Sunday, July 11, 2010

A Welcome Comment

I am not going to chop this one up like I usually do. I will have a few comments at the end after you read what this man says...

Anonymous has left a new comment on your post "More From The Comments":

Neveragin: I'm surprized at the callous attitudes of the "nurses" who post here. Patients are damaged by drugs everyday. Basically is a patient says that they hadmemory loss, amnesia, PTSD then I assume that they did. I see a lot of damage from a lack of informed consent; ie: sign this so we can keep you comfy mention of amnesia etc. This is bad. I personally dislike midazolam and so do most anesthesiologists; it's a minor drug that gets thrown into the mix (often by nurses) who don't know what they are doing. I have administered it rarely, never as a single agent. I have had multiple procedures and surgeries without midazolam. About a year ago, I accidently shot myself in the foot with a speargun in Hawaii; painful but not a big deal. The ER team knew my credentials and I asked to be awake and aware for the removal. After a Bier Block and a lot of pulling and tugging, no luck. Propofol was unavailable (recall) and I wasnt' doing GA. The ER doc explained the midazolam amnesia exactly right, acknowledged that this was going to be painful and that it was probably better not to remember it. I have 30 years as a physician and normally would avoid this drug but consented to it because I knew exactly what I was getting into. It worked well, not great but o.k. I sympathize with your midazolam experience and it burns me up that this could have been avoided if you were properly consented. Midazolam isn't awful if you are told the truth about why it's being used. More than one of my physician collegues self-administer midazolam and are quite addicted to it for the sedative effect. Try to realize that many healthcare people appear to be uncaring (some are) when they rush thru a consent process; most are genuine in their belief that they are doing you a faor when they lie to you about the amnesitic benzos like midazolam. I hate it, my wife (a surgeon) loves it for her own procedures. And she's smarter than I am. You have a right to be angry, just try not to let it ruin your life. List it as an allergy (causes hives) and you are set. Don't go into a midazolam rant because they won't take you seriously. Personally, I believe your story. It's all too common. God Bless.

First notice the reasonable tone of his post. HE DISAGREES WITH WITH ME ON SOME ISSUES, but his approach is one that makes me willing to entertain his thoughts. He has had Versed without incident although he didn't like it much, as has his wife whom he claims is brighter than himself. That kinda shoots down my theory on high IQ people having a problem with Versed while more average brains don't doesn't it? I will have to do some more research on this and some more cogitating. I hate the idea that I can't figure out what happened and why my brain objects so vigorously to brain disabling drugs. Not JUST Versed, but Versed has been by far the worst experience I have ever had with anesthesia. Maybe it's time for me to return to college and study brain function in more depth?

I am grateful that this PHYSICIAN agrees with me about the "informed" informed consent. It's the law and as this rational man states, the consent process could ameliorate some of our reactions to Versed. I am thinking that those of us who have had a bad reaction most likely would not have consented to Versed in the first place but the end result would be the same... In that if we had refused the Versed we naturally wouldn't have a reaction to something which wasn't used. If we had allowed it with full disclosure, then it wouldn't have been a huge shock to find out later that we were given an amnesia drug. That really angers a lot of people. As you all know, I had declined sedation type drugs, didn't get amnesia, but I sure hated the fact that I was totally mesmerized by Versed and didn't have the willpower and the ability to stop these cretins from doing everything else I had forbidden. Then to have the CRNA use my drugged inability to stop him as my CONSENT! Infuriating.

What I don't get is why would anybody who doesn't know me at all, think that they are doing me a "favor" by sneaking in a type of drug that I had *clearly* told them I found unacceptable and proceed with other things like g/a that I had also very clearly declined. I just don't understand the mind set of this. If anybody told me NOT to do something, in no uncertain terms, there is no freaking way I would proceed! Especially in a medical setting with the laws that pertain to patient consent. I would have wheedled and cajoled, but no is NO. I would NEVER have simply injected a control drug and proceeded willy nilly.

The alleged informed consent that I was tricked into signing as it was unrecognizable as such, (and also found to be in violation of the law by the Idaho Board of Health and Welfare) was clearly countered verbally by myself. At no time was I offered the opportunity to leave AMA. I can guarantee that I would not have died as a result of declining their services. I would have left with my RESPECT for them and their profession intact. It wouldn't have been the first time I walked out AMA. Someday my possessiveness over my body and overwhelming desire to protect my mental function may kill me. Too damn bad, it's still not medical personnel's decision about how much intervention and drug therapy I want. I will simply go home to my God a little sooner with my mind intact.

Thank you Dr. for believing me about the effects of Versed. I have tried to describe the feeling of having my brain firing on too many cylinders. It felt like I had been fighting the Versed particularly as it was completely unexpected, and once it's influence was gone my brain went into hyper overdrive. Like if you were pushing against a wall and suddenly it was removed you would be propelled forward like a shot! Add to that the absolute SHOCK of being drugged against my will, the humiliating conversation I heard in the OR, and the horror of my absolute docility about them assaulting me was just too much.

By the way Dr. you confirm my desire to avoid nurses who deliver anesthesia at all costs. As a physician you apparently have the knowledge and the lack of ego (after all you ARE a Dr.) to actually entertain the idea that all drugs are not for all people. Especially this one. It also appears from your post that other Dr.'s are not as enamored of Versed as the little nurses are. I am absolutely correct that there is a (huge?) difference between anesthesia as provided by a PHYSICIAN as opposed to anesthesia provided by a NURSE.

Every time I get a "comment" on my blog I steel myself for the vitriol I am going to face. My heart races as I prepare for battle. Thanks for the comment. I can't tell you how grateful I am that THIS time, it was all for naught!

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