Tuesday, April 26, 2011

E-mail From a Reader

This is reproduced with permission from the author... My comments will be in blue this time and in parenthesis.


mmm, never realized i actually emailed you that terrifying night before a grisly surgery...........but now that i have you, might as well describe my experience. was intensively studying anesthetics to be used the next morning for surgery to repair my left wrist with a metal plate, the wrist broken badly in an attempted mugging in the caribbean.....had long previously read extensively about general anesthesia and sedation also so knew more than nearly most any layman on the subject.....a control type, (me too) the idea of complete strangers injecting powerful drugs to make me lose awareness has always been difficult for me to accept. i had read about versed for coloonoscopy (at 55 the next cloud on my horizon). (According to the medical personnel who have written to me, control freakishness by anybody other than themselves is a major mental health issue.)
the big day came on april 7. i was expecting versed and axillary nerve block of the entire arm (this is EXACTLY what I was expecting) but upon check in the chirpy 29 year old anesthesiology resident (I had a youngish chirpy CRNA who was masquerading as a Dr.) informed me i would be having the whole banana----LMA (laryngeal mask anesthesia-----sevoflurane via tube in your throat) and michael jackson's infamous white propofol, as well as versed and nerve block. the works. (Once again this whole issue is left until the very last second when you are naked, maybe fearful and usually once the IV is running. At least Jon was apprised of the situation. My team simply did it to me without warning!) this news got my heart racing even faster than the 105 beats measured at check in. so they threw everything at me including fentanyl. i feared the anesthesia more than them filleting my forearm and drilling screws into my bones. (me too and my experiences with anesthesia make me even more alarmed) the whole prospect was without a doubt the most frightening experience of my life, and i'm 55, nearly crashed a small plane i was piloting solo in florida 35 years ago as a student pilot in over his head in a violent thunderstorm----but this was far scarier to me.

the versed was for me not a bad experience. in the block room i recall nervous chit chat with the two too young anesthesiologists preparing to inject the local anesthetics into my arm pit....(I got, you guessed it, a little anesthesia NURSE) last memories were thinking how intensely fluorescent orange and bobbly/soapy was the betadyne. i was not aware of them actually injecting the sensitive armpit area, thank god.....then i think they let me float back briefly before taking me to the operating room. i have vague memory of the dr. telling me she used only 2 or 3 mg. versed to that point (i had expressed interest in the procedure/dose, to a point, had asked if they could use lowest dose possible consistent with lowering anxiety and pain). (2 to 3 mg. Versed is NOT a low dose. 2 mg is usually enough to create amnesia and abject obedience. .5 would have been a low dose. Versed doesn't alleviate pain, Fentanyl does. In fact, in many cases Versed exacerbates and even creates anxiety. Especially judging by how many patients blood pressure and heart rate shoots up after injecting this poison.) then i remember them telling me they were going to put an oxygen mask on me, and last memory was them slipping a clear oxygen mask over my face and a warm, comfortable relaxation. that was my last memory. that's when they must have deepened the versed again. never saw the o.r., or if i saw it, never remembered it. next thing i knew 2 hours had passed and i woke in recovery with a pleasant short nap refreshed feeling, no nausea, and a bizarre completely numbed arm that remained numb for 12 hours. (Wow! So different than my experience! I woke up yelling and throwing things while my nurse cowered in a corner. Even my husband was terrified of me! My arm was numb as well, with the added effect of a CAST on it which I was wielding as a club. I was so uncoordinated that I was having some very near misses with my face, so I quit swinging it. My numbness has abated mostly, but all these years later it is still an issue. Due entirely to this particular surgery.)

i can certainly understand people's anxiety about a drug that seems to hit everyone differently. i'm 145 lbs male and not a drug user not even prescription drugs if avoidable so the benzodiazepines hit me like a freight train. i've talked to others who had unpleasant colonoscopy experiences under versed including pain.

one question i might ask you, the doctors barely spoke to me throughout this odyssey, very impersonal medicine, (I guess they are too good to speak to you, you are beneath contempt! As a patient you are only there to enrich them, you certainly have no standing as a human being, nor are you worthy of wasting their valuable time actually interacting with you! Answer questions? Explain themselves? Are you kidding? Sorry, but that's the attitude.) everything i know i learned myself from the net.......(yes and why is that? Whatever happened to "informed" consent? That's exactly how *I* learned about any medical stuff. It's the LAW that medical people must reveal all! Why then are we all having to discover this stuff on our own, online?) in recovery i very briefly saw a very detailed sheet used in the o.r. by the anesthesiologist, with all sorts of hand written details like drugs given, dosages, blood pressure and other anesthesia tech readings.....i believe this is called the "intra-operative anesthesiologist's report"? i've scooped up all my med records from the med records office but have been unable to ever see this particular again....i really want to see it because it's by far the most detailed record of how my body reacted to the anesthesia, exact time in operating room, etc. is there anything else this is called? is it commonly available to the patient/kept in files, or, discarded? (I have tried without success to obtain my anesthesia report as well. I have several posts about this very issue! It's the LAW that they must release this information, but having tried everything imaginable including complaining to the FBI and other regulatory and compliance bureaucracies, I have gotten nowhere. That's why you can't see a copy of my own anesthesia report. They won't release this in defiance of the law. I guess when you can't even get copies of your medical chart at all, a copy of the anesthesia report is out of the question. The law states that this information be kept for a number of years, I think it's 8, but I could be wrong. Of course when does compliance with the LAW have anything to do with medicine? The best you can do is get a copy of the BILLING from point of treatment. The drugs will be listed and amounts given that they charged you for. At least you will have some idea of what the Hell they pumped you full of and an approximation of the amounts.)
hope this account of one more person's experience with versed adds to your record of its effects.



So as you can see, even though Jon had no problem with Versed, his EXPERIENCE with medical care parallels mine. He has the same complaints about the quality of care, the sudden change of plan to include g/a when he was at his most vulnerable, the lack of adequate dialogue between he and they, the inability to obtain his patient records, all of this goes to the heart of medical care in today's world.

I also want to add that Jon has had many of the same problems with his wrist surgery that I have had... This ORIF surgery for distal radius fractures is highly dangerous and it seems, not very effective. He is facing additional surgery and has the motion problems like I had. We should have been told about the RISKS of this surgery so that we could choose another course of action. I would NEVER, EVER have this surgery again. I wouldn't have had it in the first place if the horrendous risks had been fully revealed as the law requires!

No comments:

Post a Comment