Parkinson's Movement
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General Anaesthetic

General Anaesthetic and repercussions. Was doing ok until 3 weeks ago when I had to have minor operation involving anaesthetic. Have been on Byetta for 6 months giving me some brilliant days... that is/was ....now I’m back to maximum dosegases of Madopar. I’m praying it’s a set back only and once the Anaesthetic has dissipated I’ll be on track again.

Does ANAESTHETIC have an adverse roll in general ?

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Yes, I’m wondering about this myself. Have a 6-7 hr operation coming up in April that I must have. Dx 15 mths ago. Not on meds. Will all that toxic anaesthetic gases hasten my progression? It’s frightening. Will look into detoxes that i can do afterwards.

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In response to your question as to whether the use of general anesthesia can have adverse affects on PWP, put me down as a definite "YES!!!!!!" In early 2016 I submitted to surgery to repair 2 lumbar discs. I was assured that it was a simple surgery, would be done under general anesthesia in the afternoon and I would probably be released the next morning.. Several months later I learned from my family that I had been held in the hospital for six days, had been incoherent much of the time since. It has been over a year now and I still experience confusion, memory loss and many symptoms of cognitive decline.

Since the late 1900s, the medical profession has been aware of a problem with post-operative patients who are recovering from the effects of surgery and sedation. The anesthesia used to eliminate pain during surgery had many side effects, including postoperative delirium and many of the characteristics which appear in dementia. Studies done at the time were quite productive but doctors seem to have turned away from the information gained and blame the condition on the stress of surgery having activated an underlying brain defect or roused dormant dementia. The medical profession seems unwilling to recognize, or act upon, the numerous studies that have shown a definite risk associated with the use of anesthesia. This is understandable since there is not at this time any substance proven to present less risk. One of the best articles on this is "The Hidden Dangers of Going Under" by Carina Storrs on April 1, 2014. I hope you find this information helpful. My apologies for any lack of sentence structure or coherent thought in this message. Repair of cognitive "potholes" is still a work in progress.

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I hope you find your cognition improves with time. It appears you have regained much of it. Good info to have. Thanks.

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What type of anesthetic did they give you?

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I don't know what type and, at this point, it would serve little purpose to inquire. There is considerable information on line about anesthesia and amnesia producing "Forget" drugs.

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All anaesthesia carries an element of risk whether you have pd or not. The adverse effects and recovery time increase with age.

Anaesthetics are even more of a potential problem with pd, they can trigger a psycotic episode and we seem to take longer recovering from the anae#thetic too.

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Anesthesia is particularly damaging in certain mitochondrial diseases. It might be good to find out what was used, so that you could avoid it in the future.

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My response, based on personal experience, is that if General Anaesthetic is responsible for causing Pd then having had 23 visits in the past to the operating theatre, I think my Pd would be far worse than it is. My first operation was at the age of 21 but the second one was only 2 years before my Pd symptoms started to appear. That might make you think that this proves your point but the other 21 visits should have had a major impact on my Pd but they haven't.

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Actually, I believe it's not the anaesthetic itself (although that can slow things down and cause issues) but the antinausea drugs. These meds, called antiemetics, are dopamine blocking by nature and are the root cause of the issue. There are antiemetics that have a different method of action and should be the preferred choice if you have Parkinson's. Tigan (trimethobenzamide) is one such drug here i the states. In general, the surgeon should be made aware that you have PD well before scheduling surgery and can direct the anaesthesiologist to choose alternate drugs.

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That's interesting, so what about the domperidone (antiemetic) that I've been prescribed to have with my sinemet to help with the nausea (I only take it with my first thing in the morning dose btw)

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Domperidone is one of the more affective formulations of an antiemetic that doesn't block dopamine . Unfortunately, it's not available in the states although it is possible (with some effort) to import it from Canada. Trimethobenzamide is probably the more common one in the US... there are actually a very large number of drugs that use the blocking of dopamine is there a method of action from antipsychotics, drugs got stomach motility and many more. Drug-induced Parkinsonism is actually the second most common causes of Parkinsonism. In the states, awareincare.org provides a free kit with materials you can share with health care providers during hospital visits. That may be a resource worth checking out for more info.

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My mother didn't have PD, but she did develop dementia after hip surgery and a general anesthetic.

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Did her symptoms appear right after the anesthesia and operation? Or gradually afterward?

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I'd say they were gradual. I am an RN, and I have read that older people can suffer for a year or more with a sort of brain fog after general anesthesia. I talked to a pharmacist who felt my mother's dementia was probably caused by her general anesthesia. I had 7 teeth pulled recently in preparation for implants, as well as the implanting of the posts, and i had Novocaine rather than being knocked out.

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When I had my new hip replacement four years ago I I was offered and took a nerve block as opposed to anaesthetic, I was fully concieous at all time, but would highly recommend it, especially for us older people.

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After having approx. 1 year and 5 DBS related surgeries mostly awake, I feel as though I would take almost any surgery awake. Just as long as no one say oops while i'm coherent!

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I am thinking about DBS so I am curious as to why you had five surgeries. I thought only two were necessary.

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actually only one long surgery was needed from my Neuro. But strange things can happen even at the best places. Starting two weeks post surgery, I barely had the 2nd programming round done when i noticed a little redness and puffiness around the battery incision in my chest and a streak up my side of my neck.... That resulted in a surgery to remove just the battery pack and a four day stay to make sure the antibiotics worked.

Sent home to wait until they felt all was calm enough to "re-wire" my DBS unit. This will be #3 surgery if you've been keeping score. Being skeptical or superstitious maybe about putting battery back in the same spot, the same Neuro team (by on a first name basis) moved all the wiring and picked the battery on the other side. Complete shaved head. (my Rawlings baseball look). Ive got some great pics but not for the faint of heart.

I was programmed and running for the next 3 months when I called my Neuro ("Hey Mark.!" "What's the prob?"). Thinking its was a dermatology problem healing up from the 80 staples on multiples stitches in my scalp, I drove the 100 mile trek and parked in 10 minute visitor parking.

10 minutes later I moved my car to the ramp where it stayed for a week! I went into an emergency surgery with in-two hours (same team), sort of felt I was ready frequent flier miles or......? Surgery #4 removed everything. Evaluated over the following week and sent home with a pic line and two months of follow up with visiting nurses and IV antibiotics.

Made it thru all of that and one year (almost to the date) after the same team installed another medtronics DBS in my brain and wired me up (surgery #5). 5 years and a battery replacement later, I can't tell you how I got through it all. ....but I can tell you I'd do it all again. Even with programming quirks, and progressions it has increased my usefulness and quality of life 100%!

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Thank you. It s useful to hear that despite the complications, you are glad you did it.

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absolutely !

The secret isn't the surgery.....It's a good consistent programmer!

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Very good news and I'm glad as well that you feel so much better. Continued good health!

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Pelley I’m almost on the Gurney waiting my turn but I think I’ll jump ship. I’m hedging my bets and hope Byetta will like me enough to want to stay and pick up pace.

With your sense of humour I think you’d get through anything, I’m so glad for you and for me posting the original query, to which there have been so many reply’s.

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I had my first clear PD tremor the day after my surgery which involved general anesthesia My movement specialist agreed about the dangers.

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Hi. You mentioned taking Byetta. Can you tell us more about your experience with it? Thanks!

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I heard about Byetta several years ago and have had it written on a kitchen blackboard. ‘GO BYETTA’. However nothing eventuated until 6 months ago when purely by accident a friend mentiioned (she has PD), her Obesity (yes Obesity Specialist) put her onto a similar drug involving injections . The one she uses very successfully I cannot spell but goes simething like this .....Liraglide......daily . He had mentioned Byetta but why he chose the one over the other , I can’t tell you. As we use the same Neurologist ......Mike...we are on first name terms which is so nice as it gives me so much confidence

I asked him about it....Byetta....and he was prepared to write the prescription as there was an article in a recent LANCET publication giving positive results. It is a Diabetes injection readily avalable here in Australia. I have to buy it though because I don’t have Diabetes. If I had Diabetes it would be Government subsidised. I have a nurse come to my home every Friday who administers it. Kept in my refrigerator. My husband was doing it however when I could get a nurse changed to relieve him of the pressure on his nerves plus it is now recorded properly.

Results were slow but I had had some brilliant days where I cut my Meds from 8 daily to 3. Longer, stronger ‘on’ times. Almost no Dystonia . No dizziness. Enthusiastic to want to cook again.....I hate cooking but to feel so alive again I even made a Chocolate Cake......not important in the scope of things but it was a positive step.

Then pain in my teeth initiated a quick appointment with my Dentist who did X-rays and found a tooth had embedded itself into my jaw bone. Had to come out necessitating hospital and anaesthesia.

Since then I have had to have more meds etc , low blood pressure, very dizzy and shaky, can’t drive, teary, some Dystonia again.....back to pre Byetta days.

No one had mentioned that the Anaesthetic could be problematic. It just occurred to me that it could be, hence my POST.

Only yesterday did I feel positive again about my future. Not as many pills and little dizziness. Dyskenesia however still lurks. The nights were awful but I’m now on a slow release only taken on retiring. Certainly improved my rest. I can get to the bathroom on my own. Yes still on Madopar but I say Thank God. It prevented me from going into a wheelchair or even a nursing home.

Not all Neurologists here in Australia are as ameniable to writing a prescription as I know of 2 who refused my friends. I am on it for 2 more months then Mike wants me off for 2 months and then re avaluate my symptoms. One drawback is I have lost a lot of weight. Byetta suppresses the appetite.

I now address that issue sensibly and endeavour to eat regularly. Small meals adhering to the time around taking Madopar.

Sorry about this ‘epic’....hope it makes some sense .

The day is just beginning here so I hope for more improvement as the hours go by.

Thanks for listening.

Bridielena

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Thanks for explaining.

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If you have PD, I would suggest avoiding general anesthesia if at all possible. There are many instances of it making symptoms worse for an undetermined period of time. It is good to know about the anti-nausea medication....I wasn't aware of that.

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Don't forget antibiotics and their effect on your gut flora. I refused a general but was given three antibiotics.

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Just don’t have morphine (which they always seem to give) and then you probably won’t need anti nausea drugs!

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I became very ill after my first knee replacement at 55. I had previous issues (excessive nausea, dizziness)with twilight anesthesia for 2 minor procedures but didn’t connect the dots until after the knee replacement. After the knee surgery, I was vomiting, dizzy, couldn’t stop crying,weak, etc. My right arm went up, I had tremors and I hunched over when I walked.And yes, they did give me tons of anti nausea meds. I felt like I had been poisoned and had brain damage.I stopped all meds within the first 3 weeks but remained weak and had problems with my right arm. The tremors stopped after about a month and I haven’t had any since(That was 3 years ago). I have not had a day in which I have felt normal or completely well since. Six months later I went to my doctor for a sinus infection and she noticed I was moving slowly and referred me to a neurologist who confirmed my membership in the Parkinson’s Club. I had a spinal for the second knee and did much better. However, I will most likely need some type of back surgery soon and am terrified of the anesthesia. I have had three nerve ablations without the usual anesthesia and found the pain to be less than the side effects of anesthesia. My theory is that the combination of the anesthesia and anti nausea meds exacerbated underlying Parkinson’s which may not have surfaced for another 20 years. And my biggest concern is that I have yet to find a surgeon who acknowledges the problems with anesthesia for me.

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Diane, To my limited knowledge the general anesthesia program usually consists of the anesthesia and an amnesia producing drug such as Versed which is used to eliminate any pain that gets through. I believe that, in my case, it was the amnesia drug that caused the problems. Wishing you a favorable outcome.......

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