Malignant Hyperthermia and Anesthesia: What You Need to Know About This Life-Threatening Reaction

OMG this is so important!! I had my tonsillectomy at 7 in India and my mom said the docs just gave me the gas like nothing, no questions asked. Now I’m terrified. Why don’t they test kids here? We pay for fancy hospitals but they don’t even have dantrolene on hand in 80% of places. My cousin’s brother died during a simple dental procedure 10 years ago and they called it ‘complications’-no one ever said MH. We need mandatory screening in schools, like vaccines. This isn’t just medical-it’s a human rights issue. Why are we letting corporations decide who lives or dies because of cost? I’m crying rn.

Thank you for this meticulously researched and profoundly sobering account. The clinical precision with which you delineate the pathophysiology, diagnostic markers, and emergency protocol is both admirable and deeply necessary. The systemic neglect of dantrolene stockpiling in rural facilities is not merely an oversight-it is a failure of institutional duty of care. I would respectfully urge healthcare administrators to consult the MHAUS guidelines in their entirety, and to institute mandatory simulation drills with documented competency assessments. Lives depend on procedural rigor, not goodwill.

I’ve been an anesthesiologist for 18 years. I’ve seen MH twice. Both times, it was a kid. First one was a 6-year-old for adenotonsillectomy-jaw locked, CO2 hit 68, temp hit 106 in 12 minutes. We had Ryanodex. Saved him. Second one? 14-year-old girl. Hospital didn’t have it. Had to call 3 other hospitals. Took 38 minutes to get the first vial. She didn’t make it. I still dream about that one. The cost? $70k. The price of not having it? A child’s life. And people wonder why I scream at admins during budget meetings. This isn’t about money. It’s about whether you value life enough to keep the drug on the shelf. Simple.

Let me get this straight-you’re telling me we’re spending $144,000 on a drug that only helps 1 in 50,000 people? That’s insane. We should be spending that money on cancer research or border security. This is why America’s healthcare is broken. People like you want to make everyone paranoid about anesthesia. What’s next? Do we test everyone for ‘susceptibility’ before they get a flu shot? Wake up. This isn’t a pandemic. It’s a freak genetic glitch. Stop fearmongering. If you’re that scared, don’t have surgery. Simple. And stop forcing hospitals to stockpile expensive junk just because some guy on Reddit posted a long article. We have real problems.

The moral calculus here is undeniable: a society that prioritizes cost over life has already lost its soul. The fact that a single vial of dantrolene costs more than a month’s rent for a working-class family in this country speaks volumes about our collective decay. We have the technology. We have the science. What we lack is the will. This is not a medical failure-it is a civilizational one. When a child dies because the hospital administrator chose to save $100,000 rather than save a life, we are no longer a nation. We are a corporation with a flag. And if you think this is an isolated case, you’re not looking hard enough. Look at the VA. Look at Medicaid. Look at the ERs where nurses are crying because they can’t get the drug. This isn’t about MH. It’s about who we are.

Big shoutout to the nurses and techs who actually know what to do. I work in a small-town ER and we keep 48 vials on hand-yes, even though we only do 2-3 general anesthetics a month. We trained every single staff member. We have a laminated checklist taped to the wall next to the anesthesia cart. We did our first drill last month. It was ugly. But we got it done. And I’ll tell you this: when you’re the one holding the IV line while the team is screaming for more dantrolene, you don’t care about the cost. You care about breathing. You care about heartbeat. You care about the kid’s mom crying in the hallway. This isn’t politics. This is humanity. Don’t let anyone tell you otherwise.

There’s a fundamental ontological flaw in the entire paradigm. The biomedical model treats MH as a discrete pathological event, yet it is an emergent phenomenon of a dysregulated calcium signaling cascade-essentially a failure of homeostatic feedback loops at the sarcolemmal level. The reliance on dantrolene is symptomatic treatment, not root-cause intervention. We’re applying a band-aid to a ruptured aorta. The real solution lies in allosteric modulation of RYR1 receptors via pharmacochaperones, not brute-force calcium blockade. Furthermore, the current screening paradigm is statistically nonsensical-genetic testing has a 5% false negative rate due to non-coding variants, yet we treat it as diagnostic gold. We need longitudinal phenotyping, not SNP panels. And stop calling it ‘rare.’ It’s underdiagnosed. Period.

Bro. I had my knee replaced last year. They used propofol. No gas. No muscle relaxer. I asked if they had dantrolene. The anesthesiologist looked at me like I asked if they had a unicorn in the closet. Then he said, ‘Sir, if you’re worried about this, you should’ve just stayed home.’ I didn’t say anything. But I Googled it. And now I’m scared. I’m 42. I’m healthy. I’ve never had a problem. But now I’m wondering-what if I’m one of those 29%? What if I’m the next one? Why didn’t they tell me? Why is this not standard? I feel like I almost died and nobody even knew I was in danger.

Thank you for writing this. I’m a nurse who’s seen two MH cases. One was a teenager. We saved him. The other? We didn’t. I still think about the way his mom screamed when they wheeled the gurney out. No one ever told her her son was at risk. No one ever asked her family history. I just… I wish people knew how much this matters. Not because it’s common. But because when it happens, it’s everything.

My brother had a tonsillectomy at 8. He never woke up. We were told it was ‘anesthesia complications.’ No one mentioned MH. Not until 12 years later, when my cousin’s daughter had the same thing. We finally got genetic testing. Turned out both had the RYR1 mutation. My mom’s side of the family? 3 unexplained deaths during surgery. We didn’t know. No one told us. Now I tell every doctor I see. I tell my kids. I tell my friends. This isn’t fear. It’s legacy. Don’t let your family be the next statistic. Ask. Always ask.

Interesting. But did you consider that maybe the real issue is that people are just too lazy to take responsibility for their own health? Why should hospitals be forced to spend $144k on something that might never happen? If you’re worried, get tested. Pay for it yourself. Stop expecting everyone else to cover your anxiety. This isn’t a public health crisis. It’s a personal risk management problem. And frankly, if you can’t afford to get tested, maybe you shouldn’t be having elective surgery.

Thank you for this comprehensive and deeply humane exposition. The clarity with which you present the clinical, ethical, and systemic dimensions of malignant hyperthermia is both instructive and moving. It is a sobering reminder that medical progress is not merely a function of technological advancement, but of institutional commitment to human dignity. I urge all healthcare institutions to adopt the MHAUS protocol in full, and to prioritize staff education as non-negotiable. Lives are not line items. They are sacred. And we owe them our vigilance.

So let me get this straight-hospitals are required to keep $144,000 worth of a drug that only helps one person every few years… and you’re not suspicious? What if the whole thing is a scam? What if dantrolene isn’t even that effective? What if the ‘survival rate’ is just PR? I mean, who funds the MHAUS hotline? Who owns the patents? Who profits? And why is no one asking? I’ve seen too many ‘life-saving’ miracles turn out to be corporate money grabs. This feels like one. Maybe the real danger isn’t the anesthetic… it’s the industry that profits from fear.

I work in pediatric surgery. We don’t use succinylcholine unless it’s an emergency. We use propofol, we use ketamine, we use nerve blocks. We train every new resident on MH signs. We have the cart. We practice every quarter. I’ve seen the parents’ faces when they realize their kid might have died because no one knew what to do. We don’t want that. So we do the work. No one’s giving us medals. But we do it anyway. Because it’s the right thing. And if you’re a parent, ask your hospital: ‘Do you have dantrolene? Have you drilled this year?’ Don’t wait until it’s too late.

My mom died during a C-section. They said it was a stroke. We found out 15 years later it was MH. I got tested. I have the gene. I told my doctor. He said, ‘We’ll use propofol.’ I’m not having kids. I’m not having surgery. I’m not risking it. One sentence: I’m not dying because no one cared enough to keep the drug on the shelf.