Operation on a patient with MS - Considerations?

[Revenant_Threshold]

This is from The West Wing, so i’ll do a little background for people who might not have seen it.

Basically, one of the plotlines revolves around the President having relapsing-remitting multiple sclerosis, which he’s so far kept hidden from the public. He gets shot in an assassination attempt, but is conscious. He’s asked whether he has any medical conditions, to which (it’s assumed, and later confirmed) he replies in the negative. However, he does make sure his wife (herself a doctor) makes sure that the anesthesiologist knows about his condition.

So why is it that the anesthesiologist alone needs to know about his MS? I would have thought that if there were possible complications, the entire surgical team would need to be told in order to be careful, or whatever it is that’s needed.

[FormerMarineGuy]

The National MS Society says no, unless they have other problems brought on by the MS.

Most people with MS can tolerate standard anesthesia without undue risk. Special consideration may have to be made for the minority of people with MS who are severely disabled or have respiratory problems.

Infection or fever, however, may tend to aggravate symptoms of MS. Additionally, patients who have muscle weakness and who have been confined to bed for more than several days, may find it harder to recover from surgery.

[wolf_meister]

Speaking as someone who does have multiple sclerosis, I have had one surgery (kidney stone) since I was diagnosed. As far as I could tell, no special precautions were taken with me.
I did notice that waking up after surgery was a lot more disorienting than previous surgeries when I was “MS free”.

[anson2995]

@wolf_meister

I did notice that waking up after surgery was a lot more disorienting than previous surgeries when I was “MS free”.

Interesting… My father, who suffers from MS, had a major surgery several years ago. The surgery lasted for approximately 8 hours, and the following day he had a followup surgery because of minor complications (fwiw, the first surgery was the Whipple procedure). He was disoriented and confused for almost a week after the second surgery.

Not sure how much of this was due to the length of time under anesthesia, the back-to-back surgeries, or the MS. Just wanted to toss the observation out there.

[drachillix]

@Revenant Threshold

So why is it that the anesthesiologist alone needs to know about his MS? I would have thought that if there were possible complications, the entire surgical team would need to be told in order to be careful, or whatever it is that’s needed.

No matter what happens its a bad idea to fail to disclose any prexisting problems to the docs who are about to do something major to you. Just because you don’t think it matters or seems unrelated does not mean it cannot impact what they are doing or how they go about it.