General Anaesthesia in the UK

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slinkystrudels
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General Anaesthesia in the UK

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Hi - I’ve trawled through old posts re GA but it all seems to be in the US (I’m in the UK) .
I’m a 4/4 (age 41) and have had 5/6 GAs in my lifetime before finding out my APOe status.
I need a small operation as a day patient but need to know what I should ask for and what to avoid (both during and after surgery) . Any advice greatly appreciated .
41years old from bonnie Scotland. 4/4 ....
CAngelS
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Re: General Anaesthesia in the UK

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slinkystrudels wrote: Thu Jan 20, 2022 2:19 pm Hi - I’ve trawled through old posts re GA but it all seems to be in the US (I’m in the UK) .
I’m a 4/4 (age 41) and have had 5/6 GAs in my lifetime before finding out my APOe status.
I need a small operation as a day patient but need to know what I should ask for and what to avoid (both during and after surgery) . Any advice greatly appreciated .


I believe that Stavia, a doctor & the author of our Primer, is from an English-speaking country outside of the U.S. (but I’m not sure which one?)

I believe she mentioned at one point asking her anesthetist not to give her gas for her surgery and said they were able to use propanol instead? (Inhalation anaesthetics are more problematics for apoe4 carriers.)

Others in various regions have chosen to request anaesthesia methods other than general (for example: local, spinal, epidural, etc.) depending on the surgery required. I’m not sure if the terminology for those varies between countries, however.

Also, there are quite recent findings that non-coated aluminum fluid-warmers (often used in surgical settings to help protect patients from hypothermia) can leach substantial amounts of aluminium into fluids & into our systems. Massive recalls have been issued, but it would be worth asking if they have another method of heating any fluids needed — since aluminium is even worse for apoe4 carriers.

I hope someone else can chime in and give you more country-specific advice that helps. It sounds like you’re being wise to think through what to ask!
"If you are kind only to your friends, how are you different from anyone else?" (Matthew 5:47)
slinkystrudels
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Re: General Anaesthesia in the UK

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Anyone in the UK got any advice ?
41years old from bonnie Scotland. 4/4 ....
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Julie G
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Re: General Anaesthesia in the UK

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Anyone in the UK got any advice ?
Sorry, I'm not in the UK but did dig up some notes I made on a surgery and hospitalization I had almost nine years ago. Perhaps, you can translate some of this to your health care system: Surgery and Hospitalization Tips for E4 Carriers
Tabby
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Re: General Anaesthesia in the UK

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Is it the general anesthesia or the gas anesthetic that is the problem? I am exposed to low levels of isoflurane at work for six hours, 3 days a week. I love my job as it is my intellectual stimulation as well as my social outlet. I can smell the isoflurane, but it doesn't make me sleepy or give me a headache.
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Julie G
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Re: General Anaesthesia in the UK

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Is it the general anesthesia or the gas anesthetic that is the problem? I am exposed to low levels of isoflurane at work for six hours, 3 days a week. I love my job as it is my intellectual stimulation as well as my social outlet. I can smell the isoflurane, but it doesn't make me sleepy or give me a headache.
I don't think anyone has specifically teased out which type of anesthesia is the worst, but apparently both general and spinal anesthetics have been associated with increased risk of dementia following surgery although the stress of surgery itself must surely play a role.

Apparently, isoflurane has been associated with an increased risk of amyloid and neuronal cell death. That said, I wonder if the very small amount that you're exposed to would have an effect. You can read more here.
Conclusion. The demonstration that isoflurane contributes to well-described mechanisms of Alzheimer's neuropathogenesis provides a plausible link between the acute effects of anesthesia, a well-described risk factor for delirium, and the more long-term sequelae of dementia. These findings suggest that isoflurane-induced Aβ oligomerization and apoptosis may contribute to the risk of postoperative cognitive dysfunction and provide a potential pathogenic link between delirium and dementia.
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