INDIANAPOLIS, Ind. – How many times have you lied to your doctor? Withholding information because you’re embarrassed or scared to get into trouble?
Well, turns out it’s more common than you think and it’s putting your health in danger. There are things you must tell your doctor, even if it’s illegal.
There’s no room for mistakes inside the operating room, when every second counts. Yet people are still nervous to tell the truth.
“We’re not here to judge,” said Corinna Yu, the Assistant Professor of Clinical Anesthesia at the Indiana University School of Medicine, and a staff anesthesiologist at University Hospital.
“We’re just here to take care of you,” Yu added, “It’s human nature to want to put your best face forward. We do have to destigmatize some of these things so we can just be honest.”
Yu considers herself the internal medicine doctor of the operating room.
“We manage the air way, the breathing, your circulation and we watch all of your vital signs, your heart beat,” said Yu.
However, Yu can’t do her job unless she has all of the facts about the effects of marijuana and anesthesia.
According to a recent study out of Colorado, marijuana users need more than twice as much anesthetic than non-users. The objective of the study by Dr. Mark Twardowski was to determine “whether regular cannabis use had any effect on the dose of medication needed for sedation during endoscopic procedures.”
Dr. Twardowski examined medical records from 250 people. We spoke with Twardowski over the phone who says his research was meant to start an important conversation.
Dr. Yu did not participate in that study, but says she’s had similar experiences during her time practicing in Indiana.
“Some of the friends that I spoke with and colleagues across the country have commented that they’ve used two to three times of large doses for patients who have admitted to marijuana use,” said Yu.
Doctors who participated in the Colorado study believe patients felt more at ease to tell them about their use because it’s legal there. Twardowski says more research on the topic is underway to learn more about the effects.
According to the research discussion:
"With little research currently done in this area and the continued increase in legalization and use of cannabis, the field of anesthesia and sedation needs further studies with greater depth."
Here in Indiana, marijuana use is still illegal, and doctors say, there’s a serious risk if you don’t fess up to your doc.
“That could lead to intensive care unit stays and being on a ventilator, it’s kind of a big deal,” said Yu, “Sometimes they wake up a little bit faster also.”
To prevent the unknown, before each medical procedure, doctors go through a pre-operative anesthetic evaluation. Doctors and patients talk medical history, a time where doctor Yu says there’s no such thing as too much information.
“I think patients eventually share information because they’re scared because they don’t know what might happen if they don’t tell the truth,” said Yu.
Doctors not only need to know if you use marijuana, but how much alcohol you consume. Chronic drinkers may need more anesthesia than most. Plus, what other drugs you may take.
“Cocaine is definitely something that can increase your rate for heart attack, stroke and high blood pressure and issues in fluctuations, that could easily be a canceled case,” Yu added.
Her job is not to get you in trouble but to keep you safe. Yu says under doctor-patient confidentiality she will not report drug use.
“My obligation to report anything to the authorities really is based on if you tell me you’re going to hurt yourself or hurt somebody else,” said Yu.
We know it’s critical to be honest and upfront with your doctor before a procedure. That also stands true at the dentist office. If you keep secrets it could turn into an emergency.
Dentist Michael Tillery at Tillery Family Dental uses sedation for multiple procedures.
“It could be a huge risk,” said Tillery.
Tillery says knowledge of someone’s use of marijuana or illegal drugs is just as important at his office.
“Most illicit drugs that people may have a hesitation to tell us about will usually have an effect of lowering their blood pressure and increasing their heart rate,” said Tillery, “That’s where you can get into the problems.”
A patient could pass out or Tillery says, even die.
“Sometimes you’ll give it to them, where somebody would be out like a light, these people are still sitting there talking to you like I am now,” Tillery explained, “Then, you start to quiz them a little bit more abruptly as to what they may or may not taking medication wise and they’re like, well yeah, I did a little pot before I came in or I did this, or I take that.”
Tillery and Yu agree, more research needs to be done on how marijuana affects medical care and the administration of certain medications.
“In states where it’s legal, people are actually admitting to their usage, which I think helps physicians start to make connections and have more case reports and anecdotes,” Yu explained.
Until then, it’s up the patient to be honest and disclose information, even if it’s illegal.
“We need to know what’s in their body right then and how we would treat it or if we have to call outside help from 911,” said Tillery.
“That’s where the research starts,” said Yu.
So, what about CBD oil? Yu says she’s not sure anesthesiologist are screening for it. She says she hasn’t noticed a difference and that could be because it lacks the compounds found in THC. Like marijuana, Yu says more research needs to be done.
When it comes to legal things to tell your anesthesiologist there are several topics you should discuss before a procedure.
- Yu says, inform your doctor on what medications or supplements you’re taking
- If you snore, your anesthesiologist needs to know
- If you’ve had a negative reaction in the past to anesthesia
- Chronic health issues
Doctor Yu says one of the most important things to be honest about is what you’ve had to eat or drink, because of the risk of your stomach contents going into your lungs. That could cause bad pneumonia and put you right in the Intensive Care Unit.