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What conditions would require special considerations before anesthesia?

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Posted on Thu, 17 Dec 2020
Question: Hi! I have been having a range of strange symptoms, which started on March 3rd and I'm slowly being evaluated by specialists to determine the cause. (Main symptoms are extreme exhaustion, unintended weight loss of 31.5 lbs, making me underweight now, cognitive decline, and a recurring fever of unknown origin) My Gynecologist wants me to have surgery to remove a uterine polyp within a month. Which diseases or disorders would increase my risk during surgery, particularly regarding the safety of anesthesia? One thing that I'm supposed to be tested for is Addison's disease. I have read that special precautions have to be taken before a person with Addison's has anesthesia because of the risk of an Addisonian Crisis and shock. What other conditions would require special considerations before anesthesia? I want to make sure to be tested for those things (if I have related symptoms) before the surgery. So far, I have had most heart problems ruled out, but I do have unexplained Tachycardia with exertion (180 sometimes just by showering). I have also had lung problems ruled out. I had some lab work which may indicate an autoimmune disease (which needs further testing) and I have low WBCs. Thank you so much for your input!
doctor
Answered by Dr. Hari Charan Perigela (2 hours later)
Brief Answer:
Addison's disease has to be excluded.

Detailed Answer:
Hi
I saw your Blood reports.Most of them are normal.
The symptoms that you have mentioned are not specific to any disease or condition.
Regarding POLYP in the Uterus,it is.not an emergency.You can.PLAN it.
As you want to exclude Addison's disease,do it first.Once the disease is confirmed, appropriate treatment will be given.Then,there will be no complications before, during or after surgery.
As most of the Surgeries of the Uterus are done under Spinal Anaesthesia, complications are very minimal.
Nothing to worry.
As Cardiac problem is ruled out, you can proceed with Surgery after exclusion of Addison's disease.
Hope I answered your query.If you have any questions,I will clarify further.
Wish you good health.
Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Hari Charan Perigela (53 minutes later)
Thank you so much!

I do want to add that I will not be having spinal anesthesia- it will be general. My gynecologist said that it will be a complicated removal because of the way my uterus is positioned. She is very urgent in her desire to remove it, even though I asked if we could wait. I'm not sure if there is something she is concerned about. I will ask her that question.

So, does knowing that I will be under general anesthesia and that it will be a complicated removal, influence your answer? Are there any other conditions that need to be ruled out before I have general anesthesia? I am also wondering about the tachycardia since I have heard that general anesthesia can make your heart behave differently anyway. I had tachycardia when my heart rate was averaged during a 24 hour holter test and I certainly have tachycardia with any activity at all (even walking across the room) although my resting heart rate is often in the high 80s to 90s.

I have been referred to an endocrinologist, infectious disease doctor, and rheumatologist. Those appointments are not soon, but I could ask for testing specific to my surgery related needs.

Thank you again!
doctor
Answered by Dr. Hari Charan Perigela (41 minutes later)
Brief Answer:
Nothing to worry about General Anaesthesia

Detailed Answer:
Hi

Even though your Gynaecologist is planning Surgery under General Anaesthesia, nothing to worry. Anesthetist will have Pre Anaesthesia Check up (PAC). During that Check up, each and every aspect will be thoroughly addressed.
As your Resting heart rate is normal,there is nothing to worry about.Tachycardia could be due to Anxiety. During Surgery, Pulse rate, BP, Oxygen saturation etc will be controlled by Anaesthetist.
If possible, please attach the Scan report showing Uterine polyp as Attachment.

What is the Indication of Surgery for POLYP?
Whether you are having Bleeding or Pain in lower abdomen?
Whether the procedure is planned Laparoscopically or by Open method?
Endocrinologist will exclude Addison's disease and any other systemic disease related to Endocrine glands.
If there is no emergency for Surgery, you can wait till Endocrinologist opinion.

Hope I answered your question.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Hari Charan Perigela

General Surgeon

Practicing since :1995

Answered : 2737 Questions

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What conditions would require special considerations before anesthesia?

Brief Answer: Addison's disease has to be excluded. Detailed Answer: Hi I saw your Blood reports.Most of them are normal. The symptoms that you have mentioned are not specific to any disease or condition. Regarding POLYP in the Uterus,it is.not an emergency.You can.PLAN it. As you want to exclude Addison's disease,do it first.Once the disease is confirmed, appropriate treatment will be given.Then,there will be no complications before, during or after surgery. As most of the Surgeries of the Uterus are done under Spinal Anaesthesia, complications are very minimal. Nothing to worry. As Cardiac problem is ruled out, you can proceed with Surgery after exclusion of Addison's disease. Hope I answered your query.If you have any questions,I will clarify further. Wish you good health. Regards