Anesthetic Flair up

[dawson63]

Hi,

I was in hospital for what I was told would be 2 - 3 operations to deal with kidney stones. I had informed both the surgeon and both anesthetists (one for operation 1 and a 2nd Anesthetists for 2nd operation) that I had FND. The seem to know what I was talking about. Not so sure that is the case now. I' ve had FND for 44 years. But I was only the FND label about 12 months ago. Over the last 4 years I've had nine trigger finger release operations and two carpel tunnel operation. The last carpal tunnel surgery about 3 months ago. A number of the surgeries were done under general anesthetics a the others were done with a block. None of them I had no ill effects. FND was as normal as it usually gets.

The big difference at the direction of my psychiatrist, general practitioner as well as the surgeon they suggested I take 5 mg of diazapram (Valium) the morning of the surgery to calm me before the surgery. Neither the surgeon or either anesthetists even responded to my written requests. The surgeon said he doesn't like his patients worrying about worrying. SO much for the FND diagnosis. Next time should there be a next time the psychiatrist is going to put the request in writing.

In the end I had to 1 hour FND seizures after each Surgury (neither made it to the Discharge summary and I was sent home as though nothing happened. The surgeon happened to be going on holidays. The surgeries are usually 4 to 5 weeks apart mine were less than two weeks apart (both general anesthetics). The day after the 2nd operation the FND was in full flight. Two 1 hour seizures. Not able to walk unassisted. Congitive issues, slurred speach. Dystonia in arms and hands and tremors in my legs and arms. I was fine in bed with the exception of tremors in my hands. But soon as I put my feet to the floor I knew I was in big trouble.

To cut a long story short I rang my neurologist - He was no available until later in the week. The 2 anesthetist suggested I ring my GP or go Emergency at the hospital I did been in. Why would go back there no one seemed to care the first 2 times and I didn't feel confident they had any expertise in FND anyway. One staff member suggest she'd look look FND up in her lunch hour. Not a lot of time to research a complex condition like FND. I ended up at the GP. I initially suggested we do a telehealth appointment as Ii was having great trouble walking and the increased likelihood of a seizures. He suggested strongly I come in for an appointment to his office. I now understand why he wanted me to come in. He had the discharge summary with no mention of the seizures at the hospital. Yet he was the on e to come up with a plan of action. Thank goodness for GPs. The GPs gave me a script for diazapram with initial 10 mg twice a day then to drop it down to 5mg twice day then down to 2.5 mg PRN.

PS he did apologies for asking me to come in under the circumstances and organised a staFF member and a wheel chair back to the car so my wife could drive me home.

It's time the medical profession grew up and recognised FND for what it is and that its real.

[bookish]

Hi. That is an awful lot of operations over a relatively short time. The stress of those on the body alone would have depleted essential vitamins and nutrients, but your symptoms are screaming vit B12 deficiency to me, and that could be the case particularly if you had a % of nitrous oxide included in the general anaesthesia, as you've had so many. (Having said that, if already depleted in B12, a single operation under nitrous can be enough to trigger significant neurological damage). No doubt you've already had B12 checked (and folate, and B6) but a deficiency can be very hard to spot, there is no definitive test to rule out a deficiency, and some more investigation might be worth your time. An active (holotc) test plus homocysteine and MMA (methylmalonic acid) would be a good place to begin. Seizures can be a first sign of a B12 deficiency, and certainly can be a symptom, as can carpal tunnel and trigger finger (also of B6 deficiency, which is also a standard treatment with B12 and folate of nitrous excess). Your FND may well have other causes, but if these are contributory your symptom load may not need to be quite so heavy, I hope.

You may find this interesting ncbi.nlm.nih.gov/pmc/articl...

Note that a 'normal, in range' serum B12 does not rule out a deficiency, as a functional deficiency can be at any serum level. B12 metabolism is very complex, with many stages any of which can be failing.

Best wishes