Speaker 1: One of my favorites, The experts with Jason Lauren. Your
Speaker 1: vessel specialists who specialize in very special things.
Speaker 2: Hi, I'm Lachlan, and I'm an expert in antithesiology.
Speaker 3: Let's hear from the expert.
Speaker 4: All right, So I'm going to try and say this
Speaker 4: without stuffing it up. Here we go, Lucky you are
Speaker 4: an anetheist, No, an ethicist close.
Speaker 5: I'm doing a lot better than most people.
Speaker 6: Okay, let's see who can say an ethetist.
Speaker 5: Yeah, that's good, Lauren.
Speaker 1: Yeah, an ethetist.
Speaker 5: Yeah, yep, yep, you got it there.
Speaker 1: Okay, go to the odd one.
Speaker 3: A nethetist.
Speaker 6: Yeah, so we see it.
Speaker 1: Professional anesthesiology. She is a little patronizing, but that's fine.
Speaker 5: Lachlan Miles, good morning, Good morning, Lauren.
Speaker 6: You're are expert today in what do you do?
Speaker 5: That's a good question.
Speaker 2: So I'm an anthist, or in the States, i'd be
Speaker 2: called an anesthesiologist, and we're responsible for keeping patients comfortable
Speaker 2: and safe during surgery, but also managing them around the
Speaker 2: time of the operation, before and after.
Speaker 7: So you are the ones that keep us on that
Speaker 7: fine line between life and death.
Speaker 1: Is that right?
Speaker 7: Like we're unconscious, but you've got a monitor to make
Speaker 7: sure we're unconscious. We don't wake up in surgery, and
Speaker 7: we also don't go too far they.
Speaker 5: One hundred percent.
Speaker 2: My general line to patients is that the surgeon worries
Speaker 2: about the bit that they're operating on, and I worry
Speaker 2: about the.
Speaker 5: Rest of you.
Speaker 2: So our role is to keep you pain free, to
Speaker 2: keep you comfortable, and to make sure that you're not
Speaker 2: remembering anything that you're not supposed to during the operation.
Speaker 4: But so save Clinton and I are both been wheeled
Speaker 4: in for surgery, Right does it come down.
Speaker 1: I'm giving you an organ or.
Speaker 5: Something for kidney Clinton?
Speaker 3: I don't want your organs?
Speaker 4: But like, is it the amount of drugs isn't measured
Speaker 4: by the patient's lifestyle and weight, Like how do you
Speaker 4: work out how much to give each patient?
Speaker 5: Anesthes is half art and half signed.
Speaker 2: So there's very scientific dosing protocols that we use based
Speaker 2: on your sex, your height, your weight, and also your
Speaker 2: age is a very important fact there.
Speaker 5: But there's also.
Speaker 2: Additional things like what's your lifestyle. So patients who drink
Speaker 2: some alcohol may smoke. We might need to alter the
Speaker 2: dose of drugs that give depending on these specific circumstances.
Speaker 8: So associate professor, what are you doing while the surgeons
Speaker 8: at work? Are you monitoring the patient itself or computers
Speaker 8: or what are you watching?
Speaker 2: So basically, anesthesia, to use an analogy, clean, it's a
Speaker 2: bit like flying a plane. So the most challenging times
Speaker 2: are takeoff and landing. But just because you're cruising at
Speaker 2: forty one thousand feet doesn't mean that you're not doing anything.
Speaker 6: You're not sitting there playing snake no.
Speaker 5: Not playing snake no.
Speaker 2: The fact of the matter is that it's like flying
Speaker 2: a plane, but without an autopilot. So if you're flying
Speaker 2: a plane, you're constantly making microadjustments. You're making sure that
Speaker 2: you remain on course, you're making sure that everything's safe,
Speaker 2: and you're ready to respond to an emergency.
Speaker 5: So we monitor the patient's airway.
Speaker 2: Usually will secure the airway with a breathing tube during
Speaker 2: the procedure because you're so deeply unconscious that you can't
Speaker 2: maintain your own airway. We also make sure that we
Speaker 2: breathe for you, because you generally don't breathe under.
Speaker 6: A generatn we breathe for us well.
Speaker 2: One of the components about it's easier is that you
Speaker 2: want to make sure that the patient remains still during
Speaker 2: the operation. For obvious reasons, the surgeons don't really like
Speaker 2: audience participation on it. It's fairly safe to say. And
Speaker 2: so to do that, we need to give you a
Speaker 2: musclell accent. And this musclell accent basically stops any muscle
Speaker 2: that you would have voluntary control over, like you're breathing
Speaker 2: from moving.
Speaker 6: Oh, it's like full body boto.
Speaker 2: Yes, that's a great analogy completely. And so when you
Speaker 2: have this done, you can't move your diephram anymore. You
Speaker 2: can't physically breathe. So when we put the breathing tube down,
Speaker 2: we apply some positive pressure.
Speaker 5: We can make the chest go in and out out
Speaker 5: as well.
Speaker 4: Lucky, I've seen it in movies. How often do patients
Speaker 4: wake up mid surgery?
Speaker 2: It's a great question, and often jays. This is probably
Speaker 2: the question I get most from my patients, because people
Speaker 2: are rightly terrified of it.
Speaker 4: Oh yeah, I don't want to wake up to an
Speaker 4: open heart surgery and be like, oh, hey, gods.
Speaker 6: But that's the anithetist's job, isn't it.
Speaker 2: One hundred percent? And so there's two things that we do.
Speaker 2: The first is that the drugs that we give are
Speaker 2: very good. But in addition to that, there's a whole
Speaker 2: new family of monitors that have been around for the
Speaker 2: last fifteen years.
Speaker 5: They go on you for it.
Speaker 2: They basically measure your brain waves and they give us signals.
Speaker 2: We interpret the recording in front of us, tell us
Speaker 2: if we're giving you too much or too little, and
Speaker 2: that will alarm or generate a signal well before you
Speaker 2: actually wake up.
Speaker 6: Oh, so you know now if it's looking like we're
Speaker 6: waking up correct.
Speaker 2: So the actual instance of true awareness under an anesthesia, Lauren,
Speaker 2: it's not zero, but it's very low explicit awareness where
Speaker 2: my goodness, I was awake, I could feel everything, I
Speaker 2: could hear everything.
Speaker 5: It's very rare.
Speaker 2: We're probably looking at one in seven thousand or something
Speaker 2: along those lines.
Speaker 8: So when you do wake someone up, we'll bring someone out.
Speaker 8: Does everyone speak gibberish?
Speaker 5: Not necessarily depends on the top of vangy.
Speaker 1: Have you got some good stories that I can? But
Speaker 1: it must happen from time to time and give you
Speaker 1: a laugh.
Speaker 5: Usually on the way down is when you tend to
Speaker 5: get First.
Speaker 7: Of all, I was gonna ask there neither I've had
Speaker 7: they often have different things that they get you to do,
Speaker 7: like countdown from ten, say the alphabet. Has anyone ever
Speaker 7: made the countdown? Or is it a bit of fun
Speaker 7: for you guys when you're like, oh, they think.
Speaker 2: It depends on how much you want them to get
Speaker 2: to the bottom. So if you want them to get
Speaker 2: to the bottom, you get to the start counting, then
Speaker 2: you give the drugs. If you don't, you give them
Speaker 2: the drugs and then say now start counting.
Speaker 5: Because never I always win. No one ever gets to zero.
Speaker 1: All that tingly face you get or.
Speaker 4: Question anyone feed themselves on the table, like can you
Speaker 4: control your bows when you were out?
Speaker 6: So that should that's why, If that's why you have
Speaker 6: to do all this.
Speaker 2: Before, that's one of the reasons. Certainly I'd be lying
Speaker 2: if I said that it never happened, James.
Speaker 5: But it is uncommon.
Speaker 2: And let's go back to that earlier part of the
Speaker 2: conversation where I said, I've given you and a drug
Speaker 2: that causes you to lose voluntary control of yeahs fault.
Speaker 7: Of course it's not yours, not judging like they're saving us.
Speaker 6: They're putting my head back together with all the students
Speaker 6: rolling and watching in nude on the table.
Speaker 2: So it's always though, like an anesthetic makes you go
Speaker 2: to the toilet, it doesn't make you bear down. But
Speaker 2: if you're a bit backed up there and I relax you,
Speaker 2: I can't change the laws of physics, unfortunately, but it's
Speaker 2: something to be ashamed of, you know, a lot of
Speaker 2: this small children, it happens.
Speaker 1: It happens when we're not under you clean up.
Speaker 7: That's a different type of anesthesia. When you've had a
Speaker 7: few too many red ones. Now here's one for you.
Speaker 7: This is kind of gross, but it happens to me
Speaker 7: all the time. I'm a vomited and I had. The
Speaker 7: last anathodist who I had was like, no, no, no,
Speaker 7: trust me, I'll make sure you don't spew when you
Speaker 7: come out of this. And I was like, I'm telling you,
Speaker 7: every single time I wake up from an operation, I vomit.
Speaker 7: And he was like, you won't this time, and I
Speaker 7: still spewed on him. Bad luck felt so bad. A
Speaker 7: lot of people are really affected by it when they
Speaker 7: come out of it right well.
Speaker 2: Depending again depending on the type of anesthetic you give,
Speaker 2: you know, and particularly young women are badly affected.
Speaker 5: Lauren.
Speaker 6: So it's not uncommon, not at all.
Speaker 2: And there are certain things that we can do change
Speaker 2: the nature of the anesthetic. Give different drugs, give you
Speaker 2: drugs way you sleep, predicting that you're going to vomit
Speaker 2: when you wake up, to try and reduce the risk,
Speaker 2: and we can get the risk close to zero, but
Speaker 2: close to zero as eve unfortunately discover Lauren is not.
Speaker 5: The same as zero.
Speaker 2: And there will be patients every now and again that
Speaker 2: are agredably.
Speaker 5: Resistant to our charms. And it sounds like unfortunately category
Speaker 5: but you've got.
Speaker 7: The little funny hat on and you're throwing up on
Speaker 7: yourself and it's just a bad scene.
Speaker 2: It's just really, it's really not good. We try and
Speaker 2: avoid it whenever we can.
Speaker 3: One more. Have you ever had to do any epidurals?
Speaker 2: Oh, tons, Yeah, it's a routine anesthetic technique. I don't
Speaker 2: do obstetrics anymore, but when I did do obstetrics, I
Speaker 2: used to do a lot of.
Speaker 4: Them because I remember when we had Felix, our first one,
Speaker 4: the anetheesist clot was about to be called in for
Speaker 4: surgery and he's like, look, we wouldn't normally do the
Speaker 4: EPI this early, but he said the way. I describe
Speaker 4: it as if you're flying all the way to la
Speaker 4: why do economy to Hawaii and then do business?
Speaker 3: Why not do business the whole way.
Speaker 5: Oh, that's a great analogy.
Speaker 3: So he gave it early and she was out.
Speaker 2: I've had three marriage proposals after putting in.
Speaker 5: Two while the husband was in the room.
Speaker 4: To you, Oh yeah, well he's taken the pain away.
Speaker 3: I proposed to him as well, and.
Speaker 2: Tasting it's probably one of the best an ebceeterric epidural
Speaker 2: is probably one of the most rewarding things that you
Speaker 2: can do in anesthesia, because you do have a patient
Speaker 2: who is in terrible pain in front of you, and
Speaker 2: with a very simple, very safe intervention, you can take
Speaker 2: that pain straight away and make sure that they have
Speaker 2: as good a birth experience as they possibly can.
Speaker 5: It was a tremendously rewarding part of my job.
Speaker 6: Oh my god, you're so nice.
Speaker 1: He's so skillful as well.
Speaker 6: Bad news. I want Lachlan to tell me, all.
Speaker 3: Right, we'll stick around, lockicks through pass something.
Speaker 1: He's like, are you good at that board game operation?
Speaker 1: I'm terrible, but I don't know.
Speaker 5: I'm great at the anesthetic part.
Speaker 1: You just can't get the heart out.
Speaker 2: But like I'm not, I'm not sure you'd want me
Speaker 2: doing that part of the operation.
Speaker 4: Finally, Associate Professor Locker Miles, he is a anetheists.
Speaker 5: There, you.
Speaker 1: Think that.
Speaker 5: I want to be nice to Jason's put me on
Speaker 5: the radio.
Speaker 6: Thank you, well, we put you on the radio, Lucky.
Speaker 5: Thanks for coming in, mate.
Speaker 3: Thanks to the crew at Austin Hospital. They're doing an
Speaker 3: amazing job there.
Speaker 6: You absolutely do an amazing job. Thank you for joining us.
Speaker 5: No, thank you, Lauren. Lovely to be here, Lauren, Lauren wake.
Speaker 8: I'm feeling good following them on the socials