Zeest Khan, MD Profile picture
Apr 29 7 tweets 2 min read Read on X
The greatest risk to your health under anesthesia is typically anesthesia.

With ME and LC, you may have a tougher recovery and symptom flare.

But this is a risk assessment discussion, not risk avoidance.

Here's my advice, as an anesthesiologist and someone with LC...🧵
Risk assesment: The first step is decide if the procedure is necessary. Presumably, the surgery (& therefore anesthesia) are priority right now, and without it, you will have worse health.

So next question is: how do i get through this as safely as possible?
Talk to your anesthesia team: What type of anesthesia is recommended? What can they do to navigate your ME and LC symptoms?

You have to set expectations, knowing that anesthesia is NOT elective. Not all drugs are interchangeable or avoidable.

So how can your anes team help?
Before anesthesia, many people with ME and long COVID benefit from extra IV fluid, antihistamine and anxiolytics.

Avoiding histamine-releasing drugs is optimal, if possible. Expect longer recovery time.

Sedation is easier on the body than general, but not always possible.
The truth is it's not safe (and often not possible) to wear an N95 under anesthesia and immediately post-op (waking up in recovery).

Once you can hold a conversation and eye contact, N95 is great. Your team DOES need to look at your mouth before tho.
Things YOU can do to prepare: get rest and fluid the week leading up. Take an oral antihistamine if OK with your team.
Identify your "friend or family" who will help you keep track of what's going on day of. It's a lot of people and instructions.
Set aside recovery time. Tons!
Know your rights. Everyone who approaches you should:
-identify themselves and their role
-wash their hands
-wear a mask if you request
-slow down or repeat themselves

You have the right to decline service or interventions at ANY time.

Surgery can be stressful. Good luck!

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More from @doctor_zeest

Jul 29, 2024
Physicians are punished when they're ill.

My primary care doc has been on extended medical leave. I've had to reschedule a few times. Today, I was told she "is not allowed to be a pcp anymore. We can't keep doing this. She's just gonna staff the walk-in clinic. It's not fair to
patients." The tone was filled with annoyance. No compassion for the ailing person.

The narrator was a nurse who's worked with my doc for ages. She's the best primary I've had, and showed me such grace when I fell ill that I discussed her in the first episode of my podcast.
LongCovidMD.com
#MedTwitter, disability activism benefits you.

When your body fails - and it will - this medical system will punish you. No matter how much effort you've put in, no matter how bad staffing shortage is, you will be considered a burden.

The nurse was right. "Not fair".
Read 4 tweets
Jun 25, 2024
I'm a physician with #LongCovid. I listened to the #NIH #RECOVER webinar discussing new Long Covid research for sleep/energy. I've been critical of RECOVER. These are my take-aways. 🧵

#ENERGIZE #CSPD
1. The language surrounding #LongCovid #fatigue #PEM has improved immensely. The disease was discussed without psychologisation.

I know how to speak Doctor. The language may not have been perfect, but it was NOT psych-coded.
2. #ENERGIZE and #CSPD are interventional studies to improve sleep disorders, reduce fatigue, and how to avoid PEM.
Researchers are testing meds, light therapy, #pacing (for people with PEM) and #exercise (in patients WITHOUT PEM).

We need more interventional studied.
Read 8 tweets
Apr 20, 2022
A (LONG) thread for patients with #mecfs #longcovid expecting surgery and the #surgeons #anesthesiologists #crnas and #pacunurses caring for them. I'll share my recent perioperative experience. This is neither comprehensive nor medical advice, but I hope it helps. (0)
1. Recovery was a bitch. I've had general anesthetics before, even in the same organ system. This was not the same body undergoing #anesthesia.
2. Set Expectations: Physicians
Expect long lists of meds, allergies, requests, and questions. Listen to and engage with your patient. They may educate you. Anticipate a potentially prolonged and complicated recovery. This is not a fast-track. Respectfully, don't be a Dick.
Read 13 tweets

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