Regarding curettage, I have mostly observed procedures being performed under short-term intravenous anesthesia, though I am aware some doctors opt for local anesthesia alone, which ultimately proves to be quite painful for the woman...
Since you're receiving infiltration anesthesia, there aren't many other options—unless, of course, you have an allergy to local anesthetics, in which case we could always pivot to a different type...
Beyond those options, there are plenty of other combinations available... for instance, one could utilize regional anesthesia or a central block paired with light general anesthesia. In those scenarios, there isn't always a need to force an endotracheal tube down the throat, or what we more commonly just call a tube.
The difference lies in the administration method, the specific drugs used, and how the anesthesia is built up. Nowadays, we mostly use balanced anesthesia; this means induction happens intravenously, while maintenance involves a combination of inhaled gases—like a mixture of a potent anesthetic such as Sevoflurane, N2O, and oxygen—alongside other IV medications, primarily analgesics and sometimes muscle relaxants. If a shallower plane of anesthesia is desired, such as for short procedures where relaxation isn't necessary, intravenous anesthesia is typically used. Depending on the duration of the procedure, this can be paired with inhalation via a mask, though without additional drugs to deepen the state. You likely received an IV induction for your tonsillectomy as well, since that helps avoid some of the unpleasant side effects seen when transitioning through the stages using pure inhalation...
Honestly, the smartest move would be to call 911. It could be vasovagal syncope, but we can't rule anything out—low blood sugar seems less likely here. You absolutely need to rule out an arrhythmia; there’s something called Adams-Stokes syndrome that sounds like it might match your description perfectly. Which part of your back was hurting, and what did the pain feel like? Given that you also hit your head, an ER evaluation is definitely necessary...
silverridge36 said:Are you serious? The surgeon makes all the calls... But what if the brain is in terrible shape, or the patient is just too weak—dealing with blood sugar issues or high blood pressure? Can a surgeon really just ignore all that and proceed with surgery anyway? Shouldn't there be some kind of medical board before an operation to decide if someone is actually fit for it? The doctor who operated on my dad told me there was absolutely no committee involved.
I just explained above who manages those specific concerns—the anesthesiologist and the internist who performs the preoperative clearance. As for the core reason for the procedure itself, the final decision rests with the surgeon performing the operation...
Ultimately, it is the surgeon who determines if surgery is necessary. While a neurologist might suggest that a surgical intervention is warranted, the final decision and the responsibility for the procedure itself rest solely with the surgeon. Regarding the anesthesiologist, their role involves assessing the patient's overall health to determine if they can safely undergo the procedure. If they decide the patient isn't in the best condition at that moment, they have the authority to pull them from the schedule, just as Scott Allen10 so aptly pointed out. As for the anesthesia itself, there isn't a simple answer to that question; you don't just choose between two or three different types of anesthesia. Instead, it involves various physical methods and a combination of different anesthetic agents, analgesics, relaxants, and many other medications used to facilitate the process. It is a highly individualized assessment where a general plan is established, but the specific approach may shift during induction based on how the patient responds in that exact moment.
This is the most common infusion solution you'll see; it's a crystalloid used primarily for volume replacement. It doesn't act as a painkiller—it’s essentially just standard saline in a bag that is isotonic with our bodily fluids, for the most part, though not all of them. You were given it to compensate for the fluid and blood loss during surgery, along with the natural losses we all experience continuously after an operation.
There is no need to cut eggs out of your diet just yet; even if your total cholesterol looks high, your HDL and LDL levels are excellent. I would suggest repeating the blood work after fasting for three days and avoiding fatty foods, then testing first thing in the morning. Please let me know what the new results show... If you had something heavy or greasy that day, or even the day before, the readings might be falsely elevated.
While we wait for urbanscout50 to weigh in, here is my take on this. Certain anesthetics can certainly trigger nausea and vomiting, which is why antiemetic drugs are standard protocol following surgery. However, prolonged vomiting is almost always a direct consequence of the surgical procedure itself rather than the anesthesia, particularly when propofol is used as the induction agent. There are several different ways to prevent these symptoms, so it is quite possible your discomfort wasn't addressed by the anesthesiologist...
Generally speaking, things should turn out fine. Most issues tend to arise only if you fail to stay consistent with your prescribed medication, but even then, those situations are manageable. Anesthesiologists often enjoy experimenting with different drug combinations; they really are masters of the medical cocktail...
That single sentence says it all; that final point alone proves it isn't intense, but let’s move past that for now. What exactly do you mean when you say one side is lagging? Regarding the respiratory arrest—is it a sudden stop, or does it just become increasingly difficult until they are once again dependent on a ventilator?
Perivascular or periventricular? Periodic respiratory failure can stem from various causes, and it isn't always strictly neurological. Which department is JLL's father in? Anesthesiology or neurology?
Just a quick observation regarding that step-by-step approach to patient care. In essence, that is how most things are handled, from performing exams on one another to suturing pig snouts or practicing injections on mannequins... As for lung auscultation, I have never asked female patients to remove their bras because it simply isn't necessary, though occasionally heart sounds can be difficult to hear without doing so, but sometimes...
Look, about 90% of medicine can't be learned from a textbook alone. If you just graduate, finish an internship, and then expect someone to work independently without any hands-on experience or supervision... well, we'd end up losing half the population. Unless you view this as some sort of way to solve overcrowding, I don't see the point... Besides, isn't it true that residents learn under the direct supervision of specialists? It's the same for students and interns. You aren't actually getting lower-quality care just because a student or intern examines you; if anything, they're often the ones who take those "routine" things—like patient history and physical exams—extremely seriously. Plus, their work is always reviewed and corrected by a senior doctor. Most medical schools are now moving toward keeping groups small, ideally no more than four students per doctor, if possible... I really think those claims of ten students per group are mostly unfounded, at least based on what I know about the universities I'm familiar with.
Then don't complain when an inexperienced or incompetent doctor examines you, makes the process uncomfortable, and then just throws a diagnosis at you... because those are clearly the kind of doctors you prefer...
My intention wasn't to question the importance of personal privacy or human dignity—heaven forbid. I was simply noting that people often generalize students as being overly anxious or unprepared, and I meant that those instances aren't necessarily the norm, unless they happened to encounter a particularly rough cohort. That said, I completely agree that having a doctor surrounded by ten observers while examining a patient is uncomfortable. Because of this, smaller groups are being formed; usually no more than four people, and even then, they are scheduled so that there are ideally only one or two people present per patient. It is a much better approach for a student to eventually conduct examinations independently once they have gained sufficient experience. Establishing that direct rapport makes the patient feel far more at ease through one-on-one interaction. This is actually the standard practice in the US and Canada, where university hospitals—which typically offer the highest quality care in the country—operate by having a student perform the initial exam before referring the case to the attending physician.