Not to hijack the thread but I'm also considering rads and maybe my questions will be useful to OP. Like nicotine, marijuana can complicate surgery and should be avoided in the weeks and even months prior to your procedure. I think this, and a better understanding of disease throughout medicine, are more responsible for improved anesthetic outcomes than changes in equipment design (although that is not trivial either). You will feel this way for life. Why don't you consider ophthalmology. Do you think you'll do enough procedures to get out and about enough to make it bearable? I agree that the complications attributable to major surgery are more common overall and harder to prevent. Seems like an easy high impact/massively read study possiblity. Additionally, I noticed the burnout rate is quite high (about the same as EM, which is frankly terrifying). Coronavirus disease‐19 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), remains a public health emergency of international concern with high levels of community transmission and a high mortality rate in high‐risk groups [].The care of patients with COVID‐19 has put a significant strain on intensive care unit (ICU) resources worldwide. Hi there, I’m 1.5 years into Anesthesia practice at medium size community shop. It'll be even worse on Christmas day or a Saturday at 3am. You should be able to look at your job and say "Yea, I can be happy doing this for the next 35 years". Share via. But anesthesiology, despite meeting both those criteria (high pay and infamous for being a "you just sit around for 90% of the time" job), isn't as hard to get into. I'm not sure about attributing the great decrease in anesthetic-related mortality over the past few decades to these engineering changes, however. I don't mean interacting with patients, I mean interacting with that one patient who is obviously seeking painkillers, or the diabetic that is angry and doesn't understand why you can't just surgically reattach his gangrenous toe as he sips his 7/11 big gulp slurpy (real patient for me), or perhaps the worst, the patient interaction with the patient who wants to get better but the social system has failed via insurance, poor support, or poor socioeconomic factors. however, i will say that there is a condition that is called malignant hyperthermia, and results from really bad reactions to common drugs used during anesthesia. However, I feel many patients too quickly defer to their peers suggestions and surgeons recommendations. Work life balance present. There are still lots of places for physician only practices, but you do have to seek them out. Just to mix it up and keep things interesting? I love my job. depends on the surgical procedure and on the type of anesthesia used. administer several compounds which suppress or stimulate various functions. Few people regret rads or anesthesia. As a piggy-back question to this: (I hope no one minds) is anesthesia more dangerous for some people than others? In general, the sicker you are, the higher your risk. Just today I had a patient with a large mass in the anterior mediastinum. Can message me if you care to answer and sorry if off topic. The anesthesia costs related to (the) anesthesiologist's fee is substantially more than the colonoscopist's fee, yet the value of the procedure is the colonoscopy and polypectomy not the sedation, so this has become a contentious matter." Acute conditions are rare and often in emergencies. Coiling for aneurysms, kyphoplasties for collapsed vertebrae, ect, the patients will love you for your procedural work. I don't think you should do EM. There is plenty of depth in rads and anesthesia. No dealing with irate family members. Looks like you're using new Reddit on an old browser. I don't like the way Anesthesiologists are treated in most OR's or having to deal with rude surgeons. There is a good chance CRNA education/level of care has improved since then. Nope. However, if you want recognition and gratitude from your patients, if you want to be able to diagnose and practice clinical medicine, you might not like anaesthesia. New comments cannot be posted and votes cannot be cast. Another thing is: one radiologist I know told me practically 90% of DRs do a fellowship. It's a muscle paralytic which prevents you from moving during surgery. See if you can meet with your anesthesiology team. Most of the time, within an hour or 2 after the surgery, there are no effects at all from the anesthesia. Epidemiological studies are done where the cause of each perioperative death or injury is attributed to a specific cause. I get to dodge most of the annoying paper work, when I’m done and not on call I can walk out the door and forget work, I don’t have to maintain a clinic. Overview As is the case for us, our four-legged friends may require anesthesia as part of a surgery or procedure. The local anaesthetic given for a lumbar puncture is very safe compared to the risks of the actual lumbar puncture which include central nervous system infection, bleeding and neurological injury. I've had a great experience so far and am learning a lot, but there is not a day that goes by that I don't thank my lucky stars that I matched into radiology. Whatever you can sense or observe doesn't get written to long term memory (rohypnol or something similar) so you can't remember whatever sensations get through. Patient coded after the surgeon lacerated the inferior vena cava and failed to control the bleeding? I imagine the 1000th time you treat a CAP patient, or remove that routine galbladder, or whatever it may be doesn’t seem nearly as exciting as the first 100 times you did it. --- LIKE AND I WILL UPLOAD MORE REDDIT STORIES! Press question mark to learn the rest of the keyboard shortcuts. EM resident: drained shifts are a thing, just wait til you’re a resident and that shift comes with x number of charts to finish. I guess it matters how you define "danger". New AskReddit Stories: Doctors, nurses, and hospital staff of Reddit - what are your experiences (funny, sad, horrible) with people waking from anesthesia? A patient with aortic stenosis may not tolerate drops in blood pressure on anesthetic induction the way a healthy patient will. Devlin B. Lv 6. this is the anesthesiologists greatest concern, usually. EM from what you wrote seems like less of a good fit. It was my second option as I missed out on my first choice. I'm worried about a few things and wonder if you have any input? It’s eerie to read the description given by the radiology resident above because I feel nearly the same thing can be said of anesthesia. While general anesthesia is sometimes necessary, ask about other approaches -- like a local or spinal anesthetic. Also, the salaries look like they're starting to taper downwards in DR. What's going on there? No paperwork. Here are the different types of anesthesia: Local—Numbs only the area treated. Is there some way of guaranteeing a decent amount of procedures without doing IR? In the 1940s, the going rate was around 1 in 2,500. Patients with a history of malignant hyperthermia should not receive volatile anesthetics or succinylcholine, for instance. Not to mention I found standing and monitoring patients quite boring. Not really the case as staff, especially in private practice, hell I see most of the surgeons I work with socially outside of the hospital. (edited thanks to response from anesthesiologist) it is typically genetic, and is very much 'no bueno' (which is why they will ask you about a family history of reaction during anesthesia). If I recall they monitor heart function and issue antagonistic stimulants and suppressants to assure that your heart function is working between necessary limits (except for heart surgery duh) while a controlled rate of paralytic is administered. Perhaps on a scale of open heart or brain surgery to something like … Similarly you are a specialist, but you require a broad range of knowledge because patients with every conceivable disease will present for surgery. I'm personally skeptical about whether this correlation means causation. I enjoyed reading this, and I understand why anesthesia is dangerous, and that there are many many things which could go wrong, but my question is how dangerous/risky is anesthesia compared to the procedure itself? When you go in for surgery, you have to sign various waivers and consent forms related to the anesthesia. even in well controlled environments, the way the body reacts to having any invasion is really dependent on the individual. MH is a concern, I don't know if it's my greatest concern. I love my job and recently took the next step by working on a "locum tenens" contract basis (1099) instead of full-time (W-2). I’ve had a few fellow students try to dissuade me from it because of CNRAs taking the available positions. One compound suppresses the sensation of pain. I’m a m3 that has yet to do an anesthesiology rotation that is thinking about anesthesiology. Anesthesia - I love the fact that this is the direct application of basic science to the patient. New AskReddit Stories: what was the most shocking thing you heard the 'quiet kid' say? you won't get high off of the anesthesia. 0 comments. I love procedures and this is also great for that. Under general anesthesia, you don't feel pain because you're completely unconscious. General anesthesia usually uses a combination of intravenous drugs and inhaled gasses (anesthetics).General anesthesia is more than just being asleep, though it will likely feel that way to you. Hello! Within 10 years, the rate of death by anaesthesia fell from 1 in 10k to 1 in 200k. report. Overall, general anesthesia is very safe, and most patients undergo anesthesia with no serious issues. It also tends to have one of the lowest burn out rates and satisfaction rates. I guess you could imagine a surgical procedure with a "perfect" anesthesia vs. what is typically used today. Introduction. Yes. He was half in the bag and generally unhappy to talk about work, but some well aimed goading got him to reveal the following: Under general anesthesia, anestheticians (?) Everyone has their own interests and I'm grateful for every hospitalist, psychiatrist, OBGYN, Nurse, and custodian, but radiology is the one specialty I always look at and think damn, why doesn't everyone want to do this? This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Don't do EM if you dont like working extremely hard for a shift. I guess it boils down to doing what you love? (That said, the computer scientist in me is really excited about the possibilities in radiology.). If you inject lignocaine into a vein you can cause strange heart rhythms, but just before you push the plunger of the syringe to inject some you pull it back to make sure you're not in a blood vessel. No phone calls from unhappy patients or follow up. Anesthesia did it. One patient who smoked marijuana 4 hours prior to surgery was the topic of another case study, after experiencing an airway obstruction during the proc… Dont like working really hard for 12 hours, I feel drained at the end of the shift. Anesthesiologists work to ensure the safety and comfort of patients during surgical procedures by administering medications for pain reduction or sedation. This is fairly simple (I guess) I think they use a barbituate while monitoring brain wave function (ECG) to see if you're perceiving much. Good mix of pharm, path and physio. I was afraid I would miss diagnosing and treating patients and be mistreated by surgeons. hide. As for that standing around, now I know how many things are going on that I have to monitor and take care of. (Upside is you do get shorter hours than say surgery). You listed no negatives for radiology, that's a start. I would do anesthesia or rads, but i'm biased since i'm doing anesthesia. I don't think he meant it that way. A patient with increased intracranial pressure due (for instance) to a tumor should not receive ketamine, which increases that pressure further (at least, this is the classical teaching). All the facts in this are pulled directly from the notes I took during that lecture. how often do you see the proverbial poop hit the fan (or surgical lights)? Rads vs Anesthesia then. The depth of IM is nice. However, they might prescribe you pain medication.. lol. The depth of IM is nice. I'm also curious how much the risk changes between people being put under for the first time, and people who have been through it previously without complications. ... help Reddit App Reddit coins Reddit premium Reddit gifts. For some people, it is mandatory due to anxiety, fear, or complexity of the surgery. You feel drained from EM now. But, it doesn't sound like you enjoy the day-to-day of IM. Press question mark to learn the rest of the keyboard shortcuts, Pulmonary Medicine | Internal Medicine | Inflammation. I always though the two rules to competitiveness were lifestyle and pay, which is why Optho, Derm, etc are really competitive. 1 decade ago. IM - I love the depth of this. Malignant hyperthermia is also known in the veterinary realm; I know of one dog that was saved from malignant hyperthermia by being taken from neuter surgery and put into a snowdrift when they went into uncontrollable overheating. I know you haven't started your residency yet so you might not know about how much time you'll spend sitting, but do you think rads would be a no-go for me for that reason? In other cases, a particular drug might not be contraindicated, but the chosen plan must take into account unique dangers. 1 0. Although newer anesthesia drugs have greatly reduced side effects, operations can still produce stress on your dog’s body and they may be nauseous or vomit after the surgery. Background Balloon‐tipped bronchial blocker catheters are widely used in pediatric thoracic anesthesia to establish single‐lung ventilation. 5-year AA here. I can give a different perspective here as I wasn't happy with anaesthesia when I began. Surgical complication. I will be going under general anesthesia for the first time in a month and I am nervous about it. Can you please do the Reddit community a big service by discussing the danger of general anesthesia without an anesthesiologist around? A third compound is very critical. If you're a people person you will still get plenty of people time interacting with patients during their procedures (which there are a lot of) and you will interact with other doctors, PAs, techs, and students quite a bit if you like. This can take a few days to pass. I also hear people say they think my job looks boring, well some days it is, but remember eventually anything becomes routine if you do it enough. Much of this change was brought about by frank recognition of the hazards, and a constructive addressing of the risks. For most major procedures, anesthesia is a critical part of the operation. The case I would build for going into radiology is that you get a lot of the good of medicine and side step the bad. No rounds. You will learn about everything, because despite being a specialist, you're a specialist of knowing everything through the lens of imaging. But I generally feel pretty fired up despite exhaustion. Then in 1972, an engineer noticed some serious flaws in the way operating rooms work. This is not to say that you should not use these latter two methods. I'm an M2 so I haven't rotated in anything but I've shadowed a radiologist and have some rads pubs. You don't need to love what you do, but you should like it. I will be asking my doctor about this (and I am going to a general practitioner and a cardiologist for a check up as well) but I would like to get your thoughts. Much like smoking cigarettes, abstaining from marijuana in the weeks before surgery can decrease the likelihood of complications during and after surgery. Non-oxygen wall gas tubing cannot connect into the machine's oxygen input anymore. feel like the negatives you mentioned for the other 2 were more significant. General is the anesthesia type we think of most during a surgery where the patient is completely asleep. Many such things have been done. From the makers of our beloved OpenAnesthesia and in conjunction with IARS [International Anesthesia Research Society – they produce the journal, Anesthesia & Analgesia] there is a new study tool called Self Study Plus. Some of the bad stuff that you will dodge includes a lot of paperwork and typing, complicated call schedules (most hospitals work a night float or night hawk system), and the dreaded patient interaction. Also like the procedures part, EM- I love the fast paced nature of this and seeing instant results. ... especially in high doses. I wish you luck, certainly a good spot to be in (having many choices as opposed to none or few), feel free to PM me if you have any other specific questions. No, general anesthesia puts you to sleep, and fast. Following this internet discussion thread to figure out difficult questions to my own life. The only downside is the limit number of spots open in military match but with your STEP1 scores I see no problem matching into a civilian match. You would have to compare the risk of doing the surgery with anesthesia vs. doing the surgery without it. Of course there are things we have to do to avoid this complication - in some cases we will even put the patient on a heart-lung machine prior to anesthetic induction. Some dials rotated clockwise, others counterclockwise. 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