Botched!!!

On May 19th, I was supposed to have an RNY. I have some pretty severe sleep apnea. Most BiPAP machines go up to a setting of 20. My settings are 24/22. Whoever tried to intubate me SHOULD have done it while I was awake. However, they put me out, then tried. As any sleep apnea patient, my "neck meat" presses down on my trachea when I sleep, so they couldn't get the tube in. Poke someplace long enough and it will swell. So, it was no suprise that my throat swelled shut. My oxygen saturation dropped to 30%, and they finally managed to cram the tube down my throat 45 seconds ahead of a tracheotemy. My doctor decided to not do the surgery. I spent two days in ICU with a tube down my throat, one more day without, then another day in a room on oxygen. No doctor would admit that anyone made a mistake, instead blaming it on my physiology. Then today, I GOT THE BILL!!! Had my insurance not payed for most of it, I would have been charge over $30,000!!!!!!!!!! AAAAAAAAAAARGH!!!! Worst part is (besides the catheter) I have to do it all again!!! Needless to say, I am HIGHLY PISSED!!! That was HELL I went through with nothing to show for it except pain, anger, and debt!

I requested a new Anesthesiologist for round 2. I told them if I got the same guy, I was going to get up and walk out of the operating room.

I'm not a dr, but wouldn't an epidural be a better choice. I'm assuming it would numb you from your waist down. The idiot could have messed you up big time and I would talk to a lawyer. Any anesthisiologist worth anything could tell just looking at a person if there would be a problem. Before I could tell mine of the problem of getting a breathing tube down, he said to me, you are getting an epidural....a good dr can tell. Are you sure about having the RNY? Have you checked out DS (duodenal switch)? The results and life-style seem to be better than that of the RNY. Maybe there is a reason you are getting a second chance to have the surgery. Sorry you had to experience such a terrible event. Best wishes, Linda

You're right. Seeing the fact that I had sleep apnea should have given him a clue. I've done the research, and I am pretty sure about the RNY. It will offer me the best chance of taking the weight off and keeping it off it seems. Plus it will help me change my horrible eating habbits. Thanks for the well wishes.

Bariatric surgery cannot be done with just an epidural...must be done under general anesthesia. An epidural would have to be placed so high that we wouldn't be able to breath on our own. Our stomachs, especially the area these surgeries focus on, are well above the waist and quite high in the chest. Epidurals can be used for pain management but aren't a substitute for general anesthesia for these surgeries. Not even the lap-band can be done with just an epidural. The surgeons need the paralysis that general gives to ensure precise work. Would be cataclismic if the patient moved during some of the delicate stuff they do in the RNY or DS, etc. Nancy

Hey Nancy, thanks for that information. I've been doing my research for wls, so I'm learning. This concerns me because the last time I had surgery under general anesthesia the anesthesiologist spoke with me after the surgery and said that I was lucky that he was such a good dr. Apparently it was very difficult to get the breathing tube down my throat. Geez, now something else to worry about! I also was told that it appears I have sleep apnea and will be tested soon. Thanks again....so many people, so ready to help! Continued Success Linda

Since you now know this up front, it can be discussed/planned for ahead of time. It is, however, really important to get the sleep apnea managed prior to surgery. I believe there are a few options for difficult-to-intubate patients, such as fiberoptic methods... Nancy

Jim, I was an 18/14 on a Bi-PAP, so my apnea was not as severe as yous, but it was there. Boring personal account to give you some perspective... October of '02, in Monterrey, MX, at a teaching hospital, I got the Lap Band and they had no problem intubating me. (BMI of about 48) In May of '04, stateside at another teaching hospital, I had an abdominoplasty and was informed afterward that I was "a difficult intubation," a "Class Three." (BMI of about 41) In February of '05, at a high-rent district hosptial, I had a breast reduction that almost didn't happen, because the first anesthesiologist couln't do it. TWO HOURS LATER, a second anesthesiologist pulled it off with no problem and I was later told that I was NOT a candidate for day surgery as I would need a place with fiberoptics available for anesthesia. (BMI of about 42) In November of '05, at a small hospital in a small rural area, I had the band removed and a revision to the Duodenal Switch. (BMI of about 49) Knowing my history, they scheduled 3.5 hours for my surgery. Thing is, bariatric surgery is almost all they do...and sleep apnea patients comprise the bulk of their patient population. I was in and out in LESS THAN two hours. THAT IS, it took the small-town folks less time to do "THE WHOLE ENCHILADA" (intubation, anesthesia, the band removal and the entire biliopancreatic diversion with duodenal switch surgery, and find my husband in the waiting room to tell him how thigs went) than it took the high-rent district folks to intubate me. So...I think you need a different anesthesiologist AND you need to make sure they have fiberoptics available AND you might want to consider locating an anesthesiologist who has EXTENSIVE experience with bariatric patients. Good luck, Sue