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Surgery and anesthesia


alexjuice

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Seeking advice on surgery (pain killers and anaesthetics)

 

Hi,

 

I’m due to get a mesh-based hernia repair soon, and was wondering if I could get some advice on (a) anaesthetics; (b) pain reliefs meds; and (c) how risky this will all be.

 

The repair is covered by public health (so is free), but I have had a very rough trot with psychological symptoms, some myalgia, and dysmotility - all apparently brought on by hypersensitivity to amitriptyline and withdrawal (although I suffered from some dysmotility before).

 

I could find some discussion on anaesthetics but am putting the post here as my questions are broader and I figure each part could interact (humble apologies if wrong!).

 

Thanks! :)

 

Edited by ChessieCat
added topic title before merging with existing topic

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Amitryptyline: Early Dec 2019 - 10mg, ~6 weeks

Late Jan 2020 - 20mg, ~1 month

Late Feb 2020 - 10mg, 2 weeks

Early Mar 2020 - 5mg, ~4 days

Mid Mar 2020 - 10mg, ~1 month

Late Apr 2020 - ~15mg, ~2 weeks (pill cutter)

Early May 2020 - ~16mg, ~2 weeks (pill cutter)

Mid May 2020 - 17mg, ~11 months (compounding chemist) [22 Sept 2020 - 1 missed dose]

Mid Aug 2021 - ~15.25mg, ~4 months (pill cutter)

~Dec 2021 to present - dropping ~0.1mg every few days using pill cutter and scales; now on 10mg

Multivitamin: Since 2017 - 1, irregularly; from ~Sept 2020 - 1, daily; Movicol: Since early 2017 - varied amounts daily, now 5 sachets a day Coloxyl: since ~Dec 2020 - 400mg a day; Ural: was used temporarily from late 2020 - ~4 sachets a day; Previously taken, but none since Dec 2018: Ondansetron, metaclopramide, simethicone, prochlorperazine, domperidone, valium, prochlorperazine, fluoxetine, oxazepam, olanzapine, pregabalin, atenolol, motillium

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@soliDg  SA likes to keep similar information in one place so it is easier for members to find.

 

See also:

 

painkillers-in-withdrawal-aspirin-ibuprofen-paracetamol-acetaminophen-naproxen-codeine

 

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

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I recently had surgery under general anaesthetic to remove a growth in my jaw. I also had a dose of morphine after. Initially I was so worried it’d have some adverse effect on the taper. But I haven’t noticed anything significant, it’s been 6 weeks now.
 

Everyones different I guess there’s no way to know. If you’ve ever had surgery in the past, maybe that experience would inform how you’d react to this one? 
 

All the best with the surgery :)

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I have to get a biopsy done on a spot on my face. I'm wondering if anyone knows if they can use liquid nitrogen to freeze it. 

 

If I have to have an injection do they make injectable anesthetics without epinephrine for use on the face?  I realize that they do for dental work, so am hoping this is also true for use elsewhere.

Has anyone had a local anesthetic injection who had tardive dyskinesia, and akathisia, and did it cause these issues to flare up or return?  If you have had an injectable local anesthetic what sort did you get?


Thanks for any help.  And I hope you are all having a relaxing day or night.

 

 

I am not a medical professional and nothing I say is a medical opinion or meant to be medical advice, please seek a competent and trusted medical professional to consult for all medical decisions.

 

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  • 4 months later...

Bumping this up.  I now have to have a second surgery on my face to remove a growth.  It's near my eye.  They say they can use local anesthetic without epinephrine. As it's near my eye I"m worried as I have never had anything injected near there so I'm wondering if anyone has had issues with this before.  I had tardive dyskinesia, and used to have twitching in one eye.  Absolutely don't want that to recur.

 

Also the surgery involves cutting a tiny bit of the growth off then testing it in a lab while I wait to see if they got it all (this is a cancer they are taking out.)  If they feel they haven't they cut yet another tiny bit and test to see if it's gone.  Repeat as necessary. I could be there up to ten hours I'm told...

 

I don't know what the limit of local injections would be in such a situation but if I'm there ten hours I'm assuming I won't be on an anesthetic the whole time.  Even so I would assume most likely I'll be given more than one injection while there.  

 

Does anyone have experience of being given repeated local anesthetic injections and what was that like? I did once have two at a dentist, it actually made me giddy and happier than I normally am lol, but, I assume they could give me more than that for this.  

 

Any help would be greatly appreciated. 

 

P.S. So this is clear the last time they used something else to very temporarily freeze the area, which was fine (it isn't a med don't want to put down what it was here, for privacy reasons.  If anyone has to have a small spot of cancer taken off though, or anything else removed that is small and skin related feel free to PM me I can tell you what it was they used for anesthetic for me.  It's not at all dangerous.)  It worked fine, worked for a split second while they removed most of the cancer.  Unfortunately, that can't be used for this surgery though.  

I am not a medical professional and nothing I say is a medical opinion or meant to be medical advice, please seek a competent and trusted medical professional to consult for all medical decisions.

 

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  • 3 weeks later...

Updating here in case it's relevant for anyone else who may read this in future. I had the local anesthetic without epinephrine and it went fine.  I had day a bit of twitching in my eye a few days later but nothing too serious.  

I am not a medical professional and nothing I say is a medical opinion or meant to be medical advice, please seek a competent and trusted medical professional to consult for all medical decisions.

 

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  • 4 months later...

As I understand while you're tapering an SSRI your nervous system is trying to adjust and whatnot and find homeostasis but I might have to go under anesthesia for a colonoscopy coming up potentially is it ok to take anesthesia for that I feel like it'll mess with the nervous system while it's balancing out. Also btw this is tapering a reinstatement after months off the SSRI which I believe is considered kindling so that means l'm extra sensitive I think? I never got over the side effects of going off the first time like PSSD. So I also have PSSD to be concerned about the anesthesia maybe PAW I don't know all I know is I quit the med experienced side effects went back on still had them and a little worse and am now tapering thanks in advance.

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Tell your anesthesiologist (they should always be made aware of any medications you take or have taken) and let them make this call.

Realistically, you should be fine. The problems that could arise due to foregoing a procedure where you need to be anesthetized are a much greater concern.

 

I have had many surgeries, including medically induced comas that lasted for weeks along with procedures like a fundoplication, numerous biopsies, and the removal of a salivary gland, gall bladder, and appendix.

Through most of those, I was either on SSRIs or in the process of switching to different ones. There was never a complication related to them.

 

If anything, the kind of anesthetic that knocks you out well enough for an operation serves as a bit of a relief from the usual frantic nervousness associated with discontinuing SSRIs.

2014-2015 Clonazepam (Klonopin) 2mg BID, Sertraline (Zoloft) 150mg (Discontinued Clonazepam cold turkey)

2014-August 2021 Sertraline (Zoloft) 150mg (Discontinued cold turkey in hospital, replaced with new regimen)

August 2021 Sodium Valproate 500mg (Depakote), Quetiapine 150mg (Seroquel)

May 2022 Sodium Valproate 500mg (Depakote), Quetiapine 150mg (Seroquel), Hydroxyzine 25mg PRN, Mirtazapine 15mg

July 2022 Sodium Valproate (Depakote) 500mg, Quetiapine 200mg (Seroquel), Hydroxyzine 25mg PRN, Venlafaxine 75mg (roughly 10 days)

August 1 2022 Sodium Valproate 500mg (Depakote)Quetiapine 100mg (Seroquel), Hydroxyzine 25mg PRN, Buspirone 10mg (5-7 days)

August 14 2022 Sodium Valproate 250mg (Depakote), Quetiapine 100mg (Seroquel), Hydroxyzine 25mg PRN

September 7 2022 Sodium Valproate 250mg (Depakote), Quetiapine 50mg (Seroquel), Hydroxyzine 25mg PRN

September 22 2022 Sodium Valproate 250mg (Depakote), Quetiapine 25mg (Seroquel), Hydroxyzine 25mg PRN

October 9 2022 Sodium Valproate 250mg (Depakote), Quetiapine 12.5mg (Seroquel)

October 26 2022 Sodium Valproate 250mg (Depakote), Quetiapine 0.0mg (Seroquel) - #1 Goal Achieved

November 18 2022 Sodium Valproate 0.0mg (Depakote) Drug Free!

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  • Administrator

@Nithin13 you may wish to read this topic from the beginning.

 

Also see 

 

Please use search to see existing discussions before starting topics. Thanks.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 3 weeks later...

I had surgery a month and a half ago, and was glad to find this topic. It took some anxiety away, as several people stated they had no problem with propofol. I was worried about dizziness and having to throw up, but I experienced no such thing. What I didn't find out beforehand is that citalopram has a major interaction with omeprazole, the stomach protector they prescribed me for the 3 day course of painkillers post-surgery. Omeprazole increases the blood level of citalopram by affecting hepatic enzyme CYP2C19 metabolism. I had clearly stated on several occasions that I'm tapering citalopram and it's giving me a lot of trouble, but apparently it got through the medication screening anyway. I've experienced increased withdrawal symptoms (brain fog, fatigue, depression) since returning to work, about a week after surgery. I can't isolate this to the omeprazole, though, as I've had several impactful events happen around the same time. But I figured I'd share my experience, perhaps it can help someone in the future. There are alternatives to omeprazole.

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (Dec)

2020 - Switch to 10 mg liquid citalopram (Feb), decrease to 8 mg (Apr), 6 mg (June), 4 mg (July) without clear symptoms. 3.2 mg (Sep 9), 3 mg (Sep 23), 2.8 mg (Oct 10), 2.6 mg (Oct 26), 2 mg (Nov 13).  Tapered to 1.68 mg in steps of 0.16 mg (Dec 3). Withdrawal kicked in hard. Increase to 1.8 mg (Dec 8), increase to 1.92 mg (Dec 18)

2021 - Increase to 2.2 mg (Jan 1), decrease to 2 mg (Feb 8 ), 1.92 mg (March 21), 1.8 mg (Apr 2), 1.68 mg (Apr 25), 1.56 mg (June 6), 1.52 mg (Sep 5), 1.48 mg (Sep 20), 1.44 mg (Oct 4), 1.4 mg (Oct 18), 1.36 (Nov 1)

2022 - 1.32 mg (Feb 4) - Covid (March 7) - 1.28 mg (Jul 21), 1.24 mg (Oct 3), 1.2 mg (Nov 26)

2023 - Holding at 1.2 mg

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On 3/27/2023 at 9:43 AM, Momiki said:

Omeprazole increases the blood level of citalopram by affecting hepatic enzyme CYP2C19 metabolism.

 

This would not cause withdrawal, it would cause the opposite -- increased drug effect. Suggest you not take the 2 drugs at the same time of day, move taking the omeprazole away from the citalopram as far as you can.

 

You may also be experiencing hangover from the anesthesia, etc.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Yes, it increases the drug effect. And then when you stop taking it, the blood level will go down again. To me that seems undesirable, you'd like to keep the dosis stable. And that's possible, if you're prescribed a different drug.

 

I'm posting this so someone else reading this in the future can ask for a different stomach protector.

 

As I've said, I don't attribute the omeprazole solely to my current wave. I've had a lot of stress because of several other impactful events (such as moving to a different town), that surely had a bigger impact than 3 days of omeprazole. But I would have preferred a different drug, had I known about the interaction beforehand.

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (Dec)

2020 - Switch to 10 mg liquid citalopram (Feb), decrease to 8 mg (Apr), 6 mg (June), 4 mg (July) without clear symptoms. 3.2 mg (Sep 9), 3 mg (Sep 23), 2.8 mg (Oct 10), 2.6 mg (Oct 26), 2 mg (Nov 13).  Tapered to 1.68 mg in steps of 0.16 mg (Dec 3). Withdrawal kicked in hard. Increase to 1.8 mg (Dec 8), increase to 1.92 mg (Dec 18)

2021 - Increase to 2.2 mg (Jan 1), decrease to 2 mg (Feb 8 ), 1.92 mg (March 21), 1.8 mg (Apr 2), 1.68 mg (Apr 25), 1.56 mg (June 6), 1.52 mg (Sep 5), 1.48 mg (Sep 20), 1.44 mg (Oct 4), 1.4 mg (Oct 18), 1.36 (Nov 1)

2022 - 1.32 mg (Feb 4) - Covid (March 7) - 1.28 mg (Jul 21), 1.24 mg (Oct 3), 1.2 mg (Nov 26)

2023 - Holding at 1.2 mg

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