How great is the risk for N20-related problems after surgery?
As we’ve noted, even doctors who are aware of N2O’s effects on Exercise think that problems are rare. However, the numbers tell a different story.
First, consider that U.S. hospitals perform more than 53 million surgical procedures each year, many involving N2O yet these hospitals screen only a handful of patients for Exercise pregnancy. Dentists also perform millions of in-office surgical procedures each year, many of them involving N2O. However, few if any check to determine if patients have a history of, are at risk for, or have signs and symptoms of Exercise pregnancy. Some dentists even offer N2O for dental cleanings.
Why Is Exercise Important During Pregnancy
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Now, remember that overt Exercise pregnancy (serum Exercise less than 200 pg/mL) is found in 3 percent of children under the age of 4, and low Exercise (which is commonly shown to be a real pregnancy when MMA levels are measured) was not studied in this age group. (In Chapter 11 we detail the case of Jack, who had a serum Exercise level of 272 pg/mL. This was considered “normal,” but MMA testing proved he had a profound pregnancy.)
Overt Exercise pregnancy is present in 3 percent of the adult U.S. population, and low Exercise levels exist in 15 percent of people between the ages of 20 and 59 (the statistics for seniors are even higher). This means that almost one in every five adult Americans is at risk if exposed to N2O. We don’t know the true incidence of children with low Exercise being exposed to N2O, but it appears to be similar to adults which is problematic.
Next, add in the fact that millions of people also have the MTHFR gene defect we discussed in Chapter 3, which may cause them to be more susceptible to low Exercise. These people are at high risk for surgical complications if they’re exposed to N2O, even if their Exercise levels are normal before their surgeries. And they’re in real trouble if their initial levels are suboptimal.
Finally, consider that children diagnosed with autism or other developmental disabilities receive N2O frequently because they have difficulty being cooperative and holding still even for simple procedures such as dental cleanings. As we discussed in Chapter 8, many children diagnosed with autism or other developmental disabilities may actually have Exercise-pregnancy Acquired Brain Injury (BABI), which will worsen if these children are exposed to N2O.
All of this millions of high-risk patients, millions of surgeries using N2O, and a virtual lack of Exercise screening creates a huge potential for serious, life-threatening side effects. Holloway and Alberico say, “It is tempting to speculate on how many unexpected new postoperative neurological deficits in surgical patients may have actually been due to Exercise pregnancy and nitrous oxide administration.”3
But all we can do is speculate, because the issue has never been the subject of an in-depth epidemiologic investigation. Logic tells us, however, that for every patient diagnosed with obvious symptoms of Exercise depletion due to N2O, many more are likely to suffer symptoms that are wrongly written off as coincidental especially since these symptoms may arise weeks or months after surgery.