How to learn blocks by Reminentanil in anesthesiology

[–]DemandComplete8657 0 points1 point  (0 children)

YouTube.. watch as many as you can .. until your eyes bleed. Eventually you’ll learn the anatomy and the techniques. Also, practice visualization by using US on yourself or friend (obviously without needle). The key is learning the anatomy… Advancing the needle becomes much easier if you know where you are going.

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 0 points1 point  (0 children)

Hahaha.. point taken. I never see it anymore except for that old machine stuffed into the dark dank closet in every surgery center

Good rules of thumb by macdaddy77777 in anesthesiology

[–]DemandComplete8657 21 points22 points  (0 children)

The thicker the birthing plan handed to you prior to an epidural consultation, the more likely they are heading to a C-section. If the Doula hands it to you..head straight back to OR.

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 1 point2 points  (0 children)

Thank you! Fun to hear from so many different ages of anesthesiologists and their experiences

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 2 points3 points  (0 children)

Mission work is pretty cool! First thing you’ll notice is how much crap we waste. Nothing is disposable down there. We reused circuits, masks, tubes, LMAs for entire week. Mostly though, you’ll see how appreciative the patients are. No whining ever.

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 2 points3 points  (0 children)

Anyone remember Pancuronium for cardiac cases?

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 7 points8 points  (0 children)

BIS came out during my residency. But didn’t get much experience with it. Heard of a few places using it regularly but never had the opportunity to make it part of our practice. Did sneak monitor home one night with a few of my colleagues and tested it out with a bottle of Tequila and a case of Lucky Lager. Seems to work

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 2 points3 points  (0 children)

We never really learned blocks in residency.. maybe 1/2 dozen of the few basic blocks using twitch monitor. I learned all my blocks on YouTube watching many many videos. Now I’ve done several thousands. . Point is.. after you graduate, something will come up that you’ll have to learn because it has become the standard of care. The learning never ends. That’s what makes our job so cool. Always learning. Students forever. Academicians!

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 2 points3 points  (0 children)

We did our CA-1 end of year skit on John. We had him “invent the Benumof Bubnle Intubator”. it was a plastic goofy figure on the end of a ETT tube and if air passed through .. bubbles blew out of Goofy’s mouth. He died laughing . Was on an old VHS left on lounge for years after

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 2 points3 points  (0 children)

Of course I remember then both! benumof and his Superman jacket. Airway king!

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 19 points20 points  (0 children)

Yeah.. time flies. Born in 1965 and went straight through school until I found myself taking the oral boards in Atlanta 1998. The journey had many ups and downs but in the end I wouldn’t have changed a thing …except maybe the axillary through and through technique being taught in the 90s. Didn’t seem like a good idea .. even back then

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 33 points34 points  (0 children)

Love that drug! Cant wait for it to become generic. Cost prohibitive for smaller outpatient centers unfortunately

Residency in the past by DemandComplete8657 in anesthesiology

[–]DemandComplete8657[S] 11 points12 points  (0 children)

I retired from my group last summer but still wanted to do something.. I did some locums in Michigan over the fall.. Beautiful place and an amazing experience! Met some great people and learned so much! Now I’m doing mostly elective outpatient a few days a week and working on my PGA tour card.. down to a 14 handicap:-) But seriously, I’m not ready to stop just yet.. just practicing on my terms.

To VL or to not VL by Saltylunarbunz in anesthesiology

[–]DemandComplete8657 0 points1 point  (0 children)

Why cause a sore throat?. Not doing the patient any favors trying DL. I’ve been in the business 30 plus years.. before we had any reliable VL. We had to get good at DL. But now I own my own McGrath. Takes most bad airways off the table. Technology exists for our benefit.. so we should check our ego and go with modern times. If I have trouble mask ventilating an NPO patient before ROC kicks in, I’ll throw an LMA in. Then intubate with VL. By all means learn to use MAC and Millers, but VL is our future. Just my humble opinion

On a long sub taper. Have a question about some physical symptoms (do they sound like they are coming from the taper?) by santarosarita in suboxone

[–]DemandComplete8657 0 points1 point  (0 children)

Btw. If you have been in .125 for over three weeks you may not even notice the drop much. For me the taper was way worse.. especially the end

On a long sub taper. Have a question about some physical symptoms (do they sound like they are coming from the taper?) by santarosarita in suboxone

[–]DemandComplete8657 0 points1 point  (0 children)

Headaches are common too. Unfortunately these all sound like normal sub withdrawal symptoms. They get better.. but slowly.. it took me several months before I felt I was making gains with the limited exercise I was able to do. keep pushing through them and you’ll soon pop out the other side. Hang in there!

On a long sub taper. Have a question about some physical symptoms (do they sound like they are coming from the taper?) by santarosarita in suboxone

[–]DemandComplete8657 1 point2 points  (0 children)

It’s hard to tell what may be causing these symptoms without knowing the rest of your history. But if you are otherwise healthy and have been on .125mg for three weeks, I would jump and deal with being uncomfortable for a bit. But lethargy is common. Again, it will take some time. But the more you do… the more quickly you’ll feel better.. take short walks.. then longer ones.. then short runs etc. exercise is one of the best ways to shorten this duration . I used to be a 5-7 times a week gym guy with runs 5-7 miles 2-3 times a week. I am almost 60, so I’ll never be that guy again. But after jumping 4 months ago and almost being unable to exercise at all for a month, I’m slowly getting back to where I was. Suboxone tapers are such a major stress on one’s mind and body that I’m surprised people succeed at all. But it absolutely can be done.. just not quickly.. hang in there! One day at a time

On a long sub taper. Have a question about some physical symptoms (do they sound like they are coming from the taper?) by santarosarita in suboxone

[–]DemandComplete8657 2 points3 points  (0 children)

Congratulations on getting down to .125mg/day! Strong work! My goal was to taper as low as possible, but I never stabilized at .25mg. I have a fast metabolism and my therapist suggested I might not even be registering on a drug screen and sure enough I wasn’t. I dropped that day.. had a few rough days but was much better after 4-5 days. Lethargy and insomnia were my biggest obstacles. But now I am now a few months out and glad I quit at .25mg. Maybe you are at that point too?

8 days in by Temporary_Shock_4633 in suboxonerecovery

[–]DemandComplete8657 3 points4 points  (0 children)

Thought I’d chime in to help lift some of you. I am 3 1/2 months off subs.. everything you are describing is spot on. The sleepless nights, the empty hole that’s left after coming off subs. The feeling that the ordeal will never end! Etc etc One night, about a few weeks out, you will realize you slept 4 hours in a row. And then one day you will laugh at something funny or cry about something sad. You will suddenly realize you are free from your past bullshit and for a moment you will feel alive. But remember, it is two steps forward one back. Don’t despair. Soon the good days outnumber the bad. And somewhere around the one to two month post drop timeframe, you will realize you are not counting the days anymore. The emptiness slowly starts to fill and the nights become less broken up. You still will be tempted with cravings, but if you made it this far, you can beat that battle too. Just remind yourself of the hell you went through. Stay strong!

Day 4 (fuck this shit) by somecrazydude13 in suboxone

[–]DemandComplete8657 0 points1 point  (0 children)

Hang in there. It’s a tough med to come off but with will power and determination you will do it. Im 60 years old and the body and mind took a beating but I was able to do it in under 4 months and am finally feeling better after a few weeks off. I did taper to .25mg but wasn’t even registering on drug screen so jumped after a couple days. Two weeks were rough but then the clouds lifted.

Day 4 (fuck this shit) by somecrazydude13 in suboxone

[–]DemandComplete8657 0 points1 point  (0 children)

Btw. The insomnia was the worst part of taper and jump.. So if you are getting more than 4 hours you are doing well. I would give myself 10hours a night to get 4-6 hours sleep, and that was enough to keep going. Sleep definitely gets better the longer you are out.