Are there alternatives to general anesthesia?

EbonyEyes · October 2015

I was diagnosed with bc three months ago. I was supposed to have a mastectomy two months ago but it has been held uo for a thrid time because of a persistent case of pneumonia. The hospital my surgeon uses will not give general anesthesia to a patient with any kind of lung problem. My PCP tells me there is still time but I'm not reassured, especially since the pneumonia shows no signs of going away. The PCP mentioned something about a local but he mumbles terribly and is always in too much of a hurry to answer questions(Yes, I know I should find another doctor but it's hard to find one who will take Medicaid patients). Are there any alternatives to general? I'm not prepared to just wait my life away. I need a mastectomy, not a lumpectomy, and the surgeon said he is going to remove one lymph node for testing.

Tomboy · October 2015

EbonyEyes, I am very sorry to hear that. I don't know if there is an alternative, there must be. I always wondered what they used when the had to do surgery ro remove a lobe of somebody's lung, I mean, that is a major complication of a lung, but I know they do it. Have they at least started you on a hormonal, if you are estrogen positive? What are they doing about the pneumonia?

marijen · October 2015

my surgeon told me last week there is an alternative for one side I think he said about nine local shots and you stay awake. I'm getting GA it's easier

Tomboy · October 2015

Ebony Eyes, check out this lady. She was a wake! She took a picture! She is pregnant.https://community.breastcancer.org/forum/83/topic/835665?page=1#idx_6

Monis · October 2015

Tomboy, that lady just had a large tumor removed, she didn't have a mastectomy. But, perhaps there is an alternative for mastectomy as well.

Penzance · October 2015

Hi Ebony

There is an alternative. At Curie in Paris they have been performing single and double mastectomies under local anesthesia and hypnosis.

See

www.connexionfrance.com/Hypnosis-cancer-operation-...

curie.fr/anesthesie/innovation-patient-l'hypnose-chirurgicale-cancerologie-eviter-anesthesies-generales

Indications are patients who are elderly or frail, or who have health problems which make anesthesia tricky. Patients are usually pleased with the experience. They 'train' with the hypnosist before the day, and decide where they are going to 'travel' during the procedure. One of the guinea pigs had two single mastectomies, one with full anesthesia, the other with hypnosis: her recovery time with hypnosis was much shorter (less side effects from the drugs) and of course her stay in hospital was reduced. There are anesthesists at hand in case, for any reason, a full anesthesia is needed. They put a sheet between you and the 'operative field' (i.e. your fields)

Curie train surgeons from overseas, however I guess it might take some time before hospitals decide to add this method to their protocols.

Have been looking at that method for myself as last time I went under, I was knackered for a whole month (and developed a nasty cold which lasted 2 weeks) and really struggled at work (I was back in the office within 4 days).

Best wishes.

Kicks · October 2015

What about a 'spinal nerve block'? They are common for C -sections. I know C- sections are lower in the body but might be something to ask about. When I had wrist surgery 3 yrs ago, I had a nerve block for it and did not feel a thing.

It doesn't make sense to me that surgery can not be done when any lung issue is present as there is surgery done for lung cancer.

rainnyc · October 2015

There is a rather fascinating thread about paravertebral nerve blocks as an alternative to general anesthesia that is well worth the read:

https://community.breastcancer.org/forum/73/topic/...

EbonyEyes · October 2015

Thanks all for your suggestions. Most interesting, I am researching them all.

@Kicks:

The way they explained it to me, bc is very slow growing, some types are thought to NOT even spread beyond the breast(I have one of those types) so they would rather wait as long as they can. But lung cancer is aggressive and fast growing and spreads quickly. Some types can cause death in as little as two months. So they will take the chance because they simply don't have as much leeway.

solfeo · October 2015

I had a pectoral nerve block with propofol, with no pain or complications whatsoever. Propofol can be used as a sedative or as general anesthesia depending on how much. My anesthesiologist was going to let me do it awake but sedated, but I requested the knock out dose for the simple reason I didn't want to lie there for 3 hours. I think it probably would have worked out just fine even if I had been conscious, because I couldn't feel anything until the block wore off around 9 am the next morning, which was 23 hours after the surgery. My recovery has been remarkably easy, with no opiates needed for pain relief.

My surgeon didn't want to do it this way but I requested it based on what I learned in the thread rainnyc mentions a few posts up. Because my results were so good, now the BS says she will be offering the procedure to everyone who comes after me. Makes me feel like a bit of a pioneer!

Actually I asked for the paravertebral block mentioned in the other thread, but they didn't have anyone at that hospital with enough experience doing them, so we opted for pectoral block instead. Worked just fine. One advantage of the paravertebral/pectoral blocks vs. the thoracic epidurals some women are getting is that I didn't need a foley catheter. To me that was big, having read that urinary catheters are the number one cause of hospital infections.

labelle · October 2015

I've always been scared of general anesthesia. When I had tubal ligation done 20+ years ago my gyno used a drug called Versed to induce twilight sedation. Don't remember a thing and no problems with recovery. When I had my lumpectomy general anesthesia was used.

I had lots of problems, it took me more time than usual to come to (per surgeon), I suffered from nausea and had a sore throat and irritation from the tubing-on the whole, I had a very unpleasant experience with the general anesthesia.

When I got an infected seroma that needed to be opened up and drained surgically, I refused general anesthesia, requested Versed plus local anesthesia be used instead-the surgeon and anesthesiologist were accommodating, agreed to use a local plus Versed with some propefel instead of general anesthesia, although they reserved the right to use general if needed was during surgery. All went well and no general anesthesia was used and as with the tubal, I don't remember a thing. I'm not sure this will work for you or your surgery but it may be worth asking your surgeon and/or anesthesiologist about "twilight' or "conscious sedation" with local anesthesia only.

Are there alternatives to general anesthesia?

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