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Thursday, March 21, 2019  Spokane, Washington  Est. May 19, 1883
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People’s Pharmacy: Surgical anesthesia may scramble the brain

By Joe Graedon, M.S., and Teresa Graedon, Ph.D. King Features Syndicate

Q. After a 13-hour surgery, it took weeks before I could read the newspaper again. My brain simply wouldn’t work well enough.

I think that anesthesia scrambles the neurons. I had insomnia, an inability to concentrate and vivid dreams. This also happened many years ago when I was younger. I believe that rest, good nutrition and brain training exercises can help speed recovery.

A. General anesthesia represents one of the great advances in medicine because it allows for pain-free surgery. Surgeons have been using medications to induce a temporary coma for 165 years, but we still don’t know exactly how they work and what else they might be doing to the brain.

Postoperative cognitive dysfunction is not unusual, particularly in older people (Annual Review of Nursing Research, January 2017). Most patients recover their cognitive function with time, though it may take several months. There is ongoing debate about the benefits and risks of inhaled anesthetics compared with intravenous anesthetics when it comes to recovery.

Q. I recently had a doctor’s appointment, and the nurse measured my blood pressure while I was sitting on the exam table with my arm dangling at my side. It was 153 over 95, and that was entered into my chart. At home it was 135 over 82.

The doctor is talking about starting me on a diuretic to lower my blood pressure. I’m not convinced I really need it.

A. Proper blood-pressure measurement requires the patient to be seated in a chair with back support and both feet on the floor. The arm should be supported at heart level, the cuff should be the right size and there should be no talking. Otherwise, the reading could be inaccurate.

We are sending you our Guide to Blood Pressure Treatment with instructions on proper measurement techniques and ways to control hypertension with and without drugs. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (68 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q. I suffered from cluster headaches for decades. Each headache would typically last 30 minutes, and I’d get up to five a day for six to eight weeks. Then they would go away for a year or two.

I took every medication available, and nothing helped. I saw a pain specialist, who suggested I use 100 percent oxygen as soon as I felt the start of a headache. It worked great, and the headache never took hold.

I explained to him that my headaches always started around the nasal area on the right side, and he prescribed lidocaine hydrochloride topical solution. If I couldn’t get oxygen, I would spray the solution up my right nostril. The pain would subside within a few minutes, and the headache would be stopped instantly.

A. Inhaled oxygen is an established treatment for cluster headaches. We weren’t familiar with lidocaine treatment for this painful condition, but we found a case study of successful treatment (Journal of Medical Case Reports, Feb. 15, 2012). A review of research concluded that there isn’t sufficient evidence to recommend it (Emergency Medicine Journal, September 2013).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”

Wordcount: 591

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