Posts by Scott Allen10

It’s not going to be some "pen service," it’s actually called a "pain service." Basically, the anesthesia department would set up a dedicated unit to manage pain relief, mostly for patients who just came out of surgery and are struggling with intense discomfort that standard protocols aren't quite hitting... Calling it a "pain service" sounds super fancy and high-end when you talk about it, but if we're being real, a systematic, professional service like that doesn't really exist in the US yet, at least not the way it should.

Thanks for the kind words! Honestly, I’m just happy if our little chats can actually help someone out. If the FBI ever gave us a shoutout, we’d probably be the most popular group on the whole health forum...😁....But look, we definitely have to keep in mind that this is all just internet talk—it’s never going to replace the actual advice you get from a real doctor sitting right in front of you at the clinic.

As for your specific question, I don't really have much hands-on experience with those types of nerve blocks myself, so I'm not about to start throwing around guesses or random advice. I know Prince is planning to swing by the thread later, so he might weigh in with some insight... But if you want my two cents on anesthesia blocks in general, my best advice is to check in with the absolute pros in the field—the guys over at the Mayo Clinic. Those people live and breathe regional anesthesia... honestly, they're so good at it, you'd think they'd try to perform brain surgery using nothing but a local block at this rate...😁...they're total experts at using ultrasound to pinpoint exactly where the nerves are for the injection, and they do it routinely, so when it comes to regional stuff, you really can't go wrong with them.

Linda Martinez60 said:I’m wondering when exactly they pull the intubation tube out? Like, once the surgery wraps up, do they just take it out and wait for the patient to wake up? And can you breathe on your own (without the tube) if the anesthesia is still really kicking in?

Also, how many hours after the surgery does the anesthetic stay in your system so there isn't any pain?
ACL surgery

An intubation tube is basically a tube placed into the trachea (windpipe) through the mouth or nose via orotracheal or nasotracheal intubation for patients undergoing general endotracheal anesthesia (GEA).
The tube has three main jobs:
to ensure a secure airway during the period of anesthesia,
to allow for normal lung ventilation (whether the patient is breathing on their own or being assisted by the anesthesia machine),
and to protect the airway from aspirating stomach contents (which is super important).

During a procedure under GEA, the anesthesiologist keeps the patient asleep while ventilating them using the anesthesia machine, where a specific mix of gases is set. So, during this type of anesthesia, the patient isn't actually inhaling air, but rather a combo of oxygen, nitrous oxide, and inhaled anesthetics (usually something like isoflurane or sevoflurane these days). If needed, they’ll also add muscle relaxants, narcotics, analgesics, and so on...

Toward the end of the surgery, the anesthesiologist adjusts the settings on the machine, stops the flow of anesthetic agents, and starts ventilating the patient with pure oxygen. At roughly the same time, they give the patient an IV combination of meds to reverse the effects of the muscle relaxants (decurarization). By watching the ventilation parameters on the monitor and observing the patient clinically, they look for signs of spontaneous breathing and the first signs of waking up. The patient still has the tube in and is connected to the machine at this point. Once it’s determined that the patient is achieving enough tidal volume through spontaneous breathing, their level of alertness is good, and there aren't any other red flags, the anesthesiologist decides to perform extubation (pulling the tube). The patient stays under the watchful eye of the anesthesia team for a bit, usually in the Post-Anesthesia Care Unit (PACU), which most American hospitals have. Here, their breathing and overall status are closely monitored, and they get help if they need it. After a while, the patient is re-evaluated, and if the anesthesiologist thinks everything looks solid, they move the patient back to a regular hospital room.

It is actually possible to do the whole anesthesia process without a tube (using a mask instead). This method requires more focus and skill from the anesthesia team and is typically used for shorter procedures. Basically, by adjusting the dosage of the anesthetic and avoiding muscle relaxants (which always require a tube), they reach the necessary depth of anesthesia while the patient continues to breathe on their own. So, the anesthesia "holds" as long as the patient can breathe independently.😁

Pain is a super individual thing, so there’s no one-size-fits-all answer here. If it starts hurting, don't feel bad about speaking up and asking for pain meds. An ACL repair will most likely be done using regional anesthesia rather than general. You should definitely chat with your anesthesiologist about those options before the big day.

Look, I’m not saying I’m 100% right—honestly, I might be totally off base here—but I figured I’d jump back into the conversation because, from where I'm sitting, the answer is... well... it's pretty multi-layered. I kind of cringed a little thinking about those laboratory loopholes, but here’s my take:

- Local clinic labs can really only run the specific tests they have contracts for under Medicare (primary care). We're talking basic stuff like a CBC, standard biochemistry, some clotting factors, and things like that which are covered by basic insurance. There might be a few extras where you have to chip in a small co-pay, like a CRP or a lipid panel. Basically, the Social Security Administration covers the basics plus a few extras if you pay the difference. So, you swing by your doctor because you've got a cough and a fever, they order a CBC and a CRP, you get the results the same day, and everything stays within the realm of primary care.
- Depending on their equipment, those same clinics could definitely run more advanced tests, but you'd likely be footing the full bill for those. It would go something like this: you show up feeling under the weather, the doctor says, "Okay, let's do a CBC and a CRP... we probably should check your PCT too, but you'd usually need to head to a hospital for that. However, if you want our lab to do it right now, you'll have to pay out of pocket at the full rate."
- A clinic lab might be capable of handling complex testing, but since those aren't part of their official contract with the Social Security Administration, the government isn't picking up the tab, so you're paying the whole thing.

- Now, a big hospital lab generally won't bother with that basic stuff mentioned above. They won't, mainly because there's no way for them to bill for it if the patient isn't actually an inpatient or seeing a specialist there—they just showed up with a referral for basic bloodwork. Plus, as far as I know, most primary care software doesn't even allow a family doctor to send a referral for basic routine labs directly to a hospital lab anyway.
- On the flip side, a hospital lab will happily draw blood for any tests requested via an internal referral by a specialist working within the hospital. For instance, if someone goes in to see an internist and that specialist orders certain tests as part of the exam—doesn't matter if it's basic or advanced—they can do it all.
- Hospital labs also handle anything covered by the Social Security Administration for tertiary care that a primary doctor requests through a specialist referral. So, if a specialist tells you to get some tumor markers or immunology tests done before your next follow-up, you get that referral from your doctor, go to the hospital lab, and they run everything you need... though you might end up with a bit of a co-pay.

Man, look at these sentences... I can barely even make sense of what I'm trying to say myself...😍...

neonowl67 said:So, over the last couple of months, I’ve actually had to go under general anesthesia twice now. The first time was for a dislocated shoulder where they knocked me out to pop it back in, and then just yesterday I had to have some manual manipulation done on the same shoulder. The thing is, both times I’ve ended up with this insane muscle soreness all over my body. It hits everything—my groin, abs, neck, back, biceps, triceps... basically everywhere except my calves. Last time, the ache cleared up in about two days, but man, it still sucks having to deal with it again because it honestly makes it hard to move around normally.

Anyone else get a weird reaction to anesthesia?

I’ve heard similar stories from patients who were given muscle relaxants during their anesthesia (especially if they used succinylcholine during induction)... you should probably ask them exactly what they administered... but honestly, it's usually nothing to worry about...

Joshua Ramos14 said:Hey everyone,

I wanted to pick your brains on something.

I've got surgery scheduled for a hernia repair on September 18th, and I have a few questions:

1. Which is better—going under general anesthesia or getting a spinal block?
2. I was chatting with a nurse who mentioned she personally thinks spinal is always the way to go, though obviously, I should just follow whatever my anesthesiologist recommends (which is what I figured anyway).
3. Does a spinal hurt? Honestly, the idea of getting an injection in my back doesn't exactly scream "painless" to me.🙂
4. Is there a chance I could get back into sports by early December or January? Something low-key like paintball.

1. They're both "equally good," really... it just comes down to which one works best for your specific situation. It all depends on your medical history, any contraindications, and honestly, just what you're most comfortable with.
2. A spinal is usually easier on your system... it basically just blocks the pain signals (and everything else) from traveling from your body up to your brain. General anesthesia affects pretty much every organ system in your body... so refer back to point one for that.
3. Most patients describe it more as a weird discomfort rather than actual pain... so don't sweat it too much. Just make sure you don't try to be a hero and stand up too soon after a spinal; if you try to act tough and get up prematurely, those post-procedure headaches will hit you, and then you'll *really* know what pain feels like.
4. Yeah... most likely... definitely check in with your surgeon about that.

Jonathan Johnson67 said:So, I’ve got this surgery coming up in about a week, it should only take maybe 30 minutes or so...
From what I’ve gathered, they’re just going to give me some kind of light local anesthesia—you know, like a heavy sedation where you drift off.

Honestly, I wasn't feeling too anxious before I stumbled onto this page, but now I’m totally freaking out.
I can't help but wonder why that cocktail they use for anesthesia includes something meant to make you lose your memory, because if we're basically unconscious, why do we need to forget what happened during the procedure?

Also, regarding what people mentioned about actually feeling pain but being unable to move—how common is that really?

Sorry for dumping all these questions on you guys, it’s just that I’m starting to get really spooked about this whole thing, especially since from talking to my doctor, it sounds like I won't even get a chance to chat with the anesthesiologist until right before they go in.

Calling it "light anesthesia" is super vague and honestly just causes more confusion, so try to be a bit more specific about what kind of procedure you're actually having so we can give you better info.

And I'll echo what was said before... don't let yourself spiral into a panic over nothing. This whole idea of being conscious or feeling pain during the surgery... those are incredibly rare outliers that people tend to blow way out of proportion, making it sound like every patient is wide awake on the table.

So, seriously, stop worrying... you aren't going to be in pain and you definitely won't be aware of it. Between the Oxycodone and the Dolophine, you'll probably just feel like a total happy camper once you start waking up.🙂...

Dana Peterson2 said:Hey everyone! I’m honestly freaking out because I have an inguinal hernia surgery coming up soon, and I can't tell if it's just the anesthesia that's getting to me, since I've never actually been under any kind of sedation before. Does anyone know how long these things usually take? Apparently, they don't always use general anesthesia for this. I actually work in the medical field myself, so while I'm totally fine holding the needle, the second someone turns that needle on me, I lose my mind!😁 I'm not even sure if I should push for general anesthesia, because if they can just give me a spinal block that makes me feel so relaxed I won't care about being awake while they work, maybe that's actually the way to go! I'm all over the place right now and honestly don't even know what else to ask, I'm just a total wreck😱 so if anyone here has dealt with an inguinal hernia, please let me know what it was like!!!

Fixing an inguinal hernia is pretty much a routine procedure, and you're usually looking at just an hour or two to get everything wrapped up.

As for which type of anesthesia you go with, definitely just chat it through with your anesthesiologist. Either way, you aren't going to feel pain during the surgery, so there's really nothing to be scared of.

I’d say just file a formal request with the hospital administration... then you can figure out your next move from there.

Man, this is such a brutal cocktail of diagnoses to deal with... I mean, how do you even begin treating a stroke and its aftermath when there's a blood clot just hanging out in the left ventricle, ready to trigger another stroke at any second? It’s a total catch-22. How aggressive can you get with the clot without making the neurological situation in the brain go from bad to worse? You’ve got carotid artery stenosis, a confirmed infarct with god knows how much myocardial damage, left-side paralysis, Type 2 Diabetes and Blood Clot issues, plus high blood pressure... honestly, it's overwhelming. I totally get why the doctors are saying they're stumped.

Look, nobody on here is going to have a magic answer for you. With a list of diagnoses like that, I can only imagine the mountain of test results involved—neurology, cardiology, endocrinology, you name it. Personally, if I were in that position, I’d lean heavily on whatever the vascular surgeon recommended, since their report is probably the most critical piece of the puzzle right now. At the end of the day, given everything on the table, I’d be seriously questioning whether aggressive intervention makes sense versus just focusing on managing the blood pressure and sugar levels, while trying to ensure some semblance of quality of life without constant pain or bedsores.

Sending nothing but good vibes your way.

Robin Gray8 said:Look, I’m honestly torn between being a "yes" and a "no" on the whole organ donation thing. It’s one of those heavy things I really need to work through internally first, and frankly, I’m just not mentally there yet.
I know for a fact she’d want to be cremated, that much is certain.

Maybe it would click for me—like, maybe by the time I'm 50 or 60—if she were actually conscious to tell me, but right now? No way. I wouldn't want her carrying around some donor card or signing anything official.

Having a donor card doesn't actually settle everything; its main purpose is just potentially making things a little easier for the family. At the end of the day, it's the family who makes the final call on whether to proceed with donation.

ironnomad13 said:Yeah, things have been looking up over the last couple of years... before that, it was just constant struggle...
There was that poll recently in the city... on that 8th Floor show. What exactly is a donor card? Most people seemed to have some idea, but...
Does anyone actually have their own DK? Not a single person I asked had one...
Unfortunately...
In my opinion, people here in America are still pretty out of the loop on this topic...

That’s just not true. You could say things were a complete mess about ten years ago, but since then, it's been getting better and better. The percentage of people willing to donate is high, and anesthesiologists in the ICU are getting way better at spotting potential donors. I make sure to specify "anesthesiologists" because in our system, almost all organ donations go through them.
The real bottleneck is more like the Neurology departments, where the doctors there aren't really paying much attention to whether someone could be a donor or not.

I'm not sure if that question about the donor card was directed at me, but it doesn't matter. That whole desperate crying about "having a donor card" really gets under my skin, so let me vent for a second.

Personally, I don't have one. And honestly, why would I? What does carrying a little card have to do with being "informed" or how people responded to that survey?
It basically has nothing to do with it.
Is a donor card some kind of ultimate certificate that officially declares you an "informed citizen"?... give me a break...
Over time, this myth has grown that having a donor card is the ultimate proof that you're "noble," "educated," or some other nonsense like that...
Let me say it again just to be clear: in a legal sense, a donor card means ABSOLUTELY NOTHING. It has about as much legal weight as a Pokémon card or a membership pass to a local gym!
The donor card is really just a clever marketing move by the HDM to promote donation, which can help ease the burden on a family when they're faced with making a decision regarding a brain-dead loved one whose organs are being considered..

But look, the card isn't meant for showing off or acting superior. I see people waving them around like they're saints and looking down on anyone who doesn't have one—it's honestly pathetic! If someone acts like that, in my book, they're either a total moron with a massive ego problem or they're completely clueless and just talking nonsense.
You can make your stance on organ donation crystal clear to your family and friends without needing a piece of plastic. The most important thing is the connection between the individual and their family, because at the end of the day, it's the family that gives or withholds consent. If the family knows exactly how their loved one felt about it, they won't be torn by guilt wondering, "Would they have wanted this?" If everything is settled within that intimate family bond, do they even need a card?... I don't think so.

wearyviper25 said:I’ve heard about those donor cards—you know, the ones where you state your wish to donate your organs if you pass away. Apparently, the family still has to give their consent, which I guess makes it an incredibly heavy decision for them, though honestly, it's pretty admirable.
Anyway, so many people are stuck on transplant waiting lists, so why not help someone out? At least we can make things easier by having that card ready.

I actually brought this up on another forum once, and the responses were basically:

"You’d have to hand over all your medical history, and who knows how long they'll let you live once they realize your heart is a perfect match for someone else."

"I’m all for it, and if I knew I was 100% protected from being exploited, I’d sign up tomorrow. But... I don't know, being a woman, I just feel like we're all just numbers to them. Whether it's some politician, a tycoon, a capitalist, or some predator in trouble, they'll buy whatever they want—just not our organs."

What do you guys think?

Sorry if this topic has already been covered. These search tools are pretty clunky.

Just a bunch of nonsense...☕

Scott Allen10 said:So, basically, what was mentioned above only applies to patients hanging out in the ICU, specifically those who:
- have suffered an isolated traumatic brain injury, or
- are dealing with intracranial bleeding, or
- have sustained hypoxic brain damage.

...it’s really only those specific types of patients (given those diagnoses and assuming there aren't any contraindications) who would even be considered potential organ donors.

Bradley Perez6 said:Well... here I am, facing a bit of a dilemma. A friend of mine has been trying to convince me of something, and I figured I’d run it by you all just to be sure. This might come across as a rather silly question, but I honestly could really use some clarity on this one. Essentially, is it actually possible for someone to donate their organs following a "natural death"?

So, I actually posted this a few years back, and if you look through that, you'll find the answer to your question about who is eligible to donate.
The whole idea of "natural death" is a bit fuzzy when we're talking about this stuff, so maybe try to be a little more specific about what you mean by that.

ironnomad13 said:I am definitely IN FAVOR of organ donation after brain death. A family member of mine actually received a transplant two years ago...
Last year, I finally got my donor card sorted out too (go me!), though it’s such a shame there isn't more interest in donating here in the States.
Even though the law says anyone who hasn't opted out is a potential donor, doctors here always make sure to get the family's consent first...

🙂....that's not actually true....organ donation rates in the US have been right up there at the top of the European charts over the last few years...

Honestly, this whole thing is a joke. It’s just a classic populist move designed to sell people on some fake sense of "reform"... My issue isn't even that most nurses wouldn't know how to draw blood if their lives depended on it—though let's be real, they'd struggle—or even the fact that it adds a mountain of extra paperwork and time to an already packed schedule... it's more about what happens to the sample once it's out of the vein?

Who’s actually supposed to drive these things to the lab? Is FedEx or DHL just going to drop by the clinic? Or is the nurse expected to slam the door in everyone's face during the morning rush just to play delivery driver for some test tubes?

And when does the transport happen?... Right away, or just whenever they "feel like it"?... How long can a sample sit there without being centrifuged, depending on what they're testing for? It's pretty obvious that in the real world, blood might get drawn around 7 or 8 AM, and then it just sits somewhere questionable—on a sunny windowsill, next to a radiator, or maybe shoved in a fridge?—and once everything is finally processed and the paperwork is sorted, it all gets hauled off to the lab around 9 or 10 AM... and that's just one clinic, imagine the chaos across dozens of them. Who can honestly say any of these samples are actually representative once you factor in the collection, storage, and transit? Nobody.

What about urine samples?... Do these small clinics even have a dedicated space to collect and store them? Or is that going to end up sitting on a radiator, a windowsill, or a random sink too?

Basically, there’s a massive pile of practical questions that none of these "experts" bothered to think about. And at the end of the day, which is the most important part, there's the question of actual expertise... properly collecting, storing, processing, and transporting samples is strictly the job of the lab technicians, not the nursing staff in outpatient clinics.... Why on earth would we tank the quality of care for the public like this?
It’s the exact same logic you'd use if you decided nurses should also handle physical therapy for certain patients... sure, why not? I mean, we have physical therapists for a reason, but why should people walk all the way to a specialized rehab center when they could just do it at their doctor's office... a little electricity, some ice, moving limbs around a bit, and boom—same thing, right? ...yeah, okay.

Chloe Garcia10 said:Hey, are you a medical professional too, Scott Allen10?

The internet is seriously driving me insane. I spent some time digging into info about dental bridging, and now everything looks terrifying.
I haven't quite wrapped my head around what the doctor said, though.
Indeed, it’s anyone's guess whether I even need it in the first place.

Just stay off the web, because if you keep searching like that, you'll somehow manage to diagnose yourself with ten extra heart conditions...😁....just look at it this way—if your EKG and ultrasound came back fine, and your stress test was pretty much okay too... then there's a huge chance your coronary arteries are wide open like the falls at Niagara... and as for that MSCT they recommended, it could have been suggested or not, and a cardiologist still wouldn't have made a mistake by ordering it....

wanderingcobra76 said:Of course it isn't simple 🙂 and naturally, by global standards, a CT coronary scan is a joint effort between a radiologist and a cardiologist; however, from the patient's perspective—once the preparation is complete, including premedication, the EKG, and setting the technical parameters depending on whether they are using prospective or retrospective gating—the whole process isn't actually all that daunting, and the time spent inside the CT gantry shouldn't be particularly long at all.🤷
In my opinion, the most demanding part doesn't even happen until later during the post-processing phase.😬

I didn't mean to imply that anyone would plan surgery based strictly on a CT coronary scan, but if the results look clean, I highly doubt anyone would feel compelled to opt for a traditional coronary angiography in that specific case.🤷

👍...I'm with you there...all five of those points...especially when it comes to post-processing...😍....

wanderingcobra76 said:As someone in the medical field, I can tell you 😉

There really isn't anything to worry about—it’s certainly not invasive like a traditional coronary angiography. You'll essentially go through the CT process just three times, and the whole thing takes maybe five minutes? (Though, most of that time is actually just the technical setup for the scan).

Hmm... I don't know, it's not quite that simple in practice... For a CT coronary angiogram to even work, you have to hit certain hemodynamic markers first. The big one is heart rate... if the patient is experiencing tachycardia, the whole thing is pretty much pointless. You have to monitor the patient constantly, which makes the process a lot more complex than people realize. Plus, a radiologist isn't going to step in to medicate a sudden spike in heart rate; you need a different specialist on hand to handle that, and so on... it's a bit more involved than that. At least, in my experience, it is. I'm not saying other places do it differently, but here in the States, when we do a CT coronary, there’s an anesthesia team right there with monitoring gear, ready to give a mix of sedatives and beta blockers via IV to get everything stable enough for a clear shot.
And another thing... a CT coronary isn't some magic substitute for a real-deal coronary angiogram. It's more like a high-tech way to get a general idea of what's happening in the coronary arteries. Honestly, it would be pretty risky to plan any major surgery or jump to a final conclusion based solely on what a CT scan shows.

edit:
My bad, I just realized you already mentioned beta blockers and tachycardia earlier... mea culpa!

I’d really rather we didn't turn this thread into a debate about specific doctors or hospital departments... honestly, it just turns into a massive mess of pros and cons from all sorts of different medical backgrounds, and then the whole point of the Health forum gets totally lost in the shuffle. This space is really meant for when you want to lay out what you're actually going through—like describing a specific condition or a symptom you're dealing with—so we can hopefully chime in with some helpful advice or perspective... if you're looking for a recommendation on which specialist to see, there's already a dedicated thread specifically for that.

So, if you could just try doing what I suggested, that would be great... once that's done, I'm planning to rename this topic since the current title doesn't really tell us much about what's going on.