Greetings, Dr. Roach I have a cataract surgery scheduled for next month. Both my primary care physician and my cardiologist have approved the treatment. According to my healthcare doctors, I am in good health and feel like I’m doing okay.
The fact that nobody seems to be paying attention to me is my issue. I have stated time and time again that I have an issue with anesthetic (midazolam and fentanyl). Narcotics are one of the many things I’m allergic to. I don’t appear to be getting any attention. Can I ask for a different anesthetic? — S.S.
ANSWER: The Greek word for numbness or stupor is where the word “narcotic” originates. Due to its negative meaning and association with illegal narcotics, the term is no longer used in a medical context. Opioids are synthetic medications that act on the same receptor as opiates, which are primarily used for natural derivatives of the poppy plant like morphine. The entire class is referred to as opioids.
Opioids seldom cause allergies, but they frequently cause negative side effects. While diarrhea, dry mouth, nausea or vomiting, disorientation, and itching without a rash are common side effects of opioids, they are not typically allergic reactions. A rash, wheezing, or swelling are typical symptoms of true allergies. A nonallergic reaction is thought to occur in 90% of patients with a medically confirmed opioid allergy.
Your anesthesiologist will carefully record the medication you took and the nature of the reaction. Since opioids come in a variety of chemical classes, you may be able to receive a chemically unrelated substitute if you are among the few individuals who actually have an allergy.
By the way, midazolam belongs to the benzodiazepine family of sedatives, which are chemically unrelated. These help patients stay comfortable and peaceful during surgery.
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Greetings, Dr. Roach I am a 76-year-old woman who had one ovary removed and a complete hysterectomy around 40 years ago. After a while, the second ovary was removed. I’ve had Pap smears every two years since. Due to my previous surgery, I asked my doctors if a Pap smear was required, and I have been receiving contradictory responses. What do you think, a doctor? — C.A.
ANSWER: Most medical professionals agree that if you had a hysterectomy for cancer, whether it was cervical or endometrial, you should never stop getting Pap smears. The possibility of a few cells remaining after surgery is always a tiny one. A small number of cases are detected early due to the Pap smear in the rare event that cervical cancer does recur.
Assuming you had a total hysterectomy rather than a supracervical hysterectomy, in which the cervix is left in place, no more Pap screenings are required if the hysterectomy was performed for a reason other than cancer, such as fibroids.
It is crucial that women understand the specifics of the operation they have had, since I have witnessed numerous instances when women have been unclear or even misinformed about the process. I believe you underwent a unilateral salpingo-oophorectomy, which involves removing the entire uterus and cervix, as well as one ovary and Fallopian tube, in addition to a total hysterectomy. For your new doctors, it would be great to have the surgical records from 40 years ago.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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