Shortness of breath and sleeping

[mainframe]

I'm 4 days out prior to my 2nd AVR with a severely leaking aortic valve. I get short of breath extremely easy but have been able to sleep up to the last couple of days with a couple of Tylenol PM. The last couple of days it doesn't seem to have helped and I got zero sleep Thurday night and only 4 hours last night after taking 3 Tylenol PM.

What happens is that while laying down I'll take about 10 breaths and I need to take what I can only describe at a couple of deep catch up breaths being out of breath. It doesn't matter how many pillows I use, my upper body is almost upright. I tried last night using different pillow combinations to from just a couple all the way to Mt. Pillows. Still no luck

I don't think I'll be well served showing up completely exhausted prior to surgery.

Any one have any suggestions?

 

[bvdr]

I think I would call my MD about it. Do you have a history of CHF? I remember before I had my mitral valve replaced I would sometimes wake up almost gasping for air. I'm glad you are close to surgery. It sounds like you are more than ready to have it done. Have you tried just sleeping in a recliner?

 

[TikTak]

Sounds like a ER visit to me, if it is CHF then it is bad idea to play the waiting game...

In a hospital they have various durgs (i.e. diuretics) to help compensate for heart failure.

 

[Bill B]

I agree with the others that you need to be checked to make sure your O2 saturation is OK when you recline and try to sleep and there are no other problems.

I had what sounds like it may be the same problem during my hospital recovery...as I relaxed and my breathing slowed, I suddenly had a startle and "catchup" breath -- mine was more like several breaths. A distended abdomen with a lot of gas in my stomach after eating made my breathing when lying down labored to begin with. Once I got rid of the gas by doing some hopping and a slight jog in-place until all the gas dissipated, my baseline breathing when lying down was no longer labored. An anti-anxiety med (Ativan) then allowed me to go to sleep. A few nights later I no longer needed the Ativan as long as I was sure I had no gas in my stomach.

Hope this passes soon.

 

[mainframe]

Unfortunately my wife is "anti recliner" from a decorating standpoint. While technically I do have CHF I've been told that should get alot better once the valve is replaced, least I hope so. I have be to the ER twice this week the first time because of excess fluid. I currently take florissimide in pill form and the ER gave me a shot of intervenous lasix. They did check my oxygen at the time and it was 93 on Tuesday and 94 on my Thursay evening visit to the ER for what seemed to be fever like symptoms. I've emailed both my primary care doc and my cardiologist, just don't know if they will get the email today.

 

[Bill B]

Chris:

Sorry I didn't notice it was you. You're scheduled with Miller on the 4th. Can I visit you once you feel better and will accept visitors in the stepdown unit? I'll call in and check on you.

Hope you get through the pre-op problems and into the surgery you need. You know I think Dr. Miller is a true Zen master and he should be able to get you back on your feet. He saved my life.

Bill

 

[mainframe]

Of course, look forward to meeting. I remember 7+ years ago after my first AVR going to meet Johnny Stephens just prior to his AVR/MVR. It was good to meet compadre.

I called the 24 on-call nurse telephone consultation service and told her of the 2 problems I've having. Obviously the shortness of breath but also I've been coughing up a clear liquidly flemmy substance. (Sorry kind of gross). The nurse chatted with the Dr in her area and prescribed a codine cough syrup but nothing in the way of sleep aid. She suggested the cough syrup should help but we shall see. I'm not entirely sure how a cough syrup might help me with a shortness of breath problem.

 

[vhmoriarty]

I'm 4 days out prior to my 2nd AVR with a severely leaking aortic valve. I get short of breath extremely easy but have been able to sleep up to the last couple of days with a couple of Tylenol PM. The last couple of days it doesn't seem to have helped and I got zero sleep Thurday night and only 4 hours last night after taking 3 Tylenol PM.

What happens is that while laying down I'll take about 10 breaths and I need to take what I can only describe at a couple of deep catch up breaths being out of breath. It doesn't matter how many pillows I use, my upper body is almost upright. I tried last night using different pillow combinations to from just a couple all the way to Mt. Pillows. Still no luck

I don't think I'll be well served showing up completely exhausted prior to surgery.

Any one have any suggestions?

I actually started the same thing last week. I am two weeks away from surgery myself. They gave me a RX for Xanax saying that may be while I am so short of breath. It has actually helped me relax and be able to sleep.

Think of somewhere calm...the ocean, etc....I know you have probally tried this but sit in a recliner.

Also call your dr about maybe getting some bloodwork done for Congestive Heart Failure and maybe some o2 for home before surgery.

I wish you the best of luck.

 

[Kevin]

I have the same thing. It's been going on for about 6 weeks. I think mine is partially due to too much fluids in my body. I'm on water pills to get rid of it, but it really doesn't do much.

I found lowering my anxiety level helped a ton.

When I go to bed now, I make sure I'm at least tired enough to think there is a chance of sleep.

I then stack my pillows around me in bed to give me an upright sleeping position. I have no intention of sleeping like that, but it helps to relax my body. Usually several pillows behind me and one supporting my upper back and neck do the trick. I also have one extra by my left side where I rest my left arm.

In this position, I can breathe pretty well.

Over time, I try to think of meditative thoughts or just try to clear the chatter from my head. Eventually, I relax. When I nod off a couple of times (sometimes it takes an hour or more), then I slowly dissemble my pillow "fort" and lay on my side. I have my head propped up more than I usually do so I don't get that drowning feeling.

When I am relaxed like that, I don't find I lose my breath at all or very, very little. If I go to bed like normal, I lose my breath just crawling in and covering myself and then get ramped up from the catching of breath thing you describe.

No guarantees this will help you at all and it isn't perfect - but it allows me to at least string together 3-5 hours uninterrupted sleep, which is enough to help me get through the next day.

Good luck with this sleep thing. If you cannot make it work, don't worry, your surgery is very soon and that will change gears for you. Best of luck.
Kev

 

[mainframe]

When chatting with the on call nurse, besides the codine cought syrup presription one of the things the nurse told my wife was to stop drinking cold liquids and try something hot like tea. So my wife gave me a good size cup of tea before she went to get the prescription. Once she was back with the prescription codine cough syrup, I took it and low and behold my SOB subsided enough that I knew the presciption had been the ticket.

Today, I took the presciption again a few times per instructions the SOB had returned enough to make it tough to take a nap. I was deflated. Then I realized the only difference between yesterday and today was the tea. I make myself a couple of cups of hot tea and again the SOB subsided enough to sleep. Just woke up from a short nap.

Go figure, tea.

 

[Bill B]

Chris:

Anxiety relief (1mg lorazepam) was key to me getting sleep when I had SOB. Codeine and other pain meds can do the same thing.. Warm tea can sooth and relax you too. You must be getting ready to leave for Palo Alto if you aren't already there.

See you in the post-op stepdown unit!