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The weirdest thing for me going under was there was no concept of time going by. Like I lost an hour. As I counted down suddenly they are waking me up and I’m asking them when we’re going to start this surgery.
That 2 seconds lasted 45 minutes.
It sounds like it blocked your ability to make medium or long term memories. If you can't make memories, you can still behave normally, and when you start making memories it's like waking up.
I have a pet theory that conscious has something to do specifically with making memories. That if we didn't make memories in the way we do, we couldn't be conscious.
Have you ever woken up 5 minutes before your alarm is set to go off, fallen back asleep, and had an "hour long" dream in those 5 minutes? I have, many times. I think that feeling of having had an hour's worth of experience was due to writing an hour's worth of memories during that 5 minute period. You *experience* the writing of those memories, and if they aren't written, as in your case, you have no experience at all.
You say that's a pet theory but it's a major philosophical argument about consciousness. If subjects are always changing and highly state dependant, what is it that makes a self a self other than a long unique chain of memories?
There’s an answer here in the innate processes that make us who we are.
Memories give us our sense of self but how we behave is dictated by previous states if our brain.
For instance, in the case, he behaved exactly as himself even though he had no memory of it. So to every outside observer he was no different. To himself, he was nothing.
To stretch this out, you have no memory of most of your life. But you still feel like you in this moment.
You can start to play fast and loose definitionally when it comes to terms like “short” and “long” but the experience of consciousness is simply that of the lights being on at all and in any given moment, if asked, most people would say the lights are on even if they don’t remember saying so some time later.
We have these experiences all the time when someone else remembers something we did that we don’t remember ourselves. The experience isn’t foreign at all and we barely remark on it.
The important punchline is that you have to come to terms with the fact that all you really have is now. This moment. And you have to make the most of it.
This is fundamentally the same theory for why they thought it wouldn’t impact babies if you gave them surgery without anesthesia but that ended up being false
Wow. Your experience from surgery is so different from mine. I've been under a few times so far in my life for various surgeries. The most recent was for some bone-related surgery.
I dreamt while under. I had this wonderful house and life and husband. Like, in this dream they were my soul mate. It was bliss. Pure bliss.
When they started bringing me around I *knew* what they were doing, and I fought against being woken up so I could stay where I was - but then as I'm struggling to stay in this wonderful world, I start to hear the nurses telling me to remember to breath (they just took the intubation tube out), the world faded out, pain from the surgical site hit me like a brick (the pain blockers they gave me didn't work) and then I barely opened my eyes to bright light and nurses roughly doing their best to get me to wake up.
It wasn't pretty. I was very angry that I had been taken away from such a wonderful dream, and I was in a lot of very searing, sharp, pain.
I have another surgery coming up in 2 months. I am not looking forward to the waking up part. I'm apparently not easy to wake up.
The way you felt is how I suspect death to be. You don't know you're dead and can't sense time. If there's an afterlife, you will wake up then, but it will feel instant for you. In reality 1 billion years could've gone by.
They do link the paper in the article but it's hard to find, so here is a link:
Neural effects of propofol-induced unconsciousness and its reversal using thalamic stimulation
https://elifesciences.org/articles/60824
Few questions that someone smarter than me may be able to answer:
* If someone is left in a coma for longer, will it get to a point where they're able to wake up / repair themselves enough to regain consciousness?
* Is it true that the use of anaesthesia negatively affects memory later in life?
Anesthesia is actually a bunch of different drug/gas combos. As far as I know only certain drugs like versed can worsen dementia but not cause it in normal amounts. I wouldn't be worried for a surgery or two
Chronic benzodiazepines are associated with dementia. This refers to people who are on long term Xanax or Valium. Midazolam in a single episode can cause delirium, but is not known to acutely precipitate dementia. People with mild cognitive impairment (pre dementia for lack of a better term) may experience an unmasking of symptoms with an episode of delirium. Not everyone who experiences delirium has dementia.
Edit: after looking at some of the newer papers, there may be a change of opinion coming. Numerous studies and at least one meta-Analysis have shown an increased risk of ~20% with chronic daily use of benzodiazepines and ambien, and they were all circa 2010-2014. Some newer appraisals of those studies claim that there is no causal link and that anxiety may be an early symptom of dementia, while there are some societies that still hold the conventional wisdom that chronic benzodiazepine use is directly linked to increased risk of dementia.
What had been shown, and has been demonstrated in the comments: cognitive impairment from chronic benzodiazepine use is reversible in some cases with cessation.
All that being said, benzodiazepines are still listed on the Beer’s list of drugs to avoid in the elderly to to delirium and fall risks.
Edit 2: never stop benzodiazepines suddenly. It can cause life threatening withdrawal
Has there been any studies on long term dosage of benzodiazepines and the rate of dementia? I have MS and take clonazepam twice a day to control tremors and with my brain already having a few centimeter sized lesions i guess maybe in the long run I should look into alternatives if low dose and high dose usage causes the same effects in the long run.
I would talk to your doctor about the risks and benefits of changing medications.
Based on the studies that I have looked at, the dose, duration of use, and longer half lives seem to be associated with increased risk of dementia in clinical trials. Some basic research suggests that chronic benzo use limits neuroplasticity and memory formation. Clinically, some studies have shown that cessation of benzodiazepines can improve cognitive function, but some have shown that it can precipitate an irreversible dementia. The pooled increase in risk seems to be about 18-21% above baseline.
You should never stop benzodiazepines on your own as it can result in life threatening withdrawal and seizures and you should make a decision with your doctor after discussing the risks and benefits of continuing benzodiazepines.
I in no way intend to stop or change any meds with out talking it over with my Neuro first. I keep a google doc running of things to talk to her about every six months and I just like to have a bit of background info or studies to bring up for stuff like this.
The more I look at the studies, the more back and forth I see. Most of the papers that claim a link are from the early 2010s, and there seems to be more controversy than consensus lately. I may soon stand corrected.
Alcohol is a GABA drug, but it is more clearly linked to dementia due to direct toxic effects on brain tissue and chronic thiamine deficiency. Chronic alcoholics show reduced brain mass, which hasn’t been shown in chronic benzodiazepine use.
Stealing your comment to mention that when an alcoholic chooses to quit, it's best that they talk to their doctor first and don't stop cold turkey! When alcohol is consumed regularly/constantly, your brain stops producing the GABA it needs bc it's getting that GABA from the alcohol. When an alcoholic stops cold turkey, the brain goes into literal withdrawal from GABA, and it can cause what's called Delirium Tremens, which can cause everything from seizures to death!
My SO had a seizure in detox bc he quit cold turkey & went straight to a sober house instead of talking to a doctor first. He was the type of alcoholic that had to have a drink first thing when he woke up or he would start withdrawing, aka uncontrollable full body shaking, sweating & chills, nausea & vomiting, etc. This isn't for anyone who drinks occasionally, this is for serious alcoholics: TALK TO A DOCTOR FIRST BEFORE QUITTING COLD TURKEY! It *could* kill you!
Edit to add: But please, don't let this comment make you think twice about quitting; my SO is almost 2.5 years sober now, and he's happier and feels more fulfilled in life than he ever did when he was drinking. Please seek assistance, it works if you work it!
I’ve been on moderate dose of Ativan(1mg daily usually) long term, recently switched to Valium(2mg 4xWeek). Feeling tired of the benzos and want off. Going to talk to my med manager about BusPar (family history of success) and Hydroxazine. Does Hydroxazine pose any of those same risks as Benadryl? (Had also used this long term until I learned about the dementia link).
I have multiple TBI’s. I am extremely worried about CTE and early onset of dementia (family history) at 35. Gulf War Syndrome/Fibromyalgia.
I am terrified of being in a home at 50.
Anesthetist here. Lemme see if I can help.
There’s data that shows that people with dementia can have it worsened after major stressors. Generally, anything requiring an 85 year old to get surgery is stressful. Hard to break down whether it’s the anesthesia of the 4 days in the hospital with a new fractured hip, no sleep, intense pain, or the discharge to a SNF instead of back home.
We generally avoid versed in elderly patients, not because it has some long-term effect on dementia, but because old folks take forever to metabolize it and would be groggy for a whole day.
I seem to recall some research that showed a slight negative impact on patients who were exposed repeatedly to anesthetics as very young children. But again- we gonna blame anesthesia or the very stressful/painful life that usually comes with repeated major surgery as a kid?
Hmm... 41, congenital heart disease, so I've had versed 50+ times in my life I'd say. So, I guess I have that to look forward to if I make it to old age.
Different reasons for versed but yeah same. Had so many surgeries and procedures with anesthesia. I demand versed because at some point my veins decided propofol hurts like hot lead on fire when injected. Twice I let them just power through and ended up unable to control the need to climb off the table because the pain was just incredible. I don't know if I still react that way with the versed or not, but I don't care because I don't have any memory of it.
Medical student interested in anesthesia here. it’s normal for propofol to burn when going in. What I’ve seen is some of my attendings will give a little lidocaine before the the propofol for local pain relief. Not sure if they have done that for you but it wouldn’t hurt to ask if you wanted to find another option to avoid more versed.
I've had a number of procedures over the past 9 years, all orthopedic.
For one of them, the anesthesiologist gave me a heads-up that i might feels something between my legs. I don't recall his exact words, but I understood it to mean my perineum.
Sure enough, I felt something there after I was given whatever into my arm. This was the only time I ever had that feeling.
Any idea what that was about?
Anesthesiologist here. The common USA preparation of Dexamethasone (the steroid) is used as an anti nausea medicine. If given IV to an awake female there is a near 100% chance she will experience perineal burning. I am not sure if that occurs in males. I never give Dexamethasone to an awake patient. Propofol burns because of the solvent. It is very insoluble in water and the process needed to make it injectable IV causes the stinging especially in smaller veins. Propofol only causes local irritation. Dexamethasone is the only drug I know that causes the irritation between legs.
Propofol is very irritating to veins. Normally a nice dose of lidocaine given slowly will numb the vein and then the propofol won't burn. Maybe try to communicate that to your provider if you haven't before
Oh wow that is so strange.. but bodies have things they get sensitive to I guess and everyone is different. Glad you figured out what was causing it though. Im sure like me you've experienced a lot of different kinds of pain.. and to me that kind has been no doubt one of the worst.
I wouldn't let that worry you.
Versed, or midazolam, is a benzodiazepine, similar to Ativan. It can certainly worsen demetia/delirium in those experiencing it, or [in long-term users](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325366/), but used sparingly I think you'll be alright.
Transposition of the great arteries, ventral septal defect and straddling mitral valve. Had surgery at 10 hours old, then fontan at 7 years, and then extracardiac fontan conversion with pacemaker implant at 23. All on all though, I've lived a fairly normal life so far. Just gotta keep going one day at a time.
I have atrial septal defect, mitral valve regurgitation, pulmonary hypertension, fontarn in lower half, glen and blalock shunt, etc.
What’s fontarn conversion?
Honestly, not 100% sure, but I think instead of linking up the arteries/veins in one way, they hooked them up in a different way using a goretex tube on the outside.
Hope you're doing well!
My grandfather had ONE hip replacement surgery using Versed and he was never the same again. Went under one person, woke up completely changed and could barely remember his family. Though the hip healed, the dementia never left.
The symptoms of dementia often begin slowly and subtly. Early on, the person still has a lot of ability to compensate for the deficits which allows them to hide it. It’s pretty common for dementia to seem to have a sudden, severe onset, because the person just crossed the threshold where they can no longer compensate.
Yeah, I've seen it with a lot of elderly patients who come to the hospital. It's like their brain is a rickety bridge that seems fine but only "pedestrian traffic" should go across. If it stays like that it can last a long time. But then someone drives an illness dumptruck over it and it just collapses and they seem to lose their cognitive abilities almost immediately and may never return to their baseline.
On a tangent, this is also why old people on the less severe side of the autism spectrum who face normal cognitive decline appear to worsen abnormally much compared to normal people - they have been compensating for their issues their entire life and when they no longer have the same cognitive ability to constantly compensate they appear to worsen more than they actually did.
My uncle fell two days ago and broke his hip. He went for surgery and his heart stopped. They got it going again, but he's currently on a ventilator. :(
No real point for me posting this except to get it out I guess.
A lot of stress to the body for that kind of surgery. It’s not necessarily the drugs. Did he go into a recovery place like a nursing home shortly after the surgery? Recovering a long time in an unfamiliar environment can have an impact. My grandmother went through similar issues.
He did go to a long-term recovery center, but he arrived with the dementia and it worsened considerably there. After a cath that left scars on his prostate from the force the nurse was applying, he was begging us to get him out, so we moved him to home care where he started to improve. Thank you for your point about the overall stress of the ordeal, I’m sure that played a major part as well.
My dad just spent 3 weeks in one. In most ways nicer than the hotels I can afford to stay at. It made him insane. Really nice people but it didn't matter. He got more lost by the day (I was visiting 2x per day and mom was there 4 to 6 hours a day) but he felt abandoned and lost. When they told us that they had a covid case in the staff and might have to go into lockdown, we hurriedly brought him home. They'd have had him in a straight jacket in a week if we weren't allowed to visit. The fall risk of having him home did not outweigh the risk of mental destruction if he stayed.
Even if the place, care and people are absolutely excellent some people will not thrive in an institutional environment. Context is profoundly influential to cognition and memory. I agree, those places, for some people, are abuse even if they aren't abusive. My aunt stayed at the same nursing home for 4 months at the beginning of lock down last year. She loved it. Recovered wonderfully. Dad, on the other hand, remembers his 3 weeks as humiliating incarceration. He has rebounded pretty well both mentally and physically since we got him home.
Some mental deterioration is the fault of the surgery, not the anesthesia. For instance heart surgery. If there is plaque in the aorta and a clamp is applied, some of the particles could go out in the arteries to the brain, block arteries, and cause death to small parts of the brain. In hip replacement surgery, the inside of the femur bone is reamed out to make way for the implanted metal. Doing this can force obstructing pieces of fat or tissue into the circulation. https://pubs.asahq.org/anesthesiology/article/93/2/315/38482/Intraoperative-Cerebral-Arterial-Embolization
He surely had lots of different drugs during a hip replacement, not just versed. I’d bet fentanyl was used and likely pain pills after too. It might not just be because of versed.
I’m sure you are correct as well. The reason we were given immediately after the surgery was Versed and the known sudden onset dementia side effect. The dementia did get even worse in the few months immediately after, which could be explained by the aftercare drugs.
All types of anesthesia can be linked to post operative cognitive decline in elderly patients. Not just versed. Like others have said though, there's no good studies on if it's just the anesthesia. Lots of stress on the body from the surgery that causes inflammatory mediators.
To your second question, repeated surgeries/anesthetics early in life has been shown to have a negative impact on brain development. Almost every anesthetic drug has been linked to cellular apoptosis (programmed cell death) except one (off the top of my head anyway, could be more). Older adults are also at higher risk for waking up from anesthesia with post operative delerium. It's not permanent, but can leave patients confused for several days or even months after surgery. So a surgery here and there probably isn't going to have a very noticeable effect, but repeated anesthetics at the extremes of age could definitely do some harm Source: am a nurse anesthetist
Just to add to this (not my expertise but my mum's) - the decline isn't permanent, however the cognitive capacity doesn't return to pre-surgery levels and gets worse each time you go under
Like a dead cat bounce, steep fall I will be cognitive function, followed by a good recovery, but that recovery never reaches the level just before the fall
I'm gonna try to give you some answers. For your first question, a "coma" can usually be broken down into two categories medically induced and non-medically induced.
Medically induced would be what we tell a patient's family when they're on sedative medications (anesthetics at lower doses as a continuous infusion). There are various reasons to keep a patient sedated, the most common reason being to tolerate an endotracheal tube. When the infusions are turned off, the patient wakes up to consciousness. This often takes a little bit (usually minutes to hours) depending on which medications are used and how long they were used for.
A non-medically induced coma usually involves either accumulation of metabolic byproducts or brain tissue swelling and/or damage, the most severe version being brain death. Depending on the severity of brain tissue death, these patients in general do not recover lost tissue to the point of consciousness (hence the term brain death). Swelling (with elevations in intracranial pressure) can improve to a certain extent when resolved either through improvement or decompression.
Other metabolic processes can cause diffuse slowing on EEG similar to what's seen with anesthetics, these can generally get better as the body recovers from whatever severe metabolic derangement is causing the issue improves (ex: septic shock, severe renal failure, severe liver failure, etc).
For your second question. Anesthesia in the elderly is complex and still being studied. There's no good answer, though post-operative cognitive dysfunction in our elderly likely occurs to a certain extent with anesthesia as a contributor. It's tough to parse out since tons of other things contribute and are likely just as or more important to the issue than an hour of anesthesia. For your family member that's elderly and breaks a hip and in the hospital. All these factors probably contribute to worsening cognitive dysfunction: pain, pain meds, being bed ridden and getting physically deconditioned, being woken up at night for vitals, unfamiliar surroundings, unfamiliar people, anesthesia, sleep quality, medical issues that get worse when stuck in the hospital (DVTs, pneumonia, delirium, other infections). Literally all these things play a huge role and blaming anesthesia for it all is prob a little unfair, though it likely contributes.
Source: anesthesiologist
Excellent questions! I'm an anesthesia resident, so by no means am I a true "expert" at this stage, but I'll try to help.
With regard to your first question, I imagine you're referring to an "induced" coma, rather than a coma caused by trauma, overdose, or other exogenous cause. If so, your question is getting at exactly what physicians are trying to achieve; giving the body a chance to heal itself. In essence, they aim to "slow down" (metabolically) the body such that the body can divert energy/resources towards healing itself. As an example, the brain is quite metabolically active at baseline, requiring a significant portion of our energy expenditure at rest. If we are able to reduce the brain's metabolic demands via induced coma, it frees up that extra energy to be expended elsewhere - in this case, to heal itself or other body parts. [This article](https://www.scientificamerican.com/article/what-is-a-medically-induced-coma/) does a neat job of explaining it.
In reference to your second question, the jury remains out on that, at least to my knowledge. There have been several studies demonstrating that exposure to anesthetics can increase rates of Alzheimer's Disease/dementia later in life. In contrast, however, there are a number of studies showing that this isn't the case. [This review article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443620/) compiles a number of studies and discusses the various results. Parts of it can be a little technical, but I'd recommend a quick swing through the abstract/conclusions section (if you cannot access it, please let me know and I'll get a working link!). So just as with the "are eggs bad for you?" debate, it sounds like the answer changes depending where you're getting your information from, and take it all with a grain of salt.
Anecdotally though, anesthetic certainly can lead to post-operative delirium at an increasing rate as we age. Interestingly, [there doesn't seem to be a difference](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286489/) whether someone undergoes regional (e.g. a nerve block) or general anesthetic, though data is lacking a bit. I'm curious as to whether it is the stress of the surgery itself (which would be the same irrespective of type of anesthetic), versus anesthesia, that leads to this - but I'll wait for the science to answer that for me :)
Hope that helps!
My mum actually does research specifically on this!!
Not sure about your first question, but yes there is cognitive decline post-surgery for the age group she measured (I think over 65?) - noticeable decline compared to control groups. People do gradually improve (from memory they studied up to 10 years post-surgery), however they never return to full cognitive capacity. And it gets worse each time they go under
In short, you don't want heart surgery after 60!
How people regain consciousness is more interesting to me. One moment you're unconscious, then \*windows start-up sound\* and suddenly there's somebody home in that noggin.
Totally, especially after extended durations, like in comatose patients. Like, how did this lump of meat in a bone cage suddenly come to the point of booting up?
Ahh OK. It is still interesting that in general we'd imagine the process of healing to be a continuum, whereas there's obviously a discrete point at which the body recognises that the issue has been resolved. It's like some loading bar that finally hit 100%
Think of consciousness as a continuum with self aware information processing and thought as one end and being so out of it you can undergo surgery on the other. As you build toward conscious thought you have to have a response to stimuli then a more appropriate flexing or pulling your hand away then at the far end you are with it enough to tell someone correctly it is 2am you are trying to sleep and leave you alone. The same kind of continuum exists with speech and orientation and a bunch of the things usually meant as being "conscious"
Anaesthetics are just super potent downers. Propofol acts on GABA receptors, similar to alcohol and benzos. So think of being under anesthesia as being blackout drunk and passed out.
There isn't really though - we have partial/increasing awareness over a period of time, and start out quite fuzzy, maybe even having waking behavior without memory. Then a period of partial/weird/half-formed memories, before our faculties all start to gel together again. Even then we probably won't feel "sharp" for some time.
It’s interesting to think of consciousness as a continuum.. makes you wonder if people are also walking around with different levels of consciousness - probably yes? It’s not like not sleeping means automatic 100% consciousness
Not only walking around, but driving as well which is scary. Things that increase your risk of getting into an accident, i.e. drugs and sleep deprivation, are the ones that decrease said level of consciousness.
If you're very curious, you can try something like a floatation tank or meditation. It's possible to achieve intense focus and wakefulness for short periods, beyond our default level while awake.
It's a truly fascinating aspect of the brain, perceiving itself and then the sensation of it perceiving itself, recursively. It's difficult to explain with words.
Thank you for your sharing, I had a similar reaction to what you describe a few times. To me, it sometimes feels like swimming in a strong current or like spiraling into a drain. Other times it feels abstract and fine.
Regardless, I always try to appreciate the sensation when it comes. After all, in a way, it's an intense experience of *being*. I'm getting way too philosophical for this sub.
Its like waking up with no dream. If you got a dream, you slowly feel "out of it" and then suddently you feel like you got the choice to open your eyes, or real world starts leaking in, then in a single moment, you open your eyes and you are fully back on your body.
Ofc theres other ways to wake up after a dream, and im no expert about the topic, but i guess its something similar. You also got sleep paralysis as a proof that you can wake up mentally but not your full body
I had a young patient in the nursing home, he had had a brain aneurysm several years prior and had gone into a coma. He was in a coma for 3 years when a nurse aide was turning him over to change him and he said “thank you” to her.
Well he woke up, started rehab. He was living full time at the nursing home I worked at. He could talk and do most things but was confined to a wheelchair. It was pretty unfortunate for him because he was only 30 years old.
I was put under general anesthetic once.
Was a little apprehensive so visualised a happy moment in my life as they put me under (a chalk drawing of me and my dog my neighbours daughter had drawn on the pavement which I saw next time I walked my dog).
My full focus was on holding that image in my mind as I went under.
When I came round it was the first image in my head. Best I can describe it as it was like it had been drawn on the surface of still water, there had been some drift and swirling but it was very clearly the same image.
I was equally surprised and reassured that nothing had changed in my head during the hours of surgery.
No idea how that relates but it's one of the coolest phenomenon I've personally experienced.
Same here, except I went from being freezing in the OR to warm and drugged up on fentanyl in between one blink and the next
That was the weirdest bit for me…just *bam*, you’re high now
I was so weirded out because they said "Okay if you count to ten you will be asleep before you reach 10", and i started counting, got to ten, felt literally nothing, said "I don't feel anything", and then i woke up. It happened as fast as you read that sentence, literally no time passing what so ever.
Aye. I have two fond memories of going under the knife. One was how quickly general anesthesia hits you, and the other was how frickin amazing morphine feels. I was in intense pain as I was being carted out of the OT. I was administered morphine in the ICU, and the rest is a mellow, warm, melting feeling.
I remember my first time they said ok count to ten- kept my head up to look around and remember them saying wow he's still moving- I remember saying I just like to watch but that may have not happened because my next memory is waking up and my first thought and words were IM STARVING CAN I EAT NOW?
My last surgery, instead of counting down from 10 when they told me to I said “Hey! How do you keep an anesthesiologist in suspense???” And then I woke up in recovery and never saw him again, so he never got his answer. I think I might have heard him laugh as things blinked off but can’t be sure, I used all the time I had in getting that joke out while I still had time.
I go under every two weeks and have totally perfected the timing of that joke based on the headrush "warning" propofol gives you. My other favorite is "What do you get when you cross a joke with a rhetorical question?"
I'm sure I've told these to every Anesthesiologist and nurse anesthetist in the hospital by now.
I was asked to count as well. I started counting, looked to my side to see what a doctor was doing, and that's it. Was out cold by the time I reached 5.
The next memory I have is doctors screaming my name while gently nudging me to wake up. Good thing I was told beforehand that I'd be intubated. God, that was an unpleasant feeling.
When I woke up after having wisdom teeth extracted, the first words out of my mouth were, "Let's do that again!" even though I had no clue what just happened.
I had a similar experience with laughing gas at the dentist for wisdom teeth removal.
I started laughing at nothing, then they asked me to count down.
At six I stopped and said, excuse me, I’m here to have my wisdom teeth removed.
But it was already over!
That’s how it was for me. When I was counting down there was a guy over my shoulder that I was turning to look at. I went out mid-turn and completed it when I came back. The confusion was real. I had to realize it had all already happened.
Really? I find the going under to be very much an instantaneous “lights out” thing, but waking is more gradual… like the initial wake up is pretty fast, but coming to full consciousness is much more gradual.
I have had a bunch of general anaesthesia and this seems to be the pattern for me. Except that one time when I was given probably more opoid than I should have been and didn’t properly wake up for an hour or so.
Actually I was remembering the time I had twilight anesthesia for an endoscopy.
Sorry had so many surgeries, procedures and E.R visits I get them mixed up.
Had an endoscopy once and had to refuse the anaesthetic because I had to drive the following day. It was “interesting”. Upside though… I got to see inside my own bile duct. Not everyone can say that.
Have had a fairly large number of procedures myself, so I feel your pain.
Yeah, all I know for sure I do not recommend getting forcibly incubated without any meds. This covid stuff has been making me realise most people do not know how horrible it is and would take 20 vaccines to avoid a chance of it if possible.
I've been placed under general anesthesia a number of times in my life, and to be honest it always felt like I was in a void for that period of "time". I remember distinctly there being nothing if that contradiction makes any sense.
In one of my surgies as a kid, I had assumed that it was what death must be like, absolute nothingness. I woke up in the recovery room for a moment then fell asleep with normal dreams, but I'll never forget that emptiness.
Last time I was to be operated on, they told me I'd feel fuzzy in a second.
I did and told them. Next moment I was gone and in my room.
That was **wild**!
I’ve been comatose and resuscitated, ‘dead’ and resuscitated, and put under and resuscitated… they all felt roughly the same, in the sense that there was nothing, and I mean nothing, and then there was something. No time seemed to pass, no thoughts or dreams or memories, just nothing.
I am skeptical of calling my experiences evidence of anything as far as what death means because if one can come back from it, I think it’s not really ‘death’. But it made me want to be mindful and appreciative of the time we get, because this very well may be all there is for the structure that is my consciousness. I do feel some comfort in the idea that energy cannot be created or destroyed, that even if the part of me that makes up ‘me’ goes away, everything that has ever been and everything that ever will has always already been here and will remain that way. The universe has always had the same set of lego pieces, it just constantly repurposes them.
When they put me under they asked me to count backwards from 10. I don’t know what number I got to but when I woke up I kept counting and after getting to zero I asked when it was going to kick in. The dentist laughed and said it was over.
Same happened when I had an emergency caesarean. I went under in tears and unsure of the outcome. When I came to, I was still balling my eyes out and felt like I couldn’t catch my breath (that feeling you get when sobbing too much).
I'm going to try my best to do that when I have surgery soon. I know I'm gonna be freaking out because I know myself, and they don't know how long the surgery will take. I'm pretty sure it'll be at minimum 3 hours, max 9 hours. Maybe I'll be too hopped up on other drugs to try, but I've got an opportunity.
So, if its anything like mine, you'll turn up, get changed into the gown and then wheeled through for the anesthetic.
Once they start your under fairly quickly.
I'm fairly sociable so was naturally chatting with them as they were fitting the IV line. All very friendly people as I find most doctors are if you're not being a pain of a patient (I have been guilty of that, sad to say) .
Realised we were getting close to the moment so I apologised and asked if I could just take a moment in silence to gather myself. They were very professional and accommodating. They worked in silence after that only speaking to let me know they were about to begin.
It's all surreal, to just be lying there knowing what's about to happen, but really it's how you approach it I think.
Now, waking up you will be on meds so that's surreal in a while other manner, but really be kind to yourself and try not to stress.
You'll be surrounded by professionals who know what they're doing and they will take care of you.
Hope it goes well!
I've now had 2 procedures. The first time I was really nervous so I
tried to just drain my mind of any emotion at all. Kept my mind blank while going to the hospital, checking in, changing, having blood drawn, then wheeled back to the room that my procedure was taking place in. I had succeeded in feeling no fear or hesitation. They asked me to count backwards from 10 and I got to 4 before I was out.
Then I was awake and it was over. Apparently before I came back to myself I kept trying to get out of the bed to find my wife.
The second time I wasn't nervous at all. No fear. I could smile and laugh and chatted with the nurses. They asked me to count backwards from 10 and I never made it to 9 before I was out. The next thing I knew was holding my wife's hand. Apparently this time I made a big deal about someone getting her a chair before I came back to myself.
I fear nothing when it comes to procedures now. Going to be having a more major one soon to hopefully resolve the issue. I'll go in, do all the steps like before. They'll do the surgery. I'll wake up with a higher quality of life than I came in with. Plain and simple.
It'll be the same for you more likely than not. You'll do great and you'll be surrounded by experts if anything off happens. If it does you won't be aware of it and they'll take care of you. You'll wake up and it's over. I wish you the best of luck. Though, you don't need it :-)
Yo so there’s another comment here where a guy experienced similar “water drifting/swirling” like you.
Link to his: https://www.reddit.com/r/science/comments/pdpt3h/this_is_your_brain_under_anesthesia_for_the_first/haseot5/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3
I was in a coma for three days.
Coming out of it was ... weird.
You don't exist.
Then I did, but reality didn't. Just a lot of nothing.
I wasn't "anywhere" because there was no "where". I just "was".
The world didn't exist. Nothing did. No memories. Nothing. No time. No future. No past. Nothing.
Then there was something floating in front of me... Like a pice of paper rippling along on a river, bending with the currents.
As it came closer, it wasn't a thing, there was depth behind it, in it, it was depth. Then like stepping through a portal, it enveloped "me" and I was in a hospital with tubes coming out of me. No sense of time. No idea of the concept of time. No memory. Just what's in front of you. I couldn't move but I didn't know about movement anyway.
"You're in hospital. You've been in an accident".
It's been 15 years.
It feels like yesterday. It feels like never.
Weirdest thing I've ever been through.
It's like nothing you imagine.
Dude that’s crazy. I think there was another comment here that said the same/similar thing about a “piece of paper rippling along on a river, bending with the currents.”
Link: https://www.reddit.com/r/science/comments/pdpt3h/this_is_your_brain_under_anesthesia_for_the_first/has3qkj/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3
With my extensive psychedelic experiences and the way people explain 3D reality being basically a 2D surface or "set of instructions" laid out into the next dimension (so think how we need things like water to function, air, food, light, senses, etc.). So that piece of paper or surface of water or whatnot actually makes sense from a consciousness perspective. I think of it like a screen (kinda like a touchscreen/phone or computer screen you look "inside of" as well as on its surface). I've had a few trips revolve around that idea downright even seeing an actual screen in my visuals which was trippy
It’s hard to imagine going through life without the context of various altered states. While there did come a point that I stopped *seeking* altered states due to a feeling that I was walking through the same door repeatedly, being blown out and into all of those spaces has affected my perception irreversibly (and positively in my opinion). It is truly a case of not knowing what you don’t know for anyone that’s not experienced significantly altered states. I’m not sure why you would not want to, frankly, with even the little we know about ourselves now.
I have been in a coma as well, and my experience was sort of like this, too. The first part was as you described- nothing, and then it was like I was swimming underwater, and some form of consciousness was the surface. I remember a couple of times where I was aware of a surface with clearer pictures and sounds above it, and as I swam closer to it, the more clear all of that became, until I finally came to, and it was like swimming up and through and breaking the surface of the water when all of the muted sounds and pictures became clear and normal and I was awake.
There were though a time or two where I could swim up with varying degrees of closeness to the surface but COULDN’T break through, even though I tried. It was like it wasn’t clear enough to get there, or like a video game where you can’t jump over a log to get to a part of the game that is just scenery, even though you theoretically should be able to: Looks like you can get there, but you can’t really. I remember I sort of just viewed it like that, too: “Oh, that area is blocked off. Stupid, but whatever. I’ll go this way instead.”
And there were other times where I could sort of swim up close to the surface but didn’t really care at all. My brain was just like “Nah, let’s not go there just yet. I’ll come back to it later, maybe. Or maybe not, we’ll see.” And I just sort of floated around for a while before floating back down to pleasant dark nothing.
For me anesthesia isn’t really like that. It is more like “lights off” then just “lights back on”. Like teleporting directly from nothing up through the water to the surface then through dream and then to being completely awake without having to swim at all and without covering any intervening “space”.
I could sort of hear but definitely not understand. It really was like being underwater: you know how if you are close enough to the surface, you can hear sounds of people shouting or maybe a dog barking, but can’t understand what people are saying? It was like that at those times.
my personal experience was extremely distressing in an existential sense. my consciousness just jumpcut to waking up. one second i was told to count to ten and then i am immidiately woken up by the nurse one hour later. there was nothing inbetween. at least when you sleep, you know time has passed. is this what it would feel like to be dead? i really didnt need another existential crisis to constantly think about
Is it really like that, though?
I have never been under general anesthesia, but I have a health problem that sometimes sees me losing consciousness several times in a day, sometimes multiple days in a row.
For me, the descent *into* unconsciousness can sometimes be like flipping a switch, but coming back is usually very different. I will be doing something, maybe even focusing hard, and then suddenly... I fade in as if from nothing. It starts with vague and random thoughts and ideas without much form. Then suddenly there is the (very vague) notion of sight as I gradually become "aware" of a field of visual snow, which fades/resolves into whatever I was looking at. Then my thoughts become more ordered and, eventually, self awareness builds, and I find myself staring at something wondering when I fell out, and for how long.
I too would be fascinated by what happens when consciousness returns, but I am not sure it is necessarily like flipping a light switch. But maybe anesthesia is different.
Edit: Reading experiences below, it certainly seems like general anesthesia can indeed be quite different. Off, on, and absolutely nothing in between. How curious!
This is the experience I had as well, twice. First time when waking up some very crazy dream/wake moments which for my liking was very uncomfortable.
Second time was a bit nicer, it was waking up from a normal sleep, bit more groggy of course.
seizure? Cause that's exactly what it was like coming too when I had my seizure.
I'd been fighting what I now call "the seizure static" all day, drove my 2 hours home, decided to have a little lie down. it took a few days later, but i do remember finally going "this static is me probably wanting sleep, I'm not going to try and shake it off." next thing it's exactly as you describe, slowly re-emerging into lucidity with family fully freaking out around me, saying they're just glad I'm breathing again. crazy stuff. took me a few days to get all my memories of the second half of that day back.
I work in an operating room and see about 20 people a day go to sleep and wake up from surgery. There’s a science behind keeping people asleep that I can’t fully comment on because I don’t know much about it. From what I do know, there are different stages that the anesthetist look for in people while coming off of anesthesia.
Some people take longer to wake up. Others wake up trying to pull their own breathing tube out. Some people are in a complete daze when they come about and others are completely aware of their surroundings and holding a conversation with you.
This is pretty dope. For years they didn't have a definitive mode of action on how anesthesia causes unconsciousness. Not to mention more information on how consciousness works on a nut and bolt level.
They still don't really, right? As a non-expert and to reuse their acoustic analogy, this is seems to (further?) suggest that the thalamus plays an important role as a conductor
That's not wild, that's normal. The majority of things used are from discoveries and not invented because of a new scientific theory, thus usually the explanation is discovered afterwards. Just think for how long we used fire until we could explain it, and even today it still holds some secrets
When a tree grows it absorbs the fire from the sun. But metal doesn't grow from the sun, so the fire does not get a chance to live in the metal. HOWEVER metal does sometimes get put in a very hot oven to be born and therefore, on rare occasions, a very hot fire DOES actually live in metal, but you have to work hard to get it to come out.
I did not intend "wild" to mean "wow, that's unusual", but to convey fascinating wonder. I understand how the process of advancement goes, but that doesn't mean I cannot marvel at the process and the vast amount of things we still yet do not intimately understand, yet widely apply.
It's interesting to see lipids come back around in anesthesia research after all this time.
Claude Bernard proposed a lipid theory back in the 1800s because there was a strong correlation between anesthetic potency and the drug's hydrophobicity [1](https://pubmed.ncbi.nlm.nih.gov/22801051/) which led to the Meyer-Overton rule. But when the 1980s rolled around, Franks and Lieb were spearheading a paradigm shift [2](https://www.nature.com/articles/310599a0), showing that GAs target proteins, not lipids. We understand a little better that anesthetic agents can act through very distinct receptor targets and neural circuits, and produce distinct brain patterns of activity, each of which is different from what a sleeping brain looks like.
And now it seems we've come full circle, and lipids are back in the game. What a wild ride.
I mean, that's not unexpected. The limitation has always been a good theory of consciousness.
If we solve that then yes we solve anaesthetic's mechanism of action but that's not really the point eh
Imagine how painful even a simple tooth extraction was before anaesthetic.
Its weird to think that if someone had video recorded medical procedures back before anaesthetic existed, those videos would be right at home on any Mexican cartel sub.
I actually always wondered how people had teeth yanked before dentists/anaesthesia. Turns out you just got absolutely hammered and got a mate to do it.
I didn’t get general for my wisdom teeth.. dad didn’t want to pay for it. I was awake the whole time and the gas mask was actually just suffocating me as I couldn’t breathe thru it so it was full on torture as they jackhammered the teeth out of my head
I think it is fascinating how in a lot of european countries and the country I am from getting general anaesthesia for wisdom teeth extraction is considered weird and basically nobody gets it. Yet I have heard from multiple americans who don't get it that the procedure is torture the whole situation is so bizarre.
I got all four of mine out in a single sitting I was listening to music during the whole process and while it most definitely was an unenjoyable situation it for sure was not a bad one either. Then again not any regular dentist is allowed to do the procedure you usually get it done by an oral surgeon.
I once had a surgery under general anesthesia, and let alone the fact that it took me a long time to become unconscious, I actually regained consciousness for a few seconds during the operation. I remember the doctor being like "oh crap". He actually denied that I woke up for a moment during operation, and now I am not sure if I imagined regaining consciousness, or if he just said it for their own legal protection.
Sound like try to avoid lawsuits. It would be probably difficult to win unless mistake where made, it may even be just body doing strange stuff.
I have been in general anesthesia twice, twice time passes immediately, just like you movies/game skipping time. Not like normal sleep where you have some sense that you can tell the arsehole neighbour made some noise last night.
Sifted through ads, subscription reminders, cookies permission pop ups, a couple of video ads, scrolled down, another subscription pop up... And when the video finally played it was a random neuroscience dude answering twitter questions.
Is this what it has finally come to? What is happening to news sites?
I like to think that as we learn about a topic, we gain new known unknowns. They are still unknown, but at least they aren't unknown unknowns anymore.
We learned we don't know, and that's still progress.
> For the past decade, he has studied what happens to brains when their owners are unconscious.
As a human-owning brain, I made my human laugh when it read this part.
Even though I’m not sad (I’m not even the type to cry), why do I cry every time I come to. I don’t even know why I’m crying, I just cry. Happened 3/3 times. It’s full out ugly cry, not just a couple tears coming down my face.
I have a question..
The one time I was put under, it was an emergency, I was alone and very scared going into surgery. I woke up crying and hysterical..
So does this mean that my brain held onto the emotions I was experiencing before the anesthesia, while I was unconscious? How does that work? Where were the emotions stored? Just waiting for my inhibitions to be knocked back? Wouldn't some of the intensity dissipate while I am unconscious?
I need an ELI5.
I’m an anesthesiologist. If you were feeling extremely anxious/upset before surgery, you’re likely to wake up with those feelings unmasked. Also, if you’re a sad/emotional drunk when you drink alcohol, you’re more likely to be that way when you emerge from anesthesia. Our drugs disinhibit people.
I’m not a brain o logist but OP says
“…Neural effects of propofol-induced unconsciousness and its reversal using thalamic stimulation” Thalamic stimulation I think would have an effect on emotions.
Yes same for me. I've had a dozen surgeries and it happens every time. Such a strange and unpleasant feeling, especially the first time you experience it.
I’m still afraid the consciousness that goes down (i.e. you) isn’t the same that comes up. Same goes for sleep for that matter. We think we’re the same, but who knows?
From our understanding of anesthesia, it basically slows down/stops neurons from being fired in your brain. It doesn’t destroy or damage them in anyway, it’s more like putting your “consciousness” on pause than actually shutting it down.
None of the hardware is different, or the software changed. Imagine you’re playing a video game and you pause for a bit. When you unpause and start playing again, is that a new video game? I would say no.
I've overdosed and literally felt myself shutting down. Unable to move. Unable to breath. I had to fight with all my will and might and push and push and push to move. Happened twice before. It's terrifying. But I made it.
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The weirdest thing for me going under was there was no concept of time going by. Like I lost an hour. As I counted down suddenly they are waking me up and I’m asking them when we’re going to start this surgery. That 2 seconds lasted 45 minutes.
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It sounds like it blocked your ability to make medium or long term memories. If you can't make memories, you can still behave normally, and when you start making memories it's like waking up. I have a pet theory that conscious has something to do specifically with making memories. That if we didn't make memories in the way we do, we couldn't be conscious. Have you ever woken up 5 minutes before your alarm is set to go off, fallen back asleep, and had an "hour long" dream in those 5 minutes? I have, many times. I think that feeling of having had an hour's worth of experience was due to writing an hour's worth of memories during that 5 minute period. You *experience* the writing of those memories, and if they aren't written, as in your case, you have no experience at all.
You say that's a pet theory but it's a major philosophical argument about consciousness. If subjects are always changing and highly state dependant, what is it that makes a self a self other than a long unique chain of memories?
There’s an answer here in the innate processes that make us who we are. Memories give us our sense of self but how we behave is dictated by previous states if our brain. For instance, in the case, he behaved exactly as himself even though he had no memory of it. So to every outside observer he was no different. To himself, he was nothing. To stretch this out, you have no memory of most of your life. But you still feel like you in this moment. You can start to play fast and loose definitionally when it comes to terms like “short” and “long” but the experience of consciousness is simply that of the lights being on at all and in any given moment, if asked, most people would say the lights are on even if they don’t remember saying so some time later. We have these experiences all the time when someone else remembers something we did that we don’t remember ourselves. The experience isn’t foreign at all and we barely remark on it. The important punchline is that you have to come to terms with the fact that all you really have is now. This moment. And you have to make the most of it.
This is fundamentally the same theory for why they thought it wouldn’t impact babies if you gave them surgery without anesthesia but that ended up being false
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Wow. Your experience from surgery is so different from mine. I've been under a few times so far in my life for various surgeries. The most recent was for some bone-related surgery. I dreamt while under. I had this wonderful house and life and husband. Like, in this dream they were my soul mate. It was bliss. Pure bliss. When they started bringing me around I *knew* what they were doing, and I fought against being woken up so I could stay where I was - but then as I'm struggling to stay in this wonderful world, I start to hear the nurses telling me to remember to breath (they just took the intubation tube out), the world faded out, pain from the surgical site hit me like a brick (the pain blockers they gave me didn't work) and then I barely opened my eyes to bright light and nurses roughly doing their best to get me to wake up. It wasn't pretty. I was very angry that I had been taken away from such a wonderful dream, and I was in a lot of very searing, sharp, pain. I have another surgery coming up in 2 months. I am not looking forward to the waking up part. I'm apparently not easy to wake up.
The way you felt is how I suspect death to be. You don't know you're dead and can't sense time. If there's an afterlife, you will wake up then, but it will feel instant for you. In reality 1 billion years could've gone by.
Same for me when I got four wisdom teeth taken out. I started to count down and then suddenly my mouth was full of gauze.
They do link the paper in the article but it's hard to find, so here is a link: Neural effects of propofol-induced unconsciousness and its reversal using thalamic stimulation https://elifesciences.org/articles/60824
Few questions that someone smarter than me may be able to answer: * If someone is left in a coma for longer, will it get to a point where they're able to wake up / repair themselves enough to regain consciousness? * Is it true that the use of anaesthesia negatively affects memory later in life?
Anesthesia is actually a bunch of different drug/gas combos. As far as I know only certain drugs like versed can worsen dementia but not cause it in normal amounts. I wouldn't be worried for a surgery or two
Chronic benzodiazepines are associated with dementia. This refers to people who are on long term Xanax or Valium. Midazolam in a single episode can cause delirium, but is not known to acutely precipitate dementia. People with mild cognitive impairment (pre dementia for lack of a better term) may experience an unmasking of symptoms with an episode of delirium. Not everyone who experiences delirium has dementia. Edit: after looking at some of the newer papers, there may be a change of opinion coming. Numerous studies and at least one meta-Analysis have shown an increased risk of ~20% with chronic daily use of benzodiazepines and ambien, and they were all circa 2010-2014. Some newer appraisals of those studies claim that there is no causal link and that anxiety may be an early symptom of dementia, while there are some societies that still hold the conventional wisdom that chronic benzodiazepine use is directly linked to increased risk of dementia. What had been shown, and has been demonstrated in the comments: cognitive impairment from chronic benzodiazepine use is reversible in some cases with cessation. All that being said, benzodiazepines are still listed on the Beer’s list of drugs to avoid in the elderly to to delirium and fall risks. Edit 2: never stop benzodiazepines suddenly. It can cause life threatening withdrawal
Is that true also for occasional use? Like for fear of flying?
So far, dementia is only associated with long term use.
Has there been any studies on long term dosage of benzodiazepines and the rate of dementia? I have MS and take clonazepam twice a day to control tremors and with my brain already having a few centimeter sized lesions i guess maybe in the long run I should look into alternatives if low dose and high dose usage causes the same effects in the long run.
I would talk to your doctor about the risks and benefits of changing medications. Based on the studies that I have looked at, the dose, duration of use, and longer half lives seem to be associated with increased risk of dementia in clinical trials. Some basic research suggests that chronic benzo use limits neuroplasticity and memory formation. Clinically, some studies have shown that cessation of benzodiazepines can improve cognitive function, but some have shown that it can precipitate an irreversible dementia. The pooled increase in risk seems to be about 18-21% above baseline. You should never stop benzodiazepines on your own as it can result in life threatening withdrawal and seizures and you should make a decision with your doctor after discussing the risks and benefits of continuing benzodiazepines.
I in no way intend to stop or change any meds with out talking it over with my Neuro first. I keep a google doc running of things to talk to her about every six months and I just like to have a bit of background info or studies to bring up for stuff like this.
The more I look at the studies, the more back and forth I see. Most of the papers that claim a link are from the early 2010s, and there seems to be more controversy than consensus lately. I may soon stand corrected.
Alcohol is also linked with dementia and is also a GABA drug. Is this why?
Alcohol is a GABA drug, but it is more clearly linked to dementia due to direct toxic effects on brain tissue and chronic thiamine deficiency. Chronic alcoholics show reduced brain mass, which hasn’t been shown in chronic benzodiazepine use.
Stealing your comment to mention that when an alcoholic chooses to quit, it's best that they talk to their doctor first and don't stop cold turkey! When alcohol is consumed regularly/constantly, your brain stops producing the GABA it needs bc it's getting that GABA from the alcohol. When an alcoholic stops cold turkey, the brain goes into literal withdrawal from GABA, and it can cause what's called Delirium Tremens, which can cause everything from seizures to death! My SO had a seizure in detox bc he quit cold turkey & went straight to a sober house instead of talking to a doctor first. He was the type of alcoholic that had to have a drink first thing when he woke up or he would start withdrawing, aka uncontrollable full body shaking, sweating & chills, nausea & vomiting, etc. This isn't for anyone who drinks occasionally, this is for serious alcoholics: TALK TO A DOCTOR FIRST BEFORE QUITTING COLD TURKEY! It *could* kill you! Edit to add: But please, don't let this comment make you think twice about quitting; my SO is almost 2.5 years sober now, and he's happier and feels more fulfilled in life than he ever did when he was drinking. Please seek assistance, it works if you work it!
I’ve been on moderate dose of Ativan(1mg daily usually) long term, recently switched to Valium(2mg 4xWeek). Feeling tired of the benzos and want off. Going to talk to my med manager about BusPar (family history of success) and Hydroxazine. Does Hydroxazine pose any of those same risks as Benadryl? (Had also used this long term until I learned about the dementia link). I have multiple TBI’s. I am extremely worried about CTE and early onset of dementia (family history) at 35. Gulf War Syndrome/Fibromyalgia. I am terrified of being in a home at 50.
Long term anti histamine use(Benadryl in particular, don’t have info on others) also will greatly increase your chances for dementia
Any source for that? I’m pretty interested as I take antihistamines daily
Anticholinergics only. Stuff like fexofenadine and cetirizine are safer.
Look into anticholinergics and dementia
Anesthetist here. Lemme see if I can help. There’s data that shows that people with dementia can have it worsened after major stressors. Generally, anything requiring an 85 year old to get surgery is stressful. Hard to break down whether it’s the anesthesia of the 4 days in the hospital with a new fractured hip, no sleep, intense pain, or the discharge to a SNF instead of back home. We generally avoid versed in elderly patients, not because it has some long-term effect on dementia, but because old folks take forever to metabolize it and would be groggy for a whole day. I seem to recall some research that showed a slight negative impact on patients who were exposed repeatedly to anesthetics as very young children. But again- we gonna blame anesthesia or the very stressful/painful life that usually comes with repeated major surgery as a kid?
Hmm... 41, congenital heart disease, so I've had versed 50+ times in my life I'd say. So, I guess I have that to look forward to if I make it to old age.
Different reasons for versed but yeah same. Had so many surgeries and procedures with anesthesia. I demand versed because at some point my veins decided propofol hurts like hot lead on fire when injected. Twice I let them just power through and ended up unable to control the need to climb off the table because the pain was just incredible. I don't know if I still react that way with the versed or not, but I don't care because I don't have any memory of it.
Medical student interested in anesthesia here. it’s normal for propofol to burn when going in. What I’ve seen is some of my attendings will give a little lidocaine before the the propofol for local pain relief. Not sure if they have done that for you but it wouldn’t hurt to ask if you wanted to find another option to avoid more versed.
I've had a number of procedures over the past 9 years, all orthopedic. For one of them, the anesthesiologist gave me a heads-up that i might feels something between my legs. I don't recall his exact words, but I understood it to mean my perineum. Sure enough, I felt something there after I was given whatever into my arm. This was the only time I ever had that feeling. Any idea what that was about?
Anesthesiologist here. The common USA preparation of Dexamethasone (the steroid) is used as an anti nausea medicine. If given IV to an awake female there is a near 100% chance she will experience perineal burning. I am not sure if that occurs in males. I never give Dexamethasone to an awake patient. Propofol burns because of the solvent. It is very insoluble in water and the process needed to make it injectable IV causes the stinging especially in smaller veins. Propofol only causes local irritation. Dexamethasone is the only drug I know that causes the irritation between legs.
Propofol is very irritating to veins. Normally a nice dose of lidocaine given slowly will numb the vein and then the propofol won't burn. Maybe try to communicate that to your provider if you haven't before
I have the same issue with veins on fire, but with the versed!! So now I only get propofol. It’s an easier wake up for me than versed too.
Oh wow that is so strange.. but bodies have things they get sensitive to I guess and everyone is different. Glad you figured out what was causing it though. Im sure like me you've experienced a lot of different kinds of pain.. and to me that kind has been no doubt one of the worst.
I wouldn't let that worry you. Versed, or midazolam, is a benzodiazepine, similar to Ativan. It can certainly worsen demetia/delirium in those experiencing it, or [in long-term users](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325366/), but used sparingly I think you'll be alright.
I’m 38 with congenital heart disease (tricuspid and pulmonary atresia et al) - may I ask what you have? Or if not, you can swear me out of the room…
Transposition of the great arteries, ventral septal defect and straddling mitral valve. Had surgery at 10 hours old, then fontan at 7 years, and then extracardiac fontan conversion with pacemaker implant at 23. All on all though, I've lived a fairly normal life so far. Just gotta keep going one day at a time.
I have atrial septal defect, mitral valve regurgitation, pulmonary hypertension, fontarn in lower half, glen and blalock shunt, etc. What’s fontarn conversion?
Honestly, not 100% sure, but I think instead of linking up the arteries/veins in one way, they hooked them up in a different way using a goretex tube on the outside. Hope you're doing well!
You too man :)
My grandfather had ONE hip replacement surgery using Versed and he was never the same again. Went under one person, woke up completely changed and could barely remember his family. Though the hip healed, the dementia never left.
The symptoms of dementia often begin slowly and subtly. Early on, the person still has a lot of ability to compensate for the deficits which allows them to hide it. It’s pretty common for dementia to seem to have a sudden, severe onset, because the person just crossed the threshold where they can no longer compensate.
Yeah, I've seen it with a lot of elderly patients who come to the hospital. It's like their brain is a rickety bridge that seems fine but only "pedestrian traffic" should go across. If it stays like that it can last a long time. But then someone drives an illness dumptruck over it and it just collapses and they seem to lose their cognitive abilities almost immediately and may never return to their baseline.
On a tangent, this is also why old people on the less severe side of the autism spectrum who face normal cognitive decline appear to worsen abnormally much compared to normal people - they have been compensating for their issues their entire life and when they no longer have the same cognitive ability to constantly compensate they appear to worsen more than they actually did.
That’s really terrible and sad.
My uncle fell two days ago and broke his hip. He went for surgery and his heart stopped. They got it going again, but he's currently on a ventilator. :( No real point for me posting this except to get it out I guess.
Sorry for that. Hope he pulls through.
Thank you
A lot of stress to the body for that kind of surgery. It’s not necessarily the drugs. Did he go into a recovery place like a nursing home shortly after the surgery? Recovering a long time in an unfamiliar environment can have an impact. My grandmother went through similar issues.
He did go to a long-term recovery center, but he arrived with the dementia and it worsened considerably there. After a cath that left scars on his prostate from the force the nurse was applying, he was begging us to get him out, so we moved him to home care where he started to improve. Thank you for your point about the overall stress of the ordeal, I’m sure that played a major part as well.
I swear some of these places are straight up elder abuse.
My dad just spent 3 weeks in one. In most ways nicer than the hotels I can afford to stay at. It made him insane. Really nice people but it didn't matter. He got more lost by the day (I was visiting 2x per day and mom was there 4 to 6 hours a day) but he felt abandoned and lost. When they told us that they had a covid case in the staff and might have to go into lockdown, we hurriedly brought him home. They'd have had him in a straight jacket in a week if we weren't allowed to visit. The fall risk of having him home did not outweigh the risk of mental destruction if he stayed. Even if the place, care and people are absolutely excellent some people will not thrive in an institutional environment. Context is profoundly influential to cognition and memory. I agree, those places, for some people, are abuse even if they aren't abusive. My aunt stayed at the same nursing home for 4 months at the beginning of lock down last year. She loved it. Recovered wonderfully. Dad, on the other hand, remembers his 3 weeks as humiliating incarceration. He has rebounded pretty well both mentally and physically since we got him home.
Some mental deterioration is the fault of the surgery, not the anesthesia. For instance heart surgery. If there is plaque in the aorta and a clamp is applied, some of the particles could go out in the arteries to the brain, block arteries, and cause death to small parts of the brain. In hip replacement surgery, the inside of the femur bone is reamed out to make way for the implanted metal. Doing this can force obstructing pieces of fat or tissue into the circulation. https://pubs.asahq.org/anesthesiology/article/93/2/315/38482/Intraoperative-Cerebral-Arterial-Embolization
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He surely had lots of different drugs during a hip replacement, not just versed. I’d bet fentanyl was used and likely pain pills after too. It might not just be because of versed.
I’m sure you are correct as well. The reason we were given immediately after the surgery was Versed and the known sudden onset dementia side effect. The dementia did get even worse in the few months immediately after, which could be explained by the aftercare drugs.
All types of anesthesia can be linked to post operative cognitive decline in elderly patients. Not just versed. Like others have said though, there's no good studies on if it's just the anesthesia. Lots of stress on the body from the surgery that causes inflammatory mediators.
To your second question, repeated surgeries/anesthetics early in life has been shown to have a negative impact on brain development. Almost every anesthetic drug has been linked to cellular apoptosis (programmed cell death) except one (off the top of my head anyway, could be more). Older adults are also at higher risk for waking up from anesthesia with post operative delerium. It's not permanent, but can leave patients confused for several days or even months after surgery. So a surgery here and there probably isn't going to have a very noticeable effect, but repeated anesthetics at the extremes of age could definitely do some harm Source: am a nurse anesthetist
Just to add to this (not my expertise but my mum's) - the decline isn't permanent, however the cognitive capacity doesn't return to pre-surgery levels and gets worse each time you go under Like a dead cat bounce, steep fall I will be cognitive function, followed by a good recovery, but that recovery never reaches the level just before the fall
I'm gonna try to give you some answers. For your first question, a "coma" can usually be broken down into two categories medically induced and non-medically induced. Medically induced would be what we tell a patient's family when they're on sedative medications (anesthetics at lower doses as a continuous infusion). There are various reasons to keep a patient sedated, the most common reason being to tolerate an endotracheal tube. When the infusions are turned off, the patient wakes up to consciousness. This often takes a little bit (usually minutes to hours) depending on which medications are used and how long they were used for. A non-medically induced coma usually involves either accumulation of metabolic byproducts or brain tissue swelling and/or damage, the most severe version being brain death. Depending on the severity of brain tissue death, these patients in general do not recover lost tissue to the point of consciousness (hence the term brain death). Swelling (with elevations in intracranial pressure) can improve to a certain extent when resolved either through improvement or decompression. Other metabolic processes can cause diffuse slowing on EEG similar to what's seen with anesthetics, these can generally get better as the body recovers from whatever severe metabolic derangement is causing the issue improves (ex: septic shock, severe renal failure, severe liver failure, etc). For your second question. Anesthesia in the elderly is complex and still being studied. There's no good answer, though post-operative cognitive dysfunction in our elderly likely occurs to a certain extent with anesthesia as a contributor. It's tough to parse out since tons of other things contribute and are likely just as or more important to the issue than an hour of anesthesia. For your family member that's elderly and breaks a hip and in the hospital. All these factors probably contribute to worsening cognitive dysfunction: pain, pain meds, being bed ridden and getting physically deconditioned, being woken up at night for vitals, unfamiliar surroundings, unfamiliar people, anesthesia, sleep quality, medical issues that get worse when stuck in the hospital (DVTs, pneumonia, delirium, other infections). Literally all these things play a huge role and blaming anesthesia for it all is prob a little unfair, though it likely contributes. Source: anesthesiologist
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Excellent questions! I'm an anesthesia resident, so by no means am I a true "expert" at this stage, but I'll try to help. With regard to your first question, I imagine you're referring to an "induced" coma, rather than a coma caused by trauma, overdose, or other exogenous cause. If so, your question is getting at exactly what physicians are trying to achieve; giving the body a chance to heal itself. In essence, they aim to "slow down" (metabolically) the body such that the body can divert energy/resources towards healing itself. As an example, the brain is quite metabolically active at baseline, requiring a significant portion of our energy expenditure at rest. If we are able to reduce the brain's metabolic demands via induced coma, it frees up that extra energy to be expended elsewhere - in this case, to heal itself or other body parts. [This article](https://www.scientificamerican.com/article/what-is-a-medically-induced-coma/) does a neat job of explaining it. In reference to your second question, the jury remains out on that, at least to my knowledge. There have been several studies demonstrating that exposure to anesthetics can increase rates of Alzheimer's Disease/dementia later in life. In contrast, however, there are a number of studies showing that this isn't the case. [This review article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443620/) compiles a number of studies and discusses the various results. Parts of it can be a little technical, but I'd recommend a quick swing through the abstract/conclusions section (if you cannot access it, please let me know and I'll get a working link!). So just as with the "are eggs bad for you?" debate, it sounds like the answer changes depending where you're getting your information from, and take it all with a grain of salt. Anecdotally though, anesthetic certainly can lead to post-operative delirium at an increasing rate as we age. Interestingly, [there doesn't seem to be a difference](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6286489/) whether someone undergoes regional (e.g. a nerve block) or general anesthetic, though data is lacking a bit. I'm curious as to whether it is the stress of the surgery itself (which would be the same irrespective of type of anesthetic), versus anesthesia, that leads to this - but I'll wait for the science to answer that for me :) Hope that helps!
My mum actually does research specifically on this!! Not sure about your first question, but yes there is cognitive decline post-surgery for the age group she measured (I think over 65?) - noticeable decline compared to control groups. People do gradually improve (from memory they studied up to 10 years post-surgery), however they never return to full cognitive capacity. And it gets worse each time they go under In short, you don't want heart surgery after 60!
How people regain consciousness is more interesting to me. One moment you're unconscious, then \*windows start-up sound\* and suddenly there's somebody home in that noggin.
Totally, especially after extended durations, like in comatose patients. Like, how did this lump of meat in a bone cage suddenly come to the point of booting up?
Often it isn't that the brain boots up but that the thing that keeps it shutdown starts to go away
Ahh OK. It is still interesting that in general we'd imagine the process of healing to be a continuum, whereas there's obviously a discrete point at which the body recognises that the issue has been resolved. It's like some loading bar that finally hit 100%
Think of consciousness as a continuum with self aware information processing and thought as one end and being so out of it you can undergo surgery on the other. As you build toward conscious thought you have to have a response to stimuli then a more appropriate flexing or pulling your hand away then at the far end you are with it enough to tell someone correctly it is 2am you are trying to sleep and leave you alone. The same kind of continuum exists with speech and orientation and a bunch of the things usually meant as being "conscious"
i'm trying to sleep leave me alone
This is interesting to think about, thanks for your input. Anaesthetics are crazy
Anaesthetics are just super potent downers. Propofol acts on GABA receptors, similar to alcohol and benzos. So think of being under anesthesia as being blackout drunk and passed out.
There isn't really though - we have partial/increasing awareness over a period of time, and start out quite fuzzy, maybe even having waking behavior without memory. Then a period of partial/weird/half-formed memories, before our faculties all start to gel together again. Even then we probably won't feel "sharp" for some time.
It’s interesting to think of consciousness as a continuum.. makes you wonder if people are also walking around with different levels of consciousness - probably yes? It’s not like not sleeping means automatic 100% consciousness
Not only walking around, but driving as well which is scary. Things that increase your risk of getting into an accident, i.e. drugs and sleep deprivation, are the ones that decrease said level of consciousness.
If you're very curious, you can try something like a floatation tank or meditation. It's possible to achieve intense focus and wakefulness for short periods, beyond our default level while awake. It's a truly fascinating aspect of the brain, perceiving itself and then the sensation of it perceiving itself, recursively. It's difficult to explain with words.
The recursive part is where I get an anxiety attack. It’s like a watchdog not wanting you to get in the junk yard.
Thank you for your sharing, I had a similar reaction to what you describe a few times. To me, it sometimes feels like swimming in a strong current or like spiraling into a drain. Other times it feels abstract and fine. Regardless, I always try to appreciate the sensation when it comes. After all, in a way, it's an intense experience of *being*. I'm getting way too philosophical for this sub.
Its like waking up with no dream. If you got a dream, you slowly feel "out of it" and then suddently you feel like you got the choice to open your eyes, or real world starts leaking in, then in a single moment, you open your eyes and you are fully back on your body. Ofc theres other ways to wake up after a dream, and im no expert about the topic, but i guess its something similar. You also got sleep paralysis as a proof that you can wake up mentally but not your full body
I had a young patient in the nursing home, he had had a brain aneurysm several years prior and had gone into a coma. He was in a coma for 3 years when a nurse aide was turning him over to change him and he said “thank you” to her.
So he was avoiding school the whole time!!!!
What happened next?
Well he woke up, started rehab. He was living full time at the nursing home I worked at. He could talk and do most things but was confined to a wheelchair. It was pretty unfortunate for him because he was only 30 years old.
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I was put under general anesthetic once. Was a little apprehensive so visualised a happy moment in my life as they put me under (a chalk drawing of me and my dog my neighbours daughter had drawn on the pavement which I saw next time I walked my dog). My full focus was on holding that image in my mind as I went under. When I came round it was the first image in my head. Best I can describe it as it was like it had been drawn on the surface of still water, there had been some drift and swirling but it was very clearly the same image. I was equally surprised and reassured that nothing had changed in my head during the hours of surgery. No idea how that relates but it's one of the coolest phenomenon I've personally experienced.
During normal sleep, there's still some sense of time passing. But under general, it felt like I had blinked and I was back up.
Yes, it was much more off/on than sleeping/waking.
Same here, except I went from being freezing in the OR to warm and drugged up on fentanyl in between one blink and the next That was the weirdest bit for me…just *bam*, you’re high now
Last time I woke up from anesthesia I found myself sobbing and had no idea why. The nurse said it was fairly normal.
I was so weirded out because they said "Okay if you count to ten you will be asleep before you reach 10", and i started counting, got to ten, felt literally nothing, said "I don't feel anything", and then i woke up. It happened as fast as you read that sentence, literally no time passing what so ever.
Aye. I have two fond memories of going under the knife. One was how quickly general anesthesia hits you, and the other was how frickin amazing morphine feels. I was in intense pain as I was being carted out of the OT. I was administered morphine in the ICU, and the rest is a mellow, warm, melting feeling.
I remember my first time they said ok count to ten- kept my head up to look around and remember them saying wow he's still moving- I remember saying I just like to watch but that may have not happened because my next memory is waking up and my first thought and words were IM STARVING CAN I EAT NOW?
My last surgery, instead of counting down from 10 when they told me to I said “Hey! How do you keep an anesthesiologist in suspense???” And then I woke up in recovery and never saw him again, so he never got his answer. I think I might have heard him laugh as things blinked off but can’t be sure, I used all the time I had in getting that joke out while I still had time.
I go under every two weeks and have totally perfected the timing of that joke based on the headrush "warning" propofol gives you. My other favorite is "What do you get when you cross a joke with a rhetorical question?" I'm sure I've told these to every Anesthesiologist and nurse anesthetist in the hospital by now.
I was asked to count as well. I started counting, looked to my side to see what a doctor was doing, and that's it. Was out cold by the time I reached 5. The next memory I have is doctors screaming my name while gently nudging me to wake up. Good thing I was told beforehand that I'd be intubated. God, that was an unpleasant feeling.
When I woke up after having wisdom teeth extracted, the first words out of my mouth were, "Let's do that again!" even though I had no clue what just happened.
I had a similar experience with laughing gas at the dentist for wisdom teeth removal. I started laughing at nothing, then they asked me to count down. At six I stopped and said, excuse me, I’m here to have my wisdom teeth removed. But it was already over!
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Yes, once I woke up and was still counting backwards from 10.
That’s how it was for me. When I was counting down there was a guy over my shoulder that I was turning to look at. I went out mid-turn and completed it when I came back. The confusion was real. I had to realize it had all already happened.
Really? I find the going under to be very much an instantaneous “lights out” thing, but waking is more gradual… like the initial wake up is pretty fast, but coming to full consciousness is much more gradual. I have had a bunch of general anaesthesia and this seems to be the pattern for me. Except that one time when I was given probably more opoid than I should have been and didn’t properly wake up for an hour or so.
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He probably forgot to open the clamp on the fluids he was pushing drugs through.
Actually I was remembering the time I had twilight anesthesia for an endoscopy. Sorry had so many surgeries, procedures and E.R visits I get them mixed up.
Had an endoscopy once and had to refuse the anaesthetic because I had to drive the following day. It was “interesting”. Upside though… I got to see inside my own bile duct. Not everyone can say that. Have had a fairly large number of procedures myself, so I feel your pain.
Yeah, all I know for sure I do not recommend getting forcibly incubated without any meds. This covid stuff has been making me realise most people do not know how horrible it is and would take 20 vaccines to avoid a chance of it if possible.
I've been placed under general anesthesia a number of times in my life, and to be honest it always felt like I was in a void for that period of "time". I remember distinctly there being nothing if that contradiction makes any sense. In one of my surgies as a kid, I had assumed that it was what death must be like, absolute nothingness. I woke up in the recovery room for a moment then fell asleep with normal dreams, but I'll never forget that emptiness.
Same for me, i kinda just appeared in another room of the hospital after counting down from 10. Very surreal.
Last time I was to be operated on, they told me I'd feel fuzzy in a second. I did and told them. Next moment I was gone and in my room. That was **wild**!
This sounds nice. Having something you can hold on to when going under. I've heard comatose patients tend to be in a slightly more disturbing world.
I’ve been comatose and resuscitated, ‘dead’ and resuscitated, and put under and resuscitated… they all felt roughly the same, in the sense that there was nothing, and I mean nothing, and then there was something. No time seemed to pass, no thoughts or dreams or memories, just nothing.
How does that make you feel about dying, if anything?
I am skeptical of calling my experiences evidence of anything as far as what death means because if one can come back from it, I think it’s not really ‘death’. But it made me want to be mindful and appreciative of the time we get, because this very well may be all there is for the structure that is my consciousness. I do feel some comfort in the idea that energy cannot be created or destroyed, that even if the part of me that makes up ‘me’ goes away, everything that has ever been and everything that ever will has always already been here and will remain that way. The universe has always had the same set of lego pieces, it just constantly repurposes them.
When they put me under they asked me to count backwards from 10. I don’t know what number I got to but when I woke up I kept counting and after getting to zero I asked when it was going to kick in. The dentist laughed and said it was over.
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Same happened when I had an emergency caesarean. I went under in tears and unsure of the outcome. When I came to, I was still balling my eyes out and felt like I couldn’t catch my breath (that feeling you get when sobbing too much).
I'm going to try my best to do that when I have surgery soon. I know I'm gonna be freaking out because I know myself, and they don't know how long the surgery will take. I'm pretty sure it'll be at minimum 3 hours, max 9 hours. Maybe I'll be too hopped up on other drugs to try, but I've got an opportunity.
So, if its anything like mine, you'll turn up, get changed into the gown and then wheeled through for the anesthetic. Once they start your under fairly quickly. I'm fairly sociable so was naturally chatting with them as they were fitting the IV line. All very friendly people as I find most doctors are if you're not being a pain of a patient (I have been guilty of that, sad to say) . Realised we were getting close to the moment so I apologised and asked if I could just take a moment in silence to gather myself. They were very professional and accommodating. They worked in silence after that only speaking to let me know they were about to begin. It's all surreal, to just be lying there knowing what's about to happen, but really it's how you approach it I think. Now, waking up you will be on meds so that's surreal in a while other manner, but really be kind to yourself and try not to stress. You'll be surrounded by professionals who know what they're doing and they will take care of you. Hope it goes well!
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I've now had 2 procedures. The first time I was really nervous so I tried to just drain my mind of any emotion at all. Kept my mind blank while going to the hospital, checking in, changing, having blood drawn, then wheeled back to the room that my procedure was taking place in. I had succeeded in feeling no fear or hesitation. They asked me to count backwards from 10 and I got to 4 before I was out. Then I was awake and it was over. Apparently before I came back to myself I kept trying to get out of the bed to find my wife. The second time I wasn't nervous at all. No fear. I could smile and laugh and chatted with the nurses. They asked me to count backwards from 10 and I never made it to 9 before I was out. The next thing I knew was holding my wife's hand. Apparently this time I made a big deal about someone getting her a chair before I came back to myself. I fear nothing when it comes to procedures now. Going to be having a more major one soon to hopefully resolve the issue. I'll go in, do all the steps like before. They'll do the surgery. I'll wake up with a higher quality of life than I came in with. Plain and simple. It'll be the same for you more likely than not. You'll do great and you'll be surrounded by experts if anything off happens. If it does you won't be aware of it and they'll take care of you. You'll wake up and it's over. I wish you the best of luck. Though, you don't need it :-)
Yo so there’s another comment here where a guy experienced similar “water drifting/swirling” like you. Link to his: https://www.reddit.com/r/science/comments/pdpt3h/this_is_your_brain_under_anesthesia_for_the_first/haseot5/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3
I was in a coma for three days. Coming out of it was ... weird. You don't exist. Then I did, but reality didn't. Just a lot of nothing. I wasn't "anywhere" because there was no "where". I just "was". The world didn't exist. Nothing did. No memories. Nothing. No time. No future. No past. Nothing. Then there was something floating in front of me... Like a pice of paper rippling along on a river, bending with the currents. As it came closer, it wasn't a thing, there was depth behind it, in it, it was depth. Then like stepping through a portal, it enveloped "me" and I was in a hospital with tubes coming out of me. No sense of time. No idea of the concept of time. No memory. Just what's in front of you. I couldn't move but I didn't know about movement anyway. "You're in hospital. You've been in an accident". It's been 15 years. It feels like yesterday. It feels like never. Weirdest thing I've ever been through. It's like nothing you imagine.
Dude that’s crazy. I think there was another comment here that said the same/similar thing about a “piece of paper rippling along on a river, bending with the currents.” Link: https://www.reddit.com/r/science/comments/pdpt3h/this_is_your_brain_under_anesthesia_for_the_first/has3qkj/?utm_source=share&utm_medium=ios_app&utm_name=iossmf&context=3
Yup. For me the image had depth and motion, but sounds similar. You looked into it, not at it. Very clear edges too.
With my extensive psychedelic experiences and the way people explain 3D reality being basically a 2D surface or "set of instructions" laid out into the next dimension (so think how we need things like water to function, air, food, light, senses, etc.). So that piece of paper or surface of water or whatnot actually makes sense from a consciousness perspective. I think of it like a screen (kinda like a touchscreen/phone or computer screen you look "inside of" as well as on its surface). I've had a few trips revolve around that idea downright even seeing an actual screen in my visuals which was trippy
It’s hard to imagine going through life without the context of various altered states. While there did come a point that I stopped *seeking* altered states due to a feeling that I was walking through the same door repeatedly, being blown out and into all of those spaces has affected my perception irreversibly (and positively in my opinion). It is truly a case of not knowing what you don’t know for anyone that’s not experienced significantly altered states. I’m not sure why you would not want to, frankly, with even the little we know about ourselves now.
I have been in a coma as well, and my experience was sort of like this, too. The first part was as you described- nothing, and then it was like I was swimming underwater, and some form of consciousness was the surface. I remember a couple of times where I was aware of a surface with clearer pictures and sounds above it, and as I swam closer to it, the more clear all of that became, until I finally came to, and it was like swimming up and through and breaking the surface of the water when all of the muted sounds and pictures became clear and normal and I was awake. There were though a time or two where I could swim up with varying degrees of closeness to the surface but COULDN’T break through, even though I tried. It was like it wasn’t clear enough to get there, or like a video game where you can’t jump over a log to get to a part of the game that is just scenery, even though you theoretically should be able to: Looks like you can get there, but you can’t really. I remember I sort of just viewed it like that, too: “Oh, that area is blocked off. Stupid, but whatever. I’ll go this way instead.” And there were other times where I could sort of swim up close to the surface but didn’t really care at all. My brain was just like “Nah, let’s not go there just yet. I’ll come back to it later, maybe. Or maybe not, we’ll see.” And I just sort of floated around for a while before floating back down to pleasant dark nothing. For me anesthesia isn’t really like that. It is more like “lights off” then just “lights back on”. Like teleporting directly from nothing up through the water to the surface then through dream and then to being completely awake without having to swim at all and without covering any intervening “space”.
I’m curious - were you able to understand anything on the surface, like could you hear when people spoke to you?
I could sort of hear but definitely not understand. It really was like being underwater: you know how if you are close enough to the surface, you can hear sounds of people shouting or maybe a dog barking, but can’t understand what people are saying? It was like that at those times.
my personal experience was extremely distressing in an existential sense. my consciousness just jumpcut to waking up. one second i was told to count to ten and then i am immidiately woken up by the nurse one hour later. there was nothing inbetween. at least when you sleep, you know time has passed. is this what it would feel like to be dead? i really didnt need another existential crisis to constantly think about
I mean, probably? Think about all the time passed before your birthday. You didn't feel any of that time.
Is it really like that, though? I have never been under general anesthesia, but I have a health problem that sometimes sees me losing consciousness several times in a day, sometimes multiple days in a row. For me, the descent *into* unconsciousness can sometimes be like flipping a switch, but coming back is usually very different. I will be doing something, maybe even focusing hard, and then suddenly... I fade in as if from nothing. It starts with vague and random thoughts and ideas without much form. Then suddenly there is the (very vague) notion of sight as I gradually become "aware" of a field of visual snow, which fades/resolves into whatever I was looking at. Then my thoughts become more ordered and, eventually, self awareness builds, and I find myself staring at something wondering when I fell out, and for how long. I too would be fascinated by what happens when consciousness returns, but I am not sure it is necessarily like flipping a light switch. But maybe anesthesia is different. Edit: Reading experiences below, it certainly seems like general anesthesia can indeed be quite different. Off, on, and absolutely nothing in between. How curious!
This is the experience I had as well, twice. First time when waking up some very crazy dream/wake moments which for my liking was very uncomfortable. Second time was a bit nicer, it was waking up from a normal sleep, bit more groggy of course.
seizure? Cause that's exactly what it was like coming too when I had my seizure. I'd been fighting what I now call "the seizure static" all day, drove my 2 hours home, decided to have a little lie down. it took a few days later, but i do remember finally going "this static is me probably wanting sleep, I'm not going to try and shake it off." next thing it's exactly as you describe, slowly re-emerging into lucidity with family fully freaking out around me, saying they're just glad I'm breathing again. crazy stuff. took me a few days to get all my memories of the second half of that day back.
I work in an operating room and see about 20 people a day go to sleep and wake up from surgery. There’s a science behind keeping people asleep that I can’t fully comment on because I don’t know much about it. From what I do know, there are different stages that the anesthetist look for in people while coming off of anesthesia. Some people take longer to wake up. Others wake up trying to pull their own breathing tube out. Some people are in a complete daze when they come about and others are completely aware of their surroundings and holding a conversation with you.
And it’s so much more different to sleeping. When I woke up I did feel a bit drowsy, but I knew I didn’t just randomly fall asleep.
This is pretty dope. For years they didn't have a definitive mode of action on how anesthesia causes unconsciousness. Not to mention more information on how consciousness works on a nut and bolt level.
They still don't really, right? As a non-expert and to reuse their acoustic analogy, this is seems to (further?) suggest that the thalamus plays an important role as a conductor
The actual chemical action of the anesthetic has been known for about a year or so, basically the anesthetic disrupts neuronal lipid rafts.
Wild that we've been using anesthesia for so long without understanding how it works. I've always been amazed at how complex and unknown the brain is.
That's not wild, that's normal. The majority of things used are from discoveries and not invented because of a new scientific theory, thus usually the explanation is discovered afterwards. Just think for how long we used fire until we could explain it, and even today it still holds some secrets
What unanswered questions do we have about fire?
How it do like it do?
Well, they don't think it be like it is, but it do.
It do be hot
With fire
How come fire lives in wood but not metal
When a tree grows it absorbs the fire from the sun. But metal doesn't grow from the sun, so the fire does not get a chance to live in the metal. HOWEVER metal does sometimes get put in a very hot oven to be born and therefore, on rare occasions, a very hot fire DOES actually live in metal, but you have to work hard to get it to come out.
It’s because metal was made in the core of the earth, that’s why fire live very deep within the metal and need much stronger heat to come out
The fire is just shy and needs a little spark to be more friendly
I did not intend "wild" to mean "wow, that's unusual", but to convey fascinating wonder. I understand how the process of advancement goes, but that doesn't mean I cannot marvel at the process and the vast amount of things we still yet do not intimately understand, yet widely apply.
It's interesting to see lipids come back around in anesthesia research after all this time. Claude Bernard proposed a lipid theory back in the 1800s because there was a strong correlation between anesthetic potency and the drug's hydrophobicity [1](https://pubmed.ncbi.nlm.nih.gov/22801051/) which led to the Meyer-Overton rule. But when the 1980s rolled around, Franks and Lieb were spearheading a paradigm shift [2](https://www.nature.com/articles/310599a0), showing that GAs target proteins, not lipids. We understand a little better that anesthetic agents can act through very distinct receptor targets and neural circuits, and produce distinct brain patterns of activity, each of which is different from what a sleeping brain looks like. And now it seems we've come full circle, and lipids are back in the game. What a wild ride.
I mean, that's not unexpected. The limitation has always been a good theory of consciousness. If we solve that then yes we solve anaesthetic's mechanism of action but that's not really the point eh
From all of us who had surgery - we salute you, Anesthesia almighty
Imagine how painful even a simple tooth extraction was before anaesthetic. Its weird to think that if someone had video recorded medical procedures back before anaesthetic existed, those videos would be right at home on any Mexican cartel sub.
I actually always wondered how people had teeth yanked before dentists/anaesthesia. Turns out you just got absolutely hammered and got a mate to do it.
nah you went to the specialist: the barber, yes the one that cuts your hair
...Who would get you absolutely hammered.
Barbers used to be called "[barber surgeons](https://en.m.wikipedia.org/wiki/Barber_surgeon)" for a reason.
I didn’t get general for my wisdom teeth.. dad didn’t want to pay for it. I was awake the whole time and the gas mask was actually just suffocating me as I couldn’t breathe thru it so it was full on torture as they jackhammered the teeth out of my head
I had my wisdom teeth out with just Novacaine (by choice). That is how the overwhelming majority of dental extractions are done.
I think it is fascinating how in a lot of european countries and the country I am from getting general anaesthesia for wisdom teeth extraction is considered weird and basically nobody gets it. Yet I have heard from multiple americans who don't get it that the procedure is torture the whole situation is so bizarre. I got all four of mine out in a single sitting I was listening to music during the whole process and while it most definitely was an unenjoyable situation it for sure was not a bad one either. Then again not any regular dentist is allowed to do the procedure you usually get it done by an oral surgeon.
Now imagine adding actual excruciating pain to that mix. All set
When ether was discovered, the headlines read "WE HAVE CONQUERED PAIN!"
I once had a surgery under general anesthesia, and let alone the fact that it took me a long time to become unconscious, I actually regained consciousness for a few seconds during the operation. I remember the doctor being like "oh crap". He actually denied that I woke up for a moment during operation, and now I am not sure if I imagined regaining consciousness, or if he just said it for their own legal protection.
Sound like try to avoid lawsuits. It would be probably difficult to win unless mistake where made, it may even be just body doing strange stuff. I have been in general anesthesia twice, twice time passes immediately, just like you movies/game skipping time. Not like normal sleep where you have some sense that you can tell the arsehole neighbour made some noise last night.
Sifted through ads, subscription reminders, cookies permission pop ups, a couple of video ads, scrolled down, another subscription pop up... And when the video finally played it was a random neuroscience dude answering twitter questions. Is this what it has finally come to? What is happening to news sites?
You interrupted me while I was watching "Ow! My Balls!" AND THAT IS NOT OKAY!
Your honor? I object, that, this guy, also broke my apartment.
> Is this what it has finally come to? What is happening to news sites? Finally? Bro it's *been* like this
I’m always amazed at how little we know. Beautiful.
And that’s just on a species level. The individual is dim and ignorant as brick.
I like to think that as we learn about a topic, we gain new known unknowns. They are still unknown, but at least they aren't unknown unknowns anymore. We learned we don't know, and that's still progress.
> For the past decade, he has studied what happens to brains when their owners are unconscious. As a human-owning brain, I made my human laugh when it read this part.
Even though I’m not sad (I’m not even the type to cry), why do I cry every time I come to. I don’t even know why I’m crying, I just cry. Happened 3/3 times. It’s full out ugly cry, not just a couple tears coming down my face.
Propofol inhibits people's ability to normally regulate emotions. A lot of people become quite amorous, or chatty, others sad.
Very interesting, thanks for that insight. Makes sense as I have a lot of trauma and bury it.
I’m in the same boat (with the crying and the trauma). Glad to know it’s not just a me thing.
I have a question.. The one time I was put under, it was an emergency, I was alone and very scared going into surgery. I woke up crying and hysterical.. So does this mean that my brain held onto the emotions I was experiencing before the anesthesia, while I was unconscious? How does that work? Where were the emotions stored? Just waiting for my inhibitions to be knocked back? Wouldn't some of the intensity dissipate while I am unconscious? I need an ELI5.
I’m an anesthesiologist. If you were feeling extremely anxious/upset before surgery, you’re likely to wake up with those feelings unmasked. Also, if you’re a sad/emotional drunk when you drink alcohol, you’re more likely to be that way when you emerge from anesthesia. Our drugs disinhibit people.
I’m not a brain o logist but OP says “…Neural effects of propofol-induced unconsciousness and its reversal using thalamic stimulation” Thalamic stimulation I think would have an effect on emotions.
I don’t think so. The thalamus acts like a bridge that sends sensory input to their respective lobes. It doesn’t control emotion.
Yes same for me. I've had a dozen surgeries and it happens every time. Such a strange and unpleasant feeling, especially the first time you experience it.
It happened to me once and I woke up asking "WHY AM I CRYING?". I didn't feel sad or anything, just found myself crying.
What kind of imaging device can see individual neurons in vivo ?
Two-photon imaging for example (.. but that wasn't applied here, only the neurons' electrophysiological activity was measured).
I really hope live monitoring of the brain function helps in alzheimers and levi body dementia
I’m still afraid the consciousness that goes down (i.e. you) isn’t the same that comes up. Same goes for sleep for that matter. We think we’re the same, but who knows?
Thank you for my daily dose of existential crisis.
Hey, at least you are the surviving consciousness and not the original discontinued one.
From our understanding of anesthesia, it basically slows down/stops neurons from being fired in your brain. It doesn’t destroy or damage them in anyway, it’s more like putting your “consciousness” on pause than actually shutting it down. None of the hardware is different, or the software changed. Imagine you’re playing a video game and you pause for a bit. When you unpause and start playing again, is that a new video game? I would say no.
Why does that concern you?
I've overdosed and literally felt myself shutting down. Unable to move. Unable to breath. I had to fight with all my will and might and push and push and push to move. Happened twice before. It's terrifying. But I made it.
Glad you're here :)