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Intubation and Microstomia

microstomia intubation small mouth endoscopy

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18 replies to this topic

#1 rubydoo

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Posted 31 October 2011 - 05:06 PM

Hi,

Has anyone else out there had to be intubated for an operation whilst they are awake? I am due to have my gall stones removed very shortly but due to the very small size of my mouth I have been told by the surgeon that they will not be able to put me to sleep before they insert the intubation tube. Normally they can guide the tube down when you are asleep but if you have microstomia you have to be awake to swallow the tube. I am dreading this experience but have been told that if I can swallow an endoscopy tube (which I did but vowed and declared never again!) then this should be a piece of cake. Can anyone who has gone through a similar thing let me know how it was for them.

Helen



#2 summer

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Posted 01 November 2011 - 04:14 AM

I have swallowed a nasal gastric tube recently, or I should say forced to swallow, the tube went through the nose, into the back of the throat into the stomach.

I had complications following a Loop Ileostomy, had an obstruction, and it wasn't very pleasant. I was awake during the procedure, wasn't sedated, due to the urgency there was no time for sedation or anything.

I'm not too sure though, whether this is similar to what you are going to have.

Summer

#3 Joelf

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Posted 01 November 2011 - 08:39 AM

Hi Helen,

One of the lung tests I had was a bronchoscopy which involved putting a tube up my nose and down into my lungs (I naively thought that the tube would be going down my throat! :rolleyes: ) Although awake at the time I was heavily sedated and basically as high as a kite throughout so I don't remember it very well but it certainly wasn't painful, just rather unpleasant. Afterwards I went through all the symptoms of a heavy head cold but over a very short time (24 hours) as I think the tube had inflamed my sinuses. Apart from that I suffered no ill effects and in fact did justice to a jolly good lunch afterwards!

Like Summer, I'm not sure if this is similar to the procedure you will have but I do hope that it won't be too uncomfortable for you and the operation on your gallstones will be successful.

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#4 Shelley Ensz

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Posted 01 November 2011 - 11:57 AM

Hi Helen,

I would think that although you won't be thoroughly under at that point, the odds are fantastic that they will still see to it that you are relaxed and happy enough to dance on the ceiling, if they asked. They have the best drugs ever now for relaxation. Odds are pretty good, if you're like me, you'll be thanking them and telling them how much you love them and yes of course you'd love to have them do the intubation now, in fact, could they please hurry it up?

Seriously, they can (and will) make you float on the clouds before asking anything of you. My husband was still flying so high after one of his operations that he blew kisses and told the charge nurse (who he hadn't even seen before) that he loved her, as we were leaving.

So if your experience is at all like mine, there's no need to worry about the intubation. What you need to seriously worry about, though, to do this properly, is exactly how embarrassing it will be when you wake up and realize that you've told everyone, including the scrub nurse and janitor, how much you love them and what a great time you're all going to have!

:emoticons-group-hug:
Warm Hugs,

Shelley Ensz
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#5 Amanda Thorpe

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Posted 01 November 2011 - 06:27 PM

Hello Helen

Shelley's right, they will give you something to relax you so it should not be as bad as you think it might.

Take care.
Amanda Thorpe
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#6 suze932

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Posted 02 November 2011 - 04:08 AM

Hi Rubydoo

Sorry to hear about your surgery and the difficulties of intubation.

I can only say that I have had both swallowed and nasal entubation for endoscopies/gastroscopies and they are both pretty unpleasant. Presumably they will give you the throat spray first to numb the area.

I found, the second time, that if I took a sleep mask with me I didn't have to see the tube heading towards me (!) and I practised taking deep, counted breaths beforehand.to control the gag reflex as best as I could. This certainly helped and gave me something else to think about!

Hope this helps a little and all best wishes for your surgery. :emoticons-i-care:

Suze932

#7 rubydoo

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Posted 02 November 2011 - 03:01 PM

Thanks for all your support. I did have sedation when I had a colonoscopy but it had no effect on me. I certainly wasn't floating on the ceiling Shelley, :'( In fact I think the doctor who performed the procedure thought I was a total baby as I cried so much he had to stop. Thought I was going to get an ASBO preventing me from ever going near a hospital ever again! Anyone know what drugs I should be asking for so I don't thoroughly embarrass myself again? :D

Thanks again,

Helen

#8 Shelley Ensz

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Posted 02 November 2011 - 03:21 PM

Ah, yes, and then there's the flip side of being whacky bonkers on their "relaxation" meds. Don't feel bad, Helen! Many decades ago I had a total meltdown when my dentist gave me "Happy Gas" for a tooth extraction.

Happy? Well, it would have been if I hadn't broken up with a boyfriend the night before. I thought I was handling it all very well, or, as well as could be expected under the circumstances. Then the happy gas hit my system and my extraction had to be postponed until I got done sobbing my heart out. Really, though, I was much better off without him, that no-good rascal, and I'm sure it was nearly all just drug-induced drama.

Another time, as I was going under for surgery, my surgeon was, literally, whistling Dixie and telling jokes. I went under in the middle of a laugh, and when I came to, I was giggling. I laughed my head off all through recovery.

I'm afraid we just need to go with the flow. Luckily the health professionals realize that we are out of it, and really don't hold anything against us personally. Odds are they've also had unusual reactions under the influence of twilight meds, too.

Chin up. You can do it. Laugh or cry, tell them you love them or try to command them out of the room -- no matter what, somehow surgery will proceed and life will go on.

On the positive side, we've got you worrying about the RIGHT issues now. :emoticons-yes: :woohoo:
Warm Hugs,

Shelley Ensz
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#9 Amanda Thorpe

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Posted 02 November 2011 - 06:06 PM

Once upon a time, a long, long time ago, I was given sedation for a colonoscopy, I figured being sedated would be a good thing. Well I came round to find out that the doctor had to stop the procedure just before the end as I came round, told him where to go very succinctly using only two words. I was mortified and no idea! :blush: :blink:

When I had my pacemaker/defibrillator put in I told the nurse beforehand that if I said anything whilst sedated I was very sorry! Thankfully I didn't!

Take care.
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#10 judyt

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Posted 02 November 2011 - 07:11 PM

Hello Again Rubydoo,

I am the world's worst at gagging when being intubated for an endoscopy - which, unfortunately, I have had lots of.

Fortunately, most of the edoscopies were done by the same man at the same hospital and he remembers me - or did - I haven't seen him for 2 years now.

I get the mouthguard in really quick, then Xylocaine spray, tube, sedation in quick succession and I go out like a light. The meds they usually give me are Midazolam and pain medication. Of course, we are on the other side of the planet and maybe what I have been given is different from what is being used elsewhere. I know that pain medication has a history of abuse, and from the way it makes me feel I am not surprised. For me it is real happy juice.

My mental preparation is to tell myself that the nasty part will be quick if I am 'good' and afterwards I will be on cloud 9 for a while.

I have had lots of colonoscopies too and the same thing applies there. I make sure everybody knows that I want to be non compis mentis throughout the whole procedure and I have never been let down. The preparation for said colonoscopies is a whole other story. I have been known to throw up all over the floor of the ward and have nurses scurrying round in damage control. Midazolam and pain medication plus a painkiller like Buscopan seem to be the things I have been given on these occasions as well.

Of course, you know that I am not the doctor and I am barely qualified to be the patient so don't quote what I say, but there is nothing to stop you asking the relevant professionals what they intend to give you and storing that away in your head for future reference. I am quoting from the printed report which I always make sure I am given at the end of a procedure and which I file away so it is available for me to refer to. My own paperwork extends to two 60 clear pocket folders and is getting ridiculous in a way but I can't help wanting to keep it all just in case!!

Sending you best wishes for a less stressful time on the next occasion.

Judy

#11 judyt

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Posted 02 November 2011 - 09:22 PM

Hello Summer,

I have just read your post from a couple of days ago. I have been wondering how you are getting on now.

A shame you had such a bad time after your Ileostomy but hopefully you are getting over it now.

Maybe I have missed a post of yours but this is the first I have seen since your surgery and since I was considering the same thing a few weeks ago I was quite interested in your progress.

As it turns out I am well on my way towards an SNS - it will hopefully happen early next year. Such a relief after being told that no way could I qualify for that kind of treatment.

Let us know how you are getting on.

Lots of gentle hugs and best wishes

Judy

#12 rubydoo

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Posted 03 November 2011 - 01:37 PM

Hey Judyt
Midazolam is a very common drug used over here for sedation so I will ask the anaesthetist if this is what he is going to use. Whatever, I agree with you all that positive thinking is probably just as powerful as any drug I can be given. Operation booked for next Wednesday (10 Nov) so will let you all know how it goes and hopefully won't disgrace myself this time.
Regards
Helen

#13 Amanda Thorpe

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Posted 03 November 2011 - 05:16 PM

Just as an aside, Buscopan itself isn't an actual painkiller but an abdominal specific anti spasmodic. You can get it plus paracetamol though.
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#14 judyt

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Posted 03 November 2011 - 11:59 PM

Hi Amanda,

Yes I guess that is right - anti-spasmodic rather than painkiller. I have been taking quite a bit of it lately and is certainly relieves the spasm and therefore the pain and so is fixed in my particular brain as a painkiller.

My newest problem seems to be Lactose Intolerance - hence the spasms - which is a real pain in the proverbial :( . On the bright side, I have discovered Lactose Free milk and Buffalo Milk Yoghurt yum. I did see dairy free cheese in the supermarket yesterday and got quite excited until I read the fine print and discovered it has more additives than real ingredients.

No more Icecream either because the dairy free one I found tasted unbelievably artificial. Made my own substitute with a jelly, berries and LF milk much yummier and just the thing to build up skinny ones like you and me.

Judy

#15 techylady

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Posted 11 November 2011 - 12:10 PM

I work as a medical secretary in an anaesthetics department in the UK and have heard mention of "awake fibre optic intubation" which is used at our hospital for patients have small mouth opening.

#16 rubydoo

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Posted 11 November 2011 - 04:46 PM

Hi Techylady

Welcome to the forum. Sorry to hear of your diagnosis but you have come to right place for support and advice. :) Have had my op on Wednesday. The anaesthatist managed to intubate me once I had been put to sleep. He felt confident that he could do it whilst I was asleep so I was incredibly relieved. It was actually more of a problem being cannulated as they couldn't get in the back of my hand as my hands are swollen and the skin has got very thick. They went in though my forearm which was bloomin' painful :( as skin there is also very thick. I didn't cry like a baby this time just tried to remember my breathing techniques from labour. I am now at home taking it easy but still in pain from stitches. Anyway got 4 weeks off work so will make the most of it and get my holiday cake made when I have come round a bit.

Take care
Helen

#17 Amanda Thorpe

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Posted 11 November 2011 - 06:03 PM

Hello Helen

I am glad the procedure went well although sorry about the painful cannulation! It hurts wherever the put it! Rest up and relax and make the most of the time off by relaxing!

Take care.
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#18 Joelf

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Posted 12 November 2011 - 02:39 AM

Hi Helen,

I'm pleased to hear that you've had the procedure successfully; what a shame it was so awful having the cannula fitted, though. :(

I can really sympathise; I had one nurse who made rather a palaver of putting a cannula in my vein. After the third attempt I very tactfully pointed out that perhaps her technique needed a little fine tuning!! ;) :lol:

Enjoy your enforced break from work!!

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#19 techylady

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Posted 12 November 2011 - 11:18 PM

Glad the procedure went well and they were able to intubate while you were asleep. Cannulation sounds a nightmare - I dread blood tests because my veins are "deep" and nurses struggle to find them. Thanks for your welcome.

Hi Techylady

Welcome to the forum. Sorry to hear of your diagnosis but you have come to right place for support and advice. :) Have had my op on Wednesday. The anaesthatist managed to intubate me once I had been put to sleep. He felt confident that he could do it whilst I was asleep so I was incredibly relieved. It was actually more of a problem being cannulated as they couldn't get in the back of my hand as my hands are swollen and the skin has got very thick. They went in though my forearm which was bloomin' painful :( as skin there is also very thick. I didn't cry like a baby this time just tried to remember my breathing techniques from labour. I am now at home taking it easy but still in pain from stitches. Anyway got 4 weeks off work so will make the most of it and get my holiday cake made when I have come round a bit.

Take care
Helen







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