Introduction

Did you get Versed (Midazolam)?

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?

That is what happened to us, Tim, Mary and Kirt. Three people who live in different parts of the country, regular folks, who met each other because we were all 3 administered the drug Versed during surgery without our knowledge and spent several hellish months trying to come to grips with what happened to us (for our personal accounts, see below).

If you don't want to know what happened to you during surgery, do not want to be involved in your medical care, or like being put to sleep, stop reading now - this site is not for you.

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.

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. Because of these qualities it is used on the street as a date-rape drug.

Why be concerned about Versed?

If you are a person who, like us, 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.

Our point in writing this is not to say that one should not be anesthetized for certain procedures, or that Versed should not be an option, but rather that:

• One should be given a complete description of what is going to be done to them - at whatever level of detail the he or she desires. If Versed (conscious sedation) is to be used, the patient should be aware of the amnesia that will result.
• If it is at all possible, the patient should have a choice about being awake for any procedure or part thereof. There is nothing wrong with wanting to be awake because you find the procedure interesting, assuming you can be kept comfortable with local anesthetics and analgesics. If you are a masochist and like pain this web site is not for you.
• Attention should be paid to the fact that some people find anesthesia very upsetting mentally, and may well prefer a few minutes of moderate physical discomfort to a longer period of mental discomfort.
• Patients have no obligation to treat doctors, nurses, anesthesiologists etc. as if they are God, or sit at his/ her right hand.
• There is nothing wrong with telling any of the above that you are unhappy with their performance.
• The use of Versed can open the door to abuse. If there is mis-handling of the patient during procedures, excessive roughness, etc., the patient will have no memory.

Versed is being used more and more routinely as hospital operating rooms become busier and busier. The use of Versed allows them to used less anesthesia in some cases and can save the hospital time.

But for the patient who goes to surgery expecting to be alert and wakes up afterward with a huge gap in memory, it can be hell. The brain struggles mightily to put something into that missing slot, and the knowledge that your memory has been taken from you can lead to anxiety and depression, and a feeling of being violated.

Even if the worst thing that happens to you is the doctor changes personality after they wheel you away from your family, you would want to remember it. Having a bad experience blocked from long term memory is not the same as never having had the experience in the first place. The bar simply must be higher than this.

There are accounts of people under the influence of Versed struggling against the procedure and feeling like they had been physically violated, (see http://www.askapatient.com/viewrating.asp?drug=18654&name=VERSED).

In addition to the 'lost time' during the period that the drug is administered, permanent memory losses can occur, (see Mary's personal account, below).

What can you do?

Watch out for these words!

• "I am giving you something to relax you." If they are talking Versed, don't think you will just be groggy - you will have no memory. Versed takes two to three minutes to take effect. You won't feel much at first then suddenly you will just have time to realize you have been lied to. If this doesn't bother you stop reading now. If it does keep on.
• "You will be awake, but won't remember anything." True in a technical sense, but from the patient's point of view you are mentally gone. If you are the type of person who likes to know what is happening you will be very distressed.
• "You will be given Conscious Sedation." See the previous entry.
• "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 Mr. Most People Surgery is something which, thankfully, most of us do not experience often, so it is an important life event. You don't want to have someone else's surgery - you want it done the way you want. If you want to be out cold that is fine, if you don't that is fine too---as long as you can be kept comfortable, and you don't compromise the work being done.
• You are not a Doctor And guess what? He/she is not you! Respect is a two-way street.

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 are dissatisfied with your treatment, you or your advocate should find the courage to say things like,"Will you take that IV? I am going home!", or, "Can you get me someone who doesn't have a problem answering questions?"

If you aren't happy - Complain, Complain, Complain

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.

While you cannot be abusive or combative, be direct and do not mince words. Do not be intimidated. They have a lot more obligation to be nice to you than you do to them!

Funny, if some one botches up a repair job on a car people don't seem to have any qualms about squawking loudly. Yet if we complain to a doctor or hospital we feel as if we have been bad. Yet they are working on something far more precious - YOU.

Personal Accounts

Here are the accounts of our personal experiences with Versed.

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:

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. 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."

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".

I have other concerns about Versed:

*Abuse or mistreatment of patients:

It should be obvious that if they are giving people amnesia, then this amounts to a date-rape drug that opens the doors to abuse. Even if the worst thing that happens to you is the doctor changes personality after they wheel you away from your family, you would want to remember it. To me, having a bad experience blocked from my long term memory is not the same as never having the experience in the first place. The bar simply must be higher than this.

Versed is a convenience for doctors who are rude, rough, or in a hurry to complete a procedure. If you have amnesia, then obviously you will never know to complain.

*Versed induces nightmarish states:

There are accounts of people under the influence of Versed struggling against the procedure and feeling like they had been physically violated, or experiencing what seemed like a nightmare but actually was a distorted version of their procedure (see http://www.askapatient.com/viewrating.asp?drug=18654&name=VERSED).

There are numerous reports of people being suspended in a nightmare like state where they lose touch with where they are and what is really going on but they are aware enough to be frightened.

There is a classic example on www.askapatient.com where a woman undergoing a colonoscopy thought she was being raped. She also describes a sense of abandonment which is also a common feature of bad Versed experiences.

Although I cannot recall anything, I strongly suspect that I had a similar experience when I was under Versed. I was given Versed two minutes before being wheeled to the OR. All that the PACU staff would admit to me is that my legs started shaking - so they put me under.

*Amnesia beyond the day of surgery:

I am an electrical engineer and I had been at my job for three months when I had my surgery. 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.

I wonder what else I have forgotten?