Dr Wise - Big 'bladder' Stones

Brinda41 · 04-19-2006, 08:42 PM

I have been diagnosed with several large bladder stones. Bladder stones not kidney stones.

I have a spinal cord injury [C4/5 Complete] with a Foley catheter and have had for 26 years. I have been extremely fortunate in not having too many problems during my first 20 years. But I was recently diagnosed with numerous large bladder stones [around 4cm being the largest] and they have obviously been caused by many recent urinary tract infections over the last two years and just by me being sedentary.

I've gotten two opinions from urologists. They both want to put me under general anesthesia.

I know that I can call the doctor and find out the reason why (I do not know why I keep forgetting to ask the doctor) ... but I was wondering what IS the reason for this?

During an interview with one urologist (that I have now chosen to do the procedure) I asked her if they could do a spinal rather than put me all the way under anesthesia. She thought possibly but she consulted with the chief anesthesiologist and because I have syringomyelia with a shunt that drains into my pleural cavity ... he said no because the anesthesia medicine could\would swoosh right up through the spinal cord and I could stop breathing.

But I am still left wondering why I have to go all the way under. Although, with my condition, and any trauma below the area of injury causes my autonomic nervous system to skyrocket and this has to be closely monitored by an anesthesiologist.

But I think this would still happen regardless if I was under general anesthesia or not.

Could you give me some thoughts as to why they choose general anesthesia?

And if all the manipulation to my bladder during the procedure does mess severely with my autonomic nervous system ... putting me into autonomic dysreflexia ... is that the whole purpose of me being under?

Even so, can't they monitor it just as well as me telling them how badly I am feeling sufficient enough if I were awake during the whole thing?

The doctor is also aware that I am nervous about postprocedure autonomic dysreflexia.

That is because I had a routine cysto in 1992 in the doctor's office and the doctor removed several small stones while I was 'wide awake.' I was absolutely wide awake and fine during the whole procedure but for a full week afterward I would have bouts of severe AD whenever I moved from a sitting position to a lying- down position.

Except THEN I did not have nitro-bid paste or other home remedies to help with that.

That was poorly worded but I think you can understand where I'm coming from.

Sincerely, Lori

SCI-Nurse · 04-19-2006, 11:38 PM

The only two choices are general & spinal & the decision is up to the anesthesiologist. For short procedures there is something called moderate or conscious sedation and your kind of in a twilight sleep but it can only last for a very short time.

CWO

Wise Young · 04-21-2006, 09:03 AM

Lori, excellent questions. I don't know exacty why your doctors want general anesthesia but I can only give you the reasons why I would want you to be under general. First, general anesthesia (depending on what they use) can and does suppress central autonomic dysreflexia. Second, they can control your blood pressure with general anesthesia as well as your respiratory rate. Third, they can give you muscle relaxants, so that your spasticity will not interfere with surgery.

Wise.

04-19-2006, 08:42 PM	#1
Brinda41 Member Join Date: Jul 2005 Location: tucson, az Posts: 40	Dr Wise - Big 'bladder' Stones I have been diagnosed with several large bladder stones. Bladder stones not kidney stones. I have a spinal cord injury [C4/5 Complete] with a Foley catheter and have had for 26 years. I have been extremely fortunate in not having too many problems during my first 20 years. But I was recently diagnosed with numerous large bladder stones [around 4cm being the largest] and they have obviously been caused by many recent urinary tract infections over the last two years and just by me being sedentary. I've gotten two opinions from urologists. They both want to put me under general anesthesia. I know that I can call the doctor and find out the reason why (I do not know why I keep forgetting to ask the doctor) ... but I was wondering what IS the reason for this? During an interview with one urologist (that I have now chosen to do the procedure) I asked her if they could do a spinal rather than put me all the way under anesthesia. She thought possibly but she consulted with the chief anesthesiologist and because I have syringomyelia with a shunt that drains into my pleural cavity ... he said no because the anesthesia medicine could\would swoosh right up through the spinal cord and I could stop breathing. But I am still left wondering why I have to go all the way under. Although, with my condition, and any trauma below the area of injury causes my autonomic nervous system to skyrocket and this has to be closely monitored by an anesthesiologist. But I think this would still happen regardless if I was under general anesthesia or not. Could you give me some thoughts as to why they choose general anesthesia? And if all the manipulation to my bladder during the procedure does mess severely with my autonomic nervous system ... putting me into autonomic dysreflexia ... is that the whole purpose of me being under? Even so, can't they monitor it just as well as me telling them how badly I am feeling sufficient enough if I were awake during the whole thing? The doctor is also aware that I am nervous about postprocedure autonomic dysreflexia. That is because I had a routine cysto in 1992 in the doctor's office and the doctor removed several small stones while I was 'wide awake.' I was absolutely wide awake and fine during the whole procedure but for a full week afterward I would have bouts of severe AD whenever I moved from a sitting position to a lying- down position. Except THEN I did not have nitro-bid paste or other home remedies to help with that. That was poorly worded but I think you can understand where I'm coming from. Sincerely, Lori

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04-19-2006, 11:38 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,301	The only two choices are general & spinal & the decision is up to the anesthesiologist. For short procedures there is something called moderate or conscious sedation and your kind of in a twilight sleep but it can only last for a very short time. CWO

04-21-2006, 09:03 AM	#3
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,972	Lori, excellent questions. I don't know exacty why your doctors want general anesthesia but I can only give you the reasons why I would want you to be under general. First, general anesthesia (depending on what they use) can and does suppress central autonomic dysreflexia. Second, they can control your blood pressure with general anesthesia as well as your respiratory rate. Third, they can give you muscle relaxants, so that your spasticity will not interfere with surgery. Wise.