Sunday, November 22, 2009

Mystery of the TIA solved

Note to followers: I went in to have my 2nd cataract surgery last Wednesday and I had a 40 point rise in blood pressure within 10 minutes after instillation of meds to dilate my eye, very similar to the rise in BP that precipitated the Transient Ischemic Attack during the previous attempt at cataract surgery on September 30. However, this time because my BP was only 113/67 when I arrived, this rise did not cause any adverse events, like last time. My nurse and I began suspecting that something in the meds was causing this to happen to me. As she read me off the list of drops she had put in my eye, I recognized one: NeoSynephrine! Who'd have thought they used NeoSynephrine to dilate eyes for surgery? I surely didn't! I discovered that this medication is routinely used to dilate eyes for examinations, but the one used for surgery is 4 times more concentrated. It has been used to dilate my eyes before, but not in this highly concentrated state. Believe me, no one will EVER use it on my eyes again, EVER! I once used OTC NeoSynephrine nasal spray probably 30 years ago when I had a head cold and allergies. After a few days of useage, I realized that it was causing my heart beat to increase drastically and made me feel sick, so I decided never to purchase that product again, and I haven't. I never added it to my long list of drug allergies, because it was OTC, considered safe, and I never even mentioned it to my family doctor. After all, my face didn't swell up, and I didn't have hives, like I did when I ingested sulfa drugs or penicillin. After I got back home, I got online and researched Phenylephrine Hydochloride, the active ingredient in NeoSynephrine. The very first paragraph under side effects reads like this: A significant elevation in blood pressure is rare but has been reported following conjunctival instillation of recommended doses of NEO-SYNEPHRINE 10 percent ophthalmic solutions. Beware! This ingredient is also found in all Sudafed products, and is used extensively in surgeries where it is important to shrink blood vessels to prevent blood loss. It is a very common medicinal chemical. Moral of this story: Know what is in every OTC product you use, note ANY and ALL adverse reactions, not just anaphylactic symptoms, and make sure all medical facilities and persons are aware of them. It doesn't matter how small or insignificant you think it is. It doesn't matter how long ago it was. It doesn't matter whether you think they are likely to use it for your procedure. And ask lots of questions. Don't be embarrassed, and be persistent, even if the medical professional looks at you like you are crazy for not simply trusting them, or tells you no one has ever asked that before. Know exactly what anyone puts in your body, BEFORE it is put there. LESSON LEARNED!

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