I woke up during surgery. I was in terrible pain and I could hear the instruments clinking into the pans so I think they were finishing up. I couldn't move or open my eyes. I kept willing myself to go back to sleep but it wasn't happening. I could hear the nurse reading off my orders and my surgeon shouted, "No, nothing by mouth until 9:30". I was shocked since he is always very soft spoken. I know the anesthesia can make people sound as if they are talking through megaphones but this was more of an angry shout. Anyway, after what seemed like forever, I went back under. I never, never want to do that again. I just don't know why I was awake for what seemed like so long. I haven't told anyone yet because I'm afraid people will think I'm nuts, but it was awful lying there in so much pain and not being able to let anyone know I was awake.

I am a Physician Assistant for more than twenty-five years (yes, old) and I was recently banded.

I picked my surgeon and hospital-based bariatric program following months of extensive research, and I am delighted with my experience as a patient of this surgeon and program. Of interest, in the United States it is fairly typical for neither the surgeon or patient to "select" his or her Anesthesiologist(s) or Anesthesia Team (possibly including a resident in anesthesia and/or a Certified Registered Nurse Anesthestist (CRNA)). I felt more comfortable with my surgeon than I did with the Anesthesia Service going into surgery. I won't go into the details or my source of anxiety, as that would serve no useful purpose.

On the day of my surgery, once settled into the pre-op area, and after being greeted by a Registered Nurse, a CRNA introduced herself to me, and advised me that she and Dr. XXXX would be part of my Anesthesia Team. She had thoroughly reviewed my medical record before seeing me, and verified or sought clarification of several important details when she was at my bedside. We talked about the anesthesia that I'd receive, and her role, and that of the (MD) Anesthesiologist. Having disclosed my training, the CRNA knew that I'd ask the following question, which I had an obligation to ask: "what is the ratio of CRNA's to MD's?" I was told 2:1, which is a very reasonable ratio, and I was told that the Anesthesiologist would be present when I was anesthetized (induction) and when the anesthesia was reversed (emergence). I was comfortable with what I heard. I then met the Anesthesiologist who was part of my Anesthesia Team. He too had reviewed my medical record before seeing me, and asked me a few questions about my medical history that had captured his curiosity. The CRNA placed an IV in my arm, and the Anethesiologist talked with me about the anesthesia that I'd receive. Although I had some reservations about the Anesthesia Service at this hospital, the CRNA and MD were very persuasive and comforting and heightened my confidence in them.

After talking with my surgeon in the pre-op area (and AGAIN asking that HE perform my surgery (not a resident, fellow, or another surgeon who may be being mentored), the Anesthesiologist gave me a sedative intravenously to "take the edge off," and he and an assistant wheeled me into the Operating Room, where I was greeted by the CRNA who I met earlier. She introduced me to the OR team, and had me slide over to the Operating Table (it was quite comfortable and should probably not be called a table). Like musicians in an orchestra led by a Conductor, the MD or CRNA gave me some more sedation IV (I did not see that, but I felt it) and the CRNA who had prepared all of the anesthesia equipment while the MD was talking to me in the pre-op area had me take a breath from a mask, and that was it.......curtains. I did not simply lie on the table w-a-i-t-i-n-g for someone to do something to me - - time to curtains was very quick, and I liked that.

I woke up six hours later in the Recovery Room (Lord knows what and how much they gave me, but six hours of sleep was not a bad thing).

While my story is longwinded, I tell it to demonstrate the skill of my Anesthesia Team. They really were like musicians in an orchestra, following the direction of a Conductor. Anesthesia is not the same in every hospital or surgical center, but I must admit, I arrived as a skeptic and departed as an enthisiastic supporter of the Anesthesia Service at this hospital. I was skillfully and compassionately cared for, and I could not have asked for more.

I went to my pre-op appointment the day before my surgery and asked my nurse if she had ever heard of anyone "waking up" during the procedure. She told me that she had heard of it but never at that hospital. They monitor your brain function during the procedure and can tell when your brain is "asleep" and "awake". I was satisfied with that answer. I did, however, tell my anthestiaoligist ( I know that's not how you spell it ) to make good and sure I was out before they even got me naked.

Maybe I just go out of my way to predict every situation that could go wrong (I guess that's why I'm a lawyer), but I was actually very concerned about anesthesia awareness. I made sure to thoroughly question my anesthesia team about the anesthesia awareness risks. I know it's very very rare, but so is dying in a plane crash-- that's not a reason not to take precautions on the front end. I think they tried to blow me off at first, but it soon became clear that I had done my research on this issue and I expected real answers. In particular, I wanted to make sure that brain monitors were available in the hospital, what the hospital's policy was on using the monitors during all surgeries, and most importantly, WOULD THEY BE USED IN MY SURGERY. I made it very clear that whomever was on call that day, I wanted the monitors used. I actually had them write this in my chart. In the end, I was thoroughly satisfied with the answers I got and that helped me to feel more calm on surgery day.

I just believe in being a good consumer. Hospital visits are very expensive and although we don't pay directly if insurance covers this, we do pay indirectly through premiums and such. Don't let doctors or anyone else bully you into thinking you should not have or raise a concern that you believe is a valid one, no matter how rare or unlikely.