A few years ago I had a back surgery that didn't go very well.  Along with some recovery difficulties I woke up in the middle of the procedure itself.  As a result I am pretty sure this had an effect on me.


Prior to this event I had no fear of needles, gory pictures, problems with be heading videos and so on.  Heck, watching the surgery channel shows was fascinating to me!


But now I can't handle ANY of that!


Pictures of animals and such isn't a problem.  But if it involving a human I can't look.  I can't stand needles anymore, can't even THINK about watching a be-heading video, I purposefully avoid looking at certain war pics, and so on and so on.

Basically...anything medical related kind of freaks me out now.

So...I ask you...

Is this normal?

Sgtar15

You need a good trail lawyer you could be rich.....

I hear John Edwards will be available sometime in November......

My professional medical advice to you would be to drink heavily.

If you woke up in the middle of the procedure and could feel everything, see the DR working on you, etc.  The pain would etch into your subconcious that needles and DR were a bad thing.  Having felt the pain you would now identify more with the people you see being injured or killed.

Oddly enough, I can deal quite well with blood, injury, etc. when it happens right in front of me and I have to help someone.

Put that up on a TV screen, or even have it described in a graphic manner and I have to leave the room or change the channel.

Not sure if it normal or not, but it sure explains alot.

i deal with people who are either unconscious  by trauma or medicated. the wierd ones are the patients that are catonic..for some reason or another..then all of a sudden the look in their eyes says they are fully awake and scared.

several articles have been written in medical journals regarding minimal loss of consciousness in procedures with the patients paralysed but fully awake and aware of all pain issues during a complete procedure.

i have talked to a woman, who told of having a complete hysterectomy ( with ovaries ) while feeling everything and hearing everything ( including the Pink Floyd - DIRTY WOMAN (?) playing on the background radio).

she told me that one of those alien abduction movies completely freaked her out..the one about the loggers in New Mexico. she said she could basically feel the pain in her body that the scenes where showing..

weird...she seemed credible..

Sounds like a normal reaction to me.

It's only abnormal if it interferes with daily life.  I doubt it does, so your fine.  It's possible that your unconscious mind harbors anxiety towards this event and is triggered by anything medical.  Not your subconscious!  That's your preconscious and totally different in psychology.  Preconscious is sort of a latent part of your conscious, like thinking about a task you have to do tomorrow, but not all the time.

OMG, that's horrible!  Did they know you woke up?  They probably stilled charged you too!  

Quoted: Oddly enough, I can deal quite well with blood, injury, etc. when it happens right in front of me and I have to help someone. Put that up on a TV screen, or even have it described in a graphic manner and I have to leave the room or change the channel.

EGGS ACT LY!!!!!!!!!!!!!!!!!!


I can deal with it person, hence the animals don't bother me, but pics and TV and I literally have to leave...NOW!!!!!!!!!!


Sgat1r5

Quoted: OMG, that's horrible!  Did they know you woke up?  They probably stilled charged you too!

You'd be surprised at how easy this can happen.  Some anesthesiologists run patients real light and others real deep.   I see them wake right up and other take 45 minutes just to get out of the OR suite!

And yes muddydog, radio is are integral part of every OR.

Sgtar15 there is not a whole lot of things that are normal about you but remember this "Only you can prevent forest fires".

I woke up during a knee operation.  The tourniquet pain was impressive.  None of that stuff bothers me (I see it every day).  Must be you

I suppose I could chime in on this, since it happens to be my area of specialty.  Please note that this is not to be construed as medical advice, and does not represent the views of Partners Healthcare, Harvard School of Medicine, or the Massachusetts General Hospital.  In fact, I don't even play a doctor on television.

I'm curious as to what you mean by "woke up during the procedure."  There are varying degrees of intraoperative awareness, from explicit recall of conversations and sensations through vague images and dreams.  During some back procedures, we must actually awaken the patient to test for movement and rule out spinal cord damage/paralysis.

The incidence of intraoperative recall runs between .1 to 3%, depending on the type of procedure.  Cardiac surgery, trauma, and emergent cesarean sections have the highest risk.  These are often marked by significant instability in blood pressure and other vital signs.  If your surgery was not going well, meaning major blood loss and instability, it may have been a significant challenge to resuscitate you.  Our FIRST priority is to keep you alive, and the anesthetic agents can have profound effects on this (depressing heart function, dropping blood pressure, etc).  If they make it impossible to keep you stable, then careful titration or changing agents is necessary and is not always possible.  There is not yet an economical and efficient way of monitoring complete unconsciousness for routine surgeries.  Equipment failures are hopefully infrequent, but an anesthesia machine is deceptively complex and has several possible failure points.  Google search "virtual anesthesia machine" for an idea of some of the plumbing.

It's unfortunate that you experienced this, and I would highly recommend that you speak with a mental health professional (psychologist, counselor, psychiatrist, etc).  Post-traumatic stress disorder is not uncommon following this kind of event, and some of your feelings seem worrisome for that.  I do not know the details, so will say nothing regarding the medicolegal aspects of it.  Suffice it to say, that it may or may not have been negligent, actionable, and below the standard of care for your community.  Despite the best efforts of researchers, it has been impossible to reduce the rate of awareness to zero.

Misery, sometimes we could run two people at exactly the same plane of anesthesia through the case and have one wake up as the drapes come down.  The other would take 30 minutes longer.  It's more than just technique - preoperative fatigue, stress level, comorbid conditions, anxiety, age (teenagers are notorious for taking forever to wake up with ZERO anesthesia left on board), calibration of anesthesia delivery systems, and any other of a host of variables can affect it.  It's easy to blame the operator, but the art of running an anesthetic and timing a wakeup is frequently elusive to even our most experienced staff.

Sorry, no more time to write - am on call and things just got busy.
sleepdr out.

Quoted: I'm curious as to what you mean by "woke up during the procedure."  There are varying degrees of intraoperative awareness, from explicit recall of conversations and sensations through vague images and dreams.  During some back procedures, we must actually awaken the patient to test for movement and rule out spinal cord damage/paralysis. sleepdr out.

It  was that type of proceedure, I believe it was called the disk-o-gram where they injected dye into by disks and such.  The goal was to slightly awaken me and ask me if I felt anything.  But once I woke up I started screaming from the intense pain.  At that point the pain was SOOOO bad that I would have easily choosen death over enduring another minute of that pain.  I vaguely remember them trying to calm me down, but with the pain and my screaming it was all kind of confusing.

I won't even tell you about the nightmares........



SGtar15

To add, I don't think it was negligent, other then the fact that they didn't expect to find that many bad disks...hense that much leakage of the dye onto the nrves/spinal column

SGtar15

Quoted: My professional medical advice to you would be to drink heavily.

And make it a double

Quoted: My professional medical advice to you would be to drink heavily.

sgtar15, your feelings are Ugly and Wrong.

Quoted: Misery, sometimes we could run two people at exactly the same plane of anesthesia through the case and have one wake up as the drapes come down.  The other would take 30 minutes longer.  It's more than just technique - preoperative fatigue, stress level, comorbid conditions, anxiety, age (teenagers are notorious for taking forever to wake up with ZERO anesthesia left on board), calibration of anesthesia delivery systems, and any other of a host of variables can affect it.  It's easy to blame the operator, but the art of running an anesthetic and timing a wakeup is frequently elusive to even our most experienced staff. Sorry, no more time to write - am on call and things just got busy. sleepdr out.

Not sure what you do?  It's been a while, but we had doctors who pulled the deep sleep shit with everyone.  One lady was notorious for this.  She was always picked by this one ortho surgeon for total hip repairs.  We would joke about how long it would be before they were done since her patients were so far under.  I've seen a lot of anesthesiologists who have a pretty good pattern for how the patients do.  I've also seen my share who shouldn't be doing the job at all!  Never forget one idiot who was always cold.  He asked for some foam and stood on his little chair on wheels to tape this foam to the ceiling!  Aside from shit falling into the surgical area, what if he would've fell onto the patient!?

Quoted: sgtar15, your feelings are Ugly and Wrong.

Well ya...but what about on THIS issue?


SGatr15

Waking up during major surgery...well, then I guess you'd be entitled to feel just about any way you want to!

Quoted: can't even THINK about watching a be-heading video,

the day you get used to watching a be-heading video, is the day you should cheak-in to the "nut house". I will never see one of those without cringing.

watching a be-heading video

Listening to the audio was bad enough...I'd never watch the video.

On the other hand, I got a hearty chuckle out of watching the video of the Sadr militiaman RPG gunner get stitched by the SAW...go figure...

Quoted: Quoted: sgtar15, your feelings are Ugly and Wrong. Well ya...but what about on THIS issue? SGatr15

Go make me a sandwich and we'll talk

Quoted: Not sure what you do?  It's been a while, but we had doctors who pulled the deep sleep shit with everyone.  One lady was notorious for this.  She was always picked by this one ortho surgeon for total hip repairs.  We would joke about how long it would be before they were done since her patients were so far under.  I've seen a lot of anesthesiologists who have a pretty good pattern for how the patients do.  I've also seen my share who shouldn't be doing the job at all!  Never forget one idiot who was always cold.  He asked for some foam and stood on his little chair on wheels to tape this foam to the ceiling!  Aside from shit falling into the surgical area, what if he would've fell onto the patient!?

(sorry to hijack thread from initial content)

Not sure what I do?  I chose the field that gets daily contempt from surgeons but still seems to be somewhat necessary for most operations for the last 150 years (first public demonstration of ether for surgery on Oct 16, 1846 for you trivia buffs).  Senior resident in anesthesia at the moment; currently headed for combined fellowship in critical care and cardiac anesthesia if my family's health issues stabilize.

I agree, sometimes folks get way too heavy-handed, and it's painful in the middle of the night to supervise someone who's done that and cost you an extra hour of sleep.  I tend to go for fairly smooth and prompt wakeups, but rushing a wakeup can really screw you if you go too fast and lose the airway.  Guaranteed lawsuit if you try to rush it just to beat a schedule and end up in trouble, since good patient care takes absolute priority.

Foam to the ceiling?!?!  He obviously didn't know some of the finer points of personal environmental control.  I'll list a few of my favorites...  For those who haven't spent hours in an operating room, temperatures can get extreme.  In burn and pediatric rooms, the temperature must often be kept between 90-100 degrees.  The room gets cold in neurosurgical cases (cooling protects the brain), cardiac bypass, and just downright frigid when we do "deep hypothermic circulatory arrest."  That involves packing the head in ice, cooling waaay down to a body temperature of 65 degrees, and essentially stopping all blood flow for a period of time.  

Hot rooms:
Cold soaked towels to the back of the neck
IV fluid bags stored in freezer
I've heard that some people have put gatorade in the skin graft tissue fridge, but would never personally admit to it
Alcohol rubs
Some of the old guys go "commando" when doing hot rooms regularly.  No thanks.

Cold rooms:
Towels/blankets/bottles of fluid kept in blanket warmers
A blanket over the shoulders then a surgical gown over the top makes a great coat
Forced air warming system - tie it to one leg of your scrub pants and it makes a cushion of hot air
Using the heat generated from monitoring equipment
My personal solution was to get fatter, but it's unfortunately a little permanent.

Anesthesia tends to be a fairly misunderstood specialty, and appears deceptively easy and mundane.  Think of it as flying an airplane.  The basic mechanics of flying are usually not terribly complex, but when things go bad they do so quickly and catastrophically.  When things are going bad, you truly may only have seconds or minutes to make critical decisions that can result in life or death.  Those times age us quickly, and my wife can attest to the level of psychological and physical drain that occurs.  It's a specialty that demands calm during chaos, and draws a certain kind of personality.  Most appear laid-back, but constantly have an underlying level of vigilance and are trying to think several steps ahead.  There are also that appear laid-back and are truly just ignorant of the seriousness of their situation (hopefully they get weeded out early on).  You don't do it for glory - the surgeons are the ones who make the headlines.  I guarantee you, however, when someone almost dies in a car accident and has emergency surgery that the anesthesia and surgical folks are both working hard as a team.  We transfuse the blood, manage the airway, and administer the resuscitation drugs, etc. while the surgeons stop the bleeding and fix the mangled body parts.

With regards to your waking up during surgery....what makes you think you did. Do you remember discussion going on during surgery, etc... I am not herer to say that you didn't, its just not really easy to wake up during a surgical proceedure, unless the person doing your anesthesia was asleep, or a complete idiot. Your vital signs would change, your Blood Pressure and Heart rate would skyrocket as your anesthesia became light, and all this happens long before you should be aware of what was oing on. I am not saying it does not happen, because it does on occasion. That said Discograms are a diagnostic test, not surgery. Patients DO NOT get general anesthetics for them.I have given sedation for discograms, lots of em. You have to be awake for them so that the surgeon gets feedback from the patient. In a discogran a needle is placed into the intervertebral disc and the disc is pressurized with IV contrast in an attempt to ELICIT the pain or sensation that the patient is having. You can't be asleep and tell the surgeon that it hurts. These test are brutal. In the anesthesia business these tests are routinely called SCREAMOGRAMS.

Back over 20 years ago when I was training we would do rod insertions into backs for scoliosis in all ages of people from kids to adults. These operations were brutal, and would often last for 8-10 hours. This was before the advent of some of the monitoring used today (evoaked potentials) and we would actually awaken the patients on the operating table and ask them to wiggle their toes. This was for real, and rarely did any patient ever remember being awakened and asked to preform.

Quoted: With regards to your waking up during surgery....what makes you think you did.

Trust me...I did, you don't forget something like that.  And as I stated, they intentially woke me up.


SGtar15

Then nothing that was unexpected happened.

Quoted: Then nothing that was unexpected happened.

Uh huh...have you ever had one of these done?

SGatr15

No I haven't, but I have given anesthesia for many of them. Let me get this right, you have a proceedure that invloves pain,they tell you that you will be sedated but awake for the proceedure, they tell you it will hurt. It does.  Am I missing something?

Quoted: No I haven't, but I have given anesthesia for many of them. Let me get this right, you have a proceedure that invloves pain,they tell you that you will be sedated but awake for the proceedure, they tell you it will hurt. It does.  Am I missing something?

Yes, the original question is how does medical trauma affect a person.


I guess if you consider everything "going as planned" then in your opinion there must be no trauma involved.


I have a feeling that untill you have this procedure done fully on yoiu WITH multiple bad disks you will never understand my viewpoint.

SGatr15

That would not happen in most hospitals.  We monitor brain waves which indicates level of consciousness.  What has been also demonstrated is that you are not really awake but due to the medications and what not, you imagine it and it seems very real.  Its like having a bad dream.  

And btw, I was FULLy sedated and then they were supposted to slightly bring me out of it I could tell them what was going on.  The only time I was awake was AFTER I had the dye injected in me with some other stuff.



It's pure torure as far as I am concerned.


SGatr15

Sarge youre kind a weird to begin with, so this abberation isnt really anything to be concerned about. Could it be that youre just becoming a, dare I say a pussy in your old age?

Quoted: Sarge youre kind a weird to begin with, so this abberation isnt really anything to be concerned about. Could it be that youre just becoming a, dare I say a pussy in your old age?

I wouldn't say that.


SGzatr15

Originally Posted By sgtar15 It  was that type of proceedure, I believe it was called the disk-o-gram where they injected dye into by disks and such.  The goal was to slightly awaken me and ask me if I felt anything.  But once I woke up I started screaming from the intense pain.  At that point the pain was SOOOO bad that I would have easily choosen death over enduring another minute of that pain.  I vaguely remember them trying to calm me down, but with the pain and my screaming it was all kind of confusing. SGtar15

Sarge I had this exact same procedure and their goal is to try to recreate the pain so you can tell them where it hurts and they can take an x-ray.  It is very painful and traumatic.  They didn't give me anything to sleep or for pain as they wanted me to tell them where it hurt. If they put you to sleep it was conscious sedation most likely a little Versed and something else and you didn't "wake up", you were already awake but not supposed to remember.  Hell, I wish they would have given me Versed or anything.  I later had the spiunal fusion at L5-S1 in 2002.  Very painful surgery but very worth it.  Have not had any pain other than a muscle spasm every now and then or a pain down my leg.  I can do everything better than I could before surgery.  'The only restriction I have is no lifting more than 50 pounds.  I have thefull shebang...rod, screws, cage and bonegraft.  I wish you the best.  

Quoted: Back over 20 years ago when I was training we would do rod insertions into backs for scoliosis in all ages of people from kids to adults. These operations were brutal, and would often last for 8-10 hours. This was before the advent of some of the monitoring used today (evoaked potentials) and we would actually awaken the patients on the operating table and ask them to wiggle their toes. This was for real, and rarely did any patient ever remember being awakened and asked to preform.

Some of the old surgeons still actually do these things.  I had to do one a couple months ago, and this was on a very uncooperative 17 year-old.  After trying to crawl off the table and not follow any commands, she STILL didn't remember anything afterwards.  This was in addition to the evoked potential monitoring, and hopefully this guy will retire soon.  It's a good way to snap the rods if a strong kid moves suddenly before we can get them back to sleep.

+1 on the comment that it's not surprising you remember a painful procedure.

Sedation in no way guarantees amnesia, and if your procedure was designed to have you awake and elicit pain then nothing unusual happened.  I had sedation for a procedure a few years back, and the surgeon administered up to 4 times the usual dose of midazolam/Versed, usually a pretty good amnestic.  Guess what?  I remember a specific conversation we had during the procedure... it's designed to sedate, not wipe you out.  Can it be an anesthetic agent?  Sure, but in massive doses and usually combined with other drugs (e.g. fentanyl or morphine, as is often used in heart surgery).

I've had several surgeries and painful procedures, so hopefully can address this from both sides of the knife.  Some degree of aversion to painful or gory things is normal, but your description sounds like it may be somewhat excessive.  If you are having evidence of PTSD, then get it checked further.

Sleepdr, didn't mean to sound when asking what you do, I simply meant "what do you do?".


I'm not so sure discograms are done much these days.  They are considered difficult and unreliable.  MRI or CT myelography is better suited for most cases in fact.  Not sure how long ago this was though.

Misery, no problem - that's actually what I read it to mean (i.e. what do you do for a living).  I was rattling around on the pain service a month or two ago, and it seems that our group here has pretty much abandoned discograms as MRI resolution has improved.

Sarge,
being a future Nurse anesthestist I am somewhat familliar with your procedure...discogram!It is not done by a surgeon...but an Anesthesiologist,an MD! What you had was probably not general anesthesia but what is called "conscious sedation" .. you were probably given 2-3 mg of Morphine and up to 10mg of Versed (IV) .(I
AM NOT AN MD..so don't take this as golden!!....but on to your issue!!

There is a phenomenon called anesthesia awareness which happens under G/A which may have been somewhat of what you experienced. I suppose things/pain can be recalled by people under C/S.

I have been diagnosed with PTSD and you seem to be experiencing the same symptoms.Loss of sleep,bad dreams,etc..etc!!good luck! it does get better after a period of time after the direct trauma!!

watch the discovery health channel tonight at 10pm est..I just saw a comercial for a show about it...anesthesia awareness!!what luck!!

Gunz...not trying to step on your answer, but amnesia is not necessarily part of concious sedation. In fact, the term concious sedation implies that you are sedated, but awake enough to respond and cooperate in the procedure. Recall of a conscious sedation procedure is not unusual.

Often Anesthesiologists do these procedures, but I have also seen surgeons do them, especially if the surgeon is going to do the cutting as a result of the discogram.

As I often tell students that rotate thru our service, and I am also sure that you will hear if and when you get into anesthesia training, there is no receipe for anesthesia. There are guidelines for sure, but as sleepdr so vividly demonstrated, one dose does not fit all.  What is adequate for one patient is not enough for the next, and leaves you taking the third patient to recovery intubated.

I suspect that sgtar15 fit into this scheme. Someone was comfortable and used to providing a particular dose/range of meds for this procedure, and he needed a great deal more. It is unfortunate that his anesthesia provider did not recognize this, and treat him appropriately. Instead he got hurt, hass vivid and bad recall of the procedure, and will look upon further procedures with a jaundiced eye.

Gunz, good luck as a CRNA, it's the best paying job you will ever find as a nurse.

sometimes they do strange things in hospitals.  I had my leg broken and put out of place 13 degrees when i was younger playing sports.  They waited two day and then tried to re-break it and reset the bone without anesthetic.  They actually had me bite on a roll of gauze.  I thought they were joking at first.  

Quoted: Not sure if it normal or not, but it sure explains alot.

Quoted: Gunz...not trying to step on your answer, but amnesia is not necessarily part of concious sedation. In fact, the term concious sedation implies that you are sedated, but awake enough to respond and cooperate in the procedure. Recall of a conscious sedation procedure is not unusual. Often Anesthesiologists do these procedures, but I have also seen surgeons do them, especially if the surgeon is going to do the cutting as a result of the discogram. As I often tell students that rotate thru our service, and I am also sure that you will hear if and when you get into anesthesia training, there is no receipe for anesthesia. There are guidelines for sure, but as sleepdr so vividly demonstrated, one dose does not fit all.  What is adequate for one patient is not enough for the next, and leaves you taking the third patient to recovery intubated. I suspect that sgtar15 fit into this scheme. Someone was comfortable and used to providing a particular dose/range of meds for this procedure, and he needed a great deal more. It is unfortunate that his anesthesia provider did not recognize this, and treat him appropriately. Instead he got hurt, hass vivid and bad recall of the procedure, and will look upon further procedures with a jaundiced eye. Gunz, good luck as a CRNA, it's the best paying job you will ever find as a nurse.

I don't think you were stepping on my post in the least!!

I agree totally with your post! just trying to give my "best" answer avaliable to what was said from Sarge. I know there are various "Cocktails" readily used for G/A as well as C/S,I was giving an example of what I have seen used. I, too have seen quite a  Surgeons and Anesthesiologist do discograms.However,I don't know if Sarge was placed under G/A for a discogram..is that common?

Also, When it comes to C/S I have seen both sides of that as well..Sometimes pts will not remember a thing and some will! I guess this is one reason I am becoming a CRNA. I love the way chemicals effect the human body differently...And the 140,000 possible per yr for a masters level education is an extra!!

By the way what type of work do you do?

edit:

I need to start reading the entire thread!!

SCREW that waking up stuff!

I've  had six "procedures" in the last eight years, mostly ortho repairs for old injuries.  I'm sked for two more in the near future.

I always tell the anesthesiologist to use LOTS of Versed (akd benzodiazapine) to make sure I don't wake up and so that I don't remember.  That stuff works like a champ in wrecking your memory.  I've been told that during one colonoscopy, I chatted up the doc (An old Navy buddy) and didn't recall a damn thing!  His nurses were cracking up later...he said we discussed an old deployement...wonder what I said?    Anyway, he promised not to tell Miz LWilde.  

I use propofol for just about all of my procedural sedation, with a smattering of ketamine here and there when I don't want to put an IV into a kid for a facial lac repair or the like.

Gunz, I do locums coverage full time. I have been doing anesthesia about 22 years. Lots of things have come and gone. Anesthesia has gotten a lot better, and a lot safer. BIS monitors claim to be the gnats ass for knowing when a patient is asleep or not. I have used them with mixed results. I think that thay are on the right track, but like everything else the delta version is usually better than the alpha edition. BTW 140K is just getting started. My first anesthesia job paid 36K. I thought that I was really kicken ass since I had only made about 24K annually as a nurse. My how times have changed.

With regards to versed. It is a very good drug for causing amnesia. I have given as little as 2 mg to a pt and had long and detailed conversations with them. Two minutes later they are asking the same question you just answered for the third time.But like everything else, dose the patient for the effect you are looking for, not by the dose that worked on Mr Smith yesterday. Everyone is different. They all fall more of less under a bell curve. Most will take Xmg for a particular effect, but some require X times 2, and some X minus two. Good Luck. It is a great field. Lots of high paying work.Some really crappy hours, but all in all a pretty good way to make a buck. I have done much, much worse!

reaction you have sounds like symptoms of post tramatic stress, and it could be somthing that you develope after an extremely stressful situation.

it does sound like they intended to do counscious sedation with you, but  weather you had you enough pain meds on board for the procedure, i don't know....

if it really bothers you a lot, i would would say find someone to get some therapy from, to disassociate the idea that medical instruments and things happening to humans is associated with the pain you remember happening to you.

as always,  you should be seen by someone in person for an actual diagnosis and therapy....