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Posts by Scott Allen10

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Anesthesia, Resuscitation, and ICU: Q&A in Health ·
stormyviper2 said:I'm guessing a headache is pretty standard after getting spinal anesthesia and just lying flat for two days straight?

Yeah, it can definitely be a thing even if it doesn't happen to everyone... that's why they always tell you to stay flat for a bit afterward... honestly, since you followed all the instructions to a T and you're still feeling it, I'd say you just landed in that tiny unlucky percentage where things don't go perfectly.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Kimberly Morris said:Hey everyone!

So, I've been dealing with some major stomach issues lately, and I urgently needed to get a gastroscopy done. Long story short, I couldn't even get through the procedure because I just couldn't swallow the endoscope—I know, sounds totally wild. Honestly, I actually gave birth with basically nothing but an IV drip and no epidural, so I thought I was tough, but this was different. I deal with a ton of health stuff and can usually push through pretty much anything, but I’ve never had an experience quite as rough as that attempt.

Well, my doctor just told me they're going to have to put me under so we can actually get the exam finished properly.

Since I'm juggling quite a few things—migraines, insulin resistance, hypothyroidism, tachycardia, blood pressure swings, you name it—I'm honestly a bit nervous about how my body will handle being sedated.

Does anyone know what kind of anesthesia they typically use for this sort of thing?

Thanks so much in advance for any help you can give!

I'm not entirely sure what you mean by "tachycardia and blood pressure swings," but regardless, they'll run a pre-anesthesia screening before the procedure to check everything out...

It's usually just a quick IV sedation, most likely using Propofol, where they just hold your chin steady for a second—nothing too intense like a breathing tube or anything.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
When you're in surgery, your arm is usually stretched out and held steady away from your body. Since you're totally relaxed and just staying still for a long stretch, sometimes the blood flow and lymph drainage can get a little... well, let's just say they take a bit of a hit. That’s what leads to those symptoms you're seeing, but honestly, they're usually just temporary and don't really need any medical intervention. It's kind of the same deal with the tourniquet, too—as long as it isn't red, painful when you touch it, significantly swollen, or running a fever, I wouldn't worry too much about it... doesn't seem like anything major to me.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
stormyhound13 said:By the way, I wanted to ask—is it actually a good idea to go through with inguinal hernia surgery if my lower back is acting up, specifically around the lumbar region?
The reason I’m asking is that once you have that surgery, you really have to be careful not to strain the groin area, which usually means leaning more on your lower back for support, but my back is already killing me right now.

So, I'm wondering if I should focus on getting my back sorted out first before tackling the hernia surgery. I'd love to hear what you guys think about this.

Also, does anyone know what neurolysis actually entails? Is it something worth doing?

Here is the specific breakdown the doctor gave me when we were talking...

Operation:
Mesh Free Shouldice Repair with neurolysis of the inguinal nerves
(Ileoinguinalis, Ileohypogastricus and genitofemoralis) and restoration of the
inguinal floor with a faszia flap

Honestly, almost everyone deals with lower back pain at some point, and while you're waiting for that to clear up, I worry you might be waiting forever... so there isn't much of a direct link there, and there's not much you can do to control one by fixing the other.

What the doctor wrote is basically his plan for how he's going to "fix" things up for you... he's going to close off the hernia opening, and while he's at it, he'll release those nerves that are getting all cramped up or irritated by the hernia sac itself.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
stormyhound13 said:I’ve got an inguinal hernia repair coming up soon, so I was wondering what kind of anesthesia they usually use for stuff like that?

Can I actually ask for a Laryngeal Mask Airway instead of being intubated if I go under general anesthesia? Like, can we skip the tube?

Since they need to relax your muscles completely, they have to stay in total control of your breathing, which means making sure the airway is rock solid. A tube is definitely the safest bet... though an LMA is an option too... but honestly, don't sweat it too much; it really just comes down to the anesthesiologist's call based on how things look once you're under... either way, you'll be fine.🙂
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
silentdriver23 said:Can I ask a question? So, I had a C5-C6 microdiscectomy at the NEA where they also implanted a device. Everything went smoothly, but I’m a little thrown by how I felt afterward. They woke me up right there in the OR and I was just covered in needle marks everywhere. My left arm and leg were totally numb, and my right leg was bruised up all over, plus my shoulder was blue. I was wrapped up in one of those thermal warming blankets they use, and they actually took off the bottom half of the clothes I was wearing when they put me under. My stuff was tucked away in a bag with a bunch of blood on it, which was honestly pretty terrifying. What I really want to know is, if I ended up needing a transfusion, are they required to list that in the discharge papers? Because my paperwork says everything was fine. Also, why would I have two bruises and be wrapped in a heating blanket? Thanks!

Look, if you're heading back to the ward, they usually wake you up right in the operating room, so that part is totally normal.

As for having two bruises, don't go looking for some huge medical drama there... it could be anything, just being safe, you know? Maybe one site wasn't quite hitting the mark or was slipping against the wall? Or maybe they tried a second spot because the first didn't take? It happens.

And about being naked or half-dressed on the table—it gets freezing in those ORs sometimes. They wrap you up in those blankets just to keep you from shivering like crazy while you're out.

Trust me, nobody is going to leave out any major screw-ups in your records if things actually went south... it's always a toss-up whether it's the surgeon's fault or the anesthesiologist's.😁...
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Charles Sanders51 said:Hey, if there’s an anesthesiologist hanging out here, could you give me a professional breakdown of what it actually means when we say adrenaline is diluted at a ratio like 1:1000? Specifically, how much adrenaline (and in what units) are we talking about when it's mixed with 1000 units of saline or whatever?
Also, when we talk about diluting adrenaline at 1:10,000, does that mean if I have 3 mL of adrenaline, I should mix it with 7 mL of saline in a 10 mL syringe, or is it more like 1 mL of adrenaline with 9 mL of saline?

Thanks!

Usually, the adrenaline in the vial is 1mg per 1ml... which is basically 1:1... honestly, that stuff is powerful enough to raise the dead. If Imhotep had access to that, he wouldn't be messing around with spells for Anck-Su-Namun in that Mummy movie.

So, you take that 1 ml vial and pull it into a 10 ml syringe (meaning 1 ml of drug plus 9 ml of saline... that gives you 1:10... which is pretty much a standard resuscitation dose...

Then, if you take 1 ml from that 1:10 syringe and draw it up again into a 10 ml syringe (another 1 + 9 ml), you’re looking at 1:100... that's what you'd use for something like titrating blood pressure after a procedure.

If you take 1 ml from that 1:100 syringe and go through the process one more time (again, 1 + 9 ml), you get 1:1000... which is perfect for fine-tuning blood pressure or handling anaphylaxis.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Eric Long22 said:Why on earth do they keep drugging people up for days before an actual surgery? It would be so much more logical if you just showed up, got your meds, and were in the OR by the next day at the latest. But at the hospital in the city, they just keep you stuck there for days, pumping you full of drugs while they lie to your face every single morning saying the operation is happening tomorrow.

☕
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Paul Ramirez59 said:Question for the veterans here... I’ve got to head into the hospital tomorrow, and by Wednesday, I’ll be undergoing laparoscopic surgery for a chronically inflamed appendix. Since I struggle with panic attacks on a regular basis, you can probably imagine the kind of mental loop I'm stuck in right now. Is it okay—I mean, am I actually allowed—to ask for something to take the edge off, maybe an hour or two before they wheel me in? Just something to calm my nerves or lift my spirits a bit. About a year ago, my kid had his tonsils out, and I remember them giving him a pill beforehand; he went into the OR looking totally high, laughing at everything, completely oblivious to where he was going, and he doesn't remember a single thing about it...



You definitely can... honestly, you'll probably get something to help you sleep the night before, too... plus they'll give you some pre-medication about half an hour before the actual procedure starts.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Jerry Alvarez7 said:Hey everyone! First off, huge thanks to the experts here for taking the time to answer our repetitive and—let's be honest—sometimes totally clueless questions. 🙂

My gut feeling is that I need an endoscopic reconstructive nasal surgery under enhanced local anesthesia, plus getting my discharge instructions.

Basically, I can barely breathe through my nose; I've been struggling with this for years, and after dealing with constant post-nasal drip and sinus infections, I finally decided to just get it fixed. I got some results from a private clinic, and their doctor suggested doing the whole thing under local anesthesia with some extra sedation.

I'm 31, about 6'4" and 205 lbs, a smoker with borderline high blood pressure and pollen allergies.

I’d love to hear what you all think—is going with local anesthesia actually a safer bet, or should I just opt for general anesthesia? It's an endoscopic procedure. To be totally real with you, I have this irrational fear of general anesthesia—like, the "what if I don't wake up" kind of fear—which is honestly why I've put off this surgery for the last few years.

Someone mentioned that enhanced local anesthesia can be a bit of a nightmare because you can actually hear everything happening, which sends your blood pressure spiking and turns the whole thing into a mess. Apparently, they don't even offer the enhanced version at Rebro.

Please help me make a call on this. 🙂

Thanks in advance!

Better late than never, right? Honestly, go with general. When someone is literally reshaping your bone and pulling tissues around in there, the last thing an anesthesiologist wants is a patient conscious enough to freak out, especially given all the variables involved...
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
wearymason2 said:Hey, I’ve got a quick question regarding CPR.

Everywhere I look, the guidelines say you should start CPR when an accident victim isn't responding to stimuli and isn't breathing—or isn't breathing normally. What exactly does "not breathing normally" mean in this context? I was digging through the official American Red Cross guidelines from back in 2015, and all it really said was that agonal gasps shouldn't be mistaken for normal breathing, but that was it. I can't find any specific details on what kind of respiratory deviations actually trigger the call to start CPR.

From what I understand, you don't bother checking a pulse anymore; you just check for breathing, because if there's no pulse, there's no breathing and vice versa when looking at CPR indications, am I right?

When you're stepping up to perform CPR, you're essentially doing a lightning-fast assessment of the victim's status—checking consciousness, breathing, and heart function all at once.
It basically happens in one fluid motion, maybe three or four seconds tops. You drop down, shake them, and shout... then immediately go for the carotid artery, lean your face near their mouth/nose, and watch the chest... it all happens simultaneously. While your finger is checking for a pulse, you're combining that with feeling for breath on your cheek and watching the chest rise and fall to gauge their breathing.
In a cardiac arrest situation, like when someone is in asystole or ventricular fibrillation, you'll see those agonal gasps, which definitely aren't normal breathing. An unconscious person might make these deep, heavy "gasping" sounds for a minute or two after their heart stops, and people often mistakenly think, "Oh, they're breathing!"... but they aren't actually breathing; they're dying.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Eric Adams4 said:Dearly respected forum members and esteemed anesthesiologists, I’m reaching out because I really need some help understanding something that's been weighing on my mind for a while now. I have an upcoming surgery to remove polyps from my vocal cords, and honestly, the general anesthesia part is what's keeping me up at night. Even though everyone keeps telling me it's a super quick procedure and there's nothing to worry about, I'm stuck on two specific things. First, what actually happens if the anesthesiologist can't get the tube in quickly enough after they've already given me the muscle relaxants? How do they handle that, and is it actually life-threatening if they can't get the tube into the trachea? Are there any alternatives to that scenario, or is it just a dead end? My second big fear is what would happen if the anesthesia machine itself malfunctions—what's the backup plan then? I'd be so grateful if you could help clear this up for me.

I actually sent you a private message regarding that first part of your question... so seriously, don't sweat it.

As for your second concern about the equipment failing, you really don't need to worry about that either. I mean, sure, machines might act up occasionally or have their own little quirks, but no matter what happens, everything is handled professionally. You can trust that they'll manage the situation perfectly.
Of course you can... Honestly, the very first thing they’re gonna see on those blood work results is whether or not you've been lighting up, so there's no hiding it. You really ought to quit messing around with those cigarettes if you don't want your doctors catching onto you during your next checkup at the Mayo Clinic.
Dealing with an alcohol problem. in Health ·
Look, if you aren't looking to end up in the ER down the road, maybe just stop drinking and call it a day...

Beyond that bit of advice, there isn't much else we can tell you here on this health forum regarding what you posted... And honestly, if you were hoping to find some clever way to "game the system" so you could sneak in a few more drinks... well, you're definitely barking up the wrong tree here; you'll have to look elsewhere for that kind of thing...
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Dennis Nelson said:So, what happens if I ever need surgery down the road?

Honestly, you just have to let them know there were issues getting you under last time. It’s probably best to grab your medical records so you can point out exactly where they noted the difficulty, which helps the surgical team prep for a tricky intubation.
I mean, think about it—during something like a quick gastroscope procedure, they usually don't have fancy gear like a video laryngoscope, a Macintosh laryngoscope with a flexible tip, or any of those other lifesavers used when things get complicated like they did for you. But if you can go under again, and they actually know ahead of time that you're a bit of a "difficult airway" case, the anesthesia crew can have all the right equipment and supplies ready to go...
At the end of the day, the big thing is that once they gave you the meds, especially the Propofol 120 mg Succinylcholine, they were still able to breathe for you manually without much trouble... or at least be able to use a laryngeal mask.
Bottom line, you really don't need to stress about future procedures as long as the team is kept in the loop about what happened before.
Good luck!
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
In theory, those two things shouldn't have anything to do with one another.

I always tell people that you have to prep for surgery just in case, regardless of what kind of regional block they're planning to use. You basically act like you're going into full general anesthesia... I mean, even if everything goes according to the initial plan, there's always that chance you might need to pivot to general anesthesia for some reason mid-procedure.
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
What exactly do you mean by "before surgery"?....If we're talking about the day before while you're just chilling at home, then sure, go for it if it actually helps you feel better....But if you're already checked into the hospital waiting for the procedure to start, then absolutely not....I just don't have enough info here to give you a solid answer...
Anesthesia, Resuscitation, and ICU: Q&A in Health ·
Local anesthesia shouldn't be an issue at all when you're taking those meds, but honestly, there’s no harm in mentioning it to your dentist—actually, I’d say you really should. It’s probably not even a big deal since every second or third person sitting in that chair is likely on something similar these days anyway...
If you want to chat about private options and what they’re actually gonna cost, just hit me up in a DM or check out the pinned thread...
thanks
Elizabeth Hall6 said:Wait, seriously??? Come on, guys, give me a break 🙂

Honestly, Google is your best friend here, and your phone works just fine too... you really could have looked all this up at least a billion times by now...☕....

I'd even suggest just using this line:

"Hi there, could you give me a ballpark estimate for this specific procedure... and let me know what my payment options look like?"

☕