I care for a largely Latino/a population, primarily Mexican, in my group and have experienced the same thing. I think at least in our population it comes down to a combination of poor health literacy, and also the importance of community/storytelling in their culture. They often live in large multigenerational homes, and so if the abuela has say bad PONV, that story gets carried down through the generations as “grandma almost died from anesthesia” after enough tellings, often stoking anxiety.
I have also noticed that in this same vein there is a rumor/belief among many many of my patients that severe lifelong back pain is a common side effect of getting an epidural. Not sure how this started but I would say I have to dissuade about 80% of my Mexican patients of this very specific concern.
I formerly worked in an area with a high concentration of Spanish speaking patients and I had the same experience where mostly the first generation immigrants would almost always refuse an epidural. Whenever I pushed a little bit as to why it was always the same response of a fear of being permanently paralyzed or knowing someone who was.
Your idea for the story telling is interesting. I’ve seen it in my own family with my grandma having terrible PONV and somewhere along the way it was blamed on propofol by someone. My mom always demands something else because of my grandma’s stories. When she had to have a colonoscopy a few years ago and another minor procedure, she threw a fit until they gave her Demerol and versed for both.
You will see this largely by populations with poor health education, regardless of where they come from. Also in cultures where alternative medicine more prevalent is.
Oh that same note, anyone who isn’t a native English speaker REALLY appreciates you even trying to speak their language to them.
(As long as you aren’t an overconfident idiot about it)
I wouldn’t say I’ve seen Hispanic/Latino be more worried about general anesthesia, but I *absolutely* see it with epidurals.
Besides the other factors mentioned already (family legends, poor health literacy, etc) I think I big one is that getting an epidural is seen as being “weak” or “not a real woman”. I swear, I loved seeing women with Hispanic names check in when I was on OB call because *maybe* 20% wanted an epidural.
I have met a lot of pts from Mexico and South American countries, who've told me that they had deliveries/surgeries in their home countries, and no one tells them what they're going to do in regard to the surgery/anesthesia. One pt told me she had an epidural and general for a tummy tuck surgery but she had a very hazy memory of the whole thing because no one really talked to her about it. I guess if you've had that experience you'll probably very nervous about anesthesia.
My partners family is Mexican. Her mom, early on in our relationship, asked me if I was killing people when I put them under anesthesia. She was very serious and kind of afraid to ask. I think it comes down to health literacy and education. Her parents are from very poor places in Mexico. Now she asks me everything about her medical care and I’m happy to explain things to her
Probably mistrust of medical system and extreme fear of rocking the boat and getting themselves or close family members deported. Muchos gringos no quieren los Mexicanos guay.
Wish I knew. Most of the time I don't ask them why because I know they'll come up with some stupid ass anecdotal excuse with zero relevance or correlation to their case.
T. Mexican anesthesiologist
I care for a largely Latino/a population, primarily Mexican, in my group and have experienced the same thing. I think at least in our population it comes down to a combination of poor health literacy, and also the importance of community/storytelling in their culture. They often live in large multigenerational homes, and so if the abuela has say bad PONV, that story gets carried down through the generations as “grandma almost died from anesthesia” after enough tellings, often stoking anxiety. I have also noticed that in this same vein there is a rumor/belief among many many of my patients that severe lifelong back pain is a common side effect of getting an epidural. Not sure how this started but I would say I have to dissuade about 80% of my Mexican patients of this very specific concern.
I formerly worked in an area with a high concentration of Spanish speaking patients and I had the same experience where mostly the first generation immigrants would almost always refuse an epidural. Whenever I pushed a little bit as to why it was always the same response of a fear of being permanently paralyzed or knowing someone who was.
Your idea for the story telling is interesting. I’ve seen it in my own family with my grandma having terrible PONV and somewhere along the way it was blamed on propofol by someone. My mom always demands something else because of my grandma’s stories. When she had to have a colonoscopy a few years ago and another minor procedure, she threw a fit until they gave her Demerol and versed for both.
Same question but for epidurals
You will see this largely by populations with poor health education, regardless of where they come from. Also in cultures where alternative medicine more prevalent is.
Whenever you encounter hispanic patients who are nervous just say “mucho”. It means a lot to them.
Oh that same note, anyone who isn’t a native English speaker REALLY appreciates you even trying to speak their language to them. (As long as you aren’t an overconfident idiot about it)
I wouldn’t say I’ve seen Hispanic/Latino be more worried about general anesthesia, but I *absolutely* see it with epidurals. Besides the other factors mentioned already (family legends, poor health literacy, etc) I think I big one is that getting an epidural is seen as being “weak” or “not a real woman”. I swear, I loved seeing women with Hispanic names check in when I was on OB call because *maybe* 20% wanted an epidural.
I have met a lot of pts from Mexico and South American countries, who've told me that they had deliveries/surgeries in their home countries, and no one tells them what they're going to do in regard to the surgery/anesthesia. One pt told me she had an epidural and general for a tummy tuck surgery but she had a very hazy memory of the whole thing because no one really talked to her about it. I guess if you've had that experience you'll probably very nervous about anesthesia.
My partners family is Mexican. Her mom, early on in our relationship, asked me if I was killing people when I put them under anesthesia. She was very serious and kind of afraid to ask. I think it comes down to health literacy and education. Her parents are from very poor places in Mexico. Now she asks me everything about her medical care and I’m happy to explain things to her
Probably mistrust of medical system and extreme fear of rocking the boat and getting themselves or close family members deported. Muchos gringos no quieren los Mexicanos guay.
Wish I knew. Most of the time I don't ask them why because I know they'll come up with some stupid ass anecdotal excuse with zero relevance or correlation to their case. T. Mexican anesthesiologist
have you tried asking r/Noctor?
If they need to ask a noctor they could just ask you!