Question of major surgery and SJS/ot?

[eyeamdry]

I have written on here that I am having a total knee replacement in early November.  I had a partial knee replacement on the other knee 8 years ago.  In the past couple of years, it has become loose.  That, is not actually causing me problems at the moment.  The other knee has been bad for two years now and it's time for a full replacement.

8 years ago, I was younger (!!) and still had one good knee.  I also remember having trouble after my surgery with the throat tube they used.  My throat was all torn up and sore.  I got an infection and had to turn the hospital upside down in the middle of the night for some throat spray.  Thinking about this, I now believe I had SJS then and didn't know it.  Makes perfect reason for the problem with dryness.

I talked to my surgeon about this and he mentioned a SPINAL. I shudder when I say the word.  He said this might be the only way to go.  I have spend my whole life trying to avoid spinals and it looks like I might have to get one for this surgery.  Can anyone give me a good word on this?  Preferably someone who has had surgery after their diagnosis.  I sure hate to go against his advice, but the spinal brings me grief.  Thanks in advance.  If you've had a spinal and had your spine ripped out--don't tell me.  Lucy

[Joe S.]

Jan had a spinal. She did one knee at a time.

[Skylar]

If I had a choice, I'd chose Epidural Block. Ask if you can speak to the Anesthesiologist about the pros and cons.

I had both my kids as an abdominal C-section under Epidural Block - and I was thrilled. I prefer Epidural to Spinal Block as it's not quite as close to the spinal cord - some hospitals may not allow you to have this option because, and the rules may have changed, but at that time only an anesthesiologist could perform the epidural and had to remain in the OR the whole time. With the spinal, the RN anesthesiologist could remain in the OR freeing the anesthesiologist to supervise many surgeries.

After my surgery, last year, not only did I have a terrible sore throat from the intubation, but my lungs were affected by the General Anesthesia and felt twitchy and irritated for months afterwards - normally I would have gotten bronchitis and asthma but I think my diet protected me from that. General Anesthesia dilates your blood vessels so you will bleed more during surgery compared to blocks - that's a big plus for blocks. A general will leave you drowsy and feeling off for a day or two afterwards - where as with blocks immediately after surgery you will feel normal so you can be up and about quickly. I also had concerns with my eyes drying out too much while under - the anesthesiologist didn't want to put anything in my eyes to keep them moist - just taped them closed during surgery. And my lips and mouth were soooooooo dry after surgery OMG miserable.

The real problem with a block is if you lift your head and sit up too quickly - you can get a horrible headache. I think I had to lie on my back for an hour or so before I could sit up - I followed what the Dr said and never had a headache.

I know knee replacement surgery isn't fun - so I wish you all the best both for the surgery and the recuperation process.

[Scottietottie]

Hi Lucy 

I had an arthroscopy and then the partial knee replacement both done with a 'spinal'. If I ever need another replacement - I'll do it that way again. I never know how I'm going to feel after an anaesthetic but I know that sometimes it's pretty awful - and that in my case it can bring on depression as well.

The night before the knee replacement I was nervous so i didn't sleep. I ended up going to sleep during the op, which confused the docs a bit - but it suited me.

Good luck - whatever you decide.

Take care - Scottie 

[gurs]

Lucy,

I need surgery too, but dont think my body can handle all that.....cheez, from reading the other postings, maybe a spinal would be best?
I dont think anyone realizes how hard surgery is on SS patients..the extreme dryness and hypersensitivy reactions seem very common in us.
Surgery also seems to throw our bodies into flares of some sorts.

I dont know what im going to do either...just get as much info as you can first..did you ask our doc?

Gursie

[irish]

I am betting that an epidural block may not cause a deep enough anesthesia for the knee surgery.

Lucy, I know that you hate the spinals, and I have never had one myself. I would add though that I think I would have one if I had a chance to talk with anesthesia prior to the surgery.Ask to have them come in and talk about the choice you have to make.

I know that the first time Ihad magor surgery I was scared to death of anesthesia and asked for a spinal. They told me that I couldn't have one at that time. I finally said "go for it" on the regular general anesthesia and I was surprised at how well it went and how well I tolerated it.

Also, ask the anesthesiologist just what he can do during a general anesthesia that would make you more comfortable. Maybe humidity in the oxygen??? Eye gel for your eyes. Be sure to take it with you though and place your name on the tube.

Also, remind them that you need a lot of lubrication prior to being intubated as your mucous membranes are so dry. They are pretty good about doing things if you talk with them. There main goal is safety for the patient and relaxed muscles so that the docs can get at that joint easily. Good luck girl. Irish

[Scottietottie]

Irish - the epidural block was certainly OK for my knee surgery. Really could not feel a thing!

Take care - Scottie 

[eyeamdry]

I've read up a bit on the breathing tube and how it can leave you with a sore throat for several days after.  Well, that was me, miserable and couldn't swallow or talk after my surgery.  If I have the spinal, I don't need the breathing tube which would allow me to come out of it without my throat all ripped up.  I read about "normal people" having sore throat and I can add that with SJS it would be much worse.

Looking back 8 years, I believe I had SJS then and thus the problems with dry throat.  I was not diagnosed until 5 years ago.  I do like my doc, and it's the same one who did my partial.  I even go to a city 50 miles away I like him so much.  When I was in the hospital before, I was appalled at the care I received.  They put me on the portapot and left me in the middle of the room where anyone passing could see me.  They never came back for me.  Not sure who I got to help me.

I am planning to having a "sitter" stay with me both nights from about 10 pm until 6 am.  The hospital might be in better shape now, but I am not leaving this to chance.  My hubby will be with me during the day but the night is where it's sometimes hard to get help.  Not sure how much this will cost me, maybe $10/hour but the security I will have won't have a price on it.  I will probably go for the spinal, but don't mind if I whine on here.  Then after I will be able to tell if it was fine or..........not fine. lol.  Lucy

[warmwaters]

If you do go with a Spinal, please listen to the recommendations about not getting up too soon. The headachses that you can get with a spinal are ferocious.

[irish]

SCottie, Thanks for the info. I really did not know if the epidural was enough to deaden the pain plus get the muscle relaxation that they need.

Lucy, I am so glad that you are getting someone to come and stay with you at night. Don't hold your breath about things being better at the hospital. I watch them like a hawk when hubby and I are in the hospital. Also, leaving someone like they did you is absolutely uncalled for. I hope that you complained to management. So much for privacy issues. I hope they got all the privacy paperwork done for you. lol lol That is a joke Lucy!!!

Who cares what happens as long as you signed the @%#$ papers!!!! Go for the spinal if you feel so inclined. I will add that sometimes people are hard to intubate because of the shape of their trachea and also because the anesthesiologists can't get a person's neck hyperextended. Any arthritis, etc can cause problems with that.

Then, there are the docs who not as good at intubating as others are. Soooo, the dryness makes a huge difference along with a bunch of other variables. Irish

[gurs]

Each time I have to go the to the hospital, I take my own bag of everything. All my dry eye-mouth things, gum, lozenges, medications, supplements I need the most, washcloths....just be prepared sweetie,as Im sure you are.

Gursie

[Katybarstool]

Lucy

I had a spinal for my last bladder surgery, and I was so much better after it than after the previous GA. I also had sedation.

Wishing you all the best for your surgery.

Kathyx

[Doxie]

I had a spinal with IV sedation when I had my hip replacement. They put me under sedation, and so I know nothing about the spinal, other than the fact that they did it.  I liked it. They say you have less blood loss, and recover a bit easily. I think my body reacted better than when I have had general anesthesia.  My hip surgeon had recommended it, but gave me my choice.

I never thought about the tubing, but now with Sjogrens, if I don't have to have something down my throat, hurray!

Good luck deciding, but for me, when I get my hip redone - I'm going for the spinal again.