Tuesday, March 15, 2011

consider the happy sleepy juice

which nobody would ever let me take home. Just a wee dram of barbituates, darlin', to settle yerself after dinner? No?


The Man and I are sitting here, thinking about our upcoming parent-teacher conferences. No, dreading them. Considering whether we're going to accept the Man's ability to discover an essential meeting - at work - and admire his ability to be crucial, elsewhere. Because the Eldest has, over the past few years, refined and expounded upon his understanding of a world that just does not quite apply to him.

Like, oh, the classroom.

Forget buckets, the kid says, who the hell are all of you, and why are your faces between me and my book? Shove off.

And, being the Eldest, he's probably offering you a winsome grin, to soothe the shove. But still. The kid has talked his way through class, called out - or been unaware that there's this shoulder joint thing, and you rotate, so! and the elbow - yes, so - and the hand? maybe? Or not. (oh, well, says the Eldest, and tries the grin again.) He's walked out of the classroom, certain that he can simply avoid a lesson, should he so choose. Or, that - they don't need me in there - he can interpret his presence as optional. And offered your astonished, sputtering self some yarn, rich with his time and genuine liking for you, o teacher. (hopeful grin.)

Oh, it's going to be a fun, fun parent-teacher conference. And, in case you were wondering:  the teachers are crackerjack, the school is supportive and the kid is miserable. When he's willing to admit it, that is. Which means that the Man and I are wavering between saying useful things like, wha'? and ohdeargah, and looking for a scapegoat.

Enter, the scapegoat.

Consider this study in the journal Anesthesiology, this news article, and this panel's thoughts regarding anesthesia in young children. No causal link has been shown - and that's crucial to remember when you are reading the next bit -  but the study found that children with 2+ exposures to anesthesia, before the age of 4 yrs, were 59% more likely to have learning disabilities than children without 2 exposures. Kids with three or more exposures to anesthesia? 2.6 times as likely to have a learning disability.

There's lots of unanswered questions, like the role of stress from the procedure, the specific condition requiring an anesthetized procedure, etc. But animal studies confirm that anesthesia has an effect on neurodevelopment.

So, go on - ask me. How many times was the Eldest sedated before age 4? And if I bring that up at the PT conference, will it do us any bloody good whatsoever?

Answer: no, given that bloody good is herein defined as that which gets the kid out of this hole, and helps him stop banging his head on reality. But hey, nice to have a scapegoat.


C said...

I haven't read the studies you're quoting, but wouldn't the medical conditions themselves confound this study design? That is, although many conditions requiring anesthesia in kids happen in kids with otherwise normal development, there's going to be a very large subset of these kids that because of their underlying condition may have been predisposed regardless. Or perhaps not due to their underlying disease per se, but confounded by lots of other coexisting exposures- like lots of other meds, or time away from school. Did those states address this confounding issue? It would be really hard to correct for, unfortunately.

Miryam said...

It would be hard to correct for, I agree. Most of the surgeries were ENT, urology, orthopedic and 'general' - which means? anything, as far as I can tell.
Here's what the article said: "They also could not exclude the possibility that the underlying conditions for which surgery was performed were responsible.

But they noted that prospective controlled studies in animal models have demonstrated alterations in neural development as a result of anesthesia drug exposure."

Makes me wonder how many anesthesia exposures a typically healthy child would have. One? Two? And how often are these for a procedure that is elective?

I'm filing this under the 'all things in moderation' tag, with a dollop of 'be sensible.'