General Anesthesia & ApoE4

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Julie G
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General Anesthesia & ApoE4

Postby Julie G » Sun Mar 16, 2014 11:30 am

It's rather common knowledge around here that we should try to avoid general anesthesia as E4 carriers, BUT what research is that notion based upon? It looks like I'm facing some rather extensive (not too serious) surgery soon and meet with the surgeon tomorrow. I want to talk him into a spinal block to avoid general anesthesia. If anyone has done the research here, I'd greatly appreciate your help. Thanks!

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KatieS
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Re: General Anesthesia & ApoE4

Postby KatieS » Sun Mar 16, 2014 12:37 pm

I had three surgeries avoiding general anesthesia before I was diagnosed with severe sleep apnea (gene SNP rs405509). So with the last surgery, the anesthesiologist would only give me the option of a spinal or general anesthesia, no conscious sedation, as their "ability to control oxygenation is not ideal when you sedate only." This last surgery was the only time, I woke up without a headache, so I'm thinking that those previous surgeries I did desaturate my oxygen level. However, with knee replacement surgeries, general anesthesia seems to prolong recovery over spinal.

Not sure how this relates to ApoE4, but I'm suspecting that sleep apnea is more common on E4 carriers.

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Re: General Anesthesia & ApoE4

Postby Julie G » Sun Mar 16, 2014 3:50 pm

Thanks, Kitano. Out if curiosity, what type of anesthesia did you settle on for your last surgery? As far as I know, I don't deal with sleep apnea. According to my hubs, the only time I snored was following surgery to repair a broken nose- paybacks are hell :D

The only research I could find specific to E4s was this http://www.ncbi.nlm.nih.gov/pubmed/22108393 If anyone knows of anything more recent I'd really appreciate it.

Kit, forgive me for not posting on your thread yet. I've not researched the cancer angle well enough to knowledgably address the topic...though my interest is high as I'm dealing with ongoing HRT issues at the moment. Sigh.

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Re: General Anesthesia & ApoE4

Postby KatieS » Sun Mar 16, 2014 6:09 pm

That's the same abstract that I read. But like alcohol, it would seem like the least of mind-altering would be best for E4.

Over two years ago, I went with general as the anesthesiologist convinced me that this was the best monitoring given my sleep apnea. What you choose, depends on what they recommend with the length of your procedure and medical history, etc… When I had my endocervical polyp removed, the anesthesia wore off too soon and I had a brief episode of severe pain. This was my fault as I had requested the "minimal of sedation".

Now that I am aware of the E4,when I need to have my knee replaced, I think I will choose spinal anesthesia.

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Re: General Anesthesia & ApoE4

Postby RBK » Sun Mar 16, 2014 6:43 pm

Juliegee, I seem to recall Mary Newport talking about this in her book? If so, she would have cited it for sure. Might try there?

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Re: General Anesthesia & ApoE4

Postby Welcomeaboard » Mon Mar 17, 2014 6:15 pm

What is the risk allele Kitano? thanks

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Re: General Anesthesia & ApoE4

Postby Julie G » Mon Mar 17, 2014 6:33 pm

Thanks for everyone's input. Even though the surgery will be 3-4 hours in length, the surgeon thought an epidural would be fine. A spinal block was a bit riskier as once the medicine is injected, more cannot be added. With an epidural, the anesthesiologist apparently has more control. Might be a good option for other E4's who are facing surgery. Can anyone recommend a good book on tape? I feel antsy thinking about it :shock:

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Re: General Anesthesia & ApoE4

Postby KatieS » Mon Mar 17, 2014 7:48 pm

Just finished The Sixth Extinction (nonfiction environmental travelog) by Elizabeth Kolbert. Here's Al Gore's NYT's review:
http://www.nytimes.com/2014/02/16/books ... .html?_r=0

My Kindle Touch will play the audio. Your library may have tapes of many old classics that you can access their inventory online.

I agree that epidural with the titration sounds like the best option.

We're all sending healing thoughts.

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Re: General Anesthesia & ApoE4

Postby RBK » Tue Mar 18, 2014 5:25 am

A great epidural goes a long way! I have three children and only a tiny bit of labor pain with #3 to show for them. Congrats on finding a solution that works for you!

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Re: General Anesthesia & ApoE4

Postby Julie G » Sun Apr 13, 2014 2:33 pm

Just wanted to thank all for the info, good wishes, and book picks. Tomorrow is D-Day (gulp.) The anesthesiologist has decided to go with a spinal block and very little or no anti-cholinergic meds to protect my 4/4 noggin. I've taken Silver's advice & have used this opportunity to begin meditating. I found an amazing guided imagery/affirmation/calming music download for my iPod designed for those undergoing surgery. http://www.healthjourneys.com/product_detail.aspx?id=29 I've been listening daily for a couple of weeks and will keep my earbuds on during surgery & recovery. Fingers crossed it helps me remain calm during my 3+ hour surgery :shock:

I'll be in the hospital for a few days, but will post with an update when I can. Peace & love to all.


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