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of the center's nurses insisted on driving me over. Two of the nurses who
cared for Jake at the ICU were former nursing students of mine. I knew he
was in good hands, but I still spent the night by his bed, reacting to every blip
of the monitors and probably being too attentive to his care like only a mother
with a nursing degree can. The ICU staff extubated Jake the next morning. He
progressed slowly, but recovered fully. He survived.
Warning signs
Patients with gene mutations associated with MH susceptibility and members of
their immediate families are at increased risk, but might not be aware of the
dangers. Just because high-risk individuals underwent previous surgeries with-
out incident doesn't mean MH won't develop during subsequent procedures.
It occurs in about 1 in 100,000 adult surgeries, according to MHAUS, although
the exact incidence is unknown.
Genetic testing showed I carry the gene for susceptibility, but I've under-
gone 2 surgeries without incident. Jake also had a previous surgery, and was
unaware he was at increased risk. MH is that unpredictable. You don't neces-
sarily know when MH will strike. Never let your guard down — always be pre-
pared to act quickly, even when MH isn't anticipated.
Know the triggering agents: inhaled general anesthetics desflurane, enflu-
rane, ether, halothane, isoflurane, methoxyflurane, sevoflurane, and the mus-
cle relaxant succinylcholine. Episodes can also occur in the hour following
emergence from general anesthesia, so remain alert for warning signs in
recovery.
Patients experiencing an MH reaction will usually have a steadily increasing
expired carbon dioxide level, tachycardia, muscle rigidity, and severe metabolic
and respiratory acidosis. Don't look for a rapid rise in core body temperature.
That telltale sign often occurs after the other early warning signs. Reacting to it
might be too late.
Be clear and comforting when communicating with the loved ones of a
