CARI: The Fear of Anesthesia

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In a message dated 1/16/2004 12:02:15 AM Eastern Standard Time,

Dapplebuck@... writes:

As I said, I am scared about all of this. I hate being put under, though it

is better for me as I get very anxious before going under. I fight coming

out of the anesthesia as I hate to feel out of control and usually get sick

to my stomach afterwards and will throw up for a day or two.

Dear Cari:

First, a very BIG " OWWWWWCH " of empathy for your pedunculated fibroid !!! I

think many of us are wincing in pain for you, having read about your harrowing

ER experience.

But, I also know, based on our own Pat --and her memorable story with a

similar type fibroid--the symptoms of such a fibroid are pretty scary and

dramatic, but a (uterus-sparing) surgery to remedy the situation can provide you

great relief.

As for your fear of anesthesiology: it is certainly understandable, if

you've had an unpleasant experience in the past.

However, be comforted in knowing that there have been some tremendous

advances in this specialty of anesthesiology, even in the last decade. I

personally

have a great deal of respect and admiration and yes,--much faith in

anesthesiologists because the degree of complexity involved in performing their

specialty.

Anesthesiologists (much more than gynos) have to be EXPERTS in the human

body, its diseases and conditions, and if they aren't familiar with a condition

you may have, they HAVE TO become " quick studies " and learn about it.

(Unlike your GYN or mine, who may be able to remain blissfully ignorant or

ill-informed about a non-gyn medical condition of ours, while operating on our

fibroids. )

Anesthesiologists have to know vast amounts of information about drugs and

drug interactions. They have to keep track of every major organ function, and

monitor those same organ systems during surgery.

So, Cari--take advantage of all that knowledge at your pre-op interview with

the anesthesiologist and tell him/her everything. I MEAN . . . EVERYTHING.

Your fears. Every negative experience. Every symptom you remember

experiencing--or fear experiencing with anesthesia.

You mention that you " fight coming out of anesthesia " and I wonder whether

this is a feeling of agitation/restlessness you're referring to. Is that what

you felt? Can you elaborate?

If it is malaise and agitation, you MUST discuss this with your

anesthesiologist. Because it would seem to me to be a narcotics or other

drug-related

symptom, rather than any kind of " phobia " or " control issues " you may or may

not

have.

I once had a strange " panic attack " out of the blue-- while in the course of

being treated by my dentist. Throughout my entire life, I have been extremely

fortunate in having only positive dental experiences, so this was completely

odd--for me. But there I was--my heart was racing, I suddenly felt strange and

anxious, although, at the moment, I had NO reason to be. I wasn't in any pain.

I wasn't upset. I wasn't scared. I had been completely relaxed in the minutes

before feeling . . . suddenly very anxious.

Later, I brought up my " panic attack " to the dentist. He immediately realized

that it wasn't connected to some newly acquired phobia of mine. Instead, he

explained that the LOCAL anesthetic he had used to do some work on a

tooth--contained epinephrine, which is really just.....Adrenaline!!! That " local

anesthetic " was actually coursing through my body and inducing a " rush of

adrenaline. " Drug- induced heart palpitations and anxiety and a fight or flight

response

in my body, while in the dentist's chair.

The dentist simply made a note in my chart to AVOID that particular

anesthetic, and to use an equally effective NON-epinephrine containing

substitute in

the future, when necessary.

No further panic attacks at the dentist, I'm happy to report, (with a toothy

grin!!!)

Although, let the record show that both Pat and I have been known to use

the " down " time in the dentist chair for the quiet contemplation . . . of

all sorts of creative undertakings!! (Search the archives of this list, for

further details!)

I've also had many, many surgeries--and have been under general anesthesia

more times than I can count. After my early surgeries, years ago, I would be

terribly nauseous, which I somehow learned to cope with. But, happily, in time,

the anesthesiologists in my care have gotten to the point of refining the drug

combo and finding something that doesn't cause ANY nausea/malaise for me.

However, far worse than the nausea for me was the fact that , I had a few

terrible " wake-ups " and lingering NEUROLOGICAL symptoms from GYN surgery, which

my gynecologist simply couldn't account for. He essentially dismissed my

symptoms because he couldn't provide an explanation--and the symptoms went away

in

a few miserable days. Not that he gave it too much thought and

consideration! No more than a nanosecond of consideration, actually.

It was only through my own research and subsequent discussions with a caring

anesthesiologist that I learned that during these same GYN surgeries, they

had administered an antiemetic (drug to control vomiting) that I knew from prior

experience that I was highly allergic to. Most people do NOT have any

adverse reaction to this particular drug/drug family.

You do NOT need to become a pharamacology expert to have a positive

experience with anesthesia. The only thing this you need to do is discuss every

unpleasant experience you've had with your anesthesiologist. Let him/her figure

out

to avoid such reactions.

You really shouldn't have to tolerate a feeling of agitatation when regaining

consciousness. Not in this day and age. There are so many antiemetics,

inhalational anesthetic agents, sedatives, muscle relaxants for your

anesthesiologist to choose from.

And he or she can individualize them to your needs-- to reduce--or even

totally eliminate the symptoms of nausea and disorientation, and agitation.

As for me--truthfully, one of the BEST parts of my myo last year was my

anesthesia. It was just PERFECT--from start to finish. I even ate MY

FIRST-TIME

EVER post-op DINNER ON THE NIGHT of surgery! A huge breakthrough for me!

So, discuss all your concerns/anxieties with your anesthesiologist.

I hope after your pre-op interview/exchange of information-- that you, (like

so many of us here), will go on to have a completely smooth, gentle,

anesthesia experience, and an uneventful surgery.

Best of luck to you,

Roma