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>> You proposed to me when you were waking up.
I've gotten marriage proposals before.
There's always a question about math.
Ooh, do I have to be good at math?
Okay, here's a question about THC causing reactions
under anesthesia versus CBD.
Hello guys, welcome back to my channel.
So today is going to be really interesting.
We're going to be answering some medically related
anesthesia related questions.
I noticed there were no really good
like Q&A subreddits on Reddit.
And so I asked you guys to either send me links
to your favorite Reddit questions or Reddit topics
or something like that,
or to just ask the questions
on my community page on my channel.
So let's get into it.
There were a lot of questions.
We're not going to be able to answer them all,
but hopefully I can readdress this post later.
I'll leave a link to it down below.
But if you want to keep asking questions,
let's just keep it all there.
And that way I can continue to look back
on it for future videos.
So let's get started.
How much schooling does it take
to become an anesthesiologist?
And there's always a question about math.
And I even thought this myself,
when I was going into anesthesia,
ooh, do I have to be good at math?
Like anything in life,
you can train your brain to become very adept
at the mathematical equations that you're going to use
in anesthesia on a daily basis.
Math is my worst subject or was my worst worst subject,
and now it's second nature.
The very simple calculations that you need to do,
it's mostly just multiplication,
because you're using weight-based dosages.
So say something is two milligrams per kilogram.
Then you're converting the patient's weight
from pounds to kilograms if you're here in the U.S.,
and then the kilogram weight will be multiplied by two,
and that's your dose.
So yes, there is a lot of that kind of in your head,
but this is not like a testing environment.
You always have your phone,
you can carry a calculator if you want.
I remember a lot of people earlier than the smartphone days
would carry around a little tiny Casio
kind of pocket calculator with them in their pocket,
in their scrub pocket,
especially on pediatric anesthesia,
because it's so heavily based on weight.
So yes, there is math involved, but it's very simple math.
The other thing I would say that you might want to brush up
on while you're in training with anesthesia residency
would be something like calculating rates
and, oh, what's it called where you're balancing?
Cross multiplication, I guess.
I guess cross multiplication is used quite a bit too.
It's all done kind of in your head at this point
when you're out of training and everything,
but that does happen.
But to answer your question,
how much schooling does it take?
Well in the United States,
it's different in different parts of the world,
but in the United States,
you need a four year Bachelor's degree.
That's a university degree.
You need four years of medical school
from a U.S. based medical school.
And then anesthesia training or residency
is a paid kind of apprenticeship
that is four years long.
I believe the shortest duration
of any residency in the U.S. is three years.
And then the longest is seven years.
And that's something like plastic surgery
and a combined general surgery
and plastic surgery situation.
Oh, this is a great question.
Do you account for people lying about their weight
when trying to figure out how much to give them?
Actually, this doesn't come up that much,
and I'll tell you why.
Weight is a vital sign.
So when you are admitted to the hospital,
or when you come in for your pre-op the morning of surgery,
let's say it's a day surgery,
and you're going to go home that day,
they're going to take all your vital signs
and that includes your weight.
So in some cases,
some places allow you to state your weight,
but most of the time, it's just very routine.
You step on the scale, we get your weight
and move on to the next vital sign,
like your blood pressure.
This is a great question.
Why does anesthesia smell so weird?
Or why do people wake up crying and fighting
and other people are perfectly fine?
I don't have a good answer for why some people wake up
dysphoric is the medical term that we use for this.
Dysphoria means that you are, it's the opposite of euphoric.
So instead of being elated and happy,
you are very sad or very distraught or crying or stressed,
and that can happen to anybody.
It relates to the individual,
but also it may relate to like making sure
that they're comfortable,
making sure they have enough narcotic on board
or any kind of pain medication on board
to make sure that you're really taking away
any stressors to the body,
physically externally you're taking care of that,
but I don't have a great answer to that,
to be honest with you.
I don't think that we really know.
Can you talk about anesthesia awareness?
Well, actually I have talked about anesthesia awareness
and I will link that video down below.
Another question is,
do red heads react definitely to anesthesia?
I also made a video on that during a Medical Minute Monday.
So I will link that one down below as well.
This is a great question.
Why do some people get extremely nauseous after anesthesia
while others, it doesn't affect them at all?
We don't have a clear answer for this
about why some people get nauseous
after anesthesia and some don't.
Typically one of the very standard questions
that I will ask a patient
while interviewing them preop will be
with your previous anesthetics
have you had any issues?
For example, nausea and vomiting, and they will say
"Yeah, I've had, you know, the occasional nausea,"
or "No, I was sick as a dog," or "Nah, I was great."
And I will use that to kind of base in conjunction
with the type of surgery, the length of your anesthetic,
the expected pain afterwards,
to kind of figure out how nauseous
they're going to be after anesthesia, if at all.
And we have ways that we can prevent that.
Not only just with IV medicines,
but with other things as well,
but there is a based on longterm studies.
There is a risk factor, a risk stratification,
typically non-smoker, females, and young.
So if you're a young female nonsmoker,
you're going to want to keep more of that
in the forefront of your mind,
when asking the anesthesiologist
during your preoperative assessment,
say, "Hey, I am young, female, and a non smoker.
Am I at a greater risk for nausea after anesthesia?"
And they'll be like, [snapping] "Yes, actually you are.
Let's go ahead and do da, da, da, da, da."
And most of the time they'll already have this plan for you.
And they were going to get to it,
but it always helps to take ownership of your medical care.
What's the worst case scenario under anesthesia
if someone has lied about pre-surgery questions?
It's very important to be upfront and honest
with your anesthesiologists.
Anytime they're asking you a question,
it's not judging you.
It's not because they want to pry.
It's because there's a medical reason for that question.
And the most important question I always ask
is about drug use.
Not because I care if you do drugs,
and I'm not going to call the cops.
That's not in my wheelhouse, that's not my job
and I couldn't care less.
But what I care about is in the last 24 hours or recently
have you used certain drugs,
and some drugs are more important than others.
We know for a fact that marijuana use
prior to anesthesia can make the airways more irritable
and make you more prone to bronchospasm.
So we ask that you refrain from any smoking,
whether it's tobacco or marijuana for at least 24 hours,
but preferably a week prior to your anesthetic.
The most important thing to me,
is if a patient is actively using cocaine.
So if they have cocaine in their system,
they are much higher risk
for complications under anesthesia.
And most of that has to do with long term
cocaine use will deeply catecholamines.
Catecholamines are things that help
your body respond to stress
and keep your blood pressure at a normal range.
Even when your blood pressure
is kind of under attack from things,
for example, from anesthesia.
So it's a harder to use pressors, which are medications
that help raise the blood pressure under anesthesia.
They are less effective when you're a chronic cocaine user.
And the other thing that's really important
with cocaine is the heart.
So if I'm going to give you some medications,
they might actually react very, very badly
with the cocaine's affects on the adrenergic system,
basically your sympathetic nervous system.
So there are things that can actually,
if I don't know that you've been taking that,
or it's not routine to do a drug test
on everybody preoperatively.
And if you don't tell me that,
you could die under anesthesia.
So sometimes if there's a high suspicion
based on history or based on clinical signs,
then I will tell them, look, no judgment,
I I don't personally care one way or another,
and there's no cops involved in this question,
but is there any chance that you have
any drugs your system right now?
I need to know, because if I don't know and there is,
then the anesthesia could kill you.
And I've only had to say that like once or twice
in my career that seriously
when I was super, super suspicious
based on clinical signs,
and I did not want to harm them under anesthesia.
I need to know, you know, it's really important.
And so, yeah, that is a very important question
that you should not lie about.
Oh, why is there a side effect of my crotch itching
that happened when I was given a sedative
before I fell asleep?
I'm not entirely certain.
The only one I know of,
that if you're awake and you receive it is dexamethasone.
So we give Decadron.
It's more commonly known now
because of its supposed utility
when combating COVID-19 symptoms.
But Decadron is a very useful, very popular generic steroid
that helps prevent nausea after anesthesia.
So it's part of our arsenal
to help prevent nausea after anesthesia.
But we always give it when you're asleep,
because while you're awake,
it might cause some burning in the perineal area.
So that's the only one I can think of.
They may have given that in this situation, I don't know,
but I would not give it to anybody while they're awake.
'Cause it's just very uncomfortable apparently.
Okay, here's a question about THC
causing reactions under anesthesia versus CBD.
Now, this is very important because I've already
talked about THC, marijuana, and smoking,
but basically smoking anything
can really kind of put your respiratory tree
under sort of a defensive mode,
and it feels like it's being attacked in layman's terms.
And so that's what makes it very irritable, very reactive,
and now we're putting a volatile gas in there
with the anesthesia to keep you asleep,
and it can react almost like can asthma attack.
So that's the issue with smoking of any kind of substance
of any irritant in general that isn't just air.
You know what I mean?
So the CBD is an oil, it's a non active ingredient
that is like the second part of the component
that makes up a marijuana or hemp.
And that is the non-active component
versus the active component which is THC,
which is the hallucinogenic.
Not hallucinogenic.
Why was I saying hallucinogenic? I don't know.
It's not an active ingredient,
which is why it's not illegal.
It's not an illegal substance to have CBD.
People are putting CBD in everything now.
There are some thoughts behind CBD
having an antiinflammatory property,
which is very useful in a lot of cases,
especially with all the kind of chronic inflammation
that the modern diet can instill upon us.
Here's a good one.
What is the craziest thing anybody has said to you
when they were coming out of anesthesia?
I think the craziest thing or the funniest thing
that we kind of just giggle about.
I don't tell the patient, if it's going to be something
that's going to embarrass them.
But I do tease them a little bit.
I'm like "You proposed to me when you were waking up."
I've gotten marriage proposals before.
so that is going to do it for today's a question and answer.
I do have a whole lot more questions
to be able to reference back to.
So again, check out the link in the description box.
If you have a burning anesthesia related question
and you want it answered, we will get to all most,
if not all of them as soon as possible.
So I hope you enjoyed this video.
If you did give it a thumbs up,
share it with your friends who might have had
some questions about anesthesia as well,
that they want answered,
or maybe you have a friend or family member
who's going to have surgery soon,
and they have questions about anesthesia,
generic questions, please.
Not specific to your case because I'm not your doctor.
I can't answer personal medical questions,
but I really do enjoy these types of videos.
So I hope you will help me out
by asking your questions in that post.
So thank you for watching and I'll see you on the next one.
Bye guys.
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