Waking Up During Surgery (2019) • Hacker News Board

Re: Waking Up During Surgery (2019)

#41

Post by BurningFrog » Thu, Apr 22, 2021, 1:32 PM UTC

batch12 wrote: post #35

flave wrote: post #2

Okay this is an interesting article and an interesting subject. But, it looks a lot like fear-mongering. I feel strongly about this because I had two procedures done under local for fear of exactly this situation (coming up but being sedated) and both experiences where tough . > Founded in 2007, it has now collected more than 340 reports So 24 self-reported cases a year in all of N America. There are 48 million in pa…

I have had several surgeries with everything from a light to general anesthetic. I warn the nurses and doctor beforehand that I have a history of waking and remember previous operations. Most do not believe me. I remember the sound of my wisdom teeth being cracked open and opening my eyes while they were being cut out. I remember scaring the shit out of a nurse and doctor when I woke and started talking mid-procedure…

Do you have red hair?

I ask because they're known to need more anesthesia.

Re: Waking Up During Surgery (2019)

#42

Post by batch12 » Thu, Apr 22, 2021, 1:33 PM UTC

BurningFrog wrote: post #41

batch12 wrote: post #35

Earlier quoted context omitted.

I have had several surgeries with everything from a light to general anesthetic. I warn the nurses and doctor beforehand that I have a history of waking and remember previous operations. Most do not believe me. I remember the sound of my wisdom teeth being cracked open and opening my eyes while they were being cut out. I remember scaring the shit out of a nurse and doctor when I woke and started talking mid-procedure…

Do you have red hair? I ask because they're known to need more anesthesia.

Yes, partially. When I grow a beard it is red.

Re: Waking Up During Surgery (2019)

#43

Post by tokai » Thu, Apr 22, 2021, 1:37 PM UTC

Dumblydorr wrote: post #33

Wow, this lady has 2 to 3 nightmares per night even ten years later, after an exploratory surgery? That's pretty extreme, I think most people wouldn't have had 6 to 8 thousand nightmares about this experience.

I would guess her actual memory of the up-waking would be very unreliable after thousands of nightmares.

Re: Waking Up During Surgery (2019)

#44

Post by IG_Semmelweiss » Thu, Apr 22, 2021, 1:37 PM UTC

bserge wrote: post #36

IG_Semmelweiss wrote: post #14

"This all makes anaesthesia as much art as science" This is one of the most important parts of the piece. It is something that most people out side of healthcare are not aware. Anaesthesia is very much an art. Anaesthesia is unlike other medications, "take xx mg over yy days." Anaesthesia effects can vary wildly from person to person. Weight plays a big role, but so does bed position, condition, sex, body part etc. T…

That's really the case for medication, as well. I wish doctors would be better in this regard and pay more attention to individual needs. I understand that would be more difficult and would likely increase costs, but still. The way it's done now is as you said, "take x mg at y interval" based on the tests done during drug development. If you don't respond to the medication the same way as the majority, you're in for…

That's well said.

Just because it is standard practice doesn't mean its the best approach. Its just the accepted approach.

Nassim Taleb has a quote on the subject that i love:

"The difference between medicine and poison... is dosage"

Re: Waking Up During Surgery (2019)

#45

Post by DanBC » Thu, Apr 22, 2021, 1:38 PM UTC

fooqux wrote: post #27

wittyreference wrote: post #21

Earlier quoted context omitted.

They went on to describe the forearm experiment which showed a much higher rate of awareness. I don’t see why you’ve chosen to omit that. You seem to casually discard the idea that awareness without memory is irrelevant, but when I’ve informed patients of amnestics they’ve been horrified - maybe needlessly so, but I’m not so arrogant as to think “silly patient, your horror is wrong and therefore irrelevant.” Many peo…

> Many people don’t regard “you’ll be in pain and then forget” as the same as “no pain.” I find this incredibly fascinating. If people were to be offered a sum of money in exchange for feeling immense pain for an hour but then having that memory wiped, I wonder how many would shrug and say "I won't remember anything? Sure, sign me up." I wonder at the ethical and morality of such things. If the person's reality is ba…

You might be interested in the radio programme "Brian Gulliver's Travels".

https://en.wikipedia.org/wiki/Brian_Gulliver%27s_Travels

https://www.bbc.co.uk/programmes/b01m29vt

They included an episode (Kognitia) where people are able to forget traumatic experiences. Here's a tiny clip: https://www.bbc.co.uk/sounds/play/p00yj97w

They're available on Archive.org here: https://archive.org/details/briangulliverstravels1-2

Re: Waking Up During Surgery (2019)

#46

Post by tyingq » Thu, Apr 22, 2021, 1:41 PM UTC

DHPersonal wrote: post #37

tyingq wrote: post #32

Earlier quoted context omitted.

Statistics on women who choose a "no painkiller" second childbirth after doing so the first time might exist.

That might be an aversion to using painkillers again after experiencing awful side-effects in the first delivery.

Ah, I meant those that go without painkillers a second time.

Re: Waking Up During Surgery (2019)

#47

Post by t0mas88 » Thu, Apr 22, 2021, 1:43 PM UTC

andix wrote: post #26

throwanem wrote: post #16

Earlier quoted context omitted.

It should be easy to disprove false memory, I'd think, at least in the case of procedures that are recorded. Ask the patient what they remember happening, and compare with the recording to see if those things did occur or didn't. I'm not inclined to assume every report of this happening is due to false memory, which is itself a somewhat controversial topic. As the article points out but is not even slightly novel in…

Doctors usually talk during (some parts of ) the surgery. About whatever is on their mind. If the patient can recite some details about that, it's probably not false memory.

I've read a story some years ago about a patient that didn't have any pain but did have some vague memories about the procedure that he should not have had if he was fully under. The patient was able to describe the topics of informal small talk during their procedure.

Re: Waking Up During Surgery (2019)

#48

Post by andrewl » Thu, Apr 22, 2021, 1:46 PM UTC

throwanem wrote: post #11

ycombinete wrote: post #3

Earlier quoted context omitted.

That speculation at the end is truly bizzare. I’m sure that, if I suffered such an experience, the first thing I’d do upon waking would be to talk about it!

Would you? It would probably be by far the worst agony you'd ever experienced, and given the circumstances you might also not be able to be certain you had actually experienced it. Beyond that, you'd likely face strong dissuasion if you did try to talk to anyone about it, even a doctor or nurse involved in your care, assuming the article is accurate in saying most don't really believe it can happen. It might be hard…

It's not uncommon to wake people up during brain surgery, or do the surgery without fully anesthetizing the patient at all. They would anesthetize the skull area they cut through. And the brain tissue itself doesn't register pain when cut. They do it so the surgeons can interact with the patient to guide them in what areas they have to stay away from when removing a tumor or doing other work. Here's more:

https://www.mayoclinic.org/tests-procedures/awake-brain-surg...

Re: Waking Up During Surgery (2019)

#49

Post by Retric » Thu, Apr 22, 2021, 1:50 PM UTC

Dumblydorr wrote: post #33

Wow, this lady has 2 to 3 nightmares per night even ten years later, after an exploratory surgery? That's pretty extreme, I think most people wouldn't have had 6 to 8 thousand nightmares about this experience.

It’s a reasonably common response to traumatic events for people to have regular nightmares for decades afterwards. ~2-3 a night for a decade would be high, but not unheard of.

a study comparing Vietnam Veterans to civilians showed that 52% of combat Veterans with PTSD had nightmares fairly often. Only 3% of the civilians in the study reported that same level of nightmares. https://www.ptsd.va.gov/understand/related/nightmares.asp

Re: Waking Up During Surgery (2019)

#50

Post by bloak » Thu, Apr 22, 2021, 1:58 PM UTC

Xenoamorphous wrote: post #20

bloak wrote: post #10

Earlier quoted context omitted.

Interestingly, in Germany at least, when someone is killed in an accident, in determining the damages payable to the person's estate (i.e. other people) they take account of how much pain (it is speculated that) the person suffered in the seconds before they died. To me this seems ... weird. I don't think they're worried about psychological trauma in the afterlife, but who knows?

Well if a loved one died I for sure would feel even worse knowing that they suffered. I guess that’s the reason for bigger compensation.

If that were the reason, then surely the compensation ought to be paid directly to the lover or lovers rather than to the estate of the person who died, who might have left their money to charity, not to the lover or lovers. They almost certainly do have mechanisms in place for compensating family members directly, but compensation for pain suffered in the seconds before death goes to the estate of the dead person, not to the family, if what I read was accurate and still applies. That compensation is presumably independent of whether the deceased had any family and independent of who inherits it.