Airway problems ?? - Cerebral Palsy Message Board

Lost&Found · 07-16-2009, 06:44 PM

Hi

I have CP hemi left side and am also visually impaired. I'm still very functional. But over the last 2 years, I have lost ground with mobility. I have gone from being able to walk a good deal to having to use a wheelchair to cover distance. My left leg has become weaker.

If I fist my left hand, I get mild spastic tremors and I now have dentists telling me that I have alot of saliva. Neither of these things were present a couple of years ago.

Ok, now to my very ***NEW*** problem. I went in for a Lap-choly (laparoscopic gallbladder surgery) 2 weeks ago. As they went to start the process of intubation, my airway completely collapsed. I was under as is the normal procedure for starting intubation, when this happened. They couldn't even secure the airway with the fiber optic scope. I reached criical and the surgeon started a tracheotomy and my airway suddenly opened. Oxygen levels were too low so they spent the next hour bringing levels back up and the surgey was canceled and I spent the night in trauma.

They couldn't tell me why this had happened but felt CP very likely played a part. I had a chest x-ray because there was so much saliva that it was felt I had flued on the lungs . Chest x-ray was clear.

I have not had a problem in any way like this before. I am now classed as a *difficult intubation* and must be intubated awake.

I went back in just 10 days ago and was intubated awake with no problem other then I locked down on the bite guard but let go when told a couple of times to do so. The surgery went without event but I spent a couple of days in trauma to make sure all was well.

I'm wondering if anyone else has had this kind of thing happen and been told intubation is difficult because of CP?

Thanks

Erin

CandP · 08-03-2009, 06:37 PM

Hi,
Just wanted to say glad to hear you passed your ordeal from what I've read above. With regards to the excessive saliva issue, and how it showed up in your lungs, I ve never heard such a thing before....you mean you could have sufficated yourself? Very strange. I have no idea if it is related to CP but I highly doubt it.

Didn't the doctor give you any idea of what it could be? The fact that they couldn't tell you why this happened sounds strange. I dont think its cp related, but keep us posted on how you're doing.

Lost&Found · 08-06-2009, 11:36 AM

Hi CandP

I am doing really well thanks. The trach scar is healing well and there has been no problem from the surgery itself.

I have been told for some time by dentists that I have excess saliva and when it was seen in the OR, they thought I had fluid on the lungs but the chest x-ray came back clear. More then one thing happened with my airway when it collapsed. Heart and BP remained fine during the airway closing up. When they started the trach, the airway suddenly opened and there was a 100% oxygen saturation.

I have been told in the past that the excessive saliva is because of the CP. The anaesthetist told me that it is possible that the muscles relaxing by drug for intubation could have relaxed too much. That is the kind of thing that is more likely to happen with the lungs not the airway. Both he and the head anaesthetist agreed that the CP played a part.

Awke intubation allows the patient to keep muscle control of the airway until intubation is complete. You are given something to help with the gag reflex. They were confident that being intubated awake would solve the problem and it did.

My swallowing has always been fine (other then with tablets( but I've been hearing for awhile from docs that it's hard to see the back of my throat by visual examination. I didn't have that issue a few years ago.

Aging and changes related to those with CP is something that hasn't really been looked into until the past few years so it's hard to say what happens. I posted just wondering if anyone else had come across sudden issue with airway.

Take care.

Erin