Expert: Dr Ian Jackson - please note UK based - 2/5/2010

Question
Hi there, I underwent an operationon 29th Jan 2010 to remove a large abscess from my vagina - not a bartholin abscess apparently. I also had a chronic pus filled abscess removed from my right foot in Feb 09, after that op the anaethesist came to see me and told me to ensure if I ever needed another op to let them know I was difficult to incubate and had very low BP afterwards.  For the op to remove the abscess from my vagina I gave this info to the anaethesist who decided a spinal would be best for me.  However, I was really ill afterwards - BP went down to 62/44, I was cold, shaking and then the nurse shouted to another nurse to get the anaethesist back as my BP was dropping further and my heart was tacky.  He then came and gave me various iv medications and when I woke I was wrapped in plastic with what looked like tumble-drier hoses blowing hot air around me.  Help! I'm now totally terrified of anaesthetics, of not coming round or having a heart attack.  I'm due to have a further op for a vaginal reconstruction at the site of a biopsy that didn't heal properly - have Lichen sclerosis down there.  Could that be done without an anaesthetic?  Also, prior to this last op the anaetheist was asking me in theatre about auto immunne deficiency, and had I had many absecess recently, also said something about low white blood cells.  I have an 4 abscesses in past 2 years - 2 dental, one removed from inside my foot and then this one in my vagina.  Could there be a link.  I have been unable to get an apt with my own GP for nearly 3 weeks and would welcome some reassurance.
Thank you for your time.
Tina

Answer
Hi Tina
You need to separate out the anaesthetic issues from everything else - so lets start with those.
You don't mention your age but it sounds to me that you have had a bit of a rough time.
First anaesthetic - a certain number of us are 'difficult to intubate', this is a fact of life for us anaesthetists and is not a major problem when you know about it. There is NO reason why you can't have a straight forward general anaesthetic for the type of operation you are due to have. Some people do tend to drop their blood pressure a bit and again this is something we can deal with.
Dropping your blood pressure after the spinal anaesthetic is not surprising - spinal anaesthetics do this plus if you had an abscess there was probably some nasty stuff from that having an effect on you as well. It is well known that people lose body heat during anaesthesics and spinal anaesthesia is just as bad as general anaesthesia for this. Therefore we often use blower heaters that have big tubes that look like those from a tumble dryer that blow hot air into special blankets put over you. We use these in theatre and aften in Recovery when patients wake up cold.
So tell your next anaesthetist about what has happened to you and they will take you through what they will do to ensure you are OK this time.
Now as to the abscess formation - that is something I can't help you with but is worth exploring with your GP. If the hospital had noticed any issue with your white cells then they would have referred you to a specialist for advice. I therefore suspect that this was just someone adding two and two and getting five without really thinking.
I hope this helps - for what its worth I don't think you need an urgent GP appointment so three weeks will be fine.
Dr Ian Jackson