With this upcoming gallbladder surgery, I've mentioned my anesthesia fears on here, but I am just as fearful of the intubation tube. Everything I swallow gets stuck. I had a swallow study a few years ago that shows that food does physically hang up, but they said nothing could be done about it. I had an endoscopy back in the 80's and they had trouble getting it in, and it resulted in the WORST sore throat for an entire month..and that is no exaggeration.
My throat and airway are more narrow, dry and troublesome in recent years and my mouth is very small. I am very concerned about that tube tearing something or getting stuck in there. My thyroid is enlarged too, so I wonder if that will pose a problem in passing that tube?
I mentioned my fear of the tube to the surgeon this week and asked if they would lube it up or what precautions would they take. All he said was " I've had patients with Sjogrens before who didn't seem to have any problems."
For those of you with really dry throats and swallowing difficulty, have you had surgery with the intubation tube without problems?
Thanks for your input.
Julie
Yes, I'm scoped every year and I have had two surgeries. At first, I was beside myself with fear because I'm very dry but it was okay. The first time, my gastroenterologist used a pediatric scope but after that I didn't need it. So that is an option. It will probably work out better than you think. At least that has been my experience.
Anna
Yes, yes! Be sure to tell the anesthesiologist (usually he will speak to you just before the procedure) about your very dry throat and ask him to make accommodations for it. I've heard they can use a lubricant on the tube if needed.
I guess I would also tell the nurses and anyone else who might be around when they put you under.
Good luck Julie!
I haven't got any experience to draw on but I have two suggestions:
1) See if you can have an appointment with the Anesthetist prior to the day of the surgery, rather than just 5 mins with them on the day... that way you can talk about your concerns.
2) Ask the surgeon if you could be first on the list, so you don't sit around for ages being Nil by Mouth.
Good Luck Julie, hope all goes well.
Aussie Mum
My GI doc gave me an endoscopy and he had to widen my esophagus. He was able to do that with me.
Julie,
I had surgery last year and they used something called a DMAP on me. They said it is less invasive than the normal tubes...I guess it doesnt go in as far. I have a very dry throat and was so afraid I wouldn't be able to swallow afterwards, but they did a great job with that and lubrication. I didn't end up with even a sore throat.
I would be sure to stress to the drs that you are very dry, and you have problems swallowing. And ask about the other type of intubation.
Good Luck, my prayers will be with you.
Last time I had an op was on my ears to put a grommet in. I was not diagnosed at that time, however there were complications due to intubation and they kept me in another 24 hrs observation. I won't go into detail for obvious reasons.
Please do tell the Anaesthetist. You might also want to tell them you have dry mouth problems so you do not suffer during Nil-by-Mouth and also post op.
I've also had trouble with intubation. The last time I had it for sugery, I was vomiting blood (not good). When I had my ankle operated on, I discussed my issues with the Anaesthetist, and he was completely willing to skip the tube. Instead I had a spinal block and then IV sedatives. I was completely out for the surgery and felt it was a very sucessful solution.
Good luck!
yes, please make sure you talk to the Anaesthetist and MAKE him aware of just how dry you are..tell him you cannot swallow at all basically..Most of them have no clue just
how dry we are/or we can get..I think they use childrens tubes on me the doc's have told me. I also drink water in the AM before any procedures-surgeries regardless of
what they tell me..Im always so dehydrated no matter how much water I drink and that certainly helps. Im not saying this is best for you, but with my dryness, this seems
to work well.
Thank you all for your replies. It helps so much to hear from others. I was hoping to get to talk to an anesthesiologist before the pretesting day, but they said they
don't usually take appointments like that and that they don't know which one is working that day that far in advance. So, I guess if it feels like my concerns seem
to be falling on deaf ears or I do not feel comfortable about the whole thing when I do finally talk to him, I will cancel and look at going to another hospital for the
procedure. I sure like the weather of the South and the humidity it provides for my dryness, but right now I'm wishing that we were back up near the Cleveland
Clinic for this.
Nurses, can you please tell me more specifically the purpose of the intubation tube? I know it's to keep airways open, but what would cause them NOT to stay
open on their own? If I didn't have the tube, do you think I'd be in jeopardy because of the mucus that I have from the dryness?
I have been reading about the different types of anesthesias too. It seems many of the general anesthesias still have the 'esthers' which I have trouble with in
local anesthesias. And...with my lung and nerve problems, I have trouble breathing in chemicals without reactions. I will have to talk to them about the possibility
of anesthesia by IV.
Right now I am battling a very inflamed, painful sty. It finally started draining this morning so I am feeling some relief. I usually have a high tolerance for pain, but
this thing burned like someone laid a hot curling iron on it.
It's ALWAYS something, isn't it! ? !
Take care
Julie
Intubation has the potential for a bit more than keeping the airways open, although for simple anaesthetic that may be the whole purpose. During even mild anaesthetic the throat, pharynx and larynx can become very relaxed and close, and the tube is a simple prop to prevent that.
Depending on the type of general anaesthetic, you may also receive a paralyzing agent...not uncommon in abdominal surgery of any type to relax the strong abdominal muscles and allow better access, even when done laproscopically. This agent can also paralyze the respiratory muscles, and the tube in that case is access for measured breaths from a ventilator.
Another possibility is the need for clearing the secretions from the airway and lungs, especially in the case of regurgitation of stomach contents (one of the primary reasons for taking nothing , even water, by mouth before an anaesthetics) because they can settle in and cause aspiration pneumonia.
The tube can also be helpful to the anaesthetist in monitoring the patient's condition, since it can provide accurate measurements of rate and volume of breaths, levels of O2 and CO2, and any increase in the resistance and/or the capacity of the lungs.
A fourth, remote possibility is preparedness for any emergency that may occur during surgery.
Linda, Thank you so much for the thorough explanation. It sounds like it is probably safer to have the tube, although I am still very concerned about them tearing something trying to get it in and out.
I went in for pretesting yesterday. They weren't going to let me talk to an anesthesiologist! I told them there is NO WAY that I will have this surgery if I can't talk to one in advance. The nurse was very understanding and was able to have one of them come in and talk to me. He was very helpful in listening to my concerns, actually read over the page long history sheet that I take with me to all of my appts, (which is a rarity) and tried to calm my fears. Just as I was feeling a "tiny" bit more relaxed, he said he will not be working next week when I have the surgery. Oh no!!! They have a team of 15 anesthesiologists, and it's whoever is on the schedule for the day.
He wrote down notes and my preferences/requests and said the one on duty would read them and take good care of me. I pray that will be the case. I was shaking like a leaf from nerves while at the hospital yesterday. And..it was ice cold in there. I told the nurse I don't know what I'm suppose to do about dealing with the Raynaud's during surgery. I hope they pile tons of blankets on me. That's the least of my concerns, but when I lose feeling from Raynauds, it makes my heart go wacky too. Loved how they had to have a urine specimen to make sure I'm not pregnant when here I am age 52 and had just started my period the day before. Gotta love the protocol. lol I haven't heard back on my labs yet. With this chronic anemia, I hope I won't have to have transfusions.
Thanks for all of the input everyone.
Take care
Julie
Good luck, Julie!
Sending my support and wishes for the other anesthesiologist to READ your message!
Janna
Julie, When you go in for your surgery take along a print out of your medications and on this write in about the need for warming blankets to keep you warm due to disease process.
Also, write down about your sjogrens and extreme dryness and being told that you have a narrow airway. Usually the anesthesia people will have your open your mouth or at least talk to you before surgery. Things have improved so much with anesthesia in the past few years and they are able to accommodate so many more health issues. I know you are scared but it is good to have some fear prior to surgery. Anyone who says they aren't scared or having anxious moments probably doesn't understand the situation.
Just know that it helps to write this down and have it all on this sheet with list of meds. I have found that the nurses refer to this a lot. I usually will print off the meds and the last time I took a dose. They ask this frequently and it can be time consuming so the print out helps.
I have issues with over sedation with anesthesia because I am so sensitive to morphine or fentenyl. The anesthesia people are always informed of this many times by me when I go in for surgery. It is also good if you can have your surgeries mostly in the same hospital. This way the anesthesia people have records to refer to. Good luck. Things will be fine. Also, lubricant is used on intubation much of the time because of the dryness people suffer from lask of fluids pre-op. Also, the drugs they give you in surgery make you dry also.
They have different sized tubes with which to intubate you. Some adults need to have a child's tube used due to small mouth. Irish ;D
I have had a number of procedures in just the last two years and I'm going to have another next friday. I have always had trouble with intubation, I even have a letter from an anastesiologist that states that a glidascope be used for intubation. The problem has nothing to do with my dryness or difficulty in swallowing, but physeology does, which might explain my sleep apnea as well.
Epson,
Can you expand on what kind of problems you had? Did they have trouble with insertion/removal? Tear anything? Sore throat for days/weeks afterwards? The anesthesiologist said they will use a smaller one on me.
Julie
Put your fears to rest,, they will do what you have voiced concerns about,, you told them,, they wrote it down,, take your notes with you,, talk to the guy before they do surgery,, by then you will have done all you can do,, try to relax,,, getting more stressed about it is just going to make it worse,, inother words,, its going to be ok,,
Julie,
The problem was insertion of the intubation tube, I looked like I went 10 rounds with Mike Tyson. My mouth was cut up and my lip was swollen. My throat is almost always sore, but I did experience some addition discomfort for a few days.
If the anaesthesiologist is aware of the problem your complications will be minimal to none, the anisesteaologist check my throat last week to determine what size tube to use and called the anaesthesiologist who wrote the letter explaining the difficulty he had encountered. I was told that if there was a problem intubating me the surgery would be canceled rather then causing trauma to the throat and mouth.
The last couple of time I had surgery they use a smaller tube and would only use the bigger intubation tube if I had trouble breathing, at that point who cares about a beat up mouth and sore throat. As long as they are aware of the problem you will be fine.
That is interesting Epson. We are all so different and have different shaped mouths, throat, etc. One of my sons has such a small mouth that they had a heck of a time removing his tonsils when he was 6 years old.
I have a sister with a very small mouth and she also has small jaws and never got 8 of her permanent teeth ---- which was very good as there was no room. Probably agenetic type thing. The anesthesia people know that we don't all come in one size and if made aware of the situation they can adapt as needed---which is what they have been doing with you. Hope you are doing ok, Epson. Irish ;D
Well....the gallbladder surgery took place last Wed. My Hgb was low going in so it's taking me longer to bounce back. I did this with no pain medication during or after surgery too, so I expect that is slowing me up more than the norm.
I felt no residual side effects of having been intubated, so that was a relief. My husband and I did get rather concerned when the nurse anesthetist came over and read through all of my health concerns and my list of DO's and DON'Ts. He just stood there skimming and going "hmmm...uh huh..you have a lot of allergies." He then went over and grabbed a syringe and came back ready to inject it into my IV. We both asked "what is that?" He said, "Versed." We picked up the paper that he had JUST got done reviewing and showed him where it said in bold capital letters, "No VERSED and No PAIN MEDS unless patient requests it." I have to tell you that I was a little nervous when I saw that HE was the one administering the anesthesia when they wheeled me into the O.R. At that point, I told myself it was in God's hands. That's the last I knew before waking up in recovery.
This past weekend, I developed pneumonia. :-\ The surgeon wasn't in yesterday so I went to my family doc. I have trouble with nearly every antibiotic out there so I was really hoping to avoid this. The only thing I can semi-successfully take is Amoxicillin. He's not sure it's going to work, but we are trying it for a couple of days.
Also, I think I have a bladder or kidney infection. I don't know if they inserted a urine cath or not..I didn't think they do that for this particular surgery. But ,it has felt kind of swollen down there since. And..the kidney region on both sides of my back is sore. Does anyone know or had experience with anesthesia causing the kidneys to be sore a few days after a surgery? Meds stay with me a LONG time, so I am hoping this is just a temporary thing that will soon pass. If it is an infection, I hope the Amoxicillin will knock that out too.
I'm ready to feel good again. Doc's orders were to keep eating bland until I see him on Thurs. I sure hope I'll be able to eat some foods that I haven't been able to touch in years. I have had bouts of diarrhea since the surgery though..even with crackers and jello.
The stone was one single one as the U/S had shown, and it was the size of a golf ball. The doc gave us pictures of it. What a great conversation starter if we leave that out on the coffee table! lol
Dear Julie:
So GLAD it went as well as it did!
And glad you and your husband stayed on TOP of everything and everyone!
My husband had a single gallstone, the size of a golf ball, that never bothered him once, until the day it blocked his gallbladder bileduct and he got deathly ill and had to have emergency surgery.
You sound like me with allergies to everything. It makes everyone very anxious...and I don't blame them. But what can you do?
It's not like we CHOOSE to become allergic.
About your possible BLADDER or KIDNEY infection. I have the test strips that the use in the doctor's office. You can buy them at a drugstore or by mail.
You can find out for yourself if you have an infection, right away, at home!
Sometimes bladder and kidney infections need Urinary Tract specific antibiotics.
Just a thought.
Take care girl, and get well.
Kisses
Carolina