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MS, surgery and general anaesthetic. ..

Posted: Mon May 26, 2014 6:38 am
by zjac020
Hi all,

I will be shortly scheduling nasal surgery to correct my slightly deviated nasal bridge/septum. It will require general anaesthetic and I understand it is a relatively short operation.

The thing is that just today I came across a comment on a small rather insignificant blog on MS (basically warning MSers to stay away from chocolate as she found that it was a major factor in her ms symptoms and that she thinks MS is.largely due to allergies) someone posted a comment thanking the author about raising awareness of diet in MS, which is fine and I believe in, but added a note saying that he was asymptomatic for over ten years and then was paralysed from waist down following surgery where . general anaesthetic was used. Well you can imagine how I felt!

Question for all the msers here is considering im currently CIS, should I avoid having surgery? has anyother MSer had problems ffollowing the use of general anaesthetic in surgery?

Thanks all.
zjac

Re: MS, surgery and general anaesthetic. ..

Posted: Mon May 26, 2014 7:02 am
by jimmylegs
prior to my surgery i had worked hard on nutrient status, and had relieved previous food sensitivities..

general anaesthetic can deplete serum cobalamin; this used to be a major concern for me since i had a quite serious deficiency early on. over the last few years with dietary modifications my b12 status has been fine. i still would have been quite happy never to test my resistance to general anaesthetic, BUT..

the docs put me under for the first time in my life last september, to rebuild my ACL. no problem whatsoever.

i woke up, waved to the next patient on his way in to the OR as they wheeled me out, and then i worked on a crossword (in a very dozy fashion) while in recovery.

overall no drama whatsoever. and, i was NOT happy about the idea of going under, beforehand. but it was that or have a knee with no ACL.

Re: MS, surgery and general anaesthetic. ..

Posted: Mon May 26, 2014 8:55 am
by zjac020
I understand that not all general anaesthetics are the same and that not all cause b12 depletion. Is that correct?

Re: MS, surgery and general anaesthetic. ..

Posted: Mon May 26, 2014 9:19 am
by jimmylegs
yep i think most of the literature on cobalamin depletion is associated with nitrous. you'd be wise to find out what they plan to use and if there might be any associated nutrient depletion complications.

Re: MS, surgery and general anaesthetic. ..

Posted: Mon May 26, 2014 9:38 am
by zjac020
I believe he did mention that it would be a different one..let me see if i can find out.

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 7:33 am
by zjac020
Any more opinions on this?

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 8:21 am
by HarryZ
zjac020 wrote:Any more opinions on this?
In general, anesthetics can be a problem for people with MS because of the way it can affect the nerves in the body. Your nerve transmission is already compromised by the MS and the anesthetic can aggravate that. Each person will likely react differently depending on the severity of their disease.

I think it is very important for you to talk to the doc who will be administering the anesthetic to ensure that he knows you have MS. I would hope that he would have administered an anesthetic to a MS patient in the past but you really want to be sure he is aware of your situation. If he needs to obtain more info he can contact his department of neurology who can advise him. Good luck and I hope the operation goes without a hitch.

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 8:44 am
by zjac020
I told the anaesthetist that I had MS and he lookes through the long list of things I was taking. He advised to stop all supplements for a few days before the operation but nothing else. This is not a critically urgent operation I just liked the idea of breathing properly again through my right nostril, but im not sure its worth the risk...

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 8:56 am
by HarryZ
zjac020 wrote:I told the anaesthetist that I had MS and he lookes through the long list of things I was taking. He advised to stop all supplements for a few days before the operation but nothing else. This is not a critically urgent operation I just liked the idea of breathing properly again through my right nostril, but im not sure its worth the risk...
That's one of the problems with MS...so many other things in life can effect it.

I believe that he wanted you to stop all the supplements because he was not sure if any of them combined with the others might be detrimental to the anesthetic. Doctors, in general, don't have a lot of knowledge about supplements and they will say to stop everything for a short period of time to be on the safe side.

As for your risk...tough call and only you know if it's worth it or not. Good luck with whichever decision you make.

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 12:33 pm
by NHE
Nitrous oxide, N2O, is often used as a general anesthetic. It inactivates vitamin B12 and if your levels are low to begin with, this can cause neurological problems after the surgery. If nitrous is being used, then it's best to get your B12 levels tested which includes a test for urinary methylmalonic acid (uMMA). A serum B12 test can give misleading results. However, a high MMA result points directly to low B12.

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 1:20 pm
by zjac020
They weren't going to use nitrous oxide...I specfically recall asking. Ita more the effect of general anaesthetic on the nervous system that worries me...

Re: MS, surgery and general anaesthetic. ..

Posted: Wed May 28, 2014 3:06 pm
by jimmylegs
heya :) so were you able to find out what they *are* planning to use yet?

Re: MS, surgery and general anaesthetic. ..

Posted: Thu May 29, 2014 12:21 am
by zjac020
I made a note of it somewhere but cant find it now. But I remember that the anaesthetist confirmed that it was not NO.

Re: MS, surgery and general anaesthetic. ..

Posted: Thu May 29, 2014 2:46 am
by jimmylegs
when you do find it, it'll be easier to figure out whether there are any known effects that might be of greater concern to pwms.

Re: MS, surgery and general anaesthetic. ..

Posted: Thu May 29, 2014 4:48 am
by zjac020
just found it...Fentanyl.