Friday, May 27, 2011

Found this...

I was combing the internet this evening when I came across this site; Birds In Spring: Versed – Forgetting Surgical Unpleasantness And Everything Else - The Myeloma Beacon The guy writing it seems like a nice man, brave and very stoic. He doesn't like Versed! Imagine that. He has some thoughts on why it's used and has opined that it seemed like his Dr. wouldn't work on him without it. Imagine that! Happy reading.

Birds In Spring: Versed – Forgetting Surgical Unpleasantness And Everything Else

Everybody reacts differently, I’ve learned, to the challenges that come with a multiple myeloma diagnosis.

What I might dislike or find annoying may not be so troublesome to someone else. Similarly, things that may not bother me much, if at all, can be hugely vexing to others.

Sometimes, as patients, we can be drawn into situations by our disease where we aren’t sure exactly what to expect. Most of us, I think, take these things in stride, and grin and bear it. Well, maybe not always grin, but as most cancer patients will tell you, you’ve just got to accept the fact that those treating you are going to do things to you that you aren’t going to like.

For my part, for example, since my diagnosis, I have had experiences that in my pre-myeloma life would have made me cringe. An open-lung biopsy in 2006 comes to mind, although that’s but one of several instances. Yet, when the cringe-inducing procedure is happening to you, and the purpose is to keep you alive, it becomes much easier to shrug it off and think, “Well, that’s just one more thing I have to put up with.” We can be pretty resilient when we have to be.

So I thought it might be helpful from time to time to give a bit of a head’s up about what one can expect over the course of myeloma treatment – from my perspective, of course.

In particular, I’d like to tell you about one of the drugs you are sure to come across. The drug is Versed (midazolam), but I refer to it as the “forget drug.” It’s used commonly in surgical procedures these days, especially ones where they’d like you to be somewhat conscious and responsive during the goings-on. It’s a sedative and relaxant, so it helps you get through the discomfort that a procedure may cause. If you’ve had a colonoscopy, you’ve had Versed, for example.

The big side effect of Versed, however, is amnesia, and I think that’s why the medical profession likes it. (emphasis mine. I have been saying for years that Versed is for the comfort and convenience of the STAFF, not the patient.) While the drug is intended to lessen your pain and anxiety by helping you relax, the drug is also going to erase your memories of the procedure, including those of any discomfort you experienced.

I’ve had a few encounters with the “forget drug,” one of which was for the insertion of an apheresis catheter prior to stem cell harvesting and transplant. I remember absolutely nothing about this procedure and for some time afterward, although I apparently was fully conscious for the duration.

It took me a while to figure out that I had never really been put under anesthesia.

I “came to” in recovery and Linda, my wife, was sitting there (hospitals don’t like you to come in for procedures alone, but especially when they are giving you the forget drug), and it seemed pretty much like I’d just came out of sedation. That’s what I thought anyway.

About an hour or so later, after we’d left the hospital, my head cleared enough for me to reflect back. I realized that when I rejoined the real world in recovery, I was sitting up and engaged in conversation. In fact, I may have come to in mid-sentence. (emphasis mine. This happened to me as well, see prior posts) I said as much to Linda.

She said something like, “Oh yeah, you were awake and talking when I came over to the operating room waiting area before they brought you to recovery.” (Oh HORRORS!)

For some 20 minutes in recovery, I apparently sat around awake and talking.

But, of course, thanks to Versed, I don’t remember.

There’s about an hour of my life – where I was otherwise aware and lucid, I’m told – during which I have no idea what transpired.

That’s what the forget drug does to you.

This doesn’t bother most of the people I talk with. They say they’d rather not recall surgical procedures anyway. Most seem to think it’s odd that I find this even the slightest bit troublesome. That includes my doctors, I suspect. ( I find it odd that this DOESN'T trouble them.)

For my part, I just don’t like to have my memories stolen, good ones or bad ones. (Tim over at versedbusters says this very same thing!)

The other thing is, there is no question that sometimes Versed procedures are going to be uncomfortable.

For example, there was an instance where I went into a procedure – a colonoscopy – with the intent of fighting as best I could the amnesia aspect of Versed. I was partly successful, and I can still recall various things that happened. Not everything, of course, but in every previous encounter with the forget drug, I had remembered nothing.

At one point, I experienced a fair amount of pain, and I turned my head to the doctor and said, “Hey, can you be a bit more careful? That hurts.”

The stunned look on his face when he got called out by a patient like that was priceless. It made me laugh, and I went back to watching my colonoscopy on the little television monitor they give you.

And to think – that treasured little moment could have been erased.

My conclusion is that a forget drug is an imperfect solution.

In the best of all worlds, we’d find a way to eliminate pain and discomfort during procedures where you remain conscious, rather than dealing with them by having you forget they ever happened. (emphasis mine. These are my sentiments exactly. Fentanyl comes really close to being able to do this for patients. Unfortunately, this is NOT desirable to the staff. They do NOT want this solution. Funny how all these medical people want Versed and yet we patients are saying we don't like it or want it. So who is this med for? Us, or the staff?)

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