A Dialysis patient emailed the KidneyBuzz.com Team at firstname.lastname@example.org, "I am scheduled for surgery and I am scared," he wrote. "I just read a story about a girl who woke up during her procedure. I am thinking of not going through with my surgery. How often does this happen and how can I avoid it?"
This is a very good question since patients with Chronic Kidney Disease and especially those on Dialysis, often require surgical interventions for Vascular Access and for medical problems related to comorbid (underlying) conditions. Patients will likely be surprised to learn that "in the United States alone, there are over 21 million surgeries each year that require general anesthesia, and about 1,050 patients will experience an episode of consciousness (waking up) during the procedure," according to IFLscience.com. The large news station, Cable News Network (CNN) noted, "Previous studies in the United States reported a far higher rate of one in 1,000 surgical patients." Let's be clear, this is still a rather rare occurrence.
Formally termed, "Accidental Awareness," is the terrifying phenomenon when patients can actually hear and feel surgeons cutting into them with no way to communicate that they are conscious. Carol Weihrer, experienced Accidental Awareness during eye surgery, "I could hear the surgeon telling his trainee to 'cut deeper into the eye,'" she said. "I was screaming, but no one could hear me. I felt no pain, just a tugging sensation. I tried to move my toes or even push myself off the operating table, but I couldn't move. I thought I was dying."
Sarah Thomas said that she was forced to endure 15 minutes of "agony" when she woke up during surgery, "I could hear the laser and clinical noises like staff moving about. Due to the pain, I knew where I was and that I had woken up. I was screaming inside my head and trying to move but I had no means of signaling that I was awake,” she told the Daily Mail. She recalled waking up to pain. Her body had been strapped down before the procedure with her eyelids taped shut so Sarah could not alert doctors that she was awake, but "she felt everything." Thankfully, a nurse said, “I think she has woken up,” according to Thomas and put her back to sleep.
CNN reported, "awareness was most likely to occur when patients were being put to sleep before surgery started or after the surgery had ended." However, forty-one percent (41%) of patients who awoke mid-surgery were psychologically damaged for years after, suggested Medicaldaily.com. Dr. Morris Brown (Chair of Anesthesiology at Henry Ford Hospital) mentioned that those at highest risk of Accidental Awareness are "critically ill patients" who come to the operating room for cardiac and other emergencies.
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Still, Anesthetists (a medical specialist who administers anesthetics) don’t always find out about patients becoming aware while under anesthesia, for a few reasons. One is that some patients are not distressed at all by the experience and don’t think to tell their Anesthetist. Others want to take the time to be sure about whether they remember anything before they tell their doctors.
While rather rare, this is a very complicated situation. If you are concerned about waking up during your surgery try to avoid Anesthetists who are early in their training. Also, ask your surgeon about nerve stimulators, which would monitor the body’s state of paralysis. This could lessen the amount of medication required, granting the patient the freedom to move if they regain consciousness.
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