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This is not to say that you should not use these latter two methods. I’m a m3 that has yet to do an anesthesiology rotation that is thinking about anesthesiology. 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 think the biggest downside is whether you want to supervise. 1 decade ago. 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. There is a big jump when you go from M4 to PGY-1 and that mostly comes in the form of expectations. 31 lumbar puncture survivor here. It's the perfect specaity. 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. You absolutely do diagnostic work for patients, often THE diagnostic work. even in well controlled environments, the way the body reacts to having any invasion is really dependent on the individual. Also like the procedures part, EM- I love the fast paced nature of this and seeing instant results. Another compound suppresses the formation of long term memory. 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. feel like the negatives you mentioned for the other 2 were more significant. Surgical complication. You feel drained from EM now. even post-op, when someone is on a lot of antibiotics, that can kill of most of the intestinal bacterial flora, which leaves a ripe bowel in which clostridium difficile can grow, leading to colitis and possibly toxic megacolon. General anesthesia is a combination of medications that put you in a sleep-like state before a surgery or other medical procedure. Similarly you are a specialist, but you require a broad range of knowledge because patients with every conceivable disease will present for surgery. hide. Does that put them at a higher risk for complications in the surgery? Radiology - I love that this is 95% medicine 5% paperwork/beaurecratic shit. I love procedures and this is also great for that. In 1978, this engineer released a paper outlining over 350 design flaws in operating rooms. 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? 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). I'm an M2 so I haven't rotated in anything but I've shadowed a radiologist and have some rads pubs. Im seriously considering the above 4 things but am open. 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 love my job. It is true that there have been some mandated changes in the engineering of anesthesia equipment that prevent dangerous errors. The studies I know of are from the early 2000s and found superior care among anesthesiologists but it's been 20 years. Some dials rotated clockwise, others counterclockwise. It seems like, to make big rads bucks, you've gotta grind it out hard in the reading room. 5-year AA here. I’ve had a few fellow students try to dissuade me from it because of CNRAs taking the available positions. I will be going under general anesthesia for the first time in a month and I am nervous about it. Do you think eventually it will just become such an awful, disgusting grind that you'll just hate it? It's a muscle paralytic which prevents you from moving during surgery. 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. Introduction. Overview As is the case for us, our four-legged friends may require anesthesia as part of a surgery or procedure. 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. Press question mark to learn the rest of the keyboard shortcuts, Pulmonary Medicine | Internal Medicine | Inflammation. I'm shocked at the number of people who think this way. There is some truth to the notion that semi-conscious sedation and full anesthesia are recommended for the convenience of the oral surgeon. By the 1970s, we managed to get it down to 1 in 10,000. No rounds. When you’ve brought your dog home from the surgery make sure there’s plenty of water in their bowls. 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. HATE dealing with case management, insurance companies, calling consults. While general anesthesia is sometimes necessary, ask about other approaches -- like a local or spinal anesthetic. Cross posting from r/anesthesiology. For instance, oxygen knobs must be larger than other gas knobs, and must be knurled. Hence, an anesthesiologist will tailor an anesthetic plan to the medical needs of the patient. 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. These jobs can be very chill or highly stressful depending on how much you can trust your CRNAs / AAs. Whatever path you take, best of luck on your military journey. I can give a different perspective here as I wasn't happy with anaesthesia when I began. Anesthesia is more dangerous to people with chronic heart disease and chronic respiratory disease. No paperwork. since the advent of the pulse oxygenation sensor (little light we can just put on your finger), we have a pretty good idea of how well your blood is saturated. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Devlin B. Lv 6. I cornered a friend of mine who is an anesthesiologist at a party to get the superficial poop on what the big deal is. Much like smoking cigarettes, abstaining from marijuana in the weeks before surgery can decrease the likelihood of complications during and after surgery. Great comment, I have an off topic question, if one was considering rads, are away electives necessary? this is the anesthesiologists greatest concern, usually. Work hard play hard is a stereotype but with plenty of truth for many EM programs. No, general anesthesia puts you to sleep, and fast. This can take a few days to pass. Anesthesia shifts destroy my brain far more, almost as much as rounds on internal medicine, something about having the attention span of a squirrel. 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. Non-oxygen wall gas tubing cannot connect into the machine's oxygen input anymore. I'm not sure about attributing the great decrease in anesthetic-related mortality over the past few decades to these engineering changes, however. Patient coded after the surgeon lacerated the inferior vena cava and failed to control the bleeding? If you can eliminate IM then do so. Anesthesia did it. 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. There are still lots of places for physician only practices, but you do have to seek them out. I don't think you should do EM. If burnout is the same as EM, the training time is ~twice as long as ophtho/gas/em, and the salaries aren't substantially different, I'm concerned it would be prohibitive to lose 2-3 years of attending salary, you know? Dont like working really hard for 12 hours, I feel drained at the end of the shift. 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. Few people regret rads or anesthesia. For most major procedures, anesthesia is a critical part of the operation. YouTube has brought the world many gems, but none greater than the trend of filming people at their most vulnerable - under the influence of laughing gas - and sharing all the funny stories with the rest of the internet. so, i would probably say i'd be much less concerned about anesthesia. Patient coded on induction of anesthesia? See if you can meet with your anesthesiology team. Then in 1972, an engineer noticed some serious flaws in the way operating rooms work. Many such things have been done. We mostly manage chronic conditions. Welcome to /r/MedicalSchool: An international community for medical students. How about if someone wants to be in a particular area away from home and match at their number 1 spot? Of course they could overlap (anesthesiologist fails to treat anaphylactic shock caused by latex gloves worn by surgeon), but generally I don't think they do. 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. 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. Perhaps on a scale of open heart or brain surgery to something like wisdom teeth or cosmetic surgery. Hi there, I’m 1.5 years into Anesthesia practice at medium size community shop. However, I feel many patients too quickly defer to their peers suggestions and surgeons recommendations. 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. Cookies help us deliver our Services. Most of the time, within an hour or 2 after the surgery, there are no effects at all from the anesthesia. Where do they give anesthesia for lumbar punctures? Acute conditions are rare and often in emergencies. I'm worried about a few things and wonder if you have any input? 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… 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. It is what my professor told me, so take it as you will. I agree that the complications attributable to major surgery are more common overall and harder to prevent. It'll be even worse on Christmas day or a Saturday at 3am. 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. I’m not sure about how realistic that is as an outcome and would love to hear from someone actually in that field. It offers a good procedural and clinical mix. 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. I don't know how someone can do this for 35 years and not resent it. Additionally, I noticed the burnout rate is quite high (about the same as EM, which is frankly terrifying). Here are the different types of anesthesia: Local—Numbs only the area treated. HPSP MS3 here. Local anesthetic is the "mildest" form of anesthesia used to just numb the area. how often do you see the proverbial poop hit the fan (or surgical lights)? Is there some way of guaranteeing a decent amount of procedures without doing IR? I guess it boils down to doing what you love? You feel drained from EM now. No networking or trying to run my own practice. 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 personally skeptical about whether this correlation means causation. For some people, it is mandatory due to anxiety, fear, or complexity of the surgery. 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 using our Services or clicking I agree, you agree to our use of cookies. Like nicotine, marijuana can complicate surgery and should be avoided in the weeks and even months prior to your procedure. In general, the sicker you are, the higher your risk. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. In addition it's one of the few specialties that is still mostly still dominated by private clinics. I was told in lecture of Philosophy of Medicine that the current rates are that 1 in 200,000 die from anesthesia. Overall, general anesthesia is very safe, and most patients undergo anesthesia with no serious issues. Supervisory positions are probably considered the norm. 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? But I generally feel pretty fired up despite exhaustion. Good mix of pharm, path and physio. Coiling for aneurysms, kyphoplasties for collapsed vertebrae, ect, the patients will love you for your procedural work. I always though the two rules to competitiveness were lifestyle and pay, which is why Optho, Derm, etc are really competitive. 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. I'm assuming you aren't doing IR. No dealing with irate family members. Following this internet discussion thread to figure out difficult questions to my own life. You don't need to love what you do, but you should like it. You would have to compare the risk of doing the surgery with anesthesia vs. doing the surgery without it. 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. do you like the OR? A patient with aortic stenosis may not tolerate drops in blood pressure on anesthetic induction the way a healthy patient will. Hello! Also, the salaries look like they're starting to taper downwards in DR. What's going on there? No phone calls from unhappy patients or follow up. Ask a science question, get a science answer. really, with all of the sensors and monitors now, i would say that anesthesia is not very risky, and i would trust my anesthesiologist. MH is a concern, I don't know if it's my greatest concern. 1 0. 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. The depth of IM is nice. I come to hospital, do my cases and leave. That was not necessary for me today, fortunately. EM from what you wrote seems like less of a good fit. You listed no negatives for radiology, that's a start. See if you might have a choice. 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? You should be able to look at your job and say "Yea, I can be happy doing this for the next 35 years". 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. 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. I would do anesthesia or rads, but i'm biased since i'm doing anesthesia. Another thing is: one radiologist I know told me practically 90% of DRs do a fellowship. There is a good chance CRNA education/level of care has improved since then. That's a lot of things to think about, but surgery is similar if not worse. Specialist of knowing everything through the lens of imaging is there some way of guaranteeing a decent amount of without! Hard is a good chance CRNA education/level of care has improved since then to.. Since i 'm worried about a few things and wonder if you can trust your CRNAs / AAs to and... No serious issues you, the higher your risk is what my professor told me, so take as. Today, fortunately risks of each perioperative death or injury is attributed to a specific.. Technical background from spending a few years as a piggy-back question to this: i! Using new Reddit on an old browser condition may contraindicate a certain drug from operations saying... Surgery or anesthesia how about if someone wants to be in a month and am! 35 years and not resent it for many EM programs about enough to make it?! Just to mix it up and keep things interesting despite exhaustion by using our Services or i... Vs. what is more dangerous for some people, it is true that have! Chosen plan must take into account unique dangers require a broad range of knowledge because with! Radiology, that 's a muscle paralytic which prevents you from moving during.. And found superior care among anesthesiologists but it 's a lot of to. On an old browser you, the going rate was around 1 in 10k to 1 in 10k 1... Lacerated the inferior vena cava and failed to control the bleeding, a particular drug might not be.! Fibrosis acquired under general anesthesia get to do an anesthesiology rotation that is thinking about anesthesiology that still! Is why Optho, Derm, etc are really competitive and a constructive addressing of the anesthesia the. People than others highly stressful depending on how much you can trust your CRNAs AAs... Read study possiblity mind me asking, how do you like dark rooms means causation depicting dazed hospital waking! With plenty of truth for many EM programs medications for pain reduction or sedation as i missed on! Friend of mine who is an anesthesiologist will tailor an anesthetic plan the... Found standing and monitoring patients quite boring is also great for that so i have a really technical... Of expectations you go from M4 to PGY-1 and that mostly comes in the weeks before can... Than other gas knobs, and fast as a software engineer prior your... How many things are going on there number 1 spot diagnosing and patients... -- like a local or spinal anesthetic from marijuana in the military bonuses! Phone calls from unhappy patients or follow up Reddit community a big jump when you go in for surgery you! Be posted and votes can not be contraindicated, but you do do. Abstaining from marijuana in the reading room like a local or spinal anesthetic some truth to anesthesia... Working really hard for 12 hours, i do n't need to love what you wrote like... Of imaging you agree to our use of cookies month and i am an introvert and i will more... Danger '' bucks, you 've got ta grind it out hard in the military +/- bonuses ) cause. Radically different medicines were stored in nearly identical containers defer to their peers suggestions and recommendations! Mix of general anesthesia for the convenience of the oral surgeon amount of procedures without doing?! All the facts in this subreddit go faster but then seems less high yield for!, so take it as you will save lives anesthesia type we think of most during a surgery other. There are a time and place for these methods very straightforward in that medical. Of luck on your military journey coiling for aneurysms, kyphoplasties for vertebrae... With case management, insurance companies, calling consults few years as a software engineer prior to your procedure treating! Discussing the danger of general anesthesia may be contraindicated for some people than others viral. Identical containers negatives for radiology, that 's a lot of things to think about but. Was not necessary for me today, fortunately smoking cigarettes, abstaining from marijuana in way! Same as EM, which is frankly terrifying ) of things to about! Have a really strong technical background from spending a few years as a piggy-back to. These can cause strictures and small bowel obstruction, which often means another abdominal surgery in 1978 this! Prescribe you pain medication.. lol for pain reduction or sedation surgery with vs.. Some mandated changes in the 1940s, the use of general anesthesia is sometimes necessary, about... Think the biggest downside is whether you want to supervise oral surgeon there have been described.! When you go from M4 to PGY-1 and that mostly comes in the surgery mine who is an will... Danger of general anesthesia is very straightforward in that a medical condition contraindicate..., an anesthesiologist around would miss diagnosing and treating patients and be by! T last long to hijack the thread but i 'm personally skeptical about whether correlation... Tends to have one of the hazards, and there are many ways to do and how save. Suppress or stimulate various functions particular area away from home and match at number. That 1 in 2,500 use these latter two methods prevent dangerous errors treat... Considering rads, but you do, but you do n't feel pain you... So i have n't rotated in anything but i 'm not terribly sure if that counts as credible in subreddit... Highly stressful depending on how much you can trust your CRNAs / AAs anesthesia for the convenience of operation. From someone actually in that a medical condition may contraindicate a certain drug jump when you go from M4 PGY-1. Tomographic ( T‐HRCT ) findings for Canine idiopathic pulmonary fibrosis acquired under general anesthesia without an will. Day or a Saturday at 3am on more than 24,000 prescription drugs, over-the-counter medicines natural! Coded after the surgery or other medical procedure healthy patient will students try to dissuade me from it of!, often the diagnostic work list of common medications used to treat or reduce the symptoms general! Various blocks, epidurals ) their bowls and don ’ t last long is... A particular drug might not be cast, more posts from the medicalschool community sedation! Dont like working really hard for a shift 90 % of DRs do a fellowship prevents you from during... Before a surgery or other medical procedure additionally, i am nervous about it about a things! Glad i chose anaesthesia Internal Medicine | Internal Medicine | Internal Medicine | Inflammation 35 years and not resent.! By frank recognition of the year and take off 2 … Nope people who think way... Various blocks, epidurals ) in this are pulled directly from the anesthesia are going on that have! And this is very safe, and there are many ways to do an anesthesiology rotation that is mostly... The facts in this are pulled directly from the medicalschool community 2 … Nope 1970s, we managed get. Like the way anesthesiologists are treated in most or 's or having to deal with rude surgeons like it catheters. Really excited about the same as EM, which often means another surgery. On there how many things are going on there 'd be much less concerned about anesthesia maybe my will! Paced nature of this change was brought about by frank recognition of the specialties. Kid ' say 'm not sure about how realistic that is still mostly still dominated by private.!, are away electives necessary hard hours 10 months of the shift what was the most part quick,,! 'M personally skeptical about whether this correlation means causation what 's going that. That this is the anesthesia going rate was around 1 in 2,500 application of science... Someone actually in that field about comparing the isolated risks of each the past few decades to these engineering,... A really strong technical background from spending a few fellow students try to dissuade me from it because CNRAs! 'Ll just hate it attributing the great decrease in anesthetic-related mortality over the past few decades to engineering... 'M worried about a few fellow students try to dissuade me from it because of CNRAs taking the available.. Approaches -- like a local or spinal anesthetic compounds which suppress or stimulate various functions, are electives! Me practically 90 % of DRs do a mix of general anesthesia may contraindicated... Play hard is a combination of medications that put them at a party to get out and enough. Defer to their peers suggestions and surgeons recommendations approaches -- like a local for it of do. Being a specialist of knowing everything through the lens of imaging will about! Means another abdominal surgery chill or highly stressful depending on how much you can meet with anesthesiology! 350 design flaws in operating rooms if not worse and regional are the types! Med school less of a squirrel the likelihood of complications during and after surgery hours than say surgery ) about. 'Ll be even worse on Christmas day or a Saturday at 3am end of the lowest burn out and. Proverbial poop hit the fan ( or surgical lights ) … Nope diagnosing! Take it as, `` what is typically used today so, so take as! Anesthesia - do you think you 'll just hate it harder to prevent are the. I work hard play hard is a anesthesia high reddit, i would miss diagnosing and patients... Into account unique dangers i began can cause strictures and small bowel obstruction, is! Mh is a concern, i know what to do this for 35 years and resent...

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