Respiratory tube

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Susan Allen

Chris,
Thanks for the input on the homograft - one more question please. After rereading you first messae to me you mentioned the respiratory tube. That is also a great concern of mine. My biggest fear in life is not being able to breath. Never even tried smoking because of fear of interrupted breathing - swim but not under water.
Can they not take the tube out before you become concious?? If not why?
The thought of something down my throat is unthinkable and one man's story described it as breathing through a straw ??
Thanks
Susan
 
Some people recall the tube. If you do, I understand you should not fight it. Personally, I was soooooo sedated. Have no recollection. :) Try discussing this fear with your surgeon, it really helps.

All the best to you.
 
In almost all cases, the tube is removed before your awake enough to know. There are exceptions, some people (Like me) simply are not able to breath on their own and must have it in. They will remove it as soon as your body is able to resume breathing on it's own.

If you find yourself with it still in, try to relax and just go with the flow of the respirator. You'll be heavily sedated, so don't worry yourself silly over this. Do however, discuss this fear with the Surgeon. They can take steps to help prevent unnecessary panic.
 
I understand your fears completely! I ,too, was terrified of the knowing I would be on a venilator!!!!!! I expressed this concern to my surgeon, cardiologist , and every family member. I have no recollection of the venilator. I assume I was very heavily sedated. I was on the venilator for 4 days.
I suggest, like the others, to share this concern with your surgeon and cardiologist. I reminded each of them the morning of surgery that I did not want to remember the venilator!!!
 
Hi Susan - The posts that Nancy gave you are a required reading for us respiratory tube wusses. Obviously, I got thru it ok and have only a vague memory of them removing the tube. I do not remember it being in, and had no discomfort. The reason you need to talk to your surgeon and cardio about this is that you are given two types of drugs during surgery. One type paralyzes your muscles including your heart so it doesn't wiggle (beat) during the surgery. This drug also stops your breathing. The other drug makes you sleep, and there is an amnesia effect at work as well. If your docs understand your fears, then they can make sure you are sedated (asleep) until right before its time to remove the tube - (when the paralyzing drug wears off) As you can tell by the old posts, I was really bugged by the prospects of the tube, but all the fine folks here got me really calmed down and it turned out to be a non event. Hope this helps. Chris
 
Good and Bad Experiences

Good and Bad Experiences

I have a not-so-good story for you, followed by a good one.

I wasn't concerned about the tube until after my first operation. I was totally coherent for about an hour and they refused to take the damn thing out. I even asked for a pad and pen and wrote them to take it out, so there could be no misunderstanding of my intentions.

They would not take it out until I "stable". This was back in 1990, so maybe they view things differently now. As far as I was concerned, I was stable.

Consequently, I panicked a little and fought the ventilator. It felt very unnatural and foreign and I had trouble allowing the machine to breathe for me. It was as though my involuntary response kicked in and fought the machine - this was not pleasant. It backed up air into my stomach and filled it full of air.

My guts expanded like a freaking haggis and after they finally pulled the tube out, they had to stick another tube down into my stomach to release the air that had built up. They used the opportunity to have an inexperienced trainee try it. She kept missing and going into my lungs with the tube. In the end I accidentally vomited on her face. I felt so bad for her. She was trying so hard to get it right and I was whining like a kid.

After another 20 minutes some resident came and got it first time. It took about a week for my throat to heal from the scrapes and jabs.

So, that's the bad story.

My second operation went much better. This was the only part of the operation that I was nervous about because of my past experience.

I woke and was more heavily sedated than after my first operation. Things seemed very foggy and I wasn't entirely aware of everything. I remained in this state until they pulled the tube maybe an hour later. I do recall thinking to myself that it was important to stay calm and allow the machine to do its work. My perception of the ventilator changed a bit. I looked at it as a good friend who was helping me breathe; rather than an unfamiliar enemy. This outlook made it easier to accept the tube. It was still uncomfortable, but not to the point where I felt like I was going to freak out.

When they pull the tube, it is the greatest feeling of freedom. It does not hurt at all and is uncomfortable only for a split second.

You need not worry about gag reflex problems, since the tube hits that area only for a moment on its way out.

The only thing that is odd is the bypassing of your own involuntary breathing. It tends to expand your chest to larger than you would normally breath (at least that's how it felt).

My suggestion to you is to look at the ventilator as something that will help you breathe. Not as something that will impede it. The tube is uncomfortable, yes, but if you look at it as a friend, rather than an apparatus, it may help you to offset your panic.

I know that panic feeling you are talking about when it comes to breathing. It is frightening and not at all something one wants to experience.

The key is to remain calm and know that it will not be a permanent problem. Staying patient and allowing the machine to do its job is easier when you are sedated. From what I hear on this board, it is rare to be awake and coherent and have the tube still in. I suspect you will not have to worry about it because most people these days are under or zonked when the tube is in.

You may wish to talk to the surgeon about your fear. He/She can ensure you are either properly sedated while you are stablizing or asleep when they pull the tube.

I know my experiences are not exactly what you want to hear, but I wanted to share them so you can find a way to deal with your fear.

The tube is not a monster and it is not a problem that most of us have to deal with for more than an hour or so. If you can find a way to stay calm, you will do just fine.
Kev
 
ventilator

ventilator

I had a mitral valve replacement done at the end of Feb. and this was one of my biggest concerns. I was afraid that since I was a smoker I would never get off the machine. My Cardiologist had told me this for 15 years. To make a long story short, I don't remember being on it or them taking it out. They said that I was awake but they give you something so you don't remember. I expected to wake up in ICU with it in, but there wasn't any. I was grateful for that. I have since quit smoking and am going to stay smoke free. Gained a little weight but I can live with that. Good luck
 
My husbands biggest fear of his surgery was the tube down his throat. He gags when he has his throat checked. But, he barely remembers having it removed. He says the nurse told him he must have beeen thinking of something good when she pulled it out because he did better than most patients when it was removed.
 
Not a problem

Not a problem

Had AVR on 7/02/03 and my biggest concern was that darn tube. However, since I was fully expecting it, the tube was not a big issue. Sure you will want it removed as soon as possible, but since it goes down the "wind pipe" and does NOT block your entire throat it is not a suffocationg or choking feeling . You can still swallow comfortably as the "pipe" to your stomach is clear. I kept reminding myself, in advance, to relax - everybody has to deal with it and they do. I would deal with it as well and soon enough it will be removed. At this time you are fairly heavily sedated so this helps everything else be less of an issue. Also, when I woke up, the main thoughts were regarding - I made through the OP successfully - there were no other concerns !!!
 
Vent

Vent

HI Susan,

I had my mitral valve replacement and a window for pericardial effusion in May. I was also very scared of the vent. I witnessed my mother on it several times before she passed away and I was afraid I would end up like her.

I was lucky to find this site prior to surgery and as all suggested I spoke to all involved(from Dr's to nurses to anesthesia) about this fear, but to make a long story short it must have worked I do not remember the tube either time! I don't even remember the removals.

Talking to all involved really helped for me and I hope it helps with yours.

Take care,
 
Birky - Way to go with the smoking cessation. Its been almost 8 months for me, and I'm glad I finally quit. Visit our recipe section for some tips on diet. Chris
 
My feelings about being intubated and on the vent after surgery are really confusing. It sounds crazy but I always thought the sound of ventilators to be soothing. I loved the rhythm of the "breathing" and I even liked the little mist that they emitted. Most often however my patients were unconcious and unaware of their situation. I hope I can remember these feelings if I wake up and am aware.
 
As a spouse, I knew Joe was safe while asleep, with the ventilator in. It is a soothing sound. It has always taken Joe a long while to wake up after surgery, so the vent was in for quite a while.
 
Nancy is right - the vent is a super device that is an intregral part of the process we have all gone thru or will be going thru. It is a very sophisticated device and has several different modes it can operate in, depending on the need of the patient. A skilled nurse can entube/detube someone in a very few seconds, and the degree that we all remember all of this is a function of the joy juice that is administered. Its funny (strange) how many people get terrified at the prospects-certainly me included, and I'm an experienced SCUBA diver who can just about sleep underwater with another type of tube in my mouth. I think maybe its a control issue.
 
I've been reading this thread since it started and have been baffled by all of the experiences I've read. I have had OH twice now, and I remember the vent both times.

I do have to say that the first time was definitely the worst, because I was unprepared. I had very little knowledge at that time. When I woke up with my hands tied and had no way of communicating with anyone, it was very frustrating. And I often found myself fighting against the vent, just as Kevin said (though I didn't end up with the same complications, thank goodness). I would go in and out of consciousness, and every time I became aware of the vent I would feel like I was choking. I had to force myself to relax. I remember very vividly when they finally took the tube out. It was not a pleasant experience, by any means (some day I'll have to relate the whole story, it might even make you laugh), but I was very greatful to be free. One word of caution, though. When they finally let you have a sip to drink, be sure you actually SIP. They brought me some apple juice and I was SO thirsty that I sucked down half the container before they could get the straw out of my mouth. I regretted it after the third or fourth gulp, because it all came back up!

My second experience with the vent tube is quite different. That time I was prepared for what was to happen, and I think I was also better sedated. I knew that the only way I was going to get rid of the d**n thing was to start breathing on my own. So every time I became conscious I would tell myself (since I couldn't talk to anyone else) to breathe. I would take slow, steady breaths WITH the ventilator, and it was a much easier experience. I do not have as vivid a memory of the removal of the vent tube that time, and I'm greatful. Though, I do enjoy telling the first story to heart-healthy friends because it freaks them out. ;) (That story and the time I woke up in pacemaker surgery get the BEST reactions)

My advice to you is to talk to your surgeon about keeping you sedated, but to also be sure to keep calm if you do wake up with the vent tube in. Remember to work WITH the ventilator, not against it. I, along with many here, know from experience.
 
My first AVR in 89- I awoke and became totally lucid with that vent tube still in. I was not expecting this. I felt like I was choking and really was freaking out, as the nurse didn't seem to suction me often enough. I made suction motions to her with my hand and she then let me suction myself whenever I needed to. She gave me the suction device. ( my friend who is a nurse said actually you are choking and they don't like to suction too much as then too much mucous could build up, so we aren't crazy when we think we are choking!)
I immediately calmed down and then began to play games with the ventilator. I would breathe and then let it breathe for me, I would stop breathing and listen as it breathed for me anyway.
The nurse was mad at the doc on duty as he was afraid of my surgeon and would not remove my vent tube. When my surgeon came on, he immediately removed my tube. and it was like delivering the placenta thru my mouth! What an experience.
For my 2nd AVR in 00, my tube was already removed when I awoke, sooo much better. But, don't ask me about the chest tube removal.....
Gail
 
Gail - two good things about drainage tubes removal: 1. It doesn't take them long to do it. 2. You no longer feel like an octopus next time the nurse makes you walk down the hall.
 
All I can remember about the venilator tube was trying to figure out some way to get it out with my tongue. When I woke up I worked really hard to get that damn thing out. I twisted my tongue just about every way possible trying to force that thing out.
Funny, I don't remember my hands being tied, although they must have been. And a good thing too.
Before the surgery a doctor explained to me that I would wake up with the venilator. During the surgery they give you a drug that surpresses the breathing impluse. It takes a while to wear off so most of us remember waking with the ventilator.
I didn't like it at all but I was so heavily sedated it didn't really matter. I can't remember how long I was awake before the tube came out. My wife tells me that it was hours but honestly it really felt like 10 to 15 minutes.
I didn't like the venilator and I definately didn't like having that big fat drain taken out. But, what I really remember about waking up was being truely thankful I DID wake up. I knew it was all downhill from there.

Gerry
AVR - June 9, 2003
 
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