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Our Experience with Anesthesia and Autism

September 17, 2010 · 5 comments

in Autism, Awareness, Resources

Let me start this post by saying that I am the farthest thing from an expert on this subject and that my intention is simply to share our recent experience with anesthesia for our son, who has autism.

Given the fact that my son’s biochemical pathways are already compromised, I was definitely concerned when his dentist recommended a surgical procedure to remove four baby teeth that needed to come out.

Choosing Surgery

First of all, I didn’t want to assume that surgery was automatically the best answer. I mean, why should I assume that we couldn’t work with him to handle the procedure in the dentist’s office? It might take a bit longer or need to be stretched over multiple visits, but shouldn’t be dismissed without consideration.

We did end up choosing the surgical option, partly because we were worried about whether a negative or even traumatic experience would set us back in the future for dental care and partly because I was concerned about the multiple exposures to medications and other toxic substances in the doctor’s office if this took a few visits.

And that led me to the question of how safe anesthesia would be for my son, not just in terms of the actual procedure but also with regard to the possibility of regression or negative impact on his health.

Researching Anesthesia

I had read a couple of great articles on the topic of anesthesia and autism in The Autism File magazine, one of them specifically about dental work. I had loaned my copy to a friend and didn’t have the opportunity to get it back from her in time, but thankfully was able to find both articles on the Autism Research Institute’s website.

Anesthesia and the Autistic Child by Sym C. Rankin, RN, CNRA was the first article I looked at. It is fairly lengthy and in-depth, so I won’t attempt to summarize it. Here are a couple of statements that struck me as critically important:

An anesthetic may represent yet another toxic insult our children get exposed to. Therefore, we must help anesthesia providers understand the physical and biomedical problems our children have so that the providers may minimize the insults.

The most important thing to discuss with the providers is detoxification pathways. Let them know that your child may have a problem with glutathione production and have defects in the methlylation pathways. A child’s liver is not able to detox as much as an adult. The need is to “keep it simple.”

From this article, I was able to get a lot of information on specific drugs in terms of how they might affect my son, which was tremendously helpful. I would highly recommend reading this article if you are facing any type of procedure which requires anesthesia. The information on nitrous oxide is especially enlightening.

The second article, Anesthesia and Fluoride, was written by Annette Van Dyke, RPh, MPH, a registered pharmacist and mom to a child on the spectrum. Her son had experienced an extremely bad reaction to swallowing fluoride at the dentist’s office and later responded very badly after the use of sevoflurane during a tonsillectomy.

Turns out that sevoflurane can metabolize to fluoride. This information left me in a bit of a quandry, since Ms. Rankin had recommended sevoflurane as a fairly safe option since very little is absorbed into the body.

Going In

When we spoke to the anesthesiologist, I was relieved that he was willing to take the time to discuss all of our questions and address our concerns. First of all, he planned to give Versed to help Michael relax before going back. This medication appeared to be fairly safe based on what I had read, so we were okay with that.

He did want to use sevoflurane, but would not be using nitrous oxide with it. He could not speak to the issue of regression but felt that it would be safe because it would be low-flow and for a very short time. After discussing our options for a bit, we decided to go with his recommendation and trust that we had done our very best to prepare and that God would take care of him.

Coming Out

Michael did wake up not too long after coming out of the procedure, which lasted about 35 minutes, but then he immediately went back to sleep and took quite a long nap (exactly the same thing that happened when he had surgery as a baby). Once we finally got him changed and in the car, however, he merely dozed off and on for the hour-long ride, and then he was awake and ready to play and watch videos for the rest of the day.

For pain management, we used dye-free ibuprofen every six hours (acetaminophen/Tylenol can cause problems with sulfation). The surgery was done on Friday, and by Sunday afternoon, he was not having any more pain and we stopped the medication.

Over the last few days, he has continued to be alert and social, with no sign of any regression or difficulties. And he’s just so darn cute with all those missing teeth!

{ 5 comments… read them below or add one }

Sandy September 23, 2010 at 8:07 pm

Your story reminded me of all the trouble I have had with anesthesia.

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Trish September 29, 2010 at 3:11 am

I’m sorry to hear that you had so much trouble with anesthesia. The wisdom teeth removal sounds absolutely horrifying! Some of the drugs I read about had quite severe side effects listed, so I am thankful our experience went so well. :)

I have had mild anesthesia for endoscopies several times and used to throw up for 2-3 days afterward, but the place I go now uses propofol and some other drugs that don’t cause that reaction in me.

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Jessica March 21, 2011 at 9:23 am

Hi Trish.
My son 3.5 yrs old was diagnosed with ASD at 16 mnths. He had just previously to that received anestesia during a minor surgery at CHOP. That day when he came home from sugery was when I first recognized the signs of Autism. He had lost his speech, relationships changed, ect.,. He may possibly need to undergo a 2nd surgery and I am frightened of the negative effects it may have on him. I will read up on the links you have attached in your information and hopefully will settle my concern so that he may receive the treatment he needs. Thank you for your information.

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Trish March 21, 2011 at 9:31 pm

I am so sorry to hear of your son’s difficulties, and I hope you are able to find a solution for the anesthesia that will work successfully for him and not trigger any other issues. Thank you so much for leaving a comment – my thoughts and prayers are with you and your son.

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Kris May 23, 2011 at 9:43 am

Trish,
Is there a way that I could communicate with “Jessica from 3/21/11 comment?

I also have a son who had surgery at 15 months. Very shortly after we found ourselves in to early intervention and a PDDnos diagnosis. My son is now 5 and needed dental surgery. I too was terrified at the thought of a second surgery and researched everything to the best of my ablilities. I work for a Doc who does bio med. and he was very helpful going into and through the process. My question to Jessica is is there any chance that she or her son has had Lyme?

My experience has taught me that lyme (or the coinfections that come with it) can be a huge factor in triggering autism, anethesia can stir up the “lyme”. We sought out bio med after the autism diagnosis (after the first surgery). At that time my son had soo much going on he wasnt even testing for strains of lyme yet. At 5 yrs he had just started testing for 1 strain of lyme that his system was ready to deal with. We started treatment well before the 2nd surgery. He needed to get the bad bacteria out of his mouth – the second surgery had to happen. I prayed. I researched and prayed more. The second surgery came and went. I quickly got him into the bio med doctors office following the surgery. After the second surgery we found that my son was testing for every strain of lyme that we had a slide for. We started treatment for that and he quickly came around again.

Interestingly, of all the stuff they insist they need for anesthesia – everything I had researched and worried over, the biggest issue for us was the “pain management” part at the end. I was very concerned going in, felt very pressured to ask the right questions and know the right answers on the spot. We we had not been permitted to meet with the anethesaologist prior to surgery as it was considered an out patient procedure – everythig had to be done that morning imediately prior to going in. (I had called and explained, pestered and complained, got as much out of them as I could prior, but couldnt actually speak to our anesthesiaologist). We met and talked about surgery and anesthesia that day. For some reason I had assumed they would discuss pain stuff after they talked to me again. They didnt. They did what they do – knowing he was autistic. They gave him a tylenol suppository prior to him leaving the surgical room. Of all the stuff they gave him, my bio med doc said that that is what caused my son the most distress to his system.

If Jessica hasnt scheduled or had the surgery yet – have her son tested for lyme. Not just the regular blood test – find a kenesiologist to muscle test. If he has a strain of lyme or a coinfection that needs to be addressed, take care of it. Talk about pain meds for after the procedure – BEFORE the procedure. Most doctors dont seams to make the connection that autistic kids usually dont do well with tylenol. – Kris

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