Saturday, December 16, 2006

Anesthesia, Meredith Grey and Me

Grey's Anatomy was a repeat this week and while frustrating, still entertaining to watch. Meredith's reaction to her pain med/pre-op meds was unnerving me a bit - ok- a lot.

Over the last 10 years, I have had several occasions where I have gone into the OR either as an inpatient or an SDS and so have experienced the various effects of the meds given. Actually, in 1988, I had a spinal for a c-section and I remember the delivery clearly. I was expecting to experience the immediate post delivery events along with chatting with the Doc and staff. When I saw him the next day, I asked him why he put me out as I was hoping to talk afterward. My doctor said "You talked the whole time, but we gave you Versed and so you don't remember anything." I am sure my expression was priceless, that of OMG - WHAT did I say? I didn't say that, but he looked somewhat amused, which unnerved me all the more. That was 18 years ago and it STILL bothers me now that I am remembering it again! At the time, and through certain resources I had within the hospital, I was able to find out what happened after the delivery. According to someone in there with me, I kept saying the pressure hurt, etc. and they didn't say that I said anything else. However, knowing me - I probably did say it hurt and I probably DID talk the WHOLE time...sigh.

So, speed it up to the last 10 yrs where I have been through SDS, routine minor procedures and the OR where I have had several more occasions to experience the pre-op meds. (Thank God nothing really serious!) I REALLY feel like I have been in control right up to the point where I am on the OR table, chatting with the staff and then I am out.

I remember ALL the conversations, questions and friendly banter in the pre-op area and in the OR. I vividly remember getting situated on the OR table and who is in the room, the lights and overall logistics of the room. I remember everything that everyone in the OR does to get me set up or help me to be more comfortable.

I remember that warm, woozy feeling you get after the 1st injection and last week the anesthesiologist told me that he just gave me my margarita. :)

If they tell me they just gave me the meds that are putting me out, I play this little game with myself that I am going to stay alert and remember for as long as I can, but that works for a few seconds and then the next thing I remember is that I am waking up in post-op. Although, once I did wake up in the OR after the procedure, which was fine. I amazed everyone because I got back to my room quickly, got up (against nurse's advice - but she did let me) to use bathroom right away, had a sandwich and got out of there!

I don't know how common this is, but I have had times where I "am" conscious, listening to everything, but the staff thinks I am still out. I just can't open my eyes. The first time I had a meniscal repair done, I had it done in the hospital that I worked in. I was conscious, but couldn't open my eyes yet. A nurse walked in to post-op, recognized me and wanted to know why I was in there. They discussed my knee surgery, which knee etc. At another hospital, after having a large kidney stone removed, the nurses in post-op were discussing my procedure and some other things pertaining to me. (If only they were discussing what I said under anesthesia - DRATS!)

I had a laparoscopy to determine why I wasn't conceiving when I was 24. I remember waking up (eyes still closed) to hear myself sobbing and the recovery nurse on the phone saying " I can't take it. I gotta get this one out of here. She won't stop crying!" That is the only time I know of that anesthesia affected me that way. Maybe I was sad because I wasn't getting pregnant at the time? 7 years later, I went to work in that hospital and recognized the nurse's voice. We were friends and I told her what I remembered but I didn't tell her I knew it was her. I could see from her expression that she remembered the event and that she was surprised to see that I remembered it. I realize that is subjective on my part, but I know I am right and also, she had been a recovery nurse back then.

All OR staff should be really careful about what they say around a patient!

Also, when a person is dying, the hearing is the last to go, and so, even seemingly unconscious, they may very well hear everything being said. So,if a patient is unable to communicate for any reason, we should assume that they can hear us on some level. Something as simple as playing a music box for a comatose patient or talking with a dying person and holding their hand can have a profound effect. I remember when an elderly woman was brought into the ED who was seemingly out of it and a certain medical staffer was saying something really unkind about her and tears started coming out from under her closed eyelids and down the sides of her face.

OK - I digressed a bit - back to the drugs!

Versed! I hate the thought of a med that can cause me to forget something! I realize that can be a blessing as well. Who wants to remember their colonoscopy or EGD? (Actually, I do remember part of a routine EGD and then they must've given me more meds.)

In the ED a patient is often given conscious sedation while being worked on for an ortho case. The patients (all ages) often cry out in pain, etc. but because of the Versed/Fentanyl combination given to them, they don't remember anything of what just happened.

Back to Meredith Grey. While feeling the effects of her meds - she was happy AND her inhibitions were totally down. She said things that she would never say, to people she would never say them to and then didn't remember ANY of it!

I wonder if I have ever done that? I think I remember everything as I described. I in no way perceive myself to do the Meredith thing, but I am now wondering if at the point I "think" I have been put out - I was just given the Versed, etc. and just don't remember anything from THAT point?? And, if at that point I also am given more meds that REALLY lower my inhibitions and I am freer with verbalizing my thoughts?? For instance, what if some one in the OR is... let's say.. "easy on the eyes"? Or something catches your attention you wouldn't normally discuss? Would one then possibly comment about that? Or say ANYTHING they wouldn't normally reveal?? We ALL have SECRETS! Secrets about ourselves. Secrets about other people. I could picture myself being easy going and breezy like Meredith was and a little too free with the compliments - "YIKES" - like she was with George, McVet and McDreamy, although, believe me, that isn't MY life. Still, can't help but wonder......

So, SOMEONE please have mercy and tell me that from the point that I don't remember anything - they put me OUT!!! :)

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