An unexpected side effect of low carb

Dragonwolf

I got a tubal ligation done today. As the anesthesia was wearing off, I heard the nurse comment on the fact that she was surprised that I didn't need as much anesthesia to go under (and was taking a little longer than expected to come out). I found this particularly interesting, because the last time I had surgery (appendectomy) about 10 years ago, I needed extra anesthesia to go down.

Upon thinking about this, it rather makes sense that my diet is a primary contributor to this for a couple of reasons -- 1. such things seem to reach the blood stream faster or some such (this is most commonly seen with alcohol in that it takes less alcohol to reach certain states of drunkeness); and 2. my overall chemical tolerance is lower, because I use diet and lifestyle to manage all sources of pain, which means I don't get the chronic migraines/cluster headaches I used to, so I'm not throwing down 800mg of Ibuprofen every single day, and I don't use any pain meds (let alone the common Vicoden or Percoset) for my degenerative disc disease, so I have very low chemical tolerances now.

In hindsight, it makes sense, but it never occurred to me until after the surgery.

auntstephie321

That's pretty cool. Be sure to let your drs know in the future so they don't give you too much. They always give my SO to much and then he's sick all day.

nvmomketo

Interesting. I wouldn't have thought of that either.

Hope you have a speedy recovery!

Dragonwolf

auntstephie321 wrote: »

That's pretty cool. Be sure to let your drs know in the future so they don't give you too much. They always give my SO to much and then he's sick all day.

I get sick from it, anyway. Thankfully, not nearly as bad this time, thanks to like three different anti-nausea meds (phenergan, a motion sickness patch, and an IV anti-nausea) and a bowl of chicken broth. I'll definitely be letting them know, and I'm thankful that I forgot to mention that I needed extra last time, or I might have still been under!

nvmomketo wrote: »

Interesting. I wouldn't have thought of that either.

Hope you have a speedy recovery!

Thanks! Everything's going well so far, so that's good. I plan to have a fair bit of bone broth over the next couple of days, which should help, too.

auntstephie321

Yes that could've been a disaster. I'm glad you're feeling well and they didn't knock you out for the week

V_Keto_V

Anesthetics primary elimination is via distribution (Hoffman elimination)...i.e. respiration. Being in ketosis could have altered respiratory rate as well as anion gap (Carbonic anhydrase inhibitors are drug class of choice to treat altitude sickness...like ketosis, Carbonic anhydrase inhibitors cause metabolic acidosis; alkaline substances partition into the urine (alkalinizing urine). Also, having fewer fat stores provides less membranes for anesthetics to partition into and sequester...lower body fat = faster reversal of anesthetic...key being respiratory anesthetic vs. local anesthetic.

Drangonwolf, which med did they give you? Vercuronium, pancuronium, atricurium, cisatricurium, or rocuronium or other?

Dragonwolf

V_Keto_V wrote: »

Anesthetics primary elimination is via distribution (Hoffman elimination)...i.e. respiration. Being in ketosis could have altered respiratory rate as well as anion gap (Carbonic anhydrase inhibitors are drug class of choice to treat altitude sickness...like ketosis, Carbonic anhydrase inhibitors cause metabolic acidosis; alkaline substances partition into the urine (alkalinizing urine). Also, having fewer fat stores provides less membranes for anesthetics to partition into and sequester...lower body fat = faster reversal of anesthetic...key being respiratory anesthetic vs. local anesthetic.

Drangonwolf, which med did they give you? Vercuronium, pancuronium, atricurium, cisatricurium, or rocuronium or other?

I don't know, they didn't tell me exact names of any of them. It was a full anesthetic (total knock-out), but that's about all know.

AshleyC1023

My daughter is 7 and she weighs 40 lbs. She's also very tall for her age, but super lean (and is tracked by her doctor every 3 months to make sure her weight is ok) and very low body fat. When she had a minor surgery in May of last year, she came out of the respiratory anesthetic before they even got her out of the OR. The nurse said she sat up and asked where I was, which surprised them. She wasn't groggy in the least and sat and ate ice cream until they discharged her 3 hours later. She was actually very chipper and figured out that the nurses would let her eat her body weight in ice cream.
When I had surgery 2 years ago (a major arm surgery to repair nerve damage and scar tissue from an accident when I was little) I felt like garbage all day and certainly didn't feel like eating anything. That "white stuff" is the devil when it comes to anesthetics. I've had it twice and it made me feel horrible for the rest of the day.

Dragonwolf

AshleyC1023 wrote: »

My daughter is 7 and she weighs 40 lbs. She's also very tall for her age, but super lean (and is tracked by her doctor every 3 months to make sure her weight is ok) and very low body fat. When she had a minor surgery in May of last year, she came out of the respiratory anesthetic before they even got her out of the OR. The nurse said she sat up and asked where I was, which surprised them. She wasn't groggy in the least and sat and ate ice cream until they discharged her 3 hours later. She was actually very chipper and figured out that the nurses would let her eat her body weight in ice cream.
When I had surgery 2 years ago (a major arm surgery to repair nerve damage and scar tissue from an accident when I was little) I felt like garbage all day and certainly didn't feel like eating anything. That "white stuff" is the devil when it comes to anesthetics. I've had it twice and it made me feel horrible for the rest of the day.

I was groggy for a little bit, but wore off fairly quickly. My brain actually woke up before my body would cooperate enough for people to tell I was awake. Made it nice to eavesdrop on the nurses.

I made myself take it slow, too, because anesthesia makes me horribly nauseous. The first time I had surgery, I could basically throw up on demand by simply turning to my right. This time, we were all prepared for that and they gave me three different kinds of anti-nausea medication. My husband was also kind enough to track down some chicken broth for me, which helped me get something in my stomach for the first time that day (taking percoset right after waking up after having neither food nor water for 17 hours sucks in so many ways), though the nurse apparently didn't like that he was "accommodating me" so much (it was outpatient surgery, so it was PACU, then home), but she apparently didn't get that I wasn't about to try to do just about anything, let alone stand up, take a wheelchair down and elevator, then take a ride in a car while I feel like I'm going to turn my insides inside-out, so the more accommodating people can be, the quicker I could get out of there.

By the time I got home, I was feeling pretty good, minus the pain from the residual air bubbles under my bottom rib and in my shoulder (holy hell, those hurt!), and ended up eating three eggs in butter and a can of tuna made into tuna salad. I ended up paying for that this morning, though, and ended up sick. Apparently, the hydrocodone has a side effect of nausea, too, and screwed with things this morning, even though I had taken it last night. I've had it before, though, for other things, and never had that issue, but I suspect my stomach is a little more sensitive right now from the surgery/anesthesia.

AshleyC1023

Anything with codeine makes me nauseous, so I sympathize with that! My ride home was way more eventful, I actually threw up in my own truck...at least it was my truck and not someone elses. It's hard to hit a grocery bag when you have 1 arm cast up to the shoulder at a 45 degree angle, lol.
Taking anything with codeine on an empty stomach is going to make you feel barfy, pretty sure that's why the label says to take with food or milk. I never understood why they give it to you directly after surgery on an empty stomach, as if you didn't already feel like barfing.

deksgrl

I had outpatient surgery years ago when I was not on LCHF and I was nauseous, they had to keep me a lot longer than most people before I could go home because I was so sick. So you are telling me if I have to do that now on LC it will be even worse? Let's hope I never need it....

KarlaYP

Glad your recovery is going good! But yes, the air bubbles that show up under the ribs and shoulder blades are terribly painful!! Memories for me (weird how we forget about this!)! Make sure you take the pain medicine with some food, or try half the dose. Hopefully that's more nausea from the anesthesia instead of the meds. Btw: I've never had a nurse anesthetist or anethesiologist tell me the exact name of the agent used either.

JQuinnLife

Another surprising side effect of low-carb: Amazing muscle definition

V_Keto_V

"White stuff" was probably propofol...in the form of an emulsion. AKA Michael Jackson's anesthetic of choice

slimzandra

I think you are on to something that's worth some MD/Phd candidate research project. I would love to be a subject to show the before/after of a keto diet impacting the effects of alcohol, smoking, sedation w surgery. Even recouping from an injury is significantly different. IMHO.

KarlaYP

I have felt the same way @slimzandra! I think we would all make great subjects in a research project! The changes have been so drastic, and wonderful! I want the world to KNOW about this potential! I went into nursing because I wanted to help people, but quickly realized that other than a helping hand, there isn't true help (treatment based medicine is sad, they've stopped looking for cause, and cure, imo)to give! But helping others learn about this woe, I believe that would be truly helping others! Maybe one day!

Dragonwolf

deksgrl wrote: »

I had outpatient surgery years ago when I was not on LCHF and I was nauseous, they had to keep me a lot longer than most people before I could go home because I was so sick. So you are telling me if I have to do that now on LC it will be even worse? Let's hope I never need it....

The nausea actually wasn't worse than before, but it might have had to do with having pre-emptive anti-nausea meds. There's simply too many variables to know on that one. I've only thrown up once, and have been better able to hold things down in general, so that's good. It seems to be lasting longer overall, but it's a lot lower level and is controlled with phenergan.

Karlottap wrote: »

Glad your recovery is going good! But yes, the air bubbles that show up under the ribs and shoulder blades are terribly painful!! Memories for me (weird how we forget about this!)! Make sure you take the pain medicine with some food, or try half the dose. Hopefully that's more nausea from the anesthesia instead of the meds. Btw: I've never had a nurse anesthetist or anethesiologist tell me the exact name of the agent used either.

That's been another fun one. I've only needed the hydrocodone once and that was more of a "better safe than sorry" thing, because I didn't want to wake up in agony at 2 in the morning. I've been fine with prescription Ibuprofen, and most of the pain is everywhere but where the surgery was actually done. My neck is stiff/sore and I feel like I did the core workout to end all core workouts or something. But the incision and lower ab area where the work itself was done? Not a whole heck of a lot. The incision hurts about as much as any other deep-but-clean cut does, which isn't bad considering it's in my belly button (which you'd think would be sensitive as hell).

AshleyC1023

V_Keto_V wrote: »

"White stuff" was probably propofol...in the form of an emulsion. AKA Michael Jackson's anesthetic of choice

I think so. All I know was it was white, thick, and burned like a SOB all the way across my chest before I was out. It was the suck.

V_Keto_V

AshleyC1023 wrote: »

V_Keto_V wrote: »

"White stuff" was probably propofol...in the form of an emulsion. AKA Michael Jackson's anesthetic of choice

I think so. All I know was it was white, thick, and burned like a SOB all the way across my chest before I was out. It was the suck.

Nah, if it was a topical anesthetic it's not propofol

AshleyC1023

Not topical, injected via IV. I could feel as it hit every single vein (from my right hand, up my arm, across the shoulder and into my chest). Liquid fire.
It looked and felt like a penicillin shot!

KarlaYP

I always feel like I've been beat up (stiff neck....) after surgery! I accuse them of man handling too much, so to speak, which they do, sort of! But yes, it leaves a bit of soreness after! My history of laparoscopic surgery (5 abdominal surgeries in 7 years! Geez!) I never have had pain at the incision sites! It's always been deeper, where the inside manipulation was, or just the trapped air (as you described!). It's great that you haven't needed the pain meds and that ibuprofen works (it was my go to until I had a life threatening allergic reaction to it, I miss it) for you! Glad to hear your recovery is continuing to go well!

markrgeary1

Very interesting, expecially your comments about cluster headaches. I would get them weekly for years, haven't had one since last May. I'm also of the opinion that less is more for medication. I was leaning toward giving the credit to eating differently as my diet and symptoms changed almost the same time, I'm grateful those headaches are gone.