E-mail From a Reader

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

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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.

jon

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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!

Another Problem With My Surgeon

I found this article here;How to discharge a patient from your practice This very problem was the straw that broke the camel's back in my decision to sue... Not only was my surgeon remiss in his duties as far as informed consent, he also fired me as a patient when I complained. He had already claimed amnesia for our discussions on anesthesia, (actually where I told him that I was NOT going to have a g/a for this stupid minor surgery) he had downplayed or omitted all the side effects of my surgery, failed to tell me that a PA was going to be my doctor, was an HOUR AND A HALF LATE for surgery leaving me to be drugged and doped to wait for him, performed the surgery sloppily, denied there was a problem with the results, accused me of being a basket case for not liking the very poor outcome of the surgery, and as the last and final straw he fired me. He didn't fire me to my face, I found out about it when I got (tried to get) my patient records. I found a letter to the NP that referred me to this butcher stating that he was terminating me!

So he flouted the law all along, treated me with complete and utter disregard for my safety, botched the surgery and allowed a nasty little control freak nurse to dope me against my will, now HE IS FIRING ME, without even the courtesy to inform ME of his plan! I guess once you screw up the patient badly enough you can simply wash your hands of the whole mess by simply jotting a note to the referring entity!!!!

Well not so fast Dr. Here is the proper procedure for firing a patient... First you tell THEM! IT'S THE LAW! Anyway, I didn't know this. I thought that a cowardly communication from the doctor to my nurse practitioner was the way business was done. Can't have the patient find out that they were fired! Especially if it looks like the patient won't be coming back for more sub standard treatment anyway! This royally pissed me off! On top of everything else the man who ruined my life thinks that *I* am a lower life form unworthy of even this much communication!

How bad was it? I was super angry at the CRNA, a total idiot with delusions of grandeur. I was not so mad at my surgeon because *I* assumed that the reason the surgery was performed so badly was because I fought while under anesthesia, just like I have done every single time g/a has been administered in my long and injury prone life. I blamed the CRNA for the poor outcome of my surgery. However, once I discovered that the surgeon thought that his bad surgery was actually good, that my surgeon was perfectly happy to allow my tendons and nerves to continue to be shredded and damaged by his surgery, and all the rest of it, impugning my mental health, etc. now he was firing me without telling me? That's when I turned on him. Enough subterfuge is enough. Final straw. Here's the article...
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by Adam Alpers, DO

Occasionally, you may encounter patients who you no longer wish to treat. Reasons for ending the physician-patient relationship may include chronic non-compliance, rudeness to office staff, or non-payment of bills. (Not applicable to me...)

While these patient behaviors can affect the interactive care-giving process, they may also identify patients with a propensity to file a claim against you. To help reduce the risk of a future claim, a physician may terminate or discharge a patient from the practice. (Finding out that the ARROGANT man who wrecked my hand and mental health was firing me, AND the way I found out CAUSED me to sue him! Oh yeah, he just cared so much that when I had a bad outcome, instead of helping, he fired me. He could care less, not when he performed the surgery and certainly not after. Complain and you are gone.)

There are, however, certain exceptions that apply to terminating a patient.

• You may not terminate your professional relationship for any discriminatory purpose or in violation of any laws or rules prohibiting discrimination such as the Americans with Disabilities Act.
  
• You also are not permitted to terminate a patient where you know, or reasonably should know, that no other healthcare provider is currently able to provide the patient the type of care or services that you are providing to the patient.

Reduce the risk of abandonment for the patient

Abandonment occurs when a physician suddenly terminates a patient relationship without giving the patient sufficient time to locate another practitioner.

A patient, however, may withdraw from a physician’s care at any time without notifying the physician.

• To reduce the risk of allegations of abandonment, it is recommended that you discuss with the patient in person the difficulties in the physician-patient relationship and your intention to discharge the patient from the practice. (emphasis mine)
  
• Be sure to document the discussion fully in the patient’s medical record, also noting the presence of any witnesses such as a patient’s family member or a member of your office staff. (What discussion? What medical record? No such thing exists or at least was given to me, except a letter he wrote to my NP, which was in the only part of my patient records I was given... letters to others! A copy of this is on the blog elsewhere.)

Write a formal discharge letter to the patient

You are required by law to notify the patient in writing of the termination. The letter must state that you will no longer provide care to the patient as of a date certain. The date certain must be at least 30 days from the date of the letter. You must also state in the letter that you will be available to provide emergency care or services, including provision of necessary prescriptions, during the 30 day notice period. (Why a patient would want emergency care from a physician who can't stand them is beyond me. I never got a formal discharge paper at all. My NP didn't get one either as he was already gone to another job by the time that the letter from my surgeon was sent. )

The discharge letter should also include:

• A description of any urgent medical problems the patient may have.
  
• An offer to forward copies of the patient’s medical records to the subsequent treating physician. (This is not a good idea... Really! Please see the letter from my surgeon to the second opinion Dr. As a patient you do not want this discussion to take place. Your guy will probably try to black ball you, if he/she is anything like mine.)
  
• The name and phone number of a local physician referral service or the local/state medical society to assist the patient in locating a physician who is accepting new patients.

The care of a patient is a mutual agreement and is in many ways a team between you, the provider, and the patient, but when that relationship is strained and you can no longer feel that you are able to provide quality care to the patient, at that point it is time to end that patient-provider interaction. Make sure you have attempted all you can do to help and when you realize there is no more to do, discharging the patient may be the only course of action.

This is all laughable isn't it? What team? I was the sub human underling and he was almighty God. My surgeon didn't provide quality care from the start, so what changed? What exactly did he do to help? Nothing but denigrate me and my concerns out of hand. Go read what he said about me and about the problems I had with the surgery, it's all here. Look at my x rays. Read what other surgeons have said about the problems I had. The relationship was strained because of HIS behavior and performance, NOT mine. I took exception to the whole nasty business, and I'm the bad guy? Then this final act of lawlessness on HIS part in not following the laws about how to fire a patient.

About My Previous Post

When I checked up on the Dr. whose angry rant I published a little while ago, guess what? He is actually a very interesting man. I needed to see what kind of person the doc was, that he would disparage patients to this degree, not to mention his thoughts about the lawyers who help us seek redress from sloppily performed health care! I am not sure where the virulent anger on that post came from, but most of the stuff on his blog I agree with. Sorry Doc, you are completely wrong about medmal, (in my not so humble opinion) but you are exactly right on most of your other stuff. Just a little disclaimer.

Do You Like This Dr?

Here is a SHOCKING statement by a doctor! I grabbed it from here;Doctors can reduce malpractice by being better people The only thing I see to admire about this person is his CANDOR! My comments will be in red and in parenthesis! I have to laugh because this doctor exhibits the same RAGE towards patients as I feel toward the medical community. He needs patients to realize his excessive salary, and I need doctors on occasion to maintain this marvelous machine called a human body. Maybe I should look this doctor up. A match made in heaven isn't it? We could have a relationship based on MUTUAL distrust and animosity. Keep us both on our toes!

(I have removed the doctors name. If you are that interested you can see it by clicking the link I provided above.)

What the doctor is trying to say is the evidence points to personal animus as motivating most malpractice claims. Such a motive is an improper motive and represent lawyer malpractice if it is the real reason for the lawsuit, and the alleged deviation from standards of care and its alleged harm is just a legal pretext. ( Really? Why would the patient have personal animus toward the doctor? Unless said doctor was an arrogant, egotistical, totally nasty customer, who harmed the patient by an alleged deviation from standard of care? I personally don't give a damn if my doctor is most socially inept person on the planet as long as he gets the job done PROPERLY!) The filing of such a retaliatory claim is an improper use of a civil procedure and itself a tort. The subject of anger should be deeply explored in any patient and family deposition. ( This assumes that the patient and/or family are NEVER EVER harmed by a physician. Patients must not, under any circumstances, become angry about their treatment at the hands of a so-called healer.) Then the doctor should file a countersuit against the lawyer, the plaintiff and any family member who encouraged the claim. ( That's right, rich arrogant doctors should attempt to ruin anybody who takes exception to their sub standard care! Oh, sorry, ALLEGED sub standard care!) An attempt should be made to get an injunction from a higher court against any judge allowing such venomous (VENOMOUS? omG This whole rant smacks of venom.) claims to proceed beyond first pleading to dismiss. (Note that he wants to SUE THE JUDGE as well!)

The overwhelming majority, perhaps up to 80%, of medmal claims are weak claims. (According to whose standard? YOURS?) They fail at every stage of litigation. The innocent ( According to whom?) doctor should not settle, and should consider countersuing the lawyer predator. To deter. (In order to be able to practice medicine and be immune from any liability at all? Are you kidding me? What exactly would this accomplish? Doesn't the doctor make enough money, now he wants to sue the patient, the patients family, the judge, and the lawyer. Can we say predator doctor?)

Because there is a first duty to survive and to stay open, the cover up is the most common response to medical error. (According to the AMA, the first duty is to the patient, not to survive and stay open. I have that elsewhere on this blog. Also, how can there be a cover up, if there is never a just reason to sue for malpractice? All patients, their families, their lawyer, the judge who goes forward with the case are just on a mission to attack an innocent party right? So what is there to cover up?) All investigational material will be subject to discovery and may ruin the health entity. (Sounds to me like the "health entity" is already ruined if this persons remarks are any indication.) One may conclude that these weak, hate filled, retaliatory lawsuits (Wow! As a patient I feel so safe being viewed like this!) result in the shut down of investigations into systemic improvements that would eliminate medical errors. (What might that be? Without some means of bringing justice to injured patients, what's to stop medical injuries? Why would a "health entity" try to make systemic improvements in the absence of any means of forcing them to self examine? There would be absolutely NO incentive to protect patients would there?)

Every preventable medical error may therefore be caused by the medical malpractice lawyer, with no exceptions. (Sorry this makes no sense whatsoever. The lawyer wasn't wielding the drugs, scalpel or whatever the problem was, they are necessary to help patients rein in medical practitioners and seek JUSTICE. Complaints about medical injury are the reason behind medical malpractice, ergo, if we can prevent patients from complaining about their treatment, there will be no more medical injuries? All righty then.)

As my final thoughts; We do need malpractice attorneys. They perform a valuable service to patients, not just the financial reparations to "make the patient whole" but also to constantly pressure "health entities" to make us safer, to make these entities more responsive to patients and to convince them that it's in their best interests to follow the law, and do their job to the best of their abilities. Without lawsuits there is nothing to prevent medical practitioners from doing whatever they want without fear of repercussions. Jail is a huge deterrent to me. It makes me obey the law. What if there were no consequences? Trust me, I would be speeding around in my Mustang. I would put everybody at risk with my driving, even though I feel that I am an ace driver and that *I* can control my car under any circumstance. Ditto with medical people. If there is no deterrent, then what is to stop them? It's not like we can lock up doctors that perform badly! The only recourse is financial, and we patients need this in order to police the health entities. There really is no other way at this time. Come up with some mediation, or something like it to address grievances! Maybe doctors would rather be put in jail for infractions and deviations from the law, just like the rest of us?

Update on "Minimal Sedation" Post

I got this e-mail from the person who advised me about the yahoo question in my previous post. Here's what they think...

"Jackie,

That post I sent you about "Minimal Sedation" has been deleted from Yahoo Answers ! (I wanted to see if anyone had responded to the question, and it now says "This question has been deleted." It's gone !) That has never happened before.

Why would that be ? Too many people viewing it? (If so, that must mean lots of medical people are reading your blog even if they're not posting any comments...and obviously, someone didn't want anyone to see what really happens to patients who request "minimal sedation" !"

I don't know what to think! I know that medical people will defend Versed with their dying breath. They will NOT hear anything against it, so it may be that somebody requested that the question be removed lest others tell the truth about the questioner's predicament. As for deleting the question... It's here on this blog and it's not going anyplace. The only way I will remove that question is if the person who posted it e-mails me and asks me to! And it better be the patients name as shown on the question IN the e-mail address and it better have Italy as country of origin in the I.P. Of course I would try to delve further into their debacle, and enlist their help in getting the word out about "sedation" practices...

"MINIMAL" Sedation

I snatched this post from a recent Yahoo answers. Tell me why there is any reason to trust ANYBODY who can get their hands on sedation drugs? Here's the question;

Open Question

Show me another »

Midazolan minimum dose for sedation (colonoscopy)?

I asked for a colonoscopy sedation with a minimum accuracy to be aware and follow the procedure (which may, if necessary to increase) I received: propofol induction 50mg + 5mg midazolan Maintenance: propofol 50 mg bolus. Can anyone tell me if this dose corrisoponde a minimal sedation, conscious and alert as I have specifically asked for (and as I was guaranteed?) the effects were similar to a deep sedation, which I did not want how to evaluate the dose received? Was that a minimum sedation as I wanted? thanks for an answer Ilaria from Italy

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Does anybody wish to address why this person who requested and "was guaranteed" minimum sedation was given *5* mg of Midazolam/Versed and an additional 100mg dosages of Propofol? This is absolutely NOT what this patient wanted. They were very reasonable about this, even saying that the medical personnel could increase the dosage IF NECESSARY. Why was all this "necessary" when the patient clearly wanted a different experience? This is one of those "Who the Hell do you think you are?" moments towards the person who shot this patient full of drugs in violation of this person's stated interests and wishes. This action, taken by a person or persons in a position of trust is morally reprehensible. It's sick and twisted. Made worse by the fact that most patients TRUST the medical provider to do no more than is absolutely necessary and certainly no more than the patient wants, regardless of whether some fool with a syringe thinks it's "necessary." Just one more example of how patients are treated like condemned prisoners, and are devoid of any rights, human dignity, or respect. This person was attacked and shot up with LARGE DOSES of drugs, clearly overdosed with respect to what the patient requested and "was guaranteed."

For you medical people; If you can't do it the way a patient wants, don't do it! Don't assume that you know best, and that the patient must bow to YOUR DESIRES! It's not your job impose your will on a helpless patient. It isn't your decision to make. Why oh why would you think that we patients would appreciate this kind of supreme arrogance?

E-mail From a Reader...

This e-mail was good enough to include it without any commentary from me. I didn't write this, just so you know, people other than me have had problems with the perfect drug Versed! -------------------------------------------------------------------------------------------------

First the "bad" quote :

" In one hospital where I used to work, we were not involved in the GI cases, and we jokingly called screening colonoscopies "screaming" colonoscopies "

( quote from "Pangolin" @ http://answers.yahoo.com/question/index?qid=20110322110339AADCX6K

And now the "good" quote:

"I find that Versed adds virtually nothing to propofol sedation. You might give it for excessively anxious patients in preop or pediatric patients, but most adults can handle the brief 2 minute or less transport from preop into the procedure room. They may say that they need something to calm them down but when you explain to them that Versed will prolong their post procedure stay for up to an hour, most people won't mind a little anxiety before the start of the procedure"

(http://www.blog.greatzs.com/search?q=versed)

"Unnecessary" Operation

This is a quote from a Martin Young commenting here; Why patients seek a second opinion "...There’s no such thing as an ‘unnecessary’ operation. Someone, or more correctly, several people either need the operation or would like to see it happen. The patient need not be among them..." This pretty much explains the huge problem with medical care today. "The patient need not be among them." This is what I ran into. I did NOT want surgery, but people other than me "would like to see it happen." I was lied to by a charlatan about the risks and or benefits of the proposed surgery in order to facilitate HIS best option. My needs were subordinate to his. Ditto for my anesthesia "team." What they wanted was entirely at odds with what *I* needed and was performed as they wanted it, with complete and total disregard for what *I* needed and wanted. What a succinct and frightening summation of medical care this man points out!

Typical ARROGANCE!

The following "answers" are from Ronald Levy, M.D. - Anesthesiology - Medical Specialists - Health/Fitness He's one of the anesthesia experts from http://www.allexperts.com/ They are examples of just how bad our anesthesia providers have become. We cannot say "NO" to Versed (and probably lots more) we are not in charge of our own bodies, and informed consent is absent in these comments. What is the point of informed consent if; a) they don't ask you if you find their amnesia/obedience drug acceptable, b) they will refuse to treat you without this drug, and c) they categorically deny that long term memory loss, well documented by PATIENTS (the anesthesia providers mind reading and extrasensory perceptions not withstanding) and all the rest of the Amydalla driven mental disorders caused by their precious Versed How do patients assert their right of autonomy WITHOUT having treatment withheld as shown below? Do we REALLY have to die in order to avoid the mind melting drug Versed? Is that what this is about? Submit to our horror show drug or crawl home and die? Anyway here are just 2 answers about Versed from Dr. Levy. Very scary to me. "Absolutely you can ask for some sedation prior to surgery (and they should give it to you whether you ask or not. Make sure to tell your next anesthesiologist that you had awareness with your previous general anesthetic so they can take appropriate precautions." Ronald Levy, MD Professor of Anesthesiology UTMB-Galveston On the above "answer" the patient allegedly had anesthesia awareness! The real kind, not the kind caused by the unpredictable amnesia of Versed. Anyway, I put this in here because of this statement; "...(and they should give it to you (sedation IE Versed) whether you ask or not." Unfortunately this is what is happening. As a patient this should scare you! They are giving us a drug without our permission, no informed consent and WORSE even if you refuse this type of medication. This drug is not a simple sedative like Valium or Nyquil. This Versed is a full on psychotropic drug designed to TOTALLY DISRUPT YOUR BRAIN! In my opinion Versed shouldn't even be classified as a sedative because it isn't. How many times do these medical people have to see increased heart rate and blood pressure after they administer this poison before they recognise that O-B-V-I-O-U-S-L-Y this is not sedating the patient, merely causing muscle flaccidity! Our minds are fine in those immobilized bodies! Why do you think that so many of us have PTSD afterwards? The amnesia only works (if it does) after the torture! While it is going on we are cognizant! Yet medical people feel that this is OK! Here's the next one; Answer "First of all, the memory issues your friend has is unrelated to Versed. Versed causes antegrade amnesia meaning that from the time you get it until up to 6-12 hours after the procedure you may have no memory of what happened (which is often a good thing). If your firend's memory loss includes time before the procedure or after 24 hrs afterwars, it is not Versed. That being said, the combination of the 3 drugs is actually a good combination because you need less of each of the drugs because they work synergistically with each other. There is no reason why the CRNA couldn't remove the Versed if you so insisted and she was incorrect to insist on that. I would write a letter to the appropriate people regarding that. Please bear in mind that Propofol also has amnestic effects so if you are willing to accept Propofol, you should have no problem with Versed either, but you are the patient and that is your choice. Next time I would arrange with the anesthesia provider ahead of time to follow your wishes. In the CRNAs defense, all I can say is that, like a patient, she doesn't have to do anything she feels uncomfortable with. It is likely that this is all the CRNA does and she has gotten into a pattern that she knows works and doesn't feel comfortable changing her routine. That is not an excuse. She should be able to provide any type of sedation." Good Luck, Ronald Levy, MD Professor of Anesthesiology UTMB-Galveston Here we have the "denial" from medical providers that I have written about at length previously. Right in the very first sentence of the answer the Dr. is calling patients who have experienced the brain damage from Versed liars. He claims (without any proof at all) that Versed can't cause this. False statement. Versed can cause prolonged memory loss and it DOES do this. I have a number of people that have had this long term memory problem from one experience with Versed and lots of people who have had prolonged use of Versed (ICU) have POCD. They have less or no POCD if medical people don't assault the patients brains with Versed. There are few scientific studies which back me up on this! How much more proof do they need? I can't fathom it! In the last part of the "answer" the doctor opines that the CRNA "has gotten into a pattern that she knows works and doesn't feel comfortable changing her routine." This is something I have also said in this blog, many times. Anesthesia PROVIDERS need Versed, not patients. If this CRNA is so scared and incompetent that she can't provide proper care for patients without Versed and respect their right not to have it, then she should NEVER be allowed to work on a patient again. There is absolutely no excuse for her actions in regard to Versed use. Lastly, do NOT buy in to the esteemed doctors comparison between Versed and Propofol. They are entirely different drugs; why else would some anesthesia providers use both? Does that make sense to you? With propofol you are asleep, not just amnestic! The problem lies with anesthesia stating that when you sleep at night you have amnesia. This explanation minimizes the horror of Versed. With Versed you are tortured and you know it, you are AWAKE and feel everything, you just can't remember it later. (usually) I have another post about how colonoscopy doctors want a sound proof room, somewhere well away from the other patients. Why would they want this, hmmm? Ever wonder why somebody would be screaming? It's not because they are asleep. It's because of Versed. There is no way to determine amnesia, so the continue blithely on. That my friends is why the CRNA refused to treat the patient without using Versed. She WANTED to be able to torture with impunity, counting on Versed amnesia to hide the fact that she is not adequately trained.

Excerpts

"Patients that have received excellent communication about their conditions, and the risks and benefits of treatments vs. non-treatment (opting out), are seldom if ever disappointed with their medical care. Even when a bad outcome occurs, patients and families are grateful for the efforts on their behalf, and for honest and open communication." and; "This is why communication, or lack thereof, is at the core of most suits. Angry patients and families are the ones that sue." and this; "Interestingly, there’s a growing body of knowledge about hospitals adopting a culture of apology, assuming less defensive postures. The early experience indicates there is greater satisfaction on both sides with this practice." These are from this site; Why patients file medical malpractice lawsuits We patients want to be treated with respect. We are entitled to complete information about any type of medical intervention contemplated. Slamming Versed into our veins without permission, information or consent is the ultimate "screw you" to a patient! Not only are we not being given the normal information such as "This drug is to create amnesia in you. You will be awake and aware, talking but you will probably not remember a thing." We are also not getting this discussion; "We want you to obey us without question. This drug will make you extremely obedient. It makes our job easier for these 2 things to happen." Last but by no means least, here's what else needs to be divulged, "This drug has been KNOWN to cause memory problems well after the drug is discontinued. This drug can also cause PTSD, anxiety, insomnia, anger issues and other problems in some patients." THEN, if the patient CHOOSES to risk this because of severe fear, anxiety etc. then the side effects will not come as a shock to them. Remember, patients do NOT LIKE SURPRISES! The number one cause of malpractice suits is (ta-da) SURPRISE! All the drug companies honestly advertise the side effects of their medications and there is no reason that health care workers should conceal the effects and side effects of Versed. No matter how much medical people may like this drug for THEMSELVES it is still the patients decision as to whether or not they want to endure this drug for themselves. And yes, my CRNA and every single one of the nurses who approved, facilitated, concealed and otherwise conspired to give me Versed against my wishes OWES ME AN APOLOGY!