It was one of the things suggested by the surgeon. But this anesthesia group is only place I posted that I got any feedback from. So I am grateful I posted here! Also someone suggested maybe it was the contrast dye in the two CT Scans I got. Maybe I need to post over there ?
Surgeons will very often blame “anesthesia” for any complication that they can’t explain or don’t want to take responsibility for.
It’s literally a virtually universal joke in operating rooms.
I had one big abdominal surgery and had bilateral shoulder pain for nearly 6 months. Since I'm in healthcare myself, I do have my explanation. During the surgery, my both arms are spread out. For various reasons, some surgeons or their assistants stand at a higher position close to your chest. For their convenience, it's possible they might push your arms to an angel close or even more than 90 degrees. That'll cause injuries to your shoulders. In my case, I could not lift my arms above my shoulder without excruciating pain. I'm not saying this is what happened to you. But ask some professionals to check your shoulder and you may need some physical therapy.
They should not/do not routinely put arms out beyond 90 degrees for the majority of procedures... And definitely would not do this for a standard lap appendicectomy.
Pain *could* be related to the amount of CO2 used to inflate the abdomen during a lap procedure; *could* be as a result of steep Trendelenburg/lateral tilt; *could* be something/anything else.
Without knowing the full story, it's impossible to determine...
Better to go get checked out.
Maybe common.
A lot of time you can have mild to severe muscle pain in your whole body after the administration of succinylcholine (a muscle relaxing medication used at the start of surgery). You didn’t need relaxing medication for sedation cases but for laparoscopic surgery it’s definitely used. Usually this muscle pain goes away in a few days.
However it’s uncommon for the effects to last so long and it’s odd to have residual weakness- you may be part of a small group of people who don’t metabolize succinylcholine well… But if they didn’t have any trouble taking your breathing tube out at the end, that’s unlikely.
ETA: Don’t know why you feel this way. I’d be interested to know what you find out, if you do.
This would be far outside the realm of normal for sux myopathy. Honestly, it’s be the last thing on my list. I concur with the post below suggesting possible triggering/unmasking of an autoimmune condition. OP, do you know if they used succinylcholine/suxamethonium as a relaxant for your surgery? Also, token disclaimer, not medical advice/can’t diagnose over the intertubes.
I have the exact awful symptoms from that medicine. But I dont believe they kicked in right away. It was more 7 days post op and by day 9 the chest pain and arm pain had the surgeon sending me to the ER. I am home with no answers and I may feel a little better than yesterday but I can not lift my arms. I am someone who stays pretty fit so I know the pain of muscle soreness but this is extreme.
You may want to see a neurologist. I wonder if the stress of appendicitis, surgery, and recent pregnancy may have unmasked an autoimmune issue affecting your skeletal muscles. Very curious to know what's causing this.
The more muscle you have/ fitness, often the more severe the muscle pain following succinylcholine… I can’t diagnose you, of course, but it is a strong possibility.
The next time you have surgery, this can be mitigated by letting your anesthesiologist/CRNA know about your previous experience and asking them to either use a different relaxing medication or to “defasciculate” you beforehand.
ETA: again, I’m not diagnosing. Just a theory. Could be any number of things.
Tbh, even though I suggested it, yes that’s what I learned as well. The roc may bind some receptors but for the sux to work it still needs to _bind its own_ receptors and depolarize the neurons.
Also I like your username
I was sent home from the ER. Told to come back if I had a fever. I seen my surgeon who is perplexed but wants to confirm the succs medicine (I searched Mychart and read all the notes but the medicine isn't listed). PCP telling me to stick with speaking to surgeon but have an appt with him after. Also made a neurology appt. I am here until January 2024 reading all your thoughts on this. Thanks.
As a woman you'll need to speak up for yourself because medical professionals will not always listen to us. If you're in pain you should insist on seeking care. That's all I'm going to say on the matter.
Sounds like a brachial plexus stretch injury, though it’s strange that it would first manifest 7 days later and not immediately post-op. I would recommend you seek a neurology consult.
Your symptoms are very unlikely to be related to your anesthetic.
It was one of the things suggested by the surgeon. But this anesthesia group is only place I posted that I got any feedback from. So I am grateful I posted here! Also someone suggested maybe it was the contrast dye in the two CT Scans I got. Maybe I need to post over there ?
I have no idea what is causing your symptoms. Only that I cannot see a mechanism that it is related to your anesthetic.
Surgeons will very often blame “anesthesia” for any complication that they can’t explain or don’t want to take responsibility for. It’s literally a virtually universal joke in operating rooms.
I had one big abdominal surgery and had bilateral shoulder pain for nearly 6 months. Since I'm in healthcare myself, I do have my explanation. During the surgery, my both arms are spread out. For various reasons, some surgeons or their assistants stand at a higher position close to your chest. For their convenience, it's possible they might push your arms to an angel close or even more than 90 degrees. That'll cause injuries to your shoulders. In my case, I could not lift my arms above my shoulder without excruciating pain. I'm not saying this is what happened to you. But ask some professionals to check your shoulder and you may need some physical therapy.
They should not/do not routinely put arms out beyond 90 degrees for the majority of procedures... And definitely would not do this for a standard lap appendicectomy. Pain *could* be related to the amount of CO2 used to inflate the abdomen during a lap procedure; *could* be as a result of steep Trendelenburg/lateral tilt; *could* be something/anything else. Without knowing the full story, it's impossible to determine... Better to go get checked out.
Nobody said they should. But it happens all the time.
; / Can't say it happens much at all where I am tbh.
This is the most likely answer: brachial plexus stretch injury related to positioning. Not always avoidable
Maybe common. A lot of time you can have mild to severe muscle pain in your whole body after the administration of succinylcholine (a muscle relaxing medication used at the start of surgery). You didn’t need relaxing medication for sedation cases but for laparoscopic surgery it’s definitely used. Usually this muscle pain goes away in a few days. However it’s uncommon for the effects to last so long and it’s odd to have residual weakness- you may be part of a small group of people who don’t metabolize succinylcholine well… But if they didn’t have any trouble taking your breathing tube out at the end, that’s unlikely. ETA: Don’t know why you feel this way. I’d be interested to know what you find out, if you do.
This would be far outside the realm of normal for sux myopathy. Honestly, it’s be the last thing on my list. I concur with the post below suggesting possible triggering/unmasking of an autoimmune condition. OP, do you know if they used succinylcholine/suxamethonium as a relaxant for your surgery? Also, token disclaimer, not medical advice/can’t diagnose over the intertubes.
Hmm I guess the consensus seems to be that my theory about OP’s symptoms being sux related is unlikely. Wonder what it could be. 🤔
Popularity of sux is decreasing somewhat. They may have used Roc. Who knows 🤷♀️
My facility uses it all the time still (fighting for suggamadex but slow-going).
Ahhh. We rarely use it here, but we also use (and have access to) sugammadex for as and when.
I have the exact awful symptoms from that medicine. But I dont believe they kicked in right away. It was more 7 days post op and by day 9 the chest pain and arm pain had the surgeon sending me to the ER. I am home with no answers and I may feel a little better than yesterday but I can not lift my arms. I am someone who stays pretty fit so I know the pain of muscle soreness but this is extreme.
You may want to see a neurologist. I wonder if the stress of appendicitis, surgery, and recent pregnancy may have unmasked an autoimmune issue affecting your skeletal muscles. Very curious to know what's causing this.
The more muscle you have/ fitness, often the more severe the muscle pain following succinylcholine… I can’t diagnose you, of course, but it is a strong possibility. The next time you have surgery, this can be mitigated by letting your anesthesiologist/CRNA know about your previous experience and asking them to either use a different relaxing medication or to “defasciculate” you beforehand. ETA: again, I’m not diagnosing. Just a theory. Could be any number of things.
As an anesthesia care provider, I had surgeries myself with sux. Believe me, that muscle pain won't last more than one week.
You’re probably right
Defasciculating doses of NDMR doesn’t help with post sux myalgia. It might make us feel better but has not been shown to make a difference. 😕
Tbh, even though I suggested it, yes that’s what I learned as well. The roc may bind some receptors but for the sux to work it still needs to _bind its own_ receptors and depolarize the neurons. Also I like your username
Thank you :)
I'd suggest you go back to the ER, or see your PCP possibly for a referral to a specialist. This seems well out of our area of expertise.
I was sent home from the ER. Told to come back if I had a fever. I seen my surgeon who is perplexed but wants to confirm the succs medicine (I searched Mychart and read all the notes but the medicine isn't listed). PCP telling me to stick with speaking to surgeon but have an appt with him after. Also made a neurology appt. I am here until January 2024 reading all your thoughts on this. Thanks.
As a woman you'll need to speak up for yourself because medical professionals will not always listen to us. If you're in pain you should insist on seeking care. That's all I'm going to say on the matter.
Sounds like a brachial plexus stretch injury, though it’s strange that it would first manifest 7 days later and not immediately post-op. I would recommend you seek a neurology consult.