Like having your mind disassembled, then put back together again
January 5, 2018 3:39 AM Subscribe
Over the years, I've heard various tales of patients being aware during anesthesia, and it sounds like the worst kind of hell I can imagine.
I don't know if you have read the article, but they discuss the theory that *you were awake* during anesthesia but that the memory of the experience was wiped out. That is, it is an amnesiac experience. You suffered but don't remember anymore...
posted by vacapinta at 4:13 AM on January 5, 2018 [5 favorites]
I don't know if you have read the article, but they discuss the theory that *you were awake* during anesthesia but that the memory of the experience was wiped out. That is, it is an amnesiac experience. You suffered but don't remember anymore...
posted by vacapinta at 4:13 AM on January 5, 2018 [5 favorites]
I have gotten two endoscopies (prophylactic, I am fine), and the first one I did without going under, purely out of curiosity. What a huge mistake that was! The second one (two years later) I somehow got the same doctor and he remembered me as the guy who didn't get knocked out. We laughed about it and he was like "So, anaesthesia this time, right?" Right.
I honestly feel weird just getting knocked out and waking up in a strange place, but it is much better than the alternative, at least for endoscopy.
Oh, and vacapinta, thanks for that comment. I am going to go watch Total Recall and pretend I never read it.
posted by Literaryhero at 4:22 AM on January 5, 2018
I honestly feel weird just getting knocked out and waking up in a strange place, but it is much better than the alternative, at least for endoscopy.
Oh, and vacapinta, thanks for that comment. I am going to go watch Total Recall and pretend I never read it.
posted by Literaryhero at 4:22 AM on January 5, 2018
Yeah, I read it. I guess I mean "aware" as in "telling the doctor everything they and their surgical team talked about during the surgery." I've read accounts of such events and it scares the willies out of me.
posted by Thorzdad at 4:23 AM on January 5, 2018 [2 favorites]
posted by Thorzdad at 4:23 AM on January 5, 2018 [2 favorites]
As an extra, Kate Cole-Adams (the book’s author) was interviewed on the Conversations podcast earlier this year.
posted by antipodes at 4:23 AM on January 5, 2018 [3 favorites]
posted by antipodes at 4:23 AM on January 5, 2018 [3 favorites]
One of my early memories* is becoming conscious during surgery around the time i turned four. I had no vision or tactile sensation (no pain at all), but could hear the doctors talking. I remember being bored after a while and tried to ask them when it was going to be done. There was some sort of “oops” type reaction from them and i lost consciousness again at this point. I’ve always imagined that they turned up the gas or whatever, and that anesthesia for a small child must be difficult and they erred on the side of too little rather than too much.
* This is more of a memory of a memory at this point, over four decades later, but one i recalled easily when i was growing up. I also remember the prep for the surgery that day, my relatives there, and the elevators taken from my room to the surgery. All have been confirmed by my mother. Also, the next time i was at that hospital was when i was twenty-eight, visiting my grandfather there. The elevators (and the configuration of the landing/halls outside of them) was as i remembered.
posted by D.C. at 4:27 AM on January 5, 2018 [6 favorites]
* This is more of a memory of a memory at this point, over four decades later, but one i recalled easily when i was growing up. I also remember the prep for the surgery that day, my relatives there, and the elevators taken from my room to the surgery. All have been confirmed by my mother. Also, the next time i was at that hospital was when i was twenty-eight, visiting my grandfather there. The elevators (and the configuration of the landing/halls outside of them) was as i remembered.
posted by D.C. at 4:27 AM on January 5, 2018 [6 favorites]
For her, it's the loss of control over her life and body and the time drop-out that really rattles her.
the good news is we never had control over those things!
posted by thelonius at 4:40 AM on January 5, 2018 [24 favorites]
the good news is we never had control over those things!
posted by thelonius at 4:40 AM on January 5, 2018 [24 favorites]
I was put under twice for surgeries about a year apart. The first time was unremarkable except for the surprising shock from the time loss. The second time, I felt that disorienting separation from time, but I also felt separated from myself. It was days before I felt like I was fully inhabiting my own head again. That was 25 years ago, and I haven't really trusted doctors or drugs since then. I don't know what it would take for me to voluntarily accept going fully under like that again.
posted by mumblelard at 4:57 AM on January 5, 2018
posted by mumblelard at 4:57 AM on January 5, 2018
I have gotten two endoscopies (prophylactic, I am fine), and the first one I did without going under, purely out of curiosity. What a huge mistake that was!
Why? Was it pain, discomfort, or something else? (The only time I've been under was my colonoscopy, and it was the classic example of it happening so fast that it was like blinking and suddenly an hour was gone.)
posted by Halloween Jack at 4:59 AM on January 5, 2018
Why? Was it pain, discomfort, or something else? (The only time I've been under was my colonoscopy, and it was the classic example of it happening so fast that it was like blinking and suddenly an hour was gone.)
posted by Halloween Jack at 4:59 AM on January 5, 2018
Reading these experiences of being of under its weird to me, because I have no experience of anaesthesia as such - I've been put under three times, and I remember all the experiences very well: lying in the theatre prep room, the coldness of the drugs entering my arm in the drip, looking up at the light and counting backwards, ten, nine, eight, starting to go a little dizzy and dissociated, seven, six, opening my eyes (hang on, my eyes were open) and being in a completely different part of the hospital, my operation apparently complete. No sensation of time having elapsed, like I get with sleep or passing out more mundanely. Just counting backwards with my eyes open and then opening my eyes which made no sense because they weren't closed. Like a tape spliced together, the one moment in every way felt completely adjacent to the other, even as I know they obviously weren't (many hours apart in one case, just a few in another, only the one a third time). So hearing people talk about having any awareness of the anesthesia is strange and foreign to me, because it was a notable lack of any experience of it, or of any experience of disjunction in my experience of the world (in spite of the obvious chronological disjunction) that characterised it for me, every time.
posted by Dysk at 5:00 AM on January 5, 2018 [25 favorites]
posted by Dysk at 5:00 AM on January 5, 2018 [25 favorites]
I remember reading an interview with William S. Burroughs wherein he, a man I think we can all agree had ingested and injected an ungodly amount of drugs into himself, expressed a terror of anesthesia, which he experienced, I think, in a late-life heart operation.
Tangentially, I woke up during an operation, the whole bad-dream bright lights, 5 or 6 masked strangers looking down at me, etc. I told the "world-renowned" anesthesiest that I was a heavy smoker, and that as a result I would burn through drugs faster, but would he listen??
I tried to sky off the table, but they held me down until I went back under.
posted by Chitownfats at 5:01 AM on January 5, 2018 [4 favorites]
Tangentially, I woke up during an operation, the whole bad-dream bright lights, 5 or 6 masked strangers looking down at me, etc. I told the "world-renowned" anesthesiest that I was a heavy smoker, and that as a result I would burn through drugs faster, but would he listen??
I tried to sky off the table, but they held me down until I went back under.
posted by Chitownfats at 5:01 AM on January 5, 2018 [4 favorites]
@vacapinta, I went under "light sedation" for a colonoscopy and apparently woke up, complained about pain, pulled out my IV line, struggled while being held down to have another IV line set, then finally went under as they pumped more drugs into me.
My clear memories of that procedure is going to sleep with an IV in my right arm, and waking up with an IV in my left.
I dimly recall having stomach pain during that episode and complaining about it. That'd be when I struggled, I guess. But I don't remember much else.
Apparently sedation and GA is different, because I don't remember anything at all when going under GA, except that when I woke up I was absolutely freezing...
posted by theony at 5:06 AM on January 5, 2018
My clear memories of that procedure is going to sleep with an IV in my right arm, and waking up with an IV in my left.
I dimly recall having stomach pain during that episode and complaining about it. That'd be when I struggled, I guess. But I don't remember much else.
Apparently sedation and GA is different, because I don't remember anything at all when going under GA, except that when I woke up I was absolutely freezing...
posted by theony at 5:06 AM on January 5, 2018
My GA anesthesia experience was this:
1. As Dysk describes, first an injection and then the world I was in fading away.
2. I was in a deep ocean and attempting to swim to the top but I could not reach the top. I knew I needed to get there. I wasn't drowning but I was stuck and alone.
I heard distant voices (these were in fact voices of nurses in the post-op room) and I wanted to respond to them but I could not. I again attempted to swim upward. I began to get a bit frightened that I would be forever stuck in this shapeless space and unable to communicate with anybody.
3. Eventually I responded and got a response back from the nurses. What I most felt was the memory of the fear. I was waking up now but still shaken from that feeling of being 'stuck' and drifting in a sea of nothing. That memory was clear and still is, to this day.
So, I don't recall the operation itself but I am not keen on repeating that experience.
posted by vacapinta at 5:10 AM on January 5, 2018 [3 favorites]
1. As Dysk describes, first an injection and then the world I was in fading away.
2. I was in a deep ocean and attempting to swim to the top but I could not reach the top. I knew I needed to get there. I wasn't drowning but I was stuck and alone.
I heard distant voices (these were in fact voices of nurses in the post-op room) and I wanted to respond to them but I could not. I again attempted to swim upward. I began to get a bit frightened that I would be forever stuck in this shapeless space and unable to communicate with anybody.
3. Eventually I responded and got a response back from the nurses. What I most felt was the memory of the fear. I was waking up now but still shaken from that feeling of being 'stuck' and drifting in a sea of nothing. That memory was clear and still is, to this day.
So, I don't recall the operation itself but I am not keen on repeating that experience.
posted by vacapinta at 5:10 AM on January 5, 2018 [3 favorites]
I have had one colonoscopy and they put me under GA. I remember being on the table and being told they were administering the anesthetic. There was a beat, and then I heard the voices of doctors and nurses discussing me. I called out "guys, I'm still awake" and was told no, it's over, you're just now regaining consciousness.
I told my mom the story, thinking it was funny. She got really serious and said "My doctor didn't put me out completely for mine. I don't remember anything, of course, but I had bruises from where they restrained me for several days. I'm not doing that again."
posted by middleclasstool at 5:16 AM on January 5, 2018 [1 favorite]
I told my mom the story, thinking it was funny. She got really serious and said "My doctor didn't put me out completely for mine. I don't remember anything, of course, but I had bruises from where they restrained me for several days. I'm not doing that again."
posted by middleclasstool at 5:16 AM on January 5, 2018 [1 favorite]
During my Dad's knee replacement surgery, he apparently woke and began screaming in pain. It freaked the doctor, et al, out enough to repeat the story to my family. He did not remember waking during surgery, but he had night terrors for years afterwards where he would relive waking from the surgery and seeing it all happen.
I am flat out terrified of anesthesia.
posted by slipthought at 5:22 AM on January 5, 2018 [3 favorites]
I am flat out terrified of anesthesia.
posted by slipthought at 5:22 AM on January 5, 2018 [3 favorites]
An interesting sidenote to this discussion is the fact that people with red hair appear to require more anesthesia than other people, and we don't know why.
posted by Rock Steady at 5:29 AM on January 5, 2018 [11 favorites]
posted by Rock Steady at 5:29 AM on January 5, 2018 [11 favorites]
I had IV sedation when my wisdom teeth were removed, and I did wake up halfway through and bite the shit out of the surgeon. I very clearly remember that. Otherwise, yeah, the IV went in, I chewed some very hard bubblegum, and woke up lying on a bench wondering what might have happened moments later.
My mother has had more surgeries than I can count, and had a terrible infection after one that ended with an emergency surgery and multiple weeks in the ICU with a propofol drip. She was mostly lucid during the stay, and remembers a lot, but it was a long, long stay under that sort of twilight sedation, and I'm pretty sure there are significant holes. I know she has a persistent fear of what doctors do and say around patients when they're under anaesthesia, but I don't know if it's from experience or from the sort of 60 Minute exposé that ran a lot 15 years ago.
posted by uncleozzy at 5:39 AM on January 5, 2018
My mother has had more surgeries than I can count, and had a terrible infection after one that ended with an emergency surgery and multiple weeks in the ICU with a propofol drip. She was mostly lucid during the stay, and remembers a lot, but it was a long, long stay under that sort of twilight sedation, and I'm pretty sure there are significant holes. I know she has a persistent fear of what doctors do and say around patients when they're under anaesthesia, but I don't know if it's from experience or from the sort of 60 Minute exposé that ran a lot 15 years ago.
posted by uncleozzy at 5:39 AM on January 5, 2018
When I was a teen, I was given general anesthesia to have all four wisdom teeth removed, in the hopes it would knock out my extreme gag reflex.
It made the reflex worse and they couldn't actually do anything at all. But all I was aware of was a mask over my face and then my mom trying to get my wobbly jelly legs to propel me between her car and the front door.
Apparently while I was coming to, I told them all about Cincinnati, which was interesting because I had never been anywhere near it, never known anyone from there, and had no particular interest in the place.
(I had to go back three times to get those four wisdom teeth out.)
posted by Foosnark at 5:48 AM on January 5, 2018 [2 favorites]
It made the reflex worse and they couldn't actually do anything at all. But all I was aware of was a mask over my face and then my mom trying to get my wobbly jelly legs to propel me between her car and the front door.
Apparently while I was coming to, I told them all about Cincinnati, which was interesting because I had never been anywhere near it, never known anyone from there, and had no particular interest in the place.
(I had to go back three times to get those four wisdom teeth out.)
posted by Foosnark at 5:48 AM on January 5, 2018 [2 favorites]
The anesthesiologist is the most important person in the room during surgery.
I was the person responsible for all of the design details for an outpatient surgical center. They had hired an 'expert' to review and specify equipment and plan arrangement. This person was our go-between and only real contact with medical personnel. Well, that person would never respond or review anything. Nobody else in the group would listen when we repeatedly tried to make them understand that our design was not being reviewed by experts. During construction we finally managed to get the most sought-after local anesthesiologist to review plans. All halt. The surgery rooms were not arranged to allow for optimal performance; the person who has your life under their control was the person that all the surgeons finally listened to. We rearranged the location of gas piping, the overhead surgical light, monitors and surgical table.
I learned a lot about operating rooms through that experience; the anesthesiologist is the person who everyone listens to and is the person who you should care about, more than the surgeon, even.
posted by mightshould at 6:04 AM on January 5, 2018 [23 favorites]
I was the person responsible for all of the design details for an outpatient surgical center. They had hired an 'expert' to review and specify equipment and plan arrangement. This person was our go-between and only real contact with medical personnel. Well, that person would never respond or review anything. Nobody else in the group would listen when we repeatedly tried to make them understand that our design was not being reviewed by experts. During construction we finally managed to get the most sought-after local anesthesiologist to review plans. All halt. The surgery rooms were not arranged to allow for optimal performance; the person who has your life under their control was the person that all the surgeons finally listened to. We rearranged the location of gas piping, the overhead surgical light, monitors and surgical table.
I learned a lot about operating rooms through that experience; the anesthesiologist is the person who everyone listens to and is the person who you should care about, more than the surgeon, even.
posted by mightshould at 6:04 AM on January 5, 2018 [23 favorites]
Why? Was it pain, discomfort, or something else?
They put a sort of speculum in your mouth to keep you from biting and then force a three foot long hose down your throat. To keep your throat open they force air into your stomach, so the five or so minutes of the procedure are extraordinarily unpleasant. I'm not sure it was painful in the sense of a stubbed toe, but it definitely was not good.
posted by Literaryhero at 6:04 AM on January 5, 2018 [3 favorites]
They put a sort of speculum in your mouth to keep you from biting and then force a three foot long hose down your throat. To keep your throat open they force air into your stomach, so the five or so minutes of the procedure are extraordinarily unpleasant. I'm not sure it was painful in the sense of a stubbed toe, but it definitely was not good.
posted by Literaryhero at 6:04 AM on January 5, 2018 [3 favorites]
My son, a natural blonde, has had two surgeries to reconstruct his eardrum. He has been labeled a "secret redhead". He requires much more anesthesia than is normal for his age and weight. I do have several cousins who are natural, bright red, redheads so it makes sense. My daughter, (a dirty blonde) had her tonsils removed right before this past Christmas and her surgeon made a big note across her chart with a red sharpie...."MIGHT BE A SECRET REDHEAD". She is not....normal amounts of all the drugs.
posted by pearlybob at 6:06 AM on January 5, 2018 [9 favorites]
posted by pearlybob at 6:06 AM on January 5, 2018 [9 favorites]
Reading these experiences of being of under its weird to me, because I have no experience of anaesthesia as such - I've been put under three times, and I remember all the experiences very well: lying in the theatre prep room, the coldness of the drugs entering my arm in the drip, looking up at the light and counting backwards, ten, nine, eight, starting to go a little dizzy and dissociated, seven, six, opening my eyes (hang on, my eyes were open) and being in a completely different part of the hospital, my operation apparently complete.
HOLY FUCK I THOUGHT THIS WAS JUST ME
I was about 9 when I had my appendectomy and what I remember was me screaming bloody murder as they put the IV in me (I've always hated needles), passing out, all is black, and then this image of a tree shows up and I'm counting down from 10 to 1. At one I open my eyes and I'm being wheeled out - then I pass out again. I still have no idea how or where that countdown came from, do they count you down in the OR?
When I had my last two wisdom teeth taken out a couple of years ago I was given Dormicum pills, and it was the weirdest thing. My dental surgeon had warned that I'd probably be some level aware of what's happening (which in itself wasn't too much of a problem, my first 2 wisdom teeth were taken under local anaesthetic and all I felt was prodding). Instead I took the pills, started cracking up for some reason, BLINKED - and there was gauze in my mouth. I asked my mum if the surgery happened at all and she was all "yeah, an hour passed". It was like a timeskip. At least with the appendectomy there was a sense that time had passed, whereas with this I didn't notice it at all. I'm still not 100% convinced my teeth were taken out even though I did get an infection and had to clean out my teeth holes with water syringes and blah de blah.
(It made me think that Dormicum would be a dangerously effective rape drug in the wrong hands.)
posted by divabat at 6:10 AM on January 5, 2018
HOLY FUCK I THOUGHT THIS WAS JUST ME
I was about 9 when I had my appendectomy and what I remember was me screaming bloody murder as they put the IV in me (I've always hated needles), passing out, all is black, and then this image of a tree shows up and I'm counting down from 10 to 1. At one I open my eyes and I'm being wheeled out - then I pass out again. I still have no idea how or where that countdown came from, do they count you down in the OR?
When I had my last two wisdom teeth taken out a couple of years ago I was given Dormicum pills, and it was the weirdest thing. My dental surgeon had warned that I'd probably be some level aware of what's happening (which in itself wasn't too much of a problem, my first 2 wisdom teeth were taken under local anaesthetic and all I felt was prodding). Instead I took the pills, started cracking up for some reason, BLINKED - and there was gauze in my mouth. I asked my mum if the surgery happened at all and she was all "yeah, an hour passed". It was like a timeskip. At least with the appendectomy there was a sense that time had passed, whereas with this I didn't notice it at all. I'm still not 100% convinced my teeth were taken out even though I did get an infection and had to clean out my teeth holes with water syringes and blah de blah.
(It made me think that Dormicum would be a dangerously effective rape drug in the wrong hands.)
posted by divabat at 6:10 AM on January 5, 2018
Since we are all telling stories:
Last time I went under, for dental surgery, two funny things happened.
First, I am told that immediately upon waking up I demanded my phone and started doing a lot of typing and demanded loudly to know "how soon can I have a spa day!?" (i have never had a spa day).
Secondly, and this took a few months to find out, I bought stocks. I have a small e-trade account with a couple hundo in there, mostly intended as a learning foray into investing. And I went to look at how my 2 shares of Apple stock where doing and got all freaked out because there was a bunch of shit i didn't recognize. I totally thought my identity had been stolen or something. I looked into it and sure enough I had bought about $600 worth of stocks immediately after waking up. The fucked up part is it was raytheon and astronics and a few other companies and they all showed up on a web page about what to invest in if you wanted to profit from military drones, that was right there in my search history on that same day. They were up an average of 25% at that moment. I dumped them all, but there it was, my $120 or so of fugue state blood money. I also learned how to delete search history as a result, too.
posted by Stonestock Relentless at 6:11 AM on January 5, 2018 [71 favorites]
Last time I went under, for dental surgery, two funny things happened.
First, I am told that immediately upon waking up I demanded my phone and started doing a lot of typing and demanded loudly to know "how soon can I have a spa day!?" (i have never had a spa day).
Secondly, and this took a few months to find out, I bought stocks. I have a small e-trade account with a couple hundo in there, mostly intended as a learning foray into investing. And I went to look at how my 2 shares of Apple stock where doing and got all freaked out because there was a bunch of shit i didn't recognize. I totally thought my identity had been stolen or something. I looked into it and sure enough I had bought about $600 worth of stocks immediately after waking up. The fucked up part is it was raytheon and astronics and a few other companies and they all showed up on a web page about what to invest in if you wanted to profit from military drones, that was right there in my search history on that same day. They were up an average of 25% at that moment. I dumped them all, but there it was, my $120 or so of fugue state blood money. I also learned how to delete search history as a result, too.
posted by Stonestock Relentless at 6:11 AM on January 5, 2018 [71 favorites]
When I had a knee operated on years ago I was given an epidural and other anesthesia. When they were getting ready to operate, a leg appeared to my right. It was my leg and I was not "attached" to it. Very weird.
posted by DJZouke at 6:11 AM on January 5, 2018 [2 favorites]
posted by DJZouke at 6:11 AM on January 5, 2018 [2 favorites]
I had a colleague long ago who was awake during an appendectomy - apparently could not communicate but could feel pain. Amazingly, he was not utterly traumatized by this as far as I could tell, just recounted it as "oh, ha, then that happened, it sucked". He was an incredibly sanguine person, very smart and amazingly gifted with people but not very reflective, so at least it happened to someone who was able to move on from the experience.
My assumption is that most people are not "awake but forgetting it later" during surgery, because as far as I've read, when you're awake but not communicating your pulse and blood pressure go nuts. As long as you have a medial team who are paying attention, it should be possible to spot something like that, and it's the exception rather than the rule so I assume it isn't happening to everyone.
I've been knocked out for stuff a few times - out like a light. I try not to think of what this means for theories of subjectivity, because I find that the less I think about subjectivity the happier I (or whatever passes for me) am (is).
posted by Frowner at 6:17 AM on January 5, 2018 [10 favorites]
My assumption is that most people are not "awake but forgetting it later" during surgery, because as far as I've read, when you're awake but not communicating your pulse and blood pressure go nuts. As long as you have a medial team who are paying attention, it should be possible to spot something like that, and it's the exception rather than the rule so I assume it isn't happening to everyone.
I've been knocked out for stuff a few times - out like a light. I try not to think of what this means for theories of subjectivity, because I find that the less I think about subjectivity the happier I (or whatever passes for me) am (is).
posted by Frowner at 6:17 AM on January 5, 2018 [10 favorites]
HOLY FUCK I THOUGHT THIS WAS JUST ME
Nope, that was me, too. The hospital was very strict about my needing to have someone take me home--not just a taxi, but someone that could help me to bed if necessary--but I was honestly fine from the moment I woke back up, not groggy or woozy or anything. I was more concerned with getting back to eating real food after doing the notorious colonoscopy prep.
posted by Halloween Jack at 6:31 AM on January 5, 2018 [2 favorites]
Nope, that was me, too. The hospital was very strict about my needing to have someone take me home--not just a taxi, but someone that could help me to bed if necessary--but I was honestly fine from the moment I woke back up, not groggy or woozy or anything. I was more concerned with getting back to eating real food after doing the notorious colonoscopy prep.
posted by Halloween Jack at 6:31 AM on January 5, 2018 [2 favorites]
So, I have a disassociative disorder. Anyway, I've had a few surgeries with general anesthesia .
Honestly for my brain it feels no different than dissociated
events, for me mostly related to childhood trauma,. After GA I react in a pretty PTSD fashion. I get really disoriented about the year, and am pretty sure I have been hurt by my past abusers. I try and run, and babble rather openly about memories until I come to enough to actually put the pieces together.
Generally I have someone who knows me well to help me sort this stuff out.
It's pretty distressing and embarrassing, because I really don't want random nurses to know that much detail about my abuse history.
posted by AlexiaSky at 6:32 AM on January 5, 2018 [6 favorites]
Honestly for my brain it feels no different than dissociated
events, for me mostly related to childhood trauma,. After GA I react in a pretty PTSD fashion. I get really disoriented about the year, and am pretty sure I have been hurt by my past abusers. I try and run, and babble rather openly about memories until I come to enough to actually put the pieces together.
Generally I have someone who knows me well to help me sort this stuff out.
It's pretty distressing and embarrassing, because I really don't want random nurses to know that much detail about my abuse history.
posted by AlexiaSky at 6:32 AM on January 5, 2018 [6 favorites]
For my quadruple bypass surgery in 2004, they sedated me with Versed at the point where they just wanted me to be "out", but that was only a precursor to the surgical anesthesia. The last thing I remember is railing on about George W. Bush while some dude shaved my balls for surgery prep. But the world ended at that point, and I was gone until I started to come out of sedation in the CICU many hours later. Because of the seriousness of the procedure, I was pretty weak and unconfortable when I did come to, so I can't be sure, but I don't feel like I had any particularly notable after-effect from the anesthesia itself. When I had my colonoscopy in 2016, they gave me a mild sedative that was enough for me to drift off to sleep before they started the procedure and wake up just as they finished, again with no notable after-effects.
posted by briank at 6:38 AM on January 5, 2018 [1 favorite]
posted by briank at 6:38 AM on January 5, 2018 [1 favorite]
An interesting article, though one of the things that intrigues me more is the longer-term effects of anesthesia - which I imagine are difficult to isolate from the mind's and body's reaction to whatever procedure necessitated the anesthesia. This 2014 Scientific American article touches on it towards the end.
posted by dendritejungle at 6:58 AM on January 5, 2018 [1 favorite]
posted by dendritejungle at 6:58 AM on January 5, 2018 [1 favorite]
I've never been under general anesthesia--didn't even get put under for major oral surgery, an exploratory lower GI colonoscopy, or foot surgery, though I did at least get Ambien for the foot surgery (didn't knock me all the way out, though, and I had a creepy moment when the bones of my foot were evidently unwrapped and the surgeon was wiggling my toe up and down talking about what "great action" it had post surgery. Couldn't really feel it very well due to local anesthetics, but that was a bizarre experience for sure, listening to the doctor calmly inspecting and fiddling around with my physical architecture like it was machinery. I used to be a redhead, till my hair turned brown in college and later just gave up on me and fell out. Hmm, bet I've got a high tolerance to anesthetics, too, though. The Ambien was meant to knock me out.)
posted by saulgoodman at 6:59 AM on January 5, 2018 [1 favorite]
posted by saulgoodman at 6:59 AM on January 5, 2018 [1 favorite]
I guess it was light sedation when I had my wisdom teeth out. I remember feeling like I was spinning, then I fell asleep, then I woke up slightly, and the tape in my walkman needed flipping over, so I naturally tried to do that.
They flipped out because I was moving, but I was ignoring them and quickly flipped the tape over so I could keep listening to Placebo (because it was 2000 and that's what you did when you were me). Then I fell asleep again.
Later on that night, we went to see X-Men, and I had to see it again the next day to make sure that I really did like it or if it was a side-effect of the medication.
I think if I need any sort of anaesthetic now, it'll be very similar. Just probably with a podcast or two instead of Placebo.
posted by Katemonkey at 7:10 AM on January 5, 2018 [2 favorites]
They flipped out because I was moving, but I was ignoring them and quickly flipped the tape over so I could keep listening to Placebo (because it was 2000 and that's what you did when you were me). Then I fell asleep again.
Later on that night, we went to see X-Men, and I had to see it again the next day to make sure that I really did like it or if it was a side-effect of the medication.
I think if I need any sort of anaesthetic now, it'll be very similar. Just probably with a podcast or two instead of Placebo.
posted by Katemonkey at 7:10 AM on January 5, 2018 [2 favorites]
I'm a terrible anesthesia patient. I have a really hard time waking up and it just is a miserable experience. I tend to dissociate. I had a spinal block for an emergency c-section and that experience was legitimately traumatizing. The anesthesiologist was really useless, too. He just kept saying, "Well, that's not supposed to happen. You're fine." YO, I AM NOT FINE. That completely confirmed for me the stereotype of anesthesiologists as doctors who prefer their patients not talk.
posted by soren_lorensen at 7:13 AM on January 5, 2018 [2 favorites]
posted by soren_lorensen at 7:13 AM on January 5, 2018 [2 favorites]
I guess I mean "aware" as in "telling the doctor everything they and their surgical team talked about during the surgery." I've read accounts of such events and it scares the willies out of me
I had a colleague long ago who was awake during an appendectomy - apparently could not communicate but could feel pain. Amazingly, he was not utterly traumatized by this as far as I could tell, just recounted it as "oh, ha, then that happened, it sucked".
"It damn well 'urts!"
"Certainly it hurts."
"Well what's the trick then?"
"The trick, William Potter, is not minding that it hurts."
I think this last, along with the amnesia so we're not bothered about recalled pain, is a large part of what sedative anaesthetics achieve when they work properly.
posted by flabdablet at 7:22 AM on January 5, 2018
I had a colleague long ago who was awake during an appendectomy - apparently could not communicate but could feel pain. Amazingly, he was not utterly traumatized by this as far as I could tell, just recounted it as "oh, ha, then that happened, it sucked".
"It damn well 'urts!"
"Certainly it hurts."
"Well what's the trick then?"
"The trick, William Potter, is not minding that it hurts."
I think this last, along with the amnesia so we're not bothered about recalled pain, is a large part of what sedative anaesthetics achieve when they work properly.
posted by flabdablet at 7:22 AM on January 5, 2018
Not the thing to read as I go through the start of nicotine withdrawal leading up to anesthesia for a tonsillectomy.
posted by PMdixon at 7:29 AM on January 5, 2018 [2 favorites]
posted by PMdixon at 7:29 AM on January 5, 2018 [2 favorites]
I'm one of those people who wake up sobbing after anesthesia. Doesn't matter if it's GA or sedation or twilight sleep. As I start coming to, I sob uncontrollably. I don't *feel* sad, I just cry. A lot.
The process for me, though, is very similar to just falling asleep. I'm fortunate that when I *do* sleep (chronic insomnia), I fall asleep almost immediately instead of tossing and turning and gradually losing consciousness. So one moment I'm awake, the next moment I've woken up after hours of sleep. I don't usually dream, either, so there's hardly ever a time when I feel like time has passed while I'm sleeping.
I've always been fascinated by the fact that no one really knows how or why anesthesia works.
posted by cooker girl at 7:32 AM on January 5, 2018 [2 favorites]
The process for me, though, is very similar to just falling asleep. I'm fortunate that when I *do* sleep (chronic insomnia), I fall asleep almost immediately instead of tossing and turning and gradually losing consciousness. So one moment I'm awake, the next moment I've woken up after hours of sleep. I don't usually dream, either, so there's hardly ever a time when I feel like time has passed while I'm sleeping.
I've always been fascinated by the fact that no one really knows how or why anesthesia works.
posted by cooker girl at 7:32 AM on January 5, 2018 [2 favorites]
I'm one of those people who wake up sobbing after anesthesia. Doesn't matter if it's GA or sedation or twilight sleep. As I start coming to, I sob uncontrollably. I don't *feel* sad, I just cry. A lot.
My wife had an endoscopy and left the office unable to stop laugh-crying. Nothing was funny or sad, she was just laughing and crying and couldn't stop.
posted by uncleozzy at 7:38 AM on January 5, 2018 [1 favorite]
My wife had an endoscopy and left the office unable to stop laugh-crying. Nothing was funny or sad, she was just laughing and crying and couldn't stop.
posted by uncleozzy at 7:38 AM on January 5, 2018 [1 favorite]
My experience was like others of conking out in the prep and suddenly awake in another room with nothing in between. Two things though that spring to mind in terms of how little we understand.
There's a real link between surgery and subsequent depression but we don't know why. The fact that we do things to the brain that we don't entirely understand seems like it would be significant.
And just a note on "This is more of a memory of a memory at this point" to say that there's a theory that all memories are memories of memories, which is why ketamine can be effective as a one-time treatment for PTSD when taken while recalling the experience.
posted by idb at 7:42 AM on January 5, 2018 [4 favorites]
There's a real link between surgery and subsequent depression but we don't know why. The fact that we do things to the brain that we don't entirely understand seems like it would be significant.
And just a note on "This is more of a memory of a memory at this point" to say that there's a theory that all memories are memories of memories, which is why ketamine can be effective as a one-time treatment for PTSD when taken while recalling the experience.
posted by idb at 7:42 AM on January 5, 2018 [4 favorites]
A sinus operation as an outpatient so, needle in arm, feeling cold, being told to count down from 10 and as I got 7, I felt like I was sinking down, everything was going black around the edges, and I said "Oh wow" but I was out before I could finish the sentence, "This is so cool."
Woke up and immediately knew where I was, a clinic in Germany and I don't speak German. I was in the recovery room and a bit annoyed that I was all by myself, still cold. So I pretended to cry figuring that would bring someone and it did and she fetched my boyfriend who drove me home. I was given pain pills but I didn't need them. The enormous bandage on my nose was removed a couple days later and I could breathe again. Will *never* use nasal sprays again.
posted by TWinbrook8 at 7:48 AM on January 5, 2018 [2 favorites]
Woke up and immediately knew where I was, a clinic in Germany and I don't speak German. I was in the recovery room and a bit annoyed that I was all by myself, still cold. So I pretended to cry figuring that would bring someone and it did and she fetched my boyfriend who drove me home. I was given pain pills but I didn't need them. The enormous bandage on my nose was removed a couple days later and I could breathe again. Will *never* use nasal sprays again.
posted by TWinbrook8 at 7:48 AM on January 5, 2018 [2 favorites]
Hey PMDixon, I had general anesthesia for a tonsillectomy. They started me off with demerol in my room before I ever got wheeled to the O.R. It was great. Pharmaceutical grade legal high in a safe and controlled setting. After a bit, I was almost completely immobilized but so chilled out and high that I remember thinking the hospital could have caught fire and burned to the ground around me and I wouldn't have cared at all. The general anesthetic was like being switched off like a light. They were like "Count backwards from ten!" I was like "Ten, nine, eigh...." and cut to black.
Have no fear.
posted by kaymac at 7:51 AM on January 5, 2018 [4 favorites]
Have no fear.
posted by kaymac at 7:51 AM on January 5, 2018 [4 favorites]
Well. I will count it a mercy that this was published a couple weeks after, rather than a couple weeks before, I went under general anesthesia to have an inguinal hernia repaired.
I was terrified of it anyway, both because I didn't like the idea of surrendering control of my body to a bunch of strangers as they slice my crotch open and shove a piece of plastic in (I'm weird that way), and because a grandparent had hernia surgery at about my age and the story that's been passed down to me is that he "almost didn't wake up." Nobody knows anything more specific than that. (He did wake up, though, and went on to have at least a couple less dramatic hernia surgeries after that.)
In my case, it probably helped that I'd been under general anesthesia before, for a ruptured appendix when I was a kid, because I could at least tell myself well, you did it once before and that was okay.
In both the appendectomy and the hernia repair, my experience of anesthesia was the same as Dysk's: counting down, then a jump cut to the recovery room, with no sense of time having passed, and felt more or less like my brain was functioning normally. I was apparently speaking more or less normally to people after waking up, anyway. No lingering effects that I'm aware of, though thanks to dendritejungle I can now worry about my brain having subtle long-term damage, so that's awesome.
The part of the anesthesia that was actually terrifying and horrible was the nerve block, which involved injecting something into my side below the rib cage to numb a stripe of my body from rib cage to crotch. Nobody had told me about it beforehand, I hadn't heard of the procedure before, there wasn't a lot of time to process it emotionally, and I didn't feel like I was exactly being given a choice (though I suppose if I'd had the presence of mind to insist, they would have skipped it). Also the injection was itself fairly painful, and the site remained painful after waking up: I could feel it for several days afterward. I don't know what pain the nerve block was sparing me from, so I suppose I can't say that it was worse than the alternative, but if there's a next time, I'm going to skip the block and find out.
Just to be clear: I'm not actually upset, dendritejungle.
posted by Spathe Cadet at 7:52 AM on January 5, 2018
I was terrified of it anyway, both because I didn't like the idea of surrendering control of my body to a bunch of strangers as they slice my crotch open and shove a piece of plastic in (I'm weird that way), and because a grandparent had hernia surgery at about my age and the story that's been passed down to me is that he "almost didn't wake up." Nobody knows anything more specific than that. (He did wake up, though, and went on to have at least a couple less dramatic hernia surgeries after that.)
In my case, it probably helped that I'd been under general anesthesia before, for a ruptured appendix when I was a kid, because I could at least tell myself well, you did it once before and that was okay.
In both the appendectomy and the hernia repair, my experience of anesthesia was the same as Dysk's: counting down, then a jump cut to the recovery room, with no sense of time having passed, and felt more or less like my brain was functioning normally. I was apparently speaking more or less normally to people after waking up, anyway. No lingering effects that I'm aware of, though thanks to dendritejungle I can now worry about my brain having subtle long-term damage, so that's awesome.
The part of the anesthesia that was actually terrifying and horrible was the nerve block, which involved injecting something into my side below the rib cage to numb a stripe of my body from rib cage to crotch. Nobody had told me about it beforehand, I hadn't heard of the procedure before, there wasn't a lot of time to process it emotionally, and I didn't feel like I was exactly being given a choice (though I suppose if I'd had the presence of mind to insist, they would have skipped it). Also the injection was itself fairly painful, and the site remained painful after waking up: I could feel it for several days afterward. I don't know what pain the nerve block was sparing me from, so I suppose I can't say that it was worse than the alternative, but if there's a next time, I'm going to skip the block and find out.
Just to be clear: I'm not actually upset, dendritejungle.
posted by Spathe Cadet at 7:52 AM on January 5, 2018
"The trick, William Potter, is not minding that it hurts."
When I was driving back from the holidays I failed to bring food for lunch, and I never get off the interstate to eat anymore - just want to power through the trip. So I got really hungry, and I started wondering, why isn't this just a sensation? Why is it unpleasant? Of course, an animal that didn't respond to it by seeking out food would be in a bad way, but to me, that still leaves the question open. Couldn't I be reminded it's time to eat by the feeling of hunger, without that feeling being so bad?
posted by thelonius at 7:53 AM on January 5, 2018 [1 favorite]
When I was driving back from the holidays I failed to bring food for lunch, and I never get off the interstate to eat anymore - just want to power through the trip. So I got really hungry, and I started wondering, why isn't this just a sensation? Why is it unpleasant? Of course, an animal that didn't respond to it by seeking out food would be in a bad way, but to me, that still leaves the question open. Couldn't I be reminded it's time to eat by the feeling of hunger, without that feeling being so bad?
posted by thelonius at 7:53 AM on January 5, 2018 [1 favorite]
Fugue State Blood Money sounds like a rippin' death metal band.
posted by snwod at 8:02 AM on January 5, 2018 [8 favorites]
posted by snwod at 8:02 AM on January 5, 2018 [8 favorites]
I always look forward to the Fugue State game in the Fall
posted by thelonius at 8:04 AM on January 5, 2018 [10 favorites]
posted by thelonius at 8:04 AM on January 5, 2018 [10 favorites]
Cardioversion is where they use a defibrillator on a patient with arrhythmia, essentially to shock the heart back into normal rhythm. It's a routine procedure, not at all like the dramatic scenes one tends to associate with defibrillator use. They sedate the patient for the process, since it's not exactly pleasant to receive an electric shock to the chest, but they don't necessarily use heavy sedation.
I watched a woman undergo cardioversion in the ER once. She looked about half-asleep, but cried out in pain and alarm when the shock came. Then she moaned a bit and went back to looking half-asleep. They hit her with the juice again a few minutes later, provoking the same reaction. The doctor said not to worry about it--she won't remember a thing.
posted by dephlogisticated at 8:17 AM on January 5, 2018
I watched a woman undergo cardioversion in the ER once. She looked about half-asleep, but cried out in pain and alarm when the shock came. Then she moaned a bit and went back to looking half-asleep. They hit her with the juice again a few minutes later, provoking the same reaction. The doctor said not to worry about it--she won't remember a thing.
posted by dephlogisticated at 8:17 AM on January 5, 2018
My family has a genetic mutation where we lack a series of enzymes that break down certain things like milk fat and complex proteins, which makes eating fun.
But we also cannot break down anectine anesthesia. Like at all. We remain in a coma until a dialysis machine clears it from our blood.
As a result we all have a healthy fear of any anesthesia.
posted by 80 Cats in a Dog Suit at 8:21 AM on January 5, 2018 [8 favorites]
But we also cannot break down anectine anesthesia. Like at all. We remain in a coma until a dialysis machine clears it from our blood.
As a result we all have a healthy fear of any anesthesia.
posted by 80 Cats in a Dog Suit at 8:21 AM on January 5, 2018 [8 favorites]
I've been put under GA five or six times during my life for procedures, and I have "woken up" during the procedure twice, in that I became fully consciously aware (despite being high af) and retained full memories afterwards.
The good news is that both times I woke up I seemed to be entirely immune to pain and had basically no tactile experience of the actual surgery that was happening. The bad news is that I was entirely paralyzed and unable to let anyone know that I was awake and didn't want to be. And one of those times was during open eye surgery.
Fucking terrifying.
posted by 256 at 8:21 AM on January 5, 2018 [6 favorites]
The good news is that both times I woke up I seemed to be entirely immune to pain and had basically no tactile experience of the actual surgery that was happening. The bad news is that I was entirely paralyzed and unable to let anyone know that I was awake and didn't want to be. And one of those times was during open eye surgery.
Fucking terrifying.
posted by 256 at 8:21 AM on January 5, 2018 [6 favorites]
GA (and most strong psychoactives, really) leave me feeling like not-myself for about a week. The first time I smoked pot I was high for three days. You know the dentist kid in the viral video who’s all “Will I be like this forever?” That’s what I’m like.
I do bounce back from nitrous in about an hour, though, so that’s helpful.
posted by infinitewindow at 8:23 AM on January 5, 2018 [2 favorites]
I do bounce back from nitrous in about an hour, though, so that’s helpful.
posted by infinitewindow at 8:23 AM on January 5, 2018 [2 favorites]
Couldn't I be reminded it's time to eat by the feeling of hunger, without that feeling being so bad?
The badness of hunger can be trained out of a person, with practice at fasting. I've done it myself, so I know it's possible: hunger can indeed become mere information. It's even possible to learn to associate the feeling of hunger with pleasurable emotions, like feeling powerful and in control, which is how anorexia works.
The trouble with messing with these systems that is that it's roughly equivalent to disconnecting the oil pressure light on your car's dashboard. Without the irritation of that constant distracting red glow, it's just way too easy to put off doing anything about the knowledge that you should have topped the oil up a thousand km ago and changed the filter at least twice since last year.
I've found hunger acceptance training to be quite useful for weight loss, but I've also found that living for months at a time with a deliberately disrupted hunger response leads to eventual constant irritability, depression and motivation loss. We're complex beasts with many interacting feedbacks, and messing with them can bite later in unpredictable ways.
posted by flabdablet at 8:24 AM on January 5, 2018 [8 favorites]
The badness of hunger can be trained out of a person, with practice at fasting. I've done it myself, so I know it's possible: hunger can indeed become mere information. It's even possible to learn to associate the feeling of hunger with pleasurable emotions, like feeling powerful and in control, which is how anorexia works.
The trouble with messing with these systems that is that it's roughly equivalent to disconnecting the oil pressure light on your car's dashboard. Without the irritation of that constant distracting red glow, it's just way too easy to put off doing anything about the knowledge that you should have topped the oil up a thousand km ago and changed the filter at least twice since last year.
I've found hunger acceptance training to be quite useful for weight loss, but I've also found that living for months at a time with a deliberately disrupted hunger response leads to eventual constant irritability, depression and motivation loss. We're complex beasts with many interacting feedbacks, and messing with them can bite later in unpredictable ways.
posted by flabdablet at 8:24 AM on January 5, 2018 [8 favorites]
I don't have any particular phobia or worries about anesthesia - I've been under three (?) times in my life. I have a pretty good understanding of how it feels, that whole time-skip sensation, the absence of anything, etc.
A few years ago I had to get a cholecystectomy and I felt like the hospital staff were taking good care of me during prep. Every person that entered the room asked me my name, asked why I was there, and so on. Then the anesthesiologist came in and I was distracted by the fact that she strongly resembled Ygritte from A Game of Thrones. She asked my name, and why I was there, and then asked if I had any questions. I said, "Sure" and the look on her face was not resigned disgust at being delayed in her duties but more of an honest 'okay cool what do you want to talk about' and then she said something to that effect.
"Well I was reading a while back about some anesthesiologist at a small regional hospital near where I grew up who was being sued for multiple cases of awake intubation, and I wanted to ask about that."
She looked kind of shocked and said, "Nothing like that happens here."
"Of course not! I'm just curious - how do you know I'm, y'know, out deep enough?"
and she said something along the lines, and to this day I'm sorry I can't remember the quote verbatim, "My job is to give you drugs and monitor the effects and put you under so deep that you could die, but I'm there to make sure that doesn't happen."
No sarcasm, I really appreciated that blunt response. I asked her about what my experience would be.
"We'll introduce the drug though this IV. Then we'll wheel you down the hall into the operating room. You'll be moved onto the table, and then I'll check to make sure you're out, and then Dr. Whoever will take your gallbladder out."
and then I said okay let's do this and I thought to myself, "Alright, step one: drugs. Step two will be the ride down th-"
and then as you can expect I woke up in a nice dark room in recovery thinking "where's the hallway?"
anyway I often think back fondly to that day that a Wildling kept me from dying from the drugs that she herself gave me.
posted by komara at 8:26 AM on January 5, 2018 [17 favorites]
A few years ago I had to get a cholecystectomy and I felt like the hospital staff were taking good care of me during prep. Every person that entered the room asked me my name, asked why I was there, and so on. Then the anesthesiologist came in and I was distracted by the fact that she strongly resembled Ygritte from A Game of Thrones. She asked my name, and why I was there, and then asked if I had any questions. I said, "Sure" and the look on her face was not resigned disgust at being delayed in her duties but more of an honest 'okay cool what do you want to talk about' and then she said something to that effect.
"Well I was reading a while back about some anesthesiologist at a small regional hospital near where I grew up who was being sued for multiple cases of awake intubation, and I wanted to ask about that."
She looked kind of shocked and said, "Nothing like that happens here."
"Of course not! I'm just curious - how do you know I'm, y'know, out deep enough?"
and she said something along the lines, and to this day I'm sorry I can't remember the quote verbatim, "My job is to give you drugs and monitor the effects and put you under so deep that you could die, but I'm there to make sure that doesn't happen."
No sarcasm, I really appreciated that blunt response. I asked her about what my experience would be.
"We'll introduce the drug though this IV. Then we'll wheel you down the hall into the operating room. You'll be moved onto the table, and then I'll check to make sure you're out, and then Dr. Whoever will take your gallbladder out."
and then I said okay let's do this and I thought to myself, "Alright, step one: drugs. Step two will be the ride down th-"
and then as you can expect I woke up in a nice dark room in recovery thinking "where's the hallway?"
anyway I often think back fondly to that day that a Wildling kept me from dying from the drugs that she herself gave me.
posted by komara at 8:26 AM on January 5, 2018 [17 favorites]
Interesting article and discussion. I have a few minor factual quibbles with the article, but overall I thought it was good. For an excellent description of the daily life of an anesthesiologist, I highly recommend Counting Backwards: A Doctor’s Notes on Anesthesia. It is currently being passed around our OR and we all agree he describes our job perfectly.
posted by TedW at 8:26 AM on January 5, 2018 [9 favorites]
posted by TedW at 8:26 AM on January 5, 2018 [9 favorites]
Couldn't I be reminded it's time to eat by the feeling of hunger, without that feeling being so bad?
Off topic, but I've been doing intermittent fasting for several months. I have an 8 hour eating window, then no food for 16 hours.
Every single day, at about the 14 hour fasting mark, I feel hungry. I suddenly go, damn, I could use a sandwich. I ignore it, and within 20 minutes or so, the feeling fades. I see it as the body's "hey, the tank is low here, mind filling up?" Then I say, "Not filling up now, sorry." And the body is like, "Cool, we'll use reserves."
Then I can go much longer than the 16 hour fasting window without feeling hungry or tired or weak at all.
Which is to say, there is hungry, and then there is hungry. The body can do some incredible things to survive, but it would really rather not, thank you very much.
posted by slipthought at 8:27 AM on January 5, 2018 [3 favorites]
Off topic, but I've been doing intermittent fasting for several months. I have an 8 hour eating window, then no food for 16 hours.
Every single day, at about the 14 hour fasting mark, I feel hungry. I suddenly go, damn, I could use a sandwich. I ignore it, and within 20 minutes or so, the feeling fades. I see it as the body's "hey, the tank is low here, mind filling up?" Then I say, "Not filling up now, sorry." And the body is like, "Cool, we'll use reserves."
Then I can go much longer than the 16 hour fasting window without feeling hungry or tired or weak at all.
Which is to say, there is hungry, and then there is hungry. The body can do some incredible things to survive, but it would really rather not, thank you very much.
posted by slipthought at 8:27 AM on January 5, 2018 [3 favorites]
The first time I smoked pot I was high for three days
Ah! Nobody believes me when I tell them that I often have floaty body tingles for at least a day after I smoke pot. It's the best.
posted by uncleozzy at 8:34 AM on January 5, 2018 [1 favorite]
Ah! Nobody believes me when I tell them that I often have floaty body tingles for at least a day after I smoke pot. It's the best.
posted by uncleozzy at 8:34 AM on January 5, 2018 [1 favorite]
I'm one of those lucky ones that enjoy the floaty pre-drugs, get in the room, start counting, and wake up in recovery--no problem--after eight generals and two twilights, this makes me incredibly happy. I don't care if it's being totally unaware or amnesia, it's all good. From first appendectomy thru the back surgeries to the last knee replacement, my only complaints are that I wake up freezing cold, thirsty, and starving. Some of you have stories that are absolutely terrifying. Moar drugs, please!
posted by BlueHorse at 9:18 AM on January 5, 2018 [1 favorite]
posted by BlueHorse at 9:18 AM on January 5, 2018 [1 favorite]
I'm a GI nurse, and we do a decent amount of colonoscopies/EGDs at my hospital. They are all done either IV sedation by me (which is considered light sedation) or monitored anesthesia care (MAC) by a CRNA, or anesthesiologist.
IV sedation involves versed for relaxation, and fentanyl to help with pain. This usually works for most people undergoing colonoscopies. Some people stay awake and watch the screen the entire time, but most people go to sleep. When it comes to EGDs however, I recommend anesthesia. Nothing like a patient waking up panicking because there is a scope down their throat (and obv., it must be horrible for them). MAC drastically reduces the chances of this happening. They wake up when it's over, asking when we are about to start.
posted by triage_lazarus at 9:19 AM on January 5, 2018 [1 favorite]
IV sedation involves versed for relaxation, and fentanyl to help with pain. This usually works for most people undergoing colonoscopies. Some people stay awake and watch the screen the entire time, but most people go to sleep. When it comes to EGDs however, I recommend anesthesia. Nothing like a patient waking up panicking because there is a scope down their throat (and obv., it must be horrible for them). MAC drastically reduces the chances of this happening. They wake up when it's over, asking when we are about to start.
posted by triage_lazarus at 9:19 AM on January 5, 2018 [1 favorite]
The first time I had to have general anaesthetic before surgery, I was so terrified. I had no idea what to expect and was really afraid of waking up during surgery and being paralyzed and unable to tell anyone, like this person (don't read the article or watch the video if you're just about to have surgery).
Like komara, I had an anaesthesiologist who was very kind and took the time to talk to me extensively and answer all my questions. When I told him my fear of waking up and being paralyzed during surgery and asked if that ever happens, said that it does (!!!), but that it was his job to carefully monitor my responses the whole time, and that he would immediately know if I were not fully under and would immediately adjust the drugs so I would be sent back under.
I was reassured by him but still terrified. I was freezing cold and shaking with fear, but the surgery team were all so kind and lovely. The nurses held my hands while I was administered anaesthetic and I was in the middle of telling them anxiously that I felt very weird when--boom, I was waking up in the recovery room.
posted by hurdy gurdy girl at 9:34 AM on January 5, 2018 [2 favorites]
Like komara, I had an anaesthesiologist who was very kind and took the time to talk to me extensively and answer all my questions. When I told him my fear of waking up and being paralyzed during surgery and asked if that ever happens, said that it does (!!!), but that it was his job to carefully monitor my responses the whole time, and that he would immediately know if I were not fully under and would immediately adjust the drugs so I would be sent back under.
I was reassured by him but still terrified. I was freezing cold and shaking with fear, but the surgery team were all so kind and lovely. The nurses held my hands while I was administered anaesthetic and I was in the middle of telling them anxiously that I felt very weird when--boom, I was waking up in the recovery room.
posted by hurdy gurdy girl at 9:34 AM on January 5, 2018 [2 favorites]
I bought stocks. I have a small e-trade account...
I initially read that as "socks", and was mightily confused right up to the $600 figure (!!) before I realized ohh, stocks...
posted by Greg_Ace at 9:37 AM on January 5, 2018 [3 favorites]
I initially read that as "socks", and was mightily confused right up to the $600 figure (!!) before I realized ohh, stocks...
posted by Greg_Ace at 9:37 AM on January 5, 2018 [3 favorites]
The twilight anesthesia I had to have two of my wisdom teeth removed definitely produced some memories of memories. It took a while for the propofol and gas to fully knock me out, during which time I was very interested in both the visual hallucinations and the endodontist's inability to decide what to do about his kitchen, which he was discussing with his assistants while finishing up the preparations to cut open my gums.
The way they do it, they use nitrous to knock you out and then turn it off and just let the propofol do its thing on your memory, so you aren't actually unconscious for the actual surgery. I'll be damned if I can remember anything about it, though. I have a few memories of memories starting within what I'm told was about 5 minutes after they cut off the drip, but the normal "original" memory didn't return for another 10 or 20 minutes while I was being walked to the car. Basically I remember remembering on the way home walking from the procedure room to a recovery room, sitting for a few minutes, getting the post-op care instructions, and being walked out to the car and being quite insistent I didn't need their help to walk to the car. It was only ever fragments, though, and I'm quite certain I only remember the specific bits I do because I was actively trying to remember on the way home. Not because I felt that I was missing time or anything, just because I find it fascinating to feel the effects of drugs like that doing their thing.
It makes sense, given the way human memory works. Propofol and other similar drugs don't have any impact on working memory or even short term memory, they just prevent short term memory from being committed to long term memory, so you forget anything that happens while you are in that state quite shortly. However, since it doesn't do anything to short term memory, anything that's still in there as your capacity to form long term memories returns can be retained indirectly if you are actively trying to recall.
Human memory is both bizarre and highly exploitable through both chemical and non-chemical means. Consciousness itself is far more a fleeting thing than the vast majority of us are really comfortable with. There is no there there. Without memory there is no continuity and arguably no self at all.
posted by wierdo at 9:41 AM on January 5, 2018 [6 favorites]
The way they do it, they use nitrous to knock you out and then turn it off and just let the propofol do its thing on your memory, so you aren't actually unconscious for the actual surgery. I'll be damned if I can remember anything about it, though. I have a few memories of memories starting within what I'm told was about 5 minutes after they cut off the drip, but the normal "original" memory didn't return for another 10 or 20 minutes while I was being walked to the car. Basically I remember remembering on the way home walking from the procedure room to a recovery room, sitting for a few minutes, getting the post-op care instructions, and being walked out to the car and being quite insistent I didn't need their help to walk to the car. It was only ever fragments, though, and I'm quite certain I only remember the specific bits I do because I was actively trying to remember on the way home. Not because I felt that I was missing time or anything, just because I find it fascinating to feel the effects of drugs like that doing their thing.
It makes sense, given the way human memory works. Propofol and other similar drugs don't have any impact on working memory or even short term memory, they just prevent short term memory from being committed to long term memory, so you forget anything that happens while you are in that state quite shortly. However, since it doesn't do anything to short term memory, anything that's still in there as your capacity to form long term memories returns can be retained indirectly if you are actively trying to recall.
Human memory is both bizarre and highly exploitable through both chemical and non-chemical means. Consciousness itself is far more a fleeting thing than the vast majority of us are really comfortable with. There is no there there. Without memory there is no continuity and arguably no self at all.
posted by wierdo at 9:41 AM on January 5, 2018 [6 favorites]
The author interjecting hazy personal memories -not related to anesthesia - seems to undermine the scientific anecdotes.
I'm pretty sure I recall a doctor telling me about the amnesiac aspect of anesthesia, and what that implies. (That you're aware, you just don't remember.)
I'm not certain if some past procedures involved GA or a lesser level of sedation. They've ranged from knocked out on lighter meds to Oh boy, I wish I was knocked out. During a colonoscopy I suddenly was awake and aware of the procedure, and the discomfort, and saying something of the "Hey, I'm awake!" or "Hey, that hurts!" variety. Ugh.
My other colonoscopy and a sigmoidoscopy(sp) were without incident. (I dont recall if you even get drugs for the latter.)
And I don't recall if I had GA for wisdom teeth removal (or just Valium and a painkiller), but I had a nice nap.
When I had a uterine laproscopy under GA I only recall waking up in recovery and babbling about god knows what, as were others around me. Speaking of:
people with red hair appear to require more anesthesia than other people, and we don't know why.
Interesting. I also recall a dr. telling me red-haired women seem to have more of certain gynecological conditions than the general population.
This topic of anesthesia is part of a greater issue of drug tolerance/reactions. Like how some oral meds will make me more drowsy than they will you, etc. (Or how recently a dentist tried two different numbing agents on different teeth during fillings, and hello, one didnt work well at all! Give me whatever that childhood dentist of the "nice nap" memory did.)
posted by NorthernLite at 9:52 AM on January 5, 2018
I'm pretty sure I recall a doctor telling me about the amnesiac aspect of anesthesia, and what that implies. (That you're aware, you just don't remember.)
I'm not certain if some past procedures involved GA or a lesser level of sedation. They've ranged from knocked out on lighter meds to Oh boy, I wish I was knocked out. During a colonoscopy I suddenly was awake and aware of the procedure, and the discomfort, and saying something of the "Hey, I'm awake!" or "Hey, that hurts!" variety. Ugh.
My other colonoscopy and a sigmoidoscopy(sp) were without incident. (I dont recall if you even get drugs for the latter.)
And I don't recall if I had GA for wisdom teeth removal (or just Valium and a painkiller), but I had a nice nap.
When I had a uterine laproscopy under GA I only recall waking up in recovery and babbling about god knows what, as were others around me. Speaking of:
people with red hair appear to require more anesthesia than other people, and we don't know why.
Interesting. I also recall a dr. telling me red-haired women seem to have more of certain gynecological conditions than the general population.
This topic of anesthesia is part of a greater issue of drug tolerance/reactions. Like how some oral meds will make me more drowsy than they will you, etc. (Or how recently a dentist tried two different numbing agents on different teeth during fillings, and hello, one didnt work well at all! Give me whatever that childhood dentist of the "nice nap" memory did.)
posted by NorthernLite at 9:52 AM on January 5, 2018
For a few days after either general anesthesia or conscious sedation, I have this overwhelming sense of well-being and calm for several days. It gives me hope that if Ketamine treatment for clinical depression becomes available to me, I'll probably respond well to it.
My immediate reaction to general anesthesia is similar to vacapinta’s, with the feeling of struggling to break through the surface as it wears off. Once I’m back, I get nausea and terrible itching in my hands and feet. So, I usually get a dose of something like Ativan in the recovery room, which makes me happy-doze for a while longer.
I've had the conscious sedation for minor procedures more times than I can remember, and that's almost always a positive experience. I've woken up during the procedure a handful of times, but I usually end up laughing or joking with the doctors before nodding back off. I remember during a skin graft, the plastic surgeon chatted with his assistant the whole time about his new 3/4 left hand Stratocaster. While I was having my broken hip but back together, I'm told that I sang “Every Little Thing She Does is Magic” along with the radio in the OR.
The only negative experiences I had were waking up during an endoscopy (felt a strong gag reflex, and a feeling of pressure like something was trying to burst out of my chest cavity), and during eye surgery (the automatic blood pressure cuff was too tight, and it kept waking me up with a terrible pain in my arm, blinding white lights in my eyes while hands and instruments came toward my face, and an incredible feeling of pressure around my forehead).
posted by The Underpants Monster at 9:55 AM on January 5, 2018
My immediate reaction to general anesthesia is similar to vacapinta’s, with the feeling of struggling to break through the surface as it wears off. Once I’m back, I get nausea and terrible itching in my hands and feet. So, I usually get a dose of something like Ativan in the recovery room, which makes me happy-doze for a while longer.
I've had the conscious sedation for minor procedures more times than I can remember, and that's almost always a positive experience. I've woken up during the procedure a handful of times, but I usually end up laughing or joking with the doctors before nodding back off. I remember during a skin graft, the plastic surgeon chatted with his assistant the whole time about his new 3/4 left hand Stratocaster. While I was having my broken hip but back together, I'm told that I sang “Every Little Thing She Does is Magic” along with the radio in the OR.
The only negative experiences I had were waking up during an endoscopy (felt a strong gag reflex, and a feeling of pressure like something was trying to burst out of my chest cavity), and during eye surgery (the automatic blood pressure cuff was too tight, and it kept waking me up with a terrible pain in my arm, blinding white lights in my eyes while hands and instruments came toward my face, and an incredible feeling of pressure around my forehead).
posted by The Underpants Monster at 9:55 AM on January 5, 2018
Since we are sharing anesthesia stories:
Last year I had a fibroadenoma removed from my breast. I also had the time-lapse: a countdown, comforting sleepiness, and then the next thing I knew, I was being wheeled to the recovery room.
The operation apparently took a lot less time than the hospital people had told my husband (my required escort) it would take, so when I woke up, he had stepped out to get a bite to eat with my friend Katja, who had shown up in support.
I don't remember this, because post-anesthesia weirdness, but apparently I started asking for my husband and he wasn't there, and then a few minutes after I started asking for him, he was there and he apologized for not being there right away but the hospital had told him the operation would take over an hour and it took half an hour. And he said "and Katja's here! she came to see you!"
And I apparently replied "Katja... can go fuck herself."
And my husband, overjoyed, apparently announced to the room that the anesthesia had worn off, that I was back to being myself (clearly, an asshole).
posted by millipede at 9:56 AM on January 5, 2018 [12 favorites]
Last year I had a fibroadenoma removed from my breast. I also had the time-lapse: a countdown, comforting sleepiness, and then the next thing I knew, I was being wheeled to the recovery room.
The operation apparently took a lot less time than the hospital people had told my husband (my required escort) it would take, so when I woke up, he had stepped out to get a bite to eat with my friend Katja, who had shown up in support.
I don't remember this, because post-anesthesia weirdness, but apparently I started asking for my husband and he wasn't there, and then a few minutes after I started asking for him, he was there and he apologized for not being there right away but the hospital had told him the operation would take over an hour and it took half an hour. And he said "and Katja's here! she came to see you!"
And I apparently replied "Katja... can go fuck herself."
And my husband, overjoyed, apparently announced to the room that the anesthesia had worn off, that I was back to being myself (clearly, an asshole).
posted by millipede at 9:56 AM on January 5, 2018 [12 favorites]
I had completely forgotten my first experience with anesthesia/sedation. When I was maybe seven or eight, they had to pull and/or cut out some permanent teeth in the back to make room for braces. I can't remember if I had an IV or not; it was probably some combination of gas and an injection.
Anyway, the nurse kept saying I would go to sleep and they would send me on a trip to Disneyland. Then they put headphones on me, and started playing a record of Disney songs. When I woke up, the nurse and my mother kept asking about my “trip to Disneyland,” but I didn't have any memories of the music or anything while I had been out. But they were so earnest and eager I couldn't stand to let them down, so I lied and said something like, “Oh yeah, I went to Disneyland. It was great. Mickey Mouse was there. Can we go home now?"
Even years later, Mom would occasionally bring up my "trip to Disneyland," and how clever it was of the doctor to think it up.
posted by The Underpants Monster at 10:10 AM on January 5, 2018 [5 favorites]
Anyway, the nurse kept saying I would go to sleep and they would send me on a trip to Disneyland. Then they put headphones on me, and started playing a record of Disney songs. When I woke up, the nurse and my mother kept asking about my “trip to Disneyland,” but I didn't have any memories of the music or anything while I had been out. But they were so earnest and eager I couldn't stand to let them down, so I lied and said something like, “Oh yeah, I went to Disneyland. It was great. Mickey Mouse was there. Can we go home now?"
Even years later, Mom would occasionally bring up my "trip to Disneyland," and how clever it was of the doctor to think it up.
posted by The Underpants Monster at 10:10 AM on January 5, 2018 [5 favorites]
My grandfather was a huge guy—lotsa muscles that can only come from a lifetime of hard farm work. He had a hernia in the late 1950s, and had to have surgery. Family legend has it that the doctor thought he was fully sedated, but when the knife touched Pa's flesh, he rose from the table like the Incredible Hulk, snapping his restraints like they were Christmas ribbons. Afterwards, he remembered nothing.
I'm not as big as Pa, but I have had two hernia surgeries. For the second one, I fasted like instructed, showed up at the hospital at 7 AM for a scheduled 10 AM surgery. Well, the doctor didn't show up until after 6 PM. By that point I had been sitting in pre-op for a couple of hours with raging caffeine withdrawal. A nurse comes by to check on how I'm doing and tell me that they don't know when the doctor is going to get there. I said "Look, the fucking doctor is seven hours late, and I'm hungry, thirsty and extremely angry. You're about to inject me with a shit-ton of drugs as soon as the doc gets here. How about we get this party started?" She just nodded and gave me a valium IV. My mood improved.
Finally, the doc shows up and they put me under. The doc had told me it was a minor hernia, and it would only take about 90 minutes to repair. Instead, it took four hours. When I went in for my check up a week later, he described my pelvic floor as "shredded" and told me he didn't know how I could even walk.
When I woke from anesthesia, I asked for my wife. She was right there by my side. I grabbed her hand and yelled about how much I loved her for about a half hour. When I calmed down, a laughing nurse told her "You know, they always tell the truth when they come out of anesthesia. He really loves you."
posted by vibrotronica at 10:16 AM on January 5, 2018 [13 favorites]
I'm not as big as Pa, but I have had two hernia surgeries. For the second one, I fasted like instructed, showed up at the hospital at 7 AM for a scheduled 10 AM surgery. Well, the doctor didn't show up until after 6 PM. By that point I had been sitting in pre-op for a couple of hours with raging caffeine withdrawal. A nurse comes by to check on how I'm doing and tell me that they don't know when the doctor is going to get there. I said "Look, the fucking doctor is seven hours late, and I'm hungry, thirsty and extremely angry. You're about to inject me with a shit-ton of drugs as soon as the doc gets here. How about we get this party started?" She just nodded and gave me a valium IV. My mood improved.
Finally, the doc shows up and they put me under. The doc had told me it was a minor hernia, and it would only take about 90 minutes to repair. Instead, it took four hours. When I went in for my check up a week later, he described my pelvic floor as "shredded" and told me he didn't know how I could even walk.
When I woke from anesthesia, I asked for my wife. She was right there by my side. I grabbed her hand and yelled about how much I loved her for about a half hour. When I calmed down, a laughing nurse told her "You know, they always tell the truth when they come out of anesthesia. He really loves you."
posted by vibrotronica at 10:16 AM on January 5, 2018 [13 favorites]
The author interjecting hazy personal memories -not related to anesthesia - seems to undermine the scientific anecdotes.
The New Yorker is a general interest magazine, not a scientific journal
posted by thelonius at 10:20 AM on January 5, 2018 [5 favorites]
The New Yorker is a general interest magazine, not a scientific journal
posted by thelonius at 10:20 AM on January 5, 2018 [5 favorites]
I've been under full anesthesia 4 times and it was generally as Dysk described. I go out in the OR and wake up somewhere else. I did have a benign tumor removed from my breast under twilight anesthesia and apparently I talked through the entire thing, according to the surgeon. The only thing I remember is a nurse gently stroking my hair (or surgical cap, I guess), which was really quite lovely since I was finding out if I had breast cancer or not and wasn't used to such lovely treatment by medical professionals. I wouldn't mind twilight anesthesia again if I had a choice.
posted by Sophie1 at 10:25 AM on January 5, 2018 [2 favorites]
posted by Sophie1 at 10:25 AM on January 5, 2018 [2 favorites]
The fasting. Heh. I've told this before but it still makes me laugh, so: when I had a burst torsioned ovarian cyst in Helsinki, I walked to the nearby women's hospital where it was diagnosed. I had been eating dinner when it burst, so it had been about an hour since eating when the nurse asked that question.
Nurse: "well, we need to operate immediately."
Me: "Isn't general anesthesia dangerous if you haven't fasted?"
Nurse: "Yes, but if we wait that long, you will be dead from the internal bleeding."
Me: "Oh. Okay."
Thankfully I had an all right anesthesia experience. I went under as a one-year-old for an umbilical hernia operation and still remember the anesthesia, especially my (long-abusive) mother rolling her eyes and walking out of the room when I screamed and wept in fear. The next thing I remember was waking up on the top bed of a bunk bed and screaming again because I was alone and didn't recognize anything.
So when the laparoscopy for the burst torsioned cyst came around at age 22, I was happy to nod off (it felt like sleep in my case) and wake back up with little panic and in a normal bed that time around. My abdomen hurt like hell, so that was an interesting real-life flashback. Also my (always abusive) mother called the hospital a few hours later and said I should have died because it was God's punishment for being a whore (thanks Mom!), so it was kind of like a karmic bookend to the experience as a two-year-old. Not too long afterwards, when she repeated the death wish, I told her it was granted, I was dead to her.
Anyway yes, thankfully my physical makeup didn't add to trauma. I've been grateful for it ever since first hearing about people who remember their experiences while under anesthesia.
posted by fraula at 11:00 AM on January 5, 2018 [4 favorites]
Nurse: "well, we need to operate immediately."
Me: "Isn't general anesthesia dangerous if you haven't fasted?"
Nurse: "Yes, but if we wait that long, you will be dead from the internal bleeding."
Me: "Oh. Okay."
Thankfully I had an all right anesthesia experience. I went under as a one-year-old for an umbilical hernia operation and still remember the anesthesia, especially my (long-abusive) mother rolling her eyes and walking out of the room when I screamed and wept in fear. The next thing I remember was waking up on the top bed of a bunk bed and screaming again because I was alone and didn't recognize anything.
So when the laparoscopy for the burst torsioned cyst came around at age 22, I was happy to nod off (it felt like sleep in my case) and wake back up with little panic and in a normal bed that time around. My abdomen hurt like hell, so that was an interesting real-life flashback. Also my (always abusive) mother called the hospital a few hours later and said I should have died because it was God's punishment for being a whore (thanks Mom!), so it was kind of like a karmic bookend to the experience as a two-year-old. Not too long afterwards, when she repeated the death wish, I told her it was granted, I was dead to her.
Anyway yes, thankfully my physical makeup didn't add to trauma. I've been grateful for it ever since first hearing about people who remember their experiences while under anesthesia.
posted by fraula at 11:00 AM on January 5, 2018 [4 favorites]
When I had my wisdom teeth out all they gave me was Novocaine and some laughing gas. The gas successfully dissociated me from the experience even though I could pretty much feel all of it. When the dentist had to put his knee on my chest for leverage while extracting a particularly tough tooth and then had blood splatter all over his face when it came out I was not, as I would have otherwise been, aghast and feeling woozy - instead I imagined the blood droplets with top hats and canes, marching around his face like a Steamboat Willie cartoon.
Recovery did take longer than anticipated, though.
posted by grumpybear69 at 11:36 AM on January 5, 2018 [3 favorites]
Recovery did take longer than anticipated, though.
posted by grumpybear69 at 11:36 AM on January 5, 2018 [3 favorites]
Yeah, all of the above. As a kid, woke up because I thought they were hurting my younger sibling. I pulled out the IVs and made it off the table.
Always out of body experiences. It took from May until December to get the benzos out from a two hour shoulder surgery. Also, I woke up completely uncovered for pain in an unbelievable agony, and just covered my face and silently sobbed in recovery, and I have a really high pain threshold. I think the temp nurse took the pain med and hoped the residual anesthesia would ride me out to the next dose.
The colonoscopy I flat out told the guy the lowest benzo dose and just talk to me nicely about untoward movement. So I remember them putting my hands back on the bedrail and reminding me to stay on my side. But with that, I woke up after a three hour nap at home, completely refreshed and no after effects.
My father never fully recovered from a bout of anesthesia that basically just slipped him loose from everyday reality, after that he had symptoms of Lewy Body dementia and the parkinson's worsened until he was bed ridden.
posted by Oyéah at 11:56 AM on January 5, 2018
Always out of body experiences. It took from May until December to get the benzos out from a two hour shoulder surgery. Also, I woke up completely uncovered for pain in an unbelievable agony, and just covered my face and silently sobbed in recovery, and I have a really high pain threshold. I think the temp nurse took the pain med and hoped the residual anesthesia would ride me out to the next dose.
The colonoscopy I flat out told the guy the lowest benzo dose and just talk to me nicely about untoward movement. So I remember them putting my hands back on the bedrail and reminding me to stay on my side. But with that, I woke up after a three hour nap at home, completely refreshed and no after effects.
My father never fully recovered from a bout of anesthesia that basically just slipped him loose from everyday reality, after that he had symptoms of Lewy Body dementia and the parkinson's worsened until he was bed ridden.
posted by Oyéah at 11:56 AM on January 5, 2018
I had a colleague long ago who was awake during an appendectomy - apparently could not communicate but could feel pain. Amazingly, he was not utterly traumatized by this as far as I could tell, just recounted it as "oh, ha, then that happened, it sucked".
In a medical context I've only had "conscious sedation" with IV midazolam/Versed/Dormicum (or something of the sort) where I was apparently interactive during the procedure but totally amnesiac afterward. But I've messed around with dissociatives recreationally/experimentally and the idea of being aware that you are in pain but not fully connecting to it is fairly consistent with that.
(my understanding is that the volatile anesthetics are currently thought to work through some combination of positive modulation of GABA receptor function like a lot of the classic "downers" and blocking NMDA receptors like ketamine etc.)
posted by atoxyl at 12:08 PM on January 5, 2018
In a medical context I've only had "conscious sedation" with IV midazolam/Versed/Dormicum (or something of the sort) where I was apparently interactive during the procedure but totally amnesiac afterward. But I've messed around with dissociatives recreationally/experimentally and the idea of being aware that you are in pain but not fully connecting to it is fairly consistent with that.
(my understanding is that the volatile anesthetics are currently thought to work through some combination of positive modulation of GABA receptor function like a lot of the classic "downers" and blocking NMDA receptors like ketamine etc.)
posted by atoxyl at 12:08 PM on January 5, 2018
I was in my teens hanging out with the teenaged son of a family friend and ended up swapping general anasthaesia stories.
Me, 12 or 13, going full under to remove four wisdom teeth. 10, 9, 8....
7, 6... huh? urgh, my face is stuffed with gauze.
Him, 14, going under for a circumcision (!). 10, 9, 8...
Wakes up, screaming and in unbelievable pain halfway through the procedure.
... we changed subjects.
posted by porpoise at 1:25 PM on January 5, 2018
Me, 12 or 13, going full under to remove four wisdom teeth. 10, 9, 8....
7, 6... huh? urgh, my face is stuffed with gauze.
Him, 14, going under for a circumcision (!). 10, 9, 8...
Wakes up, screaming and in unbelievable pain halfway through the procedure.
... we changed subjects.
posted by porpoise at 1:25 PM on January 5, 2018
The author interjecting hazy personal memories -not related to anesthesia - seems to undermine the scientific anecdotes.
---
The New Yorker is a general interest magazine, not a scientific journal
I was referring to the book that's profiled in the article,
Kate Cole-Adams' “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness.”
(She) has written an obsessive, mystical, terrifying, and even phantasmagorical exploration of anesthesia’s shadowy terra incognita. In addition to anesthesia, the book describes Cole-Adams’s childhood, her parents, a number of love affairs, and various spiritual experiences and existential crises—a drifting, atemporal assemblage meant to evoke the anesthetized mind.
posted by NorthernLite at 1:50 PM on January 5, 2018 [1 favorite]
---
The New Yorker is a general interest magazine, not a scientific journal
I was referring to the book that's profiled in the article,
Kate Cole-Adams' “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness.”
(She) has written an obsessive, mystical, terrifying, and even phantasmagorical exploration of anesthesia’s shadowy terra incognita. In addition to anesthesia, the book describes Cole-Adams’s childhood, her parents, a number of love affairs, and various spiritual experiences and existential crises—a drifting, atemporal assemblage meant to evoke the anesthetized mind.
posted by NorthernLite at 1:50 PM on January 5, 2018 [1 favorite]
the part where the woman getting a c-section could feel everything legitimately made me start crying at work
posted by taskmaster at 1:50 PM on January 5, 2018
posted by taskmaster at 1:50 PM on January 5, 2018
I am not a doctor, but anesthesia has always been an important part of my life for family reasons and I follow the developments. In that sense, the article was disappointing. Normally I find the New Yorker's medical/health reporting to be quite good, but this article was a bit of a mess.
Whatever, I want to contribute to the anecdotes!
My Gran had a bleeding ulcer and was brought to the hospital in haste. When I came out there, the anesthesiologist was waiting for me because of hospital policy: they wanted to discuss with my 90-year old grandmother wether she wanted to be woken up if her heart went out during surgery, and they wanted a next of kin to be there during the discussion. That doctor was the bravest and kindest person I have ever met. He sat down with Gran and held her hand and explained what was going to happen and why he was asking: if her heart let out, the resurrecting procedure might permanently ruin her quality of life, he wanted to know if she wanted to live on as a vegetable. I just cried and cried because their conversation was an amazing example of human dignity.
Days later I met him on the street and thanked him for his humanity and courage.
Gran came out just fine, but had a week or maybe two in the ICU where she hallucinated wildly. All her hallucinations were positive, she imagined all her long dead girlfriends had been to visit her, and generally felt life was good. I credit the amazing anesthesiologist for setting a positive frame for her.
posted by mumimor at 1:56 PM on January 5, 2018 [17 favorites]
Whatever, I want to contribute to the anecdotes!
My Gran had a bleeding ulcer and was brought to the hospital in haste. When I came out there, the anesthesiologist was waiting for me because of hospital policy: they wanted to discuss with my 90-year old grandmother wether she wanted to be woken up if her heart went out during surgery, and they wanted a next of kin to be there during the discussion. That doctor was the bravest and kindest person I have ever met. He sat down with Gran and held her hand and explained what was going to happen and why he was asking: if her heart let out, the resurrecting procedure might permanently ruin her quality of life, he wanted to know if she wanted to live on as a vegetable. I just cried and cried because their conversation was an amazing example of human dignity.
Days later I met him on the street and thanked him for his humanity and courage.
Gran came out just fine, but had a week or maybe two in the ICU where she hallucinated wildly. All her hallucinations were positive, she imagined all her long dead girlfriends had been to visit her, and generally felt life was good. I credit the amazing anesthesiologist for setting a positive frame for her.
posted by mumimor at 1:56 PM on January 5, 2018 [17 favorites]
I don't know what it would take for me to voluntarily accept going fully under like that again.
A modicum of excruciating pain?
posted by notreally at 4:04 PM on January 5, 2018 [1 favorite]
A modicum of excruciating pain?
posted by notreally at 4:04 PM on January 5, 2018 [1 favorite]
Had my first colonoscopy last summer (a relative was diagnosed with colon cancer and so there I was a few years earlier than recommended). At first I scheduled the procedure but didn't say anything about how/if I wanted sedation. I then took a look a few weeks before and it said propofol.
This was going to be the first time in my entire life I was going under and I felt I ought to give myself a shot at seeing how I'd do under light sedation instead of going under with GA (I wondered about no sedation, but realized I really wasn't that masochistic, especially since the procedure was happening early due to circumstances that had already put me in a dark place). So I called and asked for light sedation, and they rescheduled me with a doctor who used light sedation.
On the day of the procedure, I was fine until I was on the gurney and they attached the IV. Right then and there my BP and HR spiked like no tomorrow, close to palpitations. The nurses had to calm me down and I hadn't even gone in "the room". Getting wheeled over while staring at the lights on the ceiling felt surreal and had me thinking, "I feel like I'm watching a medical drama."
The doc was very nice. Non-patronizing, easy to chit chat with, considering what was about to happen (the idea of getting snaked like a toilet is not exactly a pleasant thing to chat about). The nurse told me the drugs were going in and interestingly, I FELT it. THe liquid traveled down the line and once it went under my skin I felt a mild sting where it entered, then running through to my elbow and up my arm.
I said, "Ouch, I felt that."
"Really?!" said the nurse, a little incredulously.
I said, "Yeah. It's going away now. When does it --"
"Oh, hi, you're back," said a totally different nurse.
I think I literally blinked once and the world changed. I knew Versed would inhibit my short-term memory but I didn't think the shift would be so jarring; I thought I'd maybe drift to sleep, have a quick little dream, and wake up. Nope. One blink, and there I was in the outer area.
When I had recovered enough to get up and dressed, they wheeled me over to a small meeting room to speak with the doctor. They found a half millimeter polyp. One. Almost positive nothing to worry about but they were testing it, again because circumstances (results later showed it was nothing). The relief I felt was enough that I didn't have the awareness to ask if I'd been a jackass during the procedure.
And the relative had a successful procedure to remove the mass and is on mild chemo -- everything looks good. Good enough that I get to complain that now I have to get my plumbing snaked every five years instead of ten and the blame is all on them. And that's okay.
posted by linux at 4:38 PM on January 5, 2018 [1 favorite]
This was going to be the first time in my entire life I was going under and I felt I ought to give myself a shot at seeing how I'd do under light sedation instead of going under with GA (I wondered about no sedation, but realized I really wasn't that masochistic, especially since the procedure was happening early due to circumstances that had already put me in a dark place). So I called and asked for light sedation, and they rescheduled me with a doctor who used light sedation.
On the day of the procedure, I was fine until I was on the gurney and they attached the IV. Right then and there my BP and HR spiked like no tomorrow, close to palpitations. The nurses had to calm me down and I hadn't even gone in "the room". Getting wheeled over while staring at the lights on the ceiling felt surreal and had me thinking, "I feel like I'm watching a medical drama."
The doc was very nice. Non-patronizing, easy to chit chat with, considering what was about to happen (the idea of getting snaked like a toilet is not exactly a pleasant thing to chat about). The nurse told me the drugs were going in and interestingly, I FELT it. THe liquid traveled down the line and once it went under my skin I felt a mild sting where it entered, then running through to my elbow and up my arm.
I said, "Ouch, I felt that."
"Really?!" said the nurse, a little incredulously.
I said, "Yeah. It's going away now. When does it --"
"Oh, hi, you're back," said a totally different nurse.
I think I literally blinked once and the world changed. I knew Versed would inhibit my short-term memory but I didn't think the shift would be so jarring; I thought I'd maybe drift to sleep, have a quick little dream, and wake up. Nope. One blink, and there I was in the outer area.
When I had recovered enough to get up and dressed, they wheeled me over to a small meeting room to speak with the doctor. They found a half millimeter polyp. One. Almost positive nothing to worry about but they were testing it, again because circumstances (results later showed it was nothing). The relief I felt was enough that I didn't have the awareness to ask if I'd been a jackass during the procedure.
And the relative had a successful procedure to remove the mass and is on mild chemo -- everything looks good. Good enough that I get to complain that now I have to get my plumbing snaked every five years instead of ten and the blame is all on them. And that's okay.
posted by linux at 4:38 PM on January 5, 2018 [1 favorite]
I routinely wake up under anesthesia. Hurts like the dickens. You can feel the knives cutting and the doctors sawing away like you are a piece of wood.
Normally someone will notice and ask if you are awake. After that, oblivion.
Still, I've never forgotten the white cold spikes of metal as they cut on me.
I still have surgeries of course. Better than dying. I just have talks with the anesthesiologist before hand. And sometimes during.
posted by pdoege at 4:49 PM on January 5, 2018 [2 favorites]
Normally someone will notice and ask if you are awake. After that, oblivion.
Still, I've never forgotten the white cold spikes of metal as they cut on me.
I still have surgeries of course. Better than dying. I just have talks with the anesthesiologist before hand. And sometimes during.
posted by pdoege at 4:49 PM on January 5, 2018 [2 favorites]
I have an 8 hour eating window, then no food for 16 hours.
This subthread is fascinating to me. I eat once a day, a behavior I developed in early adolescence as a way to turn my lunch money into disposable cash. My wife disapproves, but I'm the cook in the house. When she is out of town, I can and do skip meals. I'm not anorexic or underweight or malnourished, but yer damn right I feel like a boss when I tell myself, "self, not today."
(I'm pretty analytic about our meals, we eat well and have a balanced, vegetable-dominant diet. We're fine.)
posted by mwhybark at 5:25 PM on January 5, 2018 [1 favorite]
This subthread is fascinating to me. I eat once a day, a behavior I developed in early adolescence as a way to turn my lunch money into disposable cash. My wife disapproves, but I'm the cook in the house. When she is out of town, I can and do skip meals. I'm not anorexic or underweight or malnourished, but yer damn right I feel like a boss when I tell myself, "self, not today."
(I'm pretty analytic about our meals, we eat well and have a balanced, vegetable-dominant diet. We're fine.)
posted by mwhybark at 5:25 PM on January 5, 2018 [1 favorite]
The last procedure I had was an endoscopy, and boy howdy am I glad I had sedation, because I was fully awake when they put the numbing spray in my throat and the bite block (?) in my mouth. I was overwhelmed with a choking/suffocating sensation for maybe 10 seconds, but then the next thing I knew I was being wheeled out to the recovery bed. It was not general anaesthetic but to me it may as well have been.
A friend of mine had the same procedure done without sedation. His doctor and wife expressed concern but he was determined not to have it, so they just went ahead without it. Afterward he said to his wife, "Gosh, that was much more horrible than I thought it would be!" I just have to wonder, what did not seem horrible beforehand about having a tube stuffed down one's throat?
But I have seen in this thread a few people who have had procedures without sedation, so maybe I'm just an anomaly and overly afraid of pain. It's funny, I have a high pain threshold and can tolerate surprising amounts of it when push comes to shove, but I really stress out when anticipating it. That's probably the biggest blessing of anaesthesia for me. I know I won't feel the pain/remember it.
posted by hurdy gurdy girl at 5:47 PM on January 5, 2018
A friend of mine had the same procedure done without sedation. His doctor and wife expressed concern but he was determined not to have it, so they just went ahead without it. Afterward he said to his wife, "Gosh, that was much more horrible than I thought it would be!" I just have to wonder, what did not seem horrible beforehand about having a tube stuffed down one's throat?
But I have seen in this thread a few people who have had procedures without sedation, so maybe I'm just an anomaly and overly afraid of pain. It's funny, I have a high pain threshold and can tolerate surprising amounts of it when push comes to shove, but I really stress out when anticipating it. That's probably the biggest blessing of anaesthesia for me. I know I won't feel the pain/remember it.
posted by hurdy gurdy girl at 5:47 PM on January 5, 2018
The first and only time I was put under I woke up. It was having all 4 wisdom teeth removed and I woke up while they were doing the stitches. I could feel the thread against the side of my mouth and sense their movement, but I couldn't feel what was happening in my gums, thankfully.
It was TERRIFYING, though, because I was also paralyzed and had a cloth over my eyes so I couldn't alert them that I was aware and I was afraid I would start feeling pain any second. Thankfully, they finished quickly and then realized I was coming out of it and uncovered me and sat me up.
I already have a fear of surgery, but this doesn't help.
The other procedure I had was under "conscious sedation." That was actually fairly awesome, because whatever drugs they gave me were AMAZING and I went from scared and tense to giving NO FUCKS WHATSOEVER. I was vaguely aware of the procedure, and spoke back and forth with the doctor and nurses a few times. I did feel a little pain where they were working and the anesthesia tech was all "huh, guess you have a high tolerance" and then she gave me more happy drugs and I lost track of things for a while. All told a procedure that took about 50 minutes felt like maybe 15 to me, so I think I was in and out or forgot quite a bit.
I will say having experienced how amazing those drugs were, makes me fear sedation a little less. But definitely the next time I have to go under I'm telling the doctor I tend to have high tolerance.
posted by threeturtles at 5:49 PM on January 5, 2018 [1 favorite]
It was TERRIFYING, though, because I was also paralyzed and had a cloth over my eyes so I couldn't alert them that I was aware and I was afraid I would start feeling pain any second. Thankfully, they finished quickly and then realized I was coming out of it and uncovered me and sat me up.
I already have a fear of surgery, but this doesn't help.
The other procedure I had was under "conscious sedation." That was actually fairly awesome, because whatever drugs they gave me were AMAZING and I went from scared and tense to giving NO FUCKS WHATSOEVER. I was vaguely aware of the procedure, and spoke back and forth with the doctor and nurses a few times. I did feel a little pain where they were working and the anesthesia tech was all "huh, guess you have a high tolerance" and then she gave me more happy drugs and I lost track of things for a while. All told a procedure that took about 50 minutes felt like maybe 15 to me, so I think I was in and out or forgot quite a bit.
I will say having experienced how amazing those drugs were, makes me fear sedation a little less. But definitely the next time I have to go under I'm telling the doctor I tend to have high tolerance.
posted by threeturtles at 5:49 PM on January 5, 2018 [1 favorite]
I was referring to the book that's profiled in the article,
Kate Cole-Adams' “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness.”
Sorry - I misunderstood!
posted by thelonius at 1:29 AM on January 6, 2018
Kate Cole-Adams' “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness.”
Sorry - I misunderstood!
posted by thelonius at 1:29 AM on January 6, 2018
"the anesthesiologist is the person who everyone listens to and is the person who you should care about, more than the surgeon, even."
During one of my colonoscopies I emerged from unconsciousness a little, and, on a conveniently positioned monitor, I watched the roto rooter device navigate my bowels. Sort of like a video game, then after a short lapse in time, I heard the doctor say "Hey, look at this." I opened my eyes and looked at the monitor. He'd found a small benign polyp, looked to me a little like a wart. I watched him lasso it with a device that had a wire loop on its end. Then he zapped it with the laser (I guess it was a laser), and the polyp exploded. Kind of like Star Wars meets Aliens. Then it was over and I was awake. During the time I'd risen to the surface I'd felt a slight discomfort in my bowels from the air they'd pumped in to keep things inflated during their journey. I guess I mumbled about because the gas passer did something to my drip, and I forgot all about it. I think I dreamed.
Time goes on. My cardiologist had to remove my old pacemaker and give me a newer model that had more wires. The procedure was delayed because the pro from Dover who specialized in the newer model had to wait for his gas passer to free up his schedule. They gave me a light sedative, then wheeled me into the operating room. After a few moments of friendly chatter the gas passer asked me to count backwards from one-hundred. I got as far as one-hundred, then realized they were wheeling me back to the recovery room. It took a few moments for me to put together that the procedure was over.
When I had my hip replacement, the doc used a local stab in my spine to block the nerve to that leg. "You should feel a slight sting down your right leg," he said, and poked the needle into my spine, just above my hip. I felt a sting down the other leg, and said so. "Oops," he said, and gave me another jab. I had a moment of indecision about the whole procedure. But his gas passer was good. He engaged me in some friendly chatter and asked me to count backwards....I never found out where he wanted me to count from. I woke up in a recovery room, but I seemed to have some notion that time had passed.
All in all I seem to have a good relationship with anesthesia and sedatives. Demerol used to be my favorite. It still hurt, but I didn't care. Something about being on friendly terms with pain appeals to me. As I mover deeper and deeper into geezerhood I believe I don't quite have the physical reserves for this sort of thing, though.
posted by mule98J at 12:22 PM on January 6, 2018 [1 favorite]
During one of my colonoscopies I emerged from unconsciousness a little, and, on a conveniently positioned monitor, I watched the roto rooter device navigate my bowels. Sort of like a video game, then after a short lapse in time, I heard the doctor say "Hey, look at this." I opened my eyes and looked at the monitor. He'd found a small benign polyp, looked to me a little like a wart. I watched him lasso it with a device that had a wire loop on its end. Then he zapped it with the laser (I guess it was a laser), and the polyp exploded. Kind of like Star Wars meets Aliens. Then it was over and I was awake. During the time I'd risen to the surface I'd felt a slight discomfort in my bowels from the air they'd pumped in to keep things inflated during their journey. I guess I mumbled about because the gas passer did something to my drip, and I forgot all about it. I think I dreamed.
Time goes on. My cardiologist had to remove my old pacemaker and give me a newer model that had more wires. The procedure was delayed because the pro from Dover who specialized in the newer model had to wait for his gas passer to free up his schedule. They gave me a light sedative, then wheeled me into the operating room. After a few moments of friendly chatter the gas passer asked me to count backwards from one-hundred. I got as far as one-hundred, then realized they were wheeling me back to the recovery room. It took a few moments for me to put together that the procedure was over.
When I had my hip replacement, the doc used a local stab in my spine to block the nerve to that leg. "You should feel a slight sting down your right leg," he said, and poked the needle into my spine, just above my hip. I felt a sting down the other leg, and said so. "Oops," he said, and gave me another jab. I had a moment of indecision about the whole procedure. But his gas passer was good. He engaged me in some friendly chatter and asked me to count backwards....I never found out where he wanted me to count from. I woke up in a recovery room, but I seemed to have some notion that time had passed.
All in all I seem to have a good relationship with anesthesia and sedatives. Demerol used to be my favorite. It still hurt, but I didn't care. Something about being on friendly terms with pain appeals to me. As I mover deeper and deeper into geezerhood I believe I don't quite have the physical reserves for this sort of thing, though.
posted by mule98J at 12:22 PM on January 6, 2018 [1 favorite]
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This thread has been archived and is closed to new comments
My wife, on the other hand, fears anesthesia like nothing else. For her, it's the loss of control over her life and body and the time drop-out that really rattles her.
Over the years, I've heard various tales of patients being aware during anesthesia, and it sounds like the worst kind of hell I can imagine.
posted by Thorzdad at 4:05 AM on January 5, 2018 [3 favorites]