Scary post-surgical sleep problem

[Bill B]

Dorsai mentioned sleep problems in his post-op report. I'm still in the hospital coming up on day 6, and my only significant problem is almost complete inability to sleep. Mine has a specific pattern. If I try to lie in a bed put in any position, I experience labored breathing. As I get tired and start to drift off, my breathing slows and relaxes, but then I suddenly startle and hyperventilate. This repeats over and over in 30 second cycles.

I can't get the doctors here at Stanford to pay much attention because I am doing remarkably well over all. I made 15 quick rounds of the unit yesterday in 20 minutes - you only need 6 in 24 hours to qualify for discharge. I am eating well and have great strength.

The sleep problem seems to me to be centered around these issues.
-My stomach is distended and gassy. This makes breathing labored as it restricts the movement of the diapragm. I have active bowel sounds and am passing small aounts of watery stools.
- I have deviated septum and am a mouth breather.
- My neck feels as if there is a string rapped around it when I lie down. There is pressure on my jugulars. This seems to be some incisional swelling.
- I am anemic to HCT 28
- I was on O2 early on, but still did not sleep at all the first night.
- I had some low O2 sat triggers tonight when I startled.
- I slept 3 hours the next night after a pain pill. Only 2 hours since. Reluctant to try pain pills again due to bowel effect.
- My resting heart rate is racing aound 90 which makes it hard to relax.
- I do seem to fall asleep in a chair occaisionally, but their are no good sleeping chairs here. I tilt over dangerous in the chairs they have.

Note I did have an apnec episode in early recovery that that required bagging after Ambien was given (why, I'm not sure yet). They asked if I had sleep apnea. Not that I know. I do strongly prefer to sleep on my sides.

Any comments?``

 

[JimL]

Before surgery, I had trouble sleeping lying down because of the congestive heart failure. After surgery, few sleep more than three hours at a time for weeks. If sleeping in a more upright position does not help, the only observation I have left is to take the pain medication. It not only prevents pain, but helps you recover and also sleep.

 

[Dorsai]

I wish I had some advice to offer, but I don't; I am still not sleeping. I think I *could* sleep, if I could get comfortable, but I can't.

I have my own sleep issues anyway, foremost among them sleep apnea that I use a CPAP for. Let me tell you what fun *that* was in the hospital. I had severe problems with dry-mouth (I use a humidifier attachment at home, but didn't bring it to the hospital), and would startle awake often as well. I had the same problems with a distended stomach, although that has gotten vastly better over the last two days.

Currently I am just experimenting with positions to sleep in...I'm going to try a nap in my bed today, and if that doesn't work I am going to sleep in a different chair tonight. Right now, I think sleep is my biggest challenge. If I could get three hours at a time at least once a night, that would be a wonderful improvement.

 

[lb151]

Sleep was most certainly one of my biggest problems. I had everything you describe plus terrible dreams. I gave in to taking ambien for the first 6 months or so. As the physical pain got better I weaned myself off of it. Now I may take a valium if my arthritis is kicking up but most every night now is med free. I understand the distress pain pills cause. I now take 7 different meds and its an everyday fiber battle!
Hang in there,I think it will get better for you.

 

[Danny]

Same thing here. Sleep is still a struggle. Only because i cant sleep on my back, and never have, but cant sleep on my sides yet due to discomfort. Hope this gets better for all of us. Which im sure it will.

 

[Lily]

Bill

Bill

.
Just wondering if you are full of a lot of fluids, which I think is not uncommon following surgery, though can be extremely uncomfortable. They're weighing you regularly?

After my valve replacement and a subsequent kidney issue, I had some trouble with that issue (fluid retention) and the cardio put me on a restriction of fluid intake for a few weeks.

 

[Danny]

No fluid here.... X rays showed clear lungs... and im on a diruetic.

 

[Lily]

No fluid here.... X rays showed clear lungs... and im on a diruetic.

Oh, sorry Danny . I meant that comment in regard to what Bill had written earlier.

Regarding your sleeping issues, I used a recliner quite a bit, off and on, for the first few weeks post-op, which seemed to help me .

 

[Bina]

Post op sleeping is difficult. I slept on my back, small pillow under my knees.
The fall asleep and startle awake, weird throat sensations, palpitations, etc. were awful.
I did take Metoprolol to keep the HR down, but it was a long road before it got significantly better.

 

[ShezaGirlie]

Best cure for the lack of sleep was a nice, soft recliner at home. I napped lots during the daytime, but slept in bed at night. Sleep does come, but it takes a while just like everything else. Recovery is slow as you've been through a major surgery. Time is your friend...along with a good masseuse.

 

[Nancy]

I think most, if not all of what you are experiencing is about par for the course (unfortunately) early on. Remember that all of your insides are swollen and quite cranky. They put you into ungodly positions during surgery to get at your heart and every muscle in your chest has been irritated and inflamed and surely swollen.

Also, the hospital notoriously pumps everybody full of fluids via the IVs during surgery and afterwards. Once that goes away, you will feel much better.

As far as your neck feeling funny, remember the vent? And I bet they also has a Swan catheter in your neck during surgery. Those two things combined will make your neck swollen and put pressure on the blood vessels there.

I would venture to say that almost everyone who has had this surgery has trouble sleeping at the beginning and for several weeks afterwards.

Just go with the flow and pay attention to your body and what it wants to do now. Be gentle with it and treat yourself as if you were a newborn. You sound like everything else is coming along wonderfully. As others have said, a recliner would be your best friend when at home for quite a few weeks.

Things will improve. I have seen my husband in this position many times, and it all worked out.

 

[Superbob]

Bill, this is a quite common problem for weeks, sometimes months after OHS. (Misery loves company. Hopefully it will help to know that many others are in this boat. I slept for months in my recliner because of difficulty getting in and out of bed and into a comfortable position to sleep. Slept maybe 3 hours at a time -- couple of 3-hours sleep-ins at night and then catnaps during the day. Seemed to get enough rest that way. Try to relax and not worry too much about it. You can get your rest in alternative ways til you can sleep in a bed the whole night through.

 

[vhmoriarty]

Sometimes some of the meds they are giving you could do this. I was in the ER the other night and they gave me morphine for chest pain...well it wired me up as all get out. I talked everyones head off. Then they gave me a sleeping pill along with Lasix...how convient, lol. So hopefully when you get home in your own bed you will sleep easier.

Take care! This group is wonderful about checking up on you....and if you become tardy in attendance on here...We will find you!

Loves and hugs

 

[Alex B]

My sleeping trick (since I was and now am again a stomach sleeper) was to stay in a reclined position but not flat on my back. I found that at a slight recline I could slightly lean to my right and find a comfortable position, but yeah sleeping was the worst part about recovery for me. I only actually slept probably 5 hours a night off and on, but several naps throughout the day kept me going.

 

[kfay]

Bill, I hope it offers you some comfort that most, if not all of us, experienced some of what you are going through. I too am a side/stomach sleeper and was miserable in the hospital. When they finally pulled my last chest tube at day 6 or 7, I was lucky enough to be comfortable immediately on my side which helped me sleep better. I was able to continue that once I got home and was sleeping on my stomach about a week or two after that. The only thing that would hurt was when I actually tried to get out of that position. Hopefully, when you get home, with the help of some pillows, you will find a place that is comfortable for you and you will finally be able to sleep. It may be a while before you sleep through the night though.

Kim

 

[ALCapshaw2]

Bill,

As you see, most of us had problems sleeping more than a few hours at a time for several weeks following surgery.

Have you tried raising the Head and Knee sections of your Hospital Bed?
I found I was able to sleep that way in the Hospital bed,
rolling over *slightly* to one side with the pillow folded over to elevate my head.

You may also want to ask if the Hospital can provide you with a recliner chair which also seems to work well for many OHS patients.

Hope you can start sleeping soon. Just remember, it's very common to only sleep in short shifts for some weeks.

'AL Capshaw'

 

[Bill B]

Update: It's resolved. Going Home in the am.

Had a complete meltdown last night. At about 2 the on-call surgeon came to look me over. Agreed I had an illeus, and neeeded to get moving. He prescribed Benadryl for sleep. Ugh! I didn't think that would work, but I decided to go ahead. It turned out to be 25mg IV. Egads, that's different. BUT it did not seem to do anything. I had the sense I was just watching the wall for one minute. Anyway, I looked over at the clock - an hour and 1/2 had gone by! The nurse said I was snoring like a trucker and my sats were 100. But it was terribly unrestful as I dreamed I was awake. Still it was proof I could sleep.

I ran into my day nurse just coming on-shift. She said, "Mr.Ball you need to trust us. If there were anything seriously wrong with you we would be all over it. You are worrying too much and directing your care. Just relax and let us take care of you." She was absolutely right on. I spent months researching the subject. In recovery I warned the fellow about the dangers of over aggressive furosemide therapy. I spent most of my time asking them about lab results and therapy plans, and thinking about what they might be missing. I worried about the valve clatter, high rate, correction in my anemia,nurses not payinmg attention to the monitors. I was worrying, second-guessing and raising myself to a panic. I always overthink things. In this case, I needed to focus on recovery and I had no time left for anything but worry,

So, I could not sleep and the problems magnified in my head over time.

The morning nurse asked about anxiety, We agreed a trial Ativan woul be a good idea. It took the edge off everything, and I fell into a long, pleasent sleeep. Immediate problem resolved.

 

[Danny]

Sounds great Bill...glad you finally got some rest. Post when you can.

 

[ALCapshaw2]

Sounds like you have some pretty good Nurses (and Doc) who 'know their stuff' and can read their patients.

Glad to hear you were able to 'take the edge off' enough to relax and get to sleep.

It should all be downhill from here on out.

But it will take TIME and PATIENCE :-0

'AL Capshaw'

 

[catwoman]

Bill:

Glad you're getting some help in the sleep department. That's very crucial, because sleep is needed for cell repair & growth. Probably why we need more naps when recovering from surgery!