Anesthesia, Resuscitation, and ICU: Q&A

Emily Sanchez90 said:Thanks for breaking that down for me. Honestly, the discomfort isn't even the worst part—what really matters is making sure they aren't in massive pain. When people are in that state, they can't even vocalize how much they're hurting, which is pretty heavy when you think about it.

On a side note, I feel like anesthesiologists should totally start a database of all the hilarious things patients say when they’re waking up and get asked their names.🤣
A buddy of mine once blurted out "Madonna" like he was answering a question in class.😁

Usually, those kinds of patients are tucked away in the ICU, where they're looked after by highly trained, specialized teams—doctors and nurses who live and breathe monitoring vitals. They're constantly on top of everything, ready to jump into action the second something looks off.
People in the ICU are basically in the safest, most capable hands our healthcare system has to offer. The only real heartbreak is that most of them are dealing with such critical situations that even the best doctors and the smartest tech in the world can't always pull them back.

urbanscout50 said:Typically, patients in those conditions are placed in Intensive Care Units where they're looked after by highly experienced, specialized teams—doctors, nurses, and techs who live and breathe critical care. These professionals monitor vital signs around the clock and are ready to jump into action the second something shifts.
Patients in the ICU are truly in the safest, most capable hands our healthcare system offers. The only real tragedy is that we're often dealing with incredibly critical cases where all the skill and expertise in the world can't change the outcome.

I couldn't agree more. From what I’ve seen in the ICU, the level of care is incredible. They go above and beyond, even helping patients with basic things like bathing or applying lotion while they're bedridden. It’s honestly impressive.

Since these patients can't speak for themselves, how does the doctor track their pain levels to know when to adjust the medication?

dr_pelo, thanks for such a detailed breakdown.

I don't have any allergies to local anesthetics. Plus, this is a major specialized surgical center—they focus strictly on hernia repairs and apparently always use local anesthesia (if my math is right, they’ve done about 17,000 of these...).

Nerve damage and chronic pain... that's the worst-case scenario. That's what I was thinking, too.
The one time I had an epidural, it took four tries before they actually hit the mark. Then I read some horror stories about people ending up with arachnoiditis from those procedures, so I'm pretty sure I'll never touch an epidural or spinal again.

Thanks again for the reply and the kind words. 👍

Emily Sanchez90 said:Totally. From what I’ve seen working in the ICU, some of the best care is just the little things—like bathing patients while they’re lying there or applying lotion. It really goes a long way.

But those patients can't even talk, right? And they're in the ICU because they're in massive pain—so how does a doctor actually track if their pain levels are spiking and if they need more meds?

If they aren't awake, we mostly look at things like pulse, blood pressure, and their breathing depth and rate (assuming they're breathing on their own).
If they *are* awake and the staff picks up on signs that they're hurting, we just ask them. Even if they can't speak, they can nod, blink, or move their lips.
Plus, most people in the ICU are on some kind of analgesic (usually an opioid or a cocktail of them) or a sedative, so they aren't feeling nearly as much pain as you might think. And honestly, once they get moved out of the ICU—if they're lucky—most of them don't remember a single thing. Just a total blank.
In my opinion, the real issue is on the regular hospital floors. You have patients who aren't intubated, who *can* talk, and who tell you they're in pain, yet they aren't getting proper pain management. Why is that? I think we've touched on this topic here before.
That’s basically why "acute pain services" exist—to have a specialized team roaming the wards to ensure patients get one of their basic human rights: living without pain, especially when it's acute pain that we definitely have the tools to manage.

Regarding the question about when the breathing tube is removed—I’ve actually had two surgeries myself, and I don't recall the actual extraction process at all. Both times, my first conscious memory was just hearing voices while being wheeled toward the recovery ward.
However, I have heard stories from others who distinctly remember the tube being pulled out, sometimes even remembering doctors calling out names to check their responsiveness, such as
"Can you hear me?" or similar. Is this experience unique to each person? Does consciousness return right there on the operating table, or does it happen a bit later during recovery, as it did for me?🤷

Brenda Jones5 said:Regarding that question about when the breathing tube comes out—I’ve had two surgeries myself, and I honestly don't remember the actual extubation part. Both times, I just started hearing voices while I was being wheeled back to the recovery room.
That said, I’ve heard stories from others who actually *do* remember the tube being pulled, or even doctors calling out their names to check if they're awake.
Is that just down to the individual? Like, does consciousness return right on the operating table, or is it more like my experience where it happens a little later?🤷

It's totally individual!
It really boils down to which anesthetic is chosen, the dosage used, and just how your specific body reacts to those drugs.
If you ask me, you actually had the better deal. Waking up from anesthesia can be pretty gnarly and disorienting, so honestly, it's probably for the best that you don't remember that part.
So, don't sweat it. You're doing just fine.

urbanscout50 said:If they aren't awake, you mostly have to rely on watching their pulse, blood pressure, and how deep or frequent their breathing is—assuming they’re breathing on their own.
When patients are conscious, if the staff notices any signs suggesting someone is in pain, they just ask. Even if a patient can't speak, they can nod. They can blink. They can move their lips.
Plus, most people in the ICU are already on analgesics—almost always some kind of opioid alone or in a combo—or maybe a sedative, so they aren't hurting nearly as much as you might think. And when they finally leave the ICU, if they’re lucky, most of them don't remember a single thing. Total memory blackout.
In my opinion, the real issue is that patients on the regular hospital wards—those who aren't intubated, can talk, and actually tell you they’re in pain—often don't get adequate pain management and end up suffering through intense agony. Why does that happen? I think we touched on this topic here on the forum once before.
That’s exactly why those "acute pain services" exist. The whole point is to have a dedicated hospital team that rounds on the wards to ensure patients get one of their fundamental human rights: living without pain. Especially avoiding that severe, acute pain that could easily be managed.

I haven't read that specific thread, but from what I've seen, the best meds seem to be reserved for the patients with the best connections. I'll have to Google "acute pain services," because that's news to me.

As for that memory gap after being in the ICU... honestly, maybe it’s better that way. It’s wild how much stuff people end up blabbing once they finally wake up. 😁

You guys have really put my mind at ease regarding everything about the ICU. Thanks again!

Emily Sanchez90 said:I haven't really followed that whole thread, but honestly, from what I've seen, the good meds usually get saved for patients who have the best connections. I'll probably have to Google those pain management services since they're news to me.

That’s just not how things work in the ICU!
Patients get whatever they need, period.
It's a different story if certain drugs aren't available because they're either used up or the hospital couldn't afford to stock them due to budget cuts. But you can count on analgesics being in every single ICU, and in plenty of supply, too!

urbanscout50 said:It varies!
It really depends on which anesthetic is chosen, the dosage used, and how your specific body reacts to those medications.
In my opinion, you actually had the better experience. Waking up from anesthesia can be quite unpleasant at times, so it’s often a blessing not to remember it.
So please, don't worry. You are doing just fine.

Thank you for the reply; I agree, it's definitely better not to remember those moments.🙂
To clarify, before this surgery, I made sure to mention—I even brought my latest thyroid lab results—that I take 125 micrograms of Synthroid. My anesthesiologist pointed out how dangerous it would be if I hadn't disclosed that medication.
My last surgery was five years ago, and about four months after that, I was diagnosed with hypothyroidism.
I think I might have forgotten to mention it during this most recent procedure simply because I was so nervous. Could you briefly explain why there is a risk when combining Synthroid and anesthesia?

Thanks.

urbanscout50 said:That’s just not how ICU works!
Patients get whatever they need.
It's a different story if certain meds are missing because they ran out or the hospital couldn't afford them due to budget cuts. But you can bet any ICU has plenty of analgesics on hand!

I wasn't talking about the ICU; I meant the wards leading up to it. 😁
I actually ended up buying medications myself because my anesthesiologist told me the hospital didn't have what was needed, though she thought it would be a good idea if I could track it down. So, I bought it. It was expensive, sure, but I truly value her dedication. In that moment, she went way beyond her job description—she showed such incredible humanity by going above and beyond to help. You could really feel that effort.

Hey everyone. I’ve been lurking on this thread for a long time now. I have an upcoming surgery myself, and honestly, the anxiety is starting to kick in—probably because I already had to go under the knife twice when I was a kid. The whole reason I need this procedure is for ptosis in my left eyelid. During my follow-up last month, the doctor mentioned they'd be doing the surgery under local anesthesia. Does anyone know what specific kind of local anesthesia they actually use for this type of thing?

I’ve been wondering about the protocols regarding general anesthesia during pregnancy. It is my understanding that general anesthesia is typically considered an absolute contraindication, much like how one might avoid certain high-risk maneuvers in other delicate situations, but what happens when delaying surgery until after delivery poses a genuine threat to the mother's health?

Olivia Howard45 said:I was wondering if surgeries under general anesthesia are actually done during pregnancy? I know general anesthesia is usually a huge no-no when you're pregnant, but what happens if waiting until after the baby is born would actually be bad for the mother's health?

Look, if a surgery and anesthesia are absolutely necessary, then they just go ahead and do it. It’s not like doctors just wing it; they carefully pick specific anesthetics and techniques designed to have the smallest possible impact on the baby.
The real danger zone is during those first three months—what we call embryogenesis, when all the organs are basically being built from scratch—so doctors always try their best to push any non-emergency procedures to a later stage in the pregnancy.
If someone is in the late stages, getting close to their due date, and a surgery is decided upon, you wouldn't just have a standard surgical team in there. You'd definitely need an OB/GYN on standby with a fetal monitor to keep a super close eye on the baby, just in case they need to jump straight into an emergency C-section if things look dicey.

Brenda Jones5 said:Thanks for getting back to me, and yeah, I totally agree—better to just forget about those old memories.🙂
Anyway, before this surgery, I made sure to be super clear, like, "hey, listen up," and brought my latest thyroid labs showing I’m on 125 mcg of Synthroid. My anesthesiologist pointed out how risky it is if you don't mention that medication.
My last surgery was five years ago, and then about four months later, I got diagnosed with hypothyroidism.
I think I was just so nervous during that last procedure that I completely blanked on mentioning it. Could someone give me the quick rundown on why Synthroid and anesthesia can be such a tricky combo?

Thanks.

It’s not even really about the pill itself, more about how your whole system handles the stress of something like surgery, and your thyroid hormone levels play a huge role in that.
If your levels are dialed in and you're properly supplemented, you should be fine. It’s mostly just important for the anesthesiologist to know so they can note your regular meds and make sure there isn't a gap in your treatment.
With hyperthyroidism—especially if it's untreated or if someone's overdoing it on hormones—you can run into some scary stuff during surgery, like crazy high blood pressure, a racing heart, or a fever. Those are all pretty serious, especially for anyone with existing heart issues. If the anesthesiologist doesn't realize thyroid hormones are part of the equation, they might waste precious time trying to figure out what's causing the "glitch" instead of treating it right away.
Hypothyroidism isn't quite as "wild" during the actual surgery and anesthesia; you might just see slightly lower blood pressure or a slower pulse. The real headache usually happens afterward when patients take longer to wake up or their overall recovery feels sluggish. That’s easily handled with a little Synthroid tablet, provided the patient actually told them they were taking it (or needed to).
Usually, doctors will just push the surgery back until your thyroid levels are stabilized, whether that means suppression or replacement.
Hope that helps clear things up!

Help me out here. Seriously, I need some advice because if this doesn't get sorted, I’m probably going to bail on my surgery, and I really can't afford to just walk away from this.

urbanscout50 said:I hope you find this explanation helpful.

Thank you, I really appreciate it. It has helped clarify a few things for me.🙂
To be honest, when I was waking up from anesthesia about five years ago—before I started my current medication—it felt much smoother. I would come around quickly, without any nausea, and didn't feel overly drowsy during that first day.
However, since starting this second medication, the experience has been quite different. I struggled to speak, felt stuck in a sort of constant fog, and spent most of the day dealing with nausea and feeling incredibly weak and exhausted.😢

Hey everyone,

I’ve been lurking here for quite a while now—honestly, at first it was just pure curiosity, but lately, it’s become more of a necessity 🙂
So, basically, I ended up needing surgery on my sinuses, specifically the paranasal ones.
The exact moment my ORLOG doctor told me that the surgery was optional (which my primary care physician had also mentioned previously) and I agreed, and then he started writing down that I was scheduled for procedures at the Mayo Clinic and that I should head to the front desk to check my appointment time... man, that feeling is priceless. There I am, staring at this paperwork, having absolutely no clue what "FESS" even means,
other than maybe some kind of sinus surgery, but I definitely knew what the abbreviation meant regarding anesthesia—endotracheal anesthesia. Total panic. I started getting these massive flashbacks of health anxiety, projecting scenarios where they wouldn't be able to intubate me, or how my blood pressure might be too high, etc. In short, I went into a state of panic equivalent to the first time I ever had to give a public presentation to people
who were complete strangers. So, anyway, I set the date, got stamped with a thousand different tests, and immediately grabbed the internal referrals...
At that point, I slowly started picking up anesthesia textbooks (Lognecker) and ENT manuals, since I decided it would probably be better for my mental state if I stopped checking the forums for a bit.

In the meantime, I had my consultation with the anesthesiologist (everything was fine up to that point), and I remembered those comments posted here 😉 about how you can—and really should—speak openly with them, tell them everything that worries you about anesthesia, and ask any questions you have. And that’s exactly what I did. 🙂 One of my questions, when the anesthesiologist looked at me with that "OMG, are you one of us or just a hypochondriac?" kind of vibe, was whether they perform this specific surgery while I'm in a hypotensive state. Toward the end of the exam, because I had three hives of unknown origin, the doctor offered
either allergy testing or some kind of "protection" before the surgery—to make sure I don't break out in a rash on the operating table, he said. And I told him, look, it doesn't matter if I get a rash, what matters is that I don't go into anaphylaxis. So, allergy testing it was.
I was relieved to find out if I was allergic before hitting the table, though the doctor performing the test was pretty skeptical about why we were doing it... thirteen stabs and a few pretty painful ones later—turns out, I am indeed allergic to almost all relaxants except Atropine, plus I'm reactive to the others, like Midazolam. Copy that report and carry it everywhere with you, and just make sure
that the anesthesiologist who is going to, you know, treat you 🙂

And, looking through Lognecker, Atropine lasts much longer than the others, and almost twice as long as what I actually need for my procedure... just let it go, rapidgull94, I told myself, and I enjoyed life until hospitalization. I eventually made it to the pre-anesthesia exam (the third one, by the way 🙂. There was this incredibly sweet anesthesiologist,
I ran into her in the hallway that day; she’s in the OR from 8 AM, and she drives every single patient back to the ICU after surgery. You can imagine how much of a hero she seemed to me in that moment. It was already late afternoon, and she looked visibly exhausted. She checked me over and gave me a brief rundown (without using any heavy medical or anesthetic jargon) of her part of the job. Then, being a bit of a jerk, I asked: "Can I ask something now 🙂" about which relaxant they'll be giving me (since I knew exactly which ones were left that I wasn't allergic to). She just said, "Anesthesia without a relaxant." My mind raced—how are they going to intubate me? Okay, fine, they can intubate me, but what if I move right at a sensitive spot during the surgery? And most importantly, who is going to anesthetize me? Well, I won't be doing it, and I'm only available on the days you guys are on the schedule. Goddamn, she really made an impression on me.

The night before the procedure and again in the morning, I was given prophylaxis consisting of Synophene and Solu-Medrol, but I didn't get any anxiolytics, sedatives, nothing. My "anxiolytic" was my own doctor, who checked in on me both the night before and the morning of. And several times after the surgery. Okay, Synophene makes you *very, very* sleepy. On the way to the OR—I asked the nurse if they had taken all my lab results...
Do you guys have the CT scans from the imaging department? Or maybe an allergy test result—wait, yeah, I have one. Just kidding. A microscope. I really want to see a microscope. Honestly, they probably wouldn't even let me, they’d just knock me out with one of those tranquilizer guns they use for cattle. So, looking at the crowd I managed to count: two scrub techs actually working, one who clearly isn't, an anesthesia tech, the lady who wheeled me from the unit, the nurse positioning me on the bed, and some gentleman who asked me to scoot over so my head would sit better on the pillow—and no, before you ask, I am not the anesthesiologist. Nobody is talking to me, but I’m just sitting here watching everyone. I’m staring at the Drager machine, too. Such an imposing piece of equipment. I’m trying to spot where the CO2 absorber canister is located, but I can't find it, which is a total letdown. On this Drager, the mask is made of this gross, brownish-translucent rubber. It's nasty. And still, absolutely nobody is addressing me.

I mean, why didn't they just look at my pre-medication records and realize, "Hey, he's not sedated yet, this would be great"? 🙂 If anyone would just say something to me. But then again, is it dangerous if I start peppering them with questions?

Then comes Nurse Brenda Jones5. She’s an anesthesia nurse/tech. A familiar face. I ask her, "Are you Nurse Brenda Jones5?" and she goes, "Yes, yes, I remember you!" Great. Maybe she’ll actually be communicative. And she was. <3. There's a pad on my foot. Is that char from the cautery? An EKG?
A pad on my chest. Okay, that's the EKG. Then a cuff on my right arm, and then a cuff on my left arm. WTF? Just in case, I guess, it's your classic blood pressure monitor. Okay, as long as Nurse Brenda Jones5 is here, I think I'll be fine.

The anesthesiologist walks in and greets me. She asks if I have any allergies to local anesthetics. I had to exercise a massive amount of self-control not to say something rude to her. I don't. But I am allergic to relaxants. "I know, I know," she says. She looks at me, looks at the mask, and starts searching for a new one. Looking for an 8mm? Probably the tube. I lift myself up off the bed and glance at the vitals monitor. Okay, which number is the BP, which is the pulse, and which is the oxygen saturation? Two numbers are slightly under a hundred, and two numbers are hovering around 150. Fuck.
To all the anesthesiologists (I hate it when I don't know their names)—is it going to pass once you knock me out? I really hope so. That is definitely not the answer I want to hear a few minutes before anesthesia.

And there we go. I'm hooked up to everything—IV lines everywhere, one tube for saline, and then Nurse Brenda Jones5 jams the Propofol syringe into my other line. Here it is. I know how long it takes to kick in, and I know plenty of people experience pain or a burning sensation. To my surprise, I didn't feel the need to watch it happen; I just lay back and waited. Someone tossed something onto my chest. I couldn't care less what it was. Was it starting to work? Did she give me a little dose just to drop my blood pressure?
I remembered reading somewhere that Propofol affects the cardiovascular system and lowers blood pressure. So, I figured my pressure was about to tank. It's taking a while, though, so I lift my head and see that the line running from the saline bag into me is cloudy. What? I say, "Nothing is happening." They swap out the saline and finally give me a decent dose. "Goodnight," says the anesthesiologist. "Grrr—thanks," I mutter. And then, a flash of panic hits me because I realized I'm under anesthesia without any relaxants, and Propofol won't stop my breathing—give me oxygen! She gently places the mask over my face; I try to take the deepest breath possible, but then I start shallow, panicked breathing. "Breathe deeply," she tells me. I take two more deep breaths. Have we flushed out the nitrogen? Now I can hold my breath until they intubate me.
Two more times—"goodnight"—"thanks," and now I'm getting dizzy. Which is exactly what we're aiming for. "Goodnight"—no response. The next thing I remember is intense... coughing, coughing. Someone is adjusting the bed. I can't see anything, I just hear and feel things. Someone holds my shoulder and—bam—back into a deep sleep.

Christ—this is like a light version of my fate... to get straight to the point—I have a few questions, mostly just out of curiosity, if anyone has the time or inclination to answer them. 🙂

So—regarding the allergy test—since I'm allergic to the aforementioned components of anesthesia—is it standard practice to write some kind of
"card" listing the substances I'm allergic to—with the doctor's name and the composition—or am I actually supposed to carry an A4 printout in my wallet?

The physician who performed my allergy test told me that it isn't even that precise anyway, since allergens are introduced under the skin, and the skin reacts to physiological saline too. In other words, it primarily reacts to the physical stimulus of the needle prick and the fluid being injected.
And then there are the mast cells... right?

I'm curious how you guys actually handle patients—from an allergy standpoint—who go into anaphylaxis right there on your table? Like, who takes over the follow-up, and what's their specialty? In my case, I was handled by a clinical pharmacologist (which, if you're reading between the lines, might give you a clue which hospital system I was at).

Also, why on earth did I get prophylaxis with Synopene and Solu-Medrol when they were running anesthesia with Propofol and Fentanyl through an oxygen tube? I'm definitely not allergic to those substances, and honestly, can you even be allergic to Propofol? Or maybe it was a reaction triggered after the Fentanyl hit? (Maybe an allergy test thing?)

Is it actually "normal" to run parallel infusions of saline or whatever else through the same IV line with two lumens?
Because when they were putting me under, they inserted a second IV line.

Does Propofol drop your blood pressure by an average of 20mmHg? Is that systolic and diastolic?

Why do they rub ointment in your eyes?

I had this pain in my lower back that lasted for three weeks after the surgery—could that be related to lying on the table for so long? Could it have been prevented by keeping my knees slightly flexed?

How do they decide on volume replacement? I ended up getting 1.5L of saline plus another 0.5L during the procedure while I was in the ICU. Is that based on estimated blood loss or just how much fluid someone should ideally drink in a day?

I haven't asked anyone yet, but what do you think—did they have my head fixed in place during the procedure, even though I didn't have any relaxants?

In endotracheal anesthesia without relaxants, since I'm breathing on my own, what role does the anesthesia machine actually play? How does it deliver the gases—is it under pressure? How do you set it up so it stays in sync with my own breathing? And what happens if my depth or frequency changes mid-way? Does that change during the anesthesia process?

My pressure stayed at 120/65 throughout the whole anesthesia—does that mean I had enough anesthetic, or...? I mean, shouldn't it fluctuate?

I saw that crazy little thing that changes color based on CO2 (to check if the tube is in the right spot)—is that a single-use thing, or do they sterilize it?

About 3 or 4 days after the anesthesia, my incision developed this little blue "spot" right at its peak. Any idea what that could be?

Thanks so much in advance for the answers 🙂 and sorry for this total life confession;S

rapidgull94 said:Thanks so much in advance for any help 🙂 and sorry for the whole dramatic vent session ;S

😁....man, you could honestly write a novel with this stuff....it’s such a wild experience....though I feel like you might have handled the whole thing a bit easier if you hadn't been so "involved" in all the details....but hey, everyone has a right to know what they want to know, especially when it involves things like anesthesia procedures which...cough, cough...can sometimes lead to unexpected hiccups...

Anyway, I'll try breaking this down from the bottom up so you can follow along...

- That little scratch, I'm guessing it's nothing serious, probably just a tiny bruise from some of the gear being moved around during the procedure (like the tube, laryngoscope, airway, or suction catheter)...doesn't sound scary at all...
- Your blood pressure was fine...those little ups and downs aren't really worth worrying about.
- The CO2 absorber is basically a plastic canister sitting inside the breathing circuit on the exhale side, and it changes color from white to purple depending on how saturated it is with carbon dioxide (using stuff like soda lime...). It isn't there to check if the tube is in the right spot. We don't use soda lime once and toss it; it's just part of the circuit, and on modern machines, you swap it out roughly every week (the machine actually pings you) or whenever the CO2 monitor starts acting crazy because the soda lime is full. To check if the ET tube is placed correctly, you usually don't need a specific tool—you just see it happening in real-time, and it’s usually a total scramble...like, "wait, the chest isn't rising...stethoscope...nothing...crap...get me a laryngoscope/Ambu bag/new tube"...then bam, everything is fine again...🙂....The CO2 monitoring we use routinely can definitely show you where the tube is, but it’s a nightmare for an anesthesiologist if the CO2 waveform on the monitor is the *only* thing telling them the tube isn't in the trachea....basically, the CO2 absorber and CO2 monitoring are two totally different things.
- Just because you had ET anesthesia without a paralytic doesn't mean you were breathing on your own. Even without the relaxant, you probably weren't doing the heavy lifting yourself; you were likely being ventilated through the ET tube by the anesthesia machine while inhaling a mix of nitrous oxide/sevoflurane or isoflurane on one of the various ventilation modes. There are endless ways to explain those modes—textbooks are practically thick enough to use as doorstops just trying to cover them all. To put it simply, depending on how the patient is doing and what settings we want, there are three main groups: controlled, assisted, and spontaneous. You can control ventilation via pressure, volume, or flow (though that last one is rare). If you're feeling particularly masochistic, go ahead and Google SIMV, CMV, PCV, BIPAP, AC, APRV, CPAP with or without ASB, PEEP... On an anesthesia machine (or the ventilators they use in places like JLL), you can see every single detail of the breathing or ventilation; the machines in assisted or spontaneous modes sync up with any natural breaths you take and supplement them in a bunch of different ways....so yeah, that's the gist.
- As for your head being fixed in place...I haven't seen any weird, mysterious head stabilizers used in ENT departments here. Honestly, you were under such deep anesthesia that I'm pretty sure you couldn't have moved your head even if you tried, even without the muscle relaxants.😁
- Honestly, how much fluid they pump back into you depends on what your anesthesiologist sees happening in real-time—they’re looking at things like how much you bled during the procedure, how long the surgery dragged on, your urine output if you had a catheter, the specific type of anesthesia used, and your lab results. Plus, you can't forget about all that moisture lost just through breathing while you're under.
- That lower back pain? It’s almost certainly because you were stuck lying perfectly still on the operating table for so long. As for bending your legs... honestly, just find whatever position feels comfortable for you, provided there aren't any medical reasons why you shouldn't.
- They put that ointment in your eyes because when you're under anesthesia, your eyelids often don't close all the way, and more importantly, they stop doing their job of keeping things lubricated. That ointment is basically there to prevent any accidental damage to the eye surface.
- How Propofol hits your blood pressure is pretty much unique to everyone, though most people will agree it tends to pull it down—but then again, there are so many other meds involved that it's hard to pin down exactly which one is the "culprit," and in anesthesia, we're usually just keeping a close eye on your systolic numbers anyway.
- Using a dual-lumen IV line along with infusions and specific meds is actually super common; it’s really just a matter of how the tech handles the setup depending on what's happening with the patient.
- I'm not totally following you on the whole allergy testing thing, but it sounds to me like you might have been a victim of "overkill"—sometimes having way too much medicine thrown at you can be just as rough on the system as not having enough. 😁

I honestly don't know how people deal with this stuff without losing their minds, I really don't. You see someone like brightwolf9 posting about their experience and you just think, "Yeah, that sounds about right," because life is just one long series of unexpected hurdles, isn't it? It’s like when you’re driving down a highway in Chicago and suddenly everything just goes sideways—you can't plan for it, you just have to react. And speaking of reacting, I was thinking about what Scott Allen10 mentioned earlier regarding the whole situation, and it really hits home how much we all just rely on luck sometimes. It’s exhausting, honestly. You try to follow every single rule, you stay on top of your health, maybe you even take your Synthroid exactly like the doctor told you, and then boom—life happens. It’s easy to get cynical, but I try not to. I really do. I think if we all just took a second to breathe and realize we're all in this messy boat together, things might feel a little less heavy. Anyway, I'm rambling now, my bad. Just one of those days where my brain won't stop spinning. kaže:
😁Man, you could seriously write a novel with this stuff... honestly, such an intense experience. I can't help but think that maybe everything would have been a little easier for you to swallow if you hadn't stayed so "involved" in all the details... but hey, what do I know? Everyone has a right to satisfy their curiosity, especially when it involves things like an anesthesiologist's procedures which... well, let's just say they can sometimes have some pretty unexpected side effects.

Man, I don't even know where to start with this one, but honestly, what do you guys think is actually the best way to go about it? For me, I found the whole thing pretty eye-opening, like, I walked away with a lot more insight than I expected to get, you know? 🙂 Honestly, the whole medical team was just beyond professional—like, seriously top-tier. But man, the stress is killing me... it’s that constant, obsessive need I have to feel like I’m actually in control, you know? Like, if I can just wrap my head around exactly what’s going to happen next, I might actually stay sane. But that's just how I'm wired, I guess. It’s been that way my entire life, in basically every single thing I do :S

I was just sitting here thinking about how much everything changes, you know? Like, one day you’re cruising along, thinking you’ve got the whole thing figured out, and then suddenly life throws a curveball that makes you question every single decision you've ever made. It's wild. I was reading some of those threads earlier—shout out to brightwolf9, by the way, because your perspective on the whole situation really hit home for me—and it got me spiraling down this rabbit hole of "what ifs." It's funny how we all try to find these patterns in the chaos, right? We look for rules, we look for logic, but sometimes there isn't any. You just have to ride the wave. I mean, I’m definitely not an expert, and I probably ramble too much, but I truly believe that being honest with yourself is the only way to actually move forward. Even when it's messy. Especially when it's messy. Anyway, just a thought I had while staring at my coffee this morning. Hope everyone is hanging in there. kaže:
So, just to clear the air on this one because I feel like there’s been some confusion lately—that CO2 absorber isn't there to tell you if your tube is sitting where it should be. It’s basically just a plastic canister tucked right into the expiratory side of the breathing circuit. Its whole job is to soak up the carbon dioxide using stuff like soda lime (you know, that calcium hydroxide mix), and the only way you'll really know it's working is by watching the color change from white to purple as it gets saturated. It's a chemical indicator, not a positioning tool, so don't go relying on it for placement!

Wait, wait, hold on—are we talking about closed-loop systems here? Because if that CO2 adsorber is running while it's actually in the middle of adsorbing, I honestly had no clue the machine was smart enough to give you an automated alert like that.
I was thinking along these lines:
I can't really click through to that link properly on my end, but I think I see what you're getting at with that product shot! It looks like one of those specialized medical supplies—maybe some kind of surgical instrument or a specific piece of equipment? Honestly, looking at stuff like this always makes me go down a bit of a rabbit hole. One minute I'm just glancing at a thumbnail, and the next, I've spent twenty minutes reading the technical specs and wondering about the logistics of how they even ship these things around the country. It’s funny how much detail goes into these tiny little items, isn't it? You look at it and think, "Okay, it's just a tool," but then you realize it's part of this massive, incredibly complex web of healthcare in America. It reminds me of that time I was reading up on how hospitals manage their inventory—it’s basically like trying to run a giant warehouse in Chicago while simultaneously performing surgery. Everything has to be perfect, right when you need it. Anyway, if there was something specific about this item you wanted to chat about or if you were looking for a comparison to something else, let me know! I'm happy to geek out over the details with you.

I am like, 100% positive that the anesthesiologist pulled that thing right out of her kit, but honestly, having something that shifts colors based on CO2 levels would be such a game-changer for lab work—so I figured I’d double-check if that was actually what it was.

I honestly can't even begin to wrap my head around how much things have changed lately, you know? It feels like just yesterday we were all sitting around talking about the basics, and now everything is moving at a hundred miles an hour. I was reading what Scott Allen10 was saying earlier—and I mean, I totally get where they're coming from, really I do—but there's just this underlying feeling that we're missing the forest for the trees sometimes. It’s like when you're driving down a highway in the Midwest, everything looks so flat and uniform, but then you hit one of those unexpected construction zones and suddenly the whole rhythm of your trip is thrown off. That's how this feels. We're cruising along, thinking we've got a handle on the situation, and then *bam*, a new variable pops up and we're all scrambling to adjust our expectations. I don't want to sound like a broken record, but I really think we need to slow down and actually digest what's happening instead of just reacting to the immediate noise. It's easy to get caught up in the hype or the panic, but if we take a second to breathe, maybe the path forward won't seem quite so chaotic. Anyway, just some rambling thoughts while I sip my coffee and try to make sense of it all. kaže:
Look, the standard CO2 monitoring we all use every single day can definitely give you a hint about where things stand, but honestly? It’s pretty pathetic if an anesthesiologist only realizes they aren't actually in the trachea because they finally notice the CO2 waveform disappearing on the monitor... I mean, come on. Also, just as a side note for anyone getting confused, let's be clear: the CO2 absorber and CO2 monitoring are two completely different things entirely.

Man, I honestly wouldn't have even noticed the CO2 monitoring if it wasn't for that time over at Lognecker when I saw the concentration curve spiking like crazy because the tube was actually sitting in the esophagus... you know how it goes, just sitting there with those muffled stethoscopes and trying to watch chest rise like it's some kind of high-stakes guessing game.

Scott Allen10 said:Look, if you're actually some kind of masochist, just go ahead and Google SIMV, CMV, PCV, BiPAP, AC, APRV, CPAP—with or without ASB, PEEP, whatever...

I guess I should've looked at your previous post to see if I really am a masochist, 😉but by then it was probably too late, though once I actually dive into all that stuff, would it be okay if I hit you up via DM if I run into anything confusing? 😉

Scott Allen10 said:- regarding the whole allergy situation and those allergen tests... I don't quite follow you there, but I get the impression you were basically caught in a crossfire of being overmedicated, which honestly, having way too much medicine can be just as bad as not having enough...😁

Man, I totally would have agreed with you right up until the moment I realized I actually *am* allergic to anesthetics and muscle relaxants. Once you've dealt with a hellish bout of hives from a mild anaphylactic reaction, you realize there's such a thing as too much medicine. 😉

Thank you sooooo much for taking the time out of your day to give me such thoughtful answers. 😁

rapidgull94 said:Yeah, yeah, you mean for closed circuits? A CO2 adsorber works while it's actually adsorbing. I didn't realize the machine would flag it itself <3 I know from my chemistry background that it should probably be heated up.

I was thinking more along the lines of this:
http://www.lifemedicalsupplier.com/i...image&pID=3416

I'm almost 100% certain the anesthesiologist pulled it right out of the packaging, and since having something that changes color based on CO2 levels would be pretty handy (for labs), I just wanted to check if that was what we were talking about.

🙂.....now I'm pretty sure you didn't actually see what you linked, but rather something very similar to it...basically this...meaning an HME filter, which tons of different manufacturers make.

That Statista detector you linked doesn't really make sense when you consider that every single operating room or JLL setup already has full gas monitoring. Maybe it’d come in handy in some field conditions, like during transport or in an ambulance... basically where they don't have gas monitoring and need this as a backup (though even then, I can't imagine anyone checking the tube location that way).

An HMEF (heat-moisture exchange filter) is a piece of gear that filters while also keeping heat and moisture inside the patient's lungs; you swap them out after every patient, or at most, they stay in for 24 hours.

The actual gas monitoring I was telling you about looks more or less like this...usually you have a monitor or a gas module that plugs into a compatible monitor...you've got a CO2 sensor, which is mostly located within the respiratory circuit as close to the ET tube as possible (the tube comes out of the mouth, there's the HMEF on it, and then the CO2 cuvette with the sensor sits on top of that)...and once you set everything up properly, after the initial calibration, it's basically just "PressPLAY"😁....or sometimes the monitor just shows the end-tidal CO2 curve and the numbers right away...

edit - just so we aren't getting confused, my description of a CO2 absorber and yours aren't the same thing. I was talking about soda lime/calcium hydroxide as an absorber... whereas you're talking about Starbucks, which isn't an absorber, it's a detector...