Paging Dr. De Sade...

Miscellaneous and Personal Stuff I Must Share
1

I participated in drug-study some time back. I had done it a couple of times to pick up a little extra cash for something, and I had a lot of free time. The list of possible side-effects was minimal and pretty harmless.

A couple of days in to the study, I was laying in bed reading a novel and got up to get a drink. My heart started pounding. I mean I could FEEL it hitting my ribs.

This didn’t alarm me overly much, as it has happened to me on occasion for years. Generally when I’m doing something strenuous and get overheated. Occasionally in my martial arts class, or when snowboarding. I generally just sit down/lie down, and take off any overly warm clothing I might be wearing. Heart generally regains a normal beat after a minute. When this happens, I can feel that the heartbeat is irregular, some beats closer together, some not. If I remain standing/working it beats VERY hard. Somewhat alarming the first couple of times it happened, but as I could get it to regulate itself pretty quickly by just sitting/lying down and cooling off, I just got used to it. It didn’t happen all that often.

(Meanwhile, back at the ranch…) So when it happened at the drug-study I just sat back on the bed and slowed my breathing, trying to relax. Still pounding. I lay back, willing my heart to slow (generally very effective). No luck. The nurse is walking by and asks how I’m doing. I tell her what’s going on, and she and another nurse take my pulse/blood-pressure then hook me up to an ECG machine.
My pulse was very erratic, and my heart was still trying to beats it’s way out of my chest. They took some blood samples and continued to monitor me. The head doctor was called in and he told me my pottasium was a bit low. They gave me a banana and some water, and called the paramedics just to be safe. They wanted to monitor me at the hospital. I get strapped to the gurney, put on oxygen and wheeled out in my own personal RESCUE 911 (sans William Shatner).

At the hospital they kept me hooked up to a monitor and took what had to be 40 or 50 ECG readings. A few hours passed and my heart still had not regained a normal beat. They called down the chief “Cardio Specialist” to talk with me. He told me that the condition was called atrial fibrillation and wasn’t an immediate danger. One of the chambers of my heart wasn’t pumping the way it should and was just kind of quivering. The rest of the heart was trying to compensate. But if it continued too long the blood in my heart could start to congeal and form a clot, which WOULD be dangerous. He said that he wanted to force it back into a normal rythym. Sure, okay, whatever. I just want it over. I’m having trouble standing up without getting faint, or feeling like my heart wants to explode.

He gives me some waivers to sign (thought I had signed those already… No wait… these are new ones. Its a special procedure). He then tells me they’re going to “Restart” my heart, as a nurse wheels in the DEVICE. You know the one. You see it on ER all the time… George Clooney rubs the paddles together and… “CLEAR!”

He tells me that they will administer a shock to my heart which will cause it to stop momentarily, and that it should resart at its normal rythym.

“You want to WHAT???”
“Its really a pretty common procedure…”
“But my heart will stop?”
“Technically yes, but just for a moment. Then it should beat normally.”
“Is it dangerous?”
“There are of course some risks. But as I said, its not an uncommon procedure in these situations. The risk is minimal.”
“Are there any side effects? Will it Hurt?”
“You might have localized burns from the paddles.”
“Does it hurt though?”
“Well, I’m not going to lie to you. It WILL be painful. But its just for a moment.”
“Your going to give me a painkiller, right?”
“Not exactally. Its still going to hurt, but the drug will make it so that you don’t remember afterwards.”

The nurse started the machine. Found some sort of lube. Asked me again to sign the forms. I sat up on the edge of the bed, heart pounding harder and harder. Then SWITCH. It went back to a normal rythym. The doctor watched it on the monitor. One moment beating out of control, the next a slow, regular rythym. Guess he scared it back into line.

But how F’d up is that? He’s going to give me something so that I -DON’T REMEMBER- the pain? Its still gonna hurt like a sonofabitch, but I won’t remember afterwards. Does that really sound humane to him? I guess so. I mean afterwards, I’ll thank him for helping me, none the wiser. But what about the fact that the procedure hasn’t happened yet. I’m about to experience this procedure, and I KNOW that I’m going to feel it. Its going to happen, and its going to hurt.

Does that seem wrong to anyone else? What if I were to rip out his nose hairs one by one, then zap him with the Men-In-Black-Forgeto-Ray? Shove needles under his fingernails, then give him the amnesia pill? Is this really acceptable? What does it matter, if I REMEMBER it? I don’t want TO FEEL the damn thing. Once its over, what does my memory of it matter, other than how it affects my feelings towards him personally? Some weird medical practices out there my friends.

2

The drug does have it’s uses- like just before a colonoscopy. Then you’ll be thanking your lucky stars for it, my friend.

Seriously, sounds scary and I’d be very nervous. Good luck with that.

3

I often wonder if no one is ever out for the surgery, and everyone just forgets afterwards.

There have been cases of people who were alert and could feel everything but not move. There’s a nice thought to go off to bed on.

Good post, thanks for typing it all up.

4

Oh, this happened a couple of years ago. Just reminiscing. I did learn a few things though. Like the pottasium thing. Low pottasium can cause irregular heartbeats like that. Common cause of low pottasium? Dehydration. I’ve know for years that I drink FAR TO LITTLE. I often go through a whole meal without touching my drink. Have gone whole days and realized that I only drank half a coke the whole day. No other beverage. When I think back to the times I’ve had the irregular rythym, I’m generally very hot, sweating a lot, and haven’t had much to drink for quite some time. Now I keep pottasium supplelments around, and try to make a conscious effort to keep hydrated. My heart reminds me if I forget too much.

5

Maybe he did shock you and you just don’t rememeber it.

Maybe he gave you another medication to make sure you don’t remember taking the one he was talking about

Maybe he…

6

I had this drug. Before a colonoscopy.

Guess what?

I “woke up” during. Remember it clear as day.

Also remember the nurse going, “She’s awake doctor.” Just before I started crying out from pain.

It was only a few seconds, but still.

I don’t trust that drug anymore.

7

A fairly small percentage of people don’t take well to that drug type, but you could say that about any anesthesia or any other kind of medication, for that matter. It’s definitely something to tell your physician and anesthesiologist before the next procedure!

Without knowing the name of the drug, my guess is that it was used because it wouldn’t affect your heart rate (the point of the whole procedure, after all) or breathing rate, and they needed to see immediately how you responded to the treatment. I’m sure that in any other situation, they probably would have given something that also promoted sleepiness, loss of anxiety, etc., but for something over with so quickly, they needed only a short term drug and one with as few side effects as possible.

8

CubHubby once watched while the EMT’s shocked a awake (an aware) man with the heart paddles. It gave him the heebie-jeebies for quite a while. I’ll bet it was similar circumstances as the OP’s.

9

It’s a common misconception that when someone is defibrillated, their heart is shocked into starting. As your doctor said, it’s intended to stop your heart. The problem with fibrillation is that different areas of muscle are contracting at different times, which results in the heart quivering rather than pumping. You had AF, which although bad, is not nearly as dangerous as ventricular fibrillation.

The defibrillation shock depolarizes all of the muscle (kind of like doing a CTRL-ALT-DEL to reboot a stalled computer) and then the hope is that your body’s natural pacemaker takes over to restart everything in a coordinated fashion.

As for not remembering the shock, that’s probably a good idea. In fact, one of the complications of patients who receive an implantable debrillator is that some develop post-traumatic stress disorder after they’ve received one or more shocks. Some request an explant of their device. There are all sorts of ideas to try to get around this.

Why yes I work for a cardiac device company. Why do you ask?

10

My mother works as a nurse in the outpatient surgery ward of our local hospital. They give their patients Versed (which is probably what you had) and a local anisthetic most of the time. Mom said that most of the patients get wheeled out of the surgery and ask her how it went. If she gives them an answer that takes too long they’ll interrupt her to ask her how the surgery went.

I’m glad I’m not a nurse because I’d probably say something like “I’m sorry mr Jones, but we just couldn’t save the leg” to a cataract surgery patient. And get fired.
I’m pretty sure Versed and other hypnotics like that are also used as date-rape drugs (scary!)

11

How coincidental - I’m getting (what I assume is) Versed tomorrow for my day surgery. I have somewhat the opposite reaction to yours: if I have no memory of something, in what meaningful way have I experienced it (in a psychological sense)? It makes me feel weird and uncomfortable when I muse on it. But then I muse on the fact that they’ll be sticking a huge needle into my cervix, and I decide I probably don’t want to remember it after all.

12

I don’t think it’s so much that you will have no memory of the procedure as much as it is feeling “dissociated” from the event that you have no negative psychological reactions following something that would otherwise be painful and traumatic.

I’ve had a colonoscopy and just yesterday an endoscopy where they gave me demerol and versed. The nurse told me that I may or may not fall asleep but either way, I would feel so removed from the procedure that I wouldn’t care.

She was right. I remember everything from both procedures, the endoscopy was a bit painful and I recall whimpering and gagging a few times as the Dr told me everything was fine and that my reactions were normal.

It was over before I knew it and 5 minutes later I was wide awake sitting up on my gurney in the recovery area telling my mom how I gagged and belched as we both squeeled with laughter.

My day-after recollection is pretty non-chalant. If I had to get it done again, I would be pretty calm going in. I doubt I would feel that way were it not for the drugs.

13

I used to work for a doctor who had an endoscopy done to him without any sedation because at the time he simply had no means of getting home if he were sedated (they don’t want you to drive after getting that particular medication, even after you’re “awake” again, just because you might become easily confused). Apparently no, it was not a picnic. He got through it all right, but was very uncomfortable and generally Not Happy.

14

Apparently some people are allergic to Versed. Such as myself. I don’t remember what happened, but after the procedure (putting a dislocated elbow back into joint) the nurses told me a fantastic story. One involving mild mannered Madd Maxx getting physically agitated, to the point where four male ER staff had to be called to restrain me until the antidote could be administered, and me using my still dislocated elbow to prop myself up under the weight of the above mentioned staff. My mother was there at the time, and it happened at the hospital where she worked, so she knew all of the nurses involved, so I have absolutely no reason to doubt their recollection of what happened.