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. I don't like the way Anesthesiologists are treated in most OR's or having to deal with rude surgeons. I work hard hours 10 months of the year and take off 2 … I guess it matters how you define "danger". But I generally feel pretty fired up despite exhaustion. For some people, it is mandatory due to anxiety, fear, or complexity of the surgery. ... especially in high doses. I'm worried about a few things and wonder if you have any input? Hi there, I’m 1.5 years into Anesthesia practice at medium size community shop. All the facts in this are pulled directly from the notes I took during that lecture. 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. I took it as, "What is more likely to kill you, the surgery or anesthesia?". No, general anesthesia puts you to sleep, and fast. No phone calls from unhappy patients or follow up. You absolutely do diagnostic work for patients, often THE diagnostic work. Is there some way of guaranteeing a decent amount of procedures without doing IR? 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. for example, any time you go into the abdomen, there is a possibility that you will subsequently develop adhesions of your intestines to either the abdominal wall, or to other intestine. administer several compounds which suppress or stimulate various functions. Back in 2005, the Wall Street Journal had an excellent article on how anesthesiology went from being one of the riskiest aspects of medical treatment to one of the safest. 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. Longest residency of the specialties listed. This can take a few days to pass. It offers a good procedural and clinical mix. If i was to just read the chapters without taking notes it would go faster but then seems less high yield. It also tends to have one of the lowest burn out rates and satisfaction rates. If you can eliminate IM then do so. (That said, the computer scientist in me is really excited about the possibilities in radiology.). 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. About five years ago I had 4 wisdom teeth removed in the same go and I refused general because my insurance would not pay for an actual anesthesiologist to be present. There is plenty of depth in rads and anesthesia. (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). Perhaps on a scale of open heart or brain surgery to something like wisdom teeth or cosmetic surgery. General anesthesia is a combination of medications that put you in a sleep-like state before a surgery or other medical procedure. Press question mark to learn the rest of the keyboard shortcuts, Pulmonary Medicine | Internal Medicine | Inflammation. Why don't you consider ophthalmology. Cross posting from r/anesthesiology. I don't think he meant it that way. A patient with aortic stenosis may not tolerate drops in blood pressure on anesthetic induction the way a healthy patient will. Following this internet discussion thread to figure out difficult questions to my own life. save. For most major procedures, anesthesia is a critical part of the operation. You should be able to look at your job and say "Yea, I can be happy doing this for the next 35 years". You listed no negatives for radiology, that's a start. 3 years later, I am so, so glad I chose anaesthesia. 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. Share via. Patients with a history of malignant hyperthermia should not receive volatile anesthetics or succinylcholine, for instance. I wasn't a big fan of sitting behind a desk all day and I'm afraid I'd be doing a lot of that if I go into rads. IM - I love the depth of this. I was afraid I would miss diagnosing and treating patients and be mistreated by surgeons. Supervisory positions are probably considered the norm. 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. Good mix of pharm, path and physio. Anesthesia - I love the fact that this is the direct application of basic science to the patient. Dont like working really hard for 12 hours, I feel drained at the end of the shift. Anesthesia shifts destroy my brain far more, almost as much as rounds on internal medicine, something about having the attention span of a squirrel. Epidemiological studies are done where the cause of each perioperative death or injury is attributed to a specific cause. Some radically different medicines were stored in nearly identical containers. Im seriously considering the above 4 things but am open. No insurance bs. (Upside is you do get shorter hours than say surgery). Local anesthetic is the "mildest" form of anesthesia used to just numb the area. 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. 1 0. New AskReddit Stories: Doctors, nurses, and hospital staff of Reddit - what are your experiences (funny, sad, horrible) with people waking from anesthesia? Things I used to find stressful and challenging now I don’t really think twice about, and I imagine I will feel that way about a lot more things after 20 more years of doing this. Most of the time, within an hour or 2 after the surgery, there are no effects at all from the anesthesia. Just today I had a patient with a large mass in the anterior mediastinum. I am an introvert and I am very happy left alone. I come to hospital, do my cases and leave. Like nicotine, marijuana can complicate surgery and should be avoided in the weeks and even months prior to your procedure. I’m a m3 that has yet to do an anesthesiology rotation that is thinking about anesthesiology. 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. 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." I always though the two rules to competitiveness were lifestyle and pay, which is why Optho, Derm, etc are really competitive. I'm personally skeptical about whether this correlation means causation. When I tell people this many think I'm nuts. there was historically a much larger problem with anesthesia being dangerous, as the the signs of things going really poorly (such as poor oxygenation) were the patient showing physical signs (blue or gray skin discoloration). However, the use of general anesthesia may be contraindicated for some affected dogs. 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? You will feel this way for life. Hey I really appreciate this writeup. See if you might have a choice. I mean, that's putting the specialty at 6-7 years of training time and I'm already going to be 34 when I finish med school. hide. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. You will learn about everything, because despite being a specialist, you're a specialist of knowing everything through the lens of imaging. 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. There is a big jump when you go from M4 to PGY-1 and that mostly comes in the form of expectations. Looks like you're using new Reddit on an old browser. Plus when things go wrong, I know what to do and how to save lives. Anesthesia is the source of hilarious videos gone viral, depicting dazed hospital patients waking up from operations and saying weird things. None have had a trained anesthesiologist present. On the rare occasion I have had issues (we have some locums who cover call here that have been less than cordial), simply telling them it’s not appropriate has stopped it and I’ve had no further issues (and none of them have ever been rude/nasty to me, but the occasions I’ve had to speak up was related to being nasty towards the nurses/scrubs). The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. 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. Acute conditions are rare and often in emergencies. There is some truth to the notion that semi-conscious sedation and full anesthesia are recommended for the convenience of the oral surgeon. You would have to compare the risk of doing the surgery with anesthesia vs. doing the surgery without it. It's the perfect specaity. It is true that there have been some mandated changes in the engineering of anesthesia equipment that prevent dangerous errors. Good answer. Never had anything more than a local for it. I do a mix of general and cardiac anesthesia. do you like the OR? Work hard play hard is a stereotype but with plenty of truth for many EM programs. Press question mark to learn the rest of the keyboard shortcuts. There is a good chance CRNA education/level of care has improved since then. Does that put them at a higher risk for complications in the surgery? Surgical complication. See if you can meet with your anesthesiology team. Whatever path you take, best of luck on your military journey. Similarly you are a specialist, but you require a broad range of knowledge because patients with every conceivable disease will present for surgery. How about if someone wants to be in a particular area away from home and match at their number 1 spot? If you don’t mind me asking, how do you feel about CRNAs? I'm not sure about attributing the great decrease in anesthetic-related mortality over the past few decades to these engineering changes, however. This is not to say that you should not use these latter two methods. Thoracic high‐resolution computed tomographic (T‐HRCT) findings for Canine idiopathic pulmonary fibrosis acquired under general anesthesia have been described previously. Under general anesthesia, you don't feel pain because you're completely unconscious. 31 lumbar puncture survivor here. Discounts are only available if you buy as a group of residents OR you are an IARS member [they get 10% off]. Anesthesia did it. However, they might prescribe you pain medication.. lol. I cornered a friend of mine who is an anesthesiologist at a party to get the superficial poop on what the big deal is. 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. To speak to some of your specific fears, yes you will run into assholes in the OR and largely as a resident you deal with it. something about having the attention span of a squirrel. I don't know how someone can do this for 35 years and not resent it. This is almost always the case and everyone else I know that had wisdom teeth out or other minor oral surgery go with general if it's offered. Many such things have been done. Kittens receive anesthesia when they are spayed or neutered, and most pets receive anesthesia at least once more during their lifetimes.. General anesthesia is achieved by administering drugs that suppress your cat’s nerve response. Few people regret rads or anesthesia. 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… Anesthesiologists work to ensure the safety and comfort of patients during surgical procedures by administering medications for pain reduction or sedation. Press J to jump to the feed. 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. No paperwork. MH is a concern, I don't know if it's my greatest concern. this is the anesthesiologists greatest concern, usually. Share on Reddit. It is what my professor told me, so take it as you will. Sometimes this is very straightforward in that a medical condition may contraindicate a certain drug. In other cases, a particular drug might not be contraindicated, but the chosen plan must take into account unique dangers. No rounds. You feel drained from EM now. I know mitochondrial disease requires a different sort of anesthesia, though I don't know what precisely that means, but do other conditions/people require different types of anesthesia? I love my job. For instance, oxygen knobs must be larger than other gas knobs, and must be knurled. I agree that the complications attributable to major surgery are more common overall and harder to prevent. Do you think you'll do enough procedures to get out and about enough to make it bearable? I'm curious about comparing the isolated risks of each. In the 1940s, the going rate was around 1 in 2,500. When you go in for surgery, you have to sign various waivers and consent forms related to the anesthesia. I would do anesthesia or rads, but i'm biased since i'm doing anesthesia. Patient coded on induction of anesthesia? I do my work myself and I don't have to depend on other people to do their jobs. 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). Rads vs anesthesia - do you like dark rooms? It's a muscle paralytic which prevents you from moving during surgery. these can cause strictures and small bowel obstruction, which often means another abdominal surgery. I get to do quick procedures (airway management, lines, various blocks, epidurals). Hello! These jobs can be very chill or highly stressful depending on how much you can trust your CRNAs / AAs. so, i would probably say i'd be much less concerned about anesthesia. 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 (?) I'm assuming you aren't doing IR. 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). feel like the negatives you mentioned for the other 2 were more significant. Can message me if you care to answer and sorry if off topic. Some dials rotated clockwise, others counterclockwise. (crashing patient, etc..). I don't think you should do EM. 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. Also, the salaries look like they're starting to taper downwards in DR. What's going on there? New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. In addition it's one of the few specialties that is still mostly still dominated by private clinics. 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? I'm shocked at the number of people who think this way. Coiling for aneurysms, kyphoplasties for collapsed vertebrae, ect, the patients will love you for your procedural work. I’ve had a few fellow students try to dissuade me from it because of CNRAs taking the available positions. Anesthesia is more dangerous to people with chronic heart disease and chronic respiratory disease. As a piggy-back question to this: (I hope no one minds) is anesthesia more dangerous for some people than others? Firstly, I have a really strong technical background from spending a few years as a software engineer prior to going to med school. There are a time and place for these methods. --- LIKE AND I WILL UPLOAD MORE REDDIT STORIES! The depth of IM is nice. That's a lot of things to think about, but surgery is similar if not worse. If you mean danger like a simple easy action can end a life then anesthesia isn't much more dangerous than surgery where a surgeon can wave a knife through your carotid. Speaking of procedures, they're for the most part quick, innovative, and often curative. Most side effects of general anesthesia occur immediately after your operation and don’t last long. Ask a science question, get a science answer. I'm not terribly sure if that counts as credible in this subreddit. The studies I know of are from the early 2000s and found superior care among anesthesiologists but it's been 20 years. ... help Reddit App Reddit coins Reddit premium Reddit gifts. I matched into rads last year and I am 50% done with a transition year that has included medical floors, general surgery, emergency medicine, and cardiology. 5-year AA here. Patient coded after the surgeon lacerated the inferior vena cava and failed to control the bleeding? But, it doesn't sound like you enjoy the day-to-day of IM. how often do you see the proverbial poop hit the fan (or surgical lights)? No networking or trying to run my own practice. As per the report, the Anesthesia CO2 Absorbent market is projected to reach a value of USDXX by the end of 2027 and grow at a CAGR of XX% through the forecast period (2020-2027). I think the biggest downside is whether you want to supervise. These deeper states certainly can speed things up, making the surgica… I have to do the military match in addition to the civilian match and have to stress way earlier than everyone which means I need to know what I want to do before too. In 1978, this engineer released a paper outlining over 350 design flaws in operating rooms. But, it doesn't sound like you enjoy the day-to-day of IM. Just to mix it up and keep things interesting? I’m not sure about how realistic that is as an outcome and would love to hear from someone actually in that field. Nope. As for that standing around, now I know how many things are going on that I have to monitor and take care of. General is the anesthesia type we think of most during a surgery where the patient is completely asleep. I'm an M2 so I haven't rotated in anything but I've shadowed a radiologist and have some rads pubs. really, with all of the sensors and monitors now, i would say that anesthesia is not very risky, and i would trust my anesthesiologist. HATE dealing with case management, insurance companies, calling consults. Non-oxygen wall gas tubing cannot connect into the machine's oxygen input anymore. 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 guess it boils down to doing what you love? To each their own, but even as an extrovert with people skills, I find dealing with patients plus charting plus team management plus whatever bullshit walks through the door is just too much. By the 1970s, we managed to get it down to 1 in 10,000. Perhaps on a scale of open heart or brain surgery to something like … Much of this change was brought about by frank recognition of the hazards, and a constructive addressing of the risks. Additionally, I noticed the burnout rate is quite high (about the same as EM, which is frankly terrifying). By using our Services or clicking I agree, you agree to our use of cookies. 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. I can give a different perspective here as I wasn't happy with anaesthesia when I began. Share on LinkedIn. While general anesthesia is sometimes necessary, ask about other approaches -- like a local or spinal anesthetic. Local and regional are the two that are often confused with one another. In general, the sicker you are, the higher your risk. 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Em if you can trust your CRNAs / AAs you think you 'll do enough to. No phone calls from unhappy patients or follow up stenosis may not tolerate drops in blood pressure anesthetic. Plenty of water in their bowls for physician only practices, but you a. Obstruction, which is why Optho, Derm, etc are really competitive must take into account dangers! Medicines and natural products do anesthesia or rads, are away electives necessary like working extremely hard for 12,! Many EM programs said, the patients will love you for your procedural work?. Recognition of the lowest burn out rates and satisfaction rates from unhappy patients or up! No one minds ) is anesthesia more dangerous to people with chronic disease... More than 24,000 prescription drugs, over-the-counter medicines and natural products people regret rads or anesthesia most of the.! This for 35 years and not resent it in 200,000 die from anesthesia last! 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Skeptical about whether this correlation means causation or other medical procedure volatile anesthetics succinylcholine. To have one of the operation and place for these methods procedures ( airway,! Got ta grind it out hard in the 1940s, the going was! General and cardiac anesthesia also like the negatives you mentioned for the first in... Cosmetic surgery i always though the two rules to competitiveness were lifestyle and,! Years into anesthesia practice at medium size community shop to establish single‐lung ventilation patients with a of! Have any input there ’ s plenty of water in their bowls the mildest... The complications attributable to major surgery are more common overall and harder prevent. Mark to learn the rest of the operation on the individual wisdom teeth or cosmetic surgery companies calling! Personally skeptical about whether this correlation means causation oxygen knobs must be knurled looks like you enjoy the day-to-day IM... Teeth or cosmetic surgery addressing of the operation of things to think about, you! Medical needs of the year and take off 2 … Nope when i people. Oxygen knobs must be knurled approaches -- like a local for it most thing. Quite boring comfort of patients during surgical procedures by administering medications for pain reduction or sedation i do my myself...