General anasthesia if you haveMAC and bronchiecstasis

Posted by doberdoo @doberdoo, Apr 12 3:59am

It's me again. I’m wondering if it’s safe to have surgery with general anesthesia if you have MAC and bronchiecstasis? I was told yesterday I need a total hip replacement on my left hip, immediately, as the pain is so severe I cannot walk. Since my pulmonologist fired me I no longer have a doctor to answer this question. I posted the question on the Facebook page and these are the answers I got so far. They leave me terrified. Can anyone offer advice and experiences please.

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Deborah Schab
I’m wondering if it’s safe to have surgery with general anesthesia if you have MAC and bronchiecstasis? I need a total hip replacement on my left hip, immediately. I thought I read that general anesthesia has the potential to cause pneumonia. And, the recovery pain makes it difficult to do daily air clearance techniques, nebbing and all the other things that have become part of our daily routine. Not doing those every day could cause a deterioration and hospitalization. Your input is appreciated.

Kelly Kat

Deborah Schab, I am so sorry. Please make sure the surgery is essential ❤️‍🩹
Many folks will try to ease your mind. I will always be honest, which can be uncomfortable for some people.
Nothing about intubation, pain relief, surgery, or the removal and replacement of bone is safe.
With my nickel allergy, metal devices and surgical clips would kill me.
Intubation is a known cause of atelectasis (lung collapse) and infections from disinfectant-resistant pathogens.
I have never had a surgery that didn't cause lung scarring and pneumonia. I cannot skip Airway Clearance Techniques (ACTs) without feeling the consequences.

Amanda Olivier Engelbrecht
Just discuss your concerns thoroughly beforehand with everyone who is going to be present during the surgery.
I have bronchiectasis and struggles to wake up after surgery. I was monitored constantly by the hospital staff.
This problem only started because of certain meds that I am using for bronchiectasis and allergic asthma.

Caroline Nixon
I had a ga ( bronchiectasis and ntm) and after , despite iv antibiotic cover, my chest was worse for a long time. More recently I had a hysteroscopy under spinal. Though it was unnerving to be awake for the procedure the pain control was total- worth enquiring about. a lot more spinals are done since covid, when they were used to reduce aerosol producing procedures

Maggie Willis
My Stanford doctors have told me that I should never have general anesthesia going forward. When they use general, they put you on a breathing tube (intubation - as in- life support). In my case, the doctors have said, there is a danger that I might not be able to be weaned off the breathing tube as well as possible bacteria being introduced. Currently, I need surgery on a tumor that can't be removed with a local. I also need hip and knee replacement. None of this is going to happen as the disadvantages are greater than the advantages (FOR ME). I will say that IF I am told that it is a matter of life or death (imminently), I am wondering what decision I will make. I have been close to death and at that time, I can say the brain doesn't function on a logical level and survival instinct kicks in. Best wishes for the best results for you.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Sue, Volunteer Mentor | @sueinmn | Apr 12 9:00am

Dear @doberdoo, That is the problem with posting questions like yours on social media, and even though Lung Matters portrays itself as more than that, it is run by one person without any medical training, according to their own personal biases, who may ban anyone whose beliefs do not align with them.

Here at Mayo Connect, we share our experiences, but encourage all points of view. Only those that may be dangerous or are against medical knowledge are notated or reviewed. I can tell you that I have had surgery under general anesthetic twice since my diagnosis, once directly after I stopped antibiotics (but still had MAC) during the pandemic, and just this past October.

The anesthesiologist and surgeon were aware of my lung conditions and took precautions to use as little anesthetic as possible. They were more concerned about my asthma and reactive airways than the BE. I was intubated both times, and was prescribed a precautionary antibiotic for 14 days.
After gall bladder surgery, I missed 48 hours of airway clearance, but was able to resume on the third day without any exacerbation. I just needed to hold a pillow firmly against my abdomen - similar to a heart patient doing coughs after surgery.
After a 2.5 hour complex rotator cuff surgery, I began huff coughing as soon as I woke up, and continued airway clearance daily with saline the day after.

I know other members of the group have had surgery as well, maybe they can add their experiences here.

lenorj | @lenorj | Apr 13 7:05am

I too have had general anesthesia for a hernia repair. I had no problem with the surgery or recovery. My pulmonologist from NYU Langone put me on a med to reduce my cough for a few days, that along with an antibiotic kept my lungs clear enough to skip nebulizing for several days. After that period of time I returned to my twice daily lung clearing with no negative effects.

bayarea58 | @bayarea58 | Apr 13 11:09am

I agree with others comments here. General anesthesia is a concern with lung disease and it’s important everyone on the surgical team be fully informed (well before the surgery). I was told by someone in my pulmonary rehab group by a fellow patient that he needed a surgery but his doctors didn’t want to do it because of his lung disease and risks of general anesthesia. So, it definitely is a consideration and something important to work through with your team in advance. Of course, intubation also brings its own risks for our patient population and in general all surgery presents risk, and so I would agree that in general surgery cannot be described as “safe” … which is backed up by the informed consent form you are required to sign before any surgical procedure. But with that said, life in general is about balancing risks. I think the take away from the feedback generally is to 1) be judicious in choosing when to have surgery, I myself would limit only to what is necessary as opposed to to elective; 2) choose a skilled surgical team that is fully informed of your lung disease and risk profile generally; 3) expressly walk through with your surgical team the measures they are going to take to address your lung disease/other risk factors; 4) do what you are doing now - research, understand the procedure and risks so you can evaluate your team’s suggested approach from an informed position. Good luck!