News Anesthesia Awareness Isn't Just In The Movies

[Kb3]

What you just described is EXACTLY what happened to me during orthopaedic surgery on my knee in 2008. Wide awake, no pain while I thought they were sawing my leg off above the knee. When I came around from the paralytics I WAS believed and BLAMED for it - the nurse anaesthetist (who was on drugs himself) claimed that I was under the influence of drugs or alcohol (I wasn't)and the very junior staff and sadistic nurse that I had been left with verbally and physically abused me until the consultant surgeon and anaesthetist came running back into the OR one at a time. The consultant surgeon jumped on me to hold me down, and dislocated my hip. A few minutes later (felt like an hour!) The consultant anaesthetist came back into the OR to see the aftermath of this disaster, and in an attempt to damage control she put me back under with propofol, otherwise known as the milk of amnesia. As she injected it, she said to the consultant surgeon "you had better pray to God that she doesn't remember this". The surgeon called her a "lezzer" in response. Charming, I think you'll agree. They have never admitted any of this happened, even what happened to my hip.

I didn't remember what happened for months and it took years to remember most of it (there are still pieces that are missing). By the time I did, I had PTSD and avascular necrosis of the hip (bone death from the dislocation, will need a total hip replacement).

I COMPLETELY agree that I would not have developed full blown PTSD if they had been honest with me from the start. Would it have been extremely difficult and caused me a lot of pain? Yes, but if I had felt supported I would not be dealing with the weight of this massive coverup in addition to the original traumas of being awake and the post operative abuse. How can I ever completely trust another doctor again, particularly if I need surgery? It is simply impossible.

The fact is, while you are under for a general anaesthetic you are completely at the mercy of people who in most cases cannot afford to admit to errors such as these. Medical staff deny, dismiss and marginalise these events to protect themselves, not their patients. That they will fry in the pits of hell for their dishonesty and not for their original errors is a foregone conclusion to me. Dishonesty in these cases is evil and self serving.

I don't know what kind of treatment you have had, but I am happy to share what has worked for me if you want me to. I have been able to gain some peace around this trauma in the last six months or so with a specific combination of drugs and therapy and I hope that you have as well. Above all, I am so sorry that this happened to you too and I wish you all the best. If you want to discuss this more, please let me know.

 

[Deaf Global Nomad]

This is definitely an important topic and should be brought to the awareness of the public, medical professionals, therapists, etc...

Although my experiences related to medical experiences were significantly different, I can relate to all of you who experienced AA. I grew up in Europe and was diagnosed as profoundly mentally retarded with an IQ of 24. Somehow during the 80s and 90s (the last surgery was in 97) doctors in Germany thought that profoundly mentally retarded children could not feel and therefore did not need anesthesia. I experienced 5 surgeries (appendectomy, reopening of an infected abdominal suture site a week later, adenoidectomy, ear tube insertion, and removal of impacted wisdom teeth) all without anesthesia. Because of my ability to dissociate, I actually proved them 'right.' I have had therapists here in the US tell me in the past 5 years that no doctor in a Western world would do that. Luckily for me, my mom was present for several of these surgeries (though not all) and is willing to admit that she was witness to this. In contrast to other areas of abuse (e.g. sexual abuse by my father during which she was present), which she still cannot admit or accept, at least the surgery part has become a relatively moot point for me in therapy...

My thoughts go out to all of you...

 

[Kb3]

I experienced 5 surgeries (appendectomy, reopening of an infected abdominal suture site a week later, adenoidectomy, ear tube insertion, and removal of impacted wisdom teeth) all without anesthesia.
My thoughts go out to all of you...

Dear Deaf Global Nomad, my thoughts and heart go out to YOU. This is such inhumane treatment that I don't have the words to express how shocked and sorry I am that you had to go through it! You have my profound sympathies. Keep fighting the good fight with SE, I pray that you can overcome these traumas as well as the others that you have written about. ((((hugs)))))

 

[islandog]

What you just described is EXACTLY what happened to me during orthopaedic surgery on my knee in 2008.

I am so sorry for you. I so understand, You and I have A lot in common.

But I may have mis-spoke I DID feel the pain. It was horrible. Hands inside my guts.

I so want to talk with you more. Please try and reach out to me. IM private room etc.

I couldn't read all of your post because, I am now so very triggered, I just couldn't read it all. I am printing it out tho' and taking it to shrink today.

I can't believe I am not alone.

 

[Girl3]

After being nearly beaten to death by a grad student I dated, I was taken emergently to the OR and operated on while awake and paralysed. That was 1981. It wasn't until I became an anesthesiologist that I understood what had happened.
I take great care to prevent awareness from happening to patients. There is no perfect monitor for it, but we do know there are risk factors. Blood carries the anesthetic to the brain - so if you are bleeding profusely, there goes your anesthetic. Trauma patients (like me) along with open-heart, major transplant, and C-sections for bleeding are surgical risks. Patient risks are females of childbearing age, alcoholics, drug abusers, and people who have had prior aneshtetic awareness. Because we don't know how all - or even most - medications interact with anesthesia, there may be other reasons for awareness. Anesthesia provider risks are failure to turn on the anesthetic gas after putting someone to sleep, turning the gas on but there isn't any in the vaporizer, and diversion of medications (anesthesia providers using the drugs themselves.)
Over the years I have also had patients tell me about awareness when they were having a procedure under sedation like colonoscopy, or a minor procedure under sedation with local aneshtetic. I am always very clear with patients that if we are doing sedation, that it isn't impossible that they might remember something.
I taught nearly a thousand residents when I was still in academics, and we seriously undertook to prevent awareness in patients. I have also fought with surgeons to wait until I got the patient deeper before they begin. Colleagues that I have worked with take it very seriously. When it happens to a patient, there needs to be an open discussion with the patient about it.

 

[Kb3]

I haven't visited this thread in a long time, and I'm happy to say that I have finally been able to process the absolutely horrific trauma of being awake and paralysed during surgery by doing somatic experiencing.

What I have never been able to understand though, is how other people, and by this I mean a lot doctors(by no means all!), fail to grasp just how traumatising lying totally exposed and helpless, for a significant period of time, on an operating table, suffocating on a breathing tube while a surgeon takes apart a portion of your body, truly, truly is.

I saw a GP today who (and I hope I misinterpreted their reaction, I really didn't have the heart to explore it) did not seem to see the reason that I might need trauma therapy for this.

All I can say is, thank God that I did not sit around and wait for this doctor (who incidentally is a very capable and professional GP) - or any other - to recommend that I get help. I would have never made it.

If this ever happens to anyone on this forum, please get help for yourself and do not be surprised, hurt or confused if you are not given any support by either A)the people responsible for the awareness or B)a very large percentage of other doctors, including GP's and notably for me, a psychiatrist who claims to specialise in trauma.

I have really learned the limitations of both human behaviour, and mainstream medicine through this experience. The good news is that I survived it and grew from it.

 

[simplekindofgirl]

This thread is so difficult for me to read.

I had a surgery some years ago in which I experienced anesthesia awareness. Long story short, I had gone in to have a blockage removed from my kidney. Once they actually got in and observed it was decided to remove the kidney with said blockage. What would have been 2 hour procedure turned into 9 hours.

I can remember the conversation that was taking place, I could hear the doctor giving orders. I could hear it, them talking about the damage to the kidney and the loss of function. I did not feel pain, but pressure. A lot of pressure, like I was being pulled, stretched, pushed.

The worst of it for me was at the end. I could hear the doctor talking about the intubation. But I could not breath. I felt this sensation, a lack of air, a lack of ability to breath. It was not as if someone was covering my mouth, it was as if no air would enter my lungs, like they were seized. I could not breathe. I thought, this is it, I am going to die, and I tried to scream, and nothing happened. Nothing. Nothing at all. I could not open my eyes, I could not breathe, I could not move. My brain was in full panic as I listened to them carry on, talking, unable to decipher what they are saying, I can only think, I can't act, and I try but nothing. Then I hear the doctor say I think she is coming around too quick, take it out quickly." and then this rough feeling, a ribbed, hard, plastic feel sliding up my throat. And I heard myself gasp and suck in air heavily, and quickly. I think I had three deep breaths before I my mind just turned itself off.

Anesthesia awareness is very real, and it is terrifying! am so sorry for anyone else that has gone through this. It is a horrible experience. My biggest problem with it is not so much as how often it is reported and recorded, but the level of seriousness and therapy offered to a patient following its occurrence. I talked with my urologist and nephrologist, I explained it to them. They agreed, yes, this is what happened, yes, this is what was said. One of them even went so far as to say "So your medical conditions are as difficult and mysterious in surgery as they are in every day symptoms." which was followed by a- So sorry. We will be in again tomorrow. Nothing at all was done about it afterwards.

 

[Kb3]

((((((simplekindofgirl)))))). I'm so, so sorry that this happened to you and I really understand what you went through.

One organisation that has helped me is http://. It's very worthwhile having a look at their website if you haven't already. They seem to take people's experiences of A/A very seriously, and are trying to make a difference.

I also just found this link to a site which describes a horrific case of anaesthetic awareness which happened to a woman having an emergency c section in 2004.

She describes in an extremely articulate way what she experienced and how she suffered, and how it affected her both in that moment, and afterwards.

What is absolutely amazing though, and something I have not come across before, is that there is an interview with the anaesthetist who was responsible for the error. In it this doctor describes how she met with the patient many times after it happened, and helped her to understand what had happened to her for as long as it took.

This doctor's commitment in helping this woman is nothing short of heroic. Words fail me - I cannot say how differently the course of my recovery would have been if the anaesthetist responsible for what happened to me had displayed even a fraction of the support that this doctor showed her patient.

There really are good, caring doctors out there, and reading stories like this makes me understand the suffering that they also go through when patients in their care are injured. I was very moved by both of their stories.

http://www.bmj.com/content/341/bmj.c3669

 

[Gamereign555]

My grandmother recently went under for an operation, cheap painkillers were used during the surgery and she became aware.

I would like to know that one day if and when I require surgery needing sedation that I am in good hands. I am not so optimistic after hearing the stories, close to home and on the internet.

I don't know what needs to happen for this to be a non issue, even capable people cannot predict totally if the meds and amounts are adequate for the job. Being aware isn't good at all but neither is complications due to too much medication, which can often be responsible for death during surgery.

 

[Girl3]

I'm not sure what cheap pain killers are since the pain medicine most commonly used in the OR is fentanyl which is 100 times more potent than morphine and works in 2-4 minutes and it is cheap because it went off patent 30 years ago.

If your grandmother is elderly and has heart problems, then her blood pressure might have gone very low and the anesthesia provider may have turned off the gas until the blood pressure or heart function recovered.

Or if she were having hip or knee surgery those are usually done under spinal anesthesia with a little sedation because spinal is safer for most patients.

Statistically the odds of being aware during a surgery in which you are not supposed to be aware is 1 in 40,000. Some general anesthetics are done without paralysis - an LMA device is used which means if the patient gets "light" they can move - a cue for the anesthesia provider to do something to get the patient back into a proper depth of anesthesia.

I do tell all patients that it is possible to recall having the breathing tube in their trachea simply because at the end of surgery if a patient vomits and is still asleep when you pull the tube out, the patient will breathe in the vomit and die or get aspiration pneumonitis. I would much rather apologize to the patient about the breathing tube than apologize to the family about why the patient died.

Recently I had a patient with an unusual reaction to the paralyzing drug for her cancer surgery, called eaton-Lambert syndrome. Despite adequate reversal she still could move. I kept her intubated for four hours and held her hand, gave pain medicine, and worked with her until she was strong enough to get the breathing tube out. I went to see her every day in the hospital because I wanted to make sure she didn't get PTSD like me. Everytime she sees someone who works with me she tells them "tell doc I love her".

When it happens, it is a horrible feeling. It is even worse when the surgeons are having an inappropriate discussion about your body, as I experienced.

Anesthesiologists have to know about surgery, diabetes, heart disease, geriatrics, pediatrics, obstetrics, etc and how all of that mixes in with anesthesia. Other doctors may have only had a 2 week rotation on anesthesia when they were in medical school so they have no clue as to what we do. Surgeons don't come into the room until after we have the patient on the table and leave before we get the patient off the table.

I'm sorry for anyone who has a bad hospital experience, in the OR or not. When you are a patient you are very vulnerable and it is just terrifying when things start going wrong and no one cares.

 

[Karens1065]

New here. I had this happen to me 31 yrs ago during a c-section. Sort of an urgent thing. Was 19 at the time, 50 now....Was "put to sleep" sort of, but not quite. Remember going to sleep and then becoming aware of voices thinking it was over, only to realize they hadn"t started yet. Truly was a horrible thing...I felt pain and could recall conversation and I felt no one believed me. I guess no one had heard of this at the time. I am a 50 yr old operating room nurse still haunted by the memory. I don't talk about it much because after all these yrs, I don't think anyone believes me or cares. I think I wanted to work in the OR just to make sure this doesn't happen to anyone else. And I suffer from chronic depression, anxiety and seperation fears. Related? I don't know...Oh and I'm a redhead....

 

[Girl3]

They probably put you to "sleep" with pentothal - which didn't usally do a very good job of putting people to sleep. Back then they had halothane and isoflurane, both of which took a while to set on unless you turned it to a very high concentration which they wouldn't do for a C-section because it hung around in the baby for a long time.

So while they briefly knocked you out, they started your surgery and yes you 'woke up' from your intravenous induction agent without enough anesthesia gas to keep you asleep. People didn't use to talk about it for a variety of reasons; not the least of which was that you were having an urgent C-section and in those days, it was considered part of the territory. I talk to patients about this - and I talk to them post operatively as well.

So I believe you and I believe you were scared and that it has had a big impact. Oh and redheads take more anesthetic in a study looking at that phenomenon.

Hope this helps a little.