I am having the thymectomy (full sternotomy) done on February 18/09. I would like to know any questions I should ask at the pre-op appointment on Monday. I have heard that there are special considerations needed in regards to anesthesia and Myasthenia Gravis. Please share your knowledge on this subject.

For any of you who have had this surgery .... please tell me what I am in for. I am scared but hopeful that this will help improve my condition.

Thank you so much for any input. =)

Regarding the anesthesia: there is an order that they use putting in muscle relaxants and the drug that actually puts you out. If they do not know that you have MG they'll inject the relaxants before you're out. When I had this done it felt like I was drowning and was quite unpleasant. When I went in for my thymectomy I discussed this with my anesthesiologist and he adjusted the order for me to make sure I was out before the muscles were shut down.

As far as questions go... you'll probably want to know what possible complications could arise (for me the risk of complications was well worth the expected benefit of the thymectomy.) You may want to ask why the surgeon has decided on full sternotomy as opposed to some of the less invasive methods. In my case the mass on my thymus was too large to use any of the less invasive methods. Understanding why decisions are being made in your health care makes this kind of thing much easier to accept.

You'll have 6 to 8 weeks under strict weight restrictions after the surgery. You will not be allowed to lift/push/pull anything greater than 5 lbs or so. This will follow with an extended period of lighter weight restrictions where you'll be allowed to move heavier things. You will want to discuss weight restrictions during recovery with your surgeon. You will be given a heart pillow - you will want this close by at all times during your recovery. You will cough and it will hurt if you don't have your pillow to hug. Sleeping propped up is much more comfortable for at least a little while, you may want to get a good foam wedge or something that will help you with that.

Everyone is different with respect to pain tolerance, don't be shy about asking for pain killers (especially while you're in hospital during recovery). I found the pain was quite manageable after the first three or four days and was off pain meds all together within about 10 days.

hth. If you have any specific questions shout 'em out and I'll try to help.

Best of luck.

Cheers,

Brian

Hi rezmommy

firstly make sure you anaesthetist(sp?) knows you have mg, as the muscle relaxants they give you can be a problem, they didn't use any on me, and I grilled my anaesthetist for ages, asking all sorts of questions.

I agree with Brian about pain management. I stayed on paracetamol for about a week afterwards.

take care
redtail

Hi rezmommy,

I've not had the thymectomy (sadly) but i have had an anesthetic induced crisis so i thought I'd add my 2 cents. Apparently I'm psuedo-cholinesterase deficient (I think a lot of myaesthenics are) so I can only have a certain type of anaesthetic - the doctor knew which type. It's a simple blood test to see if you are deficient. I also required more "reversal" medications to revive me after the surgery. I've had three other surgeries after my crisis and no other problems, so don't be concerned. Once the doctors know you have MG they'll take excellent care of you.

I should explain that the surgery which caused my crisis was done before I had a diagnosis of MG so they thought I was just a healthy 24 year old.

Good luck with everything! I'm jealous a little bit - is that wrong? Hee hee.
~Kathy