Episode #12 – 5 Questions you need to know BEFORE surgery with Dr. Dave.

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Straight Shot Health Talk

A special guest on today’s episode! Dr. Dave of the website Anesthesia Myths
Listen in for the discussion on the questions below (this information is can be found in its original form at AnesthesiaMyths.com)

5 Things to Ask Your Anesthesiologist BEFORE Going Under

1. Whatʼs the anesthesia model you are using?

Most people are unaware that in the United States there are several ways of providing anesthesia care.

Anesthesiologist Only:  An anesthesiologist (a physician specifically trained in anesthesia)  personally performs your anesthetic from beginning to end.

Anesthesiologists have completed 4 years of college, 4 years of medical school, and 4 years of residency training as well as additional medical training each year they practice.

Anesthesia Care Team Model:  An anesthesiologist supervises 2 to 4 CRNAʼs (2-4 different surgeries at a time).  The CRNA’s are in the Operating Room.  Your individual surgery may be just one of the surgeries your anesthesiologist is responsible for.
A CRNA is a certified registered nurse anesthetist. This person typically has a bachelors degree in nursing, several years of ICU experience as a nurse, and then completes a 2 year nurse anesthesia program.
In the care team model, the CRNA stays with you from beginning to end, with the anesthesiologist present at key parts of the case and available should the CRNA need help.
In academic training centers (large hospitals which train physicians) you may have an anesthesia resident (a physician still completing their specialty training) or an SRNA (student nurse anesthetist) involved in your care.  But with both there would be a anesthesiologist supervising them and, potentially, other trainees in other operating rooms.

When you are  performing informed consent (which you sign before having surgery) you should know which model is being used.  If you don’t–ASK!

ASK whoever is discussing your anesthesia for your surgery exactly what are their qualifications and what kind of model will be used in your case.

If you prefer one model over another, it is within your right to make a request (BUT options could be limited.  To prevent this talk to your surgeon BEFORE GOING TO THE HOSPITAL and ask them who will be providing your anesthesia during the case).

2. Training/ Board Certification
An anesthesiologist has gone through extensive training: 4 years of college (at least, right), 4 years of medical school, and 4 years of residency training.
Additionally, they must pass two rigorous exams in order to be board- certified by the American Board of Anesthesiology (www.theABA.org).

One is a written exam.  The other is an Oral exam (the doctor sits in front of two board certified anesthesiologists who ask him or her questions about different types of operations, anesthetics and potential catastrophes.  The doctor who is being questioned has no idea what questions or cases the examiners will use before the exam begins.
Itʼs a tough exam, and it should be.
After passing BOTH of these exams the doctor is now a Board Certified Anesthesiologist.

(You can verify this by checking your anesthesiologists name at www.theABA.org)

3. Do you have experience with this type of case?

This question may be especially helpful if you are about to undergo a very complicated or rare procedure.
The rarer or more complicated the surgery the more important it is to know how experienced your SURGEON and your ANESTHESIOLOGIST are in caring for you during it.

If in doubt ASK!!!!

4. Whatʼs the anesthesia plan?

You may be placed under general anesthesia (“completely asleep” but more than that.  This type of anesthetic means your brain is turned off and you may need a machine to breath for you)

You may experience regional anesthesia which is when the area of your body being operated on is “numbed up” with local anesthetic (“numbing medicine”).  This includes epidurals and spinals for c-sections/delivering babies OR numbing up arms or legs for other surgeries.

You can be completely awake for surgeries with regional anesthesia OR you can be in “twilight” sleep.  “Twilight” sleep is when you get some medications to make you sleepy, you may not even remember your surgery, but you should be breathing on your own and could even be talking with your anesthesiologist during the surgery (the surgeons generally don’t want to talk with you during the surgery :) )

Your anesthesiologist should discuss the types of anesthesia available for you.  In some situations a general anesthetic or regional anesthetic may be safer or more preferable–they should let you know this as well and explain why.

BUT ultimately, it is your choice.

Which is why you should keep listening to Straight Shot Health Talk so you can stay informed and knowledgeable about healthcare ;)

5. Did you get a good nightʼs rest?

Emergencies and urgencies occur at all times of the day.

Your doctor may have needed to come in at 2 am or never had a chance to go home (this does happen and is part of the “job”).

If your surgery is “elective” (elective basically means it doesn’t need to be done right now) then you can ask your anesthesiologist when and how much they slept last.

They should let you know and you both should be comfortable with the answers before going back for surgery.

Thanks again to Dr. Dave of AnesthesiaMyths.com!

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