I am a patient with a question

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sleepyone

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I have had 12 surgeries and am coming up on number 13. I was wondering what do anesthesiologists do during the surgery when I am asleep? I have been wondering this so I decided to ask.

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I have had 12 surgeries and am coming up on number 13. I was wondering what do anesthesiologists do during the surgery when I am asleep? I have been wondering this so I decided to ask.

take care of you.
 
take care of you.

I know that much. I think that you guys do things such as monitor my vitals and maintain a good level of unconsciousness (not to deep or to light) but I was wondering what else is done. I like understanding, especially since I am :sleep:.
 
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Record your blood pressure, heart rate, etc. every 5 minutes. Monitor blood loss and urine output.

Breath for you when your mind doesn't feel like it.

Balance the positive (no sensation, sleepy-sleepy) and negative (very low blood pressure, coma) effects of our medicines.

Suck juice out of your stomach, keep hard metal objects off your face, make sure you don't get too cold.

Most importantly, we keep you alive while the surgeon does his (or her) best to do otherwise.



If all of the above goes well, we occasionally have a chance to read the newspaper, chat with others in the room, send text messages, generally keep our mind clear from what could otherwise be mind-numbingly boring documentation. I hear Sodoku is big, but it's not my bag.
 
I have had 12 surgeries and am coming up on number 13. I was wondering what do anesthesiologists do during the surgery when I am asleep? I have been wondering this so I decided to ask.

Watch your heart rate, blood pressure, oxygen level, carbon dioxide level, do other blood tests if needed, give you medicines to treat pain, medicines to prevent nausea, medicines to keep your muscles relaxed, medicines to keep you asleep, medicines to make you stronger at the end, medicines to fix your heart rate, medicines to fix your blood pressure, keep you warm, watch your temperature, watch how much blood the surgeons lose, give you IV fluids, give you blood transfusions if you need it, measure how much urine you make, make sure the surgeons don't poke your eyes out with the ends of their instruments or their elbows, adjust the height and angle of the operating table, make sure your arms, legs, neck, scrotum/breasts aren't pinched or laying on hard surfaces, and basically keep you both asleep and alive while trying to prevent problems or pick up on any problems while they are small.
 
removed for reasons mentioned later.
 
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Thanks guys. Also do you get p!ssed if the patient requests inhilation instead of IV? I always do because I have VERY tough veins (last time I needed an IV they ended up in my foot there was NOTHING usable in my arms) and I am totally needle phobic (NOT a good combo especially when you have multiple medical problems and an ongoing need for surgery)

It's arguably more dangerous to start an anesthetic with inhalation than IV. It's your life. Sometimes people get preop PICCs if they're got access problems and are going to need antibiotics after surgery, etc. That might be an option.
 
take care of you.

Internet forums are funny places. We talk so much about "advocating for our specialty" and making ourselves more visible, "taking off the mask" blah blah blah, but then an apparently genuine person presents with an apparently genuine question, and receives this.

No doubt there are too many trolls, and new users are met with skepticism, but it really shouldn't be that hard for a resident to explain what an anesthesiologist does during a case.

(this is in no way personal)
 
On the flip side, Bert, this IMO crosses the line into obtaining medical advice from the forum, which pretty flagrantly violates its TOS. If you guys don't agree, I'm sure the OP appreciates your help.

Sleepyone- this question is best asked face to face with your anesthesiologist.
 
and I do realize that it is just that I like to look like I know what is happening (especially because I have been through it so many times) and feel like I look like an idiot asking these types of questions.
 
On the flip side, Bert, this IMO crosses the line into obtaining medical advice from the forum, which pretty flagrantly violates its TOS. If you guys don't agree, I'm sure the OP appreciates your help.

Sleepyone- this question is best asked face to face with your anesthesiologist.

Understood, but that's not how I read it. The original post isn't asking advice. I don't even know why he's having surgery.

I chose not to respond to inhalational induction, however. To be honest, I hadn't seen that post before responding to Tough.
 
i realize the one about inhilation is close to medical advise so I will remove that post. sorry about that.
 
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Thanks guys. Also do you get p!ssed if the patient requests inhilation instead of IV? I always do because I have VERY tough veins (last time I needed an IV they ended up in my foot there was NOTHING usable in my arms) and I am totally needle phobic (NOT a good combo especially when you have multiple medical problems and an ongoing need for surgery)

No we don't get pissed but it is frustrating when people try to make things more difficult than they need to be. When they second guess everything we do like they know more about what we do than we do. Did I say "we do" enough for ya?
For example, yesterday I had a pt say to me that she is a very difficult stick (IV start). She claimed that she has had central lines (IV's placed if larger veins of the neck,etc) because of her small fragile veins. I said that b/4 I would place a central line I wanted to look around for a spot to place an IV. She was so negative, "You'll never find one." I found one on the back of her hand w/c is the most common place to put an IV. She also told the nurses that they were not to touch her, only a doctor can place an IV, this makes it very difficult at times and the nurses are very good. I had to talk her into letting me try her hand. I placed the IV and secured it then asked her "how was that?' She had the gall to say, "it won't last more than 30 minutes." I used it for the whole 3 hr case and today I saw her. The IV was still working. What a whining PITA.

Then the obvious annoyance. Pts that state they are needle phobic but have a tattoo or 20. Give me a break. Do you think I'm an idiot?

THis is surgery, there are going to be times when you are not comfortable. IV's are one of those times. Some people have expectations which are unacheiveable.
 
No we don't get pissed but it is frustrating when people try to make things more difficult than they need to be. When they second guess everything we do like they know more about what we do than we do. Did I say "we do" enough for ya?
For example, yesterday I had a pt say to me that she is a very difficult stick (IV start). She claimed that she has had central lines (IV's placed if larger veins of the neck,etc) because of her small fragile veins. I said that b/4 I would place a central line I wanted to look around for a spot to place an IV. She was so negative, "You'll never find one." I found one on the back of her hand w/c is the most common place to put an IV. She also told the nurses that they were not to touch her, only a doctor can place an IV, this makes it very difficult at times and the nurses are very good. I had to talk her into letting me try her hand. I placed the IV and secured it then asked her "how was that?' She had the gall to say, "it won't last more than 30 minutes." I used it for the whole 3 hr case and today I saw her. The IV was still working. What a whining PITA.

Then the obvious annoyance. Pts that state they are needle phobic but have a tattoo or 20. Give me a break. Do you think I'm an idiot?

THis is surgery, there are going to be times when you are not comfortable. IV's are one of those times. Some people have expectations which are unacheiveable.


And if I need an IV I am more then willing to let them do it. Once someone wanted to give up trying but I said no I need it for this test keep trying. The IV was the whole point of the test. (It was an mri i needed contrast).

I also understand that people do exagerate. however my last 2 ivs. 1 was the smallest needle before buterfly (or atlest that is what the nurse told me) in a vein at the base of my thumb, and the last one was what ever size they need for contrast in my foot.

If i need it go for it, but i am going to warn you that I am needle phobic because I have been known to freak. I know there is no point, it just happens.

I also realize that by requesting that it looks like I am second guessing you. i do not want my docs to think that, though I am sure they do. If they are really set on an IV I will let them take a look. if a vein looks good to them, i let them try 2 times, then i ask them to please stop and do the mask.
 
On the flip side, Bert, this IMO crosses the line into obtaining medical advice from the forum, which pretty flagrantly violates its TOS. If you guys don't agree, I'm sure the OP appreciates your help.

Sleepyone- this question is best asked face to face with your anesthesiologist.
He seems to be trying to stay away from asking direct medical advice and only asking general questions about what we do which I think is OK (so far).
 
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He seems to be trying to stay away from asking direct medical advice and only asking general questions about what we do which I think is OK (so far).


Exactly, I was trying to NOT get medical advise. I was trying to be VERY general. Of course I am not going to ask about my specific case but things in general (what you guys do and feelings in a particular situation of which I could NOT be the only person to have it.)
 
I take a different view; the majority of the benefit we have to the patient occurs before the patient goes to sleep. We review the chart, interview the patient, order any additional tests, and prescribe any additional pre-op medications necessary to keep the patient safe during anesthesia. The surgeon may request one type of anesthesia, but it is up to us to make a decision as to the safest anesthetic plan. Sometimes this means cancelling the case, sometimes this means changing to a different type of anesthetic.

As an example, a case I had during residency was that of a 47 yr old type II diabetic who came in for a lumbar microdisectomy. On pre-op exam, it was noted that he was slightly tachycardic, and his heart rhythm sounded irregular. We ordered an EKG which showed a-fib (no ST changes). Pt denied ever being told that he had an arrhythmia. As the the patient was asymptomatic, the surgeon wished to proceed, thinking that this could be worked up post-op. We expressed our concerns to the surgeon, ordered troponins, and low and behold found that he was actively having an MI. Of course, we cancelled the case, and likely saved all involved a potential disaster.

During the case, our main job is to anticipate, prevent, and solve any problems which arise during the anesthetic. It may be as simple as giving nauseau prophylaxis, or as complicated as treating an intraoperative cardiac arrest. The fact of the matter is that we deal with incredibly dangerous drugs. The same drugs we use to induce anesthesia are used to put to death condemned inmates. In the words of one of my former attendings, it is our job to prevent an anesthetic induction from being a lethal injection.
 
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Thanks all of you. I have always been wondering what happened once I was asleep. I was always wondering what the anesthesiologist did. Though I knew they were responsible for making sure I was ok. Such as putting things the surgeon does not think are necisarry to have on a consent because it will not be needed. The time I am thinking of was the anesthisiologist put blood transfusion on just incase though the surgeon said I would not need it ended up needing 4 units and ended up in the ICU with the ET tube left down my throat for a day due to significant blood loss.
 
Also from my side of the bed, it is appreciated when the anesthisiologist includes me in stuff.

I am not talking about asking me what anesthetics you should use obviously, I have NO CLUE about those. But things such as this.

I was having one of my surgeries and the OR nurse and anesthisiologis wheeled me into the room. The hospital I go to they both take the patient in.

So they have me move over to the OR bed and position me. Then as the anesthisiologist goes to attach all the different monitors to me, she had me talk through what she was putting on my and why (aka what they did). This was nice because it gave me a sence of controle because I actually controled what order they were applied in, she went the order that I named them.

She then asked did I want to hold the anesthisia mask, which I did for about 30 seconds before I became a bit :D and was not able to anymore. But it was nice to have that controle. Especially because you are about to be in a position where you have NO controle at all and need to put all your trust in this person who, in many cases you never met before that day.
 
I was wondering what do anesthesiologists do during the surgery when I am asleep?

We do crossword puzzles or surf the Internet. We take our masks off. We argue with the surgeons and don't pay attention to you. We are usually unbathed and unshaven... and probably drunk. And, if something really bad is about to happen, we leave the room.

I mean, come on! Don't you watch "Grey's Anatomy"?

-copro
 
i thought there was a lot of sex going on in the OR's;)
 
We do crossword puzzles or surf the Internet. We take our masks off. We argue with the surgeons and don't pay attention to you. We are usually unbathed and unshaven... and probably drunk. And, if something really bad is about to happen, we leave the room.

I mean, come on! Don't you watch "Grey's Anatomy"?

-copro


I assume that this person is actually being sincere about their concerns with anesthesia. I think it's best that medicine represents itself well when someone is asking questions without trying to joke with us or like some patients, yell at us.

This brings up a good point. I believe anesthesia needs it's own consent for every category of procedures because surgeons tend to suck at explaining risks and benefits from the other side and sort of the steps involved in induction and emergence.

This also promotes patient awareness of MD involvement in the anesthetic plan which may prove to be as good as any health transparency act. I understand that CRNAs and other midlevels can provide care, but to shamelessly claim that there is no one above them is just about as bad as an arrogant surgeon who may one day catch himself/herself in a bind. Everybody needs to acknowledge that they can't always establish lines and tube people.

Whatever though...
 
I have had 12 surgeries and am coming up on number 13. I was wondering what do anesthesiologists do during the surgery when I am asleep? I have been wondering this so I decided to ask.
That's nice from you - usually I check up the OR nurses and let my imagination wild. And I am wondering how much your crappy insurance will pay me more than a CRNA. And btw my crna is checking the boys in the OR. Sometimes her dream is to be pet by surgeon.....
 
I assume that this person is actually being sincere about their concerns with anesthesia. I think it's best that medicine represents itself well when someone is asking questions without trying to joke with us or like some patients, yell at us.

This brings up a good point. I believe anesthesia needs it's own consent for every category of procedures because surgeons tend to suck at explaining risks and benefits from the other side and sort of the steps involved in induction and emergence.

This also promotes patient awareness of MD involvement in the anesthetic plan which may prove to be as good as any health transparency act. I understand that CRNAs and other midlevels can provide care, but to shamelessly claim that there is no one above them is just about as bad as an arrogant surgeon who may one day catch himself/herself in a bind. Everybody needs to acknowledge that they can't always establish lines and tube people.

Whatever though...

Thank you. I was legitimately wondering what happened once I was asleep. I knew that someone needed to make sure I stay alive and I thought it was the anesthesiologist, but I thought I would ask.
 
We do crossword puzzles or surf the Internet. We take our masks off. We argue with the surgeons and don't pay attention to you. We are usually unbathed and unshaven... and probably drunk. And, if something really bad is about to happen, we leave the room.

I mean, come on! Don't you watch "Grey's Anatomy"?

-copro

I do not go by TV. Since I am a patient so often I KNOW that more often then not TV does not portray medicine correctly.
 
we google and drink starbucks and do crossword puzzles in the break room. then drive a porsche home ...and yes im being facitious
 
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