is two weeks between eyes ( If I had both done) and a lot of no grooming and no income during the recovery time. Oh JOY. So those of you who believe in God, please pray for me that God can work this out in my favor. I am so upset, I can't sleep pr eat. I got 6 and 1'/2 last night and only 3 the night before . I still can't believe this is happening to me. I also have dry eye which also blurs vision. Drops are not helping, and crying sure doesn't help. I am going to my church today to ask how I can get some help to deal and arrange my life.

[Shastzi]

From the sound of it you might end up *legally blind* but perhaps not without some kind of vision that
artificial means can help you with to be able to get by. (special lenses and such)
Your Dr. should spell this out better.
***
I certainly wish you the best of luck.
I'll pray that you find the strength to make it through the hard times.
That is one prayer that is always answered.

Hang in there and stay well!

[DocWils]

Okay, calm down. Firstly, there is nothing to worry about with apnoea and anaesthesia. Unless you are given a light shot to put you under, usually some version of valium or a more modern version of pentathol (there are so many now), which is possible, you are intubated, so there is no possibility of apnoea at all. Still, it is a good idea to mention it to the gas passer if they are thinking of doing a simple shot instead of a full narcosis. Either way, the amount of time you are under is very little, and to date I have not heard of any problems related to apnoea in this way, intubated or not, and looking through my gas-passer books on my shelf, I see no mention of this as a possible complication. So relax, mention it to whoever will put you out, and they will be ready for any eventuality.

Now as to the cataracts - a cataract operation essentially destroys the lens and replaces it with a plastic one, your pupil dilation shouldn't be a major factor, but if it remains fully closed, it will be very difficult to it, and it may be that they will not attempt it on that eye. If, on the other hand, your cornea is affected, the standard now is to essentially scrape off the cornea, use a laser to correct the faults of the underlying layers, and cover it up with a bandage contact lens until the cornea grows back, which is the only way air force pilots are allowed to have corrective surgery of any type on the eye. Lasik is not allowed. We are seeing a lot more people with eye damage years after Lasik operations - I honestly think it should be taken off the market.

[PaulaO2]

As for how to live on your own with a vision impairment, thousands of people do it all the time. A huge percentage of those have pets.

What DocWils says about the apnea and the anesthesia is true. If you will be in a recovery room, you will need your CPAP. The doc and the anesthesia doc will need too know ahead of time that you have sleep apnea.

Make up a "how to turn it on" sheet and take several copies with you.** Check the hospital's website to see what their CPAP rules are. If they do not have any, email the patient advocate or whatever they are called and ask. Sometimes they have you bring it in ahead of time so someone can make sure it is in good shape. I asked and they say they look at the power cord and the overall condition of the device. They do NOT want a faulty electrical device around oxygen.

--
** This is actually something we should all have anyway in case we are sick or injured and cannot communicate how to use the machine. For my old one, I used to keep it in the carry bag. I've not done one for either of my S9s.

[Schnauzers 5]

Thanks folks. If and when I have any eye surgery I will inform of my sleep apnea and how to turn it on. I can't get an appt for consult with associate who would do measurements til they decide what test I need. May sometime I might get to see him/them. Any way I look at it it is going to be difficult and if I can't work I can't earn money to support myself, obviously.
As for anesthesia, I definitely would not want to be out or asleep without my c-pap or breathing assistance. Down the road I will have more answers but for now not knowing is hard. As for scraping the cornea, I had no idea and thought if you lost that flap you would need a transplant. I agree that Lasik is not necessary and I regret I had it done. Today after I groomed two little dogs and started driving home I was seeing better than I have been recently. Maybe the drops were working or maybe the antihistimine had worn off from a few days ago. For now, I can still drive and work, To think of loosing this vision is hard, as you may remember I used tom paint and posted pics of Schnauzers on handbags.

I realize this is not apnea related but I just needed info and support from my fellow pappers. I did wonder about apnea and being under during surgery.

[PaulaO2]

It is apnea related. It is something we all have to consider whenever we are having a procedure where we will be asleep.

I need to have dental work and am wondering how they are going to do it AND keep my airway open. Maybe they have a tongue clamp!

[Moriarty]

Interesting...

Mrs Moriarty is soon to have a Cataract induced Lens replacement op. She has been told that it will be done with a Regional (Local?) Anesthetic and she will not be out to it. In fact - it is usual for the patient to walk out after the op.

(Her cararct is a bit unusual in that she is only 56)

[Ugly]

As for how to live on your own with a vision impairment, thousands of people do it all the time. A huge percentage of those have pets.

A guide dog, actually, in my friend's case. Technically not a "pet".

Make up a "how to turn it on" sheet and take several copies with you.** Check the hospital's website to see what their CPAP rules are. If they do not have any, email the patient advocate or whatever they are called and ask. Sometimes they have you bring it in ahead of time so someone can make sure it is in good shape. I asked and they say they look at the power cord and the overall condition of the device. They do NOT want a faulty electrical device around oxygen.

That's where Smart Start comes in handy. Just put it on and it works. Hopefully.

** This is actually something we should all have anyway in case we are sick or injured and cannot communicate how to use the machine. For my old one, I used to keep it in the carry bag. I've not done one for either of my S9s.

An interesting idea although I don't carry my machine with me wherever I go. It is inscribed on my Medic Alert bracelet, however, that I have sleep apnea and use a CPAP.
When I signed up for Medic Alert (Canada) it was a lifetime membership. Nowadays for new memberships in Canada it's an annual fee, but I'm not subject to that. The rules may differ in other countries (I did have to pay for a new bracelet when I got apnea inscribed).

[Ugly]

Interesting...

Mrs Moriarty is soon to have a Cataract induced Lens replacement op. She has been told that it will be done with a Regional (Local?) Anesthetic and she will not be out to it. In fact - it is usual for the patient to walk out after the op.

(Her cararct is a bit unusual in that she is only 56)

My wife had cataract surgery a few months ago. She's 44.
They did both eyes, but not at the same time. She too was awake for it. BTW yes, "local" anaesthetic is the common term, vs. "general" where they nock you out totally.

[archangle]

Done right, even full anesthesia during surgery is no problem for CPAP patients. You are monitored and ventilated or intubated while under anesthesia. Then you'll be hooked up to CPAP at the appropriate part of recovery.

Unfortunately, there are a lot of bureaucratic, arrogant, and ignorant people in the hospital system. Be sure that everyone knows that you're on CPAP.

Nurses are a particular problem in that they stick to their routine. Many of them have no clue about CPAP. Many of them think that being on oxygen makes CPAP unnecessary, which is not true. Even pure CO2 does you no good if you're not breathing.

You also have to be sure that your attending physician knows about your CPAP and prescribes it during recovery. The attending physician is God and only he can be sure you get CPAP.

The hospital bureaucracy may also want to have your CPAP "safety checked."