Respiratory tube

[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

[LUVMyBirman]

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.

[Ross]

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.

[Kim]

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!!!

[Nancy]

Hi Susan-

Please read this thread all the way through. It was started by our member ccrawford, who was also nervous about the ventilator tube. You will see how his fears gradually diminish as he learns more about the actual function of the ventilator.

http://valvereplacement.com/forums/showthread.php?s=&threadid=3050

Now read this thread after Chris' surgery:

http://valvereplacement.com/forums/showthread.php?s=&threadid=3615

[ccrawford]

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

[Kevin M]

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

[Marcia]

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

[terryj]

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.

[DANIEL]

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 !!!

[nadi]

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,

[ccrawford]

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

[bvdr]

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.

[Nancy]

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.

[ccrawford]

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.

[bvdr]

You know Chris, you might be right. The thought of having my hands restrained is worse than thinking about that tube.

Susan, I think we'll do fine;) .

[Gnusgal]

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.

[Gail in Ca]

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

[ccrawford]

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.

[Gerry Dorrian]

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

[Tom F.]

I do recall having the tube in my throat. As I was beginning to wake up there were moments when I found it hard to take a breath. But it quickly dawned on me where I was and that I should relax and let the machine dictate my breathing, which I did. That worked. Around this point the nurse came by and asked it I could raise my head, the traditional test I am told as to whether the tube can come out. I just about sat up. The nurse said something like "Oh he's ready" and out it went.

The advantage to VR.com is that it gives you information, it makes you smart about the surgical process. I was amazed that within a second or two of waking up so much of what I read here and elsewhere came to mind, foggy, but it was there. I said to myself "oh, breathing tube, don't fight it". Don't sweat the tube, if you wake up and its there it will be out quickly, and in the meantime let it do the breathing for you.

[mharris]

I too was terrified of the breathing tube. I have 2 experiences with it and they were only 5 wks apart. The first time I was in and out of it but I do remember the tube. They let me write on a board to let them know what I needed so that was comforting that I could still let them know things without speaking. Only frustrating when they couldn't read my words because I was still really out of it. The second surgery I had a different nurse which was a jerk. He wouldn't let me try to write anything. I was throwing up and he kept telling me that I wasn't I was fighting the tube and it wouldn't come out no matter how much I tried. He spraying this crappy numbing stuff that is used for a tee in the back of my throat so i wouldn't gag but that only made me feel sicker. When they finally took the tube out I was still sick I thru up for 2 more days after surgery, I guess it wasn't from the tube. Some nurses are great and some are not so great to put it nicely. Just remember to relax and if you don't fight it and let it help you the faster it will come out.

[Jamjude]

I really know I would never be able to stand that breathing tube when awake. I have a severe panic disorder. These are for the most part horror stories. :( I will tell my family to make sure I'm out until that darn tube is removed. But then how do they know one can breathe on their own without waking you up to find out? Confusing. :confused:

[ccrawford]

Hi Jamjude- I understand your feeling-beleive me I do. Make sure your cardiologist and your surgeon understand your anxiety and they'll take care of the rest. I have no idea how they know you are ready to breath on your own, but they do, and it works. They kept me so well sedated, I only have a vague memory of the tube being pulled, and other than that, I don't remember the ICU experience at all. I had several visitors - don't remember a thing !Nice to have another Hoosier on the site - where are you from? Chris

[Kim]

I think Versed, a drug that blocks your memory, might be used so the patient doesn't remember the procedure or ICU for that matter. I have been given that drug during each TEE that I have had (and I have had many!) and the doctor said I would talk and communicate to him, but I have absolutely no recollection of that.

[Sagebrush]

I personally thought that the cathater was a whole lot worse that the breathing tube. I has such a great team in the Mayo ICCU that my throut didn't even hurt after they took out the tube. It hurt worse when the riped out the cathater.
FAYE

[Kim]

I forgot I had thrush in my mouth from having the venilator in for so long. That was probably one of the worst parts of recovery. It was downright gross! Layers and layers of this white junk all over my tongue and throat. It hurt to swallow and was so hard to get rid of. Pieces of white junk would peel off gradually. I had it for 6-8 weeks. Sorry this description is so graphic!!

[Jamjude]

And to all the rest. Thanks for the input. A special thanks to Chris. Fellow Hoosier Huh? :) To answer your question Chris. I live in Anderson. My surgery will be done in Indy. I consider myself to be very strong in spite of my Anxiety disorder. I must be! I had so many phobias at one time I was Agoraphobic. (House Bound) Panic attacks came out of nowhere. But I fought my way back. I'm still on Meds for it, & The panic attacks left after six years. Now this! :( But fight again I will! Win or lose I'll fight. Hugs To You all. And again, many thanks. Ps. This Baby is worth living for! Judy.

[ccrawford]

Hey Jamjude - What a lovely young lady. I can see why you are motivated. I may have missed it in another thread, but what is your condition, and status regarding surgery? I lived in Indianapolis for many years, and now enjoy the peace and quiet of the country. If you have not read thru all the postings that Nancy located in an earlier post, I would suggest you try to do so. You'll see that I was really bugged by the prospects of the tube. The more I learned about it, and thought about it with the help of all the great people on the site, the more comfortable I got with the prospects of surgery. When they wheeled me into the surgery room, I was very relaxed, and it all went very well. Remember that the professionals do a lot of these surgeries to the point that they are very routine, and they will be watching you like a hawk both during and after surgery. All the monitoring gear in the ICU is designed to track your status very closely, and you'll have an individual nurse watching you for the first day or so. In no time you'll be walking the halls, then back home to take care of that little princess of yours. Besides that, you'll have the support of all of us here at VR.com so you know nothing can go wrong !!! Chris

[Nancy]

Hi Jamjude-

Just make sure you relate all your fears re: the vent, to your surgeon. Explain your anxiety thoroughly. Ask him/her if there is anything you personally can do to help in this regard. And ask if there is someone on his staff who can discuss the vent in detail. I believe if you understand why it is used, how it helps, and exactly what the mechanism does it will help to allay your fears. It will also help you to view this machine as a friend which is keeping you safe, when your body is temporarily unable to do sutomatic things for you.

This is in for a relatively short period of time, just until the surgical meds are gone from your system. Please try to remember that usually by day 2 after surgery you will be in a normal room and up walking around. Those few hours in the ICU you will be in La-la land for the most part anyway. There will be all kinds of marvelous machines which are a marvel of the engineering field helping you out in ICU. It's really quite magical. You will have one to one nursing care when first out of surgery.

You will be fine.

[Jamjude]

Chris I wouldn't like living in Indy. I also enjoy the quiet life now. In answer to your question Chris. I have to get a new valve. I think they said I have Aortic Stenosis. From what I gathered it's the main valve. :( I have had bouts of Strep Throat, Maybe even had Rumatic heart condition, that went un-treated. all of my life. Thanks kind sir for the words of reasurance. And Nancy. You are truely a sweetheart. ;) Thanks so very much for calming my dumb fears. :D I wish you all, Joy, Happiness, & Love. (( Hugs))) Judy.