Went for surgery on 6/25

[LAN2k 18]

I am sorry you had this reaction. I had the same and was fine. What makes people react differently to drugs?

Jane x

I had no idea that you had the same reaction Jane! Did you post it at any point? If so can you put up the link! This is no small ordeal. It is something I would not have ever thought would happen. What were the details of your encounter?

[LAN2k 18]

Well here is my story:

I went to TJ for my surgery as planned on 6/25. The hospital was super nice and I met the doctors and the staff who were all extremely well spoken and explained everything for me. I got settled into my room and they started my IV and took my blood samples for my blood tests. The anesthesiologist came in to explain her portion and we went over my medical history and current and past medications from the year. All I had left to do was my EKG. I asked the anesthesiologist if she could give me something for nerves and she said sure she had her bag with her and I clarified that it would not interfere with the EKG I was going to have she assured me it would not.

She shot the medication Midalozam straight into my IV like a gun. My mother who is an RN was right next to me on my right side along with the doctor. It burned a lot I got extremely dizzy and suddenly i felt my chest closing up the last words I squeeked out were I CANT BREATH. My mom caught the words and immediately her hand went to my chest. My body was paralyzed from my head to my toes. I could not make a sound I could not flinch a muscle all I could do was sit there in my own private torment begging for someone to start giving me air but I couldnt move let alone make a sound. I remember the doctor grabbing my chin and pulling my neck up telling me to take a deep breath and believe me I was trying so hard but my chest would not move. My mom is getting louder telling her SHE IS NOT BREATHING, the doctor ran to the other side of the bed and I remember feeling her put the oxygen mask over my face telling me to breath but I could do nothing and finally I passed out from lack of oxygen. I guess the doctor ran from the room and came back with the entire staff and the crash cart. They intubated me and pumped me with oxygen for the next three minutes during which time they threw my mom out of the room. The doctor gave me something to counteract the medication that had been given to me and within another minute I regained consciousness slowly. The first thing I remember is the metal tip of the laryngoscope (thing opening my airway up and protecting me from coming to and biting my tongue off) it was sort of gagging me though the air felt like heaven. They were all saying my name and telling me to breath...the whole room was just trying to coax me. I came too twitching and I remember them pulling the air bag away from my mouth because i was taking tiny breaths but I was thinking oh god put it back I am not getting enough air on my own. I thought crap I come back only to still not be able to breath I would rather be passed back out, but after another thirty seconds I was able to let my head roll to the side and saliva was dripping from my mouth. It felt so damn good to be able to do something that I was meaning to do. After they suctioned my airway and pulled the tube from my throat they threw the regular oxygen mask on me to help me get enough pure air into my lungs and they starting trying to get me to talk...they asked me how I felt and I mumbled out something then I just said MY MOM and they went to go get her. She walked in and then I finally started crying. I continued to be monitored and given oxygen for the next half hour where all my vitals returned to normal but I of course was an emotional wreck.

Now before anyone speculates where I had surgery I will say I am not going to be sharing that info but I assure you it was not Dr. Almanza's clinic. The doctors and the clinic I went to are great but I think two things were a fluke..first off I obviously can't tolerate that medicine and nobody could have predicted that and two the doctor administered it way to fast...those things should be titrated (given slowly) over a period of two minutes. I think the doctor learned a valuable lesson regarding that and had no way to know i personally would respond that way.

I decided to come home without going further I was in no shape mentally to have surgery and quite honestly I was too scared to have another drug pumped into me at that point.

I have been home since late that same day and am dealing with anxiety about it. I wake myself thinking I can't breath and last night it was so bad I had a panic attack that ended me up at my local ER where the doctor assured me that I was not going to suddenly stop breathing again but that the medication has it's own sort of withdrawl symptoms that can cause anxiety on top of the experience I had.

I am bummed because I really wanted the surgery but I am happy to be alive at this point and think I am going to give it a go at doing it on my own. My BMI is not that high and I think it is worth another shot at this point. Who knows down the road if I will do it, but I can't imagine right now I would have any support of my family in choosing to go back. I think if I would not have asked for anything for nerves the surgery would have went off without a hitch but I like to think I can read the signs and deduce that now is not the right time.

I wish everyone luck but I wanted to report back just to share my experience. That complication percentage is small but it sucks to the statistic and it could have cost my life.

I too would not have wanted to go through with the surgery after such a terrifying experience. Thank God your mother was by your side and alert! If at some future date decide to have this surgery and you must have it abroad due to insurance issues, I would highly suggest Dr. Aceves. My insurance covered my sleeve surgery so I had mine done by a surgeon local to me...however if money were not an issue, after reading these boards for nearly a year, I do feel that Aceves has a most reputable track record and the facility where he performs the WL surgeries is state of the art. If you are able to get insurance to pay then you can seek out an experienced bariatric WL surgeon (who has done many sleeves), here in the states. I know you feel you escaped death, and you did...what you went through was a major incident. I will tell you that pre surgery I was on a diet (4 weeks before my procedure), It consisted of 2 whey shakes and one reasonable meal of Protein and vegetables, so I would make a hearty salad or dish of broccoli, green Beans, etc...seasoned to my liking...and eat plenty of shrimp, fish, steak, ground sirloin, chicken, etc. Sometimes I'd have an egg omelette with a salad or veggies...etc. I lost 16 lbs in 4 weeks...it got me thinking that if I could do it PRE surgery than if I kept it up I'd continue to lose the weight! It gave me second thoughts as to if the drastic surgery was really necessary. It's just something to think about. The bad experience you had could be enough incentive for you to make the dietary changes you need to to lose the weight on your own. OA, overeaters anonymous is a very excellent support group and they are all over the globe. What ever you decide I am very relieved that you are alive. If you ever do have the surgery I would advise that you make it clear from the get-go that you do not want any administration whatsoever of a drug called Reglan, commonly used for motility and/or nausea. The side effects of this drug are horrific. My surgeon administered it to me round the clock for the 5 days in hospital and then instructed me continue taking it at home in crushed pill form. I suffered for many weeks with such severe anxiety and then found out through this message board from a very informed professional in the mental health field (who worked closely with medical doctors) of the side effects of this drug, one being extreme nearly unbearable anxiety. I was an still am using 0.5 mgs of Klonopin as needed for anxiety and it is in my opinion the best anti-anxiety drug out there with no addictive, or rebound effects. Best wishes to you in your journey and Godspeed through it all.

Edited June 30, 2010 by LAN2k

[Jane_J 117]

I had no idea that you had the same reaction Jane! Did you post it at any point? If so can you put up the link! This is no small ordeal. It is something I would not have ever thought would happen. What were the details of your encounter?

Sorry Lis, what I meant is I had the same drug but did not have a reaction. If sahe did actually have the drug in the 1st place as I am with the opinion that they cocked up the drugs and were trying to cover it up.

Jane x

[1MP4Life 2]

Wow, that is a scary story, but I am glad to hear you are okay now. I have had no second thoughts or fears about the surgery I am scheduled for on the 3rd of July...until now. I am scheduled with Dr. Aceves and he has a great record, but you just never know. If the doctors are having a bad day, it could have a bad outcome for the patient. Scary. Well good luck with your weightloss on your own, this might be the incentive you need to stick with a diet.

[missnyki79 1]

I am soo sorry to hear about what happened to you down there. I probably would have done the same thing and not went through with it after that experience. You are in my prayers...

[cajun 46]

How scary...I just can't imagine what that must have been like. I hope you are able to find some help to deal with the aftermath of terror that you experience, so you can move forward.

It's too bad there is no legal recourse for such problems in Mexico.

Thank you for sharing your story with us.

[mp8btpc 32]

Thank you all for your support. I know i was being an emotional baby on my other post lol. I was pretty traumatized by the whole incident. It has been about 11 days since my attempt at surgery. I started feeling quite a bit better around the 8 day marker. For some reason the week anniversary of it was a really bad day emotionally for me.

I am still trying to decide if I am going to procede and have the surgery, I am taking my time right now trying to decide.

My emotions have been so mixed, I feel like I was given a great gift by not dying and I thank god daily, yet at the same time my human nature feels strongly dissapointed. I feel robbed I feel like I was robbed of the surgery which is something I really wanted, I feel robbed that now I am scared of all surgery (I didnt take it lightly before but now I don't know how I will feel the next time they try to lay me down to put me under), I feel robbed that I was never afraid of dying (still not afraid of the after life part) but I am now afraid of dying in distress. I also get a little jealous though I am happy for everyone that comes through successful, believe me that makes me so relieved, but jealous that why did I have to be a statistic..but feel like an ass because I could have been a mortality statistic instead.

I haven't been coming to the site because I have been trying to move on and I can say I am feeling much better mentally and physically but I am emotionally confused and sometimes p*ssed off about it. I think time and counseling will help. It also helps that my mom was there and she and I talk about it and she shared it with me so I didn't go through it alone.

I am requesting a copy of my anesthesia report from a surgery I had 3 years ago to see what sort of anesthesia was used and if it was different, then maybe I can pass that along to the next anesthesiologist as a template for future surgeries. I will also be buying a medical Bracelet that identifies the medication as a no-no for me in case of emergency.

I probably will never know if the medication they gave me was the incorrect one, heck I would feel so much better if they were to say "hey you had the correct reaction to the medication that was given at the wrong time", that would make me feel better then to think I had some horrible reaction to a widely used (but known to be risky) drug. Does that make sense?

On a lighter note though one other good thing is that my hubby is now agreeing to have a vasectomy instead of me having to go in for my tubes tied and having to have anesthesia lol. Small but wonderful victory.

Thanks again everyone.

[cajun 46]

Well, at least one good thing came out of this horrific experience...the vas.

Take your time deciding on this...and if you ever decide to go ahead with the surgery, there are ways to prepare so you have the least possible anxiety. Your counsellor and surgeon can help with those things. If you decide to not have the surgery, no one could blame you after what you went through.

We are here for you....thanks for trusting us with your story.

[emilygrace 5]

Sounds terrifying, sorry you had to go through that.

A few things:

- midazolam does not have to be given slowly, it can and often is given as IV push

- midazolam cannot make you paralyzed, as an adverse effect or any other way. The drug simply does not have that ability and doesn't work that way. I absolutely agree with Cindy that you were almost certainly given a NMBA like suxamethonium, vecuronium, rocuronium. These are meant to be given so you cannot move in surgery and to allow anesthesia to take over your breathing. They are meant to be given WITH a sedative like midazolam so that you do not have the "awake and paralyzed" experience like you did.

The anesthesia staff screwed up and gave you the wrong drug. They probably already had their meds drawn up into syringes for the op and had mislabelled or just grabbed the wrong syringe.

[mp8btpc 32]

Sounds terrifying, sorry you had to go through that.

A few things:

- midazolam does not have to be given slowly, it can and often is given as IV push

- midazolam cannot make you paralyzed, as an adverse effect or any other way. The drug simply does not have that ability and doesn't work that way. I absolutely agree with Cindy that you were almost certainly given a NMBA like suxamethonium, vecuronium, rocuronium. These are meant to be given so you cannot move in surgery and to allow anesthesia to take over your breathing. They are meant to be given WITH a sedative like midazolam so that you do not have the "awake and paralyzed" experience like you did.

The anesthesia staff screwed up and gave you the wrong drug. They probably already had their meds drawn up into syringes for the op and had mislabelled or just grabbed the wrong syringe.

While I agree that the symptoms dont add up with the explanation I have of course done follow up research on the administration of Midazolam believe me ...many hours now plus I spoke with the ER doctor on my lovely midnight jaunt to the hospital. Here are a few links that support that Midazolam should be titrated due to the respiratory issues it can cause....

DOSAGE AND ADMINISTRATION

Midazolam hydrochloride injection is a potent sedative agent that requires slow administration and individualization of dosage. Clinical experience has shown midazolam hydrochloride to be 3 to 4 times as potent per mg as diazepam. BECAUSE SERIOUS AND LIFE-THREATENING CARDIORESPIRATORY ADVERSE EVENTS HAVE BEEN REPORTED, PROVISION FOR MONITORING, DETECTION AND CORRECTION OF THESE REACTIONS MUST BE MADE FOR EVERY PATIENT T0 WHOM MIDAZOLAM HYDROCHLORIDE INJECTION IS ADMINISTERED, REGARDLESS OF AGE OR HEALTH STATUS. Excessive single doses or rapid intravenous administration may result in respiratory depression, airway obstruction and/or arrest. Midazolam (Versed ?) - Intravenous (IV) Dilution

The initial intravenous dose for sedation in adult patients may be as little as 1 mg, but should not exceed 2.5 mg in a normal healthy adult. Lower doses are necessary for older (over 60 years) or debilitated patients and in patients receiving concomitant narcotics or other central nervous system (CNS) depressants. The initial dose and all subsequent doses should always be titrated slowly; administer over at least 2 minutes and allow an additional 2 or more minutes to fully evaluate the sedative effect. The use of the 1 mg/mL formulation or dilution of the 1 mg/mL or 5 mg/mL formulation is recommended to facilitate slower injection. Doses of sedative medications in pediatric patients must be calculated on a mg/kg basis, and initial doses and all subsequent doses should always be titrated slowly. The initial pediatric dose of midazolam for sedation/anxiolysis/amnesia is age, procedure, and route dependent Midazolam Injection (Midazolam) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList

BOXED WARNING

Adult and Pediatrics

• Intravenous midazolam has been associated with respiratory depression and respiratory arrest, especially when used for sedation in noncritical care settings. In some cases, where this was not recognized promptly and treated effectively, death or hypoxic encephalopathy has resulted.
  
• Intravenous midazolam should be used only in hospital or ambulatory care settings, including physicians? and dental offices, that provide for continuous monitoring of respiratory and cardiac function, ie, pulse oximetry. Immediate availability of resuscitative drugs and age- and size-appropriate equipment for bag/valve/mask ventilation and intubation, and personnel trained in their use and skilled in airway management should be assured.
  
• Midazolam Endoscopy Sedation (Versed?) | SedationFacts.org
  

All that said...it doesnt explain the paralytic state and my aware state ....I am guessing it was the Succinylcholine or those types also...given to me in error. I would think if it was the midazolam it would have induced the crazy amnesia it was meant to induce. I would rather know it was the succ given at wrong time and that the medicine did what it was intended to do, not sit here and ponder if I am to fear going under for the rest of my life.

[emilygrace 5]

My understanding from your post was that you were requesting a small dose of a sedative to relieve your anxiety, not a big dose to take you out for surgery. In that situation, it's very difficult to give a small dose like 1mg over several minutes. Nice idea, but difficult in practice due to the small volume to be injected. I work in ICU and OR and use this drug very, very, often.

Can you ask for your records? Talk to the head of the anesthesia dept about your suspicion that you were administered a paralytic rather than sedative? It is very important to know - you don't want to never be able to have midazolam again (and alert Bracelet etc) if it wasn't even that drug.

[educationrulz 18]

We all know that you may never get at the truth of what happened. So if you work under the assumption that midazolam actually caused your reaction and you choose to go foward with any surgery in the future, could you request an alternative drug at that point in the surgical process so that you don't have to worry about the possibility of having this reaction again?

[theresa 0]

i am so deeply sorry that you ever experienced this horrific situation! I'm so sorry

[Tina 0]

Glad to hear you're ok...that would have been horrifying. Good luck with whatever you decide....sometimes "the universe unfolds as it should"...

[mp8btpc 32]

I went to my doctor today who immediately rejected the theory that my reaction was from the drug midazolam, he like you very astute medical personnel, feel fairly certain it was a paralytic. So what do I do now? Calling counselor monday for sure and trying to decide if I'm ready to try surgery again.