Re: Spinal VS. General?

[Guest guest]

Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days. My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimh@...> wrote: Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general??? Tami

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[Guest guest]

Hi Tami,

I had an epidural for my TKR. The epidural stayed in for the first 48

hours which is considered to be the most painful time. I opted for an

epidural because there is less chance of an embolism than with general

anesthesia. I had a nurse anesthetist with me throughout my surgery who

could have administered a drug to make me sleep, if I so desired. When

the anesthesiologist inserted the epidural there was some discomfort.

However, I was given a drug, possibly Valium, before he inserted the

needle for the epidural. I felt no pain during my surgery, but I could

hear everything. I was draped so I could not see anything. The only

problem that I had after the surgery was breakthrough pain went I

transitioned from the epidural to the oral pain meds. The reason I had

the breakthrough pain was because the anesthesiologist took out the

epidural before I was on the oral pain meds. I should have received the

oral pain meds 2 hours before the epidural was removed.

I will choose the epidural again when I get my left knee done.

Carol, RTKR August 1, 2006

Tami wrote:

> Yesterday I went for my pre op for my TKR. I have been given the

> choice of a spinal or a general for this. Im not sure what I want to

> do. Can I get some opinions from others in the group? The nurse said

> the spinal will help longer for the pain after vs. the general???

>

> Tami

>

>

[Guest guest]

In a message dated 9/16/2006 7:19:15 AM Eastern Standard Time, tamimh@... writes:

I have been given the choice of a spinal or a general for this.

I am 4 weeks post op (TKR)....I opted for the spinal this time (first for me....all my surgeries have been general).......It seemed like the same thing as I don't remember anything from the time they wheeled me into the OR till it was all over.....but the Doctor told my husband they woke me up during the surgery to ask me something as they were working on me, but I certainly don't remember it! I found I was more alert when i woke up and not much pain as i was still a bit numb from the waist down.....no nausea from the general like I used to get....

So I was pretty satisfied with the spinal....

[Guest guest]

Honestly I dont think I can lay there knowing what they are doing to be and hearing everything

Tami

Re: Spinal VS. General?

Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days.

My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimhcharter (DOT) net> wrote:

Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general???

Tami

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[Guest guest]

At 01:40 PM 9/16/2006 -0400, you wrote:

Honestly

I dont think I can lay there knowing what they are doing to be and

hearing everything

I don't think I can, either, Tami! However, like Lakshmi, my hubby

is an anesthetist, and I've talked to him a LOT about this. (I

don't think I've introduced myself - but I'm scheduled for a LTKR on

Wednesday, September 27th)

He says that if you want to not know what's going on (and I definitely do

NOT want to know what is going on in surgery! Knock me out, for

heavens sake!), tell your anesthesia personnel that, and they will make

sure you have enough Versed on board to make sure you don't know or

remember a thing. If you start to wake up (God forbid! <G>), say

something and you will be put right back out - and you certainly won't

remember it.

So...that's the road I'm pretty sure I'm taking. I have asthma, and

the fact that my respiratory system won't be as attacked will, hopefully,

make my recovery easier.

He also said that another positive of the spinal/epidural is that your

guts won't be as interrupted, so you will probably be less

nauseated. That was an issue for me a few years ago for a

hysterectomy, so that's another point in the spinal's favor for

me.

HTH.

Anni

[Guest guest]

Tami,

You can ask for what is know as a twilight drug. You are awake

but not aware of anything. It basically gives you amnesia and you won't recall the surgery at all. When they take you

back to your room from recovery you'll probably have a "happy button"

so you can administer your own pain meds. You're allowed 2 shots

then it won't work again till 4 hours have past. I was very comfortable

in the hospital yet aware of what was going on.

Sherry

Re: Spinal VS. General?

Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days.

My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimhcharter (DOT) net> wrote:

Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general???

Tami

Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less.

[Guest guest]

the hospital that I will be going to does not use the PCA punp for your pain meds

Re: Spinal VS. General?

Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days.

My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimhcharter (DOT) net> wrote:

Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general???

Tami

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[Guest guest]

Hi Tami,

Maybe you could wear headphones. The nurse anesthetist told me that I

could be as awake as I wanted to be. In other words you can have the

epidural and be asleep.

Carol, RTKR

Tami wrote:

> Honestly I dont think I can lay there knowing what they are doing to

> be and hearing everything

>

> Tami

>

> * Re: Spinal VS. General?

>

> Unless you have a back ache problem. I think spinal shold be the

> preferred choice.I had undergone both my knees under

> epidural(spinal) within a space of three days.

> My hubby is an anesthetist and he says both are fine.Since you

> have been declared fit for both types of anaesthesia I think

> choice of any type will not matter.As for post operative pain .

> Dont worry much. It will be taken care of by doctors

> anyway.Certainly it is not the arthritic pain.Wish you the best.

> Lakshmi*/Tami <tamimh@...>/* wrote:

>

> Yesterday I went for my pre op for my TKR. I have been given

> the choice of a spinal or a general for this. Im not sure

> what I want to do. Can I get some opinions from others in the

> group? The nurse said the spinal will help longer for the

> pain after vs. the general???

>

> Tami

>

>

>

> ------------------------------------------------------------------------

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663/*http://voice.>

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>

>

[Guest guest]

At 04:26 PM 9/16/2006 -0400, you wrote:

In a

message dated 9/16/2006 7:19:15 AM Eastern Standard Time,

tamimh@... writes:

I have been given the choice of a spinal or a general for

this.

I am 4 weeks post op (TKR)....I opted for the spinal this time

(first for me....all my surgeries have been general).......It seemed like

the same thing as I don't remember anything from the time they wheeled me

into the OR till it was all over.....but the Doctor told my husband they

woke me up during the surgery to ask me something as they were working on

me, but I certainly don't remember it! I found I was more alert

when i woke up and not much pain as i was still a bit numb from the waist

down.....no nausea from the general like I used to get....

So I was pretty satisfied with the spinal....

That's a pretty great endorsement, ...thanks for the

encouragement!

Anni

[Guest guest]

Tami,I had a spinal on my right knee. On my left I had a nerve block. Reason for the change was it took 6 attemps to get my spinal in. It took 2 anesthetist to do it also. When they finally hit the right spot it felt like a ton of bricks hit my tail bone. I have had 2 other spinals in my life and never had that problem before. I knew it should have not felt that way. I think that they hit a nerve. I had back problems after the surgery too and had too see a different doctor for my back. He did say it was a nerve problem. I don't want to scare you from having a spinal my case is different. I tried to warn the anesthetist before we went in to surgery. I have burn scars on my back which makes it hard for them. That is why i went for the nerve block for next surgery. I did great on that.ShirleyLakshmi Gopalan <lakshmi_18845@...> wrote: Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days. My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimhcharter (DOT) net> wrote: Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general??? Tami Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less.

Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less.

[Guest guest]

In a message dated 09/16/2006 4:19:37 AM Pacific Daylight Time,

tamimh@... writes:

<< Yesterday I went for my pre op for my TKR. I have been given the choice

of a spinal or a general for this. Im not sure what I want to do. Can I get

some opinions from others in the group? The nurse said the spinal will help

longer for the pain after vs. the general???

Tami

>>

Hi, Tami, I wanted to have a spinal for the reasons that you mentioned.

They wouldn't let me though because I had recently had back surgery. The

general wasn't all that bad though. I was really ready to get up so I didn't

have

to use the bedpan.

[Guest guest]

And I think I should repeat a post I made earlier.

I have syringomyelia, condition in which spinal fluid gets into pockets in the center of the spinal cord. The fluid is supposed to travel down the outside of the cord. Nobody knows how these pockets get formed but it's usually associated with some spinal injury. I don't have any symptoms from this (it can cause paralysis if the fluid builds up to too great an extent & presses on the nerves), I just happened to get an MRI for my spine and it (or rather they, I have two) showed up. One is about 4" long in the lumbar area. The other, about 2", is at around T4-5. In both cases I had had an injury at those spots (in the lumbar area I had a "slipped disc" and at T4-5 -- who knows what caused it -- I was just fixing my hair and it popped and hurt for 2 years & I still have problems from it).

When I was preparing to have a partial meniscectomy in my R knee, I told the anesthesiologist about my syrinxes, and he said no way would he give me a spinal. I don't know how they know how far in to push the needle on normal people, but with the distortion of my spinal cord, he could never be sure he hadn't gone too far -- not only would you not want anesthesia injected into your spinal nerves (could cause paralysis), you don't want it injected into the spinal fluid in the case of syringomyelia because there's a chance that there's communication between the syrinxes and the brain.

Not to be a doomsayer, but I believe that nobody should have a spinal until they've had a spinal MRI proving that they don't have syringomyelia. I think syringomyelia is probably a lot more prevalent than is known, because it can be caused by a "minor" injury to the spine, and it can be asymptomatic.

Ann

Re: Spinal VS. General?

Tami,I had a spinal on my right knee. On my left I had a nerve block. Reason for the change was it took 6 attemps to get my spinal in. It took 2 anesthetist to do it also. When they finally hit the right spot it felt like a ton of bricks hit my tail bone. I have had 2 other spinals in my life and never had that problem before. I knew it should have not felt that way. I think that they hit a nerve. I had back problems after the surgery too and had too see a different doctor for my back. He did say it was a nerve problem. I don't want to scare you from having a spinal my case is different. I tried to warn the anesthetist before we went in to surgery. I have burn scars on my back which makes it hard for them. That is why i went for the nerve block for next surgery. I did great on that.ShirleyLakshmi Gopalan <lakshmi_18845 > wrote:

Unless you have a back ache problem. I think spinal shold be the preferred choice.I had undergone both my knees under epidural(spinal) within a space of three days.

My hubby is an anesthetist and he says both are fine.Since you have been declared fit for both types of anaesthesia I think choice of any type will not matter.As for post operative pain . Dont worry much. It will be taken care of by doctors anyway.Certainly it is not the arthritic pain.Wish you the best.LakshmiTami <tamimhcharter (DOT) net> wrote:

Yesterday I went for my pre op for my TKR. I have been given the choice of a spinal or a general for this. Im not sure what I want to do. Can I get some opinions from others in the group? The nurse said the spinal will help longer for the pain after vs. the general???

Tami

Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less.

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[Guest guest]

thanks Ann

im still not sure what I am going to do. My TKR is also scheduled for sept 27th

Tami

Re: Spinal VS. General?

At 01:40 PM 9/16/2006 -0400, you wrote:

Honestly I dont think I can lay there knowing what they are doing to be and hearing everything I don't think I can, either, Tami! However, like Lakshmi, my hubby is an anesthetist, and I've talked to him a LOT about this. (I don't think I've introduced myself - but I'm scheduled for a LTKR on Wednesday, September 27th) He says that if you want to not know what's going on (and I definitely do NOT want to know what is going on in surgery! Knock me out, for heavens sake!), tell your anesthesia personnel that, and they will make sure you have enough Versed on board to make sure you don't know or remember a thing. If you start to wake up (God forbid! <G>), say something and you will be put right back out - and you certainly won't remember it.So...that's the road I'm pretty sure I'm taking. I have asthma, and the fact that my respiratory system won't be as attacked will, hopefully, make my recovery easier. He also said that another positive of the spinal/epidural is that your guts won't be as interrupted, so you will probably be less nauseated. That was an issue for me a few years ago for a hysterectomy, so that's another point in the spinal's favor for me.HTH.Anni

[Guest guest]

At 07:03 AM 9/17/2006 -0400, you wrote:

thanks

Ann

im still not sure what I am going to do.

My TKR is also scheduled for sept 27th

Ohhhh, twins! LOL

I wish you only the BEST of luck!

Anni

[Guest guest]

-Hi, I'm scheduled to have a total knee replacement on 28th Sept..

Tomorrow I go for pre-op ! Is this where I talk to the

anesthsatist ? I have told them all along I don't want a General as

in the past I've had adverse reactions... how scarey is all this? I

have yet to speak to someone who has had their operation and is

happy with the results. I think all I need is a little TLC to put my

mind at rest, I do know it has to be done- as I've put off having

the OP 3 times.

Kath

In Joint Replacement , " Tami " <tamimh@...>

wrote:

>

> thanks Ann

>

> im still not sure what I am going to do. My TKR is also scheduled

for sept 27th

>

> Tami

>

> Re: Spinal VS. General?

>

>

> At 01:40 PM 9/16/2006 -0400, you wrote:

>

>

> Honestly I dont think I can lay there knowing what they are

doing to be and hearing everything

>

>

>

> I don't think I can, either, Tami! However, like Lakshmi, my

hubby is an anesthetist, and I've talked to him a LOT about this.

(I don't think I've introduced myself - but I'm scheduled for a LTKR

on Wednesday, September 27th)

>

> He says that if you want to not know what's going on (and I

definitely do NOT want to know what is going on in surgery! Knock

me out, for heavens sake!), tell your anesthesia personnel that, and

they will make sure you have enough Versed on board to make sure you

don't know or remember a thing. If you start to wake up (God forbid!

<G>), say something and you will be put right back out - and you

certainly won't remember it.

>

> So...that's the road I'm pretty sure I'm taking. I have asthma,

and the fact that my respiratory system won't be as attacked will,

hopefully, make my recovery easier.

>

> He also said that another positive of the spinal/epidural is

that your guts won't be as interrupted, so you will probably be less

nauseated. That was an issue for me a few years ago for a

hysterectomy, so that's another point in the spinal's favor for me.

>

> HTH.

>

> Anni

>

[Guest guest]

Most of the time, a hour or so prior to surgery the anesthesia

team will come into your room and discuss this with you.

At least that has been my experience in the past...and I

have had a lot of pasts (

Sherry

Re: Spinal VS. General?> > > At 01:40 PM 9/16/2006 -0400, you wrote:> > > Honestly I dont think I can lay there knowing what they are doing to be and hearing everything> > > > I don't think I can, either, Tami! However, like Lakshmi, my hubby is an anesthetist, and I've talked to him a LOT about this. (I don't think I've introduced myself - but I'm scheduled for a LTKR on Wednesday, September 27th) > > He says that if you want to not know what's going on (and I definitely do NOT want to know what is going on in surgery! Knock me out, for heavens sake!), tell your anesthesia personnel that, and they will make sure you have enough Versed on board to make sure you don't know or remember a thing. If you start to wake up (God forbid! <G>), say something and you will be put right back out - and you certainly won't remember it.> > So...that's the road I'm pretty sure I'm taking. I have asthma, and the fact that my respiratory system won't be as attacked will, hopefully, make my recovery easier. > > He also said that another positive of the spinal/epidural is that your guts won't be as interrupted, so you will probably be less nauseated. That was an issue for me a few years ago for a hysterectomy, so that's another point in the spinal's favor for me.> > HTH.> > Anni>

[Guest guest]

Kathy,

You can also ask for an anti nausea drug. It works sometimes but not always. With my knee surgery I only

got sick once but when I had my hernia surgery in Oct,

they emptied the shelves on me and I still had the dry

heaves for what seemed like forever. I wanted to croak that time because with an abdominal incision ...well you can

imagine.

Sherry

Re: Spinal VS. General?> > > At 01:40 PM 9/16/2006 -0400, you wrote:> > > Honestly I dont think I can lay there knowing what they are doing to be and hearing everything> > > > I don't think I can, either, Tami! However, like Lakshmi, my hubby is an anesthetist, and I've talked to him a LOT about this. (I don't think I've introduced myself - but I'm scheduled for a LTKR on Wednesday, September 27th) > > He says that if you want to not know what's going on (and I definitely do NOT want to know what is going on in surgery! Knock me out, for heavens sake!), tell your anesthesia personnel that, and they will make sure you have enough Versed on board to make sure you don't know or remember a thing. If you start to wake up (God forbid! <G>), say something and you will be put right back out - and you certainly won't remember it.> > So...that's the road I'm pretty sure I'm taking. I have asthma, and the fact that my respiratory system won't be as attacked will, hopefully, make my recovery easier. > > He also said that another positive of the spinal/epidural is that your guts won't be as interrupted, so you will probably be less nauseated. That was an issue for me a few years ago for a hysterectomy, so that's another point in the spinal's favor for me.> > HTH.> > Anni>

[Guest guest]

At 04:26 PM 9/17/2006 +0000, you wrote:

>-Hi, I'm scheduled to have a total knee replacement on 28th Sept..

>Tomorrow I go for pre-op ! Is this where I talk to the

>anesthsatist ? I have told them all along I don't want a General as

>in the past I've had adverse reactions... how scarey is all this? I

>have yet to speak to someone who has had their operation and is

>happy with the results. I think all I need is a little TLC to put my

>mind at rest, I do know it has to be done- as I've put off having

>the OP 3 times.

Yep, Kath, that's generally when anesthesia (either an anesthesiologist or

an anesthetist, whichever is the protocol for " your " hospital) goes over

your record with you, asks any questions, answers all your questions about

the anesthesia, and you provisionally decide which type you would like, in

conjunction with the anesthesia's recommendations. If you change your mind

about which type of anesthesia you would like, you can always change on the

day of the surgery. Write those questions and concerns down, and don't be

afraid to bring out your list and ask them to answer all of them!

Bear in mind that people who are thrilled with the results of their

procedure generally just go on with their lives and don't trumpet to the

world how happy they are. The people who did not have as good an outcome

are the ones that complain and tell the world. So, anything you hear needs

to be taken with a grain of salt, and with reference to why YOU are taking

this step, and why YOU choose the surgeon you did. Go into this with your

head held high and positive thoughts about the future!

Anni

[Guest guest]

Hi, many thanks for your reassuring email, I'll keep you posted as to what procedure I decide ! Regards KathAnn Lauer <aelauer@...> wrote: At 04:26 PM 9/17/2006 +0000, you wrote:>-Hi, I'm scheduled to have a total knee replacement on 28th Sept..>Tomorrow I go for pre-op ! Is this where I talk to the>anesthsatist ? I have told them all along I don't want a General as>in the past I've had adverse reactions... how scarey is all this?

I>have yet to speak to someone who has had their operation and is>happy with the results. I think all I need is a little TLC to put my>mind at rest, I do know it has to be done- as I've put off having>the OP 3 times.Yep, Kath, that's generally when anesthesia (either an anesthesiologist or an anesthetist, whichever is the protocol for "your" hospital) goes over your record with you, asks any questions, answers all your questions about the anesthesia, and you provisionally decide which type you would like, in conjunction with the anesthesia's recommendations. If you change your mind about which type of anesthesia you would like, you can always change on the day of the surgery. Write those questions and concerns down, and don't be afraid to bring out your list and ask them to answer all of them!Bear in mind that people who are thrilled with the results of their procedure generally just go on with

their lives and don't trumpet to the world how happy they are. The people who did not have as good an outcome are the ones that complain and tell the world. So, anything you hear needs to be taken with a grain of salt, and with reference to why YOU are taking this step, and why YOU choose the surgeon you did. Go into this with your head held high and positive thoughts about the future!Anni

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[Guest guest]

Sherry! Thank you for your email, I'll keep you posted what I decide. Regards Kathy"S.A.M." <blueopal@...> wrote: Kathy, You can also ask for an anti nausea drug. It works sometimes but not always. With my knee surgery I

only got sick once but when I had my hernia surgery in Oct, they emptied the shelves on me and I still had the dry heaves for what seemed like forever. I wanted to croak that time because with an abdominal incision ...well you can imagine. Sherry Re: Spinal VS. General?> > > At 01:40 PM 9/16/2006 -0400, you wrote:> > > Honestly I dont think I can lay there knowing what they are doing to be and hearing everything> > > > I don't think I can, either, Tami!

However, like Lakshmi, my hubby is an anesthetist, and I've talked to him a LOT about this. (I don't think I've introduced myself - but I'm scheduled for a LTKR on Wednesday, September 27th) > > He says that if you want to not know what's going on (and I definitely do NOT want to know what is going on in surgery! Knock me out, for heavens sake!), tell your anesthesia personnel that, and they will make sure you have enough Versed on board to make sure you don't know or remember a thing. If you start to wake up (God forbid! <G>), say something and you will be put right back out - and you certainly won't remember it.> > So...that's the road I'm pretty sure I'm taking. I have asthma, and the fact that my respiratory system won't be as attacked will, hopefully, make my recovery easier. > > He also said that another positive of the spinal/epidural is that your guts won't be as

interrupted, so you will probably be less nauseated. That was an issue for me a few years ago for a hysterectomy, so that's another point in the spinal's favor for me.> > HTH.> > Anni>

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[Guest guest]

At 09:34 PM 9/17/2006 +0100, you wrote:

>Hi, many thanks for your reassuring email, I'll keep you posted as to what

>procedure I decide !

>

>Regards

>Kath

I'm thinking good thoughts for you (and for me and Tami <G>)

DO let us know!

Ann