Complications, Heartbreak and Disappointment - Pre-Opp Assessment No. 3, 4 and 5 (Sleep Study, Ultrasound and Meeting Anesthesiologist)

Super Long Update on everything ahead......

Sleep Study-Results-Obstructive Sleep Apnea

So about two weeks ago, I did my sleep study to test the severity of my obstructive sleep apnea ("OSA").  I had to be hooked up to this machine, which we obtained privately which costed around RM 300.

The tubes go in my nose and there is a pulse thing attached to my finger. I taped them down with bandage tape so they would not fall off my face and off my finger. I would say that it was not the most comfortable sleep with all these stuff attached to you.

Anyway, so after that we got the results :

So what exactly do all these numbers mean mean? Well, for a situation like this the key thing to be aware of is the result of the AHI (Apenea Hypopnea Index). The severity of OSA is classified as follows :

• None/Minimal : AHI < 5 per hour
• Mild : AHI > 5, but < 15 per hour
• Moderate AHI >15, but < 30 per hour
• Severe : AHI > 30 per hour

My AHI is 37. Severe Obstructive Sleep Apnea. 

In addition to the above, what is also looked at is Oxygen Desaturation. Dips below 80% is usually considered severe. My lowest desaturation is 55%. Which is also a red flag. 

Just a small brief explanation of OSA:

Obstructive sleep apnea (OSA) (or apnoea) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation.

Below is an image of what OSA actually is :

Getting back to the point,the test confirmed what I kind of already knew, because OSA can cause sleepyness during the day despite getting a full nights rest, always feeling tired, headaches here and there all of which I have had before and now I know that the reason for the above is because my body is not getting the oxygen at night that it actually needs. 

Generally, people who have severe OSA would be advised to not to any elective surgeries because the risks and complications that may arise while under general anesthesia are much higher due to the blocked airways. 

So,after hearing all this and furthermore reading up about it broke me down. I want this surgery so bad, and I am so prepared for it, and now I find out about this. I was utterly heartbroken and could not stop crying that night. I am not prepared to take such a big risk for an elective surgery. I do not want to die. 

But then I thought to myself, ok calm down, let me first go meet the Anesthesiologist, maybe there would be a way around this. 

Consultation with Anesthesiologist

So today after my ultrasound ( I have Gallstones btw) which was already scheduled as a pre-op assessment, I went to meet the Anesthesiologist with my sleep study results. And they confirmed that it would still actually be possible to go through with the surgery, but the risk of complications are a lot higher because of the blocked airways.

What they have recommended me to do , is postpone the surgery first, lose some weight and go get a Continuous Positive Airway Pressure(CPAP) Machine. They have referred me to the Institute of Respiratory Medicine to go and get a CPAP Machine on loan. These CPAP machines are really expensive to buy here and ranges from RM2,500 - RM6,000, Bottom line is that I need it tho. 

A CPAP machine is a small machine that supplies a constant and steady air pressure through a hose, and a mask or nose piece throughout the night while I sleep. It is basically a machine that will help me breath better when I sleep and get more of the oxygen that I actually need at night. 

Apparently the benefits of using this is that I will feel less sleepy and have more energy throughout the day.This could be a good thing, because then I will have more energy to be more active and exercise towards losing some weight. 

Postponement

So in light of all the above, I have decided to postpone the surgery. I am not willing to go through an invasive elective surgery with all these risks if my body is just not read yet. I need to fix my sleep apnea first. I really feel quite down about it, but I have to remember that this is just an obstacle, and my end goal should remain the same no matter what, even though it may take a little longer or I may have to take a different way of getting there, the end goal remains the same. 

Moving Forward

So next action step I have to take, set up an appointment with the Institute of Respiratory Medicine, and find a way to get a CPAP Machine.

Speak to my Surgeon who also runs a lose weight programme for obesity, see if I can sign up for it, and hopefully if I lose some weight, it could bring down my AHI.

I have to remind myself to keep moving forward.

Thank you everyone for all the support you have been giving me so far, I will continue to update my progress with everything on this blog. 

A Choking Experience - Pre-Op Assesment No. 2 : Endoscopy

Okay, so the other day I went for my Upper Endoscopy assessment. Upper Endoscopy is a medical procedure where a device tube thing with a light and camera is used to look inside the body through the mouth. For me it was to look inside my stomach, to check if I had any ulcers and other stuff before they do the surgery. It looks something like this below :

Anyways, so last Thursday I went for it and lets just say I was not prepared for it all! Because of reading the internet, I thought I was going to be sedated while the tube is stuck down my throat.

But that was not the case for this hospital, the way they do it at this hospital is that my throat is only numbed and I am awake, cos they need to ask me to swallow the tube. So when the tube went in, they asked me to breathe through my nose. At first I was doing okay, but then I started to feel the tube in me, and it felt like something foreign and alien was in my body and I started to panic, and forgot to breathe through my nose and was trying to breath through my mouth, and then I started choking,  and I felt like I was suffocating,the doctors and nurses kept telling me calm down and breathe through my nose, but my brain could not process those instructions up to a point when the doctor said "ok this has got to stop now" and he pulled the tube out of my mouth.  I felt so violated after that, and it was quite a traumatic experience, I just wanted to cry after.

Urgh, but it is true my body does have a tendency to fight back foreign things,once even though I was sedated (not GA), 4 people still had to hold me down  cos something foreign was being inserted and I was just fighting it.

So the test was done, and they said I am actually ok for the surgery. However, the doctor said that I do have some Acid Reflux, and it may be better to do the Gastric Bypass surgery instead. Which is something I am not entirely keen on because it has a lot more risks. But he said wants to see all results from all the tests first, and then we can explore further if there needs to be a change in the type of surgery.

sigh. I really hope I can just stick to the sleeve surgery.

My next test is the Sleep Study, which I will be doing tonight!!