WEBVTT - Bonus: An Anaesthetist Reveals Everything You Need to Know About "Going Under"

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<v Speaker 1>One of my favorites, The experts with Jason Lauren. Your

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<v Speaker 1>vessel specialists who specialize in very special things.

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<v Speaker 2>Hi, I'm Lachlan, and I'm an expert in antithesiology.

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<v Speaker 3>Let's hear from the expert.

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<v Speaker 4>All right, So I'm going to try and say this

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<v Speaker 4>without stuffing it up. Here we go, Lucky you are

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<v Speaker 4>an anetheist, No, an ethicist close.

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<v Speaker 5>I'm doing a lot better than most people.

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<v Speaker 6>Okay, let's see who can say an ethetist.

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<v Speaker 5>Yeah, that's good, Lauren.

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<v Speaker 1>Yeah, an ethetist.

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<v Speaker 5>Yeah, yep, yep, you got it there.

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<v Speaker 1>Okay, go to the odd one.

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<v Speaker 3>A nethetist.

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<v Speaker 6>Yeah, so we see it.

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<v Speaker 1>Professional anesthesiology. She is a little patronizing, but that's fine.

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<v Speaker 5>Lachlan Miles, good morning, Good morning, Lauren.

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<v Speaker 6>You're are expert today in what do you do?

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<v Speaker 5>That's a good question.

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<v Speaker 2>So I'm an anthist, or in the States, i'd be

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<v Speaker 2>called an anesthesiologist, and we're responsible for keeping patients comfortable

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<v Speaker 2>and safe during surgery, but also managing them around the

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<v Speaker 2>time of the operation, before and after.

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<v Speaker 7>So you are the ones that keep us on that

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<v Speaker 7>fine line between life and death.

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<v Speaker 1>Is that right?

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<v Speaker 7>Like we're unconscious, but you've got a monitor to make

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<v Speaker 7>sure we're unconscious. We don't wake up in surgery, and

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<v Speaker 7>we also don't go too far they.

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<v Speaker 5>One hundred percent.

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<v Speaker 2>My general line to patients is that the surgeon worries

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<v Speaker 2>about the bit that they're operating on, and I worry

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<v Speaker 2>about the.

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<v Speaker 5>Rest of you.

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<v Speaker 2>So our role is to keep you pain free, to

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<v Speaker 2>keep you comfortable, and to make sure that you're not

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<v Speaker 2>remembering anything that you're not supposed to during the operation.

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<v Speaker 4>But so save Clinton and I are both been wheeled

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<v Speaker 4>in for surgery, Right does it come down.

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<v Speaker 1>I'm giving you an organ or.

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<v Speaker 5>Something for kidney Clinton?

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<v Speaker 3>I don't want your organs?

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<v Speaker 4>But like, is it the amount of drugs isn't measured

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<v Speaker 4>by the patient's lifestyle and weight, Like how do you

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<v Speaker 4>work out how much to give each patient?

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<v Speaker 5>Anesthes is half art and half signed.

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<v Speaker 2>So there's very scientific dosing protocols that we use based

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<v Speaker 2>on your sex, your height, your weight, and also your

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<v Speaker 2>age is a very important fact there.

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<v Speaker 5>But there's also.

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<v Speaker 2>Additional things like what's your lifestyle. So patients who drink

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<v Speaker 2>some alcohol may smoke. We might need to alter the

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<v Speaker 2>dose of drugs that give depending on these specific circumstances.

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<v Speaker 8>So associate professor, what are you doing while the surgeons

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<v Speaker 8>at work? Are you monitoring the patient itself or computers

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<v Speaker 8>or what are you watching?

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<v Speaker 2>So basically, anesthesia, to use an analogy, clean, it's a

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<v Speaker 2>bit like flying a plane. So the most challenging times

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<v Speaker 2>are takeoff and landing. But just because you're cruising at

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<v Speaker 2>forty one thousand feet doesn't mean that you're not doing anything.

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<v Speaker 6>You're not sitting there playing snake no.

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<v Speaker 5>Not playing snake no.

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<v Speaker 2>The fact of the matter is that it's like flying

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<v Speaker 2>a plane, but without an autopilot. So if you're flying

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<v Speaker 2>a plane, you're constantly making microadjustments. You're making sure that

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<v Speaker 2>you remain on course, you're making sure that everything's safe,

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<v Speaker 2>and you're ready to respond to an emergency.

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<v Speaker 5>So we monitor the patient's airway.

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<v Speaker 2>Usually will secure the airway with a breathing tube during

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<v Speaker 2>the procedure because you're so deeply unconscious that you can't

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<v Speaker 2>maintain your own airway. We also make sure that we

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<v Speaker 2>breathe for you, because you generally don't breathe under.

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<v Speaker 6>A generatn we breathe for us well.

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<v Speaker 2>One of the components about it's easier is that you

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<v Speaker 2>want to make sure that the patient remains still during

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<v Speaker 2>the operation. For obvious reasons, the surgeons don't really like

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<v Speaker 2>audience participation on it. It's fairly safe to say. And

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<v Speaker 2>so to do that, we need to give you a

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<v Speaker 2>musclell accent. And this musclell accent basically stops any muscle

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<v Speaker 2>that you would have voluntary control over, like you're breathing

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<v Speaker 2>from moving.

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<v Speaker 6>Oh, it's like full body boto.

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<v Speaker 2>Yes, that's a great analogy completely. And so when you

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<v Speaker 2>have this done, you can't move your diephram anymore. You

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<v Speaker 2>can't physically breathe. So when we put the breathing tube down,

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<v Speaker 2>we apply some positive pressure.

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<v Speaker 5>We can make the chest go in and out out

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<v Speaker 5>as well.

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<v Speaker 4>Lucky, I've seen it in movies. How often do patients

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<v Speaker 4>wake up mid surgery?

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<v Speaker 2>It's a great question, and often jays. This is probably

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<v Speaker 2>the question I get most from my patients, because people

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<v Speaker 2>are rightly terrified of it.

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<v Speaker 4>Oh yeah, I don't want to wake up to an

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<v Speaker 4>open heart surgery and be like, oh, hey, gods.

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<v Speaker 6>But that's the anithetist's job, isn't it.

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<v Speaker 2>One hundred percent? And so there's two things that we do.

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<v Speaker 2>The first is that the drugs that we give are

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<v Speaker 2>very good. But in addition to that, there's a whole

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<v Speaker 2>new family of monitors that have been around for the

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<v Speaker 2>last fifteen years.

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<v Speaker 5>They go on you for it.

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<v Speaker 2>They basically measure your brain waves and they give us signals.

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<v Speaker 2>We interpret the recording in front of us, tell us

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<v Speaker 2>if we're giving you too much or too little, and

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<v Speaker 2>that will alarm or generate a signal well before you

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<v Speaker 2>actually wake up.

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<v Speaker 6>Oh, so you know now if it's looking like we're

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<v Speaker 6>waking up correct.

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<v Speaker 2>So the actual instance of true awareness under an anesthesia, Lauren,

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<v Speaker 2>it's not zero, but it's very low explicit awareness where

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<v Speaker 2>my goodness, I was awake, I could feel everything, I

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<v Speaker 2>could hear everything.

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<v Speaker 5>It's very rare.

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<v Speaker 2>We're probably looking at one in seven thousand or something

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<v Speaker 2>along those lines.

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<v Speaker 8>So when you do wake someone up, we'll bring someone out.

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<v Speaker 8>Does everyone speak gibberish?

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<v Speaker 5>Not necessarily depends on the top of vangy.

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<v Speaker 1>Have you got some good stories that I can? But

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<v Speaker 1>it must happen from time to time and give you

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<v Speaker 1>a laugh.

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<v Speaker 5>Usually on the way down is when you tend to

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<v Speaker 5>get First.

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<v Speaker 7>Of all, I was gonna ask there neither I've had

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<v Speaker 7>they often have different things that they get you to do,

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<v Speaker 7>like countdown from ten, say the alphabet. Has anyone ever

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<v Speaker 7>made the countdown? Or is it a bit of fun

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<v Speaker 7>for you guys when you're like, oh, they think.

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<v Speaker 2>It depends on how much you want them to get

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<v Speaker 2>to the bottom. So if you want them to get

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<v Speaker 2>to the bottom, you get to the start counting, then

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<v Speaker 2>you give the drugs. If you don't, you give them

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<v Speaker 2>the drugs and then say now start counting.

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<v Speaker 5>Because never I always win. No one ever gets to zero.

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<v Speaker 1>All that tingly face you get or.

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<v Speaker 4>Question anyone feed themselves on the table, like can you

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<v Speaker 4>control your bows when you were out?

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<v Speaker 6>So that should that's why, If that's why you have

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<v Speaker 6>to do all this.

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<v Speaker 2>Before, that's one of the reasons. Certainly I'd be lying

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<v Speaker 2>if I said that it never happened, James.

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<v Speaker 5>But it is uncommon.

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<v Speaker 2>And let's go back to that earlier part of the

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<v Speaker 2>conversation where I said, I've given you and a drug

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<v Speaker 2>that causes you to lose voluntary control of yeahs fault.

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<v Speaker 7>Of course it's not yours, not judging like they're saving us.

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<v Speaker 6>They're putting my head back together with all the students

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<v Speaker 6>rolling and watching in nude on the table.

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<v Speaker 2>So it's always though, like an anesthetic makes you go

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<v Speaker 2>to the toilet, it doesn't make you bear down. But

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<v Speaker 2>if you're a bit backed up there and I relax you,

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<v Speaker 2>I can't change the laws of physics, unfortunately, but it's

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<v Speaker 2>something to be ashamed of, you know, a lot of

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<v Speaker 2>this small children, it happens.

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<v Speaker 1>It happens when we're not under you clean up.

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<v Speaker 7>That's a different type of anesthesia. When you've had a

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<v Speaker 7>few too many red ones. Now here's one for you.

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<v Speaker 7>This is kind of gross, but it happens to me

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<v Speaker 7>all the time. I'm a vomited and I had. The

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<v Speaker 7>last anathodist who I had was like, no, no, no,

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<v Speaker 7>trust me, I'll make sure you don't spew when you

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<v Speaker 7>come out of this. And I was like, I'm telling you,

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<v Speaker 7>every single time I wake up from an operation, I vomit.

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<v Speaker 7>And he was like, you won't this time, and I

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<v Speaker 7>still spewed on him. Bad luck felt so bad. A

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<v Speaker 7>lot of people are really affected by it when they

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<v Speaker 7>come out of it right well.

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<v Speaker 2>Depending again depending on the type of anesthetic you give,

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<v Speaker 2>you know, and particularly young women are badly affected.

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<v Speaker 5>Lauren.

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<v Speaker 6>So it's not uncommon, not at all.

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<v Speaker 2>And there are certain things that we can do change

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<v Speaker 2>the nature of the anesthetic. Give different drugs, give you

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<v Speaker 2>drugs way you sleep, predicting that you're going to vomit

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<v Speaker 2>when you wake up, to try and reduce the risk,

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<v Speaker 2>and we can get the risk close to zero, but

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<v Speaker 2>close to zero as eve unfortunately discover Lauren is not.

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<v Speaker 5>The same as zero.

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<v Speaker 2>And there will be patients every now and again that

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<v Speaker 2>are agredably.

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<v Speaker 5>Resistant to our charms. And it sounds like unfortunately category

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<v Speaker 5>but you've got.

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<v Speaker 7>The little funny hat on and you're throwing up on

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<v Speaker 7>yourself and it's just a bad scene.

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<v Speaker 2>It's just really, it's really not good. We try and

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<v Speaker 2>avoid it whenever we can.

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<v Speaker 3>One more. Have you ever had to do any epidurals?

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<v Speaker 2>Oh, tons, Yeah, it's a routine anesthetic technique. I don't

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<v Speaker 2>do obstetrics anymore, but when I did do obstetrics, I

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<v Speaker 2>used to do a lot of.

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<v Speaker 4>Them because I remember when we had Felix, our first one,

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<v Speaker 4>the anetheesist clot was about to be called in for

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<v Speaker 4>surgery and he's like, look, we wouldn't normally do the

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<v Speaker 4>EPI this early, but he said the way. I describe

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<v Speaker 4>it as if you're flying all the way to la

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<v Speaker 4>why do economy to Hawaii and then do business?

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<v Speaker 3>Why not do business the whole way.

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<v Speaker 5>Oh, that's a great analogy.

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<v Speaker 3>So he gave it early and she was out.

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<v Speaker 2>I've had three marriage proposals after putting in.

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<v Speaker 5>Two while the husband was in the room.

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<v Speaker 4>To you, Oh yeah, well he's taken the pain away.

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<v Speaker 3>I proposed to him as well, and.

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<v Speaker 2>Tasting it's probably one of the best an ebceeterric epidural

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<v Speaker 2>is probably one of the most rewarding things that you

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<v Speaker 2>can do in anesthesia, because you do have a patient

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<v Speaker 2>who is in terrible pain in front of you, and

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<v Speaker 2>with a very simple, very safe intervention, you can take

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<v Speaker 2>that pain straight away and make sure that they have

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<v Speaker 2>as good a birth experience as they possibly can.

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<v Speaker 5>It was a tremendously rewarding part of my job.

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<v Speaker 6>Oh my god, you're so nice.

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<v Speaker 1>He's so skillful as well.

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<v Speaker 6>Bad news. I want Lachlan to tell me, all.

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<v Speaker 3>Right, we'll stick around, lockicks through pass something.

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<v Speaker 1>He's like, are you good at that board game operation?

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<v Speaker 1>I'm terrible, but I don't know.

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<v Speaker 5>I'm great at the anesthetic part.

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<v Speaker 1>You just can't get the heart out.

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<v Speaker 2>But like I'm not, I'm not sure you'd want me

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<v Speaker 2>doing that part of the operation.

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<v Speaker 4>Finally, Associate Professor Locker Miles, he is a anetheists.

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<v Speaker 5>There, you.

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<v Speaker 1>Think that.

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<v Speaker 5>I want to be nice to Jason's put me on

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<v Speaker 5>the radio.

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<v Speaker 6>Thank you, well, we put you on the radio, Lucky.

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<v Speaker 5>Thanks for coming in, mate.

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<v Speaker 3>Thanks to the crew at Austin Hospital. They're doing an

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<v Speaker 3>amazing job there.

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<v Speaker 6>You absolutely do an amazing job. Thank you for joining us.

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<v Speaker 5>No, thank you, Lauren. Lovely to be here, Lauren, Lauren wake.

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<v Speaker 8>I'm feeling good following them on the socials