ARDS is an acute, severe injury to most or all of both
lungs. An ARDS survivor when faced with the possibility of surgery is
faced with a very fearful situation. This natural fear is compounded if
the survivor developed ARDS following a previous surgery. The ARDS Support
Center receives inquiries from survivors who are faced with this very
serious situation. The following information has been gleaned from the
experiences of ARDS survivors who have already faced this situation or who
have secured guidance and advice from their physicians, surgeons or
First, it is important to know that even though in some
cases ARDS developed following a previous surgery that does not mean that
it will necessarily happen again. All ARDS survivors who face surgery
should do as much research and ask as many questions of the health
professionals as possible. The more understanding that is gained the more
it will be possible to develop a good level of confidence in yourself and
confidence in those who will be caring for you.
Prior to surgery the services of an Ear, Nose and Throat
(ENT) specialist may help determine if there are any abnormalities or if
there are any atypical conditions in the respiratory system that may make
a difference in the work of the anesthesiologist. The anesthesiologist
should be made fully aware of the specialists' findings. If the ARDS
resulted from lung aspiration make sure the aspiration was not the result
of any abnormality in the swallowing mechanism.
Another preparatory step would be to
consult with a pulmonary physician to have a pulmonary function test
performed in order to determine if there is any diminished lung capacity.
Musicians playing wind instruments and vocalists learn breathing
techniques that maximize utilization of lung capacity.
The physician may be able to provide advice about how some of these
techniques could be used to improve lung function.
Another consideration is to determine if the procedure is
one that can be performed with a regional or local anesthetic. If so, a
general anesthesia may not be required. The current trend is to perform
many procedures on an outpatient basis because the 23-hour period permits
an overnight stay. Make sure the health professionals are aware of the
ARDS medical history. Even though the procedure is one normally done on an
outpatient basis be sure that the ARDS history is recognized in order that
the surgery not necessarily be considered as an out patient procedure.
If the surgical procedure requires the
services of an anesthesiologist the role of that person may be as vital as
is the role of the surgeon. In
advance of the day the surgery is scheduled make every effort to meet with
the anesthesiologist who will be assisting the physician at the time of
the surgery. If that is not
possible be sure to speak with one on the staff who will be able to relay
the information you provide to the anesthesiologist who will be on duty.
In the discussion with the anesthesiologist be sure to give all the
information you have about the previous experience with ARDS, the
treatment received and about any abnormalities or information of atypical
situations of which you are aware. Provide
the anesthesiologist with the results of the pulmonary function test.
As a last resort, if you have not been able to meet with an
anesthesiologist prior to the date of the surgery ask the admitting nurse
for the name of your anesthesiologist and indicate that it is imperative
that you speak with that person. Be
sure that this is done before any pre-operative sedation is administered.
It is necessary to have a clear mind during the discussion with the
anesthesiologist. Ask the
scheduled anesthesiologist if he has been made aware of the previous
encounter with ARDS. Every
effort should be made to assure that the health professionals are aware of
your previous experience with ARDS and of any other factors that may be
Determine the level of familiarity the surgeon and
anesthesiologist have with ARDS. If a general anesthesia is required the
surgery should only be done in a major facility that has ventilators and
Not only is it important to make every effort to assure
that the medical professionals are aware of as many aspects of your
previous ARDS experience as possible but it is also wise to share this
information with family and loved ones. This will be of help to them in
providing much needed support and understanding before, during and after
the surgery. It will bolster your level of confidence to know that others
share in what you have learned and what you have done to assure that the
surgery will be successful in every respect. Doing so may lessen the
sometimes inevitable questions like…"if we had only known" or
"why didn't we think of that".
As mentioned above, do as much research and ask as many
questions as possible. Being sure that the medical professionals are aware
of all known factors will help in arriving at a good level of comfort and
confidence. Develop and maintain a positive attitude, something that is of
great importance at all times whether before or after the surgery is
performed. One medical professional follows the practice of telling the
patient that if they go to sleep with a smile on their face they will wake
up with a smile.