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Usher's wife update on anesthesia complication

Posted Feb 18 2009 12:00pm 1 Comment

Information about the emergency Usher's wife underwent in Brazil recently came to light. Two months after giving birth to the couple's second son, Raymond, 38, traveled to Brazil to have liposuction on her stomach by São Paulo plastic surgeon Dr. Silvio Sterman.According to the doctor involved, Tameka Raymond went into "cardiac arrest" while being anesthetized before a liposuction procedure. She was quickly revived and then placed in an induced coma(?) for 24 hours as a precaution and apparently remains in stable condition in a Sao Palo hospital. The news wire is reporting that she was discharged today and will be returning stateside shortly.



Ellen Dastry, spokeswoman for plastic surgeon Silvio Sterman, says Tameka Raymond checked into the Sao Rafael Hospital last Friday for a "simple liposuction." Dastry said that Raymond suffered a cardiac arrest while being anesthetized for the procedure "but was revived in less than a minute by heart massage." She was then placed in an induced coma before being taken to the intensive-care unit, a procedure Dastry said was "absolutely normal" and performed in order to "avoid unnecessary complications."


I'm a little confused about what may have happened here. It doesn't sound like she had a malignant hyperthermia (see related post here ) reaction, but I can't figure out the rationale for the "induced coma". That would not be a normal treatment for a heart attack or lethal arrhythmia (irregular heartbeat), but could be present with malignant hyperthermia.

In a brief search for some consensus in the anesthesia literature on this I found some reference in a recent text which wrote

"Postpartum concerns include a decreased blood hemoglobin and the increased risk of pulmonary aspiration. Anemia is almost always present as a result of physiologic anemia of pregnancy combined with blood loss during and following delivery"


That's pretty tangential to this case, but it's all I can find with superficial snooping. Now liposuction after childbirth would not be expected to be a particularly bloody procedure, it is still something to consider.

More important would be questioning the logic of doing liposuction that early after pregnancy. I'd submit it would be someone with poor judgment who would proceed with that surgery on a practical basis. Good results with lipo rely upon contraction of the skin after it's debulked. There a are a number of circulating hormones associated with pregnancy that predispose tissue to expand to accommodate the developing embryo. Those mediators have clearly not normalized at only two months, and the patient has not reached a plateau in terms of her weight or abdominal wall tone at that point. Pro ceding with surgery is likely to not achieve the expected results in most instances. When would be a "normal" recommendation to proceed in the short term? Think closer to 9-12 months post delivery.

Of note, the NY Daily news is reporting that that the patient may have not been truthful with her surgeon about how far post partum she was. Evan a few months may have been the difference in her being deemed fit for surgery in this instance.


So what else could have happened?

Well, as the fluid used to perform liposuction has adrenaline and local anesthetic solution in it, a large intravascular bolus of this could precipitate a heart arrhythmia or event. Dilated veins in the postpartum abdominal wall may be more likely "targets" to be inadvertently speared by the infusion cannula used to put fluid in to tumesce the tissues for liposuction.

Just a thought!

Rob
Dr. Rob Oliver Oliver Plastic Surgery www.oliverplasticsurgery.com
Comments (1)
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Your anesthesiologist is unlikely to directly measure your brain with a brain monitor unless you demand it!

 

Download the FREE checklist of the 9 essential questions (& answers you must get) to enable yourself to become your own anesthesia safety advocate when you first discuss surgery with your surgeon.

 

The aging brain is more sensitive to the negative effects of anesthesia over medication which is routine without the use of a brain monitor.

 

Propofol ( the 'P' in 'PK') is an anti-oxidant while general anesthetics are oxidizing agents that raise your C-reactive proteins, markers of inflammation.

 

Propofol ketamine (PK) intravenous sedation anesthesia has safely anesthetized more than 5,000 patients of more than 100 different surgeons for ALL cosmetic procedures including tummy tucks and post-bariatric procedures.

 

You can get everything you want from PK anesthesia; i.e. you don't hear, feel or remember your surgery. Why would anyone want an oxidizing general anesthetic that includes the deadly risks and odious side effects like postoperative nausea and vomiting (PONV)?

 

Since its conception in March 26, 1992, the SAFETY record of PK anesthesia includes:

NO pulmonary embolisms (deadly blood clots to the lungs),

NO patient deaths (like Donde West or Stephanie Kuleba),

NO cardiac arrests (or near death experiences like Tameka Foster),

NO negative pressure pulmonary edema or aspiration, NO 911 calls, and

NO hospital admissions for PONV or pain management

 

- NONE of those outcomes can proponents of general anesthesia claim.

 

FWIW, PK anesthesia has the lowest rate of PONV in the anesthesia literature & does not require the use of anti-nausea drugs that have their own side effects.

 

Goldilocks Anesthesia Foundation is a public, non-profit dedicated to educating Americans about the PUBLIC HEALTH RISK of too much anesthesia and

the value of direct brain monitors to avoid this risk.

 

Disclaimer: Neither Dr. Friedberg nor Goldilocks Anesthesia Foundation accept financial support from brain monitor makers.

 

 

 

 

 

 

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