Instructions for avoiding Versed/Midazolam

Although I have directions on how to avoid and/or prevent Versed from being used on you elsewhere in this blog, it's a long ways back. I am going to restate these instructions again.

My sister called me in a panic this evening because she is facing a rotator cuff surgery in the very near future! She has had nothing but bad experiences with Versed and being the very sweet lady that she is, she has been unable to convince her anesthesia providers NOT to give it to her. They have insisted on giving her MORE Versed as if that would help. They have assured her that they will use only Fentanyl without Versed and then immediately injected her with Versed. At this point she is unsure whether to even allow the Fentanyl as it seems that it's always Versed/Fentanyl as if the 2 drugs are inseparable. Here is what I told her...

First of all, never point to any scientific studies or Dr.s who agree that Versed is a really bad drug for a substantial number of patients. Please believe that your anesthesia person, usually just a nurse and NOT a Dr., does not care what you or anybody else thinks. They want you to have Versed. So don't say a word about science or empirical evidence. Don't bother to fight with them. They are your employees, not Gods.

Do NOT say anything about the internet. They do not care about the internet unless those posts agree with them, I.E Versed is just wonderful and has zero side effects.

Here is what you do;
1) Insist on speaking to your anesthesia provider AHEAD OF TIME! Do not let anybody persuade you that you will see them just before your procedure. NO! You are going to pay this person a huge amount of money for a small amount of their time. They can spare you a few minutes of their precious time, on the phone, prior to the event. If they can't, find somebody on your own! Ask to speak to a different person at the same establishment. Why should you be able to pick your surgeon etc and not the anesthesia provider?

2) Ask this person if they have a problem with omitting the Versed. If they argue, get somebody else. Now you see why I say to speak to this person prior to being in the medical treatment center? Preferably DAYS before! You need to be able to find the right person. If they argue the merits of Versed, ridicule your concerns, or tell you that you MUST have Versed, again, find somebody else. Don't waste your time arguing with them. Simply replace them!

3) When you arrive at the point of treatment have a RED INK PEN in your possession. Get there even earlier than usual because you will be reading EVERY SINGLE WORD of the sign in sheet. With the red pen you are going to STRIKE OUT every line on that "consent to treat" (as opposed to the actual "informed consent") that you disagree with.
One of the lines to strike is the one which gives the surgeon or provider the latitude to "decide" anything based on their findings. "No" to this otherwise you may find that you are going to get Versed because your medical provider deems it "In your best interests." Admittedly there are a few instances where this isn't applicable. Cancer surgery, where the Dr. needs to be able to perform more than you bargained for and so forth. You are smart enough to know when this is necessary... Even IF they want to be able to amputate, remove and other wise do additional things, you still don't have to let them! However none of this requires Versed. Dr. CANNOT decide unilaterally what they want to do to YOUR body and mind. Kinda defeats the whole purpose of "INFORMED" consent doesn't it. It's the law.
Also, rule out the bit about having people watching or participating in your care at the Doctors discretion. This is a sure fire way to be used as a living cadaver for beginners, students, janitors, and anybody that the Dr. desires. If you want complications, this is a good way to get them. Don't believe the "observing" part. They will be participating, not just observing.
They may want permission to experiment with your body parts. They may call it "disposing" of them. Question that. They may ask for permission to mess with your dna or other things. Nope! They will probably do it anyway, but don't give them permission. If anything comes up later you will have a leg to stand on.

4) Bring the red pen into the preop area with you. Hopefully you have somebody you trust with you who knows your wishes. If not, bring the red pen anyway. Take the time to read the paperwork!!!! Don't let them rush you. Don't let them take your glasses and then try to get you to sign. If you have any questions, like "where the hell is the surgeon?" and "what exactly are you planning to do to me?" etc. DO NOT SIGN THE DOCUMENT! Do not think for one minute that once you sign the document that the questions will be answered. The whole purpose is to get you to sign the alleged "informed consent" without actually giving you any information. Once signed it's too late.

5) Once everybody has given you the amount of information you want, FIRST WRITE IN BOLD RED INK, IN LARGE LETTERS, DIAGONALLY ACROSS THE "INFORMED" CONSENT FORM THESE WORDS; "UNDER NO CIRCUMSTANCES AM I TO RECEIVE VERSED/MIDAZOLAM!" Write this right across the wording. Then you can sign your name and they will sign theirs. Don't forget the "under no circumstances" or they will figure out how to get around it. Trust me, I've been through this very thing...

6) UNDER NO CIRCUMSTANCES are you to sign a consent for sedation of any kind. If your point of treatment has a separate consent for anesthesia, this is great. That's where you write again (in red) UNDER NO CIRCUMSTANCES AM I TO RECEIVE VERSED/MIDAZOLAM IN ANY AMOUNT OR FOR ANY REASON. You may also have a space to write other instructions like "Fentanyl only" or some such. Since you have already established this when you spoke to your anesthesia provider about this, this should not be a problem... You are just helping them remember what your instructions are. You DON'T have to justify why you don't want Versed. Don't let them embroil you in an argument about it. They can and will try to misconstrue anything you say into some kind of permission for Versed...

7) Do not let medical people bully, harass, threaten and cajole you. You are in charge, they are YOUR employees. As much as I despise CRNA's as a whole, there are some EXCELLENT individuals out there who are perfectly capable of doing their job without Versed. Ditto for your Dr. I have heard, and my sister has experienced, people who will tell you anything to get you in there and then subject you to emotional blackmail to get you to accept Versed! Do you really want to give people like that the big bucks? Walk out if they try any funny business. Find somebody else. IT'S YOUR BODY AND MIND. IT'S AGAINST THE LAW TO FORCE YOU TO ACCEPT VERSED!

8) These instructions will not work in an emergency situation. Make sure you family and friends know about your Versed aversion, allergy, whatever... Wear a piece of medical jewelry. They are very reasonable on e-bay and you can get them inscribed with NO VERSED for a nominal fee. Also put a card in your wallet with precise instructions to your EMT should the occasion arise. Have your GP, NP or whomever your primary care provider is put IN YOUR CHART that you are not to have Versed under any circumstances. Make sure that you check your chart for this statement. Watch for any prevarication from your provider like "Patient claims to have an allergy" or "patient thinks they have an allergy to Versed." If they make it sound like you are a loony tune or that you are a hypochondriac, difficult patient etc. it is your right under the law to correct that. Then I would find somebody else who believes that drugs do have side effects even if they don't KILL you!!! PTSD isn't any more fun to live with than a physical problem!

9) KNOW THE LAW as it pertains to "informed consent." There are a lot of things that are being left out of the informed consent discussions. Did you know that they are required by law to tell you the name of every single person who will be involved in your care? It must be in writing... Your consent can't just say "...and anybody the Dr. so directs" If there isn't enough room on the sheet then they must provide you with a second sheet which lists them. There's lots more, read up before you go in. These laws are here on this blog, they are just back a ways...

10) The most important thing is to use the red pen to write the words "Under no circumstances am I to receive Versed/Midazolam" in large red print across the informed consent page.

If you don't do anything else that I have written about, this is the key issue. There is no prevarication or wiggle room left! Be prepared for subterfuge and threats to withhold treatment. Even if they do, you CAN find somebody else. You may have to leave, but it's unlikely... I sure wish I had just gotten up, dressed and left the medical center. I would have been better off without medical treatment.