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again on the bladder questions....

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    again on the bladder questions....

    Hello everyone, I finally went to the urologist on monday and, he said i need a bladder endoscope and irrigation, so I guess I'll be going for my tune up shortly. However, I have to go under anastasia for that and, this brings me to my questions:

    1. If I have an AD issue, what r the drugs to nivelate the blood pressure and what r the DON'T U DARE! ones?

    2. Is there any AD brochure in spanish I can copy for my mom?

    3. Since I'll be out and my mother gets very nervous easy, what r the things I should prepare her on?

    4. The doc said to use either gen. anasthesia or an epidural but, I'm not to thrilled with the idea of a needle to the spine, besides, does that really eliminate the risk of AD?

    And last, is there anything else I should know?

    Thanks for all the help.


    ...and the soul afraid of dyin'... That never learns to live...
    Thoughts become things, choose the good ones!

    #2
    Polett: I had a cystoscopy last year under general anesthesia. I had no problem w/AD afterwards. If you're having the procedure done down here, there should be literature provided in spanish - or, someone to translate the info. to your Mom. It's rare to bump into anyone here who doesn't speak spanish. Tú tienes mi numero de teléfono si tú necistes algo. Buena suerte.

    Great spirits have always encountered violent opposition from mediocre minds. ~Albert Einstein

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      #3
      Polett, you should have a visit from the doctor doing the procedure and the main anestheiologist in the pre-op area. Your Mom can go there with you. The meds to deal with AD depend on the drugs used to put you under. If the anestheiologist doesn't volunteer the information ask her/him how they will deal with your blood pressure if it becomes a problem. When I went in for a laporatomy the doc told me she would take over for the RN administering and monitoring and would pump me up with pain meds first to see if that would lower my BP and also take me deeper under. She let me know in advance that if I had AD hit I might wake up in the ICU and spend a few hours on monitors but that's all it would be--a few hours to make sure my BP stayed down. But then my normal BP is 90/60 and I made it all the way up to 115/70. They figured that was not worth treating. LOL

      Let the docs know what sets you off and how bad your AD gets when they brief you. I never get AD...well, except when I hurt my leg that time and pain meds were all I needed. You'll be fine and they do know how to deal with stuff like this. Now if ER docs did. [img]/forum/images/smilies/tongue.gif[/img]

      Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."
      Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

      Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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        #4
        We recommend a spinal (not an epidural) anesthesia for anyone with a SCI who is a risk for AD during a cystoscopy.

        General anesthesia will NOT necessarily block the AD messages, as it works primarily in the brain and does not block the pain messages from going to your cord, nor the sympathetic nerves from increasing your blood pressure with AD. If you have a general, the anesthesiologist will have to monitor your blood pressure and be prepared to give you IV medications to manage any high blood pressure. This should be a ganglionic blocking agent that is fairly short acting.

        The Consortium clinical practice guidelines for AD management recommend treating with medication any time your baseline systolic blood pressure exceeds 150 (given that most people at risk have a BP in the range of 100-90/50-60).

        I do not personally have any information in Spanish other than the Spanish language version of the book "Yes, You Can" and a hard copy of the Consortium booklet on AD. Unfortunately the Spanish version is not available on the internet. In a pinch I could fax this to you if you can send me a private message with a fax number. I also found these resources:

        http://comnet.org/mpva/publications.html

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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          #5
          Any time I've ever had anything done to my bladder I've had an epidural and never had problems with AD. Also with the epidural they won't have to put you all the way under so recovery is a lot faster and you don't feel so crappy afterward.

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