I had a sinus surgery once and my doctor and anesthesiologist started off with the most terrible possible outcomes (those being death and permanent brain damage) and then told me all the ways they avoid those particular problems, and then ended with the most common risks, that was really good for me because I knew the absolute risks, but also knew just how much care they take to avoid those risks
I discovered your channel while recovering from robot assisted prostate surgery last week. I agree with all the positive comments about your presentation/teaching style - it's very good. I must be a dream patient because I remember the doc telling me that he would put a mask on me that would deliver 100% O2 and that Propofol would be injected into my IV to put me to sleep. At that point my memory shut off. I don't remember the O2 mask and I don't remember anything about the recovery room. My next memory is being wheeled into my room for the night. Everything between being told about the mask and entering my room is gone. Fine with me!
Max, your videos are educational for patients too. I have had general anesthesia 36 times.. the last time was nearly 24 years ago. I learned the risks long ago. The biggest issue I have had is nausea and vomiting with sedatives and anesthesia. Anesthesiologists must work with patients on prevention as much as possible. It was really no fun to wake up from surgery and deal with hours of nausea and vomiting.
As a medical student, I’ve learned that one of the best ways to learn is to teach! Thank you for your videos; I learn a lot from them, and I’m also certain you are becoming better as you make them.
Good video man! I always learn a lot from you, you inspire me so much, I have had 14 surgeries because of my cerebral palsy, that’s one reason I tried to go to college to be a anesthesiologist, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy!
Twenty two surgeries on me with general. One jaw dislocation, one brachial plexi injury which resolved in six weeks, and one wake up with the tube being pulled out in the or. So, it does happen some serious, some not serious. Great video!
Was doing an assignment on informed consent, and I stumbled upon an article by you. Was such a surreal experience to recognize one of the authors as a UA-camr
I had a friend who had severe hyperthermia after anesthesia. It was good he had to stay in the hospital anyway because it happened so fast after he was moved to his room after surgery. It is really rare he said.
Please Max make a video in anaesthesia for opiate and benzodiazepine tolerant people, I meant for me who is regular user of the IV opiate benzodiazepine and sedative cocktails. Which I know is frequently if not always used in one or multiple phases in anesthesia .
As someone who is opiate dependent and a natural redhead I am EXTREMELY hard to sedate. I’ve had 4 surgeries this year alone, getting ready for my fifth, and each time they have literally had to give me more induction medication because I did not go to sleep. I really love Max’s videos . I find them very interesting and educational.
Thank you very much for your videos about anesthia. I have never experienced general anesthia before so I thought I would just educate myself if this situation arises in future plus as I have degree in chemistry I was interested in it from the scientific point of view how it works. Well I was in that situation much much sooner than expected. It was like 3 weeks after I checked your videos when I badly broken my arm and surgery was needed. Your videos actually helped me to be a much more relaxed before the surgery. The general anesthia was actually quite pleasent for me as if I had really good sleep. And I was really surprised how fast it was. I had IV induction and anesthesiologist told me that I can feel tingling sensation in my arm which started to feel like 2 seconds after she told me that. Then she continued I can just relax now and think about something pleasent to have a nice dream. Well after she told me that i felt how fast the tingling travels through my arm to my head and then I remember absolutely nothing. Next memory I have is as I am waking up and doctor asking me how I felt. At first moments I didnt actually believe I was after surgery. It was like total time-skip. As they were transporting me with my bed to my room I was like oh, that looks like I really am after the surgery. I was amazed how well this works.
🤣post-operative nausea is so common for me, that after one of my ENT surgeries, (while I was dry-heaving like nobody's business), one of the recovery room nurses chuckled and said to another nurse "Yeah, she's notorious for throwing up really bad after surgery, so they pump her stomach before she wakes up".
Thank You for this awesome educational video which helps patients understand the different risks and outcomes after undergoing any kind of surgeries which requires the application of Anesthesia …
I had a scoliosis spinal fusion 3 months ago and after they surgery they had planned to wake me up and see if I had reflexes in my feet but they notice when they stopped oxygen that I was not breathing properly, reason being was my body was enjoying the ketamine and my anesthesiologist had be a little to generous with it but what ever less then an hour after surgery I was extabated.
I remember going under for wisdom tooth extraction and talking about the risks. Think I surprised the dentist/doctor when they briefly mentioned the remote chance of death and I just went "sometimes, sh happens you can't predict everything". I know people dislike hearing that risk, but there is always a remote chance of things going horribly wrong for no real reason and I'd rather be told upfront vs. sugarcoating everything.
I have never had the anesthesiologist explain the risks of anesthesia or what level they would be using. Either general vs. other (e.g., nerve block) was implied or the surgeon said what would be used.
I am a slow metabolizer of drugs broken down by CYP 450 2D6 and CYP 450 3A4. If I don't get that info to the anesthesiologist, there is a risk of overdose - They had to stop the morphine when I broke my back as I wasn't breathing well The fentanyl for the shoulder surgery was too high and a hypoxia alarm kept going off (I had to focus on breathing so they'd do the surgery!) The anesthesia for a colonoscopy had to be pulled back as my BP dropped too much (got to watch on a monitor, though - fascinating)
Excellent video, Dr Max. If someone has had general anasthetics before with no problems, is that an indication that that person tolerates them well and there is little likelihood of any problems during future surgeries, or could you have bad vomiting for example any time you 'go under'?
I had a hysterectomy which also ended up intentionally taking one of my ovaries (which wasn't initially planned). I suspected they may need to remove it eventually so I gave my explicit verbal consent multiple times in the OR while being prepped for anesthesia because you can't get consent from an unconscious person.
I think i've had this discussion before. Where I really do think is dental offices should NOT be ALLOWED to sedate and put patients under. The offices that always want to put patients under do NOT even want to have these conversations with patients, let alone they seam VERY ill-equiped to handle the one-offs that can happen during a procedure.
From what I’m aware of dental offices don’t use general anesthesia because only an anesthesiologist can perform general anesthesia since they have the license dental offices can only do regional anesthesia or extremely mild sedation but I’m pretty sure they don’t use general anesthesia unless a certified anesthesiologist works in that dental office which is unlikely because they mostly work in hospitals dealing with different medical issues and not teeth
I’ve been knocked out a couple of times during dental procedures. Once was via IV and twice was via oral sedation. The second time they did oral sedation, I woke up during the middle of it by vomiting while I was asleep. They just stopped in the middle of what they were doing and sent me home. The only silver lining there was that I got it all over the dentist.
I’ve had to be sedated at the dentist because of how bad my anxiety gets. but when I’ve had that done, I had to go to an oral surgeon center, not just a regular dentist. so they are more prepared for things and know more about what they’re doing. they always gave me IV sedation
@@joyceutt3419 They do it the patient has a fear of dentists, when they’re going to be doing a lot of work, or pulling several teeth, etc. If the patient wants it, a lot of dentists do it.
Honestly Max, I've had surgery twice and was never really given any of this info. When I stated I was nervous about being put to sleep, I was given versed lol.
Have undergone surgery 7 times under general anesthesia over the past 10 years. About the only thing I have noticed is having esophagus problems after the last two surgeries with swallowing food and it goes does the windpipe instead of going to stomach. Could this be as a result of the airway trac used for general anesthesia?
Modern life in the US makes a mockery of disclosure forms. The average person is not a lawyer and can understand the text or its implications. My mom went into respiratory arrest during a dental procedure in her 50s. She was quickly revived. She had to warn all future anesthesiologists she had an issue. My oral surgeon lost a patient on the table 2 months before my scheduled jaw surgery. It was a rare event and I went ahead with my procedure. 8 needed blood due a complication but he didn't administer any due to the time. 1988. The blood supply wasn't fully tested for HIV and there was a notable case of someone contracting HIV due to a transfusion. He prescribed iron supplements instead.
my biggest fear about anesthesia is waking up paralyzed, although its not a permanent affliction I get panic attacks when I cant move (being held down), I liken it to claustrophobia as its likely the same despite me only having problems with closed spaces if I cant move at all. Extubation also scares me, despite not being aware of my extubation, if I woke up with it down my throat I would most likely panic. Damage or even death doesn't actually spook me, one can be fixed or managed, the other I wont even realize I died.
I wish my anesthesiologist would have told me that the medication they gave me to relax my muscles would make me feel like i was hit by a mac truck for the next 4 days. That definitely would have been nice to know.
My father had vocal cord injury during surgery that took a while to resolve. I don't get the possibility of eye injury though. What is awareness vs. pain? During my last colonoscopy I was aware but had no pain.
Wonderful video as usual. Had general anesthesia in April and again in September. On both occasions I was out prior to entering OR. Is that common? Thank you!
Great video's. Have a question in regards to someone having bad breathing problems before any operation . Was told for example my back is in need of a operation but back doctor told me my breathing is so bad i would never get out of ICU ...breathing tube would be like this forever. He refuse to touch back because of breathing. Great video's.
When I had my knee replacement surgery, I told the anesthesiologist that I didn’t want to feel pain, but more importantly, I didn’t want to hear anything. I had watched a number of UA-cam videos of knee replacement surgeries and was horrified of the sound of the saw! 😂
DR. iam a 74 year old male with heart disease i have had 9 stents inplanted in me , i also have a host of other medical conditions, kidney disease stage 3 copd, the list goes on . however my question isdoctors say iam a high risk for anistology i take anti platelet drugs paxil 75 mg and one 81 mg of aspirin plus an array of other daily meds.what would my chances be for favorable outcome because of the drugs i take cause excessive bleeding , etc , please answer or make a video with these concerns ,i would really appreciate it . thanks for taking time to read my situation .
My phone battery is draining and I will watch the rest of this later. However, when I was in labor with my daughter (Miya Jane Justeson), I NEVER had an indepth conversation with the Anesthesiologist, Dr. Murphy, regarding the process. In fact, he administered an epidural, that made my body completely numb, and I began to shake, as if my body was in tetany. Then, the decision was made to give an emergency c-section, and Dr. Murphy (who have me a creep vibe) administered FULL sedation against my will ! I did not want it, and feared it would harm the fetus, and I would not wake up because of being over medicated. I did NOT need full sedation, because my body was already numb. I wanted to be awake to see her when she was initially born. Also, Dr. Murphy, Tampa Anesthesiologist, was disbarred for possession of child pornography on his home computer. This only reiterates why individuals who receive initial gut feelings, must follow them ! My infant daughter 2/23/2007-3/18/2007, is buried at Florida National Cemetery in Bushnell, FL. Her body needs to be exhumed for a full investigation and legitimate autopsy.
Someone going in for brain surgery and is told there's a 10% chance of problems (Death or disability) due to the anesthesia; there's really not much choice as it's not really elective surgery.
I had a tubal 3 years ago when I was being extubated I vaguely remember waking up feeling like I was drowning swallowing to get more air and couldn't move i swore I heard the docs say they were going to loose me, next I know I'm waking up coughing up alot of yellow stuff. My fiance said they had to reintubate me I Had a layrngospasm but. I'm About to request my medical records. As after this experience I found I have lingual tonsil hypertrophy which also can cause difficult intubation. I need a endoscopy in feb and maybe lingual tonsil surgery find out in Jan but I link surgery to death now... idk what happened 😭
What would you say about a patients family that claims the patient isnt entirely themself after the surgery and they dont recover from it, on subsequent surgeries the staff dismiss it entirely as being 'imagined'. despite the symptom getting worse with each surgery. eventually requiring the family to force them to use a different method of putting the person under. Is this really "imagined" or is this potentially brain damage from a complication related to being under that the staff is simply ignoring to keep their record clean?
How to discuss with patients, What talk to patients. In Oklahoma all we see is the nurse and the doctor and that is it. The only time the anesthesiologists comes in it to check your IV and then walk out and that is it,. There is no discussion with the anesthesiologist before surgery. The only discussion is when your doctor comes in and says are you ready and you say yes and he ask if you have any questions abour surgery. Thats it and you are on your way.
Have you covered different types of anesthesia teams that are used? When I had my colonoscopy, the anesthesiologist MD did the pre-procedure warnings/risks chat but in the procedure room anesthesia was handled by a NP. I was knocked out with just propofol if that helps.
That analogy would be inaccurate though. If I remember correctly fatal aeroplane accidents were at about 1 in 3 million flights whereas fatal general anesthesia incidents were at about 1 in 200K.
Honestly, as a patient...none of this matters. My appendex is going to burst, or my spine needs a fusion, or my infection has spread and i need debarment.....JUST DO IT. We as patients can NEVER be told enough or not enough toactually know anything of use but we still need to get the procedure. Informed consent in medical procedures are a formality and frankly they dont do anything but make the doctors and lawyers happy. Its similar yo a car mechanic saying you need x, y, and z or your car will be unsafe/break. You basically have to hipe they have your best interest at heart and knowledgeable about the situation to act correctly
Is there any way to ask you to actually answer? After a fatal arrhythmia, I was intubated for two weeks almost ten years ago. My speaking voice came back with a notably shortened breath, and my singing voice was obliterated. At this time, I can almost get through a long, complex sentence and sing a few notes. It's been ten years, for crying out loud. What happened?
So have you ever had any experiences of post anesthesia psychosis? If so what is normally done ahead of time if someone is known to have had an episode?
Ketamine-Induced Exacerbation of Psychotic Symptoms and Cognitive Impairment in Neuroleptic-Free Schizophrenics, 1997 (tested with sub anesthetic doses. It did worsen symptoms) But it’s not clear to me what that psychosis was, because that whole ketamine therapy seems to promote temporary dissociation which is a form of psychosis I think? The non schizophrenia volunteers had similar effects. Effects of Ketamine in Normal and Schizophrenic Volunteers, 2001
I would like your opinion please. I have been waiting for gynaecological surgery for over 2 years ( it was cancelled due to pandemic just before Surgery was due) since then, I have been scheduled for Surgery and twice was actually prepped with a slot booked. The anaesthetist the came to speak to me and said that he wasn’t prepared to go ahead because of the risk. At the time I had suspected Supra Ventricular Tachycardia (which was confirmed shortly later) and I have Sleep Apnoea. I am not overweight, I just stop breathing many times an hour, and always have). Is this really a risk or are they being extra cautious?
He’s a resident. Residents work an incredible number of hours and don’t make as much as you might think, although NYC hospitals might be more generous than other places. You can likely look online and learn what residents earn at his hospital.
@@mikiegood you guys are all so weird He is is resident he isn’t an attending anesthesiologist just yet and the hospital covers his mala practice and residents don’t even have to worry about mal practice since the hospital pretty much covers them in full
@@CTyankeeinVA yeah he is a third year resident so he is making about 90k but it’s just hospitals which are located in big cities in general which pay their doctors a lot not specifically just NYC but yes NYC hospitals does compensate their doctors extremely good.
As an outsider, this seems very strange to me. I don't think the air-travel example illustrated anything but the absurdity of it all. When you book a flight, do you expect to be sat down with the pilot, who would then explain the remote possibility of a crash, after which you'd have to provide your consent? Would you like for that to be how that works? The same thing with "throat discomfort" -- 'You are going to be cut open, but don't worry about that, we have drugs to solve the horrific pain; it's the throat "discomfort" that I am required to inform you about.' I also have trouble believing the "informed" part of the "informed consent." Are you telling me that after a short talk on the incidence of complications (by someone who is - presumably - improvising), people will be making an "informed" decision? Ask them to subtract a two digit number and they'll struggle, but You're saying that in the during the short talk which almost certainly went entirely over their heads, they've had enough time to objectively evaluate the risks for themselves? Do You think, if you stood up half-way through your first lecture on anesthesiology, you would by that point be capable of making informed decisions?
The airplane analogy could be used if you were to be informed of the general situations that could go wrong with a flight and what they would do in that emergency. While it's true you wouldn't know or understand All the possible details of what's in a given drug based on the limited time they have with you, pilots and flight attendants Also won't inform you of all their protocols to you during an actual emergency. You can choose to read the document provided by your Doctor or Nurse before signing it like you can do with reading the instruction manual on flight emergencies. Beyond that, in either case - if we have time, it's up to us to determine whether or not we will do additional information for the risk we are about to take.
Sorry my last one cut off My daughter is allergic to sucs whenever she has a surgery it has to be done in the main wire and I asked for one of the three anesthesis doctors that have worked with her and know that I do know what I'm talking about she immediately goes into anaphylactic shock and even flatlined twice are there other paralytic agents that can be used? She's had a number of surgeries since then only one episode where they used sucks like I told them not to but I'm wondering if she just needs to be put to sleep heavier or if she needs a paralytic agent
Interesting video 👍 About EEG monitoring the patient, would you suggest to make that obligatory? Because in my country, at least for the ambulant surgeries I went through this is usually a "Patient's Choice" for $ $ $ or € € €. I think my question is interesting, because I often see surgery videos or reports where the patient's eyes are closed or even taped, or they're unable to move anything or open their eye lids because of the general anesthesia, how do do check without monitoring if a patient is really not feeling/aware of anything or is awake? 😆 Eh and before you ask, I already had a minor surgery (perianal hematoma) where obviously general anesthesia would obviously be way too much, yet the feeling of a sharp knife on my ass wasn't exactly a pleasant experience even with local aneasthesia 😂, can't imagine how an appendectomy while actually awake would feel like 😱
I imagine tachycardia and hypertension might be a clue as to the patient feeling something but I'm wondering if the meds can keep vitals so under control that it could make it difficult for those reactions to take place 🤔 Telling someone they can have the extra safety during anesthesia only if they fork over more money sounds horrible and honestly like a very U.S. healthcare thing to do.
@@XSemperIdem5 German Public Health Insurances are cheap skates and only pay if there is sufficient scientific evidence for an intervention or therapy. And even then they only pay for what's economic aka cheapest solution, just about sufficient therapy/intervention that works. In terms of dental health care germany isn't far away from the U.S. either, you'll either get the cheap skate solution if you're poor, and if the dentist smells your fat purse he's attempting to install a premium car's worth of implants and crowns in your oral cavity. Something your average patient can't just decide on his own anymore. Would you be able to tell if you need fillings for ~20€ or100+ €?
one day hes gonna give the likleyhood of being in a car crash speech to a patient and there just gonna stare at him and turn down the surgery hell then look down at his notes and see oh... the patient was in a car crash today
It really bothers me that the doctor kept saying“consider disclosing.” Who is he to decide what to tell me about risks, he doesn’t know my values and beliefs well enough to know what side effects are important to me. This doctor will never be my doctor. I want the full list of risks, every one in detail, anything less is malpractice in my opinion. A better approach would be to give the patient a document with the full list of the risks with details a before the meeting with the anesthesiologist so you can ask about the risks that ate important to you. The arrogance of the medical profession I displayed in this video.
I had a sinus surgery once and my doctor and anesthesiologist started off with the most terrible possible outcomes (those being death and permanent brain damage) and then told me all the ways they avoid those particular problems, and then ended with the most common risks, that was really good for me because I knew the absolute risks, but also knew just how much care they take to avoid those risks
Anesthesiologist are the ROCK STARS in the surgery room.
I discovered your channel while recovering from robot assisted prostate surgery last week. I agree with all the positive comments about your presentation/teaching style - it's very good. I must be a dream patient because I remember the doc telling me that he would put a mask on me that would deliver 100% O2 and that Propofol would be injected into my IV to put me to sleep. At that point my memory shut off. I don't remember the O2 mask and I don't remember anything about the recovery room. My next memory is being wheeled into my room for the night. Everything between being told about the mask and entering my room is gone. Fine with me!
Max, your videos are educational for patients too. I have had general anesthesia 36 times.. the last time was nearly 24 years ago. I learned the risks long ago. The biggest issue I have had is nausea and vomiting with sedatives and anesthesia. Anesthesiologists must work with patients on prevention as much as possible. It was really no fun to wake up from surgery and deal with hours of nausea and vomiting.
Same thing happens to me, it’s awful!!
As a medical student, I’ve learned that one of the best ways to learn is to teach! Thank you for your videos; I learn a lot from them, and I’m also certain you are becoming better as you make them.
I think they should have each and everyone in Medical School wake up with a breathing tube down there throats. No one told me this, NOT GOOD.
Good video man! I always learn a lot from you, you inspire me so much, I have had 14 surgeries because of my cerebral palsy, that’s one reason I tried to go to college to be a anesthesiologist, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy!
Twenty two surgeries on me with general. One jaw dislocation, one brachial plexi injury which resolved in six weeks, and one wake up with the tube being pulled out in the or. So, it does happen some serious, some not serious.
Great video!
Aren't you scared? I have been postponing my surgery for five years now... scared of general anesthesia 😢😢
Was doing an assignment on informed consent, and I stumbled upon an article by you. Was such a surreal experience to recognize one of the authors as a UA-camr
I had a friend who had severe hyperthermia after anesthesia. It was good he had to stay in the hospital anyway because it happened so fast after he was moved to his room after surgery. It is really rare he said.
Please Max make a video in anaesthesia for opiate and benzodiazepine tolerant people, I meant for me who is regular user of the IV opiate benzodiazepine and sedative cocktails. Which I know is frequently if not always used in one or multiple phases in anesthesia .
As someone who is opiate dependent and a natural redhead I am EXTREMELY hard to sedate. I’ve had 4 surgeries this year alone, getting ready for my fifth, and each time they have literally had to give me more induction medication because I did not go to sleep.
I really love Max’s videos . I find them very interesting and educational.
Thank you very much for your videos about anesthia. I have never experienced general anesthia before so I thought I would just educate myself if this situation arises in future plus as I have degree in chemistry I was interested in it from the scientific point of view how it works.
Well I was in that situation much much sooner than expected.
It was like 3 weeks after I checked your videos when I badly broken my arm and surgery was needed.
Your videos actually helped me to be a much more relaxed before the surgery.
The general anesthia was actually quite pleasent for me as if I had really good sleep. And I was really surprised how fast it was. I had IV induction and anesthesiologist told me that I can feel tingling sensation in my arm which started to feel like 2 seconds after she told me that. Then she continued I can just relax now and think about something pleasent to have a nice dream. Well after she told me that i felt how fast the tingling travels through my arm to my head and then I remember absolutely nothing.
Next memory I have is as I am waking up and doctor asking me how I felt. At first moments I didnt actually believe I was after surgery. It was like total time-skip. As they were transporting me with my bed to my room I was like oh, that looks like I really am after the surgery. I was amazed how well this works.
🤣post-operative nausea is so common for me, that after one of my ENT surgeries, (while I was dry-heaving like nobody's business), one of the recovery room nurses chuckled and said to another nurse "Yeah, she's notorious for throwing up really bad after surgery, so they pump her stomach before she wakes up".
GREAT VIDEO Max! Keep them coming - super valueable to the patient's and anesthesia practitioners! Greetings and congratulations from NYSORA!
Thank you Dr. Hadzic, means a lot coming from you!
@@MaxFeinsteinMDhow risky is general anesthesia for obese female with a bmi of 37😢
Thank you for your videos. My first experience with anaesthesia was a few weeks ago & your videos helped so much pre surgery.
Did you wake up with the breathing tube down your throat???
@@patriciaparsons2655 no
Great information! thank you Dr. Feinstein.
I had some ongoing long lasting hoarse throat problems for many month. Thank-goodness eventually got better.
Thank You for this awesome educational video which helps patients understand the different risks and outcomes after undergoing any kind of surgeries which requires the application of Anesthesia …
I’d rather get medical advice from this channel than some of my docs
Amazing video, per usual!
was wondering if you can make a video in which you interview a CRNA! Would love to see your viewpoint of that profession
I had a scoliosis spinal fusion 3 months ago and after they surgery they had planned to wake me up and see if I had reflexes in my feet but they notice when they stopped oxygen that I was not breathing properly, reason being was my body was enjoying the ketamine and my anesthesiologist had be a little to generous with it but what ever less then an hour after surgery I was extabated.
I remember going under for wisdom tooth extraction and talking about the risks. Think I surprised the dentist/doctor when they briefly mentioned the remote chance of death and I just went "sometimes, sh happens you can't predict everything". I know people dislike hearing that risk, but there is always a remote chance of things going horribly wrong for no real reason and I'd rather be told upfront vs. sugarcoating everything.
I have never had the anesthesiologist explain the risks of anesthesia or what level they would be using. Either general vs. other (e.g., nerve block) was implied or the surgeon said what would be used.
Another great video max!
I would really appreciate a video on the gasses used before the major anesthetics are administered.
He has a video on medications used, which includes gases.
I am a slow metabolizer of drugs broken down by CYP 450 2D6 and CYP 450 3A4. If I don't get that info to the anesthesiologist, there is a risk of overdose -
They had to stop the morphine when I broke my back as I wasn't breathing well
The fentanyl for the shoulder surgery was too high and a hypoxia alarm kept going off (I had to focus on breathing so they'd do the surgery!)
The anesthesia for a colonoscopy had to be pulled back as my BP dropped too much (got to watch on a monitor, though - fascinating)
Excellent video, Dr Max. If someone has had general anasthetics before with no problems, is that an indication that that person tolerates them well and there is little likelihood of any problems during future surgeries, or could you have bad vomiting for example any time you 'go under'?
Really enjoy your videos, Dr. Max!
I had a hysterectomy which also ended up intentionally taking one of my ovaries (which wasn't initially planned). I suspected they may need to remove it eventually so I gave my explicit verbal consent multiple times in the OR while being prepped for anesthesia because you can't get consent from an unconscious person.
I think i've had this discussion before. Where I really do think is dental offices should NOT be ALLOWED to sedate and put patients under. The offices that always want to put patients under do NOT even want to have these conversations with patients, let alone they seam VERY ill-equiped to handle the one-offs that can happen during a procedure.
From what I’m aware of dental offices don’t use general anesthesia because only an anesthesiologist can perform general anesthesia since they have the license dental offices can only do regional anesthesia or extremely mild sedation but I’m pretty sure they don’t use general anesthesia unless a certified anesthesiologist works in that dental office which is unlikely because they mostly work in hospitals dealing with different medical issues and not teeth
I’ve been knocked out a couple of times during dental procedures. Once was via IV and twice was via oral sedation. The second time they did oral sedation, I woke up during the middle of it by vomiting while I was asleep. They just stopped in the middle of what they were doing and sent me home. The only silver lining there was that I got it all over the dentist.
I’ve had to be sedated at the dentist because of how bad my anxiety gets. but when I’ve had that done, I had to go to an oral surgeon center, not just a regular dentist. so they are more prepared for things and know more about what they’re doing. they always gave me IV sedation
Why in the world would a dentist put a patient under when any dentist I have had uses a shot in the gum near where the dentist is workimg?
@@joyceutt3419 They do it the patient has a fear of dentists, when they’re going to be doing a lot of work, or pulling several teeth, etc. If the patient wants it, a lot of dentists do it.
Honestly Max, I've had surgery twice and was never really given any of this info. When I stated I was nervous about being put to sleep, I was given versed lol.
Anesthesia is amazing
Have undergone surgery 7 times under general anesthesia over the past 10 years. About the only thing I have noticed is having esophagus problems after the last two surgeries with swallowing food and it goes does the windpipe instead of going to stomach. Could this be as a result of the airway trac used for general anesthesia?
Corneal abrasions in 27% of patients, lid taping should be standard practice
Modern life in the US makes a mockery of disclosure forms. The average person is not a lawyer and can understand the text or its implications.
My mom went into respiratory arrest during a dental procedure in her 50s. She was quickly revived.
She had to warn all future anesthesiologists she had an issue.
My oral surgeon lost a patient on the table 2 months before my scheduled jaw surgery. It was a rare event and I went ahead with my procedure.
8 needed blood due a complication but he didn't administer any due to the time. 1988. The blood supply wasn't fully tested for HIV and there was a notable case of someone contracting HIV due to a transfusion.
He prescribed iron supplements instead.
Great post! Thanks.
my biggest fear about anesthesia is waking up paralyzed, although its not a permanent affliction I get panic attacks when I cant move (being held down), I liken it to claustrophobia as its likely the same despite me only having problems with closed spaces if I cant move at all.
Extubation also scares me, despite not being aware of my extubation, if I woke up with it down my throat I would most likely panic.
Damage or even death doesn't actually spook me, one can be fixed or managed, the other I wont even realize I died.
I wish my anesthesiologist would have told me that the medication they gave me to relax my muscles would make me feel like i was hit by a mac truck for the next 4 days. That definitely would have been nice to know.
My father had vocal cord injury during surgery that took a while to resolve. I don't get the possibility of eye injury though. What is awareness vs. pain? During my last colonoscopy I was aware but had no pain.
Cornea abrasion
New profile picture? Haha loved the video Max
Wonderful video as usual.
Had general anesthesia in April and again in September. On both occasions I was out prior to entering OR. Is that common? Thank you!
Can you comment on risk (if any) of longer term cognitive issues following anesthesia ?
Great video's. Have a question in regards to someone having bad breathing problems before any operation . Was told for example my back is in need of a operation but back doctor told me my breathing is so bad i would never get out of ICU ...breathing tube would be like this forever. He refuse to touch back because of breathing. Great video's.
When I had my knee replacement surgery, I told the anesthesiologist that I didn’t want to feel pain, but more importantly, I didn’t want to hear anything. I had watched a number of UA-cam videos of knee replacement surgeries and was horrified of the sound of the saw! 😂
I have had other surgeries and never had throat problems like that.
Hi Dr Max! 👍
DR. iam a 74 year old male with heart disease i have had 9 stents inplanted in me , i also have a host of other medical conditions, kidney disease stage 3 copd, the list goes on . however my question isdoctors say iam a high risk for anistology i take anti platelet drugs paxil 75 mg and one 81 mg of aspirin plus an array of other daily meds.what would my chances be for favorable outcome because of the drugs i take cause excessive bleeding , etc , please answer or make a video with these concerns ,i would really appreciate it . thanks for taking time to read my situation .
My phone battery is draining and I will watch the rest of this later. However, when I was in labor with my daughter (Miya Jane Justeson), I NEVER had an indepth conversation with the Anesthesiologist, Dr. Murphy, regarding the process. In fact, he administered an epidural, that made my body completely numb, and I began to shake, as if my body was in tetany. Then, the decision was made to give an emergency c-section, and Dr. Murphy (who have me a creep vibe) administered FULL sedation against my will ! I did not want it, and feared it would harm the fetus, and I would not wake up because of being over medicated. I did NOT need full sedation, because my body was already numb. I wanted to be awake to see her when she was initially born.
Also, Dr. Murphy, Tampa Anesthesiologist, was disbarred for possession of child pornography on his home computer. This only reiterates why individuals who receive initial gut feelings, must follow them !
My infant daughter 2/23/2007-3/18/2007, is buried at Florida National Cemetery in Bushnell, FL. Her body needs to be exhumed for a full investigation and legitimate autopsy.
Praying for you!.. my sympathies. A doctor should NOT force a procedure on you without consent, that's assault here in EU!!!
Someone going in for brain surgery and is told there's a 10% chance of problems (Death or disability) due to the anesthesia; there's really not much choice as it's not really elective surgery.
fantastic
I had a tubal 3 years ago when I was being extubated I vaguely remember waking up feeling like I was drowning swallowing to get more air and couldn't move i swore I heard the docs say they were going to loose me, next I know I'm waking up coughing up alot of yellow stuff. My fiance said they had to reintubate me I Had a layrngospasm but. I'm About to request my medical records. As after this experience I found I have lingual tonsil hypertrophy which also can cause difficult intubation. I need a endoscopy in feb and maybe lingual tonsil surgery find out in Jan but I link surgery to death now... idk what happened 😭
I’d be like you know what? Suddenly my back feels so much better sorry to trouble you hey any good pain clinics nearby?
What would you say about a patients family that claims the patient isnt entirely themself after the surgery and they dont recover from it, on subsequent surgeries the staff dismiss it entirely as being 'imagined'. despite the symptom getting worse with each surgery. eventually requiring the family to force them to use a different method of putting the person under.
Is this really "imagined" or is this potentially brain damage from a complication related to being under that the staff is simply ignoring to keep their record clean?
How to discuss with patients, What talk to patients. In Oklahoma all we see is the nurse and the doctor and that is it. The only time the anesthesiologists comes in it to check your IV and then walk out and that is it,. There is no discussion with the anesthesiologist before surgery. The only discussion is when your doctor comes in and says are you ready and you say yes and he ask if you have any questions abour surgery. Thats it and you are on your way.
Have you covered different types of anesthesia teams that are used? When I had my colonoscopy, the anesthesiologist MD did the pre-procedure warnings/risks chat but in the procedure room anesthesia was handled by a NP. I was knocked out with just propofol if that helps.
That analogy would be inaccurate though. If I remember correctly fatal aeroplane accidents were at about 1 in 3 million flights whereas fatal general anesthesia incidents were at about 1 in 200K.
Honestly, as a patient...none of this matters. My appendex is going to burst, or my spine needs a fusion, or my infection has spread and i need debarment.....JUST DO IT. We as patients can NEVER be told enough or not enough toactually know anything of use but we still need to get the procedure. Informed consent in medical procedures are a formality and frankly they dont do anything but make the doctors and lawyers happy. Its similar yo a car mechanic saying you need x, y, and z or your car will be unsafe/break. You basically have to hipe they have your best interest at heart and knowledgeable about the situation to act correctly
Hipe
I. Hipe my me mechanic
Hipe my doctor
all these risks are concerning. dr incompetence could be distraction, or not caring
Would there be instances where you *would* expect to damage the vocal cords?
Is there any way to ask you to actually answer? After a fatal arrhythmia, I was intubated for two weeks almost ten years ago. My speaking voice came back with a notably shortened breath, and my singing voice was obliterated. At this time, I can almost get through a long, complex sentence and sing a few notes. It's been ten years, for crying out loud. What happened?
I've got a question Max, I am having an EUA and they will use general anesthesia, how will they turn me and keep the ventilator in?
So have you ever had any experiences of post anesthesia psychosis? If so what is normally done ahead of time if someone is known to have had an episode?
Ketamine-Induced Exacerbation of Psychotic Symptoms and Cognitive Impairment in Neuroleptic-Free Schizophrenics, 1997
(tested with sub anesthetic doses. It did worsen symptoms)
But it’s not clear to me what that psychosis was, because that whole ketamine therapy seems to promote temporary dissociation which is a form of psychosis I think? The non schizophrenia volunteers had similar effects.
Effects of Ketamine in Normal and Schizophrenic Volunteers, 2001
Love that
Just had heart valve replacement aborted after having a bronchial spasm. How common is this?
What could cause eye injury during anesthesia
Machine behind u... That is Aisys Cs2 by datex ohmeda right?
I would like your opinion please. I have been waiting for gynaecological surgery for over 2 years ( it was cancelled due to pandemic just before Surgery was due) since then, I have been scheduled for Surgery and twice was actually prepped with a slot booked. The anaesthetist the came to speak to me and said that he wasn’t prepared to go ahead because of the risk. At the time I had suspected Supra Ventricular Tachycardia (which was confirmed shortly later) and I have Sleep Apnoea. I am not overweight, I just stop breathing many times an hour, and always have).
Is this really a risk or are they being extra cautious?
Breathing problems were mentioned as a reason to avoid elective surgery.
Did Dr. Max get a new camera? 👀 I thought you’re doing your fellowship elsewhere, I didn’t know you’re still with MS
He is still a third year resident though he has one more year before he takes a fellowship
Does is it really matter the risks of you still need the surgery to survive?
Only some surgeries are to help someone survive. Many are optional / elective.
Risk vs reward.
Ahh I miss the good old days when I was given ether on a mask administered by a nurse. I remembered the coldness.
I want to be an anesthesiologist so bad but I don't think I'm able to anymore :(
A shoutout to all the people that love medicine but have nothing to do with it in terms of career.
Sir how much do you earn as an anesthesiologist? Plz reply. Thanks a lot.
probably $150-250k/year.
Probably pays $50,000/year in malpractice insurance
He’s a resident. Residents work an incredible number of hours and don’t make as much as you might think, although NYC hospitals might be more generous than other places. You can likely look online and learn what residents earn at his hospital.
@@mikiegood you guys are all so weird He is is resident he isn’t an attending anesthesiologist just yet and the hospital covers his mala practice and residents don’t even have to worry about mal practice since the hospital pretty much covers them in full
@@CTyankeeinVA yeah he is a third year resident so he is making about 90k but it’s just hospitals which are located in big cities in general which pay their doctors a lot not specifically just NYC but yes NYC hospitals does compensate their doctors extremely good.
As an outsider, this seems very strange to me.
I don't think the air-travel example illustrated anything but the absurdity of it all. When you book a flight, do you expect to be sat down with the pilot, who would then explain the remote possibility of a crash, after which you'd have to provide your consent? Would you like for that to be how that works?
The same thing with "throat discomfort" -- 'You are going to be cut open, but don't worry about that, we have drugs to solve the horrific pain; it's the throat "discomfort" that I am required to inform you about.'
I also have trouble believing the "informed" part of the "informed consent." Are you telling me that after a short talk on the incidence of complications (by someone who is - presumably - improvising), people will be making an "informed" decision? Ask them to subtract a two digit number and they'll struggle, but You're saying that in the during the short talk which almost certainly went entirely over their heads, they've had enough time to objectively evaluate the risks for themselves? Do You think, if you stood up half-way through your first lecture on anesthesiology, you would by that point be capable of making informed decisions?
The airplane analogy could be used if you were to be informed of the general situations that could go wrong with a flight and what they would do in that emergency.
While it's true you wouldn't know or understand All the possible details of what's in a given drug based on the limited time they have with you, pilots and flight attendants Also won't inform you of all their protocols to you during an actual emergency.
You can choose to read the document provided by your Doctor or Nurse before signing it like you can do with reading the instruction manual on flight emergencies.
Beyond that, in either case - if we have time, it's up to us to determine whether or not we will do additional information for the risk we are about to take.
My daughter is allergic to
Sorry my last one cut off My daughter is allergic to sucs whenever she has a surgery it has to be done in the main wire and I asked for one of the three anesthesis doctors that have worked with her and know that I do know what I'm talking about she immediately goes into anaphylactic shock and even flatlined twice are there other paralytic agents that can be used? She's had a number of surgeries since then only one episode where they used sucks like I told them not to but I'm wondering if she just needs to be put to sleep heavier or if she needs a paralytic agent
Don't know why this isn't showing up
The risk of death is something you MAY want to disclose to your patients? No. Disclose it.
Umm one question: Who is the dude behind you?
Interesting video 👍
About EEG monitoring the patient, would you suggest to make that obligatory? Because in my country, at least for the ambulant surgeries I went through this is usually a "Patient's Choice" for $ $ $ or € € €. I think my question is interesting, because I often see surgery videos or reports where the patient's eyes are closed or even taped, or they're unable to move anything or open their eye lids because of the general anesthesia, how do do check without monitoring if a patient is really not feeling/aware of anything or is awake? 😆
Eh and before you ask, I already had a minor surgery (perianal hematoma) where obviously general anesthesia would obviously be way too much, yet the feeling of a sharp knife on my ass wasn't exactly a pleasant experience even with local aneasthesia 😂, can't imagine how an appendectomy while actually awake would feel like 😱
I imagine tachycardia and hypertension might be a clue as to the patient feeling something but I'm wondering if the meds can keep vitals so under control that it could make it difficult for those reactions to take place 🤔
Telling someone they can have the extra safety during anesthesia only if they fork over more money sounds horrible and honestly like a very U.S. healthcare thing to do.
@@XSemperIdem5 German Public Health Insurances are cheap skates and only pay if there is sufficient scientific evidence for an intervention or therapy. And even then they only pay for what's economic aka cheapest solution, just about sufficient therapy/intervention that works. In terms of dental health care germany isn't far away from the U.S. either, you'll either get the cheap skate solution if you're poor, and if the dentist smells your fat purse he's attempting to install a premium car's worth of implants and crowns in your oral cavity.
Something your average patient can't just decide on his own anymore. Would you be able to tell if you need fillings for ~20€ or100+ €?
Propofol is gonna feel so good. Not much of a risk unless you have enough money to hire your own Doctor, but if one could...
one day hes gonna give the likleyhood of being in a car crash speech to a patient and there just gonna stare at him and turn down the surgery
hell then look down at his notes and see oh... the patient was in a car crash today
it was a voice problem
Propofol is just like a quick nap.
My Mom said 'I just want to wake up'
It really bothers me that the doctor kept saying“consider disclosing.” Who is he to decide what to tell me about risks, he doesn’t know my values and beliefs well enough to know what side effects are important to me. This doctor will never be my doctor. I want the full list of risks, every one in detail, anything less is malpractice in my opinion. A better approach would be to give the patient a document with the full list of the risks with details a before the meeting with the anesthesiologist so you can ask about the risks that ate important to you. The arrogance of the medical profession I displayed in this video.
I'd feel more comfortable buying a plane ticket.
OK