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Let me say I am hard to sedate. My body eats thru pain or…

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First, let me say I...
First, let me say I am hard to sedate. My body eats thru pain or sedation meds. My wonderful dentist, yes she is, knows and sees how fast I go thru numbing meds and how hard it is to numb me. Last month I woke up during my colonoscopy.. they had to stop as they said I became combative. I have no memory of it thank goodness. So, there ut is. Also I have no good veins from 30 years of prednisone. So i have a port a cath. Okay. Today I had cataract surgery. They tried four times to start an iv but it blew or they couldnt thread it in. Yeah thats why I have a port. They tried 2 more times in each hand. No success. I reminded them how hard im to sedate just to be sure all were on same page. So they gave me a pill to dissolve under my tongue. It had no effect. I told them several times. The procedure began and I was wide awake. The eye drops did have some effect but wore off quickly. I say this because it was very painful. Where they had the clamps or whatever to keep my eye open.. was painful. When he would repeatedly flood my eye with lidocaine it burned like fire. He kept asking me to look downward. I kept trying so hard. When they would rub something in my eye to dry it or something... it felt like they were pressung hard and scrubbing my eye with a rough piece of fabric. Im sure it wasnt but ut hurt. The entire procedure was painful. I wanted to ask them to please stop.. but i wanted to be able to see again so i gritted my teeth and my fingernails unfortunately pierced the armchair. Finally he told me he was almost thru and to hang in there so he could finish. He did. I was a wreck after. Everyone had told me id not hardly even know what was going in and feel little to nothing. For me it was horrible. I dont understand why they couldnt give me a shot to sedate when I told them the pill did nothing. They could tell i was under distress as the girl kept saying my blood pressure was high. It was 185/115 and she said my pulse was 120. Surely this doesnt need to be this way. Isnt there something that can be done if I dont have any veins for an iv... they said they cannot ise my port.. something to help and something to reduce the pain I felt during the procedure as well? Im supposed to have my other eye done in 2 weeks and i do not think I can go thru it again.
Submitted: 4 months ago.Category: Eye
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Answered in 8 hours by:
12/8/2017
Eye Doctor: Dr. Rick, Board Certified MD replied 4 months ago
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 12,008
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Hi. I'm Dr. Rick and I have two decades of ophthalmology and retina surgery experience. I'm online and happy to answer your question today.

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Eye Doctor: Dr. Rick, Board Certified MD replied 4 months ago

why have you been on prednisone for 30 years?

What is your dosage?

Do you have any other medical problems or take any medications?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.

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Customer reply replied 4 months ago
Hi Dr. Rick,
In answer to your inquiry; Ive had Lupus for 30 years. I take prednisone for this. Current dosage is 25 mg daily... im titrating slowly down to my regular 20 mg dose as I had an episode of a cranial nerve palsy 8 weeks ago so getting the dosage down to my normal one. I take many meds, most for high blood pressure, I have peripheral neuropathy also onset 24 years ago due to Lupus. Blood pressures a new problem since 8 years ago; side effect to ling term steroid use. I take plaquenil, Imuran and prednisone daily for Lupus control.. somewhat control. I take prevacid and aciphex for GERD, have gastroparesis... big “L” again. I have high cholesterol and take two statins for it... mostly genetic tendency but also steroid effect. I was an athlete when younger, have maintained good diet and cycling activity... i am 5’8 and weigh 142 lbs. I swim a mile a day twice a week when Im not flaring. I hung up my road bike due to ankolysing spondylitis but invested in a cool recumbent trike this past year and now ride three days a week with spouse when feeling okay. I have permanent double vision... and the double images move around... the muscles of my eyes have been attacked but cannot have surgical resolution to this because the severity of double images changes daily. So it goes. I also have cranial nerve involvement which causes this too. Its been going in for four years. I wear prisms in glasses and it helps. I have removable prisms to attack to my prism glasses to adjust the need as is needed right now. I needed to get cataracts removed so will enable my neuro-opthamologist elsewhere to do a few other things to help my vision. So this cataract surgery was part one of a planned treatment process im now diabetic... again steroids. But i no longer take any meds as diet has taken care of it a lot. My a1c is 5.4
Good progress.
I do wear a duragesic pain patch.. have for 18 years. I wanted to try get by on less and have been able to lower dose to the 62.5 mcg patch! Yippee! I had a colon resection to remove 75% of colon in 2013 to address damage... thank you Lupus. Doing very well now. Less pain less problems. My Lupus likes attacking my gi system the most. Ive had optic neuritis 5 times and always resolved. Sounds like a lot, maybe it is compared to ones without Lupus... but ive managed things well and my greatest difficulty is with blood sugar dropping.. crashing without warning... thats a scary thing when it happens. Keeping eye on my levels every few hours helps ward off getting too low. Im now allergic to Morophine, Demerol, Biaxin, Iodine in contrast dye, and Dilantin. Anaphylactic shock. Not fun. So thats me in a short story. Lupus has attacked my brain (cerebritis) several times and affected most body systems but my kidneys are GOOD! Thank heaven for small gifts. Well big gift really. So there you are. A complicated medical history but I get aong pretty well, manage things as they come, deal with the pain pretty well, im getting older now, get tired easily compared to a few years ago and any stressor causes a flare now. Im hoping my eye procedure wont cause a flare.. but if it does I will get thru it. It causes bad rash to pop up and a lot of sweats, chills, low fever, aches and pain for sure, and gi problems but after a week im good to go and back whistling and smiling again. So it goes with this disease. But Im very apprehensive about getting my other eye done in a few weeks after what I went thru and after repeatedly telling personnel I was hurting and very uncomfortable. Im not a baby. My docs routinely call me “a trooper” and if anything... get on to me for grunting thru things and not coming in to address things early enough. I know there’s no magic bullet and I dont expect a pain free symptom free life. So Im more apt to just bear things at times... till its just well... no linger bearable! Yesterday was unbearable. Awful. And im very scared to repeat it. A good friend had his eye done same day I did at same clinic same doctor! He said he was asleep and felt nothing. Quite opposite of my experience. I just dont understand why theres nothing to do to make my experience better with much less pain thru entire procedure. Maybe since no IV could be started i just have to either have this as the way it has to be... or not get my other eye done at all. Which is what im thinking of. Its like going to have a dental procedure done without any anesthesia at all. Archaic. I hope. I hope there is an answer. The disolvable pill certainly had zero effect.
Customer reply replied 4 months ago
Nnn
Eye Doctor: Dr. Rick, Board Certified MD replied 4 months ago

From what you have posted I feel that you would do best to have your other cataract surgery done under general anesthesia.

They will have no problem putting you asleep and keeping you that way using gas.

Does this make sense to you?

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the excellent feedback button for this encounter. And, don’t forget, I work for tips. I would also be happy to continue to answer any more questions you have until we have resolved your concern.

Dr. Rick MD FACS

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