Sometimes the nightmare starts when you wake up.
Eight years ago Yvonne Coleman drifted off to sleep on a New York operating table as a team of surgeons prepared her for a two-hour surgery to remove an abdominal hernia.
“I remember the surgeon asking, `Are you ready kiddo?’
“`Ready for what?’ I thought to myself,” says Coleman who, at that point, wondered if her surgery was over and she was being awakened.
Then she felt a knife cut her open. “I felt every tug and pull. I heard them making fun of my weight. I heard them making plans for the Christmas party. But I was completely paralyzed,” she says.
“In my head I was screaming. I wanted to die.”
Any patient who’s lived through the horror of regaining consciousness in the middle of a surgical procedure will never forget the surgeon’s scalpel slicing their skin, the sight of their own blood, the smell of cauterized flesh and the business-as-usual conversations going on above them. Meanwhile, they lay still, unable to wiggle a finger, blink, cry out, or in any way indicate they’re awake.
Now, the victims of this rare and traumatic experience are the subject of a Hollywood thriller about their painful ordeal.
Awake features Hayden Christensen as a young husband who comes to during open-heart surgery, but who is also unable to move or talk.
Like other patients who’ve experienced intraoperative or anesthesia awareness, Christensen wakes up just as his complicated surgery is about to begin. Jessica Alba stars as his wife, and Terrence Howard plays a doctor in the film, which is set for release this fall.
He is being operated upon without benefit of pain-blocking anesthesia but, because he’s paralyzed, he can’t do a thing about it.
The movie’s premise is not so far-fetched, writes Dr. Beverley Orser, a professor with the University of Toronto’s physiology department, in the June issue of Scientific American magazine. Her article, Lifting the Fog Around Anesthesia, clears the air on the complicated subject of modern anesthetics.
“Anesthesiologists are not looking forward to (Awake) coming out at all,” says Scott Beattie, director of pre-operative assessment and clinical research for the University Health Network, and a professor at UofT.
“The public has become more aware of the possibility,” he says. “People are plugged in and they worry about it,” and some patients fear it’s unsafe to go under the knife.
Beattie is mainly speaking of the subgroup of patients who are most at risk: those who must receive limited amounts of anesthesia, such as high-risk cardiac patients, women having caesarean sections and patients whose doctors want them to awaken immediately after surgery.
Those who are regular users of narcotics or sedatives are also at risk. And trauma victims set for emergency operations also must receive a lighter than normal dose of anesthesia.
Carol Weihrer recalls waking up during eye surgery nine years ago. Weihrer, speaking from her home in Reston, Va., says her life was destroyed by the experience. She’s been anticipating the release of the film Awake since first hearing it was in production almost two years ago.
“Anyone who has experienced this personal horror is anxious for the movie to come out.”
Weihrer says she has spoken with people who have already seen the film in trial showings: “People in the audience absolutely scream.” Weihrer is convinced the film will bring international attention to her organization, the Anaesthesia Awareness Campaign, and her role as advocate for others who have woken up mid-surgery.
She is furious that nearly a decade after her ordeal, and despite years of campaigning, the problem has not been addressed.
Back in 1998 during an operation on her right eye, Weihrer regained consciousness but could not move. She heard the surgeon say to the resident, “Cut deeper, pull harder.” She was awake, paralyzed, and the surgery was far from over.
Weihrer says the trauma has left her unable to sleep lying down and she spends every night in a chair – sleeping for 90-minute intervals – terrified to let her brain relax into a deep, REM sleep.
Most studies suggest that, in adult patients, the possibility of waking up from a general anesthetic happens in one or two of every 1,000 surgical candidates. In North America, there are approximately 40 million surgeries conducted each year, says Weihrer.
Of those, 80 per cent require general anesthetic. According to those stats, between 100 and 200 patients wake up during surgery every day. Sometimes they’re only conscious for a few seconds. But in rare cases, where the patient is awake throughout the procedure, the post-traumatic stress can include a range of effects from sleeplessness to depression and even suicide.
Last April, the family of coal miner and Baptist minister Sherman Sizemore of Charleston, W. Va., filed a complaint after their father killed himself in the wake of his ordeal with anesthetic awareness. The Sizemore suit is the first of its kind – in which the family sues over the death of a loved one. Their case states Sizemore fell into a deep depression after his ordeal, despite having no history of psychological distress before his surgery.
Insult is added to injury when medical professionals, including anesthesiologists, dismiss patients’ claims that they were awake during surgery. As well, many victims don’t speak out, fearing doctors and nurses will think they’re crazy.
Advocates, including Weihrer, support the use of a monitoring device that measures brain waves and ultimately alerts the anesthesiologist when a patient is not completely under. A recent report on CNN estimated they’re found in only one in five U.S. operating rooms.
Few of the devices, which cost between $4,000 and $5,000, are available in Canadian operating rooms. But, says Beattie, “Patients are starting to ask for them. And I support them.”
Weihrer insists they are an important line of defence. “The technology has been proven in double-blind studies to be 82 per cent effective,” she says. “It’s not good enough to ask the hospital if they have it and if they use it. You have to ask, `Will you use it on me?’”
And Coleman, who has had other surgeries since the hernia operation, now insists on first meeting with her anesthesiologist. I make them promise never to cover my eyes. I want them to look at me.”
Source: The Star.com
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