The medical student on my surgeon’s team told me that being “foggy” from the anesthesia after my surgeries fit in with the problem I had waking up. My body has a hard time expelling the anesthesia. I’ve learned over the years not to multi-task, or do my business accounting, too soon after the surgery as it is just hard for me to think straight.
They did further testing while I was in the hospital and found that I tested positive for an enzyme deficiency called pseudocholinesterase deficiency. This means that I take a longer time than normal to metabolize certain anesthesia drugs, most commonly muscle relaxants. This is the reason why I took an extra 2 hours to wake up from anesthesia during my surgeries.
This has been fully charted in my Stanford medical chart. It also has an anesthesia muscle relaxant called "succinylcholine" as an allergy. If I have a planned surgery in the future, the anesthesiologist will be able to see this information very clearly. I will put a note next to my insurance card, behind my license, and hope this is seen if I have an emergency surgery. (Using the same anesthesia again will not kill me, it just makes it difficult for me to wake up so it’s not a life and death matter for an emergency surgery).
The communication process through these events really bothers me. Of course, the biggest problem is that it wasn’t charted two years ago. But once I told them about the problem, and they checked the charts and nothing was there, no one came back to me to double-check. By thinking I was mistaking “not waking up” for the recovery area, they ignored some essential facts:
1. This was my fifth surgery for cancer (so I have some experience)
2. I used to work in the health care field so I’m familiar with terms
3. I’m a fairly intelligent person
I did do another step to follow up on advocating for myself. When I got the hospital bill, I called the hospital to let them know I do not want to pay out-of-pocket expenses for anesthesia, as (basically) ignoring my communication really compromised my recovery. I’m waiting to hear the final results on that.
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The work I do in Kenya and the women and girls I interact with are so inspiring to me. They make my issues seem minor and the trips take me to another world, another culture, where it is easy to forget my problems. The work I do there is so fulfilling that it is the best antidote to dealing with my problems. (I teach communication tools to help empower women and girls so their voices will be heard!) I must admit, this trip did stretch me though--smile. I have a scan tomorrow to see if my pneumonia returned and I'm still dealing with the intestinal issues. Thank you for your kind words! Mary Schnack
June 1, 2009 - 4:39pmThis Comment
Mary, you're amazing, to be dealing with all your health issues, plus traveling to Africa. I used to live in North Africa and I'm not so sure I'd be able to handle traveling there with compromised health.
I'm in awe. Be well. :))
June 1, 2009 - 4:28pmThis Comment
Thank you for this informative article. I was not aware that there was a test to check for enzymes deficiencies that cause an adverse reaction to anesthesia.
This article caught my eye, as I remember my mother relaying a similar story about my adverse reaction to anesthesia. I believe I was about 10 years old, undergoing surgery for an adenoidectomy (removal of the adenoid glands, near the tonsils). My mom said I became violent under the anesthesia, and the nurse had a horrific time of waking me from it. I left the clinic with what looked like "hickeys" around my neck, from the nurse pinching my neck so hard and frequently to wake me from the drug.
I am wondering when it is indicated that individuals be tested for the enzyme deficiency you are referring to. As you said, it is not a "life or death" situation, but may be good information to have? Can you tell me what the exact test was called?
And, by the way...(and, most importantly), how did your fifth surgery for cancer go? How are you feeling?
May 31, 2009 - 12:38pmThis Comment
I'm sorry but I don't know what the test is called. I think the information I outlined is probably enough for a doctor to know what to do. I would definitely be tested for it if I was you, especially if the surgery is going to be elective. Whether you want to be tested so you have the info in case of an emergency surgery or not......? (This reminds me, I still have to put this info by my insurance card!)
June 1, 2009 - 8:42amI have quite a bit in my blog on my surgery. I had two tumors and part of the intestine removed where the cancer had spread so it was quite intense. But it's been over two months now and although I'm still feeling some residual effects, I'm feeling prety good. I just got back from two weeks in Africa, in fact! Thanks for asking and keep up the dialogue as much as you want. Best--Mary
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