After going in for a routine surgery, Donna Penner slowly woke up. "Oh good, it's over, it's done," she thought. Then she heard the surgeon ask for a scalpel. Horrifyingly, she was wide awake and the hour and a half long ordeal was just beginning.
It sounds like something from a horror movie or nightmare, but according to the Royal College of Anesthetists, "accidental awareness during general anesthesia" happens in roughly one in 19,000 operations. Although patients are awake, they are not able to speak or move due to the effects of muscle relaxants. Instead, they are forced to silently endure the pain and trauma of surgery.
Donna was severely traumatized after her experience in 2008. Finally, after nine years, she's ready to talk about it. In a recent editorial for BBC, she explained what it was like "waking up under the surgeon's knife" during a routine laparoscopy. What follows are excerpts from her story.
"In 2008, I was booked in for an exploratory laparoscopy at a hospital in my home province of Manitoba in Canada. I was 44 and I had been experiencing heavy bleeding during my periods...During a laparoscopy, the surgeon makes incisions into your abdomen through which they will push instruments so they can take a look around. You have three or four small incisions instead of one big one."
"The anesthesiologist gave me something in an intravenous drip and then he put a mask on my face and said, 'Take a deep breath.' So I did, and drifted off to sleep like I was supposed to."
"When I woke up I could still hear the sounds in the operating room. I could hear the staff banging and clanging and the machines going - the monitors and that kind of thing. I thought, 'Oh good, it's over, it's done.' I was lying there feeling a little medicated, but at the same time I was also alert and enjoying that lazy feeling of waking up and feeling completely relaxed. That changed a few seconds later when I heard the surgeon speak."
"They were moving around and doing their things and then all of a sudden I heard him say, 'Scalpel please.' I just froze. I thought, 'What did I just hear?' There was nothing I could do. I had been given a paralytic, which is a common thing they do when work on the abdomen because it relaxes the abdominal muscles so they don't resist as much when you're cutting through them."
"Unfortunately the general anesthetic hadn't worked, but the paralytic had. I panicked. I thought this cannot be happening. So I waited for a few seconds, but then I felt him make the first incision. I don't have words to describe the pain -- it was horrific. I could not open my eyes. The first thing that I tried to do was to sit up, but I couldn't move. It felt like somebody was sitting on me, weighing me down."
"I was in a state of sheer terror. I could hear them working on me, I could hear them talking. I felt the surgeon make those incisions and push those instruments through my abdomen. I felt him moving my organs around as he explored. I heard him say things like, 'Look at her appendix, it's really nice and pink, colon looks good, ovary looks good.'"
"I managed to twitch my foot three times to show I was awake. But each time, someone put their hand on it to still it, without verbally acknowledging I had moved. The operation lasted for about an hour and a half."
"To top it all off, because I was paralyzed, they had intubated me -- put me on a breathing machine -- and set the ventilator to breathe seven times a minute. Even though my heart rate was up at 148 beats per minute, that's all I got -- those seven breaths a minute. I was suffocating. It felt as though my lungs were on fire."
"There was a point when I thought they had finished operating and they were starting to do their final things. That's when I noticed I was able to move my tongue.
I realized that the paralytic was wearing off. I thought, 'I'm going to play with the breathing tube that's still in my throat.' So I started wiggling it with my tongue to get their attention.
And it worked. I did catch the attention of the anaesthesiologist. But I guess he must have thought I was coming out of the paralytic more than I was because he took the tube and pulled it out of my throat.
I lay there thinking, 'Now I'm really in trouble.' I'd already said mental goodbyes to my family because I didn't think I was going to pull through. Now I couldn't breathe."
"I could hear the nurse yelling at me. She was on one side saying, 'Breathe Donna, breathe.' But there was nothing I could do. As she was continuously telling me to breathe, the most amazing thing happened. I had an out-of-body experience and left my body."
"I'm of Christian faith and I can't say I went to Heaven, but I wasn't on Earth either. I knew I was somewhere else. It was quiet. The sounds of the operating room were in the background, I could still hear them. But it sounded as though they were very, very far away.
All of a sudden the anesthesiologist said, 'Bag her!' They put a mask on my face and used a manual resuscitator to force air into my lungs.
As soon as they did, the burning sensation I'd had in my lungs left. It was huge relief. I started to breathe again. At that point, the anesthesiologist gave me something to counteract the paralytic. It didn't take long before I was able to start talking."
"Later, as I recovered from the ordeal, the surgeon came into my room, grabbed my hand with both of his and said, 'I understand there were some problems, Mrs. Penner.' I said to him, 'I was awake, I felt you cutting me.' His eyes filled with tears as he grabbed on to my hands and said, 'I am so sorry.'"
"I said, 'Have you noticed that I have not asked you what the diagnosis was?' And he looked at me for a moment and said, 'You already know, don't you?' And I said, 'Yes I do,' and I told him what my diagnosis was. It's now nine years since I woke up during surgery. I have since pursued a legal claim against the hospital which was resolved."
"Immediately after the operation I was referred to a therapist because I was so traumatized. I didn't even have a clue what day of the week it was on my first appointment. I was pretty messed up. It definitely takes its toll on a person."
"But talking about it has helped. After time, I was able to tell my story.
I have done a lot of research into anesthesia awareness. I contacted the University of Manitoba's anesthesiology department and have spoken to the residents a couple of times now. They are usually horrified by my story. There are usually quite a few who have tears in their eyes when I'm speaking to them.
My story is not to lay blame or to point fingers. I want people to understand that this thing can happen and does happen. I want to raise awareness and help something good come out of this awful experience."