POCD The Gorilla in the Operating Room

Here is another article on the alarming incidence of POCD.  At last some anesthesia professionals are taking a second look at why this is happening to us.  I think they should be looking at the drug which CAUSES the very symptoms they don't like.  Versed.  Just because the "ultra short acting" drug is allegedly excreted from the body quickly doesn't mean that the effects are transient as well.  (new studies out which show Versed remains in the body much longer than they originally thought) When a hurricane blows through a city, is everything normal when the wind and rain are gone?

Surgeons Question Surgery's Impact on Brain | Medpage Today

The Bale of Hay

I got this excellent post in my inbox this morning.

 Is Surgery a Risk Factor for Cognitive Dysfunction? | Medpage Today

Even though this is well written, it ignores the one thread that runs through all of this.  Sedation via Versed. How many of these people had a procedure featuring a beloved little "sedative" called Versed?   Like the doctor says "Have you ever tried to get a cat to look at its face in the mirror? They won't look..."  Ever tried to talk to a doctor or anesthetist about POCD after Versed?  They won't look.  These people squirt a drug into our system which causes cognitive dysfunction and then when the condition persists afterwards, they feign surprise and just can't put the two together.  So very many smart, well educated, experienced people in the medical field and they can't see "causation" in POCD patients.  It's perplexing, but thankfully there are a few that are sounding the alarm.

Versed Use Explained by a Cardiologist

A cardiologist whom I am not going to use explained why he wanted me to have Versed...  See if you notice any problems with this statement.  "I want you to have Versed because I don't want anybody talking to me."  (scandalized look from me)  Then quickly "I don't want you to remember anything either."  (Hmmm)

Let's examine this.  First of all I have already had a heart cath without Versed, so I am familiar with the procedure.  A heart cath is a non-event!  Nothing whatsoever was scary about it.  Nothing.  The reason I don't use the first cardiologist was because of a lack of informed consent.  Not a big deal to most people, but HUGE for me.  There is no reason that I can see to need amnesia for this procedure.  If I were a freaked out patient there are still other methods besides Versed to keep me calm.  Remember that, according to a poster on this blog, heart patients are most at risk from POCD (post operative cognitive dysfunction)  Special care should be used, in my opinion, to minimize that risk by not using something as poisonous to the brain as Versed.  This pathetic excuse is just that.

As far as the "I don't want anybody talking to me" statement, are you kidding me?  One of the major side effects of Versed is a motormouth.  Most patients babble on and on about anything including any secrets they may have.  It is my contention that many medical minions seize this opportunity to have a little fun ferreting out deep dark patient secrets for the entertainment of the staff.  So the doctor doesn't want anybody "talking" to him, but it's OK to hear screams, babbling, begging for the procedure to stop, and revealed secrets.  Nice.  Are patients really stupid enough to fall for this?  Maybe once... If you DON'T have Versed, doctors can expect quiet, not with it.

It really isn't worth arguing over.  Don't squabble over it, just get another doctor.  They are a dime a dozen, just like patients.  You will both be happier.  Yes I got a phone call from his PA when I went to another cardiologist.  I didn't argue with her, I explained that even though I liked the doctor on a personal level, Versed was a deal breaker and I didn't want to make him "uncomfortable" by fighting over it.  All true.

The scheduling nurse at the hospital took the same vein (clever pun) when I said "no Versed".  She was horrified.  I had to hear about the excruciating pain, and how terrifying it would be for me to remember the wire in my heart, blah, blah, blah.  Maybe she should have looked at my chart (in the same hospital) to see that I had already had this procedure?  Whose side are these people on?  I said NO to any crna and NO to Versed.  (common usage of "no", not the medical "no" which appears to mean "maybe, if you want")  I haven't changed my mind in two years.  It wasn't exceptionally painful, not scary at all, interesting to listen to the conversations (because they knew I didn't have amnesia, it was pleasant conversation, not personal attacks like before)  My cardiologist was talking about a certain famous submarine Admiral whom I, as a submarine buff, am very interested in.  It was hard not joining in the conversation.  That was the most difficult part of the whole thing.

I DON'T NEED VERSED!  As far as I'm concerned there are a small minority of patients who might need something like Versed, although there are other drugs which can perform the same service without the horrible side effects like early onset Alzheimer's. Most of us do not need it, it's dangerous and mind numbing.  I wish these medical people would recognize that what we need is patient care, not being drugged until we are brain damaged.  We pay enough for medical attention that we DESERVE decent care.  Give me a good nurse, not Versed.  We do not deserve Versed.  (Plus all the additional costs associated with Versed, but that's another story.)

How Long does Versed Stay in Your System?

How many of us have heard medical minions state that Versed is "short acting"?  Have you heard that Versed leaves the body almost immediately?  Well, not so fast.  Here is an article about how long Versed lingers in the body.  I wonder how long the Versed molecules are embedded in the brain? (Where the minions WANT them to be)  No test for that and medical workers don't care.  Versed may be "short acting" in the hospital, but the effects are felt by many patients months after being poisoned.
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How Long Does Versed Stay in Your System?

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Interesting Discussion

Here we have a question posed by a member of the public who takes exception to Versed's brain scrambling effects.  Two people answered.  Of note is the anesthesia person.  Look carefully at how little he/she cares about continuing cognitive dysfunction.  This should scare EVERYBODY!  Medical minions in anesthesia don't give a damn whether they turn you into a permanent vegetable.  It's not their problem, as shown.  These people are incorrigible.  Don't let these anti-social miscreants have their way with you.  The level of disdain they show for your brain function is out-of-control.  Let me ask you this: Would you rather be alive in a permanent vegetative state, with chemically induced Alzheimer's via Versed, or would you rather have a different drug which isn't KNOWN to cause brain damage?  The choice isn't live or die.  The choice is living with your brain intact or living without.


Alternatives to the drug Versed, Midazolam? | Yahoo Answers

Another Man Harmed by Versed

I got the following story from my inbox.  It saddens me that with all the negativity surrounding the drug Versed/Midazolam it is still squirted into the IV without a second thought about the brain function and emotional health of patients.  This story is far too common.  Here's what "G. P." says.
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"I too was brain injured by a colonoscopy via Versed...no analgesia on board. The little bit of Fentanyl did nothing since they pierced my vein. I disassociated into 4 brains/people.  I screamed, cried, tried to get away.  It was terrifying.  I was in a chemical straight jacket and they just kept pushing more Versed every 2 minutes when my left brain would wake up from the pain and was trying to help me but they just rendered me more incapable. I asked for general anesthesia during the consultation and they gave me 9 mg Versed and 200 mcg (?) Fentanyl instead without telling me before hand. It did nothing.  I remembered everything.  I felt everything.  He was unskilled, rough and the n a hurry he was an hour behind and was rushing and did not stop until the ascending colon when i screamed (the right side of one of my brains screamed "Take that f*cking pole out of my ass now you bastard!" He noted in his report that I asked him to stop.  What about the 7 other times I screamed for help? Yelling, pulling away involuntarily each time.  Yet he refused to acknowledge my pain and kept on hurting me even removing a flat polyp I would not have allowed me him to do because he was so unskilled.  He refused to answer my questions that day 3 hours later when I called.  In fact I had to make an appointment and pay to complain, then he lied in his report saying I was dreaming.  I was not dreaming it was reality.  Not one staff member or the doctor would admit any thing.  I am permanently disabled now from disassociating and have severe PTSD.  Dr Brain Cleary, an Eisenhower Medical Associate in Palm Springs, California committed this brutal and cruel act on me and big famous Eisenhower Medical Center didn't even do a thing to him or offer me help.  My life for the past 1 1/2 years as been living hell and will continue to be until I die."
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As you can tell, this was the colonoscopy from HELL!  Just like most of them are, except this time the guy remembered it.  This is barbaric.  If this is what you want from your medical minions, by all means allow them to abuse you like this.  Otherwise demand to know what the "sedation" is and if it's Versed, refuse it.  Do not engage in any discussion over this issue, they will argue until they are blue in the face, and, ominously, they will find something in what you said or didn't say which they can misconstrue as permission to use Versed.  

Too Many Cooks

There are too many cooks in the health care kitchen  This article is also from Dr. Kevin's blog.  This is something which I have previously mentioned in a slightly different context.

I object to all the extraneous people costing patient money.  There is no end to people populating medical entities all doing minor variations of the same job.  Do we need to pay all those people a lavish salary?  My contention is NO.

Do we need 40 or so different people roaming around and questioning us like a team of homicide investigators?  I don't think so.

Do we need a different diagnosis from myriad people?  Is it a game of 20 questions and we get to pick which diagnosis we wish to have?  Of course not, the patient's job is to endure it all and then pay up.  It's scandalous.

I got around it by having a patient advocate.  One more person involved in my care, right?  lol.  The difference is that the patient advocate was MY employee.  Her job was to make sure that the HOSPITAL workers remembered their place.  Her job was to make sure that I was treated like a human being, not a slab of meat, there to be used for profit.