But taking an oral drug may not be possible when under anesthesia. In addition, medications for managing epilepsy and Parkinson's are often eliminated from the body relatively quickly and must be taken on a regular schedule to keep symptoms at bay. Sieber, MD, professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine in Baltimore. And both general anesthesia and some pain medications can lead to hallucinations.Īnesthesia also poses risks for people with epilepsy, who may be more likely to experience seizures after surgery, says Frederick E. Seeberger notes that orthostatic hypotension-a failure of the nervous system to regulate blood pressure when a person changes body position, leading to dizziness and fainting-is more common in people with Parkinson's and can be worsened by anesthesia. Because most of the anesthesia drugs used in surgery can slow respiratory function, Parkinson's patients are at higher risk for aspiration (when food or liquid gets into the lungs or airways, sometimes causing pneumonia) during surgery or recovery, she explains.ĭr. People with Parkinson's disease often have decreased respiratory function and a diminished cough reflex and swallowing ability, says Lauren Seeberger, MD, FAAN, associate professor and director of the Movement Disorders Center at the University of Colorado School of Medicine in Aurora. But by taking a team approach with their doctors, patients can minimize these risks and maximize their chances of the best recovery possible.
People with neurologic conditions such as Parkinson's and Alzheimer's disease can be particularly vulnerable to side effects and complications from general anesthesia, experts say. "For this surgery, I knew I had to talk to my neurologist, my surgeon, and my anesthesiologist about minimizing any problems that might be caused by the anesthesia," says Horton. "The hallucinations were mild, and I knew what they were, so they weren't as frightening as they might have been." He also noticed that his tremor worsened significantly for about three weeks following the operation. "I'd see a creepy face out of the corner of my eye when I looked over, it was gone," he says. He'd had general anesthesia during a previous operation, and for about a day and a half afterward he experienced hallucinations. Horton, who was diagnosed with Parkinson's disease in 2014, was more concerned than the average person about surgery because he knew about the effects of anesthesia on Parkinson's symptoms. Finally, in January 2019, I had to have the surgery." Illustration by Sam Island
"I kept thinking, 'Surely this will go away,'" says Horton, 76, who lives in Colorado Springs. For about a year, Phil Horton put off knee replacement surgery.