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Author Topic: What are the effects of anaesthetics on the liver, and...  (Read 7992 times)

Offline OldDragon

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...can anything be taken to help detox that following surgery, please?

Having been given two general anaesthetics during the past six weeks, I have been saying that I feel toxic, and that my natural body chemistry and things like my biological time clock have gone haywire.

Please can someone explain this and what I might be able to do in order to address it from the physiological and medicine perspective?

Thank you. :)


 

Offline grumpy old mare

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What are the effects of anaesthetics on the liver, and...
« Reply #1 on: 21/06/2008 10:06:47 »
See here:

http://www.nda.ox.ac.uk/wfsa/html/u10/u1005_01.htm [nofollow]

http://bja.oxfordjournals.org/cgi/content/abstract/58/1/69 [nofollow]

and if I have understood this article (my understanding of scientific talk can be questionable...), this may be interesting for you re the pain after the ops and might be worth printing and talking about with your doctor:
http://www.nmdinfo.net/anesthesia%20&%20nmd.htm [nofollow]
 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #2 on: 21/06/2008 14:05:31 »
Jutta, those articles have certainly enlightened me considerably - and my understanding of scientific talk is probably a lot less than yours.

Lots of things leaped out at me in those articles and beginning with this from the first...
Quote
...the overall effect of both surgery and inhalational anaesthesia is to elevate blood glucose...

I even asked the district nurse if she would check my blood sugar levels, although a few days after the last GA.

I have asked for detailed information about exactly what anaesthetic and other drugs were used on me during and after surgery and when I wasn't in a position to know what they were doing.

It's a long time since I've had a liver function test and by the time the doctors started giving me those, I think the reasons they did so, would have manifested themselves as presenting symptoms long before. ;)

That last article... WOW! The anaesthetist for the first op was more concerned about my obvious hayfever/asthma and the fact that I'd been taking antibiotics for seven days pre-op to address a sinus infection than anything else, and ordered a chest x-ray before he was happy to proceed with that op. I had told him the infection hadn't progressed to my chest and had been jumped on and cleared with the antibiotics straight away.

I'll be interesting to discover whether the same  anaesthetic drugs were used for both ops - if I ever manage to get that information out of those concerned.

The muscle spasms were certainly considerably worse following the second op, but I'd just been putting that down to an increase in the inflammation in the area of my spine that was putting pressure on the nerve endings in that area and, in turn, triggering the spasms in my chest and diaphragm.

I haven't had a severe spasm now since the last one mentioned in the other thread on this forum, just a few minor and topical ones to that location, and that I have been able to tolerate and ease without recourse to medication of any sort. My ribcage seems to have now almost recovered from the sensation of having had broken ribs and being held in a vice, but I'm still aware of discomfort in the region of my diaphragm on the right side, which, coupled with the feelings that I've had of toxicity, led me to pose the questions that prompted this post.

Neither anaesthetist specifically asked me about neuromuscular diseases - but then, do what I have actually been diagnosed with equate to a neuromuscular disease? (Sero-negative poly arthropathy and Fibromyalgia.) Probably not!

Is something being missed? I don't know. I will, however, print a copy of the article, and this thread to date - and if you don't mind, Jutta - and pass it to my doctor.

The specialist nurse at the hospital has asked me to ask him for a referral to the pain management clinic at the hospital, so I need to contact him anyway.

I have mixed thoughts on the matter of pain management clinics, partly because 99% of the time when allowed to manage it myself, I've learned how to do so effectively and with minimal use of medication. However, when management of pain is, for whatever reason, taken out of my control, all hell breaks loose - oh, and the old dragon's reptilian brain wakes up and tries to take over! Lol
« Last Edit: 21/06/2008 14:07:39 by OldDragon »
 

Offline grumpy old mare

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What are the effects of anaesthetics on the liver, and...
« Reply #3 on: 22/06/2008 08:44:23 »
Quote
I'll be interesting to discover whether the same  anaesthetic drugs were used for both ops - if I ever manage to get that information out of those concerned.


They HAVE TO give you that information by law - well, they have to make proper notes in your patient notes and by law they have to let you read all of your 'patient notes' on request, so they cannot fob you off!!!

Sero-negative poly arthropathy and Fibromyalgia are probably not the 'neuromuscular diseases' they mean (like all sorts of 'sclerosis') - but on the other hand both are (to my limited knowledge) muscular probs due to neurological malfunctions - so not that 'far off' and could well be very similar with regard to general anaesthetics.

Pain management clinics don't necessarily come up with medication to help. At least I doubt very much that "my" consultant at the pain clinic here would prescribe anything if you don't want it. They are known to try alternative routes as well (like e.g. water therapy, osteopathy, ...), especially for patients that for whatever reason can't take certain medication. (But do talk to them about the anti-convulsant medication mentioned in one of the other threads)

And why should I mind if you print this thread? If it can help you - definitely go ahead!!
 

Offline Andrew K Fletcher

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What are the effects of anaesthetics on the liver, and...
« Reply #4 on: 22/06/2008 09:42:52 »
Save your urine produced during the night and fiorst thing in the morning in a clear tall jar. Tilt your bed raising it 15 cm's or 6 inches in real measurements :) Higher at the head end and repeat the urine collection.

Use a hydrometer to determine how much dissolved solutes are in your urine and compare the density and you should see some pretty convincing differences. Repeat over several days of sleeping flat and tilted and have your partner do the same just to confirm you are not imagining it. Colour, smell, clarity should be different, and if you remain unconvinced about the connection with gravity, renal filtration and detox, sleep head down and feet up one night. Now you will learn that solutes do not get filtered by the kidneys when we are upside down but remain in the body becuase the density of urine drops off to near water density.

Add to IBT some asparagus and a cup or two of nettle tea and you unleash an amazing detox assault on your blood.

http://www.newmediaexplorer.org/sepp/2007/04/12/medical_underground_inclined_bed_therapy.htm
« Last Edit: 22/06/2008 09:45:25 by Andrew K Fletcher »
 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #5 on: 22/06/2008 17:16:58 »
Thanks, Jutta and Andrew.  :)

At that bit of fun the other night, I was given some nettle tea to try, oddly enough, and also some of the homemade elderlower/springwater drink and sweetened a little with apple juice, as I prefer something a shade on the sharp side, rather than sweet drinks. I'd asked especially for the latter, as it's a favourite and refreshing. (I haven't drunk alcohol in over fifteen years.)

On the way home I fell asleep (in the front passenger seat), and although dozy when I got home (not a very long journey) I felt refreshed, but ready for more sleep as soon as I'd been to the bathroom  - and certainly seemed to have a lot of urine to pass. Slept really well after that and for a reasonable time, then felt better in the morning than I have for weeks. Nothing like as toxic. Slept well again last night, too.

Andrew, I'll be getting down to a local manufacturer of wooden hotel and bar furniture to see if their off-cuts box can provide a couple of 6" blocks for the bed, and must get those photos of the varicose veins sorted for you, too.  :) That's if they are visible enough with the oedema I seem to have acquired in my lower legs of late, and perhaps because I've not been able to take the usual small amount of walking exercise I'd normally manage.(And that 15st 2lbs from 14st in 6 weeks is scary - going in the wrong direction there, for sure!)

This village is useless for getting things like batteries for my scales, but feeling more mobile now, so aiming to get into town this week and get better organised - also back to work on Monday! Doing so little is getting to me now.. and yes, Jutta, I know I can be a workaholic. Lol (And that even from home and without a boss breathing down my neck, too!)

Presumably I can get a hydrometre from Boots or, if not, any clues, please? I can't even get asparagus in tins from the local Co-Op - the manager tried to order it in especially for me, but if it's not on their list... and I offered to buy a whole case if it was something that didn't sell well, too! I love the stuff.

Instinctively, I don't think sleeping head down would be a wise move for me, Andrew, even for experimental purposes. The very last thing I want to risk, is kicking my back off again.  :D

Re. my medical notes and so on, I can't help the feeling that some are afraid of what I might discover from those, or that they have something to hide? I have told them that I'm not looking for litigation or anything like that, simply answers to understand my own condition more. I only have part of the story, and no medical knowledge. It's like doing a jigsaw puzzle when only half the pieces exist.

When working in the prisons, it was my job to dig, and I knew instinctively when one of the lads there was trying to con me. (Often to con themselves too, but that's another story.) I also know that I don't deal well with many women, unless those like Jutta here, and who don't run away to bury there heads if they hear things that frighten then, hence only worked with men in that environment. I've worked with very few women on the outside, too. Just those who have come to me, and for the right reasons. The more those have hurt, the lower down into the gutter they have gone, the better - as long as they are prepared to go to any lengths to recover, then there is a chance I may be able to help them. Alas, they have to be that desperate even to approach me! Lol The only reason they will then is because they can identify with me, and then we both know where we are at.  ;)

This could be why I have problems dealing with some of the medical staff, who are oh, so careful over the way they phrase things to me when I start questioning things. That, if anything, makes me even more suspicious. What are they afraid of? I will TELL them where I am at long before I'm any physical danger to them. I have to trust them on medical matters, but they've given me little reason to do so in many ways. Crazy really, because we should be batting for the same side. I can learn as much from them as they could from me if we were.

One of the best compliments I have ever received happened when in a meeting of prison inmates some years ago, and I'd been firing both barrels trying to wake up a bunch of stunned, open-mouthed lads to themselves. When one finally found his voice he said something along the lines of... "My God! You aren't one of them, you are one of us!"

Breakthrough point finally reached!

The only difference being I'd never been caught or locked up, or quite tipped over that thin line that exists. Not quite - but I know it could happen, given a particular set of circumstances and something in my system that could knock out the instinct for self-presevation and/or logical reasoning etc. I've seen countless examples of people who haven't been so fortunate, and I don't take prisoners, not even myself. My job's to put the bits back together after the event or to try and stop them falling into bits in the first place. (And that includes my own!  :D )

It might be the truth that I do it voluntarily now, but the more honest answer would be that the government pays me to do so, and through various disability benefits.

It amuses me greatly on the occasions when I've approached their various staff at the 'back to work' initiatives to see what they might be able to offer me. On one occasion I was sent for assessment and given a variety of tasks along the lines of putting nuts onto bolts, or picking up shapes and fitting them into their respective holes, this to see what my physical dexterity and cognitive ability were capable of achieving! (Well, I do have some peripheral neuritis in my hands but really...?)

During those courses, there is a psychologist present who assesses one's suitability and fitness for work etc. It's at that point I get sent home, and usually both myself and the psychologist are chuckling. We both know there's a limit to how many and which square pegs can bet fitted into round holes and the other way around. (And we talk about governments wasting taxpayers resources?)

The best advice I was given by anyone at the job centre was to see what might be available online because they couldn't help me, and that after I'd asked about the availability of work from home. That was years ago, and they haven't sent for me for a review since... Sometimes, I wonder why not?  ;)

Why don't they look and ask what people with disabilities CAN do, instead of what they can't? Just because I struggle to get a nut screwed onto a bolt without dropping one or other bit, doesn't mean I'm incapable of getting another type of nut to attach and anchor itself to its own particular bolt. It's just a matter of delegation, surely?  ;) (And a bit of back-up from the experts in their own fields on occasions.)

The reality now is that I am probably too well rusted and fit only for the scrap heap in the government's eyes, but hey, even a 'Dead Woman Talking' just might manage to get through to one person without their ears stuffed with cotton wool one day, and who could make a difference? (And I always have been a stubborn chopsy cow, so what have I to lose in trying! Lol)  ;D
« Last Edit: 27/06/2008 11:53:12 by OldDragon »
 

Offline Andrew K Fletcher

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What are the effects of anaesthetics on the liver, and...
« Reply #6 on: 22/06/2008 18:55:36 »
Hydrometer from a homebrew stores but Boots may have one at twice the price :) get a tall one as these are easier to read than the stubby ones.
http://faculty.washington.edu/kepeter/119/images/urinalysis_tests.htm

 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #7 on: 22/06/2008 23:35:26 »
Thanks, Andrew. There used to be a little health foods shop down a side street in town that sold all manner of home brew stuff. Will see if it is still there when I can get into town. Need to take a planning application into the council's office nearby on Tuesday, so a good chance then, perhaps... ;)
 

Offline grumpy old mare

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What are the effects of anaesthetics on the liver, and...
« Reply #8 on: 23/06/2008 10:42:29 »
Quote
Re. my medical notes and so on, I can't help the feeling that some are afraid of what I might discover from those, or that they have something to hide? I have told them that I'm not looking for litigation or anything like that, simply answers to understand my own condition more. I only have part of the story, and no medical knowledge. It's like doing a jigsaw puzzle when only half the pieces exist.

Whether they are afraid or not - they have to let you see your notes. But they do not have to let you take the notes away. If you encounter any problem whatsoever, get hold of your local PALS person - if you still encounter problems, I'll organise for you to get all the relevant laws, rules and regulations so they won't be able to refuse anymore. OK? I'll come along, too, if needed! Just shout.

Quote
This could be why I have problems dealing with some of the medical staff, who are oh, so careful over the way they phrase things to me when I start questioning things. That, if anything, makes me even more suspicious

Give me five....
 ::)
 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #9 on: 24/06/2008 20:52:21 »
Giving you a seven, not a five... Weird day. You'll never believe what happeded in that little home-brew/health foods place... I though it was strange enough in the cafe at lunchtime and meeting someone like your team's Shaman, Jutta. Things just became stranger than ever after that! Still trying to get my head around it! ::)
« Last Edit: 25/06/2008 03:44:42 by OldDragon »
 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #10 on: 27/06/2008 11:37:08 »
Just to add here that I have been drinking a couple of cups of nettle tea for the past two days, and the sense of discomfort to the right of my diaphragm, and just inside and below my ribcage, has now eased.

Whether this was connected to muscle strain resulting from the severe muscle spasms spoken of previously, or had bearing on the levels of anaesthetics and medications left in my system following surgery and treatments, I don't know.
 

Offline Alan McDougall

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What are the effects of anaesthetics on the liver, and...
« Reply #11 on: 30/06/2008 18:33:00 »
Bad so you must avoid when possible
 

Offline Bored chemist

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« Reply #12 on: 30/06/2008 19:20:19 »
Can someone parse this "Bad so you must avoid when possible" for me please?
 

Offline Alan McDougall

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What are the effects of anaesthetics on the liver, and...
« Reply #13 on: 01/07/2008 08:13:20 »
[edit] Undesired Effects

[edit] Localized Adverse Effects
The local adverse effects of anesthetic agents include neurovascular manifestations such as prolonged anesthesia (numbness) and paresthesia (tingling, feeling of "pins and needles", or strange sensations). These are symptoms of localized nerve impairment or nerve damage.


[edit] Risks
The risk of temporary or permanent nerve damage varies between different locations and types of nerve blocks [1].


[edit] Recovery
Permanent nerve damage after a peripheral nerve block is rare. Symptoms are very likely to resolve within a few weeks. The vast majority of those affected (9297%), recover within four to six weeks. 99% of these people have recovered within a year. It is estimated that between 1 in 5,000 and 1 in 30,000 nerve blocks result in some degree of permanent persistent nerve damage [2].

It is suggested that symptoms may continue to improve for up to 18 months following injury.


[edit] Causes
Causes of localized symptoms include:

neurotoxicity due to allergenic reaction,
excessive fluid pressure in a confined space,
severing of nerve fibers or support tissue with the syringe/catheter,
injection-site [Hematoma] that puts pressure on the nerve, or
injection-site infection that produces inflammatory pressure on the nerve and/or necrosis.

[edit] General Adverse Effects
(See also local anesthetic toxicity)

General systemic adverse affects are due to the pharmacological effects of the anesthetic agents used. The conduction of electric impulses follows a similar mechanism in peripheral nerves, the central nervous system, and the heart. The effects of local anesthetics are therefore not specific for the signal conduction in peripheral nerves. Side effects on the central nervous system and the heart may be severe and potentially fatal. However, toxicity usually occurs only at plasma levels which are rarely reached if proper anesthetic techniques are adhered to. Additionally, persons may exhibit allergenic reactions to the anesthetic compounds and may also exhibit cyanosis due to methemoglobinemia.


[edit] Central nervous system
Depending on local tissue concentrations of local anesthetics, there may be excitatory or depressant effects on the central nervous system. At lower concentrations, a relatively selective depression of inhibitory neurons results in cerebral excitation, which may lead to generalized convulsions. A profound depression of brain functions occurs at higher concentrations which may lead to coma, respiratory arrest and death. Such tissue concentrations may be due to very high plasma levels after intravenous injection of a large dose. Another possibility is direct exposure of the central nervous system through the CSF, i.e. overdose in spinal anesthesia or accidental injection into the subarachnoid space in epidural anesthesia.


[edit] Cardiovascular system
The conductive system of the heart is quite sensitive to the action of local anesthetics. Lidocaine is often used as an antiarrhythmic drug and has been studied extensively, but the effects of other local anesthetics are probably similar to those of Lidocaine. Lidocaine acts by blocking sodium channels, leading to slowed conduction of impulses. This may obviously result in bradycardia, but tachyarrhythmia can also occur. With high plasma levels of lidocaine there may be higher-degree atrioventricular block and severe bradycardia, leading to coma and possibly death.


[edit] Treatment of overdose: "Lipid rescue"
There is evidence that Intralipid, a commonly available intravenous lipid emulsion, can be effective in treating severe cardiotoxicity secondary to local anaesthetic overdose, including human case reports of successful use in this way ('lipid rescue').[3] [4][5][6][7]


[edit] Hypersensitivity/Allergy
Adverse reactions to local anesthetics (especially the esters) are not uncommon, but true allergy is very rare. Allergic reactions to the esters is usually due to a sensitivity to their metabolite, para-aminobenzoic acid (PABA), and does not result in cross-allergy to amides. Therefore, amides can be used as alternatives in those patients. Non-allergic reactions may resemble allergy in their manifestations. In some cases, skin tests and provocative challenge may be necessary to establish a diagnosis of allergy. There are also cases of allergy to paraben derivatives, which are often added as preservatives to local anesthetic solutions.

Stub: Allergic reactions during anaesthesia

[edit] Methemoglobinemia
The systemic toxicity of prilocaine is comparatively low, however its metabolite, o-toluidine, is known to cause methemoglobinemia. As methemoglobinemia reduces the amount of hemoglobin that is available for oxygen transport, this side effect is potentially life-threatening. Therefore dose limits for prilocaine should be strictly observed. Prilocaine is not recommended for use in infants
 

Offline OldDragon

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What are the effects of anaesthetics on the liver, and...
« Reply #14 on: 02/07/2008 02:00:27 »
Thanks, Alan. :)

I'm hoping that my doctor wlll be able to succeed where I've failed in getting details of the drugs I was given in hospital. He is also interested to help ensre I'm not given anything in future whic may have been responsible for screwing up my system.

Found a big gap in my medical records and of over 20 years. [::) )
 

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What are the effects of anaesthetics on the liver, and...
« Reply #14 on: 02/07/2008 02:00:27 »

 

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