Sunday's article provided the background on why you should have a plan for discussing with your doctors potential complications from certain types of anesthesia. In today's article, I will provide some actual steps you can take to minimize complications and delays for needed surgeries.
1. Emergency Medical Card – This card or something similar needs to be carried in your wallet. It will forewarn emergency response personnel and hospital staff that you have a health issue that needs to be considered when treating the patient.
2. Medical Information Form - This form, when filled out, provides detailed information about your health condition, medications, doctors, health insurance, emergency contacts, etc. I recommend carrying a copy in your car, giving a copy to your doctor, and having a copy at home. Because I traveled quite a bit in my earlier life, I also carried a copy in my carry-on bag. In the “Medical Concerns” section, add specific wording that you feel is appropriate. A discussion with your doctor on what he would add to this section is most helpful. Included in my form are the following:
· Certain anesthetics could be hazardous to the patient’s health. Of primary concern is how the anesthetic agents will affect the patient’s muscles (including the heart and lungs) during surgery and recovery. Certain neuromuscular blocking agents are a major concern. The use of syccinycholine should be avoided because of possible unpredictable side effects. Reactions could include malignant hyperthermia (MH). The best treatment is not to give this patient any MH triggering agents.
· Patient needs to be kept well hydrated before during and after surgery.
· Patient does not tolerate changes in body temperature (especially cold). Try to keep him warm.
· Caution should be used since the patient chokes easily and could experience difficulty swallowing.
· Patient may be predisposed to regurgitation and pulmonary aspiration.
· Post-surgery pneumonia is a potential complication because the patient cannot easily clear his lungs.
3. Communicate your Condition – During your next doctor’s visit, discuss your medical condition and any potential issues that need to be considered by an anesthetist prior to any surgery as well as the hospital staff pre-during-and post operation. Ask your doctor to document these concerns in your medical record should emergency surgery ever be needed.
4. Planning for Surgery – If there is time (elective or an upcoming planned surgery); discuss potential issues with your surgeon and surgical team. Make certain they are well versed in Spinal-Bulbar Muscular Atrophy and the potential side effects including those from certain anesthetics. Ask if they have performed surgeries before on patients with similar conditions. If you have concerns, discuss these with your regular doctor and neurologist.
A key resource in getting your message out is your family doctor and you/your spouse. Do not be shy and always error on the side of caution. If you do not feel you are being listened to, call a “time out.” Yes, you are dealing with professionals, but that does not mean they have experience with neuromuscular disorders (NMD) and in particular your, or similar, disorders.
Be prepared ... it might save your life.
Readers, if you have some particular recent experiences with surgery, please share them.
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