Re: Choosing a GOOD ANESTHESIOLOGIST!!

[Powersurge]

Dear Pat (and anyone else who can help!)
I am a newbie! I really admire your work! Unfortunately, I just had an unfortunate experience. I am a 40 year old with longstanding AS (rheumatoid arthirits mainly of the spine in young males). I was supposed to have a right resurfacing. But, the anesthesiologist could not get an appropriate spinal anesthesia and nor could he get me intubated so I was sent home that same day and told to get an "ENT workup!" I have three anesthesiologists in my family and all of them told me this evening that atleast another anesthesiologist could have been called in and my spinal could have been done with me sitting (he did it with me on my side because he was afraid I was going to have some spasms)

I am not complaining, for the staff and the surgeon were very nice. But, do you have any suggestions, and have you run acoss this with other members? Please help! I do not know how to allign myself with a good anesthesiologist who also works with on of the well known orthopedic surgeons in the US. Thank you very much!

[nysoccermom]

I am sorry to hear about your unfortunate experience. I don't know where you are located, but I was very impressed with the anesthesiologists at the Hospital for Special Surgery in New York. I was very worried going into surgery as I had suffered through several unsuccessful attempts at an epidural during childbirth (and the resulting "spinal headache" with an infant and a toddler). So my main fear was the anesthesia rather than the resurfacing itself. However, when the anesthesiologists came in to answer questions prior to surgery, and I had many, they took the time to answer all of them and put me at ease. I asked them (there were two, one was doing a fellowship or orthopedic rotation I believe? - I asked him how many he had done and he said he had lost count) if they were confident they would be successful in administering the spinal and they took a quick look at my back and said "yes", no hesitation at all. The PA also told me that they were experts and dealt with all kinds of spinal issues including severe scoliosis and were able to administer the spinal anesthesia. They sedated me prior to the spinal so the last thing I remembered was being transferred to the operating table and then I woke up in the recovery room, no problems at all. As far as resurfacing surgeons at HSS, you can't go wrong with Dr. Su of course and I have heard good things about Dr. Boettner as well. Best of luck to you.
Melanie

[Pat Walter]

Hi

I am sorry to hear about your anesthesia problem.  It is not something that I have heard of before.  I am not a doctor, so I don't know as much as an orthopedic surgeon would.  The only thing I can say is to find another doctor.

Many doctors only use a general anesthesia like my Dr. De Smet of Belgium.  He believes a general is the best because it leaves your body most relaxed.  His surgeries take about 45 mintues to complete.  He feels the quicker the surgery, the less problems you have post op.  Seems to work for most De Smet patients because generally we all have fast, easy recoveries.

So my suggestion would be to contact some of the most experineced surgeons on my list and ask waht type of anesthesia they use.  Explain your situation.  Seems to me that your doctors should have just switched to a general for your surgery - but again I am not a doctor and have no idea about how that is all done.

I do hope you can find a surgeon that will get the job done for you without probelms.

Please keep in touch and let us know how you are doing.

[Jim1957]

So when they do a spinal are you awake during this procedure? Holy cow no way.  I was glad I missed the whole thing.  The smells, the buzzing, sawing and hammering, yuck.  Just watch the procedure then decide if you really want to be awake for that.  I took the happy juice Monday afternoon, took the general anesthesia in the OR, then slept through the night Monday, and then was feeling good Tuesday.

[dw]

"So my suggestion would be to contact some of the most experineced surgeons on my list and ask waht type of anesthesia they use.  Explain your situation.  Seems to me that your doctors should have just switched to a general for your surgery - but again I am not a doctor and have no idea about how that is all done."

Except that a) the list isn't complete and b) the sugeon is the bone doc - the anesthesiologist is also a specialist (as you'll see on your bill for surgery) - and part of the operating team, but usually aligned with the operating hospital staff. The bone doc (your primary surgeon) might have some say in it, but more than likely it'll be up to the anesthesiologist - who, hopefully, you will meet at a pre-op meeting - that's the time to ask about the knock-out procedure. At least that's my experience.

[DonC]

Sorry to hear. It must have been an enormous disapointment.

They don't keep you awake when you're given a spinal. As I discussed with the anesthesiologist during my procedure with Dr. Gross, they first give you a spinal that completely numbs the lower body. I sat up on the operating table and tried to bend over as far as possible to spread the vertebra apart to insert the needle. I was so stiff with arthritis that it took two nurses pulling down on my shoulders to achieve the position. Then, they carefully administer just enough anesthesia to keep you asleep and allow you to breath on your own. Had I been given full anesthesia I would have had a breathing tube inserted and recovery time extended. I fell asleep talking to the nurse at approx. 11:30 and woke up around 2:45 feeling quite alert and no pain at all. I ate dinner with my wife at 6:00.  Severe constipation was another problem I had experienced in the past due to heavier anesthesia and had no problem during this procedure.

I experienced no nausea or headache. Dr. Gross administered anti nausea medication prior to surgery. I have had 6 prior orthepedic operations and this was by FAR the easiest and most painless.

Get a second opinion and don't give up.
Best of luck!

DonC

[obxpelican]

That headache is caused by the anesthesiologist inserting the needle into your spinal column and breaking the sac in your spine causing it to leak.

I had that concern before my surgery, Lee, Dr. Gross's assistant explained that it's rare and it happens more often with really obese people because it can be harder to hit the target without busting that sac.

Now being nauseous --- me I was, but it only lasted part of the first day.


Chuck

[Barbara]

I had a spinal with my two surgeries and am having a spinal tomorrow again. I though it was excellent. I had no pain or nausea and didn't even feel the needle going in.
Powersurge, I would think that if you have family members who are anesthesiologists, they would be the best people to find you a good one. I agree that the anesthesiologist should have called for backup if he was having difficulties.
Good luck
Barbara

[tedroberts]

I had a spinal with my bi-lateral resurfacing (4 hour surgery).  I didn't get to pick my anesthesiologists but I met them in the operating room.  I felt right at home, the place looked like a machine shop.

I was put lightly under during the surgery but I know two guys who had total hips and stayed awake!

I was also given what I'll call a spinal narcotic that lasted for two days after my surgery at which time I was switched over to Oxycodone.  If I had it to do over I would skip the spinal narcotic because it cost at least $245.00 net (after insurance deductions) and the Oxycodone worked great for me.  Zero pain except when doing PT or walking, etc.

I had some numbing in my lower right leg and foot that I feel was from the spinal.  I have a customer that had a similar experience after a spinal with her C-Section.  This numbing actually got painful for awhile and I was prescribed a anti-spasm drug of some kind that seemed to help.  I still have only partial feeling in the skin on the outside of my right calf, but no problems with movement or strength.

Ted Roberts, bi-lat BHR, 1-7-09, Dr. Nelson, Edina, MN