General Anesthesia & Reactions to Drugs
 

Hello,

I am having a surgery in the next few months where general anesthesia will be administered.

I have several concerns here.

1) In the past surgeries I've had (I've only had twilight anesthesia and local for an endoscopy and some dental surgeries) I've woken up during the surgery. During the endoscopy I started pulling the tube out of my mouth, and with the dental work I was never sedated when the doctor said he was going to "put me to sleep." I didn't really feel much pain during the procedures, but the fact that I was awake when I was not supposed to be aware of what was going on really scares me. The nurses later said, "we gave you as much sedative as we would a 300 lb man," whatever that means...

I'm 23, 5'4'' and weigh about 105-110. That being said, I "shouldn't" require the same amount of sedative that a 300 lb man would?

2) I intend to tell my doctor/anesthesiologist about my past surgeries and medications/drug use, however, if anyone could shed some light on this that would be great.

I was taking heavy pain killers for about a 3 month period when I was 19 (fentanyl and percocet) I don't remember the dosages. I remember that I think I was being given too much because I would get kind of loopy and sleepy on those medications, but I only took them for that period of time and then stopped.

I also used to take quite a cocktail of anti-depressants, mood stabilizers and sleeping pills. (All prescribed by my doctor) lexapro, lamictal, seroquel, trazodone, and geodon were my regular medications, as well as the ADD medication, provigil, although I took a variety of different medications over the years (ages 16-21) those are the ones I remember.

When I was 21-22 I quit taking all prescription medication (titrating down with the help of my doctor).

I have also experimented with some drugs recreationally, but not often. And what I have noticed is that I don't get the same reaction to drugs that my peers do.

For example when I take MDMA i just get a headache (this has happened almost every time, and it's not just bad drugs). When I take ketamine nothing happens. I think the only "normal" reactions I have with recreational drugs is with hallucinogens. And due to most of my experiences with drugs, I have decided not to mess with them, being that I never feel good and it's probably not good for my body.


LONG STORY SHORT, I am wondering why I react so differently to drugs...is there something wrong with the way my body metabolizes drugs? My blood-brain barrier?

And will this peculiar reaction to drugs and opiates/ surgeries I've had in the past mean that having general anesthesia could be potentially dangerous for me?

My biggest fear would be if the anesthesiologist sees that I'm not reacting as desired to the drugs administered and so she/he decides to give me more, and then my heart stops beating, or some other complication arises...


Anyway, I'm so sorry for the long-winded question. For those that took the time to read this, thank you. I hope that I can get some answers or at least come to understand my situation a little better. :)

There are DNA tests today that will show how you metabolize drugs. We are starting to see commercials about University medical schools that use this technology, to custom taylor chemotherapy treatments in individuals. This is the way modern medicine is going now.

For anyone who suspects they are a fast metabolizer or a slow metabolizer, today, I think it is a matter of SAFETY to get this test done. It would reveal quite a bit and therefore lead to safer use of drug treatments, and combinations of them. There are several enzymes in the liver and GI tract which are responsible for drug elimination, and they vary according to genetics from person to person. It is called the Cytochrome P-450 system.

Another place that does it, and without a doctor's order is
23and Me which you can find on the web easily. You would have to pay for it out of pocket then.

Thank you, MrsD, for your response. You have given me some important information that I will look into further. Thank you for taking the time to read my concerns and thoughtfully write out a reply.

One question I had in relation to your reply is: Is the name of the DNA test called "Cytochrome P-450 system," or is that the name of the enzymes you were talking about?

Thanks for your time.

More:
http://www.mayoclinic.com/health/cyp450-test/MY00135

another example:
http://genetechdnaservices.com/page2.html#drug

from 2007:
http://www.aafp.org/afp/2007/0801/p348.html

http://www.genome.gov/19516567

https://www.23andme.com/health/drugs/

This wiki article explains more-- but it IS complicated:
http://en.wikipedia.org/wiki/Cytochrome_P450