I am about to have a consultation assessment for a hip replacement and having already posted about my concern with having to stop my Flecainide (150mg x 2) pre-op and being scared of going into A.F. prior or during the op. -my other big problem is having used Otrivine type nasal decongestant sprays (oxymetazoline hydrochloride) on & off during the whole of my adult life with the resultant rebound effect of terribly blocked/pressurised nasal passages/head throbbing I am also concerned as to whether I will be told NOT to use the spray before my op (I wake most nights gasping for breath due to what I call 'Nocturnal Asphyxia' with pounding heart as my nose is completely sealed and my tongue stuck to the top of my totally dry mouth). The problem now is that I just cannot survive without the spray each day as otherwise my nose seals shut & my head/neck throb with pressure more so when I become stressed or anxious about anything (yes I AM the world's worst stress-head) (such a relief to use the spray!)- I have been to E.N.T. twice now and had a camera up both nostrils with the outcome "no bony outgrowths no polyps" and discharged with Steroid puffer spray or Nasonex drops with the advice "stop using the Otrivine type sprays" - Have tried and tried sometimes managing a few days but the pressure just becomes unbearable so back to the spray I go. Have also tried Sterimar Sea Water sprays, Neilmed Saline saltwater bottle, Olbas Oil etc etc but no joy.
I just wonder if anyone out there can identify with my dilemma and experiences and offer any words of advice and comfort please??
Thank you
Fib 36
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Fib36
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So very sorry to read of your issues pending a consultation. I can only assume that, having got to the stage of a pre op consultation/assessment being considered you have already had at least one meeting with the consultant who will run your hip replacement surgery. If so, what has been his response.
If not then I would expect him to ask questions like ... is the Flec prescribed and being taken as a Pill in the Pocket or on a regular basis - once or twice a day, ongoing. He might also want to know details of your AF, like, does it come and go, is it permanent, is it irregular or anything else that might be relevant about your AF. I think also, that all the fears you have written in your post here need to be explained at the forthcoming assessment and maybe even see what opportunities are available to have your concerns explained to the anesthetist and get his/her reaction/assurances etc.
When I had my knee replacement surgery I had a GA (I never asked why) however about 2 years later my sister had a knee replacement surgery op in a different county and she had a local anesthetic/ spinal injection and could hear music and tapping and so on during the op. So, with that in mind I wonder if hip surgery can be carried out in a similar manner. I just don't know.
Anyway, I do wish you every success and hope some of the above may give you a different take on things. Good luck.
My AF has always been paroxysmal,.never permanent - my first episode way back in 2005 eventually put on Flecainide 100mg x 2 and was on it continuously for 12 years (repeat prescription from G.P.) but no further episodes ( except few palps.) until 2020 with 2 nocturnal episodes, 3 nocturnal episodes in 2021, 17 nocturnal episodes in 2022 (admitted to A & E on 2 occasions for observation but discharged next day) then Flecainide increased to 150mg x 2 in Dec. 2022 and soon afterwards became AF free and have been so until now hence my fear of being asked to stop the Flecainide pre op. I have usually been able to revert the AF within 10-30 mins. each time by deep breathing, valsalva manoeuvre & splashing cold water on my face. As I mentioned in my post my other serious worry is to do with the Rhinitis Medicamentosa (excessive & prolongued use of oxymetazoline nasal sprays such as Otrivine) such that my nasal passages are usually blocked 90-100% such that I have to use the spray every day with the inevitable rebound effect making it even worse, If I dont use the spray at night then I wake regularly with what I call 'Nocturnal Asphyxia' with nose sealed and mouth bone dry with tongue stuck to roof of my mouth and my heart thumping & racing & gasping for breath.
I have been a chronically stressful person for the whole of my life such that just thinking of an appointment or any other event gives me instant fight or flight, raised blood pressure and inevitably seals up my nose to the point of head/neck throbbing and having no option but to resort to the nasal spray - a horrid vicious circle AND without the spray pre-op how on earth will I cope?
Anyway, thanks for looking and yes I must raise all of this with my surgeon & anaesthetist. I will mention that I am presuming it will be by epidrural as was case with my knee replacement in 2018 but also to be clarified.
My wife did this with otrivine about 8 years ago and her GP now prescribes a different nasal spray. It didn't work straight away and there were quite a few disturbed nights. We also now use a netti pot every evening swilling the nostrils out with saline - only use medical grade salt and make sure the water you use has been boiled and cooled before use, and this has meant that my wife no longer has problems with hayfever - though this year for about the first time in 8 years she did have for a short while. Using the saline rinse with the netti pot has also meant she doesn't always use her prescribed nasal spray. Maybe you should check for irritants in your bedroom, don't have the heating on too high and leave a window open a crack (fine for us we are in a semi rural area but maybe in large towns or cities not such a good idea You already know you do really need to get off the otrivine so that you only need to use it when absolutely necessary.
I have had both a hip replacement and total knee replacement with epidural and listened to some good opera whilst on the operating table - almost enjoyable! You should ask about that most hospitals offer this. My wife had a procedure where she was sedated but not given a GA and had oxygen delivered via a cannula in her nostril. She was worried about laying flat on her back for not just the procedure but for at least 6 - 9 hours afterwards as she has trouble breathing (asthma and bronchiectasis as well as rhinitis) when in a prone position without lying on her side. also try the old fashioned remedy of steaming using menthol crystals in the water. Be careful with the menthol crystals - you really only need one or two small crystals in boiling water.
Many thanks for the info and advice. Actually I have sadly used Otrivine sprays for most of my adult life with the dreaded rebound effects -I have had brief spells when managed almost without but not quite. I have had a Neilmed sinus rinse bottle & salt sachets on and off also for many years (always use boiled water etc) at present however I always find that after using the Neilmed my nose gets considerably worse. I have also had Mometasone Furoate steroid sprays from the G.P. for ages but no relief. I also use Sterimar sea water sprays. ENT also prescribed Nasonex drops but again no ,result. Anyway I'm seeing the surgeon tomorrow for assessment so will see what he says.
Hello, I was at the hospital quite recently for ongoing headaches and pressure in my head, which has been going on for over a year. I had a head scan which indicated a sinus infection. I was given a Beclometasone nasal spray and a 3 week course of Doxycycline antibiotics. I'm not sure if it is connected but since taking the antibiotics l seem to been almost constantly in afib.
My Afib had been diagnosed paroxysmal but maybe it is becoming more permanent due to my medication (Sotalol 80mg twice a day) becoming less effective.
I have a date for surgery to a complex fracture of my right arm. When l had my pre-op assessment there was concern about my low blood pressure and heart rate, now with my Afib becoming more frequent l am concerned my planned operation might not go ahead.
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You already know you do really need to get off the otrivine so that you only need to use it when absolutely necessary. 
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