Birds In Spring: Versed – Forgetting Surgical Unpleasantness And Everything Else
Everybody reacts differently, I’ve learned, to the challenges that come with a multiple myeloma diagnosis.
What I might dislike or find annoying may not be so troublesome to someone else. Similarly, things that may not bother me much, if at all, can be hugely vexing to others.
Sometimes, as patients, we can be drawn into situations by our disease where we aren’t sure exactly what to expect. Most of us, I think, take these things in stride, and grin and bear it. Well, maybe not always grin, but as most cancer patients will tell you, you’ve just got to accept the fact that those treating you are going to do things to you that you aren’t going to like.
For my part, for example, since my diagnosis, I have had experiences that in my pre-myeloma life would have made me cringe. An open-lung biopsy in 2006 comes to mind, although that’s but one of several instances. Yet, when the cringe-inducing procedure is happening to you, and the purpose is to keep you alive, it becomes much easier to shrug it off and think, “Well, that’s just one more thing I have to put up with.” We can be pretty resilient when we have to be.
So I thought it might be helpful from time to time to give a bit of a head’s up about what one can expect over the course of myeloma treatment – from my perspective, of course.
In particular, I’d like to tell you about one of the drugs you are sure to come across. The drug is Versed (midazolam), but I refer to it as the “forget drug.” It’s used commonly in surgical procedures these days, especially ones where they’d like you to be somewhat conscious and responsive during the goings-on. It’s a sedative and relaxant, so it helps you get through the discomfort that a procedure may cause. If you’ve had a colonoscopy, you’ve had Versed, for example.
The big side effect of Versed, however, is amnesia, and I think that’s why the medical profession likes it. While the drug is intended to lessen your pain and anxiety by helping you relax, the drug is also going to erase your memories of the procedure, including those of any discomfort you experienced.
I’ve had a few encounters with the “forget drug,” one of which was for the insertion of an apheresis catheter prior to stem cell harvesting and transplant. I remember absolutely nothing about this procedure and for some time afterward, although I apparently was fully conscious for the duration.
It took me a while to figure out that I had never really been put under anesthesia.
I “came to” in recovery and Linda, my wife, was sitting there (hospitals don’t like you to come in for procedures alone, but especially when they are giving you the forget drug), and it seemed pretty much like I’d just came out of sedation. That’s what I thought anyway.
About an hour or so later, after we’d left the hospital, my head cleared enough for me to reflect back. I realized that when I rejoined the real world in recovery, I was sitting up and engaged in conversation. In fact, I may have come to in mid-sentence. I said as much to Linda.
She said something like, “Oh yeah, you were awake and talking when I came over to the operating room waiting area before they brought you to recovery.”
For some 20 minutes in recovery, I apparently sat around awake and talking.
But, of course, thanks to Versed, I don’t remember.
There’s about an hour of my life – where I was otherwise aware and lucid, I’m told – during which I have no idea what transpired.
That’s what the forget drug does to you.
This doesn’t bother most of the people I talk with. They say they’d rather not recall surgical procedures anyway. Most seem to think it’s odd that I find this even the slightest bit troublesome. That includes my doctors, I suspect.
For my part, I just don’t like to have my memories stolen, good ones or bad ones.
The other thing is, there is no question that sometimes Versed procedures are going to be uncomfortable.
For example, there was an instance where I went into a procedure – a colonoscopy – with the intent of fighting as best I could the amnesia aspect of Versed. I was partly successful, and I can still recall various things that happened. Not everything, of course, but in every previous encounter with the forget drug, I had remembered nothing.
At one point, I experienced a fair amount of pain, and I turned my head to the doctor and said, “Hey, can you be a bit more careful? That hurts.”
The stunned look on his face when he got called out by a patient like that was priceless. It made me laugh, and I went back to watching my colonoscopy on the little television monitor they give you.
And to think – that treasured little moment could have been erased.
My conclusion is that a forget drug is an imperfect solution.
In the best of all worlds, we’d find a way to eliminate pain and discomfort during procedures where you remain conscious, rather than dealing with them by having you forget they ever happened.
If you are interested in writing a regular column to be published on The Myeloma Beacon, please contact the Beacon team at .
Interesting stuff. My last apheresis catheter insertion was just a week ago for my transplant with my sister's precious cells, yesterday was the transplant as a matter of fact. I did not want the Versed and had told the nurse in my pre-cat class. I wasn't sure if my sister would be available or if she would be harvesting and besides it does give you a bit of a hangover. Once at my appointment a couple days later, they gave it to me anyway, I just went along and my sister was able to wait.
I was awake during the procedure, I do remember a lot of what was going on to a certain point. But you are right, afterward you don't remember a darn thing. No wonder they tell you not to sign anything important or make important decisions. One thing I do know, is my shoulder is very sore for quite some time, so you know they manipulate you a lot.
Interesting stuff.
Tricia -- good luck with your transplant. I hope it all goes well for you.
I've heard others say, but can't verify, that they've been administered Versed even though they said they didn't want it. The last time I had it, I told the doctor afterward that if I ever came back to him, I didn't want to be given Versed. From his reaction, I got the impression that he wouldn't do the procedure without it.
I wouldn't like my memories stolen either. Just recently I had some dreaded dental surgery, and they were going to put me under, and I said, "Oh, no, I don't do that." They were a bit stunned and said, "Well then we'll just do part of it and break it up into two visits." I said, "That'll work." They told me they did it to keep the patient calmly sitting in the chair for long periods of time. Good grief! As it was, they had a delightful conversation the entire time, which was enjoyable to listen too, though I couldn't respond with hands and tools in my mouth. I wouldn't have wanted all that going on while I was supposedly asleep.
There is strong evidence that everything is "recorded" whether you are aware or not and in some cases can have the same effect as a hypnotic suggestion. So if they just happened to be talking about their sister have anxiety and panic attacks, I could have found myself experiencing sudden anxiety and panic attacks with no knowledge as to why the sudden circumstance.
I'm totally with you on this one Lou. If I ever do go under it will be under patient's orders of "NO TALKING!"
I put your blog up on my site. Thanks for sharing your experience with the "forget drug." I have been verbally assaulted, threatened with physical violence and lawsuits, and my mental processes impugned because I have the unmitigated gall to not only dislike their precious wonder drug Versed, but write about it. Too bad, so sad, FOR THEM! You seem very lucid and stoic, not a hysterical basket case by any stretch of the imagination. They can't very well accuse YOU of hyperbole. I love it. Thanks again!
Thanks for commenting, Never Again. Versed can cause adverse behavioral effects. My anecdote about that is that the first time I was administered Versed several years ago, I took a swing at the nurse during the procedure. They tell me (of course I don't remember)that at one point they thought I might be experiencing some discomfort and they asked me if I was ok and I responded, they say, that everything was fine. And then, they said, out of the blue, I punched the nurse.
Lou, I think that's just GREAT! One guy I've "talked to" said he stabbed his CRNA with a cannula and upset her terribly. Good for him! If I hadn't been so dizzy in the PACU I would have taken out several of the people in there. I didn't get amnesia and I remember the abject, craven feeling that I must OBEY them, and an inability to speak coherently. The next time I start to have either of those symptoms in a medical setting, I will assume that they are trying to drug me with Versed and will respond accordingly! It won't be pretty. I can only hope that 1) nobody ever tries this with me again, or 2) If they do I can follow through with some physical violence such as you did. I consider Versed to be an assault...
Versed is a patient control drug that invites patient abuse; but it has a more sinister side: long-term amnesia (memory loss) that can be very long-term. PTSD also occurs after Versed administration. I work in a hospital and have seen too many of my patients hurt by this drug. If you don't want Versed, don't waste your time pleading; list it as an allergy. "I had versed once for dental work and it caused hives and severe difficulty with my breathing" Write on the consent: "allergic to Versed".
Many I've talked with seem to have no problem with Versed, or complaints or reports of untoward events. Of course, and I don't mean this flippantly, they wouldn't likely remember things that occurred while under the influence of the drug. Insider: That's a really clever point you make.