Anesthesia, Resuscitation, and ICU: Q&A

I’m scheduled for gallbladder surgery next week. I just got my thyroid hormone results back today, and my TSH is elevated at 6.75. My other two levels are within the normal range. Does this present any issues for the procedure?

Kevin Garcia12 said:Regarding local or regional anesthesia and procedures in general—yeah, you can pretty much do most standard operations under those types. I guess you just have to keep in mind they carry their own set of risks and complications. To be more specific, I’d need to know exactly what we’re dealing with, but aside from massive, complex surgeries involving the chest, major blood vessels, the heart, or deep abdominal work, there’s almost always a way to handle things while the patient stays awake...

It's an operation for a benign tumor in the middle ear area. "The CT scan shows a soft tissue mass filling the right middle ear's hypotympanum, starting from the cochlear promontory and extending toward the mesotympanum, near the tensor tympani muscle. Based on its location, it looks like a glomus tympanicum. We're also considering a cholesteatoma, though there doesn't seem to be any bone destruction."

At the end of the month, I’m scheduled for gastric sleeve surgery under general anesthesia. I have an appointment this Monday with the anesthesiologist to go over everything once more after all my preliminary exams—which I've been doing since July (everything from endocrinology and gastro to psychology... you name it). My chest X-ray came back perfect, EKG was great, endocrine tests were fine... everything seemed on track until my latest blood and urine work, where they found elevated CRP and white blood cell counts. My doctor thinks it's just a urinary tract infection, so she put me on a week of antibiotics. I'm wondering if this will cause any issues with the anesthesiologist's clearance? Up until now, through all these months of testing—including a stint in the hospital where they monitored my blood and urine constantly—I've never had a single sign of infection. Everything has always been perfectly normal until this moment. Do you think the anesthesiologist will still give me the green light?
I know it seems strange to see the anesthesiologist so far in advance of the actual procedure, but it's to sign the consent forms for a surgery like this... after that, I'll meet with a different anesthesiologist at the hospital once I'm put on a zero-calorie diet right before surgery.

I would love to hear your thoughts.

I know my situation isn't exactly the same as yours, but I saw my anesthesiologist this past Wednesday. I was also on antibiotics because of some nasty gum inflammation. She told me there was no connection between the two. But hey, you’re better off getting an answer from someone more qualified than me.

My apologies if this topic has already been covered somewhere—I just couldn't seem to track it down. Here is my situation: I was expecting my period about ten days ago, but it hasn't shown up, so I went ahead and took a pregnancy test myself... and it came back positive. Now, here is where things get complicated. On February 1st, I had to undergo surgery under general anesthesia to have some dental work done. Then, just five days ago, I went back in to have some dental X-rays taken. Does anyone know how risky this actually is for the baby? If you have any advice or insight at all, I would truly appreciate it.
thanks

Chris Howard3 said:Please forgive me if this topic already exists somewhere—I simply couldn't find it. My situation is as follows: I was supposed to start my period ten days ago, but I haven't yet—and I just took a test that shows I am pregnant. Furthermore, back on January 2nd, I underwent surgery under general anesthesia to have some dental work done. Then, just five days ago, I had dental X-rays. Does anyone know how dangerous this might be for the baby? If you have any advice at all, I would truly appreciate it.
thanks

You really should contact an OB-GYN as soon as possible. They can date the pregnancy and, based on that—along with the specific medications used during your procedure and the exact amount of radiation exposure from those X-rays—they will be able to give you much more informed advice.

Thanks for getting back to me. I actually called my OB-GYN to explain the whole situation, and she told me to come in this Friday for a full exam. Honestly? I am incredibly anxious about all of this—between the various medications and the idea of being put under, it’s a lot to process. On top of that, I’ve been on Citalopram for anxiety for about a year now—though, to be fair, for the last three months I’ve only been taking 0.5 mg every third day—so I have no idea if that could potentially harm the baby either.

Chris Howard3 said:Thanks for getting back to me—I actually called my OB-GYN and explained the whole situation, and she wants me to come in this Friday for an exam. I am honestly quite worried about all these medications and the idea of being put under—especially since I've been on Citalopram for anxiety for a year now. Though, for the last three months, I’ve only been taking 0.5 mg every third day, so I really don't even know if that could harm the baby.

I completely understand why you're feeling anxious—it's a lot to process—but please try to stay calm until Friday arrives.
It is vital to get that exam done so the pregnancy can be dated as accurately as possible; once that happens, your doctor will be able to provide much more concrete information and guidance.
Best of luck!

Thanks so much, everyone 🙂

Honestly, aside from giving you an idea of how long the pregnancy will last, your OB-GYN isn't going to have any profound insights on that specific topic. There just isn't much more they can do. The only real thing is to keep a close eye on the pregnancy and how the baby is developing.

From what I've seen, there’s really no reason to spiral. Don't let all those old wives' tales get under your skin. It's worth noting that even medical professionals sometimes pass along those myths, so if you feel like someone is just trying to scare you, honestly, just tune them out. So many women run into some kind of "scary" situation early on—you aren't some weird outlier or anything. Getting a tooth pulled or having dental X-rays done is about as risky for the baby as walking past a massive electrical substation on your way home from work every single day...

What I'm trying to say is, don't panic. You still need to see your doctor, tell them everything, and follow the schedule, but you'll manage this pregnancy just like anyone else and everything is going to be fine...

Good luck!

Donna Brooks18 said:I’m scheduled for gastric sleeve surgery under general anesthesia at the end of the month. I have an appointment with the anesthesiologist this Monday to prep everything after all my checkups—which I've been doing since July (endocrine, gastro, psych, you name it). My chest X-ray was perfect, EKG was great, endocrine stuff is fine... everything seemed totally normal until the last round of blood and urine tests. My CRP and white cell counts came back elevated. My doctor thinks it's just a UTI and put me on antibiotics for a week. I'm wondering if this will be an issue when I meet the anesthesiologist. Up until now, I haven't had any infections, even when I spent some time in the hospital for testing where they were monitoring my blood and urine constantly... everything was always clear before. Will the anesthesiologist clear me to move forward?
I know it seems weird to have such a long consultation before surgery, but it's really just about signing the consent forms for a procedure like this... after that, I'll just see the anesthesiologist again at the hospital once I'm on the liquid diet right before the operation.

let me know what you guys think

Honestly, there isn't much point in me trying to play doctor here; you just have to wait and hear what the professional says. If he gives you the green light, you're good to go... but if he says it's better to wait, then you really should listen. Since this isn't some emergency procedure, there's absolutely no reason to rush things if your body isn't ready.

By the way, regarding those high CRP and white cell counts... the part that worries me most is that you mentioned being in the hospital for testing recently.

Scott Allen10 said:I don't feel like playing the expert here; I'd rather just wait and see what the doctor tells you. If they say it's okay... then it's okay. If they say better not... then better not. Since we're talking about a cold procedure, there's really no point in forcing anything...

By the way, looking at this whole situation with your elevated CRP and white blood cell counts... the part that bothers me most is that you spent some time in the hospital undergoing tests...

Thanks... the anesthesiologist is all sorted out.

But now there's a new headache... first, because of that strike, I had to wait two and a half months just to get seen by a specialist to find out if that pancreatic tumor was benign or malignant... fine, it's benign... but now... just imagine... due to shift changes, they aren't even accepting my specific type of surgery anymore... the nurse actually told me, "Ma'am, only the stars know when you'll finally get operated on!"... I'd love to know who's going to pay for my psychotherapy after all this, considering the 2.5 months of pure anxiety I already went through the first time, and now God knows how much more...

So, I finally went in for my checkup, and the doctor basically gave me the classic "we can't guarantee anything" speech—you know, the one where they play both sides of the fence by saying everything *might* be fine while leaving the door wide open for things to go sideways? They essentially left the whole decision up to me, which, if we're being honest, doesn't exactly make me feel any more enlightened than I was before. So, thanks for nothing, I guess—I'm still just as stuck in limbo as I was yesterday. Thanks for all the advice, though, truly.

Hi everyone,

I’ve had two general surgeries before, and honestly, anesthesia always hits me hard. I have a septoplasty scheduled for March 4th, and I’m already starting to panic at the thought of being stuck vomiting for hours while dealing with nasal packing... Basically, a nurse from another department mentioned there might be an anti-nausea injection I could ask for. Is that actually a thing? I haven't had my consultation with the anesthesiologist yet, so I was wondering if anyone here has any insight?
LP

I’m in the same boat here. The anesthesiologist I saw during my consultation told me to just speak up once I'm actually in the OR if I want that administered. My concern is simple: will there even be a window of time to bring it up? And more importantly, what exactly are we talking about here? Thanks.

electricangler32 said:I'm wondering about this too. The anesthesiologist I saw during my checkup told me to just ask for it once I'm actually in the OR. But honestly, will there even be enough time for that? And what exactly does it involve? Thanks!

They really ought to include that in the prep notes. Last time I had an ENT procedure, they listed all my meds and prep instructions right there, but I didn't know about this back then. Next time, I’ll definitely ask them to put it in writing.

She didn't tell me directly because I had already grabbed the paperwork. She just said I could look for it once I was in the room. Honestly, I have no idea if I'll be able to pull off this presentation. There are still 12 days left until then.

electricangler32 said:She didn't actually write it down because I had already grabbed my paperwork. She just told me to ask once I'm in the room. Honestly, I don't know if I'll be able to pull this off. There are still 12 days left until then.

It’s actually pretty chill once you get to the hospital—you aren't usually rushed right away (at least in Rhode Island, you typically wait a day or two). Just find the head nurse and let her know, or tell the doctor when they come by to check on you before the procedure. Make sure to emphasize it to them! 🙂

They told me to show up at 11, but the OP says noon. I’m going to follow the original instructions. Thanks!

electricangler32 said:They told me to show up at 11, but the OP says 12 AM. I'll just stick to that plan then. Thanks!

Aha, okay, fair enough. I'm heading through the hospital, so I'll probably just camp out there—plenty of time to kill while waiting for my turn. 😍But honestly, good for you! Just mention it politely; I'm pretty sure if you're going through a private clinic, they won't give you any trouble about getting that. 🙂