I've got severe Sleep Apnea & I'm afraid to see surgeon!

My BMI is 44.7, I was referred by my medical doctor to Dr.Miles in Wilmington,NC for gastric bypass last August 2007. I received all their paperwork & I completed it right away. I have already had all the pre testing by my medical doctor. SO why am I just sitting on mailing the paperwork back to the surgeon???? I've afraid of dying on the OR table due to my sleep apnea!!  I am trying to lose 50 pounds to shake the sleep apnea before the surgery but that's near impossible. With all my health problems, if I don't have the gastric bypass I won't have more than 5-10 years left....I'm only 52. If I go thru with the surgery with the severe sleep apnea I could never make it out of the OR.  My adult daughter still lives with me while attending UNC-W fulltime. My adult son lives on his own but has never married as yet. I'd hate to leave them at this point. Frankly I just am afraid & don't know what to do. I'd appreciate some advise from those with the sleep apnea & if it caused any problems during surgery?

Hi Debbie, Don't give it a second thought!  I had severe sleep apnea just like you and never had a problem.  Here is why:  when you are under anesthesia, you are intubated as soon as they knock you out.  This means they slip a tube down your trachea (throat) and a machine does the breathing for you. The tube "feeds" you just the right combination of gases like oxygen and other goodies that will keep you asleep and unaware and pain-free until the nurse in recovery tells you "DEBBIE!!!  YOU"RE IN RECOVERY!!!  YOUR SURGERY IS ALL OVER!!!"  It's a breeze.  And before they even knock you out they give you some great relaxing stuff like Valium and also amnesiac drugs like Verset so you don't remember any of it.  And you don't even know they are doing any of it.  Once they get the IV going it's a smooth ride! And here's the best part:  I am 6 months post-op and haven't had to sleep with a CPAP machine for a good 3 months now!  It's a miracle!  You might want to consider Dr Harris whose office in Wilmington in a Bariatric Center of Excellence, unlike Dr Miles.  Have a look at my profile if you like. Hope this helps!

Now I must admit I am confused. I was under the impression Dr.Miles was a Center of Excellence. I spoke with my doctor just this morning & he agreed that with sleep apnea, should you go into apnea under general, they can't bring you out. That is so confusing because I've had many surgerys in my lifetime & am familiar with the intubation you spoke of. Seems that would cover any breathing problems. But I also watch TLC show on gastric bypass & the surgeon also spoke to patient with our apnea problem that she could die from that on table. She had it anyway & survived. I will look into this more. Many thanks to you for taking the time to respond! ~Debbie~

WELCOME to our NC world here... Most ALL WLS patients have sleep apnea.  It was my ONLY co-morbidity!  My BMI pre-surg was 43.  My weight was 305.  Much of the general population now suffers from it, but most of them are undiagnosed.  You have that benefit. AND, they told me to bring my bi-pap with me to the hosptial, which I did. I was DX with SA in 2001.  It was SO bad, the tech told me to sleep upright in a chair until seeing the doctor once he got the report.  He sent me for surgery... my uvula was removed, my tonsils were taken out, and they removed some bones in my sinuses! After that, my apnea was still extremely dangerous... over 300 "non-breathing episodes" in the 5 hours they monitored me with multiple periods up to 1 1/2 minutes long that I was not breathing! Post WLS surgery, my breathing (as monitored by the pulse-ox monitor they put on your finger) was labored for the first day or so, so when the pulse-ox alarm sounded that my ox had dropped too low, I'd just put my bi-pap on.

I haven't been re-tested yet for the apnea... I'm 3 mos. post op, but not using my bi-pap.  Probably should be, but I can tell a TREMENDOUS change in my breathing even when just sitting around.  Did you know that there's an 87% CURE rate of Sleep Apnea for those having WLS??? Talk to your doctor about your concerns.  I'd bet close to 100% of WLS patients have sleep apnea.  There are other things that are more of a risk than what you fear, but your fears are not to be discounted.  Rest assured that the anesthesiologist will be aware of your sleep apnea, from your medical record, but also, from YOU when they come and pre-op interview you. Keep asking your questions.  We're all here to answer them and support each other.  Rest assured that we ALL have our fears and concerns pre-op.  They may be different from yours, but real just the same.

And P.S.... as for what you saw the doc tell the patient on TV... our docs tell us that about all sorts of OTHER things as well.  They have to do that.  WLS is not without riskS.  It is his obligation to tell us we can die from the surgery due to this or that.  My fears were post-op and having a blood clot.  That is more common than dying from sleep apnea, I would guess.  That's why they have us up WALKING almost before we're out of the recovery room... and why we all post on here to folks just home from surgery to KEEP WALKING.  Blood clots can wreak havoc up to several months post-op.  You probably already know that due to your other surgeries... And think about the HUGE risks and other illnesses and damages being done to your body by your apnea!  Be sure to factor those in when weighing your fears... Your fear is NORMAL... we all have 'em about one thing or another.   Sure you don't want to leave your children, but wouldn't you love to be able to do more things with them now and LIVE by getting rid of the weight that's holding you back from that??  Make a list of things you'd love to be able to do WITH them NOW... that you could do or do better with more vitality IF you have the surgery.  Maybe doing a Pro/Con list of everything will help you make a final decision.  One of my biggest motivators is my little 3year old nephew, Wyatt.  I wanted to be FREE of all that lard on me so I could run and chase and swim and play with him.  And at just 3 months post op, I've lost SEVENTY pounds and am doing all those things WITH him now, no****ching from the sidelines anymore... as for me, I would do it again in a nanosecond!

Wow Wendy, you are a motivational speaker! I think I could walk into that OR now if you were standing beside me telling me all these things! But, like you said, my fears are real because there are so many things we must consider before taking this huge step. I need to look into this more than I have. I "thought" I was going to be seeing a surgeon at a Center of Excellence. Another person just shared Dr.Miles is not in one! I checked & she sure is right! I don't know where I read he was online but it was not correct. My primary medical doctor referred me to Dr.Miles because I have medicaid & have to be referred to a participating doctor & have to meet guidelines. I already meet the guidelines & then some. Besides, a couple nurses working for her had WLS & went to him & loved him.  Thank you for sharing all this with me, it means alot! ~Debbie~

Glad to help Debbie!   Just do a little more "homework" and I think your fears will be soothed.

SweetGal_Debbie: I have very severe sleep apnea. I also weight 467 lbs when I started seeing my surgeon.  My CPAP is kept on the highest setting (15). At my sleep study, I had 293 episodes in a 3 hour time frame. My pulmanologist said it was the most he had ever seen in his practice.  I had the gastric bypass and had absolutley no problems.  I was warned that because of my apnea there was risk of needing to put a tube down my throat and kept in for a while after surgery - which I would need to be in the ICU ward for 24 hours.  I did have it during surgery.. but it didn't stay. I woke up in the afternoon and it was all me and no tube. I just had to take my mask to the hospital with me and a CPAP machine was brought to my room. They had a pulmonary nurse come and check on me every night to make sure I wore it LOL. 

Debbie, You have been given some great advise from other members here. I had severe SA before surgery and I really belive I have had it for more than 30 years. Having a sleep study and getting my bi pap machine was a blessing for me. The blessing was I was able to sleep most all night. I am 6 months post op and havent used my machine in months. I can now sleep on my side at night and my hubby says I dont snore any more. I am even able to watch movies now. Before surgery it was very rare that I could even sit and watch a whole show or movie without falling asleep. I was terribly afraid of surgery too and had some of the same fears you do. The co morbiditys of being obese can cause lots of health problems. I was very sick before surgery and did not relize just how sick I was till after my wls. I am alive for the first time in my life and loving every minute of it. I am 48 and plan on living life to the fullest.                                           Annie

Hello, I believe you can go to http://www.rhhn.org/17351.cfm and see that both miles and Harris recieved the same recommendation in 2005 for Bariatric Excellence......If not  search Dr, David Miles, NC and you will find it....On another note I too have sleep apnea and have had surgery other than WLs with no problems.  God Bless you I hope you will be well in your journey however you choose