There's a general rule about surgery. Whatever you do on the lines of "self-medication," whether it's herbs or vitamins or marijuana, you need to let your anesthesiologist know before the procedure. Your anesthesia usually can be adjusted for your personal habits, but don't expect your doctors to be psychics. Tell them what you are doing. Marijuana is something they will ask about, so be honest about it. This is so they can give you the right amount of the right anesthetic at the right time.
There are some misconceptions about marijuana that are particularly persistent. Here's what you need to know.
- No, marijuana is not an antibiotic. It does not preclude the possibility of an infection after surgery.
- Smoking both marijuana and cigarettes after surgery increase the likelihood of pneumonia. Just smoking marijuana isn't as much of a problem, but you really shouldn't be smoking anything at all when you lungs are recovering from anesthetic.
- Both tobacco and marijuana activate the same enzyme (CYP1A2) in the liver, and their effects are additive. Why should you care? If your doctor gives you warfarin to prevent blood clots after surgery and you smoke pot, the warfarin won't work as well. If your doctor gives you something for irritated airways, it won't last as long. Simple drugs for pain relief like Tylenol will be "eaten up" by the increased production of this enzyme. Your doctor can compensate for the effects of marijuana that interfere with other drugs, but not if your use is not known. Let your doctor know.
- Marijuana smoke isn't a vasodilator. It's a Vasoconstrictor. There's nothing magical about vasodilators and Vasoconstrictors. Sometimes you need more circulation. Sometimes you need less. When you smoke marijuana, you get less circulation.
- Mixing marijuana and Oxycontin increases the effects of the Oxycontin. You will get more pain relief. The problem is that an overdose can occur with smaller doses. It would take less to lower your blood pressure, interfere with your breathing, and give you either cardiac or respiratory arrest, although those are not common problems. If you let your doctor know, you will get a safe dose that accommodates your marijuana habit. You may also get a lecture on combining drugs. But as mentioned several times in this answer, it's the combination of marijuana and other drugs that causes most of the problems.
- The combination of marijuana and anesthetic can cause severe vomiting in some long-time pot smokers. This doesn't happen to everyone who smokes pot or consumes marijuana edibles who then has surgery. It's mostly an issue for heavy smokers. The way you can tell that pot is the problem is if it is, then taking hot showers makes the stomach settle down. This "cannabinoid hyperemesis syndrome" isn't something that the doctor can treat with the usual anti-nausea and anti-vomiting drugs. You actually have to abstain from marijuana until the anesthetic is totally out of your system for the vomiting to stop. This can take about a week.
There aren't any hard and fast rules that apply to absolutely every user of cannabis after absolutely every surgical procedure with absolutely any kind of anesthetic.
Whether you use cannabis is not your doctor's primary concern, but if you are going to use cannabis, use it safely. Surgery is not the time to keep secrets from your doctors and nurses, even if they tend to lecture you.
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