What They Don’t Know Can Hurt You!

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

In the last 13 months I’ve had the fortune or misfortune (depending on how you look at it) to be hospitalized twice. The first admission was for removal of uterine fibroids following a miscarriage… a dreaded hospitalization. The second admission was for the birth of my daughter via cesarean section… a highly anticipated day. Despite the circumstances, the fibroid hospitalization was very well orchestrated and proved to be a very good experience. Conversely, the night that my daughter was born ended up being unnecessarily traumatic.

Because I have very strong reactions to anesthesia, (I vomit profusely, am very hard to awaken and have had significant drops in blood pressure.) before the fibroid surgery my physician and I spoke very explicitly about my previous experiences with various medications and dosages. He instructed me to relate my past experiences in detail to the anesthesiologist. I did. I arrived at 6:00 am for my surgery. Before signing in, I was given medication to settle my stomach. I was given various pills and syrups throughout the 2 hours prior to the surgery. Although I was still slow to wake up post operatively, I was much less groggy than after previous surgeries. There was no nausea, no vomiting and no pain during the entire admission. The dreaded hospitalization resulted in a positive experience.

The night that my daughter was born started out happily. A cesarean section had been scheduled for later in the month due to the fibroid surgery, but I went into labor so they had to take the baby. An hour before the surgery, the anesthesiologist arrived. It is unclear if in my excitement I was not explicit about my history or if she mistook my words for those of an anxious mom to be. In any case, I was given one small cup of fluid and taken into the surgical delivery suit.

I knew that I was in trouble when I vomited right after receiving the spinal block. That was at approximately 7:30 pm. They gave me something to get me through the actual cesarean but I began to be sick at regular intervals after the procedure. The nausea and vomiting continued through the recovery period and I worried I’d burst my stitches. The oral Vicodin lasted 10 minutes before it came back up. I asked to see the anesthesiologist but she did not come the entire 2 hours that I was in the post anesthesia care unit.

On the labor and delivery unit, my husband went to find my nurse but was told that all of the nurses were in change of shift report until 11:30 pm. At my insistence, he found a nursing assistant who found my nurse who paged the anesthesiologist. The anesthesiologist read the chart notes she replied, “You really do have a strong reaction to anesthesia!” She changed my medication to be administered via the IV and after 7 long hours, I was finally able to rest and go to sleep.

It is critical to be very explicit with physicians and family members about prior medical history and health care needs.

· Have your medical information readily available for your loved ones to access in the event of an emergency.
· Don’t assume that prior records will be available, physicians automatically share information with one another, “the doctor knows what I need” or loved ones know how to advocate on your behalf.
· Always ask questions. Now question is too insignificant or stupid.
· Be sure others understand what you mean. Ask their opinions on what you have said. See if they received the message that you were trying to convey

During an emergency is not the time to be without pertinent medical information. Time is critical. Make known your needs and wishes in advance, while you are calm and can think clearly. Sometimes snap decisions cannot be helped. But for all other times, be prepared because what physicians and loved ones don’t know can hurt, or possibly kill you.