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My father had a significant cognitive decline after two surgeries within 6 months of each other (Cardiac Ablation). The second surgery resulted in septicimia so

My father had a significant cognitive decline after two surgeries within 6 months of each other (Cardiac Ablation). The second surgery resulted in septicimia so the inflammation is definitely a factor but both me and my mother also noted decline after the first surgery. It was very obvious in term of decline, my father had trouble with doing some tasks on his computer (when he never did before having been an early adopter and programming some educational software for schools in the 80s), he no longer could concentrate enough when reading and became more extreme in his politics (he went from voting from the parti socialiste and being mostly center left to being very left wing). He also had less control over his emotions and would sometimes explode in a rage unlike anything he had before. He himself felt diminished mentally and that greatly bothered him during the last years of his life. On my side, I've refused general anaesthesia as much as I can because it scares me deeply. When I was a kid, I had an operation under general anaesthesia and I woke up with a very strong asthma attack, completely unable to breathe. Reading this, it does give argument towards my stance to asking for local anaesthesia as much as possible.

xhkkffbf 5y ago
Have you had much luck convincing doctors to go with locals? A doctor who did colonoscopies said that they needed to use a general for their own convenience. Everyone just went along and so that became the standard.
- PawBer 5y ago
  Having the patient awake is a liability. It's understandable that doctors don't want to take the risk.
- pge 5y ago
  Not OP, but I have convinced a surgeon not to use a general for shoulder surgery. I was fortunate to have had a previous surgery with a doctor that avoided general when he could, so I knew it could be done and that it worked well for me. To bolster my case, I found research papers showing that recovery from the surgery I was having was faster and better with a local nerve block + sedative instead of a general. The nurses tried to convince me I was wrong and making a bad choice, and the doctor would not do the surgery unless I agreed that he could use general if he felt he had to in the middle of the surgery. But then he did the surgery, did not have to use the general, and thanked me, because he said he was going to start doing more surgeries without general.
- spapas82 5y ago
  I don't think it's common to do general anesthesia for colonoscopy (or gastroscopy). Doctors do a minor anesthesia (intoxication) so you sleep while the operation in performedbut that's not a general anesthesia. In a general anesthesia you can't breath on your own so they stick a tube in your mouth. And it needs a special doctor (anesthesiologist) to perform the general anesthesia.
  - typh00n 5y ago
    I am curious: I had both my colonoscopy and gastroscopy while I was asleep. (On one procedure I woke up in the middle of it however. It felt like beeing drunk :-)) After the hospital I was happy and relaxed for the rest of the day. There was no anestesist (extra doc) present in the procedure, so I assumed it was no general anesthesia. But I dont know. Was it?
    - sseagull 5y ago
      I have had some gastroscopies done. For me they used some lidocaine (intravenous) and then propofol. This was done by a certified nurse anesthetist. I don’t know the distinction between that and “general” anesthesia (they called this general), but I know there are different levels (and there was no need for breathing assistance at that level).
    - spapas82 5y ago
      No it was not general anesthesia. I've had general anesthesia for a hemmorhoids surgery and it was a completely different thing than the intoxication I got for colonoscopy/gastroscopy! General anesthesia is a big deal both for the patient and for the doctors/hospital.
- nostromo 5y ago
  Colonoscopies are no big deal. Do not let them put you under for them. They are odd/uncomfortable but not painful. As an added bonus the doctor can show you anything they find on the screen and answer questions.
  - azinman2 5y ago
    You don’t need to have general. You can have a sedative. Why you’d want to be awake for that I have no idea. Knock me out!
  - slkdk32 5y ago
  - magicalhippo 5y ago
    I've had one (just check, no biopsy) and while it was quite uncomfortable in a weird non-specific way at certain points, it didn't hurt. It wouldn't have occurred to me at all to ask them to put me under if there's a next time. And according to my SO, I'm rather pain intolerant. If you're doing a biopsy I can imagine it's something else.
- nonce42 5y ago
  I had no problem getting my colonoscopy without drugs, and I recommend considering this route. It's very cool to see what's going on—how often do you get to see your appendix? Discomfort was minimal; I get more pain from my abdominal workout at the gym. (Although I suspect my doctor was unusually good.) For the most part, it was kind of like watching a procedure on TV, with occasional reminders that I was the subject: "You're watching in Cramp-O-Vision!" It was nice to have zero recovery time and drive home.
- nicolas_t 5y ago
  I have actually refused to do a colonoscopy with a doctor who insisted on general and went to a different doctor who agreed to it. It's definitely a wasteful use of general anaesthesia.
- kwhitefoot 5y ago
  I had a colonoscopy a few years ago. I didn't need any anaesthesia at all. It was merely intermittently rather uncomfortable. I got the impression that this was perfectly normal and that Norwegian medics are much more reluctant to use anaesthesia of any kind and especially total anaesthesia than in many other countries.
- winrid 5y ago
  Interesting. In my case they just lubed me up and went in LOL
rstuart4133 5y ago
> (Cardiac Ablation). I've had two ablation's myself. After the 2nd one I suffered a stroke. It had no lasting effects I'm aware of, but that's just luck. Heightened stroke risk is a well know is a side of ablation's. In the week or two after they are done tend to spin off clots, and that's when mine happened. However, to put that risk into perspective, stroke is also a well known side effect of the thing ablation's treat - arrhythmias. Unlike the risk from ablation's, the risk caused by arrhythmias goes on for life, and goes up as they get worse over time - which they almost inevitably do.

xhkkffbf 5y ago

Have you had much luck convincing doctors to go with locals? A doctor who did colonoscopies said that they needed to use a general for their own convenience. Everyone just went along and so that became the standard.

PawBer 5y ago
Having the patient awake is a liability. It's understandable that doctors don't want to take the risk.
pge 5y ago
Not OP, but I have convinced a surgeon not to use a general for shoulder surgery. I was fortunate to have had a previous surgery with a doctor that avoided general when he could, so I knew it could be done and that it worked well for me. To bolster my case, I found research papers showing that recovery from the surgery I was having was faster and better with a local nerve block + sedative instead of a general. The nurses tried to convince me I was wrong and making a bad choice, and the doctor would not do the surgery unless I agreed that he could use general if he felt he had to in the middle of the surgery. But then he did the surgery, did not have to use the general, and thanked me, because he said he was going to start doing more surgeries without general.
spapas82 5y ago
I don't think it's common to do general anesthesia for colonoscopy (or gastroscopy). Doctors do a minor anesthesia (intoxication) so you sleep while the operation in performedbut that's not a general anesthesia. In a general anesthesia you can't breath on your own so they stick a tube in your mouth. And it needs a special doctor (anesthesiologist) to perform the general anesthesia.
- typh00n 5y ago
  I am curious: I had both my colonoscopy and gastroscopy while I was asleep. (On one procedure I woke up in the middle of it however. It felt like beeing drunk :-)) After the hospital I was happy and relaxed for the rest of the day. There was no anestesist (extra doc) present in the procedure, so I assumed it was no general anesthesia. But I dont know. Was it?
  - sseagull 5y ago
    I have had some gastroscopies done. For me they used some lidocaine (intravenous) and then propofol. This was done by a certified nurse anesthetist. I don’t know the distinction between that and “general” anesthesia (they called this general), but I know there are different levels (and there was no need for breathing assistance at that level).
  - spapas82 5y ago
    No it was not general anesthesia. I've had general anesthesia for a hemmorhoids surgery and it was a completely different thing than the intoxication I got for colonoscopy/gastroscopy! General anesthesia is a big deal both for the patient and for the doctors/hospital.
nostromo 5y ago
Colonoscopies are no big deal. Do not let them put you under for them. They are odd/uncomfortable but not painful. As an added bonus the doctor can show you anything they find on the screen and answer questions.
- azinman2 5y ago
  You don’t need to have general. You can have a sedative. Why you’d want to be awake for that I have no idea. Knock me out!
- slkdk32 5y ago
- magicalhippo 5y ago
  I've had one (just check, no biopsy) and while it was quite uncomfortable in a weird non-specific way at certain points, it didn't hurt. It wouldn't have occurred to me at all to ask them to put me under if there's a next time. And according to my SO, I'm rather pain intolerant. If you're doing a biopsy I can imagine it's something else.
nonce42 5y ago
I had no problem getting my colonoscopy without drugs, and I recommend considering this route. It's very cool to see what's going on—how often do you get to see your appendix? Discomfort was minimal; I get more pain from my abdominal workout at the gym. (Although I suspect my doctor was unusually good.) For the most part, it was kind of like watching a procedure on TV, with occasional reminders that I was the subject: "You're watching in Cramp-O-Vision!" It was nice to have zero recovery time and drive home.
nicolas_t 5y ago
I have actually refused to do a colonoscopy with a doctor who insisted on general and went to a different doctor who agreed to it. It's definitely a wasteful use of general anaesthesia.
kwhitefoot 5y ago
I had a colonoscopy a few years ago. I didn't need any anaesthesia at all. It was merely intermittently rather uncomfortable. I got the impression that this was perfectly normal and that Norwegian medics are much more reluctant to use anaesthesia of any kind and especially total anaesthesia than in many other countries.
winrid 5y ago
Interesting. In my case they just lubed me up and went in LOL

rstuart4133 5y ago

> (Cardiac Ablation). I've had two ablation's myself. After the 2nd one I suffered a stroke. It had no lasting effects I'm aware of, but that's just luck. Heightened stroke risk is a well know is a side of ablation's. In the week or two after they are done tend to spin off clots, and that's when mine happened. However, to put that risk into perspective, stroke is also a well known side effect of the thing ablation's treat - arrhythmias. Unlike the risk from ablation's, the risk caused by arrhythmias goes on for life, and goes up as they get worse over time - which they almost inevitably do.