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Anesthesia, Resuscitation, and ICU: Q&A

Started by Sean Doyle · · 👁 24 views · 1K replies

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Participants Sean DoyleScott Allen10Casey Palmer5Jose Miller3stormylynx14Donna Robinson5quietharbor2Kenneth Hernandez67Betty Bennett10Gary Jones10Walter Garcia6feraleagle75rowdyfox12Eric Robinson81Jack Gonzalez4Drew Kim3granitetrucker11hiddenscout362electricpanther82Michael Sanders54Justin Alvarez4Thomas Roberts2Jeffrey Palmer7casualraven55 …
Christian Wood2 Christian Wood2 Newcomer
3 messages
joined Feb 2016
#861 ·
Can someone who actually knows their stuff tell me how to best prep for an upcoming surgery? It’s going to be about a 2-hour procedure to fix my septum and nasal pyramid (but honestly, just general advice for any surgery works too).
So, I was wondering what I should focus on eating—and more importantly, what I should stay away from—during the week leading up to the big day.
Also, what’s the move for the day before? Like, what should I eat, what should I drink, and what's the best thing to have for my last meal the night before?
And maybe, if anyone knows, what’s good to take to help me chill out and get some sleep the night before?
Lastly, any tips on how to deal with the nerves and that racing heart feeling right before things kick off, like an hour or two before the surgery?
shadownomad43 shadownomad43 Member
35 messages
joined Apr 2016
#862 ·
Well, I figured I’d share a few thoughtful observations, given that I actually have some lived experience to draw from...
Basically, I was discharged from the hospital this past Friday following my twelfth surgery. Out of those twelve, ten were performed under general anesthesia.
So, here is how it goes...
I’ve learned one vital little lesson: the experience of general anesthesia varies drastically depending on which hospital you are in and, perhaps more importantly, which anesthesiologist is on duty.

During my first six anesthesias, everything went perfectly smoothly. No side effects, no complications, though those procedures happened quite a while ago—somewhere between 1970 and 1996—and since all my pre-op testing was done right at the hospital after being admitted, I don't truly remember the specifics of what they actually did to me during those sessions.

For surgery number seven, I was rushed straight to the operating table via the ER. The anesthesiologist on call that day was clearly a master of her craft; based on nothing more than a few brief mentions of my medical history and without any formal pre-op workup, she whipped up a perfect cocktail. I woke up from that anesthesia feeling as if I had just woken from a dream, completely free of any lingering issues or side effects. I can't praise her enough.

Then came surgeries eight and nine. These were scheduled in advance with the surgeon, and I completed all my pre-op screenings before arriving at the hospital. I also sat down for a consultation with the anesthesiologist beforehand, but apparently, that made no difference at all, because those experiences were pure nightmare fuel. Waking up to intense nausea, vomiting, and total physical exhaustion... it was honestly a horror show.

As for surgery number ten, that took place just a few days ago, specifically on November 30, 2016, again as a pre-arranged appointment with my surgeon. I went through all the standard pre-op checks and spoke with the anesthesiologist upon admission. Given my previous bad experiences, my knees were shaking a little, but it turned out to be unnecessary anxiety because, much to my astonishment, the anesthesia was absolutely wonderful. It was genuinely as if I had simply drifted out of a beautiful dream. I didn't deal with any of those postoperative issues like nausea or vomiting. I am truly, positively surprised by how well I handled it this time.

To summarize...
I am certainly no medical professional, so I don't know the exact "cocktails" these anesthesiologists mix to put patients to sleep, but it is abundantly clear that the RATIO of the substances used is incredibly critical.
You have certain anesthesiologists who likely don't believe in holding back, mixing up a concoction strong enough to drop an ox, and then you have those who pay close attention to the patient's overall condition—considering the basics like weight, height, and so on—and tailor a formula that is, quite literally, a magic potion.
I have such immense respect for those types of anesthesiologists; they clearly know their business and approach their patients with genuine humanity and responsibility.

This most recent procedure was the absolute gold standard, thanks to a brilliant surgeon whose skill and expertise turned the operation into a literal masterpiece, and of course, thanks to the anesthesiologist (who I later learned was a woman) and her incredible proficiency in her field.

I have already expressed my gratitude to the surgeon, but when I go back this Friday to have my stitches removed, I am going to do my level best to track down this anesthesiologist within the hospital. I want to thank her personally for her skill and expertise, which allowed me to sail through the anesthesia so flawlessly that I don't even feel like I underwent surgery at all.

If anyone is curious about which specific anesthesiologists I am talking about, send me a private message; I wasn't sure if I was allowed to promote them here...

Regardless, to everyone waiting for a surgical procedure, I sincerely wish you a speedy recovery and hope that everything goes perfectly smoothly.
shadownomad43 shadownomad43 Member
35 messages
joined Apr 2016
#863 ·
velvetcobra6 said:I have a question for anyone who has undergone surgery, or better yet, for an anesthesiologist.
I’m scheduled for gallbladder removal soon. I've completed all the necessary tests, including the anesthesia clearance.
One thing isn't quite clicking, though. I'm supposed to check into the hospital on the morning of the procedure, but the anesthesiologist noted that I need to receive a Clexane injection the evening before. My primary care physician doesn't carry it and mentioned they don't even have the means to source it.
How am I supposed to manage getting this medication?

I might be a bit late to the conversation, but in my experience, you typically head into the hospital ward the evening before to get the Clexane, unless your surgeon or anesthesiologist has arranged a different plan... at least, that was how it worked for me.
shadownomad43 shadownomad43 Member
35 messages
joined Apr 2016
#864 ·
Christian Wood2 said:I’m looking for some professional advice on how to best prepare for an upcoming surgery—specifically a two-hour procedure to correct my nasal septum and nasal pyramid (though this applies to any surgery, really).
Basically, I want to know what foods are best to focus on, and which ones to steer clear of, during the week leading up to the operation.
Also, what should be the priority for meals and hydration the day before, and specifically, what should be my very last meal on the evening preceding the surgery?
Furthermore, what would you recommend taking to help with calming nerves and getting some sleep the night before?
And finally, how can I manage the anxiety, fear, and elevated heart rate in those critical one to two hours right before the procedure begins?

In my experience, preparation protocols have varied quite a bit; there was one instance where they had me on a strict fast the entire day before surgery—not even a drop of water or a crumb of bread allowed. In another case, despite being told to fast, I ended up having a fairly heavy meal the evening before, though for this most recent one, surprisingly, I was allowed to eat normally until the actual day of the surgery, when everything—both food and drink—had to stop completely. As for calming my nerves, I didn't take anything specific, but I suspect if you were to ask the staff at the hospital, they might offer you something... perhaps something like Xanax...
wiredpuma5 wiredpuma5 Member
37 messages
joined Nov 2020
#865 ·
I’m looking for a bit of professional insight here. A few weeks ago, I underwent laparoscopic surgery—basically some poking around my intestines—but since I know absolutely nothing about anesthesia, what happened next was terrifying. They placed a mask over my face, lifted it slightly, and then I think they injected something into my vein. Immediately after, I found myself unable to breathe; no matter how hard I tried, I just couldn't get air. I attempted to tell them I couldn't breathe, but while my brain was screaming it, I couldn't make a sound. I couldn't move my hands or even my pupils, and then everything went black. I have no idea what actually happened, but I am completely traumatized by it, especially since I suffer from chronic claustrophobia and a fear of choking. After the surgery itself proceeded without issue, I woke up in the ICU with an oxygen mask on my face, fully conscious. As for the moment I drifted off during anesthesia, I have no clue. Can anyone explain what was done to me?
Laura Cox5 Laura Cox5 Active Member
53 messages
joined May 2015
#866 ·
Honestly, anesthesia has come such a long way lately. We’re talking full-blown general anesthesia these days—it doesn't even matter what kind of surgery you're having. That’s exactly what went down with my hernia repair. You wake up feeling absolutely hammered, totally argumentative, and just plain offended at everything. Plus, trying to pee for the first time after that? A complete nightmare. I managed to get back on my feet within about four hours by basically doing heavy breathing exercises, bracing my diaphragm like I was hitting a heavy set at the gym, and then twenty-three hours later, they sent me home with a massive 25 cm scar thanks to those abdominal surgeons and the anesthesiologists. I was actually expecting local anesthesia, but honestly, this turned out better because you don't have to listen to the surgeons rambling on, or so my roommate tells me.
Edward Taylor2 Edward Taylor2 Newcomer
1 message
joined Feb 2017
#867 ·
To whom it may concern, I am hoping someone here can provide some clarity on a few questions...
My father recently survived a heart attack. He spent about three to four weeks at Mount Sinai undergoing tests while doctors held consultations. They’ve informed us his heart is quite weak and his arteries are damaged. This past Monday, he underwent heart surgery at Mayo Clinic, where they installed three bypasses. He is currently in the ICU. From a surgical standpoint, everything went smoothly, though he did experience some arrhythmia; however, the doctor mentioned they managed to stabilize it.
The day before yesterday, I spoke with him and he was lucid, sounding good, and seemingly fine. But yesterday, we were told he fell into what is called delirium—he's disoriented and keeps trying to get out of bed. The doctor explained that this is actually a common reaction for some patients following major surgery. They are monitoring him closely and keeping him medicated (likely sedatives for calming and sleep). They haven't given us specifics, such as how long this might last or if this indicates a decline in his actual condition, or if we just need to be patient. Visits are also restricted due to the flu going around.
Does anyone here know more about this? I am completely losing it; I haven't been able to function since I heard the news. I would appreciate any firsthand information or insight you could offer regarding what this means... and what the general prognosis is for this kind of state?
Thank you in advance!
Nicholas Doyle91 Nicholas Doyle91 Member
28 messages
joined Dec 2008
#868 ·
I’ve spent about ten days hanging out on the surgical floor, and man, I’ve seen my fair share of people coming out of anesthesia acting just like that... You know, they try to hop out of bed right after some heavy-duty procedure, or they start making a huge scene and picking fights with everyone in sight... It was honestly pretty wild, like a nonstop party that never slept, day or night.
Brian King3 Brian King3 Newcomer
1 message
joined Feb 2017
#869 ·
Please forgive my sudden intrusion here—I have a question that I'm hoping someone might be able to clear up for me.
What exactly does "bolus" mean? Specifically, administering a medication as a bolus... which types of drugs are given this way, and what is the clinical reasoning behind it?

I’m asking on behalf of a close family member who is trying to wrap their head around this, as they have an upcoming procedure at the hospital quite soon. My apologies again for the interruption.
velvetmoose9 velvetmoose9 Active Member
163 messages
joined Apr 2020
#870 ·
Brian King3 said:Sorry to jump in out of nowhere, but I have a question if anyone can help me out.
What does "bolus" actually mean? Like, giving a drug as a bolus... which drugs are given that way and why?

I'm asking for someone close to me who’s curious because they have to head into the hospital for a procedure soon. Sorry for the intrusion.

Basically, it means delivering a dose within a pretty short window of time, usually straight through an IV.

Think of it this way ( keeping it super simple here!)—it's done so the medication hits the system fast, and sometimes it's used to make the effect wear off quickly, too.
Of course, it really depends on what you're using.
For instance, if you're giving Dormicum (Midazolam) as a bolus, it kicks in incredibly fast—which is why it’s often used as pre-medication before someone goes under for surgery.
darkgardener9 darkgardener9 Member
20 messages
joined Mar 2017
#871 ·
Hello. It has been 15 days since my surgery, and I am dealing with a terrible reaction to the anesthesia. My entire face is peeling intensely, and a heavy rash has broken out across my whole face and around my eyes. Does anyone have any advice, or has anyone had a similar experience? If so, could you recommend a specific cream or treatment? This is truly frightening. Thank you.
Charles Sanders51 Charles Sanders51 Newcomer
1 message
joined Mar 2017
#872 ·
I was wondering if there might be an anesthesiologist here who could provide a professional, specialist explanation regarding dilution ratios. Specifically, if we say adrenaline is diluted in an ampule at a ratio of 1:1,000, what does that actually represent in terms of the amount of adrenaline (and in which specific units) being mixed with 1,000 units of saline or distilled water?
Furthermore, when we talk about diluting adrenaline at a 1:10,000 ratio, does that mean if I have, say, 3 mL of adrenaline, I should mix it with 7 mL of saline in a 10 mL syringe? Or would it be more like mixing 1 mL of adrenaline with 9 mL of saline?

Thank you!
Emily Palmer24 Emily Palmer24 Newcomer
1 message
joined Apr 2017
#873 ·
I have a few questions. I've undergone general anesthesia three times now, and everything went fine until the last session. That one was a disaster. I dealt with a low-grade fever of 99.5°F for an entire week, coupled with excruciating pain in my neck and shoulder area. On top of that, I developed two painful lumps on my arm—specifically the arm where they administered the anesthesia. The neck pain eventually subsided after about ten days, but now that dull ache is returning, and one of those small lumps on my arm has popped up again. It's infuriating.
Does anyone actually know why this happens?
Aaron Sanchez12 Aaron Sanchez12 Newcomer
4 messages
joined Jan 2008
#874 ·
velvetmoose9 said:What you’re describing is actually super common.
The whole anesthesia process isn't exactly harmless, but honestly, modern medicine would pretty much fall apart without it.

It’s a good sign that he’s mostly oriented during the day 👍, which usually means things will probably settle down once he’s back home on "familiar ground" and gets his bearings...

Nighttime is the real killer, though—that disorientation (especially in a hospital setting when you’re hooked up to all sorts of tubes and bandages 😵 ) hits way harder, particularly with older folks...

In cases like this, Haloperidol is basically the gold standard 🙏

EDIT: Just noticed he’s a smoker, which definitely doesn't help the situation at all...


I'm desperate for some advice or help here... my father-in-law is 83, had spinal surgery 10 days ago, and even though he was discharged after 6 days, he’s been in a constant state of delirium ever since. It's day and night—he’s wandering, shouting, talking nonsense, calling out for people, and won't even recognize us... he even gets aggressive sometimes. He was totally sharp and fine before the procedure, no mental issues whatsoever. We’ve talked to the surgeon and his primary doctor, and everyone says this can last 7 to 8 days, especially in older patients, but it’s been 10 days now and nothing has changed. On top of that, he ran a fever, so his doctor put him on antibiotics. What could have happened to a healthy, clear-headed man's brain, what can we actually do, will this pass, are there any medications, and what kind of long-term effects are we looking at...
velvetmoose9 velvetmoose9 Active Member
163 messages
joined Apr 2020
#875 ·
Olivia Bennett81 said:I’m looking for some advice, maybe even a little help... my father-in-law is 83 years old, and about 10 days ago, he... So, I finally went under the knife for my spine surgery. Honestly, it’s one of those things where you spend months dreading the whole ordeal, playing out every worst-case scenario in your head, and then it just happens. It’s a bit surreal looking back on it now—just one of those big life milestones you have to check off the list. Everything went according to plan, though I'm definitely feeling the aftermath today. Just taking it slow, leaning into the recovery, and trying not to rush the process too much.So, he finally got discharged after six days, but honestly, the whole ten-day stretch was... well, you know. He was just stuck in that state the entire time. It’s just non-stop delirium at this point—they're basically up all night, totally out of it. They’re wandering around, shouting, rambling on about things that don't even make sense, and calling out for people who aren't even there. It’s getting pretty unsettling because they don't even recognize the people living in the house anymore, and every now and then, they just snap and get really aggressive. Before the procedure even started, he was totally sharp—no mental fog or anything like that, just his usual self. We actually went as far as calling in the surgeon and his primary care doctor, and everyone gave us the same line: they said it could take anywhere from seven to eight days for things to settle down, especially since he’s older. Well, it's been ten days now and there hasn't been any change at all. In the meantime, he's... Woke up feeling like absolute garbage today—caught a fever out of nowhere. Honestly, it just came out of left field. Everything feels heavy, and I’m just trying to ride this out. So, his doctor put him on some antibiotics, and now we're all sitting here wondering what exactly could be going on inside his head. It’s a bit unsettling when someone who was perfectly healthy and sharp as a tack suddenly seems... off. I can't help but wonder what actually happens in the brain during something like this, or if there's anything we can even do to help him through it. Is this just one of those things that'll eventually blow over on its own, or should we be looking into specific medications to steady him out? Honestly, the uncertainty about potential long-term consequences is the hardest part to wrap my head around.

Based on what you're describing, this sounds like the kind of situation where you really shouldn't wait around—you need to get a doctor to take a look at this right away. 🧐

First things first, you really have to rule out meningitis. If that turns out to be what we're actually dealing with, there’s zero time to waste—you've got to jump straight into aggressive treatment immediately.
They’re probably going to need to do a local exam on the wound, and there's a good chance they'll run some imaging through radiology too. Honestly, if the pathology report comes back with anything specific, we might even be looking at a revision.

Honestly, dealing with pneumonia and a UTI is pretty much par for the course when you're looking at procedures like this in patients of that age group. It’s one of those expected complications, and frankly, it could easily be the underlying reason behind everything you're seeing with their current condition.

It's peak flu season right now, so there's a pretty good chance he just picked up some nasty virus going around. 🤷

It’s also worth keeping in mind that it doesn't necessarily have to be an infection causing the issue—if someone has been hitting the booze on a regular basis, what you're looking at might just be a textbook case of delirium tremens.

Sometimes, anesthesia itself just leaves you feeling completely out of sorts, like your whole system is totally thrown off balance. 🤷

You really have to approach a patient this heavy with total focus and extreme care; there's no room for cutting corners when things get that complicated.
Maybe there's just a bit too much going on here. ☕
Aaron Sanchez12 Aaron Sanchez12 Newcomer
4 messages
joined Jan 2008
#876 ·
velvetmoose9 said:The situation described needs an urgent doctor's consult right now... 🧐

First things first, you gotta rule out meningitis, and if that's actually what it is, they need to start aggressive treatment immediately.
They also need to check the wound locally, maybe run some imaging, and there might even be a need for revision if there's any pathological substrate involved.

Pneumonia and UTIs are pretty standard complications after procedures like this in people that age, so that could definitely be causing what's going on.

It's virus season, so who knows, maybe they just picked up some nasty bug... 🤷

Then again, it doesn't even have to be infectious—if the guy's been drinking regularly, this whole thing could just be delirium.

Sometimes anesthesia itself just throws everything into total chaos... 🤷

A patient this sick absolutely needs immediate, careful attention.
There's just too much ☕


Thanks a lot, but he's never been a drinker, just the occasional drink here and there...
silentbison17 silentbison17 Member
31 messages
joined Aug 2012
#877 ·
Hi,

My husband just had surgery for a deviated septum and they scorched his nasopharyngeal area (I forget the technical term)...
The day of the surgery was rough. The next day—which is today—he was doing okay this morning, but by this afternoon, man... he can barely walk. He’s dealing with general weakness, and don't even get me started on the nasal pain, though I guess that's expected. Even after showering or taking a short walk, he hasn't felt any better; if anything, he feels worse. I called the doctor, and he administered a Sulumedrol injection (my husband is an atopic patient and passed all the allergy testing related to anesthesia, so those were fine), and they put him on Klavocin because he hit a fever of 99.5.

Is there any major reason to be worried?
Carol Taylor10 Carol Taylor10 Newcomer
1 message
joined Dec 2016
#878 ·
Why on earth do they keep drugging people for days right before surgery? It would be so much more logical if you just showed up, got your meds, and headed into the OR by the second day at the latest. But instead, here in Chicago, they keep you stuck there for days on end, pumping you full of drugs while they lie to your face every single morning, promising that the surgery is finally happening tomorrow.
Betty Hughes6 Betty Hughes6 Newcomer
5 messages
joined Mar 2012
#879 ·
Question for the veterans here... I’m heading into the hospital tomorrow, and on Wednesday, I’m having laparoscopic surgery to remove a chronically inflamed appendix. Since I struggle with panic attacks, you can probably guess the kind of mental gymnastics I'm doing right now. Is it even okay to ask—can I request something to take an hour or two before the procedure to just chill me out or lift my mood? About a year ago, my kid had his tonsils out, and I remember they gave him a pill beforehand that left him walking into the OR looking totally high. He was cracking jokes, had no clue where he was going, and doesn't remember a single thing about it.
Scott Allen10 Scott Allen10 Regular
315 messages
joined Jun 2005
#880 ·
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.

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