Question:
I am having open rny in 8 days and a problem has reared it's ugly head

and I advise from you that have been there. I am having open rny with stomach stapled and sutured not transected. I have sleep apnea with a setting of 12 which I intended to use post op at the hospital. I read a website on here in which a man had his sutures blown out inside because a nurse turned up the machine to 20. I know my machine cannot be changed but is a setting of 12 significant enough to blow out MY sutures? I am scared to death of this happening. Have any of you had the similar operation and used your cpap at a 12? I intend to discuss this with my anesthesiast but I will only see him briefly (if at all) when I enter the hospital next week. I am afraid he won't be "up on this" and just dismiss it lightly and go on. These things happen and God help me, I am trying my best to cover all bases. I don't know about you but it seems if a patient becomes "proactive" in their care and asks questions etc. it is not appreciated by the medical community. Still, I will insist on satisfaction since it is my body! Thanks for any information    — Marilyn C. (posted on November 18, 2000)

November 18, 2000
Marilyn, I had an open RNY in August. My surgery involved transection of the stomach. I am on a CPAP with a 15 setting and I have used it every night since my surgery with no problems. In fact, with a 60 pound weight loss, I am working with my pulmonologist at reducing the setting. As to the reaction to your questions, I had a similar experience 15 years ago when I had a serious illness. I finally pointed out to the doctor that it was my body and I needed to have the information so that I could make the most informed and best decisions for my self. One of the reasons I chose to have my surgery where I did was because the surgeon answered all my questions and did not seem concerned that I had done as much research as I had. We are making some very significant life changing decisions with WLS surgery and we should expect to be treated with courtesy, respect and kindness. If you are not experiencing that you need to make your doctor aware of it and then change doctors if the situation is not recitfied.
   — Nanette T.

November 18, 2000
Dear Marilyn, I had the same surgery you are having. I was not allowed to use my CPAP in the hospital or afterwards for 6 weeks because my surgeon said it could blow out my sutures. I was quite freaked out about not having the CPAP, but I knew I certainly was not the first person to have sleep apnea and open RNY surgery and that certainly the surgeon and hospital would not want me to die due to not using my CPAP thereby making my son a very rich person at their expense! So I let them tell me what to do and I have not used my CPAP once since surgery on 8/29/00. I have lost 61 pounds and doubt that I will ever use it again. I was on oxygen in the hospital and also at home for a couple of weeks. Had no problem sleeping without the CPAP at all. I know some are allowed to use the CPAP in the hospital, but I wasn't. I hope you hear from some other people on this subject. --Libby
   — Libby B.

November 18, 2000
It seems that each surgeon has his own opinion as to whether to allow the patients to use CPAP after surgery. I have severe sleep apnea and absolutely cannot sleep without my machine. My surgeon has informed me that he will not let me use the CPAP for the first 2 nights following surgery. I tried to talk him into it, almost begging him, but he wouldn't relent. I wouldn't worry about the nurses changing the setting, because I think you have to open up the machine to do that. Your anesthesiologist has had experience with patients with sleep apnea, I'm sure. Make a list of your concerns and questions, and bring it with you to the appointment. I always do, because I get nervous and if I didn't have the list to refer to, I wouldn't remember what to ask. Good luck!
   — Leah B.

November 18, 2000
Hi! I had an open RNY on 2/29/00. At the time I weighed 543 lbs ( I now weigh 366) and was on a Bi-Pap (it's just a fancier C-Pap) My setting was 16 and I used it right after surgery with no complications. My surgeon had made me go to a pulmonologist in the city that I was having the surgery, and the pulmonologist was on-site during my surgery. He also came to visit me every day just like the surgeon. I was also monitored by respitory therapy technicians. I had no problems at all. My incision was 19 inches long, and I had 107 staples, and I din't lose any of them due to the BiPap/C-Pap. My suggestion would be to see if your surgeon works with a pulmonolgist or another physician who splecializes in sleep disorders. Best Wishes...
   — Holly G.

November 18, 2000
Although I was only diagnosed with sleep apnea just prior to my surgery, I refused to use a cpap machine. I preferred to snore, believing that if it was good enough for granddaddy and mom, it was good enough for me. However, with being narcotized from the anesthetic, my brainstem would not be able to 'wake' me to breathe. In fact, in ICU right after surgery, I kept setting off the breathing alarms and kept desaturating my blood oxygen. The nurse offered to turn off the alarm so I could get some sleep, I felt that would be unwise, because then I wouldn't wake up to breathe. I suggested, and the resident doc wrote the order for a cpap, which I used for 3 out of four nights I was hospitalized. On the fourth night, the floor nurse kept an eye on me and said that, although I snored like a contestant in a chain saw contest, I did not stop breathing. Now, at 6 months post op, and down 120 pounds, my sleeping partner indicates that I do not snore at all. Hope this gives some help. fondly,
   — merri B.

November 19, 2000
My CPAP was set at 15 and my doc prefers us to use our own CPAP post-op. As far as I know, the air blows into the lungs and not into the stomach. It surely would be uncomfortable if it got into any stomach, let alone a pouch! My machine had to be set using a key, so even I couldn't mess with it. When I first woke up post-op, I asked for my machine immediately. With the oxymeter on my finger, the beeping every 15 seconds (when I stopped breathing)was driving me NUTS!
   — vitalady

November 19, 2000
I came across that same site before my surgery and freaked out! I got in contact with my pulmonologist and surgeon and both relieved my worries. I used BiPap 15 over 10 and did fine with it after. The only thing I noticed is that for the first few weeks postop I couldn't use it lying flat, I did feel like my stomach was getting full of air, so I slept in a recliner and had no problems with it. Once I was a couple of weeks out, I got back into a real bed and had no trouble with feeling like my stomach was full of air. Now at 10 months, down 131 lbs, I no longer need it...just collects dust by my bedside. Talk with your docs and do not be afraid to grill them to feel comfortable. It's your right. I'm one who rakes them over the coals(and I'm a nurse!) Good Luck!!
   — Shannon B.

November 19, 2000
Had my consult with my Dr. for open RNY last Friday. I ask the question about my c-pap. He said to bring it with my on surgery day, and I will use it just like normal during my hospital stay. He says I may even want to use it during the day in the hospital if I am sleeping a lot. Hope this helps.
   — Pam L.