Did anyone see the Diane Sawyer segment on AUA?

[adleyinga]

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I am unclear of the purpose of this comment

 

[adleyinga]

It was me. I called it a piece of s h i t. I was introduced to it. I found it interesting. I used it, and I found that it impaired me from doing a case that way I would want. Frequently, the BIS is high when I felt no additional hypnotic was needed, and other times very low when I felt hypnotics were needed.

So I called it an expensive random number generator....after giving it due chance to impress me.

If the mortality data on low BIS scores bear out, then I will use to improve 6 month and 1 year mortality in the elderly.

Thank you for admitting that someone did call it junk-

Also- the Terry Monk data is not very convincing. I will bring the BIS down to the 30's on a spontaneous breathing LMA/mask-even if they are old-they otherwise move

 

[adleyinga]

Thanks for generalizing. A s s.

Having worked with medical students for many years- unless they were practing anesthesiologists in another country, they wouldn't have enough experience to comment- so I am not degrading med students

 

[adleyinga]

So you've been "forced to use it". Maybe that colors your opinion a little. I tried it at a place where I do some freelance work. It's not "forced" on anyone. I tried it - not worth the effort or the expense, and it doesn't change the way I do my anesthesia.

That's not to say I can't change though. I'm probably one of the oldest farts on here, and I actually used vernitrols (and even copper kettles) and curare, and still use pentothal on occasion. I know, to you these are just concepts - to me they were everyday practice. And I could still go in to work tomorrow and put a patient to sleep with a vernitrol vaporizer (if I could find one) and curare (if I could find any) and pentothal (still in our Pyxis machine), and they would stay asleep for the case and wake up at the end, just like they did in 1979.

I've seen drugs and technology that were incredible advances - and I've seen plenty of dogs as well. As it stands right now, BIS is a dog. Maybe some of these awareness monitors will pan out. And I'll make this prediction - Aspect Medical, because of it's sleazy marketing tactics, questionable science, and even more questionable "experts", will be at the bottom of the pile IF we ever consider buying an awareness monitor.

Thank you for answering instead of attacking me. Can't say I go back to 79 but not much later.

I went down kicking and screaming about using it- like many people on this site but after a number of months (not days) I came to realize it does have uses.

I question some of their experts- and I know them personally but some of them are worthy people. You have at least one in Atlanta at Emory.

Yes- Aspect tactics are questionable but their stock is up from 18 to 32 in past year. Nothing to laugh at. You may not buy the BIS but buying their stock may be worth it

I have found it interesting I got on this web site to find out about med student and ended up in a battle with practing anesthesiologists.

 

[militarymd]

Thank you for answering instead of attacking me. Can't say I go back to 79 but not much later.

I went down kicking and screaming about using it- like many people on this site but after a number of months (not days) I came to realize it does have uses.

I question some of their experts- and I know them personally but some of them are worthy people. You have at least one in Atlanta at Emory.

Yes- Aspect tactics are questionable but their stock is up from 18 to 32 in past year. Nothing to laugh at. You may not buy the BIS but buying their stock may be worth it

I have found it interesting I got on this web site to find out about med student and ended up in a battle with practing anesthesiologists.

Tell us about your educational and practice experience/background.

 

[adleyinga]

Tell us about your educational and practice experience/background.

I might have but seeing your responses to other posts on this BB- I will wait on that.

 

[militarymd]

I might have but seeing your responses to other posts on this BB- I will wait on that.

So, I take it you are a medical student wanna be?

It's ok, we were all there at one point in our career..

 

[Gimlet]

NO not calling you names BUT

""Matt Lauer truly is a f#$%ing dickhead.""

is vulgar for a professional BB

Fair enough...that comment was unprofessional, and I admit it. I would like to officially retract the Matt Lauer = dickhead statement. I still think it sucks when journalists try to twist peoples' words into the most sensational story like he did on that transcript, though.

Please note that I openly make available my med student status and have refrained from commenting on any technical aspects of this issue...I am only interested in what more experienced people have to say about the BIS. The journalist thing extends to all aspects of the news and not just this story.

On a related note, I think a lot of people would like to hear what your background in anesthesiology is, Adleyinga. It sounds like you know your stuff, but we have had some bad experinces with imposters on this board that have made people mistrustful of others until we know they're legit. Based on what you've written so far, I PERSONALLY would not be able to distinguish if you are an MDA, CRNA, AA, or a bum off the street for that matter. (That's not meant to be a rip on you, in case it sounds that way.) I would be interested to hear your background. Most of the posters on this board are pretty cool with anyone posting as long as they aren't maliciously trying to incite conflict.

 

[jetproppilot]

I would like to officially retract the Matt Lauer = dickhead statement..

No need to wear a mask here, bro.

Do you really feel that way? Do you feel you are truly right, in your heart?

Then say it. Post it. Yell it.

 

[fedor]

Thank you for answering instead of attacking me. Can't say I go back to 79 but not much later.

I went down kicking and screaming about using it- like many people on this site but after a number of months (not days) I came to realize it does have uses.

I question some of their experts- and I know them personally but some of them are worthy people. You have at least one in Atlanta at Emory.

Yes- Aspect tactics are questionable but their stock is up from 18 to 32 in past year. Nothing to laugh at. You may not buy the BIS but buying their stock may be worth it

I have found it interesting I got on this web site to find out about med student and ended up in a battle with practing anesthesiologists.

Yeah, my a s s you came on this website to find out about med student [sic] and immediately started defending the company which sells those products. Soon after you mention how the stock price has jumped and "that buying their stock may be worth it."

Don't let the door hit you in the a s s on the way out.
.

 

[adleyinga]

So, I take it you are a medical student wanna be?

It's ok, we were all there at one point in our career..

Very Far from medical student. I wish I was that young again

 

[adleyinga]

Yeah, my a s s you came on this website to find out about med student [sic] and immediately started defending the company which sells those products. Soon after you mention how the stock price has jumped and "that buying their stock may be worth it."

Don't let the door hit you in the a s s on the way out.
.

Do you really think that if I worked for Aspect I would waste my time on this site

 

[jwk]

I question some of their experts- and I know them personally but some of them are worthy people. You have at least one in Atlanta at Emory.

Yes- Aspect tactics are questionable but their stock is up from 18 to 32 in past year. Nothing to laugh at. You may not buy the BIS but buying their stock may be worth it

Yep - the one in Atlanta is one of the worst, and unfortunately, it's his data that is often quoted yet the most suspect. This is my favorite quote from the May, 2004 ASA Newsletter - it's part of a letter to the editor about BIS:

"While BIS can be a useful tool in specific settings, it is self-serving to say that all patients need such a device. If .02 percent of Dr. Sebel’s general anesthesia patients do indeed have awareness under general anesthesia without a BIS monitor, then I suggest he learn a different anesthesia technique. May I point out that 5 mg of midazolam costs about $1 versus $9,500 for a BIS monitor and $17.50 per BIS electrode array?"

This single statement summarizes the feelings of, probably, the majority of anesthesia providers in this country, who feel that they are being railroaded by the media and scandalous marketing techniques into using a device that is far from proven to even do what it claims, much less be the standard of care.

 

[adleyinga]

Yep - the one in Atlanta is one of the worst, and unfortunately, it's his data that is often quoted yet the most suspect. This is my favorite quote from the May, 2004 ASA Newsletter - it's part of a letter to the editor about BIS:

"
This single statement summarizes the feelings of, probably, the majority of anesthesia providers in this country, who feel that they are being railroaded by the media and scandalous marketing techniques into using a device that is far from proven to even do what it claims, much less be the standard of care.

If you remember- the first Aspect claimed it was awarenss monitor, when that did not pan out it became useful to reduce costs, when that failed it again became awareness monitor.

No- I don't think it should be a standard but if does give some info that can be useful in pt care

By the way- the only 2 cases of recall that my institution has has in past ten years have been with someone who swears by BIS. Titrates to exactly 50-60 and then gets caught when stimulation changes. He also only does TIVA but limits versed ( terrible technique)

 

[militarymd]

Very Far from medical student. I wish I was that young again

I wish I was young again also.

Anyways, my problem with BIS is the company....they aren't sticking to their guns. They have a monitor and they are looking for an indication for the monitor.

 

[Laryngospasm]

I wish I was young again also.

Anyways, my problem with BIS is the company....they aren't sticking to their guns. They have a monitor and they are looking for an indication for the monitor.

Money, money, not patient benefit.