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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Michael Bell on January 24, 2005, at 23:06:03
I would really appreciate some feedback especially from anyone who has undergone surgery while taking an MAOI, but all responses are welcome:
So, I am scheduled to undergo ambulatory surgery which will require general anaesthesia. The surgery is tentatively scheduled for February 14 (nice Valentine's day gift, huh?) It's no big deal, just need to remove a couple polyps from my vocal chords. However, I started Nardil about 3 weeks ago, so there are some concerns.
Anyway, I've read numerous studies from fairly reputable sources which concluded that surgery and anaesthesia posed no risk to individuals taking MAOIs. On the other hand, a lot of other material out there (which tend to be older material with outdated food restriction lists) advises discontinuing about 10 - 14 days prior to surgery. I'd rather not do so, but I will if need be. I need to make a decision quickly, since the surgery is coming up in 3 weeks.
Any suggestions? Anyone else with similar experiences? Anyone well versed in this particular issue? Thanks, folks.
Posted by cubbybear on January 25, 2005, at 3:53:04
In reply to MAOIs and SURGERY!!! - need input please, posted by Michael Bell on January 24, 2005, at 23:06:03
I raised this very difficult issue last year (2004). I think if you look under the thread Parnate and anaesthesia, you'll see it. Unfortunately, there's a lot of contradictory info going around about MAOIs and general anaesthesia. It appeared to me that there are at least a couple of anaesthetics that can be used safely along with a heavy-duty benzo hypnotic called midazolam. My questions involved anaesthesia during a colonoscopy procedure, when it's definitley OK to be partly awake. But it sounds like your case would call for being zonked out totally. My only advice is to go through Psychobabble archives to see what you come up with, as well as Google. Also make sure that your anaesthetist is well-acquainted with MAOIs and that your BP is being closely monitored throughout the operation. If anyone else can obtain more definitive info on this subject, PLEASE post, because some of us really want to know the specifics of what's OK and what isn't.
Posted by johnsmith12345 on January 25, 2005, at 3:54:16
In reply to MAOIs and SURGERY!!! - need input please, posted by Michael Bell on January 24, 2005, at 23:06:03
It depends on what drugs will be used for the anesthesia. You should contact the surgeon to get this information, only then will you be able to find out if it is okay.
Posted by Optimist on January 25, 2005, at 11:50:33
In reply to MAOIs and SURGERY!!! - need input please, posted by Michael Bell on January 24, 2005, at 23:06:03
Feb. 14, what a coincindence. That's when I'm supposed to be starting my Parnate. How romantic. :)
I'd think the best thing to do is to talk to the surgeon and anaesthesiologist if possible, since they are the one's that will be taking care of you.
All the research won't make a difference if they're not comfortable with an MAOi I'd think. Although it would be nice if you abated their fears by presenting them with research stating it's ok. You'll only know by asking.
Good luck.
Brian
Posted by Willyee on January 26, 2005, at 2:46:20
In reply to MAOIs and SURGERY!!! - need input please, posted by Michael Bell on January 24, 2005, at 23:06:03
> I would really appreciate some feedback especially from anyone who has undergone surgery while taking an MAOI, but all responses are welcome:
>
> So, I am scheduled to undergo ambulatory surgery which will require general anaesthesia. The surgery is tentatively scheduled for February 14 (nice Valentine's day gift, huh?) It's no big deal, just need to remove a couple polyps from my vocal chords. However, I started Nardil about 3 weeks ago, so there are some concerns.
>
> Anyway, I've read numerous studies from fairly reputable sources which concluded that surgery and anaesthesia posed no risk to individuals taking MAOIs. On the other hand, a lot of other material out there (which tend to be older material with outdated food restriction lists) advises discontinuing about 10 - 14 days prior to surgery. I'd rather not do so, but I will if need be. I need to make a decision quickly, since the surgery is coming up in 3 weeks.
>
> Any suggestions? Anyone else with similar experiences? Anyone well versed in this particular issue? Thanks, folks.
Within this year i had sudden pains and had to be rushed to the hospital to have my appendix removed.I had parnate in me at the time.Once there i was given right away a heavenly combination of anestetics demeroland two others possable ultram in i.v.I rember in a half awake daze i kept repeating im on a Maoi,im on a maoi,i seemed to be the only one concerned as the docters assured me there was no problem.
Surgery went and there was none.In fact i fell in love with that i.v tank,made me feel full of fuzz,wish i could keep it on my back like a ghost buster back pack.
Upon leaving i felt i now how a lot of medicine in me,i felt it in my whole body.Again i expressed the concern of taking my med when i went home,and again i was reassured.
Well they were wrong,after i got home and took my med,my head felt horrable,tight and painful,a bad feeling all around i cant rember exactly what but it was certain it was not agreeing with the meds in me.
The next day i went cold turkey on my med,and used small doses of klono through the day,once the anestia no longer felt active,i re started my med,and it was back to normal.I literally couldfeel the hospitals meds in me,and should have listened to my gut insticnt and waited a day for it to subside,i only took parnate upon such strong reassurance.For me if i had not taken any the day of surgery,and gave one day off to let the meds leave my body,i would have been fine overall.I was not comfortable at how quickly they dismissed my Maoi use,either they knew what they were doing,or they were horrificaly careless.
I will tell you this,they popped that appendex out without a hitch.
Posted by ed_uk on January 26, 2005, at 14:41:51
In reply to Re: MAOIs and SURGERY!!! - need input please, posted by Willyee on January 26, 2005, at 2:46:20
Hi,
>Well they were wrong,after i got home and took my med,my head felt horrable,tight and painful,a bad feeling all around i cant rember exactly what but it was certain it was not agreeing with the meds in me.
What drugs did they give you to take home?
Ed.
Posted by Willyee on January 26, 2005, at 23:07:20
In reply to Re: MAOIs and SURGERY!!! - need input please » Willyee, posted by ed_uk on January 26, 2005, at 14:41:51
> Hi,
>
> >Well they were wrong,after i got home and took my med,my head felt horrable,tight and painful,a bad feeling all around i cant rember exactly what but it was certain it was not agreeing with the meds in me.
>
> What drugs did they give you to take home?
>
> Ed.I dident take anything when i got home,however i had a 3 day stay and my body was full of anestethics which i was given round the clock for those 3 days,so my first day home i still could feel a good amount of the drugs instilled in my system.
Posted by cubbybear on January 29, 2005, at 3:44:26
In reply to Re: MAOIs and SURGERY!!! - need input please, posted by Willyee on January 26, 2005, at 2:46:20
Posted by Willyee on January 30, 2005, at 0:21:39
In reply to You're lucky to be alive after getting demerol (nm) » Willyee, posted by cubbybear on January 29, 2005, at 3:44:26
Thats a possability,but then again the same would be said through the past four years of use.
I found parnate alone ineffective very quickly,and for a long time have augmented it,and have done so with substances that are alleged no nos.
Honestly of every substance,whether nutrient,herb,or med,the only one i can agree for myself is a definitive no no is any ssri.
I have the occasional beer,which at times seemed to have a synergy with parnate.
Is this iresponsable,in many ways yess,BUT how and why should i put all my trust in an industry that has lied to me for five years,an industry that had me on at one point 5 different medications at the same time,an industry that took my money and showed little compassion,an industry that claimed drugs given to me would help,and instead had me not knowing who i was.An industry who prescribed mind altering drugs very quickly to me,at the age of 18,with little to no scientific method involved,but claimed there was.
An industry that denied me a medication i pleaded for,and when actualy obtained did help tremondously,this med that helped was refused upon me by various docters who claimed it would not help,i only shutter to think where id be had i kept on the cocktails i were given.
The basic foundation of theory on the dangers of Maoi interaction are sceintific and understandable,and have small number of cases to prove it.
I however like others have felt the evil pure evil of totaly untreated depression,or incorrect treatment of it,and it is not a life i would even want to live.
So i take my chances with parnate,why......cause this is a war,its fighting demons,and playing by the books,waiting weeks on end to see a doc for 5 min,is not gonna cut it for me,in war there are risks,the most i can do is research as best possable,be prepared for worst case scenerios,but i refuse however to adhere to any restrictions put forth by the same people who push zoloft,and explain its activity through means of a animated commercial.
Many of the no no substances have went well with parnate,caffiene for example is an option i often use with it,although im not fully recovered and doubt i will ever be,the methods i use allow me to work,and function 90 percent more efectivly then i did pre parnate,then i was a total mess even ending in the hosiptial for ohh 3 hours before i got outta there quick.
My feelings are i will either find something to get me where i want,or pass on due to an MAOI reaction,thats war,the only other side of the coin is to play it safe,and live a meaningless life filled with darkness and despair.
I see people so frightened to take Maois,now im not knocking anyone,that is not how i think,but i do wonder why a person feeling at the end of their rope,seeing a option would be frightened away by something as a dieatary restriction.
Playing it safe,and by the book usualy doesent bring forth dramatic results,overcomming depression requires a dramatic result,the demons wont let up or show mercy,so all aresenal to fight them is an option for me.
I hope this doesent sound forward,its actualy more of a general statment rather than a reply to your post,i also hope regardless of any posts everyone chooses their own path,i eat normaly on parnate,soy sauce is the only exception,i do everything normal,i personaly feel no limitations aside from the damn insomnia it causes.If i passed on today i know i never once gave in,and the strentgh it takes anyone with a severe emotional disorder to keep on keeping is an internal strentgh so great "normal" people could never ever begin to understand,good luck to all fighting your demons.
Posted by cubbybear on January 30, 2005, at 6:26:11
In reply to Re: You're lucky to be alive after getting demerol, posted by Willyee on January 30, 2005, at 0:21:39
> Your post has plenty of grist for conversation, agreement and vehement disagreement but I'm going to say only this:
1) I fully agree that the pharmaceutical industry is playing the game solely for its own profits. The health and well-being of people like us are not their prime concerns.
2) Despite what I might think of these companies, during the depths of depression or otherwise, I would not want to be so utterly stupid as to gamble my life with a supposed, life-threatening interaction of Parnate w/Demerol, dextromethorphan, SSRIs, high-tyramine cheese, or any other substance that is clearly a so-called no-no. If you enjoy living on the edge like that, well good luck, but this is exactly why the Psychobabble Board has disclaimers. Every so often someone comes along who enjoys spittting into the wind. I've always been a die-hard non-conformist and individualist but when it comes to playing Russian Roulette with my health and welfare, I'd still err on the side of caution, no matter what I think of GlaxoSmith Kline, Roche, et al.
Posted by up'n'down on January 31, 2005, at 23:46:09
In reply to Re: MAOIs and SURGERY!!! - need input please, posted by Willyee on January 26, 2005, at 23:07:20
When I started on Nardil, which is an MAOI, I was told not to mix them with Demerol and that surgery was not a good idea to have while on them.
I read some literature that suggested the fatalities that had occured during surgery were related to Demerol being given and not surgery as such.
By 2001, I was looking at having to have open heart surgery, with anesthesia time being 5 to 7 hrs. and very serious. The surgeons at Oregon Health and Sciences University hospital were going to go ahead and do surgery without taking me off Nardil. I was amazed this was so.
However, my body intervened and started to reacting adversely to the Nardil, and I had to go off of it pronto. It seems that the MAOI's are getting more respect and a more fair trail now, for which I'm glad. They helped me with a lot of problems.
Posted by cubbybear on January 31, 2005, at 23:55:48
In reply to MAOI's and surgery, posted by up'n'down on January 31, 2005, at 23:46:09
> The surgeons at Oregon Health and Sciences University hospital were going to go ahead and do surgery without taking me off Nardil. I was amazed this was so.
> However, my body intervened and started to reacting adversely to the Nardil, and I had to go off of it pronto.What do you mean that your body intervened and started reacting adversely to the Nardil?
Posted by Willyee on February 2, 2005, at 4:01:09
In reply to Re: You're lucky to be alive after getting demerol » Willyee, posted by cubbybear on January 30, 2005, at 6:26:11
Its all in perspective i suppose,to me living life with ill treated depression was playing russian rouletter.My mood was unstable,which made me come close to doing things i normaly wouldent,there were points where it got so bad i just felt a blank page in my mind and fear or value of life did not exist.
Although i still have my struggle,the way i approach my treatment now allows me to function,feel and know who i am,i understand your point and i of course dont recomend anyone doing anything as a result of a single persons experieance,but i felt my health was quickly fading when my sympotms were untreated,i dident eat,i was nervous on the road,i had break downs,it was extremly frightful.I understand peoples views on being cautious,but i do not live life on the edge,im pretty conservative,i just can not live with the horrid pain of depression,and in that regard only i am willing to take risks because my entire existense depends on it.
LOL I dont even ride rollercoasters no way.
> > Your post has plenty of grist for
conversation, agreement and vehement disagreement but I'm going to say only this:
>
> 1) I fully agree that the pharmaceutical industry is playing the game solely for its own profits. The health and well-being of people like us are not their prime concerns.
>
> 2) Despite what I might think of these companies, during the depths of depression or otherwise, I would not want to be so utterly stupid as to gamble my life with a supposed, life-threatening interaction of Parnate w/Demerol, dextromethorphan, SSRIs, high-tyramine cheese, or any other substance that is clearly a so-called no-no. If you enjoy living on the edge like that, well good luck, but this is exactly why the Psychobabble Board has disclaimers. Every so often someone comes along who enjoys spittting into the wind. I've always been a die-hard non-conformist and individualist but when it comes to playing Russian Roulette with my health and welfare, I'd still err on the side of caution, no matter what I think of GlaxoSmith Kline, Roche, et al.
Posted by up'n'down on February 11, 2005, at 2:38:27
In reply to Re: You're lucky to be alive after getting demerol » Willyee, posted by Willyee on February 2, 2005, at 4:01:09
I hope you will allow me to use your alias to direct this note to. I am guilty of using one of those quick-fix lines when I didn't want to bore everyone with all the details. I am sorry-I shouldn't have done it.
What happened to me when I was taking Nardil was that I began to get tremors in my arms and jerks in my legs; these symptoms kept getting worse, until I was continuously having what is know as myoclonic movements. I was unable to function, and the next step most likely would have been a seizure or seizures. My doctors thought it was probably Seretonin Syndrome. Since the next step was that serious and further steps coma, and death, I did not have anymore choice but to stop the Nardil so it could leave my system as rapidly as possible.
We are each unique individuals and have to have our meds tailored to our specific body metabolism. Just when we think we have the right answer, our body alters. I somehow started to retain too much seretonin.
I am also sorry I waited so long to answer your post, but I have had a series of Migraines [which incidently, were almost totally stopped by Nardil] and so I am incapicitated from 5-7 days at a time. I know being on the computer causes me to have them sometimes, so I stay off for awhile and then I'm back again.
UP'n'DOWN
This is the end of the thread.
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