When you listen to your television or read ads for the different medications being promoted by pharmaceutical companies, there is usually a significant segment that is related to the complications of the treatment. Therefore, you have to make a decision about whether the benefits of the treatment outweigh potential complications.
The same problem is associated with particularly invasive procedures such as surgery, anesthesia, and administrations for imaging.
A good example of this risk occurred in September of 2014, when comedian Joan Rivers went into an outpatient facility to have her upper swallowing mechanisms examined — a minor procedure that, for her, turned out to be fatal.
A somewhat similar episode occurred with one of my patients who was taking anticoagulants for atrial fibrillation and experienced a drop in blood volume that caused shortness of breath. Physicians were concerned that she was bleeding from her intestine, even though examinations of stool showed no signs of blood. The consensus of her doctors was that she should have a colonoscopy
She had also experienced some episodes of difficulty swallowing. Therefore, the doctors were prepared to her swallowing mechanism her upper intestine. The combination of the two procedures made it an indication for anesthesia, which usually given as conscious sedation. But current medical data show that increasingly full anesthesia (Propofol) is used for such a dual procedure.
As the colonoscopy was being completed at an outpatient center, the patient went into respiratory arrest and had to have CPR, which resulted in three fractured ribs on the right and one fractured rib on the lefr.
Luckily, the CPR got her breathing again and she was able to leave the hospital after a week.
Unfortunately, she continues to have some shortness of breath, probably related to atrial fibrillation. She also suffers from sleep apnea which — on review of medical data after her episode of respiratory arrest — shows that there is increased incidence of complications from anesthesia for those with the sleep apnea.
The fact that she was to receive full anesthesia for her colonoscopy — and not the usual conscious sedation — was not discussed with her nor her family prior to the procedure. Considering what we now know about the increased risk from anesthesia with sleep apnea, a virtual colonoscopy with CT or MRI without anesthesia should have been performed.
Many doctors now say anesthesia with sleep apnea should only be done in a hospital, not outpatient centers.
All medical treatments and procedures have a degree of risk. Therefore, before starting a new medication or undergoing a new medical procedure, you should check the data that is available in books and websites like the ones I listed in my last entry.
Homeopathic medicine actually entails no risks, and treats the underlying cause of the problem to eliminate the symptoms. On the other hand, most current medical treatments address only the symptoms and not the underlying cause.
Posts by William Maxfield, M.D.
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