General Anesthesia & ApoE4

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hairyfairy
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Re: General Anesthesia & ApoE4

Post by hairyfairy »

Iv`e had several anasthaetics when I was young due to gynaecological issues, the last one when I was 30. I wonder if theyv`e left me with any damage, or does this issue with anaesthetics only apply to older people?
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TheBrain
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Re: General Anesthesia & ApoE4

Post by TheBrain »

Theresa, I don’t have any thoughts about the anesthesia, except that I share your concern. That’s a lot of anesthesia. But I wanted to mention what a neeurofeedback therapist told me about ECT. She said the only people she won’t work with are those who have undergone ECT because neurofeedback does not work for them. She’ll work with people with severe TBIs and see improvement, but the brains of people who undergo ECT are changed in such a way that neurofeedback can’t work.
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!
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TheresaB
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Re: General Anesthesia & ApoE4

Post by TheresaB »

TheBrain wrote:the brains of people who undergo ECT are changed in such a way that neurofeedback can’t work.
That's interesting, didn't know that. Thanks!
-Theresa
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tinamalone
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Re: General Anesthesia & ApoE4

Post by tinamalone »

Hi all, I am currently scheduled to have my left shoulder replaced, total shoulder arthroplasty, on April 11th , 2019. I had my right shoulder replaced 2 1/2 years ago before I knew my e3/e4 status. In addition, I have had general anesthesia for 2 carpal tunnel surgeries and a hysterectomy before I knew my status. I realize that we should avoid anesthesia, if possible, but living the rest of my life (I am 62) with the pain is not a good option. It literally is robbing me of sleep. So I have 2 options: 1.) Not have the surgery and have low quality sleep and low sleep volume for the rest of my life which leads to AD/dementia (not to mention how awful even the days are and that I have to take ibuprofen to function) or 2.) Have the surgery and bear the anesthesia risk. Staying awake or using a local or spinal block while they operate on my upper body left shoulder and literally use power tools to saw away the bones is not an option. I also realize that implants are a risk according to Dr. Bredesen but I am between a rock and a hard place here. My shoulder joint is so deteriorated that there is nothing I can do naturally or holistically to relieve the pain and make it livable (believe me, I have tried). So, I have made the personal decision to bear the risk of anesthesia. I won't meet my anesthesiologist until the morning of the surgery. Do any of you have any advice as to how to talk to him or her? Should I make any special requests? Any assistance would be greatly appreciated! Thanks so much
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Re: General Anesthesia & ApoE4

Post by NF52 »

tinamalone wrote:Hi all, I am currently scheduled to have my left shoulder replaced, total shoulder arthroplasty, on April 11th , 2019. I had my right shoulder replaced 2 1/2 years ago before I knew my e3/e4 status... My shoulder joint is so deteriorated that there is nothing I can do naturally or holistically to relieve the pain and make it livable (believe me, I have tried). So, I have made the personal decision to bear the risk of anesthesia.
Welcome,Tina!

As someone who is 66 and ApoE 4/4, with a history of 4 surgeries under general anesthesia, all of them necessary, the first at age 5 and the last at age 62, don’t feel guilty over what is necessary for your quality of life! I’ve worked with two women who needed extensive shoulder surgery and know that they both endured way too much pain before making that decision. My guess is that those carpal tunnel surgeries didn’t have you under too long, and that each time you came out from anesthesia without any long-term confusion.
I was able to ask ahead of time for a regional leg block and total IV sedation to keep me unconscious, but not under “general” for recent foot surgery that lasted about 90 minutes. If you want to be sure that’s not a possibility (believe me, I didn’t hear any power tools!) you could call the hospital and ask to have a pre-op call from the anesthesiologist.
But your overall risk with ApoE 3/4 is not as high as mine, and if I needed general anesthesia tomorrow I would not feel guilty at having it.
4/4 and still an optimist!
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CoachMT
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Re: General Anesthesia & ApoE4

Post by CoachMT »

NF52 wrote:
tinamalone wrote:Hi all, I am currently scheduled to have my left shoulder replaced, total shoulder arthroplasty, on April 11th , 2019. I had my right shoulder replaced 2 1/2 years ago before I knew my e3/e4 status... My shoulder joint is so deteriorated that there is nothing I can do naturally or holistically to relieve the pain and make it livable (believe me, I have tried). So, I have made the personal decision to bear the risk of anesthesia.
Welcome,Tina!

As someone who is 66 and ApoE 4/4, with a history of 4 surgeries under general anesthesia, all of them necessary, the first at age 5 and the last at age 62, don’t feel guilty over what is necessary for your quality of life! I’ve worked with two women who needed extensive shoulder surgery and know that they both endured way too much pain before making that decision. My guess is that those carpal tunnel surgeries didn’t have you under too long, and that each time you came out from anesthesia without any long-term confusion.
I was able to ask ahead of time for a regional leg block and total IV sedation to keep me unconscious, but not under “general” for recent foot surgery that lasted about 90 minutes. If you want to be sure that’s not a possibility (believe me, I didn’t hear any power tools!) you could call the hospital and ask to have a pre-op call from the anesthesiologist.
But your overall risk with ApoE 3/4 is not as high as mine, and if I needed general anesthesia tomorrow I would not feel guilty at having it.
Welcome tinamalone, its great to have you join the ApoE4.info community! What a gift to have NF52 offer such timely advice from lived experience. It sounds like you know yourself , have considered your options, and are landing on a well thought-through decision to support your long-term health. If you haven't already checked it out,the primer is a great place to start on the ApoE4.info site and offers information to incorporate into your learning journey. Wishing you the best on your upcoming surgery.
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Re: General Anesthesia & ApoE4

Post by SunnySideUp »

Interesting new study - is 5 months "slight?"

UW Study Indicates Brain Bounces Back After Anesthesia
https://www.wpr.org/uw-study-indicates- ... anesthesia
The decline from anesthesia was too small to be measured individually, said assistant scientist Dr. Bryan Krause, but after testing more than 7,500 patients, the decline amounted to roughly five months of brain aging on average. Each patient had major surgery requiring at least two nights in the hospital.
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Re: General Anesthesia & ApoE4

Post by hairyfairy »

About 3 months ago I had to have a general anasthetic for a minor investigation for a pelvic floor issue. I mentioned my worries about apoe4 to the aneasthatist and surgeon, & they didn`t think that there would be a problem. I would have opted for a local or a spinal, but they said that it was necessary for my muscles to be totally relaxed, which could only be achieved if I was unconcious. They used Propofol, & I had no cognitive issues afterwards, I felt wide awake & couldn`t sleep thank to being in a strange environment.
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Re: General Anesthesia & ApoE4

Post by NF52 »

hairyfairy wrote:About 3 months ago I had to have a general anasthetic...They used Propofol, & I had no cognitive issues afterwards, I felt wide awake & couldn`t sleep thank to being in a strange environment.
Sounds like overall it was a good result--at least for your brain. I also have had propofol for minor procedures with no issues afterwards. And I also sometimes have issues sleeping in a strange environment--probably a holdover from our most ancient ancestors wanting to keep a guard up away from home! Hope the procedure helped; thanks for sharing the results!
4/4 and still an optimist!
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Re: General Anesthesia & ApoE4

Post by Veero »

I just had my second foot reconstruction surgery a month ago. I discussed my concerns with my anesthesiologist and asked to limit the use of gas, give a (popliteal) nerve block before rather than after the procedure, and to choose desflurane rather than sevo. The first one I had not known to investigate concerns of anesthesia with the APOE e4 gene, and they used sevo at typical protocol. I was very foggy-brained for 2 months and then less so for another ~3 mo. This time around, I felt very slightly foggy-brained for a couple of weeks but fine now (other than the added stress of preparing for the upcoming hurricane when I can't walk and am in a wheelchair!). I did happen to sleep for an additional 1.5 hours after the procedure which the anesthesiologist warned me about may happen when using mainly injectables rather than gas.
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