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Alice's Weekend In The Rabbit Hole
After an upper endoscopy early Friday morning, with the kind of anesthesia ("conscious sedation") that most people apparently recover from in minutes or hours, I spent three days in a thick brain fog -- sleeping, falling asleep watching crime show reruns, and waking up terrified that maybe I'd lost my magic powers. Fun. As I boohooed to my little sister, "Without my brain, I'm just a goofy redhead with big boobs."

Two days later, on Sunday afternoon, I was still feeling high, and not in a good way, and having trouble remembering the name of the procedure I'd had, or even what I had for lunch (a fried chicken leg). I called my sister all upset again in between trying to look up studies on endoscopy anesthesia and cognitive impairment (while cognitively impaired -- super-fun). She's very wise, and said a bunch of stuff to me I can't remember much of (I do recall something about negative thoughts and a broom), but calmed me down.

Gregg, in between putting Florence Nightingale to shame, kept telling me he'd take me to the emergency room, but I declined, because I felt that the damage, if there was lasting damage, was probably done. Late Sunday afternoon, I still felt like my brain was behind a thick curtain and I didn't quite have the energy or ability to push it aside to get into the pantry and get the items I needed. Pretty terrifying. I mean, what do I do, get a job in retail?

But, around 7pm on Sunday, I talked to both Gregg and my sister, and both said I sounded more coherent and more like myself again. Finally, a friend in the medical profession e-mailed me back that he thinks it's "extremely unlikely there's any permanent harm or near that." And he sent me this quote, which pretty much sums up how I feel about my experience these past three days:

"The doctors killed him. I just shot him."
--Charles J. Guiteau, assassin of James A. Garfield

Posted by aalkon at January 14, 2008 1:41 PM

Comments

now that you have gotten your smart-cookie magical powers back this may have already occured to you...

but document, document, document in your own records... in 7 years you don't want to have to depend on a doctor's records to figure out what it was that was affecting you. Now that I have started ditching doctors that don't listen to me, I have to have a pac of information to explain all the oddness that goes on in the old man's bod. and what came before, and in what year. For example, most of the heavy duty pain meds, help with my loopy-as-a-fruitbat routine. But they don't, in fact, help with the pain. This cases all sorts of wailing an gnashing of teeth, but gives the doc an idea of what can be used... and reminds me that I'd rather be rationally in pain, able to divert my mind to work or whatever, then to be stuck between heaven and hell, impaled on lances of pain, and excruciatingly unaware of how long I will be punished there...

FWIW anyhow... hope you'se feel better. Remember to drink more water than you really want to, just to get all that chemistry out asap.

Posted by: SwissArmyD at January 14, 2008 4:31 AM

Gosh, Amy -- so sorry to hear about your ordeal. Judging by your post, however, you sound just as sharp as ever. I'm mainly sad to hear that you were frightened, because I'd never wish that for you. Your writing always cracks me up and lifts my day, and it concerns me to hear that you're down in the dumps. Anesthesia is a weird thing, but you're young, resilient, and a fighter. I think that doing intellectual tasks will help to exercise your mind and get you going again. Trying to make sense of what some of your dizzy readers write will bring anyone out of a funk! All the best; feel better.

Posted by: Norm at January 14, 2008 5:13 AM

Welcome back. Anesthesia for some is like taking LSD, you never return to the starting point.

Posted by: Roger at January 14, 2008 5:19 AM

I was very young when I had my first child and was scared to death about the delivery. Back then the epidural they gave literally numbed your lower extremeties to the point of being incapable of moving your legs, toes, anything. It also made me extremely cold, shivering in a convulsive way. I felt a nauseating groggy for several days, and although it's been a while, I remember wondering after a few days if I would ever get a clear head again. To be honest with you, I remember that once I started working out again, which was almost six weeks later, I felt 100% clearer. I actually remember waking up one day with a clear, fresh mind and thinking, "damn. It took me that long to get right?" Of course childbirth is different from what you had, but I thought I would share. I recommend exercise.

Oh, and one other thought I had during that time. It made me wonder if people who were.... uhhmmm....what's the right word??? oh fuck it this is the advice goddess blog....It made me wonder if people who were slow felt like that in their minds all the time. I guess the experience helped build a little more patience and understanding.

Posted by: kg at January 14, 2008 5:43 AM

Hope you're feeling better today, Amy! o_O

Posted by: Flynne at January 14, 2008 6:01 AM

Aww, thanks, everybody. And good advice to document everything. I'm getting the name of the anesthetics from the doctor this morning. And beyond asking him about my fun this weekend, I'm going to find out if it meant anything that they couldn't get my blood pressure up when the procedure was done. They were in an awful hurry to do it (giving me juice boxes -- how that would help I don't know), but I think the rush may have been because it's an HMO, and they needed to hit the catapult button to get me out of the bed ASAP to get the next victim in. (I just wanted to sleep where I was.)

Posted by: Amy Alkon Author Profile Page at January 14, 2008 6:43 AM

After my colonoscopy, my mind cleared up in less than 24 hours. Thinking of all the lapses of memory before it did, I can see how scared you must have been when the effects went on for a couple of days. Glad you're better.

The situation reminds me of the old bumper sticker, "Reality is for those who can't handle drugs." Looks like you're stuck with reality.

Posted by: Axman at January 14, 2008 7:45 AM

My memory's still really terrible. I can't remember names of things I normally know and my spelling ability is imprecise. Just a half hour ago I couldn't remember if "assassination" had all those ss'es or not and I had to look it up to be sure. For me, this is highly unusual.

Posted by: Amy Alkon Author Profile Page at January 14, 2008 8:01 AM

Sorry to hear you had a bad weekend and that you still not doing too well. I'd be interested to know what they gave you, too. I know the psychobiology of memory reasonably well and it's odd that the effects of the anesthesia weren't pretty transitory. The juice boxes were almost certainly intended to jack your blood sugar up (fruit juice is one of the most highly glycemic things you can consume), which in the short run will perk you up, especially since you probably hadn't eaten for quite some time. Anyway, hope you continue to emerge from your fugue and are feeling right soon!

Posted by: justin case at January 14, 2008 8:18 AM

"Without my brain, I'm just a goofy redhead with big boobs."

Yeah, but you make that sound like a bad thing.

Posted by: Steve Daniels at January 14, 2008 8:18 AM

Yeah, but you make that sound like a bad thing.

Heh heh...well, it has its good points.

And thanks, Justin.

Posted by: Amy Alkon Author Profile Page at January 14, 2008 8:25 AM

P.S. I've put a call into the doc and here are the questions I'm asking. (Feel free to suggest any additions/edits -- as I said, my brain still isn't quite up to snuff, but it's probably 85%.)

*What anesthetics was I given, and what were the doses?
(Anesthesiologist ex-boyfriend said it was unlikely it was demerol and fentanyl -- the drugs I thought I remembered --because they’re in the same class/type.)

*How did you decide to give those doses?

*Was my reaction typical? What is a typical reaction?

*Discuss hypoxia potential – given what I told you about how I get sick when there's low oxygen on planes. (Or told the nurse)

*Were blood pressure and pulse ox and level of consciousness monitored?

*What do you think happened?

*Could this be related to dopamine -- I take Ritalin daily, and perhaps ADHD has something to do with dopamine...I can't recall.

*Memory loss still. Can't remember things I would normally remember, not spelling perfectly as I usually do. Please advise.


Posted by: Amy Alkon Author Profile Page at January 14, 2008 8:30 AM

Yikes, that's scary! Anesthesia is more dangerous than doctors like to let on. I'm glad you're feeling (mostly) better! Get a lot of rest, drink a lot of fluids to help flush out any drugs that're still in there, and do some crossword puzzles to help jump start your brain again.

As for the questions, I'd stress the lingering memory loss, mainly. I would've recommended asking if it might've been the procedure instead of the anesthesia, but if it was only an endoscopy there's not really much that can mess up.

Posted by: Bad Kitty at January 14, 2008 8:58 AM

Sorry to hear you were out of it this weekend, but glad you're starting to bounce back.

I've rebounded from the 3 general anesthetics I've had quite quickly, but can't take anything in the codeine family or I stay in a constant state of fuzz head. I finally had a nurse suggest that I tell people I'm allergic to codeine so doctors quit trying to give it to me. When I told them it made my fuzzy and nauseous and that I'd prefer pain, they seemed to think I was just being a wuss. I've enjoyed my share of recreational drugs so I'm no virgin to being stoned. Codeine is simply just bad for me. I had no idea it didn't do the same to everyone until I gave a friend the liquid codeine I got for my broken jaw. (I refused to take it after the first night and he wanted the buzz -- at 19, I didn't think anything of it) and it did nothing for him. I guess we all react differently. Hope the doctor can re-assure you and you continue to improve.

Posted by: moreta at January 14, 2008 10:01 AM

Amy,
Glad to hear that you are doing better after being overdosed. I wish you good health.
William

Posted by: William at January 14, 2008 10:19 AM

love to Amy

Posted by: rusty wilson at January 14, 2008 11:22 AM

Thanks, everybody. I was given 75 mg of Demerol and 3 of Versed.

It sounds like this won't be permanent, but it sure sucks!

Posted by: Amy Alkon Author Profile Page at January 14, 2008 11:25 AM

Have you ever had an adverse reaction to benzos (e.g., valium, xanax) or opiates before? That you had this reaction is odd, since these are both short-lived meds that act on different receptor sites.

Posted by: justin case at January 14, 2008 11:36 AM

Yuck, Amy. I'm so sorry you had to go through that!

I'm very allergic to Demerol: in addition to the fugue state you went through, I tend to throw up uncontrollably when I am given Demerol. I wound up having it noted in my medical records (not an easy task, seeing as I'm a military healthcare patient, sigh) that I shouldn't be given Demerol under any circumstances. I've never had any other bad reactions to any other anesthetics or the like, though.

Posted by: Sarah at January 14, 2008 12:00 PM

I'm so glad the effects won't be permanent. How very scary for you, though!

Be well.

Posted by: Kimberly at January 14, 2008 12:12 PM

Have you ever had an adverse reaction to benzos (e.g., valium, xanax) or opiates before? That you had this reaction is odd, since these are both short-lived meds that act on different receptor sites.

Thanks for asking, Justin. Believe it or not, I've never taken valium or xanax. Except for Ritalin, which helps me write through the ADHD, I really don't take drugs. I used to sometimes take a sleeping pill when flying to France, but even that hit me too hard, so I now just take a Benadryl if I'm flying overseas.

What worries me is that this is an unusual reaction I'm having-- especially the difficulty with memory. Got a little worse at noon, so I'm eating a caesar salad Gregg left for me and drinking some Pellegrino. If there's one thing I have, it's tons of fluids. (Costco just delivered 8 cases of Pellegrino, and two cases of Martinelli's sparkling apple juice.) Just worried a little still, but hoping I'll be back to me soon.

Posted by: Amy Alkon Author Profile Page at January 14, 2008 12:37 PM

Just don't forget about that money you owe me.

Posted by: Paul Hrissikopoulos at January 14, 2008 1:03 PM

Funny.

Posted by: Amy Alkon Author Profile Page at January 14, 2008 1:36 PM

>>>"Without my brain, I'm just a goofy redhead with big boobs."

You say that like it's a bad thing. ????

Posted by: Bikerken at January 14, 2008 2:58 PM

>>>After my colonoscopy, my mind cleared up in less than 24 hours.

Hey Axman, you might wanna rephrase this?
LOL

Posted by: Bikerken at January 14, 2008 3:00 PM

Sounds like your memory is working to me.

Posted by: Paul Hrissikopoulos at January 14, 2008 3:03 PM

I'm sorry you have been so disturbed the last few days, Amy - no one should have to go through that.

Just because it's healthy to focus, I'm glad you are going ahead to pursue these drugs and the regimen for them. I think you will be surprised at how badly the medical and gov't oversight can be.

I got a tetanus vaccine recommended by my dr. at Kaiser 3 months ago. The CDC (highly recommend you go there first, because they are the ones who tell Kaiser, HMO's, all health clinics what to buy) put this on the market 2 years ago after it had been tested on only 2700 adolescents. Not only does it have tetanus bacteria, as a side (benefit???) it includes bacteria for diptheria, not seen in this country for 7 years, and for whooping cough - rare in children, rarer in adults. In fact, as the CDC says in their open online report on this vaccine, the reason they include whooping cough bacteria in this shot is not because adults even get whooping cough - it's so hard to diagnose, they can't!- but because sick days off from work are an "economic problem."

Happy to have a fever for 3 days and pain in my arm for 3 months now from the pertussis (whooping cough) bacteria, so long as big businesses aren't impacted. I filed a grievance against Kaiser and am now going through the state. Btw, there is a special arm of the FDA that PAYS OFF patients suffering from vaccine problems. Because they a) don't work and b)have way too many side effects. Yes, I'll file with them, too (they even pay for lawyers! Suspicious, anyone?) but the pain has to last for 6 months.

Sorry this is so long, but obviously our own gov't has too much to do to watch health care.

Posted by: Donna B. at January 14, 2008 3:24 PM

So sorry to hear what you're going through, Donna.

I do have to say, I feel like a total weenie in light of what Cathy Seipp went through so bravely, including what chemo fog must've been like. But, there's a reason when Luke Ford suggested she and I mudwrestle that I never went for it (besides the fact that I don't do mud)...I'm a lightweight and she would've kicked my ass (probably while she had cancer, too.)

Anyway, I typically check out all medical procedures and advice before going through with them, but this was a bit unforseeable. I don't think the doctor is at fault -- I've talked to him repeatedly today, and I've researched Versed/midazolam a bit. The lady at Roche (now out of patent) was really something else.

ROCHE PHARM: 1800 526-0625

Woman answers phone. I say I'm calling about Versed. Woman says: “It’s No longer a Roche product…no longer on the market.”

ME: Really? They used it on me on Friday.

The woman puts on Sasha LoPiccolo – registered nurse for product information in Nutley New Jersey office of Roche.

She tells me she can't give me any information unless they take my name and address. I get the spelling of old Sasha's name, too, right down to the big P. Being as I wanted answers, I restrained myself from asking for her home address, too. Bitch. (For the record, I gave them my non-home address. I hope they're smarter than to start sending me crap in the mail.)

I ask why they don't make Versed anymore. She said they "discontinued it."

Why, I ask.

It was a "business decision."

(Maybe Sasha has memory loss from this drug, too!)

As for the drug used on me, she says Roche "didn't sell it" (to Kaiser). They "stopped making it."

Oh. Well who is making it?

Sasha has no information. She tells me to go to FDA.gov. How helpful.

I asked to talk to a press rep. She said she could give me their "corporate fax number" to "submit" a "request in writing."

Yeah? Or I could fucking google it, ya dumbass. (That took 5.6 seconds, even in my slightly befogged state.)

http://www.rocheusa.com/newsroom/contacts.html

Public Affairs Media Contacts For media issues, reporters may call: Corporate News and Information (973) 562-2699

Product News and Information:
(973) 235-5330

Hmm, getting bitchier...I think that's a good sign.

Back to old Sasha...somewhere in here I yank out of her the info that they don't have the patent on it anymore. It seems they must have used the generic midazolam on me.

I think this is the point where I got all pushy, wondering aloud, repeatedly, if maybe I got some old Versed, ie, what if Kaiser has some really old Roche Versed lying around? Hmm? Hmmm?

I'm sure Sasha would give several toes at this point to be rid of me. Suddenly, Sasha blurts out the date they stopped making Versed at Roche. 2001. Amazing powers of information recovery, Sasha, darling! Let's hope mine start working as swimmingly!

I hop on FDA.gov. I couldn't find the companies with any ease at FDA.gov.

She told me I had to search "orange book." I did. Still trouble.

Magic time! Sasha now manages to come up with a list (perhaps realizing that the best way to get my ass off the phone is to info-bribe it off).

Companies now making Versed, generic name Midazolam, courtesy of my new BFF Sasha LoPiccolo, at Roche:

Abraxis
Apotex
Baxter
Bedford
Ben Venue
Hospira
International Medicated
Taylor
Hi Tech
Taddock
Ranbaxy
Roxane

I call Kaiser and find out Baxter is the brand they used.

My doctor calls me back and reassures me further. I find out that he didn't give me the whole 3mg dose at once, but gave me some initially and then more when I "grimaced," and insists he'd be giving me the same advice (calm down, very unusual reaction, but it should wear off) if I were his sister.

Okay...well, let's hope tomorrow is a brand new, cognitively perkier day!

Lucky for me, I needed this week to work on my book, so I finished a column early. So much for working on my book, but at least I'm not in serious shit for Tuesday. Sigh.

Posted by: Amy Alkon Author Profile Page at January 14, 2008 4:16 PM

Btw, there is a special arm of the FDA that PAYS OFF patients suffering from vaccine problems. Because they a) don't work and b)have way too many side effects. Yes, I'll file with them, too (they even pay for lawyers! Suspicious, anyone?) but the pain has to last for 6 months.

I'm pretty sure the reason they do this is to encourage people to get vaccines because they do work. Of course, sometimes bad side effects still occur and by having a non-judicial remedy available lawsuits get avoided. Though why your doc gave an adult DPT vaccine is beyond me.

Posted by: justin case at January 14, 2008 4:25 PM

I don't want to sideline this into my situation, but perhaps it will help Amy in her research.

Justin, until now I had no opinion about vaccines, but thought the mothers that complained were kind of uptight and possibly ignorant. But now I've done my own research, for ME.

My dr put it this way: what if you were in a car accident and metal entered you? Scaremonger. Up to 90% of the population has a natural immunity to tetanus; it's not just in dirt, it's everywhere. Otherwise anyone who touched dirt on a vegetable would get lockjaw. Who makes the decision that because there were only 50 cases of tetanus last year everyone should have a vaccine? The drug companies. Like Amy, I looked up the company right away. I haven't decided yet whether to pursue it through them, because I want to see what the gov't says, and get my ducks lined up.

It turns out that vaccines are very cheap, and the drug companies can't make much money on them. (one time use, and all that.) So they sell them cheap to the CDC/health organizations, etc, and the gov't takes over all lawsuits so the drug companies don't have to! Which is why there is a whole part of the govt that pays off vaccine sufferers or even death.

There were over 18,000 complaints registered against T-Dap (not DPT, Justin - that's the old one!) last year alone, and I don't have the whole figure yet.

Amy, as I understand it, the FDA approves drugs, but somehow the CDC makes recommendations to states on what health care providers should buy - such as Kaiser. They also do their own independent testing. You might want to see what they said on Versed in their studies.

Posted by: Donna B. Author Profile Page at January 14, 2008 4:59 PM

Demerol! Par-tay!~

Anyway, working in retail takes a lot of brainpower if you're going to make any money, but in the event of permanent damage, you could probably get job in PR.

Posted by: Kate at January 14, 2008 10:23 PM

Let's just say I'm "too selectively nice" (ie, if you're shouting into your cell phone or you're accompanied by a loud brat I'll kneecap you) to last long in retail.

Posted by: Amy Alkon Author Profile Page at January 15, 2008 12:10 AM

I'll never forget my own experience w/Versed (almost 19 yrs ago for my 1st biopsy, I was 3 d away from college graduation so I declined general anesthesia); dr assured me I would remember none of it...
I REMEMBER EVERYTHING, I was just too high to care!
At one point the dr sharply rebuked the nurse: "DON'T swab that, that's her JUGULAR VEIN!"
& I broke out in laughter -- he nervously ordered another nurse to "give her more".
Oh fun fun fun!

Posted by: Val at January 15, 2008 10:00 AM

Amy, what a scary damned experience. I'm glad you're feeling at least somewhat better and hope you're well on your way to 100% (with no lasting damage). That last post of yours is a good sign you are. I'm gonna take hope from that.

Posted by: Donna at January 15, 2008 10:13 AM

I hate Demerol. I was given a shot of it while in labor with my older son and felt like a zombie after labor ended. I thought that was related to the labor not the Demerol. Fast forward 2.5 years and I am 9-months pregnant with a migraine. Kaiser tells me to come in to be treated for it, something about migraines are not good for pregnant women. They give me a shot of Demerol and 30 minutes later I was a zombie. It took me 2 days to recover and during those 2 days I was responsible for my 6-year-old stepsons and my toddler. Fun times were had by all.

Posted by: Kristen at January 15, 2008 10:21 AM

I'm glad to see that you made it through in one piece. :)

Posted by: Morbideus Author Profile Page at January 15, 2008 10:48 AM

How frightening, Amy! I'm so sorry for your ordeal. I'll be thinking of you this week (and not just because I'm in Paris, where we made a happy memory once!).

Posted by: Jackie Danicki at January 15, 2008 10:49 AM

Thanks so much, Jackie, and everybody.

I get uninentionally high every day around noon...although I do feel a little better each day. I'll try to visualize myself at Bar du Marché with you, Jacks.

In the mean time, when I can't write, I research this drug.

And yes, the fact that I'm getting back to bitchy is a very good sign.

Posted by: Amy Alkon Author Profile Page at January 15, 2008 11:05 AM

Amy,

"a goofy redhead with big boobs"

You could never be that, just so you know.


But I'd be happy to be that...and would appreciate it.

Let me know if there is anything you need. I'm just a short drive away.

Posted by: Moxie at January 16, 2008 10:09 AM

Aww, thanks, Mox.

I'm feeling better this morning.

I went down the block for a massage, to the woman who helped me when I was having trouble from typing. She worked only on my head for an hour, and it seemed to help. I'm going back Thursday. I'm an evidence-based medicine kind of girl, but I felt a real difference when I left her place, although I can't explain it. Perhaps it's just that massage is always good for you, and relaxing. She suggests that even though I was out on anesthesia, the procedure was extremely stressful on me, and I've been clenched up ever since, plus stressed out, and perhaps sending cortisol surges through my system because of it...and not unclenching.

Posted by: Amy Alkon Author Profile Page at January 16, 2008 10:39 AM

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