Anaesthetic problems for Hypothyroidism?

[sueE17]

I think there was a similar question but cannot find the link. So apologies if I am repeating.....-:

I am having an operation later this week under a full anaesthetic. Have Hypothyroidism and on 125mcg per day. The hospital is aware and requested a blood test and full check up from my Doctor. Had to wait 3 weeks for an appointment, so asked receptionist for the blood test form immediately so I could discuss results with my Doctor. Just seen her and asked for the print out to hand to the hospital. Now there are exclamation marks next to my Serum TSH level. But on requesting an explanation was told yes will need another test in 6 months....but what about now? Hhm is ok for my operation. Ok not good enough, yes or no? Well we will look at it again in 6 months. Time up. End of conversation. Here are my results:-

Serum TSH 0.2 mU/L

Serum free T4 level 16.2 pmol/L

Serum creatinine 61 umol/L

Serum urea 4.1 mmol/L

Platelet count 278 10*9/L

Haemomglobin 131 g/l

Total white cell count 5.1 10*9/L

Now I remember reading on here that people with Hypothyroidism could have problems with anaesthetics. Could anyone advise me on this and are my blood results worrying? Thank you. Sue

[tegz]

I had a recent op whilst on T3 and a TSH as yours & had no problem with a light GA - but I did have a local in spine, due to awareness in last op and also COPD/Vagus sensitivity issues.

[humanbean]

Be wary about anaesthetics which include adrenaline, because people with thyroid issues often have poor adrenal function and can't cope with excess adrenaline.

And also be wary about anaesthetics which include nitrous oxide because it damages? oxidises? the B12 you have in your body and makes it permanently unusable. You could end up with an instant deficiency which doesn't show up on blood tests. Do a Google search for "nitrous oxide B12 anesthesia" for articles and papers on the subject.

[shaws Administrator]

Was the exclamation mark at the TSH? If so I think it's fine.

I should think the anaesthetist is well aware of potential problems if hypo/hyper patient and will take the appropriate steps to ensure you are cared for properly.

[Hidden in reply to shaws]

I beg to differ; they were useless in my case. Beyond useless. And afterwards they refused to be accountable. In fact, at my pre op assessment I had to explain what pernicious anaemia was and I had to spell "Hashimoto's"

[sueE17 in reply to Hidden]

What a terrible experience. So sorry you had to go through this before your Op. I am hoping that as the Hospital asked me to do a recent blood test to see my thyroid levels, they are well aware of what to give me! Will keep you posted... Sue

[shaws Administrator in reply to Hidden]

That's really awful. Was it the anaesthetist who asked the questions or a non-medical person.

I've found that many people, nowadays, have difficulty in spelling.

[Hidden in reply to shaws]

I was first seen by a nurse who admitted she was out of her depth. So I had to go back to see an anaesthetist and still the screwed up. I

[Hidden]

Yes, MAJOR problems.

I only found out after an op under GA that several of the drugs they gave me are contraindicated with Hashimoto;s and/or adrenal fatigue (which the nhs does not recognise as a medical condition)

I was ill for about 4 months after the op. I had the worst brain fog ever and was unable to function or work. It was totally debilitating. I felt i would never be normal again. NHS denied wrongdoing (of course) but i did my own research and found out the drugs were contraindicated.

It was on 2013 so i'm afraid i cannot remember the details - don't quote me on this but i think the drugs were: fentanyl, midazolam and propophyl (or something that sounds similar)>

Your results _ the nhs gets hysterical if your tsh is not well high; their speciality is keeping us undermedicated. So they will probably want to reduce your dose.

In any case, t3 - the one they refuse to test, is the one you really need to know

[sueE17 in reply to Hidden]

Never had a T3 test.... We have 10 mins with the Doctor and only allowed to talk about ONE problem. I was talking about my Op and Thyroid blood results then needed a prescription update, only to be told to make another appointment - with 3 weeks delay. Then I mentioned that the surgeon needed it .... did the printer roll ... Yes ...!! Sue

[Hidden in reply to sueE17]

That's why i now self medicate with ndt. Only wish i could get back the years i lost thanks to NHS negligence

[tegz in reply to Hidden]

..& I think a lot of us know well why, BlueD!

[sueE17]

Thank you so much everyone. I will definately bring up my worries and the pointers that you have kindly given me, with the anaethetist. My Doctor was so disinterested, it was appalling. And quite frightening too. Sue

[tegz in reply to sueE17]

Different parts of ship , as they say Sue! I found the NHS hospital clinical care to be good recently- but the human care a bit hit and miss. A long time since I've been under and it seemed 'the system' is tighter nowadays, but staff are tired and understaffed at the sharp end. You're right to stay on your case and get help from others and put queries straight back to the Pros, of course! They do get paid and are obliged to listen , whatever they may indicate to the contrary -so long as you stay polite and of steady demeanor

[shaws Administrator in reply to sueE17]

That's why we have to self-educate. Many doctors do not like it when we go into the consulting room with print-offs from the internet.

They will stick to the guidelines: i.e. TSH only and don't know and ignore clinical symptoms.

[silverfox7]

Just recovering from a total hip replacement and had a spinal block and minimal sedation as I wanted to remain awake. Op went well but aftercare didn't! Was sick after every meal and I expect I did t manage to ingest all my thyroid meds. It was suggested I took a PPI I said I shouldn't as not recommended as hypothyroid but as I had t had my expectedly low stomach acid tested I felt pished into agreeing but had to have it there and then so not the 4 hours after my NDT. Turns out the pain killers, Nefopam were causing the sickness, I suggested I moved to the one I'd had following my previous hip op but was ignore but the anti sickness meds did nothing. I stopped them at home but took one a week later and I wretched for 5 hours so was them. I then googled them to find I could only have a very low dose as I hypo! I'd had a week on the maximum! So check what you are given post op as well. I'm still trying to get on top of what the after care did to me!

[sueE17 in reply to silverfox7]

Sorry to hear that you were so sick after the Op. Do hope you feel better now. I will discuss this with the Anaethetist and nurses. Calm and politely as tgez advised above. It is worrying that we as patients have to investigate all this ourselves. I was horrified to learn that no aftercare was arranged automatically after my Op.... naively... but that hospitals do not talk to surgeries to arrange it. I myself have had to arrange for dressings to be changed at home, then stitches taken out by a nurse at the surgery, not at home. When I asked about convalescence homes I was laughed at.... Sue

[silverfox7 in reply to sueE17]

Well go the district nurse calling to change the dressing and take out the stitches but u appear to have a problem with the more modern dressings as well! The suture line apparently is wonderful-I can't see much of it but the change of dressing meant a reaction at each end so nurse put a different type of dressing on and the dressing was clean but the adhesive covered in blood so we decided to leave the dressings off. The lower end fine but the top end was quite deep but the scab is slowly shrinking now. I sometimes wonder why you fill forms out in your pre med assessment!