3 things you didn’t know happen to your body under anesthesia… and hacks to fix

When calling my patient before surgery this week, she told me “if only I had known my body was going to have a tube down my throat” - I wish she had known beforehand. Here's why

Anesthesia can be scary and anxiety provoking because you’re giving up control of your body, sometimes your whole body, so that you can undergo the totally unnatural state of surgery. This can be lifesaving, but it also means unusual things are happening to your body while you’re in the medically induced, anesthesia coma.

Anesthesia turns off your body’s reflexes so your body can safely undergo surgery. Otherwise, you might have a heart attack, stroke, or kick your doctors during surgery.

Knowing what happens to your body during surgery and under anesthesia is important you can prepare for it. And the more prepared you are, the safer, smoother, and more comfortable your surgery and recovery can be! You can also lower the chance of anesthesia complications.

Just a reminder: this is different than sedation anesthesia, like what you get for colonoscopies, endoscopies, and other minor surgeries. We’ll talk about that in another video post!

1: Waking up emotional or crying from anesthesia

What happens to your emotions under anesthesia? Anesthesia causes many changes to your body and brain, including taking your frontal cortex offline. This is the part of your brain responsible for inhibiting inappropriate behaviors. This can unleash lots of emotions that would ordinarily be inhibited by your frontal cortex. Part of this may be related to pre-operative anxiety state (well studied in kids).

It’s also related to dehydration, pain, drug and medication use, surgery type, and other factors.

We're not too sure yet, but delirium after surgery and anesthesia may raise the risk of cognitive problems in the elderly. It's important to prepare!

How to prevent being emotional after surgery and anesthesia?

Now you know the risks of waking up emotional or with delirium after anesthesia. Here's what you can do to prevent it:

• Mindset: treat depression, anxiety, and other mental health conditions to optimize your mindset before going under
• Pain: pain medication appears to contribute to delirium. We believe that if you need less pain medication, you can lower the risk of delirium. Fortunately, there are lots of alternatives to pain medication, like nerve blocks, mind-body techniques, acupuncture, and breathwork.
• Melatonin: your body’s normal sleep cycles are disturbed by anesthesia. Improved sleep and antioxidant effects of melatonin may help delirium, but more data is needed for routine use.
• Healing environment: your environment can have a strong effect on delirium. Being surrounded by trusted family and friends can have a powerful impact on your emotions and mental health after surgery.
• Aromatherapy: I’ve discussed this in other posts.‍
• Breathwork: one of the most effective and safe methods to quickly change your body’s autonomic nervous system - check out my video demonstrating this.

2: Breathing tube in your body under anesthesia

One of your body’s most important reflexes controls your breathing. Anesthesia turns off this reflex, and it’s one of the reasons for the opioid epidemic. This is why we place breathing tubes during surgery and connect you to a ventilator.

Fortunately, the vast majority of patients get the breathing tube placed after they’re asleep, so they have no idea it’s in there. However, there is a chance of sore throat, hoarseness, and dental damage anytime there’s anything in your mouth, even the soft plastic breathing tube.

You get a different breathing tube depending on your surgery and your medical history. Check out my video for more details!

How to reduce side effects of breathing tubes in your throat

Some things to help with the sore throat from surgery are:

• Botanicals: arnica, green tea gargle, licorice lozenge, honey - but always discuss any supplements with your doctor before starting!
• Prevention: patients with a normal body weight are less likely to need longer breathing tubes, although it depends on the surgery type, too.
• Acid reflux or heartburn: uncontrolled stomach acid means we need to use the longer breathing tube (with greater chance of side effects). I always recommend patients avoid spicy foods the night before surgery to minimize the risk of excess stomach acid during surgery.
• Guided imagery: this can be powerful and safe tool to improve your body’s dry throat after surgery. 

3: Heart reflexes lost in your body under anesthesia

Your heart has many reflexes to automatically adjust your heart rate and blood pressure to keep your vital organs online and safe. Anesthesia disrupts these reflexes in your body while you're asleep.  This can wreak havoc on your body if your organs don’t get enough nutrients.

Maybe you've heard of drugs like epinephrine or adrenaline? These are the powerful medications we sometimes need to use to keep your body safe under anesthesia.

Why is this reflex so important? Your organs will die if they don't get enough blood flow and pressure. In the heart it's a heart attack, in the brain it's a stroke, in the kidney it's kidney failure, etc.

The most important thing you can do before surgery is to optimize your heart health. That's because the stronger your heart is, the more anesthesia it can safely tolerate.

How to reduce cardiovascular complications in your body under anesthesia

You can keep your heart and brain healthy under anesthesia with these strategies:

• Hold off on drugs! Drugs like marijuana, cocaine, meth, nicotine , vaping, and alcohol can all cause cardiovascular complications in your body under anesthesia. It’s important to tell your anesthesiologist if you use any substances so they can determine the safety of proceeding.
• It’s also important to discuss with your doctors which blood pressure medications to continue and discontinue before surgery.

Learn what happens to your body for safer, more comfortable surgery

The more you learn about what happens to your body under anesthesia, the better you can prepare. More preparation means safer, and more comfortable, surgery. You can also take this with you outside the operating room to live your life in more control and with fewer, if any, medications.