I have a character who is taking medication for bipolar I disorder--I don't plan on specifically mentioning what he is taking, but based on research I would assume he's taking a combination of lithium/lamictal.
Anyways, he is stabbed in the chest and admitted for emergency surgery that involves a collapsed lung a stab wound to the heart. He barely makes it and is in the ICU for quite some time. I have done research and found a lot of indications that lithium should be stopped 24-72 hours prior to a surgery, but not a lot of info about what happens if one must undergo surgery in an emergency where the lithium is still in his blood. In the situation, the medics are told by a friend that he's on these drugs, so they are able to take precautions. The plot also doesn't enter the OR, so I'm not particularly concerned about whether they're having to give him extra fluids during the operation or anything like that, but as far as recovery goes, I have a few questions. (These also don't have to be incredibly specific, as the point-of-view is from a girlfriend with virtually no medical knowledge)
1. Would there be any side effects or complications from this?
2.What are the risks of him reaching lithium toxicity?
3.How long would he need to stay off of his medications after surgery, assuming he's in the ICU for about a week and has sustained the injuries above?
4.Does he risk falling into an episode of mania or depression?
5. Is there anything else regarding his recovery as far as his psychiatric medications, ie extra IV fluids, pain medications to avoid, other medications commonly used in the ICU that would have contraindications?
6. If there are huge risks for him being on these medications that would greatly impede his ability to survive his injuries (as the heart wound is already enough to kill him), are there other treatment options he could be on that would be more realistic to him surviving?
Thanks so much--let me know if any more information is needed from me!
--Kay
Anyways, he is stabbed in the chest and admitted for emergency surgery that involves a collapsed lung a stab wound to the heart. He barely makes it and is in the ICU for quite some time. I have done research and found a lot of indications that lithium should be stopped 24-72 hours prior to a surgery, but not a lot of info about what happens if one must undergo surgery in an emergency where the lithium is still in his blood. In the situation, the medics are told by a friend that he's on these drugs, so they are able to take precautions. The plot also doesn't enter the OR, so I'm not particularly concerned about whether they're having to give him extra fluids during the operation or anything like that, but as far as recovery goes, I have a few questions. (These also don't have to be incredibly specific, as the point-of-view is from a girlfriend with virtually no medical knowledge)
1. Would there be any side effects or complications from this?
2.What are the risks of him reaching lithium toxicity?
3.How long would he need to stay off of his medications after surgery, assuming he's in the ICU for about a week and has sustained the injuries above?
4.Does he risk falling into an episode of mania or depression?
5. Is there anything else regarding his recovery as far as his psychiatric medications, ie extra IV fluids, pain medications to avoid, other medications commonly used in the ICU that would have contraindications?
6. If there are huge risks for him being on these medications that would greatly impede his ability to survive his injuries (as the heart wound is already enough to kill him), are there other treatment options he could be on that would be more realistic to him surviving?
Thanks so much--let me know if any more information is needed from me!
--Kay
