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 Upcoming Surgical Procedure 
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Joined: Wed Sep 30, 2009 8:25 am
Posts: 227
Post Upcoming Surgical Procedure
Looked for this in previous topics but couldn't find it. My MIL will have to have a lesion on her calf removed. Depending on what type of skin cancer it is (biopsy in two weeks), the doc will determine whether or not it will be removed with local or general anesthesia (if muscle needs to be removed and reconstruction is involved). What are the risks to LBD patients who undergo general anesthesia? What do I tell the docs? I saw a general blurb on the fact sheet. Help! I don't want my MIL to have a major set back. She's having a hard enough time as it is.

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Sat Nov 13, 2010 9:47 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Upcoming Surgical Procedure
There should be a post here about preference being given for spinal blocks or regional blocks over general anesthesia. (Do a search of "regional block" and I'm sure you'll find it.) If general anesthesia is required, I believe the preference is for IV meds and conscious sedation (via Versed, for example) rather than inhaled anesthesia.


Sat Nov 13, 2010 10:27 pm
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Joined: Wed Sep 30, 2009 8:25 am
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Post Re: Upcoming Surgical Procedure
Thanks. Just trying to be proactive here and not make assumptions that plastic surgeon knows all this.

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Sun Nov 14, 2010 12:11 pm
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Joined: Wed Dec 30, 2009 1:46 pm
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Location: WA
Post Re: Upcoming Surgical Procedure
My husband had Versed when he had his colonoscopy earlier this year and he did fine with that. Prior to that one, I was pretty ignorant about these things and didn't even ask. :-( Hope the surgery goes well.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sun Nov 14, 2010 12:50 pm
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Re: Upcoming Surgical Procedure
If your family member has OH (orthostatic hypotension), that adds another discussion topic to be reviewed with the anesthesiologist.


Sun Nov 14, 2010 5:15 pm
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Joined: Wed Sep 30, 2009 8:25 am
Posts: 227
Post Re: Upcoming Surgical Procedure
@Robin - She does have blood pressure issues with sudden drops and passing out, and medication barely helps anymore. I will certainly bring this up at her biopsy appointment. Thanks.

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Mon Nov 15, 2010 8:30 am
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Location: SF Bay Area (Northern CA)
Post Re: Upcoming Surgical Procedure
It's critical the anesthesiologist knows about the OH, especially if it's associated with supine hypertension. Fluids are a key concern.


Mon Nov 15, 2010 1:33 pm
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Joined: Wed Sep 30, 2009 8:25 am
Posts: 227
Post Re: Upcoming Surgical Procedure
Just found out today that my MIL needs more surgery on her leg to remove the entire skin cancer lesion. This will entail general anesthesia. I have an appointment with the anesthesiologist and I will give him/her a packet with Lewy info. The doctor is prescribing Vicodin for pain. Anyone out there have any experience with this pain drug?

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Wed Dec 22, 2010 3:28 pm
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Post Re: Upcoming Surgical Procedure
OK. Found some older posts about Vicodin. Doesn't make me feel optimistic. Oy, vey!

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Wed Dec 22, 2010 3:40 pm
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Joined: Sat Oct 06, 2007 4:28 pm
Posts: 728
Location: LA
Post Re: Upcoming Surgical Procedure
I was not familiar with the treatment "versed". Others may be the same so I am showing what I found:

Versed - an injectable form of benzodiazepine (trade name Versed) useful for sedation and for reducing pain during uncomfortable medical procedures
midazolam
benzodiazepine - any of several similar lipophilic amines used as tranquilizers or sedatives or hypnotics or muscle relaxants; chronic use can lead to dependency

DrP


Wed Dec 22, 2010 5:06 pm
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Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3345
Location: Vermont
Post Re: Upcoming Surgical Procedure
Can they do a spinal block or some other nerve block instead? My husband had to have a growth removed about 14 yr. ago at Mass. General and they blocked the nerves to the affected leg. That way he didn't have to have general anaes. which was great, and he had no pain at all. Recovery time was much shorter. Lynn

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Dec 22, 2010 5:12 pm
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Location: WA
Post Re: Upcoming Surgical Procedure
My husband did well with Versed for his colonoscopy but it probably wouldn't be adequate for a deep resection of tissue.

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Dec 22, 2010 5:44 pm
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
Post Re: Upcoming Surgical Procedure
When Don had his surgery, the growth went almost to the bone and was about the size of a walnut. He felt nothing and yet didn't need general. Maybe you can ask about this?

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Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Wed Dec 22, 2010 6:10 pm
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Joined: Tue Dec 23, 2008 8:52 am
Posts: 154
Location: Michigan
Post Re: Upcoming Surgical Procedure
When my husband had the squamous-cell carcinoma lesion removed from his vocal cord in January of this year, they also used versed and propofal. He was age 75 then. He came out of it good, but it took several hours to bring him out of it. Then in March he had a polyp removed from the same place on the vocal cord, using the same anesthetics - this one went much faster. Different surgical places and different Anesthesiologists.

I will keep her in my prayers.

Karen


Wed Dec 22, 2010 8:35 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Upcoming Surgical Procedure
If your MIL can tolerate the Vicodin for pain, go for it. Some can, some can't. The key is starting with a low dose, monitoring closely, and increasing the dose little-by-little.


Wed Dec 22, 2010 9:01 pm
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