Patient's Medical History, Lifestyle & Medications
Prior to surgery, the anesthesiologist will evaluate the patient's medical condition and formulate an anesthetic plan which takes that patient's physical condition into account. It is vital that the anesthesiologist knows as much about your medical history, lifestyle, and medications as possible. Some particularly important information he/she needs to know includes the following:
- Reactions to previous anesthetics
If you have ever had a bad reaction to an anesthetic drug, you need to be able to describe exactly what the reaction was and what your specific symptoms were. Give the anesthesiologist as much detail as possible, such as you felt nauseated when you woke up or the amount of time it took you to wake up, etc. Any problems related to anesthesia in your family will be very useful information to your anesthesiologist.
- Current herbal supplements
It has recently been learned that certain herbal products, commonly taken by millions of Americans, can cause changes in heart rate and blood pressure, and may increase bleeding in some patients. The popular herbs gingko biloba (an herb used for many conditions associated with aging, including poor circulation and memory loss), garlic (an herb often used for cardiovascular conditions and to help prevent colds, flu, and other infectious diseases), ginger, and ginseng (used as a general tonic to increase overall body tone; considered helpful in elevating energy levels and resistance to stress) may lead to excess blood loss by preventing blood clots from forming. In addition, St. John's wort (a popular herb used for mild to moderate depression) and kava kava (another popular herb used for depression and to elevate mood) may prolong the sedative effect of the anesthetic. The American Society of Anesthesiologists advises patients planning to have surgery to stop taking all herbal supplements at least two to three weeks prior to surgery to rid the body of these substances.
Discussing any known allergies with the anesthesiologist is very important, as some anesthetic drugs trigger cross-allergies, particularly in persons who have allergies to eggs and soy products. Allergies to both foods and drugs should be identified.
- Recent and/or current prescription and over-the-counter medications
It is also important to let your surgeon and anesthesiologist know about both prescription medications and over-the-counter medications you are taking, or have recently taken. Certain prescription medications, such as coumadin, a blood thinner, must be discontinued for some time prior to surgery. In addition, since many people take a daily aspirin to prevent heart attack, and certain dietary supplements, physicians need to be aware of these habits, as they can prolong bleeding and interfere with drugs used by anesthesiologists.
- Cigarette smoking and drinking
Cigarette smoking and alcohol can affect your body just as strongly (and sometimes more strongly) than many prescription medications you may be taking. Because of the way cigarettes and alcohol affect the lungs, heart, liver, and blood, these substances can change the way an anesthetic drug works during surgery. It is important to let your surgeon and anesthesiologist know about your past, recent, and current consumption of these substances prior to your surgery.
Undergoing surgery can be a good motivator to quitting smoking. Hospitals are smoke-free and physicians, nurses, and other health professionals will be there to give you support. In addition, you will heal and recover faster, especially in the incision area, or if your operation involves any bones or spine. Quitting smoking also reduces your risk of heart disease and cancer.
- Use of street drugs (such as marijuana, cocaine, amphetamines, heroin, etc.)
Patients are often reluctant to discuss matters of illegal drug consumption, but you should remember that all conversations between you and your surgeon and anesthesiologist are confidential. It is crucial that he/she know about your past, recent, and current consumption of these substances. It is important to keep in mind that the only interest your physician has in this information is learning enough about your physical condition to provide you with the safest anesthesia possible. You could endanger your life by not telling your anesthesiologist of possible drug use. Drug interactions could be very harmful.