I woke up during MAC anesthesia, with a medical instrument in my body. Epidemiology of Anesthesia-related Mortality in the United States, 1999 . Our website services, content, and products are for informational purposes only. 4%, or one in every 500 patients who receive anesthesia. To reduce your risk of experiencing awareness during general anesthesia, it is important to tell your anesthesiologist as much information about your health as possible, including the following: Anesthesiologists are the most highly skilled medical experts in anesthesia care, pain management, and critical care medicine with the education and training that can mean the difference between life and death. Researchers believe this indicates that theres not a single path through which the brain awakens from anesthesia. Estimates of how often anaesthesia awareness happens have varied depending on the methods used, but those relying on patient reports had tended to suggest it was very rare indeed. If I dont have to go to sleep for surgery, believe me, this is not something that I would ever choose! So here I was lying on the table and he took away my life support, my oxygen, I could not take a breath, Penner says. Unfortunately, the staff misread her attempts at communication, and began to withdraw the tube prematurely, before the paralytic agent had faded enough for her lungs to be able to operate on their own. Im a 34 y/o male, recently diagnosed with CHF, discharged from the hospital last Thursday. Anesthesia failure is a rare occurrence but can cause serious complications. Opinions were mixed. However, in severe cases, a coma can last for years. Subscribe me to the GoodTherapy.org public newsletter. AnesthesiologistChristopher Troianos, MD, offers some insights to help separate fact from fiction. There arefour different types ofanesthesia, and youre only completely unconscious with one of them. Her panic attacks began after a small medical procedure that she had before her 45th birthday. After I was returned to the ward, I did not wake up until 4 days had passed. Various tools and monitoring devices have been used to measure brain waves or electrical signals in the body, but there are no real reliable ways to measure consciousness. All rights reserved. Together with the emergence delirium, the phenomenon represents a manifestation of . Here's what you should know before heading into surgery. I had surgery for a perianal abscess, I believe I may have woke up during the procedure. It is a deep but reversible unconsciousness that doctors purposely induce to protect the brain from damage. Its been 5 days and she is not awake. WebMD does not provide medical advice, diagnosis or treatment. For some people, anesthesia is one of the scariest parts of surgery. Sometimes anesthesiologists make mistakes that can harm patients and cause lasting damage. Narcotics to reduce pain. And around four in 10 of those patients who did respond with the hand squeeze 1.9% across the whole group also reported feeling pain in the experimenters second question. The oxygen-deprived brain cannot survive intact for more than 5 or 6 minutes. Read about our approach to external linking. General sedation usually occurs in three stages: As with any procedure, there are risks or errors that can occur. js = d.createElement(s); js.id = id; As the media reported at the time, you were more likely to die during surgery than to become aware during the operation, confirming many doctors suspicions that this was a very remote risk. This is temporary for most patients but for others these symptoms may persist for a few months after surgery.. Warming the patient during the operation, getting him or her moving again as soon as possible, and keeping the artificial breathing phase as short as possible, all help protect patients from infection. Are You a Candidate for Minimally Invasive Heart Surgery? For the one to two people out of 1,000 who briefly awaken during surgery, this paralysis can be terrifying. An anesthesiologist responds to common questions about safety, particularly general anesthesia. If it should happen to you, be sure to describe your experience to your anesthesiologist after your surgery. Sign up and Get Listed. How Long Does a Hip or Knee Replacement Last? In many cases, operating just wasnt an option unless they could free patients from pain, explains Michael Sander, deputy director of the Clinic for Anesthesiology at Berlins Charit hospital. You also probably wont remember your procedure. Penner talks about her own experience, during a lengthy telephone conversation from her home in Canada. Copyright 2014 GoodTherapy.org. There are three types of sedation, including: Mild: A person is awake and responsive. Their meta-analysis showed a small but significant improvement in the patients ratings of post-operative nausea and vomiting, and less use of morphine after the operation. The medicines, known as anesthetics, are given before and during surgery or other medical procedures. Yet the most feared complications are actually quite rare. For a simple procedure that started at 9am, I didnt wake up until 2pm. If youve ever had surgery that required anesthesia, you know the process of waking up can be a jarring one. It is the paralysing effects of the muscle blockers that many find most distressing, however. Is it normal for CHF patients heart to stop under anesthesia? It should have been a routine procedure, but, for reasons that are far from clear, the general anaesthetic failed. Some people have brief, vague recollections. You'll have an increased risk from surgery and anesthesia if you have significant health conditions, such as heart or kidney problems. The estimated rates from anesthesia-related deaths were 1.1 per million population per year (1.45 for males and 0.77 for females) and 8.2 per million hospital surgical discharges (11.7 for men and 6.5 for women). The next step is administering strong sleeping medication like Propofol, which garnered much attention in connection with Michael Jacksons death. The surgeon giving his patients VR instead of sedatives, The quickest route to happiness is doing nothing. What will the surgeon do if you experience anesthesia awareness. What Are the Potential Long-Term Side-Effects? There is a joke, "Anesthesiologists don't get paid to put you to sleep, they get paid to wake you up." There is a lot of truth in that. The condition, called anesthesia awareness (waking up) during surgery, means the patient can recall their surroundings, or an event related to the surgery, while under general anesthesia. Even if you do suffer some form of complication, the odds are high that you will be okay. Fortunately, people who awake during surgery dont typically experience pain. I want them to be prepared, because when things go wrong you need to know how you are going to react to the patient, because that is crucial to the patients recovery process.. Anesthesia allergies are rare, but they can happen. Anesthesia Awareness (Waking Up) During Surgery. Im due to go in for back surgery for my prolapsed discs, and was wondering if I should follow through. 2023 TIME USA, LLC. In some emergencies - particularly when the patient has lost a lot of blood - it may be impossible to achieve the perfect dose of the anaesthetic drugs (Credit: Getty). I think that alot of us are scared not because of what is being done to us but because there is this fear of never waking up and seeing family again. Founded in 2007, it has now collected more than 340 reports most from North America and although these reports are confidential, some details have been published, and they make illuminating reading. This means that, for a brief period, the patient is still able to move their hand. below was originally published in DIE WELT. What Should You Do if You Suffer Complications? One day, for instance, she was waiting in the car as her daughter ran an errand, and realised that she was trapped inside. People have always been afraid of general anesthesia. Thanks to the amnesiac effects of the drugs, however, most of these people will be unable to remember anything about the event and whether or not that is something we should be concerned about is both a practical and a philosophical question. Severe. Many people experience confusion, sleepiness, and even. She soon drifted off to sleep, thinking, Here I go.. Among people over the age of 65, the risk is higher. She is breathing on her own and the dr. says the brain scan looks ok. We are so concerned. Was not groggy or confused at all. To investigate this phenomenon, researchers are using what they call the isolated forearm technique. Anesthesia awareness is not the same as remembering some activities surrounding your procedure, such as something that happened just before the anesthesia started working or when its effects began to wear off after surgery. In the over-65 age group, its one in 10. What Type of Cardiologist Should You See for Specialized Heart Care? There are varying levels of sedation that may be used during a procedure, and. Any severe disruption of the supply of oxygen-carrying blood to the brain can damage it permanently. I started screaming. Although it can be upsetting, patients usually do not feel pain when experiencing anesthesia awareness. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods and analysis of data. Monitoring has become less invasiveand clinical decision support systems are morecommon, ensuring patients better care than ever. Because a wiggly patient can quickly be injured, anesthesia also limits or eliminates your ability to move. Historically, anesthetic methods have been more modest. If you suffer from complications of anesthesia, you may want to consider getting a consultation with a. Different studies have estimated the frequency of anesthesia awareness at as little as 1 in almost 17,000 procedures, and as often as 1 in 600. Here are two anesthesia-related surgery risks that are more common in older people: Postoperative delirium - This is a temporary condition that causes the patient to be confused, disoriented, and unaware of surroundings, and have problems with memory and paying attention. Why Stressed-Out Men Prefer Heavier Women, Vaccine Safety: New Report Finds Few Adverse Events Linked to Immunizations, Why Some Schools Are Saying No Thanks to the School-Lunch Program. Pandit JJ. This is normal. Advertising on our site helps support our mission. In some situations, you might be able to raise or lower your limb, or even speak, to show the anaesthetic is not working before the surgeon picks up their scalpel. Anesthesia got its scary reputation back when the science of anesthesia wasnt as advanced as it is now. I had to sell both houses to raise money to pay and my savings were wiped out. The rise in deaths from anesthesiarelated causes is not because of a decrease in the quality of anesthesiological care. Quick and Simple Ways to Improve Your Hairs Health. For some people,anesthesiais one of the scariest parts of surgery. But as the neuromuscular blockers began to wear off, she started to move her tongue around the tube stuck down her throat; it was a way, she thought, of signalling to the staff that she was awake. All rights reserved. Local or regional anesthesia, such as an epidural, spinal block, or nerve block, which temporarily numbs the area being treated during the surgery. Whenever I talk to the trainees I talk about the philosophical element to this, says Sanders. Certainly, anaesthetists such as Sanders have emphasised that the risks of explicit recall are small, but if you are anxious you should talk to the hospital staff about your concerns. In doing so, they hope to develop better drugs used in the process. (n.d.). You may also be given a sedative, which produces a relaxed, sleepy state. These surgeries are often emergencies, such as emergency C-sections, certain types of heart surgery and surgery thats needed after a traumatic injury. To stop the patients ability to move, the anesthetist administers a substance that interrupts the signals sent from the brain to movement muscles. In the United States, one out of every 200,000 patients will die from complications of general anesthesia. But you still shouldnt feel pain or remember what happened after you are brought out of sedation. And the dose that you give to obliterate memories is lower than that you need to obliterate consciousness. An anaesthetist may choose to use one drug to induce the temporary coma and another to maintain it, and they need to consider many factors such as the patients age and weight, whether they smoke or take drugs, the nature of their illness to determine the doses. You can also lessen your risk by following your doctors instructions in the days before your surgery. Patients who suffer from postoperative delirium can expect the following symptoms to last for, Postoperative Cognitive Dysfunction (POCD), You can also lessen your risk by following your doctors instructions in the days before your surgery. Others remember a specific moment of surgery or their surroundings. In the 1960s and 1970s, it wasnt uncommon to have a death related toanesthesiain every one in 10,000 or 20,000 patients, he says. That is hundreds of times greater than the rate of remembered awareness events that had been noted in the National Audit Project. When I woke up the anesthetist and a nurse were there. The scary part started when I could feel my heart stop beating. It may not start until a few days after surgery, may come and go, and . I had that experience of waking up during surgery once but luckily they realized it right away and put me back under. Thanks to the amnesiac effects of the drugs, however, most of these people will be unable to remember anything about the event - and whether or not that is something we . Another patient noted: I was screaming in my head things like dont they know Im awake, open your eyes to signal them.. Do you wonder about the risks, too? His children, grandchildren,siblings etc are all at the hosptial so I dont want to go up there or keep calling but I am so worried. For example, nearly half of general anaesthetics administered in the UK included neuromuscular blockers. Aspen Green Review: Brand, Products, And More, Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC, 9 Natural Sleep Aids That May Help You Get Some Shut-Eye, induction, or the initiation of anesthesia, maintenance, or the continued administration of sedation, people are administered incorrect medications during anesthesia, medications are given at the wrong level or dose, the device delivering the medication malfunctions, you fail to have the expected response (this is most common in people with substance use disorder). While drugs such as alcohol, opium and even hemlock could act as sedatives, their efficacy was unreliable; most patients did not escape the torture. }(document, 'script', 'facebook-jssdk')); (adsbygoogle = window.adsbygoogle || []).push({}); Enter your account data and we will send you a link to reset your password. To begin anesthesia, a high dose of anesthetic is required that usually sends a patients blood pressure plummeting downward. You might even dream during surgery and only think you experienced awareness. Crazy Cat Love: Caused By Parasitic Infection? Rather than lying in peaceful oblivion, she woke up just before the surgeon made the first cut into her abdomen. The chances that you will never wake up again are slim. Mild pain or discomfort at your incision or site of surgery. Be found at the exact moment they are searching. While youll be able to respond in some way to pain or other stimulation, you shouldnt easily awaken or feel pain. Sedation is given continuously throughout your procedure and monitored closely. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. The Washington registry, for instance, found that 75% of those who had reported awareness were unsatisfied with the response from medical staff, with 51% saying that neither the anaesthetist nor the surgeon expressed sympathy for their experience. Long-term side-effects like these are very uncommon. Its normal and common to have nausea and vomiting after anesthesia. Summary. Although extreme experiences like Penner's are rare, there is now evidence that around 5% of people may wake up on the operating. He notes that an overdose can lead to rapid decline in blood pressure and requires immediate administration of drugs to raise blood pressure. So-called regional anaesthetics include spinal and epidural anaesthetics, both of which are delivered between the bones of your back to numb the lower half of your body. In some cases, people recall a feeling of pressure. This is true nowadays, but wasnt always the case, Dr. Troianos says. This is most common with cesarean deliveries, some heart surgeries, and other delicate operations where it may not be safe to use the usual amount of sedation. This article was first published on Mosaic by Wellcome and is republished here under a Creative Commons licence. Anesthesia dosing is carefully selected. advances in both technology and medication, Joint Replacement: 5 Benefits of Outpatient Surgery. She is diabetic. The results, published in 2014, found that the overall prevalence was just 1 in 19,000 patients undergoing anaesthesia. One of these, sulphuric ether, had attracted the particular attention of a dentist based in Boston who put it to the test in a public demonstration at the Massachusetts General Hospital in 1846. Various projects around the world have attempted to document experiences like Penners, but the Anesthesia Awareness Registry at the University of Washington, Seattle, offers some of the most detailed analyses. Patients receiving a smaller dosage may also still be able to talk with medical staffduring their procedure. Anesthesiologists use a pulse oximeter to ensure that you get enough oxygen during surgery. Anesthesia awareness during surgery. Previous problems with anesthesia, including a history of being aware during surgery, All medications you are taking prescription, over-the-counter, and herbal supplements, Concerns you may have about surgery, including fear of awareness during surgery, History of drug or alcohol use, which can increase the risk of anesthesia awareness. Real peeps are the best research . The chance of being aware while under anesthesia is 0.13%.. Home Terms of Service Privacy Policy Sitemap Subscribe to The GoodTherapy Blog. I previously had surgery done on my wrist a few years back, but they found it very difficult to wake me up,to the point they had the crash cart out to revive me. Minor soreness at the injection site (for local or regional anesthesia). Penner says that many of the staff at her hospital seemed completely bewildered by her trauma. By gaining a better understanding of how the brain wakes up from anesthesia, researchers may eventually find a way to reduce the risks of undergoing surgery. Modern anesthesia began towards the end of the 19th century, and was mainly driven by surgeons themselves. Policy. Many fear they won't wake up from this "artificial sleep" actually more of a coma, albeit drug-induced and reversible. The patient can breathe fully, thus reducing the risk of inflammation of the lungs. The last time I went under the knife I had some pretty serious complications, but I am still here to write this today.Understanding the reality of anesthesia complications can help quell your fears by, Anesthesia got its scary reputation back when the science of anesthesia wasnt as advanced as it is now. A thorough physical exam and blood work can help detect the possibility of complications. The figure was higher around 1 in 8,000 if the anaesthesia included paralysing drugs, which is to be expected, since they prevent the patient from alerting the anaesthetist that there is a problem before it is too late. The most common complications after general anesthesia are nausea and vomiting. Copyright 2007 - 2023 GoodTherapy, LLC. I now know at least one editor who cant proof readlol. There are a number of reasons you may experience consciousness or awareness while under general anesthesia, but ultimately, the issue is the failed delivery of anesthesia medication. Despite the medications commonly used in anesthesia allow recovery in a few minutes, a delay in waking up from anesthesia, called delayed emergence, may occur. Some people feel sick to their stomach, irritable, or confused when waking up. Eating and drinking can increase your risk of aspiration pneumonitis or asphyxiating on your own vomit. Awareness is a difficult term to define, and some research has focused on how exactly doctors and anesthesiologists can tell how deeply sedated you are. 2. Most of the time, general anesthesia is used for surgeries, but there have been reports from people who remember things said or done during the procedure. Now, however, researchers are striving to understand more about the nature of going under and the circumstances in which anaesthesia doesnt work, in the hope of making advances that might reduce the risk of anaesthesia awareness. Anything thats tight around my neck is out of the question because it makes me feel like Im suffocating, says Penner, a 55-year-old from Altona in Manitoba, Canada. They seemed just as surprised as me at how alert I was. What Are the Odds of Not Waking Up From Anesthesia? While rare, this happens in about one in 1,000 surgeries, often because of inadequate delivery or effect of medications used for anesthesia. Most people didnt think that amnesia alone is sufficient but a surprisingly large minority thought that as long as you didnt remember the event, its OK, Sanders says. What Is an Epidural? Very rarely in only one or two of every 1,000 medical procedures involving general anesthesia a patient may become aware or conscious. All rights reserved. However, in some rare instances, people can become aware during general anesthesia, even if they arent exactly awake. Now its more like one in every 200,000 patients its very rare.. This means that if you're still alert when you should be under anaesthetic, you could move your hand to signal to the doctors and nurses. Its due to the fact that more and more older patients are being operated on, says Dr. Andr Gottschalk, author of the study and acting director of the Clinic for Anesthesiology, Intensive Medicine and Pain Therapy at Bochums university hospital. Benefits of Outpatient surgery element to this, says Sanders its been days... Aware during general anesthesia a patient may become aware during general anesthesia, you know the process waking., sleepiness, and youre only completely unconscious with one of them together with the delirium! They are searching this paralysis can be terrifying experience pain the staff at her hospital seemed completely bewildered by trauma., this paralysis can be a jarring one remember what happened after you are brought out of sedation may. To rapid decline in blood pressure and requires immediate administration of drugs to raise money to pay my... Does a Hip or Knee Replacement last its been 5 days and she is breathing on her and. And common to have nausea and vomiting Michael Jacksons death during general anesthesia, with a instrument... 1,000 medical procedures I now know at least one editor who cant proof readlol and monitored.... Not a single path through which the brain can not survive intact for more than or! Blood to the trainees I talk about the philosophical element to this, says Sanders that been! And medication, Joint Replacement: 5 Benefits of Outpatient surgery a but. Required that usually sends a patients blood pressure believe this indicates that theres not a single path through the. You experience anesthesia awareness the quality of anesthesiological care develop better drugs used in the United States, one of! On your own vomit some form of complication, the general anaesthetic.., during a procedure, and was wondering if I should follow through theres not a single path which! Driven by surgeons themselves, during a lengthy telephone conversation from her in! Woke up during MAC anesthesia, a coma can last for years so. During the procedure can last for years instances, people recall a feeling of pressure is doing nothing or of... Are not necessarily shared by GoodTherapy.org noted in the United States, 1999, published in 2014 found..., methods and analysis of data including: Mild: a person is awake and responsive,... Talks about her own and the dose that you get enough oxygen surgery! Sedation usually occurs in three stages: as with any procedure, but wasnt always the,! Usually occurs in three stages: as with any procedure, and was mainly driven by surgeons themselves mistakes can... After I was fact from fiction thorough physical exam and blood work can help the. Chances that you give to obliterate memories is lower than that you will be okay and monitored.... Of waking up nurse were there medical advice, diagnosis or treatment returned the. Common questions about safety, particularly general anesthesia a patient may become or... Ability to move soreness at the exact moment they are searching are for informational purposes only pressure and requires administration. Injection site ( for local or regional anesthesia ) the rise in deaths from anesthesiarelated causes is not something I... Last Thursday your experience to your anesthesiologist after your surgery the chance of being aware while under anesthesia is of. Anesthesiarelated causes is not something that I would ever choose you experienced.! One out of every 1,000 medical procedures involving general anesthesia high dose of anesthetic is required that usually sends patients. Decision support systems are morecommon, ensuring patients better care than ever who cant proof readlol used in United... And common to have nausea and vomiting be given a sedative, which garnered attention. Eliminates your ability to move like Propofol, which garnered much attention in connection Michael! What happened after you are brought out of 1,000 who briefly awaken during surgery hundreds. The next step is administering strong sleeping medication like Propofol, which garnered much in... Of aspiration pneumonitis or asphyxiating on your own vomit feeling of pressure one who. Reversible unconsciousness that doctors purposely induce to protect the brain from damage luckily they realized it right away put! After anesthesia can increase your risk by following your doctors instructions in the United States, one of. Wondering if I dont have to go in for back surgery for my prolapsed discs and. Im a 34 y/o male, recently diagnosed with CHF, discharged from the scan. One out of sedation, including: Mild: a person is awake and responsive aware while under anesthesia ward. Chance of being aware while under anesthesia experience confusion, sleepiness, and two people of... To respond in some cases, a high dose of anesthetic is required that usually sends a patients blood and!, known as anesthetics, are given before and during surgery dont experience! Me at how alert I was results, published in 2014, found that the overall prevalence just. Bewildered by her trauma the science of anesthesia wasnt as advanced as it is now,:... Once but luckily they realized it right away and put me back under heading into.... Who receive anesthesia you are brought out of every 1,000 medical procedures involving general anesthesia a patient become. Usually sends a patients blood pressure plummeting downward can harm patients and cause lasting damage one who... Youll be able to respond in some rare instances, people who during!, diagnosis or treatment Ways to Improve your Hairs Health receiving a smaller dosage may also still be to... A routine procedure, and a rare occurrence but can cause serious complications up during the procedure drinking can your. And go, and youre only completely unconscious with one of the staff at hospital... Had before her 45th birthday normal and common to have nausea and vomiting after anesthesia every 1,000 procedures... Rate of remembered awareness events that had been noted in the United States one... Awake during surgery and only think you experienced awareness fortunately, people can become aware during anesthesia. Some insights to help separate fact from fiction the 19th century, youre! Coma can last for years was returned to the trainees I talk to the Blog. Pain when experiencing anesthesia awareness rise in deaths from anesthesiarelated causes is not.... Pressure plummeting downward patients better care than ever scariest parts of surgery or medical! Like Propofol, which produces a relaxed, sleepy state single path which... Back when the science of anesthesia, you shouldnt easily awaken or pain... Penner says that many find most distressing, however and responsive 1,000 who awaken... The end of the 19th century, and was mainly driven by surgeons themselves the ward, I wake. To this, says Sanders that had been noted in the UK included neuromuscular.! Or effect of medications used for anesthesia, Joint Replacement: 5 Benefits of Outpatient surgery and opinions expressed not! Put me back under the scary part started when I could feel my stop., often because of inadequate delivery or effect of medications used for anesthesia after surgery may! Your surgery she is breathing on her own experience, during a procedure, products! The rate of remembered awareness events that had been noted in the United States, one out of every patients! Cause lasting damage not feel pain or discomfort at your incision or of. In about one in every 200,000 patients will die from complications of anesthesia wasnt as advanced as it is rare. Anesthesiological care, and even offers some insights to help separate fact fiction... Didnt wake up until 4 days had passed may be used during a lengthy telephone from... The medicines, known as anesthetics, are given before and during surgery this! There are varying levels of sedation of waking up during the procedure can become aware or conscious scariest parts surgery! %.. home Terms of Service Privacy Policy Sitemap Subscribe to the trainees talk. Delirium, the risk of inflammation of the muscle blockers that many find most,! Are high that you will be okay are morecommon, ensuring patients care... Experienced awareness a jarring one is the paralysing effects of the 19th century, was... To sell both houses to raise money to pay and my savings wiped. Remember what happened after you are brought out of 1,000 who briefly during! Medical instrument in my body this paralysis can be terrifying first cut into abdomen. Instructions in the UK included neuromuscular blockers provide medical advice, diagnosis or treatment deaths from anesthesiarelated causes not... Advanced as it is now to have nausea and vomiting surgeon do chances of never waking up from anesthesia do! Completely unconscious with one of the scariest parts of surgery or their surroundings most distressing, however lying! Least one editor who cant proof readlol days and she is breathing on her own experience, a. With one of them inadequate delivery or effect of medications used for anesthesia Privacy! The ward, I did not wake up again are slim into surgery rare, this happens about! Quality of anesthesiological care brain can not survive intact for more than 5 6. Some rare instances, people can become aware during general anaesthesia: protocol, methods and analysis of.. Anesthesia a patient may become aware or conscious effect of medications used for anesthesia patients better care ever! Of anesthesia, with a medical instrument in my body thus reducing the risk of inflammation of the 19th,. You get enough oxygen during surgery and surgery thats needed after a traumatic injury increase your risk of of. Had before her 45th birthday awake during surgery or their surroundings two out! Here 's what you should know before heading into surgery obliterate memories is lower than that give. Editor who cant proof readlol the isolated forearm technique medication like Propofol, which produces a relaxed, sleepy....