Thursday, December 15, 2005

Introduction

Why Flag Versed (Midazolam) ?

Here is a list of the complaints about Versed we commonly encounter:

* Too often, the drug is used in a sneaky or furtive manner. Every manner of lying, cheating and BS-ing has been reported by people who unwittingly received this drug. Knowledgeable people, including medical people, have been given Versed after clearly refusing it.

* Versed is NOT a pain medication. The main effects are AMNESIA and patient compliance. Many patients feel they were mishandled, given inadequate pain management, or both. The impression is that the medical staff tries to hide behind the amnesia the patient is expected to have.

* Paradoxical reactions including anxiety, delirium and aggression. This includes patients attacking or trying to leave. They lose touch with reality, not knowing where they are or what is really occurring.

* Some patients experienced a distorted, nightmarish version of their procedure accompanied by feelings of abandonment and panic. This is often accompanied by the next item:

* A kind of sleep paralysis - patient is aware but cannot move and cannot communicate.

* Amnesia did NOT take place for some patients. Patients recall a bad experience!

* Some patients report a "creepy obedience" overcoming them.

* PTSD. Many patients report symptoms of Post Traumatic Stress Disorder after having this drug.

* Weird panic or anxiety episodes ("flashbacks") for some time (weeks, months, years) post-op.

* Long term memory disruption. Memories formed prior to the use of Versed are lost. Some people are unable to retain new information or complete tasks.


What is Versed?

Versed (Midazolam) is an amnestic. It is commonly administered in combination with anesthesia before and during surgery. It is also commonly used for minor procedures like colonoscopies so that patients won't remember pain and discomfort. However, that does not mean that those sensations will not be experienced.

Why be concerned about Versed?

If you are a person who wishes to be involved in your medical care, want to interact with your treatment providers, and want to be as aware and alert as possible during procedures, then you will want to be aware of this commonly-used drug.

How would you feel if you were given a drug, without your knowledge, that wiped out any memory of events that occurred over a period of hours?

A person who is under the influence of Versed can function, and can even carry on a conversation, but will remember nothing once the drug wears off. The use of Versed can open the door to abuse. If there is mishandling of the patient during procedures the patient will have no memory.

We are not saying that people should never be anesthetized, or that sedation should never be an option, but rather that:

* One should be given a complete description of what is going to be done to them. If Versed (conscious sedation) is to be used, the patient should be aware of the amnesia that will result.
* When possible, you should have a choice about being awake for any procedure or part thereof. We take exception to being denied a choice in those cases where one exists. One reason we have this site is because so many people report being deceived.
* Attention should be paid to the fact that some people find anesthesia very upsetting and may prefer a few minutes of moderate physical discomfort to a longer period of mental discomfort. Versed appears to cause PTSD in some people.
* Having a bad experience blocked from long term memory is not the same as never having had the experience in the first place. We think that if they have to make you forget, then they are not taking adequate steps to manage pain and discomfort.
* Versed is not a requirement for surgery. Medical professionals should be completely honest about the effects, and not try to trick or coerce a patient into having it. It should not be used solely for the profit or convenience of the medical staff.


What can you do?

Watch out for these commonly used phrases:

* "I am giving you something to relax you." This is too often an understatement, given the frequent side effects. This statement also completely avoids mentioning the amnesia Versed causes.
* "You will be given Conscious Sedation." or "You will be awake, but won't remember anything." This means they probably want to use Versed.
* "You will be in La-La Land." How you can be anywhere you don't remember beats us! "La-La Land" would be more like having a large dose of pain killers - you would be awake but not care. With Versed you will be functional but won't remember a thing.
* Beware of "Most People..." When you have a choice with your anesthesia, you should not feel pressured to make a decision based on what "most people" receive.
* "You are not a Doctor " So what? That does not make you uninformed. For all they know other doctors (your primary care physician for starters) may have already told you enough to make an informed decision. Besides, this is no excuse for pushing you to have an amnesia drug!

Insist on answers!

* Remember that anesthesiologists are not employees of the hospital, but they have no problem hiding behind hospital rules when there is a problem.
* Keep in mind that they are working for you, so ultimately YOU are the boss. Most of them will not volunteer anything, so you must be prepared to ask them very specific questions, and be very assertive. A patient advocate, who can be a caring friend or relative, should accompany you to all appointments and procedures and take notes.
* Be sure to find out what your financial liability will be if you are not satisfied.

If you aren't happy, complain!

There are concerned people out there who will accept your feedback. At least we like to think there are a few. They can't read our minds. Complain first to the hospital. They may ask you to put it in writing. Do so. That way there is a record of your complaint. Then, talk to your anesthesiologist. Chances are, he/she works through a group. If the anesthesiologist does not respond, try going to the associates group.

If someone botches a repair job on your car people don't fault you for complaining. But many people feel bad about complaining to a doctor or a hospital, even though they are working on something far more precious - YOU. Don't be intimidated!


Personal Accounts

Kirt's Account:

I had bilateral hernia surgery with laparoscopy. I knew I was facing general anesthesia, but I fell hook line and sinker for the 'I am giving you something to relax you' line before the surgery.

I had what seemed like a good conversation with the anesthesiologist and was feeling like I could trust him, so I thought 'OK I will be a little groggy, but conscious until he puts me to sleep for the main event'. No mention of conscious sedation or Versed was made. Just after I reached the operating table I realized something was happening, and then my memory disappeared in a roar of static.

I awoke to discover that not only had I been put to sleep for the main event, I had even been excluded from the prep.

When I later complained, I was told "Most People are very happy to wake up and have the procedure over with". Well I wasn't, I was livid, and when I was told the above I should have said "that's fine for them, but what does it have to do with me?"

It has been eight months since the surgery and I still feel taken advantage of, treated as if I was a five year-old, and yes, raped of my memory. I cannot see how a trained MD or anyone can justify the withholding of fundamental information like this. Even when I confronted him several weeks after the surgery he still tried to avoid saying I had been given Versed, until I finally said 'you gave me Versed didn't you?' I can only think that there must be a problem with this drug if they don't want to tell you they are using it.

Worse yet, the anesthesiologist's response to my questioning him was to lecture me about how I had to 'trust those who know what they are doing', and told me that I was one of those people who wanted to know everything. Personally I will never trust another anesthesiologist in my life. I wish I had said that, but I was still so shaken from my original experience that I just listened, dumbfounded.

While the surgery was technically successful I will always regard it as a failure because of the above.

Mary's account:

I went in for out-patient abdominal surgery. I had had several surgeries in the past and am not squeamish about surgery.

Prior to being wheeled down to surgery, I was told that they were giving me "something to relax me." I recall getting in the chair and going part way to the OR, but that is where my memory stopped. I have no recall of meeting the surgical team, getting onto the table, etc.

When I awoke, I was very agitated and upset. I remember wondering what had happened to me, with the sense that something very bad had happened but I couldn't remember what. I had finger-mark bruises on my upper arms and several other, larger bruises elsewhere. My neck hurt so bad that I was unable to turn my head for 24 hours.

I was extremely distressed that the hospital had not told me about the effects of versed and experienced severe anxiety for months about the memory gap. I had to go to counseling and was put on an anti-anxiety medication.

When I complained to the hospital, I was patronized and treated like a little kid. I did not feel as if they took me seriously.

Weeks later, I went to use my instant cash card, put it into the machine, and went to enter the PIN number, when I realized, much to my shock, that I had absolutely no idea of what the number was. I had used the same PIN for years. It never did come back. No doubt there are other 'lost' things, but I haven't recognized what they are.

Tim's Account:

I had bilateral hernia repair in September of 2004. The original plan was to use MAC ("Monitored Anesthetic Care"). The anesthesiologist did not explain the effects of Versed and did not explain that the MAC would be initiated in the holding area before I was wheeled to the OR.

The drug was not named. I was only told that from my perspective, the experience would seem like general anesthesia. This did not make sense - it seemed contradictory. The "A" word (amnesia) was not mentioned. I have had numerous operations in the past and my experience led me to assume that the main event would occur in the OR. The anesthesiologist introduced the Versed into the IV while I was still in the holding area. I asked what it was and the reply was simply "benzodiazepines." I know what benzos are and thought I was getting something like Valium. I was shocked when, from my perspective, I found myself in recovery what seemed like a few minutes later.

After surgery I was told that I had a bad reaction to the Versed so they ended up putting me under. The nurse in the PACU said that my legs were shaking and this is why they used general anesthesia. The surgeon's report stated that I was moving my extremities and would not be still. I was also told that I was unable to follow instructions. This is disturbing since I am not squeamish about surgery nor have I ever been out of control like this.

When I later spoke with my anesthesiologist, she used a lot of euphemistic baby talk, describing the amnesia as "making you forgetful" and describing the general anesthesia as "we had to make you more sleepy". My surgeon dodged the bullet saying "We're always ready to do general when we do MAC". This is all BS. Looking back on the experience, my wife and I agree that the anesthesiologist was very deceptive.

I am an electrical engineer. In the weeks after my return to work, I found that I had no recall of certain details of my job. We are very procedure and detail oriented. I found that certain blocks of information seemed to have simply disappeared from my long term memory. What else have I forgotten?

For three years post-op I experienced flashbacks of anxiety that occurred randomly - while at work, while driving, while teaching. These were accompanied by an odd sensation of trying to recall a memory but it refused to come into focus. Very strange, very unsettling - and I never experienced anything like this before exposure to Versed.

I was in my 40's when this happened. I have had several surgeries, numerous emergency room visits and my share of dental work. I never had a bad outcome or cause to complain until my Versed episode.

View Comments pages 2,3 and 4:

http://www.blogger.com/comment.g?postID=113469632967363416&blogID=19908598&isPopup=false&page=2

http://www.blogger.com/comment.g?postID=113469632967363416&blogID=19908598&isPopup=false&page=3

http://www.blogger.com/comment.g?postID=113469632967363416&blogID=19908598&isPopup=false&page=4