Reminder of why we do this

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noise115

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Had a difficult yet rewarding case tonight. Elderly woman coming in for ex-lap, SBR for SBO due to CRC among many other comorbidities. Pt has evolving alzheimer’s dementia and husband is broken up about the situation.

4-quadrant TAP block, TIVA anesthetic with minimal opioid, patient woke up happy, alert and relatively clear-minded. Husband cried after he realized this is the most lucid she’s been in weeks.

Our elegant, difficult, complex anesthetics matter, even at 1 am.
 
Great job! Yes we do make a difference.
 
Sounds like a great anesthetic.

I know I don't have all the information, but why are we doing surgery/anesthesia on someone who sounds terminal and demented...?
 
MoMoGesiologist said:
Sounds like a great anesthetic.

I know I don't have all the information, but why are we doing surgery/anesthesia on someone who sounds terminal and demented...?
Click to expand...

Even if the patient is terminal and demented, I'm sure there are more elegant ways to pass away than writhing in pain or uncontrollable nausea from small bowel obstruction or sepsis after perforating your bowel. If I were the surgeon I would have performed the surgery regardless if she were terminal or not. I hope you would want the same for yourself or your family.

Nice anesthetic OP. I feel like cases like these make my week.
 
mikey014 said:
Even if the patient is terminal and demented, I'm sure there are more elegant ways to pass away than writhing in pain or uncontrollable nausea from small bowel obstruction or sepsis after perforating your bowel. If I were the surgeon I would have performed the surgery regardless if she were terminal or not. I hope you would want the same for yourself or your family.

Nice anesthetic OP. I feel like cases like these make my week.
Click to expand...

Believe it or not, there are actually other choices besides A. Maximally invasive surgery and B. Painful Horrible death.

How about put her on a dilaudid drip, keep her comfortable if terminal.
 
mikey014 said:
Even if the patient is terminal and demented, I'm sure there are more elegant ways to pass away than writhing in pain or uncontrollable nausea from small bowel obstruction or sepsis after perforating your bowel. If I were the surgeon I would have performed the surgery regardless if she were terminal or not. I hope you would want the same for yourself or your family.

Nice anesthetic.
Click to expand...
Hoya11 said:
Believe it or not, there are actually other choices besides A. Maximally invasive surgery and B. Painful Horrible death.

How about put her on a dilaudid drip, keep her comfortable if terminal.
Click to expand...


Difference of opinion, but I would say a Dilaudid drip in an elderly demented patient until you die is less humane than getting surgery and epidural / regional anesthesic and a PCA/prn opioids. My patients look much less miserable after a small bowel resection / ex lap than "painful horrible death."
 
noise115 said:
Had a difficult yet rewarding case tonight. Elderly woman coming in for ex-lap, SBR for SBO due to CRC among many other comorbidities. Pt has evolving alzheimer’s dementia and husband is broken up about the situation.

4-quadrant TAP block, TIVA anesthetic with minimal opioid, patient woke up happy, alert and relatively clear-minded. Husband cried after he realized this is the most lucid she’s been in weeks.

Our elegant, difficult, complex anesthetics matter, even at 1 am.
Click to expand...
I get more reminders a month on why I do than is necessary. Credit card bills, car bills, mortgage, power bills, cellphone bills, cable tv bills, healthcare bills, school bills, vet bills....

I get enough reinforcement already.
 
urge said:
I get more reminders a month on why I do than is necessary. Credit card bills, car bills, mortgage, power bills, cellphone bills, cable tv bills, healthcare bills, school bills, vet bills....

I get enough reinforcement already.
Click to expand...
Tax bill
 
When I saw the title of this thread this is what I expected to see:
100usd_new.png
 

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This last week, I unexpectedly received two thank you notes from patients out of the blue. Each person sincerely expressed their gratitude for the care that I provided during their procedure. It's nice to hear those sentiments expressed. I am sure there are many other grateful patients out there who don't take the time to send a note.

This job can be hard sometimes and it is easy to lose perspective. We really are in a unique position to go to work every day and have the opportunity to have meaningful interactions with people who are rightfully terrified of what is about to happen to them. We get them through surgery safely and even though most are not in a position to say thank you, that is a meaningful thing. Not a bad way to scratch out a living.
 
noise115 said:
Had a difficult yet rewarding case tonight. Elderly woman coming in for ex-lap, SBR for SBO due to CRC among many other comorbidities. Pt has evolving alzheimer’s dementia and husband is broken up about the situation.

4-quadrant TAP block, TIVA anesthetic with minimal opioid, patient woke up happy, alert and relatively clear-minded. Husband cried after he realized this is the most lucid she’s been in weeks.

Our elegant, difficult, complex anesthetics matter, even at 1 am.
Click to expand...
If you like this, you are in the wrong (sub)specialty. You should have done critical care, for example.

I personally am a sucker for grateful patients/families; happens to me on a regular and frequent basis, but rarely in the OR. There the surgeon is the hero.
 
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