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Awake for TVH and how to avoid being put under for 'convenience'? Awake for TVH and how to avoid being put under for 'convenience'?

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Unread 08-26-2010, 08:31 PM
Awake for TVH and how to avoid being put under for 'convenience'?

Okay, ladies, here's my issues: I HAVE to be awake for my surgery. Surgery is not an option if it requires me to be remotely sedated past ativan or similar. I could need a pacemaker put in and would actually choose death over the pacemaker if I had to be put under again to live.

(random question before I go tl;dr on you: Has anyone ever been awake but relaxed-with-drugs during a laparoscopic biopsy? Is it possible?)

I want to do a TVH using a spinal/epidural, but I read that someone on here talked too much during her surgery and they knocked her out for their convenience! D: I was adamant about not wanting general for my oral surgery and they put me completely under anyways without my consent... I would have a complete nervous breakdown if they did that to me for a major surgery! *cries*

Is there anything I could do to keep that from happening? I mean, short of writing all over the records "I WILL SUE IF YOU MAKE ME FALL ASLEEP" or something. I'm just so scared that after all the work I will likely have to do to be approved while away, they'll see my arms trembling and be like "Oh, she's too anxious, we have to sedate her/put her into general for her own safety (read: our convenience). I would be "too anxious" out of fear they're lying to me again and plan on knocking me out the second I let my guard down (which happened last time).

I realise I have extreme issues with this, and I know they're all related to abuse history from childhood and beyond, but I really can't deal with the idea that they might change their mind halfway through and put me into general. D: So, sisters, any tips? Here's what I have so far:

-find a good surgeon/anesthesiologist

-Don't talk to anyone at all once you're in the gown.

-Don't "help" the doctor do the surgery

-Act calm and don't go literally psycho on the professionals

-Smile, be polite, say you're excited and can't wait to see the uterus out of your body (before you get in there, of course! No talkint after that).

-Tell the anesthesiologist about previous sexual abuse, all of which involved being asleep or 'out of it', and promise that in the unlikely event you change your mind and want to be asleep/more sedated, you'll tell them right away.

-As the needle goes into your arm, sincerely thank the anesthesiologist for respecting your wish, stupid as you know it is, and that them not forcing or tricking you into anesthesia has made a huge positive impact on your life and you'll be forever grateful to have a caring anesthesiologist like them. Then, hopefully they'll feel too guilty to actually trick you and sneak the drugs in.

-Explain your previous severe reactions to pretty much all general anesthesia drugs and write on your records "NO GENERAL UNDER ANY CIRCUMSTANCES." (seriously, give me some pain relief and zofran and tie me to the table for open heart surgery if I start to die. My body will pass out on its own if it's that serious. It would be so much worse to wake up and discovered you actually almost died than to know as it's happening. D:

What else?

Side note: can you read a book, write on a netbook/piece of paper, or listen to music while they're working on you? Oooh or watch a movie with headphones on a small device?

I know I sound incredibly neurotic, but I'm just terrified. With my pituitary/endocrine problems I do NOT react well to GA at all and would seriously rather hemorrhage to death from my faulty uterus than be put to sleep again.
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Unread 08-26-2010, 09:45 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

Wow! It seems like you really need to work with a gyn and surgical facility that can help you handle your concerns - not everyone will be equipped to accommodate this request and you'll need to know in advance. This might also be a time to work with someone who can help you overcome the past issues that are probably contributing to your current stresses. I'd also suggest you look into finding a professional patient advocate who could help you navigate this difficult process, many hospitals can refer you to someone in your area. It will cost a few hundred dollars but it sounds like you might be willing to find the $$ considering how worried you are about the possibility of being put under.
Unread 08-26-2010, 10:31 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

Thanks for the suggestion! I'll definitely look into the patient advocate.
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Unread 08-26-2010, 10:36 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

First of all, with a spinal, your arm won't be twitchin' lol. Although I swore once that when I had my spinal, i could STILL FEEL MY TOE!!!! and if i can feel my toe, whatever you are fixin to do will be felt. I begged them <I was in tears> not to start yet because i just KNEW that toe was awake. I got some sweet laughter and they kindly told me that they were already halfway done, so they didn't think i would feel anything. I had a laugh and then i had a baby.

So I'm thinking you could get a spinal and any other anesthetizing meds w/o going under. SERIOUSLY talk with your surgeon and let them know what you WILL NOT do, and what is acceptable. And honestly, maybe it isn't possible to keep you awake. I actually thought about it as well, but then why? It will be a long, boring time from start to finish. I'd rather just be awake one minute and done the next.

I'm so sorry that you are having a more traumatic time that normal with this. Just talk to your surgeon and lay it out. This might actually be a new concept for him, and just assumes that no one would want to be awake for it.

Best of luck, and many blessings,
Unread 08-26-2010, 10:45 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

thanks. I was talked into "twilight sedation" by my oral surgeon because they were like, "Oh, it'll be boring! You don't want to remember it!" But they intended to put me into general anesthesia the whole time according to their paperwork. *rages* Considering what I had just been through a few weeks before that with my drink apparently getting something slipped into it, I couldn't handle waking up from them doing that when I told them I just wanted novacaine in the first place! and I'm still a complete mess months later.

I'm still on Ativan pretty much every day and I have trouble falling asleep and waking up calmly because of it. I need some procedures done but I'm such a basket case right now I literally could not do it if my life or someone else's life depended on it.

I have time, for now-- I can be on the depo shot a good while longer, enough to finish college (I'm a senior) and figure out what I'm doing before I get anything life-changing done. I'm just scared I won't be able to find a gyn to do the surgery because of my age, and then I won't be able to find one who does it while awake.

So the spinal affects your arms too? But not your breathing? Interesting. I'm honestly thinking epidural vs. spinal so I can be fully alert after it's over without the PCA.

I want local (spinal) anesthesia, and I want a relaxing agent in a very small dose BEFORE I go into the surgery but not during it unless I ask for it expressly.
Unread 08-26-2010, 10:57 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?


The spinal numbs you for the neck or top of the chest down. When you breathe it feels like someone is pushing on your chest, it has a heavy feeling to it. With the first kid, I got a morphine epidural, and absolutely felt it when they jerked my body all over the table. To clarify that potentially bone chilling picture of what happened, i just felt my body move positions, violently and repeatedly, but no pain.

Twilight sedation for my husband is actually just something to totally relax him (and blocks his brain for the day) but doesn't make him go out.

When I go in for IV sedation with the dentist, that is how it is described, twilight sedation. However, it knocks me down like a tranked elephant! I can count to 3, feel this rush of dizziness come and BOOM! I'm out for the count. Twilight sedation works different for different people.

I can't see your doctor or anesthesiologist being anything other than supportive and i can't see them not trying to work with you on that.

Unread 08-31-2010, 12:26 AM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

I had a spinal with sedation for my tvh. The anaesthesiologist told me I coukd be as awake as I wanted to be during the surgery.
Unread 09-04-2010, 06:13 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

I'm currently faced with the option of a hysterectomy and I too have contemplated having it done with an epidural and not GA. It's not that I'm scared of GA; I've had previous surgeries with GA and don't have any trauma associated with being knocked out. My wish for an epidural comes from a desire to be an active participant in giving up my uterus. I feel that instead of going to sleep and having this amputation happen to me, I'd rather be awake and aware and a part of the process. Seems like it would be far less traumatic and violating that way.
Unread 09-04-2010, 06:17 PM
Re: Awake for TVH and how to avoid being put under for 'convenience'?

Totally agreed, Phenyxxfire! Between anesthesia trauma and sexual abuse involving substances I really, really just want to be awake for it.

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