Monday, May 31, 2010

Anesthesia

I was cleaning my room/unpacking, and found a journal entry I wrote when I was 15, about what it was like going under anesthesia to get my wisdom teeth (and 5 others) removed. It's SO WEIRD! I thought I would type it up and share. Here's the whole thing, unedited.

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"Okay, Gabrielle. We're going to put this mask over your nose now." She got my name wrong. [Gabrielle is my middle name]. The mask was put over my nose. "Take deep breaths." I did. for a minute, a strawberry-cherry vapor filled my nostrils and throat. I breathed slowly and tryed [sic] to relax like they had told me. Then a new substance filled my lungs. They told me to let them know when I got a buzz on my forehead. After a few seconds, I closed my eyes. It hurt to keep them open. I quickly re-opened them, though, so they wouldn't think I had already gone under. I stared straight up, at the big blue light above me. It seemed to get farther away, and my ears started to ring. It was a scary feeling, and the only way I showed the fear was my eyes. They widened and darted furiously around. I felt trapped. I closed my eyes briefly, blinking longer each time. I pointed to my forehead, indicating the 'buzz.' I closed my eyes, and everything changed. I no longer saw, heard, or was aware of the operating room or doctors. I saw nothing but blue, red, and yellow dots forming triangles so close together that it was just a greyish mass. I could sense a very cold, robot-like voice near me. "Breath. [sic]. Deep. Breathe. Deep." Instead of getting dizzy and spinning in circles [??], there were triangles. Big triangles, made of the colored dots. I watched them as they traced the shape, beeping mechanically, then they shrunk to about one fourth of the size, all smushed into one shape. The beeping became louder, and almost audible [??], but more like sensed, the letters RGM were repeated over and over in the mechanical voice, blaring inside my head. The G espesially [sic] was emphasized, and I tryed [sic] to figure out why. Since I focused on the one letter, one of the 3 points of the triangle, the triangle became one single black dot, throbbing at great speed, beeping louder than ever. The coldness, harshness, of it all was almost unbearible [sic], and I acutely remember thinking: 'I am under anesthesia. I can tell that I am, and I'm not supposed to remember it. I hear nothing, see nothing, feel nothing psyically [sic], yet I am aware that I am unconscious.' It was such a weird feeling, and I hoped desperately the feeling would leave soon.
That is the very last thing I remember before I woke up in the recovery room.

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GEEZ!! That was a scary (and bizarre as hell!) experience that lasted for several minutes. I have NO IDEA what's up with the "RGM" and beeping triangles weirdness...and my writing is rather incoherent at times, making me wonder when, exactly, I wrote this - in the freakin recovery room?? Ha!!

Considering that was my one and only experience with anesthesia, I'm surprised I let myself go through it again this winter for breast surgery! Or rather, I'm surprised I wasn't the least bit scared of it. To the contrary - after my lumpectomy, K told my family I went under "giggling like a little girl." And I don't AT ALL remember the process of losing consciousness. All I remember is: K asked what kind of music I wanted to listen to, I thought that was hilarious and told her, "I'm not going to be awake to hear music!", and my giggling made the anesthesiologist exclaim in surprise, "I haven't even given her anything yet!" I vaguely remember K's smiling eyes, despite her face being cluttered with the necessary protective gear (that ridiculous poofy cap and face shield), and that's IT. Next thing I knew, I was waking up in recovery. I think it really helped to have IV anesthesia instead of that scary mask with the "strawberry-cherry vapor" - ugh!! I think they used that (when I was 15) because I was terrified of needles, but jesus christ, I would have preferred the temporary pain of a needle insertion, if it meant not spending several minutes aware of the process of going unconscious. It was like drowning, or like being blind and deaf and paralyzed all at once. SO SCARY.

It's so strange that surgery to get a few teeth pulled was scarier than surgery to have a cancerous tumor removed from my body. And it's so strange that for a few weeks in December-ish while I was waiting for surgery, my sprained pinky finger was way more painful, bothersome, and life-interrupting than the CANCEROUS TUMOR was. I never had a single symptom of the cancer...no way of knowing it was there, other than doctors telling me so. This is still so weird when I think about it. It's the only time I've had to undergo extensive, intense, uncomfortable medical treatments for a health problem that was simultaneously the worst health problem I've ever had and one I did not feel at all. It's not like having a really painful sore throat, getting dx'd with strep, taking the antibiotics, and then feeling the pain go away and knowing you're better. It's not like having coughing fits that kept me up at night for months, getting dx'd with asthma, treating the asthma with a combination of inhalers and alternative medicine, then stopping coughing and sleeping soundly once more. I didn't know I had cancer, and couldn't feel the cancer, and then spent a month and a half getting irradiated, which I also could not feel, and now I'm cancer-free, but it all feels so unreal, like I either possibly still have cancer or never had it at all, because either way, I CAN'T TELL! Does that make sense?? It sounds awful to say this, but I almost wish the cancer had been accompanied by at least one symptom*, so that the cancer treatments could have eliminated the symptom, and I'd thus have something to hold on to - I could believe both the reality of the cancer in my body and its elimination. Because right now it's feeling like... 'cancer? Really? REALLY?!'

*Edited to add: the lump was a symptom, duh. And I could feel it when I poked at my breast, and yeah, surgery removed it...so THAT was a clear distinction between cancer's presence and absence which I could understand. But the little lump never hurt me/bothered me so it was still hard to understand in that regard, and it was even harder to understand the whole invisible-radiation-killing-invisible-cancer-that-might-not-even-be-there thing.

3 comments:

  1. your dental experience sounds like nitrous (laughing gas.) I tried it once at the dentist (because they offered it and i hate dental work so what the hell?) and it was awful. I didn't even get to the "out" stage, i felt like i was being smothered. I felt like i had no oxygen to breathe, just this awful pungent smelling crap. I felt like i was being suffocated. I barely got a hint of the "forehead buzz" and i tore the mask off and said, "i hate this. forget it." and went ahead with just novocaine...

    Now i just take an extra xanax when i need to get a lot of work done, and bring my ipod and blast something really loud (hot water music) and try not to cry. I've gotten better though, my dentist is awesome. I can honestly say he's never hurt me (except for the damn needle...)

    When they did your surgeries, i am guessing they used a whole assortment of totally different drugs- being as it was 15 years later and newer stuff has come out, plus they were doing something totally different (and probably used drugs that were also muscle relaxants, dissociatives, painkillers, etc.) Honestly- the dentist doesn't have the assortment of drugs that a hospital does- an anesthesiologist can fine tune things so much more!

    (also i am a nerd and tried to figure out what they gave you the whole time. And also i like to know what people get and how it feels so i can tell my human clients what their dog/cat is experiencing... since i've never had anesthesia! *knock on wood*)

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  2. steph, sorry you had such a bad experience with the "laughing" gas, too! :( but this was a procedure that was actually in a hospital, not a dental office, so it was a real anesthesiologist and everything. my bottom wisdom teeth had not yet erupted, so they had to cut into my gums to remove them, and i guess that, along with having 5 other teeth out, was enough to make it a surgical procedure??

    the xanax is a good idea for dental work... i'm glad you have a good dentist now.

    OH, i can tell you exactly what kind of drugs i had for my breast surgeries!! all of that info is in my account on the hospital's website. lemme go look at it again.

    For my conscious sedation at the reexcision surgeries:

    30 ML Bupivacaine .50%
    Fentanyl 250/Midazolam 2 MG, 2 units
    30 ML Lidocaine 1% (i think this was just to numb the site of the IV insertion, which I could have done without)
    Cefazolin 500 MG, 2 units (just the standard prophylactic antibiotic)

    Okay, I'm now looking at my list of drugs from the lumpectomy, when I was totally unconscious, and I can't see any difference in the drugs they gave me! The Isosulfan blue was the dye they injected into my breast so that it would drain to my sentinel lymph nodes, but that's not an anesthesia thing. It still just says Fentanyl, Midazolam, and Bupivacaine, and even the same dosages. How can that be?? How could I have the same doses of the same drugs at 3 surgeries, but be conscious for two and unconscious for the other?? Is the difference not the drugs themselves, but how the drugs are administered?

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  3. ah ha! i had a feeling they gave you Midazolam! you were too damn happy and giggly. (it is in the same family as Valium and Xanax. Total anti-anxiety medication. A sedative, pretty much. Apparently Midazolam gets abused a lot, at least on TV shows it does...)

    Fentanyl is 10x stronger than Morphine, but essentially does the same thing. It's a straight up pain med. It blocks pain receptors. (i can't remember if it actually comes from opium or if it's synthetic. forgive me.) It comes in patch form for chronic pain, or candy form, in addition to the injectable. People abuse the SHIT out of this. It is a popular drug among HS/College kids in Greenwich/Fairfield County (at least the ones i worked with.) We have a hell of a time trying to get it legally at work (tons of forms to fill out. etc.) But- it does a good job when you need it for the right reasons.

    Bupivacaine and Lidocaine are both local numbing things. But Bupivacaine is stronger. I bet they shot up your breast tissue during surgery- sometimes they'll do a local anesthetic in addition to the pain meds, especially for big stuff like orthopedics (i think megan had this on her knee at one point.) It's a whole lot easier to keep pain from starting to begin with than to try and chase it away once it's begun.

    AND WE USE CEFAZOLIN ALL THE TIME! My dad had it too with his back surgery. Whenever something goes on IV antibiotics at work, this is usually the one...

    I dunno. Maybe they gave you gas with the 1st surgery as well. Maybe it's not recorded like the others because it's not controlled or measured out... you just turn on the machine and gas comes out...

    I am surprised you didn't get Propofol (the Michael Jackson drug.) I know a lot of people at work that have gotten it- for things like endoscopy/colonoscopies... etc. It basically knocks you out long enough to put you on gas to keep you out. And apparently, it's a pretty good feeling. Michael Jackson thought so! We use it sometimes because it's a really safe drug for older or sick patients (WHEN YOU USE IT THE WAY YOU'RE SUPPOSED TO!) But your giggly/talkative/excessive writing post surgery sounded like what other people have had with it (apparently my boss rambled on about his grandkids during his colonoscopy!)

    I'm such a nerd. But- it's interesting to know how it feels to have this stuff, since i never have, and i give it to patients that can't tell me about it afterwards...

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