Wednesday, June 25, 2008

Anesthesia must not fail

No one wants to have an actual reason for an operation. Despite the technical and medical advancement, operations are often dreaded since it is the last course to eliminate certain diseases plaguing the human body. Some operations are quick. Some operations are long, but most operations are life threatening to some extent. I never had a major one. If a 5 minute operation, to pop out a planet of a blister, while the doctor laughed and ate an apple can be considered, then put it on the list. But I did it without anesthesia.

I'm not waving the flag of courage here. I can be a pliant patient, but most of the times I'm a demanding one. I wanted to have the best anesthesia there is when I had that puny "operation". God knows how the doctor wanted to plug his ears with cotton while I sit there yacking and enumerating my researched facts from wikipedia. I even tried to tell him that I had a primary complex syndrome when I was a child and any sudden outburst of pain might make my heart seize its operations. Obviously, it was a lame lie, and I knew it was. Primary complex? Come on! But I was that desperate. Give me anesthesia, anything! But as the doctor ate his apple, frowned and prepared his materials (a small blade and a gauze pad), he swiftly explained to me that he cannot inject any type of anesthesia in any part of the blister because it would just mix up with the fluid and make the effort pointless. In short he's telling me that "this is a chicken procedure, and just endure the pain. And no, you don't need any wheelchair."

Anesthesia is probably next to the best things that happened to medicine following medical cures and breakthroughs. Anesthesia is created and developed to spare the patient from torturous pain and trauma. It also helps surgeons to perform the operations efficiently. Same as their knowledge and materials, anesthesia ranks in one of the priorities.

Naturally what we think of anesthesia is that it is applied in various dosages (injected or topically applied), depending on the gravity of the operation. The patient would then feel drugged and oblivious to the pain. The patient ideally sleeps through the operation without the knowledge of anything. That's how an anesthesia should be, but it's more complex than it seems.

According to,
"Anesthesiologists have to find a delicate balance between three types of drugs: paralytics to prevent movement, analgesics to dull pain, and narcotics to induce unconsciousness"
Just like what I remember in one of my favorite episodes in Discovery Health Special, Anesthesia should make you oblivious of the pain, make you in a way "paralyzed" or relaxed and make you unconscious. Certain mixtures of drugs will achieve this, that's why Anesthesiologists are careful in concocting to achieve all the desired effects at the right amount. Too much of any of of anesthesia's components will leave any patient with adverse and life changing effects. However, a study and documentary presented by Discovery Health Special recounted the traumatic stories of unfortunate patients who suffered from an "anesthesia failure"As a viewer, it's worse than any horror stories;l and to the survivors it's a very traumatic and most horrifying experience in their lives.

--->The Apollo Anesthesia Machine

A lady in the documentary, as I can vividly recall, underwent a very critical operation that involved her undergoing General Anesthesia (the major anesthesia). She was medically prepared, injected and slowly welcomed the effect. As the operation started, little by little, she began to step back into reality. She is gaining consciousness. She slowly heard the doctors' voices. She practically knew the details of where she is. She can comprehend her environment. She started to feel uneasy. She knew she shouldn't be in a way, awake.

Next thing that happened, she felt a tingling sensation all over her body. She felt icy cold from the instruments. She smelled everything. Uh-oh, she thought. She shouldn't feel anything at all. She wanted to warn the doctors to check what's wrong. She wanted to break free and move. But apparently she can't. It seemed her Anesthesia lacked in analgesics and narcotics to dull the pain and consciousness respectively, but her paralytic drug seemed to be doing all the work. She couldn't break free to tell the doctors what's happening. She screamed her brains out at every incision in her flesh. She endured the pain, every single sensation of it, fully awake. Doctors, looking at her, saw calmness. But they failed to interpret the monitoring machines and failed to take action. The patient, poor patient, endured the operation awake and fully aware of the pain, and now traumatized to undergo the knife again.

According to reports, she only belongs to the3% statistic of failed anesthesia procedures during operations. But hers is a story that moved hundreds of professionals, doctors and patients. According to the article, half of the importance of what goes in giving anesthesia, is the monitoring part. Anesthesiologists should be able to follow meticulous checklists, perform background medical research of the patient, and should be present in any operations. They are expected to take note of any pertinent signs given away by the patient, not only seen through machines.

A movie I watched this year, starring Jessica Alba (You will hate her here) and Lena Olin entitled Awake, perfectly reenacts the failure of anesthesia. The patient in the movie underwent preparations and even submitted himself from a very invasive heart surgery. He then felt the slow signs of anesthetic failure when he heard doctors talking. He felt the liquid being poured on his chest. He felt and heard the instruments. He was shaken, like any patient would, and wanted to scream and point out the malfunction. But apparently he is paralyzed due to one components done by anesthesia. He endured the unbelievable and inhumane pain of cutting his ribs, ripping flesh and pulling out his heart. He endured the whole heart transplant operation...Awake.

But there's a certain scene in the movie that showed the importance of monitoring the patient's activities aside from monitoring him/her through the machines. The actor who played the unfortunate patient, released a tear from his closed eye. He was conscious of it and he wanted someone to see it, but the anesthesiologist was busy and didn't see the tear that was released. From that moment, the doctor could've made necessary precautions and ensured necessary changes in the dosage.

Things like these unfortunately happen. It doesn't primary seek to frighten us and ride the commercial storytelling. It just makes the doctors aware of the possibility of these errors. It just denotes how patients should be knowledgeable about every aspect that may happen in anything done to their bodies. It aims to educate people that anesthesia is not a simple and faultless drug that we perceive to be. At the end of the day, to err is human ika nga. But if these things ever happened to me, I wouldn't know what I'd do. I wouldn't even know if I'd survive the operation. I got to hand it those who survived this ordeal. The word pain may never be the same for them. And wishing Anesthesia must not fail is truly an understatement.


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