I am so afraid of death during my elective surgery. What should I do?

If your asthma is optimally controlled the risk is very small and you can undergo major surgery without significant asthma complications. Most anesthesiologists I have worked with will recommend that you take your asthma medicine the prior to surgery with a sip of water and bring your inhalers to the surgery center. In addition, steroids are given just prior to anesthesia in most patients any way which helps prevent asthmatic complications. On the other hand, if your asthma is poorly controlled, or you are steroid-dependent, you are at increased risk and therefore it is recommended that your asthma specialist provide any needed specific medical preparation prior to surgery including a written plan to give to your surgeon and anesthesiologist regarding asthma medication recommendations pre- and post-surgery. This will include a complete pre-surgical evaluation including pulmonary function test results, physical examination, and review of your medications and past medical problems. If your pulmonary function tests are not optimal your asthma doctor and/or anesthesiologist may choose to postpone surgery until your asthma is under optimal control prior to giving surgical clearance. In addition, it is advisable that you contact that anesthesiologist beforehand to discuss any issues that might arise and their management. . This is because surgery may cause an asthma flare or related bronchospasm during or immediately after surgery. Make sure you tell the anesthesiologist and your surgeon the amount and type of steroids you take so additional steroids can be given to prevent adrenal insufficiency which can result in a sudden blood pressure drop.#asthma#breastimplantswithasthma

Your risk of death with cosmetic surgery is quite small, but you are not alone or unreasonable in your fear.  First of all, you should stop smoking.  Also asthma attacks are exceedingly rare under anesthesia since most anesthetics actually relax the bronchioles of the lungs.  Modern anesthesia is extremely safe when administered properly by a trained anesthesiologist.  You might consider speaking with the anesthesiologist ahead of time to address your fears.

Anesthesia is quite safe when done by a qualified professional in an accredited surgical facility, and part of the anesthesia plan might be anti-anxiety medications before surgery. Your asthma can be safely managed during the surgery. My concern for you is smoking and breast lift, which is much more likely to be a problem afterward. I require patients to have no exposure to nicotine for breast lifts, tummy tucks, and facelifts.

The question is:  Is your fear justified and therefore surgery should be delayed until it's safer or is your fear an indication of unjustified anxiety?  My impression is that your fear is likely a bit of both.  You are certainly aware that smoking and asthma are totally incompatible with one another.  I would defer your procedure until you have been tobacco free for a minimum of three weeks, preferably longer based on available data.  Your asthma control will improve, your ability to heal will improve, and your risk profile will improve.  Second, anxiety before surgery is normal and expected.  If yours is disproportionate to known risk, use anxiolytic medication, prescribed by your surgeon.  Last, be sure you've chosen a well trained, experienced, safe surgeon who operates in the safest possible facility.  Risks can never be completely eliminated, but they can be managed.  Membership in ASAPS is the Gold standard.

It is so extremely rare for patients to have sever problems
during elective surgery if patient selection is properly done. Everyone has a
different health status and this should all be addressed pre-operatively.
Smoking is a deal breaker for me, I would not operate on you because of the
high risk for skin flap healing problems especially with the procedure you are
having. That is more of concern to me than you having a life threatening problem
on the operating table. You do sound like you are having stress induced asthma.
The bottom line is your surgeon should address any of your medical issues that
would increase your risk of an event. Again, so extremely rare but sure,
anything can happen. The odds are in your favor.

General anesthetics today are very very safe. In fact, the chance of a serious problem with healthy adults undergoing surgery with fully qualified surgeon in accredited surgical facilities is only about one in half a million (you are far more likely to be hit by a bus today!). That said, smoking increases the risk of complications, particularly post operative complications.  I advise my patients to refrain from smoking for two weeks prior to surgery and to continue to resist smoking for as long as possible after surgery. In terms of asthma, your anaesthetist will be aware of this and can easily manage this during and following your surgery if necessary. 

The risk of death is so extremely low that I would not give it another thought.  Having not had anesthesia is not an additional risk.  The most important factors to consider are your medical history, and the experience and quality of your anesthesiologist.  In other words, if you are healthy and you have a good doctor, things will go very well.  Hope this helps.Dr. Ali Mosharrafa

Some anxiety prior to surgery is very normal; its complete elimination is usually not possible.I ask my patients to try to be as calm as possible prior to surgery; this “calmness" tends to translate to a smoother postoperative course. You may be able to alleviate some pre operative anxiety with music, exercise, meditation, a glass of wine (if ok with your surgeon), sexual activity (be careful...), and positive/objective focus on the long term outcome/benefits etc. prior to your procedure.  Of course, it will be important that your asthma be well controlled (no pulmonary compromise) prior to proceeding.  Stop smoking…Assuming you have chosen your plastic surgeon, anesthesia provider, and surgery facility carefully it will be most likely ( postoperatively) that you will feel that you “got worked up for nothing”.  I tell my patients, objectively speaking, that they will be safer while in the surgery center than they will be on the freeway. I hope this helps. Good luck!

Thank you for your question and you are at greater risk dying in a car crash on one of LA's freeways then you are under anesthesia so quit worrying - but quit smoking before surgery or it may adversely affect your resultDr Corbin

You are not being very reasonable are you? You have asthma, and yet you smoke, and you are frightened of a surgery that is quite safe. You are certainly likely to die before your time from your tobacco use. Surgery on a HEALTHY young patient is 50 times safer, statistically, than driving.