I would strongly question the idea that he has "no structural abnormality".
It would be very interesting to see exactly what type of imaging they performed on him. Bear in mind, an abnormality in the hippocampus or other memory related structures could be sub-mm in size and result in a significant impairment.
If, for example, he did not have an MRI with diffusion weighted imaging with a sufficiently high B value (gradient value) they may be missing/have missed a very small stroke (this test is also time sensitive -only positive within the first few days of insult).
If they did not perform susceptibility weighted imaging, they may have missed a tiny micro-haemorrhage. Both of these scenarios can result in memory loss if critical structures are involved.
There are also several technical issues that may have resulted in a sub-optimal scan, precluding finding a tiny abnormality. There's also the question of whether the person reading the scan got it right or whether the strength of the magnet/technical parameters of the study were sufficient to resolve a tiny abnormality.
Either of these scenarios could have been a consequence of reduced blood flow (hypoperfusion), a small clot (embolus) or a tiny blood vessel injury (dissection) that could have occurred during the procedure - possibly related to the anaesthetic but not definitively so.
I suspect there is a definitive abnormality that the clinicians that saw him were unable to pick up. This seams a lot more likely than the idea that we need to revise our entire conceptualisation of memory formation to suit a psychological theory.
Not to deny what you're saying, because I believe a key tenet of biology is that structure follows function, but how would the structural abnormality be caused by the operation?
The doctors initially suspected that he’d reacted badly to the anaesthetic, causing a brain haemorrhage – yet they failed to find evidence of injury. So he was discharged with the mystery still hanging over him, and the family moved back to England, where he was referred to the office of Gerald Burgess, a clinical psychologist in Leicester.
Scouring the medical literature, he found five similar cases of mysterious memory loss without brain damage. Although none occurred during a trip to the dentist, they do seem to follow other periods of physiological stress during a medical emergency.
That doesn't prove that the anaesthetic isn't the root cause. The article title sounds link-baity.
Earlier this year I had a medical procedure and was given "twilight" anesthesia. I was explicitly told "you need to have your spouse or a friend here because we're going to give you instructions afterward and you probably won't remember it".
And, sure enough, my memory was pretty much wiped for the hour or so after the event. Later that evening I had a conversation with my wife that went like this:
"Um, did you help me with putting my clothes back on?"
"Um, no. You did that."
"Did I talk to you and the doctor?"
"Sure. Normal conversation."
I have no recollection of these events at all. It gave me an uneasy feeling for a day or so. Nothing traumatic but every time I tried to reach back and think about that post-op period I drew and continue to draw a complete blank.
After my first knee surgery, I regained consciousness midway through speaking a sentence to my mother. I was literally listening to words coming out of my mouth and had no idea where I was, who I was, or what I was talking about. My very next sentence was a panicked question to my mother trying to figure out those things. Turned out I had 'been awake and having cohesive conversation' with her for over an hour. I still have no memory of that conversation.
As I was being prepped for my third knee surgery, my doctor asked if I had any problems with anesthesia. I told him about the memory loss after my first surgery. My friends who were accompanying me, and had been at my second knee surgery, started mumbling "um, huh, well, oh, actually". It turns out that after my second knee surgery, when the surgeon was giving me a summary of how the surgery went, he told me he botched up my knee, and I proceeded to make very coherent and precisely detailed threats against his life. (The threats were bad enough that the surgeon considered bringing security into the recovery area and restraining me. In the end, my friends, including a combat vet, convinced the doctor that I'm not actually a violent person and agreed to restrain me if I actually became violent.) Again, I have absolutely no memory of this!
I read this book "The Master and His Emissary: The Divided Brain and the Making of the Western World" and based on that I would say your left hemisphere were active when right one was suppressed for some time. I can't recommend this book highly enough - it's very comprehensive and it give you an opportunity to look at the world from a different perspective
I also highly recommend that book. I wonder whether I'd consider this a hemispheric situation.
It seems to me like the internal, autobiographic self being disabled, and then upon awakening this self immediately says "wait, discontinuity in the recording ... where was I?" and this feeds back into the rest of the brain creating the confusion.
He wasn't confused the moment before, because his autobiographical self wasn't recording.
For me the main sign is the different behaviour. Left hemisphere is vile, ignorant and selfish. Threatening a doctor with death because he hurt you falls in the being sociopathic bastard category. This is my highly uneducated guess
Yeah, I've had that also. Very strange, like how does one recognize that one has "woken up" from being already awake? It's like, oh, the tape recorder turned back on.
Yes, it's a popular view nowadays among psychologists and cognitive scientists that the conscious self is just a sort of a senior manager that receives reports and thinks he's in charge while in fact his subordinates work just fine even when he's temporarily not available at all.
Well, it's an interesting point, because apparently if the tape recorder never turns back on, you're just kinda stuck in time as the person you were. So it suggests at the least that the tape recorder aspect of consciousness, perhaps in the way it feeds back one's perception of oneself to oneself, is crucial in the sort of consciousness we humans see as critical to identity.
Clearly though, this guy is still "conscious" - it seems like a situation we don't have quite the correct terminology to describe.
It's sort of a weak version of a P-zombie. Presumably the lack of conscious awareness would still be observable using a sufficiently detailed brain scan if not anything else, as opposed to a "real" P-zombie where the presence of consciousness is assumed to be completely epiphenomenal.
It's not that we're not aware, it's essentially that we may only be aware - aware of our thoughts once our subconscious thinks them, aware of our actions and their consequences once they're made.
The trick, seemingly is manipulating the focus of awareness to convince the subconscious decision-making apparatus to make different decisions, even though all we really have control of is our awareness.
Yes, this is the "weak" position. The original definition of a P-zombie is an entity that really does have no qualia, that is, subjective experience or "consciousness", but behaves exactly like it did, down to the neuronal level. It is a thought experiment and can be used as a reductio ad absurdum to argue that eg. uploads still have qualia.
The fact that anesthesiologists apparently deliberately induce amnesia with benzos scares the shit out of me, much more so than full general anesthesia does (which seems backwards, right, because general anesthesia is actually dangerous). Why do they want me not to remember anything? Is it that horrible?
The use of amnesiacs like midazolam in conjunction with unpleasant surgery has become common practice because it has been shown to significantly reduce the psychological trauma associated with surgical procedures and related changes in behavior as a result. You will still experience the trauma at the time whether you remember it or not, but the experience is not persistently encoded into your brain.
This is important because the psychological trauma of a surgical procedure will often cause people to avoid future procedures even when procedures are medically advisable. These drugs temporarily prevent strongly negative experiences from becoming a part of who you are mentally, subconscious or otherwise.
I'll say yes. For example, sometimes we have to run electrical current through someone's chest to correct an arrhythmia. Depending on the urgency, we will give a medication such as midazolam. Ideally you want the sedation to have taken effect, but you don't always have the time to wait for that before your hand is forced and you have to cardiovert. The amnestic properties will help reduce some of the traumatic memories.
Sure. That makes sense. You gave me enough keywords with that comment to look up electrical cardioversion and pain, and so now there's something new that I'm scared of (kale for dinner tonight!) (thanks!).
But that's actually something different than what I'm asking. I have no trouble understanding why I wouldn't want to remember a pain "similar to that of surgical incision". Similarly: I wouldn't want to remember an unanesthetized incision!
But before learning that surgical patients were routinely given midazolam to zap their memory, my impression was that surgical patients were completely zonked out by general anesthesia, and so there'd be no need to zap their memory, because they weren't going to consciously experience the incision in the first place.
Now I'm like, is all of general anesthesia a scam, and we're all enduring horrible pain, and we just don't remember it? J/K ONLY SERIOUS.
Midaz can be used as premedication before induction of general anesthesia, but it's not an induction agent itself. If you're getting general (as opposed to "twilight") anesthesia, once you're induced, you should be unconscious (to the best of our ability to understand consciousness).
I'm medicine, not anesthesia, so I don't use these agents all day and therefore referred to cardioversion which is more in my domain. Cheers!
I am noting with interest and a small amount of alarm the abruptness with which you've ejected yourself from this thread after my suggestion that all of anesthesia is a huge scam. :)
FWIW, unlikely. I specifically remember being asked to count down from 10, going like 8 7 6 ... 5 wait I feel weird and sleepy. That is, my first thought after being woken up was the next number in sequence.
It seems unlikely that would be the case if the time inbetween was spent thinking 'oh my god this hurts so much' rather than just blacked out.
Were you given a benzo specifically to erase your memory of the events? Because this thread is about the fact that many (maybe most) surgical patients are.
(Let me clear, I'm being deliberately silly about all this. I do not think there is a huge anesthesia conspiracy. I am, at the same time, seriously skeeved out by having my memory deliberately tampered with.)
I asked an anesthesiologist this question and am transcribing from memory (hehe), so I may have screwed some things up.
The answer to your question in is no, you aren't suffering enduring horrible pain while under general anesthesia. That doesn't mean you won't experience things you would rather not remember. Some examples:
1) patient may experience burning sensation from propofol (induction agent) entering the body
2) patient may see something disturbing before general has kicked in (e.g. a big saw before an orthopedic procedure)
3) in certain cases (e.g. emergencies) or due to human error, patient may not be fully under pre-surgery, e.g. patient may remember breathing tube being inserted.
The high level answer for why you are given midazolam (at least in the US) is because anesthesia is a "patient satisfaction" service and giving it increases patient satisfaction.
It varies by person but - Yes, it certainly can be.
My grandma had to undergo hip surgery awake with only local anesthetic. She was too frail and had all these health conditions so she couldn't be put under or given much medication. At the same time they couldn't just leave her hip broken. It was an extremely traumatic event for her.
Of course others would think it wasn't such a big deal.
I can give you some idea. I've had two surgical procedures where something like midazolam was strongly recommend, but opted out for one of them. The one I opted out of was a four hour procedure sawing on bone and soft tissue.
For the procedure on midazolam, I have virtually no recollection of the procedure except for about a minute in the middle where it apparently wore off. It was a completely neutral experience.
For the other procedure, it was extremely unpleasant for two reasons but I got through it like a stoic. First, they had trouble keeping up with the local anesthetic, too many nerves involved, so there was quite a bit of transient pain and it got sloppier over the length of the procedure as the doc got tired. Second, even when you can't feel pain, you can still feel them tearing up your tissues and rearranging your parts, which is disconcerting if nothing else. Overall, I strongly recollect just how unpleasant and painful (even under anesthetic) that procedure was. I probably would not be able to tell you any of this if I was on amnesiacs because I would not remember.
It is really about where your thresholds are. Like you, I find the loss of memory on the amnesiacs disturbing and the alternative, anecdotally, was far more unpleasant than I think some people imagine. The experience that I remember doesn't bother me that much because that is my nature but I can't deny that I have vivid memories of it. I can easily imagine that many people would prefer to not have those memories. That said, I would likely elect to forego an amnesiac again if I thought it would inconvenience me (i.e. by making you useless for several hours). I can deal with the experience.
I've always been afraid of intravenous sedation (="twilight anesthetic" in other English speaking countries) for the same reason.
The only time I experienced it was for an endoscopy. Because I was a heavy drinker at the time (probably the reason for the symptoms that lead the the endoscopy, ironically) the intravenous sedation had little effect, so I was awake through the whole thing. I didn't find it traumatic, merely unpleasant, but I think other people might have. The local anesthetic at the back of my throat wore off after some time, so I was dry retching every few minutes. At one point they pumped air into my stomach so they could take a sample with a needle (which was in itself painless), and that sensation was also unpleasant.
So while I doubt people undergoing intravenous sedation during routine surgery are in extreme pain, they may be in very uncomfortable situations that most people would rather forget. Also if it had been effective, it would alter your state of mind as well, so that the immediate experience was less bad.
I've had an endoscopy before, to push down some food stuck at the top of my stomach, with no sedation or numbing. Being held down by a couple of nurses and the doctor whilst the procedure was done three times - the first two times I pulled the endoscope out after having panic attacks - was the worst medical-related experienced I've ever had, and it still gives me nightmares. Turns out the doctor was known for being a sadistic bastard who enjoyed seeing his patients squirm; I wish I was making this up.
OTOH I regularly have a colonoscopy under heavy sedation, and never remember a thing.I know there are risks with any kind of sedation or anaesthetic, however anecdotally they've saved me a lot of trauma.
A friend of mine had a skin graft done under a local anasthetic. Debriding the wound was worst. Harvesting the skin was unpleasant. Attaching the graft was unpleasant. Dressing it all was not fun.
As I understand it there's an increased risk of PTSD if people are chemically restrained, which is why some ITUs (but not in England) use physical restraints when needed.
This is a different use case from surgery, where these meds are useful.
A very close relative died after a procedure similar to what had happened to Joan Rivers. I've had that procedure (prior to the death) but now I am really scared to have it done again.
I talk in my sleep and my father and some roommates have had full conversations with me, to include them asking me questions and me answering them. The upshot is that I apparently don't always give accurate answers. For example, one roommate recounted me insisting that I needed to fill up the water tank in my car. When asked what I was talking about, I responded along the lines of "you know, so it will have power to drive". Not only was the "water tank" portion problematic, I didn't even have a car at the time.
Before an operation I was given a pre-med that also induced something like amnesia. About two hours before the op. Everything after taking that pill is a blur - I can recall maybe 5mins out of like 8 hours (short operation, so most of those 8 aren't op)
Your story (and others in the reply) sound a lot like experiences of people taking Ambien (Zolpidem) - sometime, they "wake up" in the middle of being awake, and more - sometimes, they do things (like eat, drive, email, etc.) without any recollection. Often, just as sharp as when they are really awake, but sometimes, very weirdly (people driving naked, stuff like that).
To me, that (and experiments of Gazanigga etc) indicate that Jaynes was onto something with the "bicameral mind" theory, as crazy as it sounds.
That's interesting and supports the idea that it might be related to genetic factors.
I've had two twilight anesthesia procedures done about two months apart and remember the events before and after waking up in a lot of detail. I've also had regular general anesthesia once in my life, with the same result.
As a bonus, I seem to resist local anesthetics to a degree that requires 2-3 times the amount a normal person does (and even then, the pain finds a way through).
Oh yeah, conscious sedation. It's 9am, I am in the dentist chair and getting pills. Next it's 5pm and I am in my bed at home and I have zero idea how we progressed from event1 to event2 yet I am told I was talking to people. WTF.
Yep - had my wisdom teeth out, same deal - I remember counting backwards, waking up in the chair, magically getting to waiting room, I blinked and my flatmate was magically there, then I magically was upstairs at home. Definitely would repeat that again rather than recall the procedure!
I've been through that as well.
It was incredibly unnerving(to me anyway). The frightening part was more how would I ever know if it happened again.
I've been a little paranoid trusting myself after it.
I _believe_ I had the same anesthesia done when I went in for an endoscopy procedure roughly a year or so back. Supposedly the doctor had told me how often to take the prescription, I had sent iMessages/SMS' to people as well. Later that day I had nearly no recollection of any of it.
It's a very odd feeling for sure. Nothing serious and I doubt it caused any damage, but it was the first time I'd ever just had a blank set of time that I just couldn't answer for. I did have family nearby though.
That blank period, where you know things happened but have absolutely no recall, is horrifying. I have a period like that, and it still bothers me a lot.
This is a problem with some of the drugs they use during C-sections, too. When my son was born by surprise Caesarean, I think that was one of the things my wife and I were most worried about - that she would have no memory whatsoever of our son's first few hours of life.
FWIW that happens even when no surgery takes place. The women have just gone through a pretty traumatic effort. It's funny how terribly my wife recalls the first hour after she gave birth.
I have seizures in which I lose as much as a month of memory. The first one that I know about I suddenly found myself driving a car as if the universe sprang into existence that very instant.
After a while I decided that I dont have month long seizures rather I have brief seizures in which I lose a month of memory.
For this and other reasons I am concerned I have a brain tumour. That would totally suck.
You're absolutely right, but there's one problem: it's hard to get in for an immediate checkup and there's a good chance he'll forget about scheduling one.
Instead, he should tell a family member or close friend right away. Then they can help him make the proper medical appointments, etc.
When I got home from the hospital after the worst of my seizures, I found the instructions that were given to my mother. She was advised not to permit me to go outside unescorted.
She had put it with my stuff then never mentioned it.
Mom is actually quite an intelligent woman but sometimes she can be a little daft.
IANAMD. Go to medical doctor and get a NMR. It provides a lot of information and is very little invasive. Perhaps it's not a tumor but a small cerebral stroke or some other cerebral problem. It may be easy to cure with the correct medication + diet. Even if it's a tumor, some of them are easier to treat than others.
Meanwhile, driving a car seam to be potentially dangerous.
Agree. While it's possible he's still fully functional and able to drive during these episodes (maybe even likely -- a driver having a full-on seizure or in some kind of black-out would crash pretty quickly) it's not worth taking a chance of killing someone or yourself.
This seems to be yet another case of HN users upvoting dubious link-bait scientific press-releases. This particular one has been posted 3 times this week.
Not only link-baity, but also blaming the doctor. Large percentage of the large percentage of people who won't read the article will move away with a inconsciouss (at least) fear of medical interventions.
Anesthesia in particular. I've had some family members who were never quite the same after general anesthesia. Not as mentally sharp, more forgetful, etc.
But they should be considered proportionally to their probability times severity, and in this case, the probability is small enough to be a rounding error, so you really should worry about other things first, like getting killed when driving to the dentist's.
"With these latest revelations, medical errors now claim the spot as the third leading cause of death in the United States, dwarfing auto accidents, diabetes and everything else besides Cancer and heart disease."
That is a highly politicized/editorialized paper, though, with a clear opinion that really belong separate from a scientific paper.
It counts every death that could have been prevented by perfect care, not only harm caused by treatment in otherwise safe individuals.
For example, if someone with heart disease visits hospital and the hospital does not administer best known treatment protocol and the patient dies, that's a "medical error". But at root it is a heart-disease death. Same for cancer.
Some of the highlighted examples from the abstracts are extreme:
>>>
One example of a lethal error of communication between provider and patient occurred when cardiologists failed to warn their 19-year-old patient not to run. The patient had experienced syncope [fainting] while running, and 5 days of inpatient, diagnostic testing were inconclusive; however, his cardiologists knew he was not ready to return to running but failed to warn him against this risk. Having not been warned against running, he resumed running and died 3 weeks later while running.
<<<
The proper analysis is "what are your odds of survival when you choose to seek vs not seek care?"
I think pointing out the deaths caused by improper care are one of the few tools we have to correct the egregious errors that go uncorrected all the time in health care.
For instance a family friend was told she had uterine cancer and was all set to start her doctor's protocol. But at the last minute wanted a second opinion from MD Anderson, the best cancer hospital in the world. After their team looked at her doctor's tests, they ordered their own test, and told her she had bladder cancer instead. They were dumbfounded how her doctor could have missed it, and that protocol would have certainly of led to her death, as bladder cancer treatment must be aggressive and fast.
Yet the only consequence her doctor faced was being told by her that two of MD Anderson's teams thought he was a dumbshit. Other than that, he'll keep on doing what he was doing.
What consequence should he face? Doctors are still people and can absolutely make stupid mistakes just like the rest of us. Any serious diagnosis should always lead to getting a second (or even third!) opinion.
That's a tough question. But right now it is near impossible for them to face any consequences. Even writing about them publicly can result in libel lawsuits. But MD Anderson's team (they don't assign a single doctor to a case) saw the cancer was on a different organ from the same tests that the original doctor used, obviously that doctor made a mistake that could have resulted in my friends death. It would be fair if these mistakes added up like points on your drivers license (adjusted for the difficulty of your medical field). Of course just reforming state medical boards to no longer put protecting doctors as their primary mission, but protecting patients first would be a step in the right direction.
Well no, that's not fair. If your chance of survival was 0% if you didn't choose care, and it's 50% receiving the care you did, it would look pretty good. But if proper care resulted in 100% survival, that statistic looks really really bad.
Yeah, I've got a friend who had a brain haemorrhage with similar memory effects. It wouldn't surprise me if that had happened on a small scale and they just failed to detect the damage. I presume they use a brain scan and it can only pick up certain types / sizes of damage.
Oliver Sacks, in his wonderful essay collection "The Man Who Mistook His Wife For a Hat" [1], describes a similar case of a soldier, "Jimmy G.", who lost his ability to form memories after being wounded in 1945. Every half an hour or so his memory resets, and so 20 or 30 years later he still thinks that he's an 18 year-old man who just got wounded in the war. There's a particularly poignant moment in the story where his brother comes to visit the man in hospital in the 1970s, and how Jimmy is puzzled why his brother looks so old.
Another well-known case of retrograde amnesia is Clive Wearing, a British pianist who was the subject of a BBC documentary, "Man Without a Memory" [2]. I recommend watching the clip. He describes his "resets" rather terrifyingly as slowly emerging from a sleepless coma. Whenever he sees his wife after such a reset, he leaps up to greet her as if they have been apart for a long time, and his evident happiness and inability to recognize his situation is heartbreaking. (His wife, unbeknownst to him, of course, has since divorced him, which only adds to the poignancy of the scene.)
This is the condition that was described in Memento. Really fascinating stuff. It makes me want to keep notes on everything, because most people rely on their memory for a lot of things. When we forget something we are frustrated "Oh darn, I forgot it again!". Imagine not being able to remember anything at all...
In a talk that I attended, Steve Wozniak mentioned that he studied a lot of psychology when he returned to the university after leaving Apple. He thinks that he may have been the first person to have come up with idea that we lose our memories with our teeth, and that researchers later discovered a link between the loss of our early autobiographical memories and the loss of our baby teeth.
He says in his autobiography that he was in a plane crash. That was the reason for leaving apple. He suffered from memory loss, so probably that is the reason for his interest in psychology.
From wiki:
"Wozniak sustained severe face and head injuries, including losing a tooth, and also suffered for five weeks after the crash from anterograde amnesia, the inability to create new memories. He had no memory of the crash, and did not remember his name in the hospital or the things he did after he was released from the hospital."
Was that in Scotts Valley? Ive flown over that strip (as a passenger). the neighbors forced it to close, the strip is still there but there are big red Xs painted all over it. I expect its intended for use in emergencies.
I understand he didnt set the trim, which adjusts the balance of the plane for the distribution of passenger weight.
I used to love flying into Scotts Valley back in the '70s and '80s. It had a great picnic spot next to the field, and a scary approach when the landing direction was toward the southeast: The base leg (last turn before final approach) took you right toward a big tree-covered hill and you had to scoot around it a bit to avoid the trees.
Most of the runway is long gone, with houses at the north end and a park in the middle. There is a bit of the old strip left at the south end - but it would have to be a real emergency to even consider trying to land on it.
You can see the old airport in Google Earth if you use View/Historical Imagery and go all the way back to 10/1991. The south end of the runway is near Mt Hermon Road and Kings Village Road in Scotts Valley.
He's talking about milk teeth, not adult teeth. There is no implication that teeth are related to memories, just that your milk teeth come out at around the same age that your memories are wiped.
A few comments in this thread mention "genera anaesthesia side effects" and long-term problems. I have never heard of this and a quick wikipedia/google search is not bringing up good source on the topic. Is this substantiated or another "vaccines cause autism" kind of thing?
General anaesthesia is actually somewhat dangerous.
Your chance of dying from anaesthesia is around 1 in 100,000 - 185,000. While it may seem like a safe number, it's orders of magnitude higher than winning a major lottery.
That number also doesn't include medical fuckups during anaesthesia, like overdose, airway obstruction. In that case the number shoots up to 1:2500 - 1:5000.
When having staples inserted (and also removed a year later) into the growth plates in my knees, I was given the option of having my legs numbed too for pain relief. I'm glad I took that option now - unless it was post-op only.
From the second op, I had a huge black bruise on my thigh in the shape of a hand print. I couldn't imagine the pain if I'd have woken during the cause of that.
There was recent news on the detrimental effects of general anesthesia has on the very young and old. Apparently it can be neurotoxic but healthy adults don't seem to have long lasting problems.
A family friend of mine went under general anesthesia and woke up senile. He was in his late-70s, early-80s at the time. Lives in a nursing home now. Once in a while can have some moments of somewhat clarity but they only last for a minute or two.
It seems possible, due to what is used for general anesthesia. However, the person in the story was not given general anesthesia, only a local anesthetic.
>he wakes up every morning believing he is still in Germany in 2005, waiting to visit the dentist. Without a record of new experiences, the passing of time means nothing to him. Today, he only knows that there is a problem because he and his wife have written detailed notes on his smartphone, in a file labelled “First thing – read this”.
Much like the movie, yes, though in her case it was a daily, not an hourly, thing. It's nice that the film seems to be based on a real-life condition and portrays it fairly accurately.
I mentioned this to a psychologist and she laughed at me very hard. She was a professor and said that she uses the movie 50 First Dates in her class -- by having them write down everything that is wrong. She says it's so horribly inaccurate that it makes for a good long discussion.
The only real "issue" that article seems to take with the movies was that (A) it used a term that doesn't exist to describe a condition that does have an actual name and (B) it was a cheesy romcom. But I mean, do you really expect any Adam Sandler movie to get to the real grit of living with a terrible disease?
We didn't get into it deeply, but apparently the biggest issue is that it wouldn't be a daily thing. The recycle period is usually measured in minutes.
That's the part about this I'm so hung up on -- that this poor guy not only has this crippling condition, but that he has to come to terms with it every hour and a half, forever.
If no link can be found between the dental surgery and the memory-forming loss, could it be that there is actually no link? Have any other hypotheses been researched besides the surgery?
Most people took a little bit of time to get familiar with smartphone UIs, especially for someone who's jumping from no smart phone at all to the latest version of iOS and Android. I wonder if he has been slowly learning how to use a smartphone like the other condition, or if he has to rediscover the UI every time.
I believe the memory used to retain skills is separate from other types of memory. There was a famous patient, Henry Molaison[0] who was the first person to suffer this condition and participated in some really amazing research. He was able to learn new skills, albeit slowly.
"His ability to form long-term procedural memories was intact; thus he could, for example, learn new motor skills, despite not being able to remember learning them."
Damaging my mind is my biggest fear. I had a simple surgery a year ago(shoulder arthroscopy), and I specifically said that I don't agree to general anesthesia or any kind of sedatives, because even a small probability of a small brain damage isn't worth it for me.
Doctors tried to push me into accepting the general anesthesia, saying that it's the only option(and that we lose brain cells every day really, so who cares). I went to a different clinic where a doctor agreed to do the surgery under local anesthetics and without sedation without any problems. Said someting along the lines "don't worry, man, your brain is gonna be fine."
He failed to mention that local anesthesia can also lead to neurotoxicity, and I was too ignorant to know about it(for some reason I assumed that local anesthetics are harmless, and didn't do my research).
During the surgery I felt the symptomps(dizziness, difficulty speaking), consistent with neurotoxicity caused by local anesthetics.
I don't notice any permanent damage, though I doubt that I'd be able to tell. 6 months after the surgery I have developed tinnitus, but I can't tell if it's connected to it or not.
Anyway, my point is that no way in hell would I agree to the surgery if I'd have known the risks.
Also, before that, doctors pushed me into unnecessarily taking general anesthesia for a routine procedure. They convinced me that it can't be harmful, and I was too young and socially awkward to ask more questions or argue.
I also fear dental anesthetics. There is research indicating that they can cause neurotoxocity. I can easily sit through filling regular cavities(with a dental laser it really isn't that painful), but I'm not sure what I would do if I have to get root canal. I would take any option over anesthesia, but I don't know of any alternative.
Some doctors say that it's just an irrational fear. But given that there's some research saying that even dental anesthesia can cause neurotixicity, I'm not sure what's so irrational about not wanting my brain cells to die. My brain is what matters to me the most in the world, far more than anything else, it has infinite value, because that's literally "me", so even small chance of small damage is worth avoiding at all cost(in my value system).
It's infuriating how casual doctors are about such risks, especially in cases when they can be avoided. I understand taking necessary risks when it's a life-saving surgery, but when you have alternatives, I think patient should be able to make an informed choice.
The "irrationality"[1] is the weight you put on the unknown risk of brain-harm from anaesthesia, while not appearing to assign much risk to how you get there.
How likely is it that you're going to suffer brain injury in your day to day life versus from anaesthetic?
[1] irrational is probably a not useful word here. You have real fear of real things.
> while not appearing to assign much risk to how you get there.
I'm not sure what you mean by this, can you rephrase it?
If you are saying that I'm not putting enough weight on the risks of avoiding the procedure - let me be clear, I'm talking about cases where anesthesia is optional, and is a matter of pain vs comfort.
I know that avoiding root canal puts me at risk of dying from infection, so of course I wouldn't avoid doing it, and it makes sense to prefer "treating tooth with anesthesia" over "not trating a tooth." But I could have avoided that surgery(it was about quality of life, not survival), and I could've avoided anesthesia if I was willing to suffer some pain/discomfort. And that should be my choice to make.
I think that it is rational to take short term pain over (even small) probability of long term brain damage. If I could take some reasonable amount of pain over brain damage risk, I would take it any time, and it would be the right choice. My problem with root canal is that I don't think I could handle the pain without anesthetics. So I fear that when faced with choice "a lot of pain" vs "safety for my brain" I will fear the pain, take anesthetics, and betray my values.
Do you see my problem here? If brain has literally "infinite" value, then no matter how infinitesimal risks are, it is rational to minimize them at all cost. If doing the procedure minimizes them, it is rational to do it, if it doesn't - the right thing is to avoid it.
Correct me if I misunderstood what you're saying.
> How likely is it that you're going to suffer brain injury
> in your day to day life versus from anaesthetic?
Having an anasthetic carries some risk. How much? How many people per million suffer the adverse outcome you fear?
Now compare that to the risk of day to day life. How much has the risk increased?
There's a bunch of stuff you do that you don't need to do that carries more risk than anaesthetic.
It's fine for you to chose your medical care. You might want to investigate an "advance health care directive". Having one should persuade doctors that you have spent time thinking about this and it is your sincere and considered desire to ignore their advice to have anasthesia.
>There's a bunch of stuff you do that you don't need to do that carries more risk than anaesthetic.
I don't have any evidence for this but I suspect that the majority of brain injuries in otherwise healthy people come from trauma due to accidents. If my suspicion is true then wearing a helmet all the time might be the most effective way to avoid brain injury.
He failed to mention that local anesthesia can also lead to neurotoxicity, and I was too ignorant to know about it(for some reason I assumed that local anesthetics are harmless, and didn't do my research).
You get that "neurotoxicity" in this case is almost exclusively referring to deleterious effects that local anesthetics can have on nerves at the site of injection, right? Subcutaneous injection of local anesthetics will have very little, if any, involvement with your brain.
You did the right thing finding a surgeon that would work with a block instead of GA if you were concerned about the (potentially real, if not that bad, effects of GA) but I think your fears of local anesthetics causing CNS damage are overblown and I wouldn't want others to refuse the use of them in themselves or their children based on your post.
Hey, don't worry about it. Tinnitus fucking sucks, but over time you get used to it. It's hard to believe at the beginning, but gradually it bothers you less and less. Eventually you can focus on whatever you are doing and not notice it anymore.
For now try not to freak out or get depressed about it, turn on air conditioner or running water to mask the noise.
Try taking ginko, try taking melatonin for sleep.
Listen to music or audiobooks when it's too annoying(not too loud to not cause any more damage).
Visit a doctor and get some advice from him. Go to a support forum or subreddit if it gets bad.
If you are lucky enough to be living in US - check out what trials you can enroll in. Some of them can probably help. People are workong on a cure and making some progress.
Any chance he suffered a profound trauma being under surgery? I imagine an utter fear of surgery and this could have been triggered by something really insignificant like a small tingling or just the thought of surgery, of a foreign element cutting deep in your tooth canal. That, amplified over and over (he might even have lost conscience if his jaw was being held in place by a device -- the doctor wouldn't have known it this way) could have given birth of some kind of mechanism of memory wipe, sort of like the one victims of rape or horrible accidents develop as a self defence mechanism to (not?) cope with what just happened. Only in this case it went terribly wrong.
Local anesthetic is pretty much just a pain killer... it's not supposed to knock you out like GA (general anesthetic). I wonder if the article got the term right.
Is it necessarily the anaesthesia or a hemorrhage? Have they considered removing the root canal? Sometimes removing the materials from a root canal has improved a patient's health significantly.
Certainly one could understand why the dental industry would avoid the meme "root canal = bad!", but in this case the patient has little to lose, his future being lost already.
Claims that dental fillings are toxic, and that removing them will provide various health benefits, are a somewhat common medical scam. There is absolutely no evidence supporting these claims.
We're talking about _root_ _canals_, not dental fillings! Other than the anaesthetic, the materials used in root canals are are entirely different from those used in a dental filling.
Furthermore, root canals require different training and are (usually) done by endodontists. Dentists usually handle the more mundane and more tested procedure of dental fillings.
My point is, root canals are much more invasive and have their own problems(not associated with dental fillings).
It would be very interesting to see exactly what type of imaging they performed on him. Bear in mind, an abnormality in the hippocampus or other memory related structures could be sub-mm in size and result in a significant impairment.
If, for example, he did not have an MRI with diffusion weighted imaging with a sufficiently high B value (gradient value) they may be missing/have missed a very small stroke (this test is also time sensitive -only positive within the first few days of insult).
If they did not perform susceptibility weighted imaging, they may have missed a tiny micro-haemorrhage. Both of these scenarios can result in memory loss if critical structures are involved.
There are also several technical issues that may have resulted in a sub-optimal scan, precluding finding a tiny abnormality. There's also the question of whether the person reading the scan got it right or whether the strength of the magnet/technical parameters of the study were sufficient to resolve a tiny abnormality.
Either of these scenarios could have been a consequence of reduced blood flow (hypoperfusion), a small clot (embolus) or a tiny blood vessel injury (dissection) that could have occurred during the procedure - possibly related to the anaesthetic but not definitively so.
I suspect there is a definitive abnormality that the clinicians that saw him were unable to pick up. This seams a lot more likely than the idea that we need to revise our entire conceptualisation of memory formation to suit a psychological theory.