Has anyone had a hernia surgery at a time when they were well along the PD path? Any pointers, tips, suggestions?
My biggest concern is the anaesthesier mixing with the 6 or 7 other meds that I need to function.
I would really appreciate some input from this pool of PD knowledge. It would be wonderful to know what to expect and know how to deal with the problems, situations and complications that are unlikely, but possible.
Thanks to anyone who can shed some light on this for me.
kk13

I was dx'd in 2003, symptoms since 2000, took lots of meds until Sept 09 when i got off all pd meds, with a struggle.

Last summer I needed to have a hormonal implant that had gone astray in my right upper arm removed. I had two botched attempts to do so in the GP's surgery; in the second he sliced into a vein and i ended up with a rock hard blood clot the size of a golfball in my arm. I abandoned the GP. Then I had to locate a surgeon who would hospitalize me and deal with the problem safely. I had major trouble locating one as i didn't want a general anaesthetic.

Eventually i went to the top plastic surgeon in the country who removed impacted implant and blood clot and tidied things up. He did not want to use a general anaesthetic on an unmedicated pwp, nor a medicated one for that matter. As a plastic surgeon, he is highly skilled at locating nerves so he spent a long time numbing me properly. I didn't feel a thing, unlike the butchery that had gone on with the gp. This surgeon said the main issue is that a general anaesthetic would 'expose' me to to more adrenaline than i could handle and in his opinion adrenaline is the biggest problem pwps face; he referred to it as 'your main problem, y'know'. I got the feeling he disrespects the obsessive focus on the presence or absence of dopamine, abstracted from the broader context of all the neurotransmitters.

This was a complex procedure as the GP had mangled the implant and buried it deeply with his messing around. It was 'like looking for a needle in a haystack'. The clot was also very dodgy. So, I guess it would be worth seeing if you can locate someone who is willing to do the hernia op under local for you. My surgeon may have been exceptional and i already had a lot of confidence in him since he had removed a large tumour off my 3 yr old's face years ago and reconstructed her lip, perfectly.

I've had worse experiences getting my teeth cleaned with numbing at the dentist's.

Best of luck to you.

Please check out NPF's Aware in Care Kit, free from National Parkinson's Foundation. Definitely worth it. There's a lot you should know about surgery for PWP. Free from their website: http://www.awareincare.org/

Muireann, I've never heard anything before about the adrenaline problem. Do you or others have any studies or other evidence to support this? I've always dreaded the dentist's injections which have epinephrine in them because it causes an unpleasant adrenaline rush. Just had a root canal this week and had to get several injections.

Have not had hernia surgery, but my husband did have non malignant tumors removed from the chest. This was after 7 years of meds for Parkinsons. There were no complications, however I learned to be very proactive when it comes to dealing with the medical staff. They tried to give him Reglan, which is usually given to combat the after-effects of anesthesia. This happened on 2 separate occasions. They did not know that Reglan can have devestating effects of tartive dyskenesia on a Parkinsons patient. (I now list Reglan as something he is alergic to, just to prevent this from happening again.) Always ask what medication is being given, and why, especially if it is not one of your regular prescriptions. Also make sure your meds are given on your usual time table, not on the nurses' schedule. Most of them don't realize the importance of taking your meds on a regular schedule.

My dad had a day surgery procedure and 2 minor surgeries for some skin cancer, with no problems.

I didn't know about the Reglan, I don't know if they used it or not for him.
I'll have to pay more attention next time, hopefully no more surgeries needed though.

It's things like this (not pre-planning for surgery) that can really mess up a symptom-controlled person with Parkinson's (PWP).

I am not a medical professional, but I helped put my two daughters through anesthesia school, and they have both have over 10 years.

First and probably most importantly, if you take an MAO-Inhibitor (Eldepryl/Selegeline, Azilect, to name two used by PWP) you need to stop that medication for 7-14 days (latter preferred)prior to surgery. If you keep taking it, you risk the chance of neuroleptic malignant syndrome, which basically can kill you! It causes autonomic dysregulation, which shoots your blood pressure aky high.

Next of importance is to know that Reglan (Given pre-surgery for nausea and vomitting, and Demerol used for pain, must be on every hospital's protocol books. Make the nurse repeat whatever pill she tries to hand out to you. These two drugs do not mix with anesthesia gases. Refuse to take them.. I have had them flag my chart, I have it stamped all over my chart, and they still try to give them to me.

What I can't understand is why they don't educate everyone about this.
Peggy

Peony,

I have not gathered any scientific papers on the role of adrenaline. My perspective that it is more of a culprit than we think comes from conversations with a surgeon, a vet, a dentist, several people who have recovered from PD and a biochemist who explained it thus - when you produce adrenalin your production of acetylcholine also rises, causing your muscles to contract. If you are then sluggish in producing dopamine, you're in trouble as there is nothing to mitigate the acetylcholine. Chronic stress which invariably sets the scene for unhappiness is not going to advance your ability to produce dopamine. How easy to become out of balance? Do it for long enough and you will get picked up by the PD radar and end up on meds which further influence dysregulation.

There has to be a better way to deal with this problem in the early stages, that doesn't involve pharmaceuticals. I agree with Dr Joe Dispenza in his book 'Breaking the habit of being yourself' when he says that if we wait for science to give us permission to do the uncommon, we are turning science into a religion. I think we need to go with our instincts a bit more.