1 00:00:00,760 --> 00:00:03,960 Speaker 1: Welcome to you stuff you should know from house stuff 2 00:00:03,960 --> 00:00:12,479 Speaker 1: Works dot com. Hey, and welcome to the podcast. I'm 3 00:00:12,560 --> 00:00:15,800 Speaker 1: Josh Clark. There's Charles W. Chuck Bryant. There's Jerry, who's 4 00:00:15,800 --> 00:00:18,640 Speaker 1: about to go to the hardware store any second now, 5 00:00:18,920 --> 00:00:23,560 Speaker 1: which no, Jerry doesn't find that very funny. Yeah, I 6 00:00:23,600 --> 00:00:26,480 Speaker 1: give the background there or to leave people wondering, well, 7 00:00:26,520 --> 00:00:29,760 Speaker 1: we need a trash cannon and dimmer background. But we've 8 00:00:29,800 --> 00:00:32,920 Speaker 1: been asking for I feel like months, but yeah, it 9 00:00:33,000 --> 00:00:35,160 Speaker 1: can't be months because we haven't even been here that long. 10 00:00:35,680 --> 00:00:38,560 Speaker 1: It's been like four days. But what what? What's the 11 00:00:38,640 --> 00:00:41,640 Speaker 1: problem here? Why isn't there any movement on this? There's 12 00:00:41,640 --> 00:00:46,040 Speaker 1: a home depot a thousand yards Crossromt. Yeah. I specifically 13 00:00:46,040 --> 00:00:48,800 Speaker 1: didn't mention their name, but yes, it is the closest 14 00:00:48,840 --> 00:00:53,320 Speaker 1: well in Orange big box hardware retailer. We could also 15 00:00:53,360 --> 00:00:57,280 Speaker 1: support local business and go to an ACE instead, yeah, 16 00:00:58,160 --> 00:01:00,760 Speaker 1: or we could just talk about and it's like we're 17 00:01:00,760 --> 00:01:03,440 Speaker 1: supposed to. ACE is a big chain too, though, Yeah, 18 00:01:03,520 --> 00:01:07,000 Speaker 1: but I think they're locally owned. Oh right, like Henry's 19 00:01:07,000 --> 00:01:13,240 Speaker 1: ACE Hardware. Sure. I like, Yeah, it's good stuff, very helpful, 20 00:01:13,959 --> 00:01:18,120 Speaker 1: very very knowledgeable staff, much more helpful. Than some of 21 00:01:18,160 --> 00:01:25,000 Speaker 1: the other big Bucks their orange and blue. Okay, that 22 00:01:25,080 --> 00:01:31,440 Speaker 1: was a great start to Uh, Chuck, Yes, do you 23 00:01:31,480 --> 00:01:35,440 Speaker 1: know how to spell anesthesia? I haven't. I struggle. It's 24 00:01:35,480 --> 00:01:37,320 Speaker 1: one of those And in fact, when you were out 25 00:01:37,360 --> 00:01:41,000 Speaker 1: of the room getting your coffee, Jerry was asking how 26 00:01:41,000 --> 00:01:43,199 Speaker 1: to spell it. I know, and I think she spelled 27 00:01:43,240 --> 00:01:48,720 Speaker 1: it right or maybe missed a letter. And Jerry, I 28 00:01:48,760 --> 00:01:51,600 Speaker 1: think she put an A where there was supposed to 29 00:01:51,600 --> 00:01:53,840 Speaker 1: be an E. Oh well, I think that it used 30 00:01:53,880 --> 00:01:56,320 Speaker 1: to be an accepted spelling. You know how in some 31 00:01:57,040 --> 00:02:02,720 Speaker 1: uh distant times, the forties the thirties, which Jerry identifies 32 00:02:02,800 --> 00:02:06,280 Speaker 1: with and like, anesthesia would have been spelled with an 33 00:02:06,360 --> 00:02:08,480 Speaker 1: A E rather than just an E because there was 34 00:02:08,480 --> 00:02:12,680 Speaker 1: another sound that. Yeah, it is a tricky one them. 35 00:02:12,800 --> 00:02:16,560 Speaker 1: Uh okay, Well, then my next question, Chuck, do you 36 00:02:16,600 --> 00:02:20,680 Speaker 1: know what anesthesia means? I do. Uh. It's from Greek, 37 00:02:20,720 --> 00:02:23,000 Speaker 1: like a lot of medical terms, and this one stands 38 00:02:23,000 --> 00:02:27,560 Speaker 1: for the loss of sensation. And uh, we'll talk about 39 00:02:27,560 --> 00:02:29,520 Speaker 1: our personal experience as I assume, but I've never been 40 00:02:29,600 --> 00:02:36,040 Speaker 1: under general anesthesia. Yeah the big Daddy, Yeah, fully under view. No, 41 00:02:36,320 --> 00:02:38,360 Speaker 1: so neither one of us has had major surgery like 42 00:02:38,400 --> 00:02:43,320 Speaker 1: that then no knock would yeah, because after doing some 43 00:02:43,360 --> 00:02:45,800 Speaker 1: research on this, like, I don't know that I ever 44 00:02:45,919 --> 00:02:49,280 Speaker 1: would want to It's scary, I mean. And let me 45 00:02:49,360 --> 00:02:52,560 Speaker 1: just say also to anybody who is listening to this 46 00:02:53,040 --> 00:02:57,800 Speaker 1: prior to undergoing a surgical procedure that requires general anesthesia, 47 00:02:57,919 --> 00:03:01,000 Speaker 1: we don't mean to scare you know, but because it's uh, 48 00:03:01,040 --> 00:03:04,440 Speaker 1: we'll talk about rate of death and and problems with it, 49 00:03:04,520 --> 00:03:07,720 Speaker 1: which there are still but it's super safe now for 50 00:03:07,720 --> 00:03:10,440 Speaker 1: the most part. But when you when you when I 51 00:03:10,440 --> 00:03:12,919 Speaker 1: was reading this, I was like, man, what they're doing 52 00:03:13,080 --> 00:03:18,000 Speaker 1: is is like bringing you toward death and then stopping 53 00:03:18,000 --> 00:03:20,600 Speaker 1: at a certain point, yeah, and just letting you hover 54 00:03:20,680 --> 00:03:23,800 Speaker 1: there then bringing you out when they're getting with a 55 00:03:23,800 --> 00:03:28,480 Speaker 1: lot of like crazy heavy heavy drugs that are only 56 00:03:28,520 --> 00:03:32,080 Speaker 1: slightly different from what they used in the like early history, 57 00:03:32,120 --> 00:03:34,040 Speaker 1: which we're about to talk about. But it's really like 58 00:03:34,320 --> 00:03:36,600 Speaker 1: it's it's kind of nuts that and they still don't 59 00:03:36,600 --> 00:03:39,840 Speaker 1: know exactly how it works. And the reason why they 60 00:03:39,840 --> 00:03:44,400 Speaker 1: don't know how it works, especially we understand local anesthesia 61 00:03:44,960 --> 00:03:48,680 Speaker 1: and um twilight sedation, sure, well we don't understand is 62 00:03:48,720 --> 00:03:50,960 Speaker 1: general anesthesia. And the reason why we don't understand because 63 00:03:50,960 --> 00:03:53,960 Speaker 1: we don't understand how consciousness works, so how can we 64 00:03:54,080 --> 00:03:58,560 Speaker 1: understand how unconsciousness works. Yeah, it's pretty weird, and which 65 00:03:58,600 --> 00:04:02,960 Speaker 1: is what it works? Yes, it definitely does, and although 66 00:04:03,000 --> 00:04:05,920 Speaker 1: there are some risks associated with it, it is far, far, 67 00:04:06,240 --> 00:04:11,640 Speaker 1: far better than the alternative, which is no anesthesia, which 68 00:04:11,760 --> 00:04:13,760 Speaker 1: was the way it was for a very long time. 69 00:04:13,800 --> 00:04:17,799 Speaker 1: I mean anesthesia is a relatively recent thing. Or getting 70 00:04:17,800 --> 00:04:19,560 Speaker 1: you super drunk, or hitting you in the head and 71 00:04:19,640 --> 00:04:23,440 Speaker 1: knocking you unconscious, which is not so knocking you unconscious 72 00:04:23,480 --> 00:04:27,640 Speaker 1: that qualifies anesthesia, but it's still not medical anesthesia. Giving 73 00:04:27,640 --> 00:04:33,680 Speaker 1: you drunk, giving you morphine, giving you marijuana, jim some weed, um, yeah, 74 00:04:33,760 --> 00:04:36,359 Speaker 1: rubbing stinging nettles on you to distract you from the 75 00:04:36,400 --> 00:04:39,440 Speaker 1: pain of having your leg cut off, belladonna, using ice, 76 00:04:39,560 --> 00:04:42,840 Speaker 1: all the stuff. These are so horrifics. These are narcotics. 77 00:04:42,880 --> 00:04:47,240 Speaker 1: These are just plain old distractions, um, but they don't 78 00:04:47,320 --> 00:04:51,040 Speaker 1: qualifies anesthesia. And the big difference, the the thing that 79 00:04:51,120 --> 00:04:57,120 Speaker 1: was such a huge, huge progression forward um with anesthesia 80 00:04:57,400 --> 00:05:00,599 Speaker 1: is that it doesn't just dull the pain. It dulls 81 00:05:00,680 --> 00:05:04,279 Speaker 1: the pain, it takes away your consciousness and it also 82 00:05:04,320 --> 00:05:07,279 Speaker 1: prevents you from creating memories during this experience, it gives 83 00:05:07,279 --> 00:05:10,560 Speaker 1: you amnesia. So it basically cuts a chunk out of 84 00:05:10,640 --> 00:05:14,800 Speaker 1: your lifetime that as far as your subjective experience goes, 85 00:05:15,200 --> 00:05:18,200 Speaker 1: does not exist. It didn't happen like you were on 86 00:05:18,279 --> 00:05:20,920 Speaker 1: the gurney going into the O. R room and you 87 00:05:20,960 --> 00:05:23,440 Speaker 1: wake up and you're in the hospital bed and you 88 00:05:23,440 --> 00:05:28,080 Speaker 1: have stitches, but there is nothing there in between, ideally 89 00:05:28,600 --> 00:05:33,039 Speaker 1: for general anesthesia, right, And that's how we can conduct surgery, 90 00:05:33,080 --> 00:05:36,680 Speaker 1: because before that there was surgery, but it was very 91 00:05:36,760 --> 00:05:41,200 Speaker 1: rare and it was very very awful. Yeah, and when 92 00:05:41,200 --> 00:05:43,040 Speaker 1: you know, we flew by some of those, but um, 93 00:05:43,080 --> 00:05:45,400 Speaker 1: we did mention a lot of this, uh sopaphorics and 94 00:05:45,480 --> 00:05:48,360 Speaker 1: narcotics that they use. They did knock you in the head, 95 00:05:48,400 --> 00:05:51,599 Speaker 1: they did get you drunk. Um. In fact, in the 96 00:05:51,640 --> 00:05:55,120 Speaker 1: mid forties, those were you know, opium and alcohol where 97 00:05:55,120 --> 00:05:58,240 Speaker 1: the two go toss like and a towel to bite on, 98 00:05:58,400 --> 00:06:01,800 Speaker 1: I guess, and just to make you like be able 99 00:06:01,800 --> 00:06:05,080 Speaker 1: to tolerate the pain, which didn't really help. No, I 100 00:06:05,080 --> 00:06:07,839 Speaker 1: mean I'm sure it helped. Uh, it dulled the pain, 101 00:06:07,960 --> 00:06:11,240 Speaker 1: but it's not gonna do what you want, which is 102 00:06:11,279 --> 00:06:13,920 Speaker 1: to kill it completely or knock you out. Or render 103 00:06:14,000 --> 00:06:19,680 Speaker 1: you an asiatic an asiatic right, um. But the so 104 00:06:19,720 --> 00:06:22,720 Speaker 1: the those were the two go to that they use. 105 00:06:22,800 --> 00:06:25,000 Speaker 1: I mean there were other ones to like um blood 106 00:06:25,040 --> 00:06:28,839 Speaker 1: lighting until a stupor or basically a coma was induced, 107 00:06:28,880 --> 00:06:33,080 Speaker 1: like you lost so much blood that's pretty dangerous. But 108 00:06:33,279 --> 00:06:36,320 Speaker 1: these were the These were the go to um pain 109 00:06:36,400 --> 00:06:39,800 Speaker 1: killers for surgery, and they still didn't work very well. 110 00:06:39,839 --> 00:06:44,080 Speaker 1: But what's weird is in the eighteen forties all that changed, 111 00:06:44,200 --> 00:06:51,440 Speaker 1: like not one, not two, but three anesthesia is UH 112 00:06:51,839 --> 00:06:55,960 Speaker 1: came into We're basically discovered for medical use, like almost 113 00:06:56,000 --> 00:07:00,440 Speaker 1: all at the same time. Yeah, people now they basically 114 00:07:00,480 --> 00:07:04,800 Speaker 1: say Crawford Long from right here in Georgia, University of 115 00:07:04,839 --> 00:07:09,680 Speaker 1: Georgia graduate fellow bulldog. UH. He was the first. He 116 00:07:09,920 --> 00:07:13,880 Speaker 1: performed a surgery removed a tumor from a neck from 117 00:07:13,880 --> 00:07:17,360 Speaker 1: a mr A bentable in UH late March eighteen forty two, 118 00:07:17,840 --> 00:07:21,840 Speaker 1: and also later did an amputation in a childbirth with 119 00:07:22,040 --> 00:07:25,920 Speaker 1: ether and UM. He was he was the guy, but 120 00:07:26,160 --> 00:07:29,760 Speaker 1: he was you know, it was pretty regional and people 121 00:07:29,800 --> 00:07:31,960 Speaker 1: just didn't know about it. Basically. I all think it's 122 00:07:32,000 --> 00:07:33,960 Speaker 1: the impression that he wasn't as much of a self 123 00:07:34,000 --> 00:07:38,840 Speaker 1: promoter as Dr William Morton. Uh, yeah, he did um 124 00:07:39,840 --> 00:07:42,080 Speaker 1: well William Morton in eighteen forty six. We might as 125 00:07:42,080 --> 00:07:43,880 Speaker 1: well go ahead and say he demonstrated it for the 126 00:07:43,880 --> 00:07:47,600 Speaker 1: first time in like a public surgical theater, right, and said, 127 00:07:47,600 --> 00:07:49,920 Speaker 1: here is what I'm doing, and this is new and 128 00:07:49,920 --> 00:07:53,680 Speaker 1: it's exciting, and I'm in Massachusetts on not some yokel 129 00:07:53,720 --> 00:07:57,440 Speaker 1: in Georgia pretty much, and that's how he gained the acclaim. 130 00:07:57,480 --> 00:07:59,400 Speaker 1: But yeah, I guess Crawford Long was able to prove 131 00:07:59,440 --> 00:08:01,960 Speaker 1: that he'd done he'd used ether earlier. He's just like 132 00:08:02,200 --> 00:08:05,200 Speaker 1: it just wasn't being a big shot about it. I 133 00:08:05,240 --> 00:08:07,720 Speaker 1: was just using it. But you know, he discovered ether 134 00:08:08,200 --> 00:08:11,400 Speaker 1: by hanging out with friends who were huffing ether at 135 00:08:11,400 --> 00:08:15,360 Speaker 1: a party and supposedly he saw one guy run into 136 00:08:15,400 --> 00:08:19,800 Speaker 1: a door and like cut his head open, and Crawford Long, 137 00:08:19,840 --> 00:08:21,520 Speaker 1: being a doctor, was like, are you okay? And the 138 00:08:21,520 --> 00:08:23,200 Speaker 1: guy was like, what are you talking about? With like 139 00:08:23,240 --> 00:08:26,480 Speaker 1: blood spurting out of his forehead, and Crawford Long went, 140 00:08:28,200 --> 00:08:31,520 Speaker 1: that's pretty funny. Uh. And he went on to uh 141 00:08:31,720 --> 00:08:35,360 Speaker 1: tell Congress about it, as did doctor Charles Jackson, who 142 00:08:35,440 --> 00:08:37,120 Speaker 1: said that he had done it before Morton as well. 143 00:08:37,160 --> 00:08:40,040 Speaker 1: They both independently went to Congress. I was okay, man, 144 00:08:40,120 --> 00:08:43,320 Speaker 1: I did that first. All right, it's a bit of 145 00:08:43,320 --> 00:08:46,600 Speaker 1: self promotion. Ye, but Morton is the guy who gets 146 00:08:46,640 --> 00:08:49,160 Speaker 1: who gets the credit. He's the one who really introduced 147 00:08:49,200 --> 00:08:51,480 Speaker 1: it to the public. Well, it gets your credit as 148 00:08:51,480 --> 00:08:54,800 Speaker 1: the first demonstrator. Yeah, he's the one that you hear 149 00:08:54,840 --> 00:08:58,320 Speaker 1: of typically. Yeah, I would say Crawford Long though. Yeah, 150 00:08:58,320 --> 00:09:01,520 Speaker 1: I guess you're right. Yeah. Lots of hospitals named after him, 151 00:09:01,559 --> 00:09:04,400 Speaker 1: at least one here, although now no it's not cropfit 152 00:09:04,480 --> 00:09:11,080 Speaker 1: Long anymore. Did they change it, yeah, to home depot um. 153 00:09:11,160 --> 00:09:13,920 Speaker 1: So a little bit later on, there was a dentist, 154 00:09:14,160 --> 00:09:17,640 Speaker 1: Dr Horace Wells, who used the first dude to use 155 00:09:17,720 --> 00:09:22,160 Speaker 1: nitrous oxide bull teeth, and then chloroform was used by 156 00:09:22,240 --> 00:09:26,480 Speaker 1: Dr James Simpson and these things. You know, you don't 157 00:09:26,520 --> 00:09:29,720 Speaker 1: want to be using that though, it's toxic. So Dr 158 00:09:29,760 --> 00:09:32,800 Speaker 1: Horace Wells actually is a pretty interesting story. It's where 159 00:09:33,160 --> 00:09:38,800 Speaker 1: chloroform um and nitrous oxide converge as a beautiful place. 160 00:09:39,000 --> 00:09:41,800 Speaker 1: So he tried. He extracted one of his own teeth 161 00:09:41,840 --> 00:09:44,400 Speaker 1: on nitrous and was like, this is great. Did you 162 00:09:44,440 --> 00:09:48,160 Speaker 1: read that history of Hippie crack article? Yeah, so this 163 00:09:48,240 --> 00:09:51,000 Speaker 1: all came after somebody, a guy named Joseph Priestley in 164 00:09:51,040 --> 00:09:56,520 Speaker 1: the eighteenth century synthesized nitrous oxide, and then very shortly 165 00:09:56,520 --> 00:10:01,960 Speaker 1: after that, a teenage prodigy named Humphrey Davy started huffing it. 166 00:10:02,360 --> 00:10:05,400 Speaker 1: And he actually had a box built for himself and 167 00:10:05,520 --> 00:10:08,000 Speaker 1: was placed in it for over an hour once, just 168 00:10:08,080 --> 00:10:13,120 Speaker 1: huffing nitrous oxide. That I am too, and he did 169 00:10:13,240 --> 00:10:15,680 Speaker 1: because that's so dangerous. Yes it is, but this guy 170 00:10:15,800 --> 00:10:18,160 Speaker 1: was huffing it like crazy. There must have been like 171 00:10:18,280 --> 00:10:21,440 Speaker 1: some escaping or other air getting at something, but he 172 00:10:21,520 --> 00:10:24,520 Speaker 1: huffed it for like an hour just for self experimentation. 173 00:10:24,920 --> 00:10:28,320 Speaker 1: By the time Horace Wells tried it on a tooth um, 174 00:10:28,520 --> 00:10:33,280 Speaker 1: there was a lot of confidence and understanding of nitrous oxide. Um. 175 00:10:33,360 --> 00:10:36,160 Speaker 1: He was able to successfully remove his own own tooth 176 00:10:36,480 --> 00:10:40,360 Speaker 1: when he demonstrated it. He didn't dose the patient properly, 177 00:10:40,360 --> 00:10:44,920 Speaker 1: and the patient apparently cried out, and so Wells had 178 00:10:44,960 --> 00:10:48,959 Speaker 1: staked all his reputation on this demonstration just failed utterly 179 00:10:49,120 --> 00:10:51,559 Speaker 1: and ended up on skid row in New York. Went 180 00:10:51,600 --> 00:10:54,760 Speaker 1: on a chloroform bender and ended up throwing acid on 181 00:10:54,840 --> 00:10:57,960 Speaker 1: a couple of women. Was put in, yeah, was put 182 00:10:57,960 --> 00:11:01,199 Speaker 1: in jail and ended up committing aside by slashing his 183 00:11:01,280 --> 00:11:04,400 Speaker 1: fomoral artery with the razor from a shaving kit. But 184 00:11:04,960 --> 00:11:09,880 Speaker 1: he was on chloroform, so he was anesthetized ironically when 185 00:11:09,880 --> 00:11:14,040 Speaker 1: he died. Oh well that's good. Weird, Yeah, what it's 186 00:11:14,040 --> 00:11:18,200 Speaker 1: strange history. But so the point is in in the chloroform, 187 00:11:18,440 --> 00:11:22,760 Speaker 1: nitrous ox side in ether all emerged to form anesthesia. Yeah, 188 00:11:22,880 --> 00:11:24,840 Speaker 1: and um, I mean it would have come around eventually, 189 00:11:24,840 --> 00:11:27,400 Speaker 1: but it's not so different today. Like I said that, 190 00:11:27,559 --> 00:11:33,200 Speaker 1: we're still using heavy duty drugs to knock people clean 191 00:11:33,240 --> 00:11:36,319 Speaker 1: out and monitor them so they don't die from it. 192 00:11:37,120 --> 00:11:39,719 Speaker 1: It's pretty crazy. Well, what one other thing about the 193 00:11:39,760 --> 00:11:43,800 Speaker 1: introduction of anesthesia is that it took another fifty or 194 00:11:43,800 --> 00:11:47,600 Speaker 1: so years before the medical establishment said yes, we need, 195 00:11:47,720 --> 00:11:50,280 Speaker 1: we need to use this widely and and as part 196 00:11:50,320 --> 00:11:53,840 Speaker 1: of standard and best practices. And part of that was 197 00:11:53,880 --> 00:11:57,559 Speaker 1: because pain was seen as necessary. It was a sign 198 00:11:57,600 --> 00:12:01,360 Speaker 1: that the patient was alive, was still idle. Um, there's 199 00:12:01,400 --> 00:12:03,560 Speaker 1: a bit of a macho edge to it from what 200 00:12:03,600 --> 00:12:08,400 Speaker 1: I understand. Uh. And then um, there was also a 201 00:12:08,440 --> 00:12:11,880 Speaker 1: reluctance to draw attention to the fact that surgery is 202 00:12:11,960 --> 00:12:15,000 Speaker 1: extremely painful. Yeah, because they didn't want people to not 203 00:12:15,600 --> 00:12:18,240 Speaker 1: go to the doctor much. Yea. So it took like 204 00:12:18,320 --> 00:12:20,319 Speaker 1: fifty years to catch on. So imagine being one of 205 00:12:20,360 --> 00:12:25,800 Speaker 1: those patients where the modern medicine is well aware of anesthesia, 206 00:12:26,040 --> 00:12:29,920 Speaker 1: but it hasn't adopted it yet. That's worse than being 207 00:12:29,960 --> 00:12:32,800 Speaker 1: a patient before they understood there was such a thing 208 00:12:32,840 --> 00:12:35,480 Speaker 1: as anesthesia. Yeah, Or imagine being because there was a 209 00:12:35,559 --> 00:12:37,920 Speaker 1: lot of figuring it out along the way, you know, 210 00:12:38,000 --> 00:12:40,319 Speaker 1: as far as dosage and stuff like that. Because so 211 00:12:40,600 --> 00:12:43,200 Speaker 1: there are a lot of you know, unwitting guinea pigs. 212 00:12:43,200 --> 00:12:47,040 Speaker 1: I guess there were Doc that hurts, don't take a 213 00:12:47,040 --> 00:12:51,120 Speaker 1: little more that, or Doc, I'm dead, you know. Like 214 00:12:51,200 --> 00:12:54,640 Speaker 1: you remember the castration episode we did, and they talked 215 00:12:54,640 --> 00:12:57,920 Speaker 1: about how they would use opium as an anesthesia, but 216 00:12:58,080 --> 00:13:01,520 Speaker 1: it was very easy to accidentally overdose the little boys 217 00:13:01,600 --> 00:13:04,840 Speaker 1: when you were removing their testicles. I think the same 218 00:13:04,880 --> 00:13:07,120 Speaker 1: thing happened when you were cutting off a man's leg 219 00:13:07,120 --> 00:13:12,160 Speaker 1: in the Civil War. Wait, removing testicles. Yeah, for castration, circumcision. 220 00:13:12,160 --> 00:13:16,560 Speaker 1: The castration said circumcision, man, We've we've done both. Yeah, 221 00:13:16,600 --> 00:13:19,560 Speaker 1: But I thought I was like, man, I thought circumcision 222 00:13:19,640 --> 00:13:23,120 Speaker 1: was something different. No, that's that means the circumcision is 223 00:13:23,160 --> 00:13:26,600 Speaker 1: going horribly awry. Yeah. Man, we've covered some gruesome stuff. 224 00:13:27,240 --> 00:13:30,480 Speaker 1: We really have, you know. All right, well, I guess 225 00:13:30,520 --> 00:13:33,160 Speaker 1: we'll take a break here and talk about some of 226 00:13:33,160 --> 00:13:52,040 Speaker 1: the different methods UH of anesthesia right after this. All right, 227 00:13:52,640 --> 00:13:54,320 Speaker 1: before we broke, we teased you a little bit with 228 00:13:54,400 --> 00:13:57,160 Speaker 1: the different types, and here we go. And up first 229 00:13:57,840 --> 00:14:01,800 Speaker 1: is my favorite twilight sleep. UH. If you've had your 230 00:14:01,800 --> 00:14:06,600 Speaker 1: wisdom teeth out or maybe an endoscopy. Um, there's plenty 231 00:14:06,600 --> 00:14:08,840 Speaker 1: of procedures that use it. You might have had twilight 232 00:14:08,880 --> 00:14:14,440 Speaker 1: sleep or conscious sedation or twilight anesthesia, and UM, I 233 00:14:14,520 --> 00:14:18,280 Speaker 1: had some for when I had my my tooth replaced 234 00:14:18,440 --> 00:14:21,800 Speaker 1: my front tooth. And it's always fun because it feels 235 00:14:21,840 --> 00:14:25,160 Speaker 1: great going in. You just relish those like ten or 236 00:14:25,200 --> 00:14:29,280 Speaker 1: fifteen seconds, and then it feels fun coming out because 237 00:14:29,400 --> 00:14:31,640 Speaker 1: you know you don't know what's going on. It's more 238 00:14:31,680 --> 00:14:35,560 Speaker 1: fun when you're picking up you're a loved one. Picked 239 00:14:35,640 --> 00:14:38,640 Speaker 1: up Emily after her endoscopy and I went in and 240 00:14:38,680 --> 00:14:40,240 Speaker 1: I don't know why I didn't think that my video 241 00:14:40,360 --> 00:14:43,240 Speaker 1: going already, but she was like, I think everyone's throwing 242 00:14:43,280 --> 00:14:46,520 Speaker 1: a party for me. Like what the people behind the curtain. 243 00:14:46,520 --> 00:14:49,160 Speaker 1: They're throwing a party. I saw balloons and it was 244 00:14:49,240 --> 00:14:51,360 Speaker 1: very cute because they're like so out of it. And 245 00:14:51,400 --> 00:14:53,080 Speaker 1: when I came out of my wisdom teeth, I think 246 00:14:53,080 --> 00:14:55,720 Speaker 1: I may have told this before, but I my friend 247 00:14:55,760 --> 00:14:59,080 Speaker 1: told me that this particular doctor put bunny ears on 248 00:14:59,160 --> 00:15:01,600 Speaker 1: you and took a picture because you're all puffed up 249 00:15:01,600 --> 00:15:04,160 Speaker 1: and you have bandages around your face. And I was like, 250 00:15:04,480 --> 00:15:07,000 Speaker 1: that's not gonna happen to me. I guarantee it. And 251 00:15:07,080 --> 00:15:10,600 Speaker 1: I remember distinctly seeing the lady come in with the 252 00:15:10,640 --> 00:15:13,280 Speaker 1: bunny ears, put them on my head and get the 253 00:15:13,280 --> 00:15:17,840 Speaker 1: polaroid out and said smile, and I just went I 254 00:15:17,880 --> 00:15:22,080 Speaker 1: gave a big smile, so that that actually, that's well, 255 00:15:22,120 --> 00:15:27,160 Speaker 1: that's definitely twilight sedation, Yes, because you are out of it. 256 00:15:27,720 --> 00:15:30,320 Speaker 1: You're but you're still conscious and you're still able to 257 00:15:30,360 --> 00:15:34,120 Speaker 1: follow instructions. Yeah, but you don't know that. When you 258 00:15:34,160 --> 00:15:37,760 Speaker 1: wake up, quote unquote, you feel like I did nothing happen, 259 00:15:37,840 --> 00:15:39,840 Speaker 1: but they're like, no, you were talking to us and stuff. 260 00:15:40,640 --> 00:15:44,520 Speaker 1: So weird. It is very weird. Um, the Twilight sedation, 261 00:15:44,560 --> 00:15:47,480 Speaker 1: they used virtually the same drugs in a lot of 262 00:15:47,520 --> 00:15:52,480 Speaker 1: cases that they used for general anesthesia, right, just smaller doses. 263 00:15:52,520 --> 00:15:57,360 Speaker 1: So they'll use a sedative or something like that, like ketamine. Right, 264 00:15:58,080 --> 00:16:00,200 Speaker 1: Like we said major drugs. I mean, if you've heard 265 00:16:00,240 --> 00:16:04,240 Speaker 1: of you know, falling into a k hole. Uh, that's 266 00:16:04,280 --> 00:16:09,120 Speaker 1: the same drug. Yeah, it's just crazy. That's like we're like, oh, 267 00:16:09,160 --> 00:16:10,800 Speaker 1: back in the days, they use cocaine on people and 268 00:16:10,800 --> 00:16:16,720 Speaker 1: that's nuts, right, Kee, big difference. Um. Yeah, so there's 269 00:16:16,760 --> 00:16:20,160 Speaker 1: like ketamine there. They might use something like valium or 270 00:16:20,320 --> 00:16:23,320 Speaker 1: at a van or something like that. Um. They'll probably 271 00:16:23,360 --> 00:16:29,320 Speaker 1: also use the dissociative, which apparently disconnects your nerves from 272 00:16:29,360 --> 00:16:33,920 Speaker 1: your brain. Yeah, that's what value is. Okay, that makes sense. Yeah. Um. 273 00:16:33,960 --> 00:16:37,280 Speaker 1: And then also they'll use an analgesic, which is just 274 00:16:37,320 --> 00:16:39,640 Speaker 1: another word for pain killer. So you've got all these 275 00:16:39,640 --> 00:16:43,880 Speaker 1: strings working in combination, probably given to you intravenously, and 276 00:16:44,240 --> 00:16:47,880 Speaker 1: you're a little bit wasted. But the point of twilight sleep, 277 00:16:47,880 --> 00:16:50,880 Speaker 1: and the thing that that um, that separates it from 278 00:16:50,880 --> 00:16:54,280 Speaker 1: other types of anesthesia, is that you are not so 279 00:16:54,440 --> 00:16:57,640 Speaker 1: wasted that you can't breathe on your own, that your 280 00:16:57,680 --> 00:17:00,800 Speaker 1: heart beat, your heart can't beat on its own, it 281 00:17:00,880 --> 00:17:04,240 Speaker 1: needs to be you'll be monitored, but really they've given 282 00:17:04,280 --> 00:17:07,320 Speaker 1: you such a low dose of this cocktail of chemicals 283 00:17:07,359 --> 00:17:10,720 Speaker 1: that you're you're still able to do things like smile 284 00:17:10,800 --> 00:17:14,159 Speaker 1: when the the dnnis put twenty years on you. Yeah to. 285 00:17:14,680 --> 00:17:19,320 Speaker 1: I also remember, Um, when I woke up, I remember 286 00:17:19,320 --> 00:17:23,720 Speaker 1: seeing a poster that said locomotive Lasagna on the wall, 287 00:17:24,520 --> 00:17:27,920 Speaker 1: and Um, of course it didn't say that unless they 288 00:17:27,920 --> 00:17:30,760 Speaker 1: went so far to like switch out posters to mess 289 00:17:30,800 --> 00:17:33,440 Speaker 1: with you. I could see that because this didn't clearly 290 00:17:33,440 --> 00:17:35,480 Speaker 1: had a sense of humor. It's putting bunny ears on people. 291 00:17:35,520 --> 00:17:38,320 Speaker 1: It's like Tim Watley from Seinfeld. Yeah, but I was 292 00:17:38,320 --> 00:17:40,479 Speaker 1: a little kid, you know. You know, I've never even 293 00:17:40,520 --> 00:17:43,199 Speaker 1: had a drop of alcohol, so I've never had my 294 00:17:43,240 --> 00:17:46,080 Speaker 1: head altered in anyway. So I was like, this is crazy. 295 00:17:46,200 --> 00:17:49,359 Speaker 1: Did you start going to dentist every Friday at all? 296 00:17:49,520 --> 00:17:53,399 Speaker 1: Fifty wisdom teeth removed? You're like, I know there's another 297 00:17:53,400 --> 00:17:56,159 Speaker 1: one in there. Uh. The only uh. The other good 298 00:17:56,200 --> 00:17:58,399 Speaker 1: thing about UM the Twilight Sleep is it's not going 299 00:17:58,440 --> 00:18:01,840 Speaker 1: to have the after effects is general like, um, probably 300 00:18:01,840 --> 00:18:04,920 Speaker 1: won't be nausea, have nausea or dizziness or vomiting. Maybe 301 00:18:04,920 --> 00:18:07,760 Speaker 1: a little bit like they will give you a prescription 302 00:18:07,840 --> 00:18:11,520 Speaker 1: probably but um, you probably want need to use it, right, 303 00:18:11,800 --> 00:18:15,760 Speaker 1: you know, Yeah, anti nausea stuff. So that's uh, that's 304 00:18:15,880 --> 00:18:19,119 Speaker 1: twilight sleep a k A procedural sedation. I don't know 305 00:18:19,160 --> 00:18:21,360 Speaker 1: if we ever called it that. That's the clinical term 306 00:18:21,400 --> 00:18:25,200 Speaker 1: for it. Twilight sleep is the prettier name for it. UM. 307 00:18:25,320 --> 00:18:28,880 Speaker 1: Then there's also a local anesthetic, which is the other 308 00:18:29,520 --> 00:18:34,000 Speaker 1: common type of anesthesia UM, where basically a is a 309 00:18:34,080 --> 00:18:37,520 Speaker 1: small area or a specific region of the body is 310 00:18:37,760 --> 00:18:41,280 Speaker 1: um basically numbed. Yeah, that's when you get the worst 311 00:18:41,320 --> 00:18:43,439 Speaker 1: thing that can happen to you in life, which is uh, 312 00:18:43,680 --> 00:18:46,520 Speaker 1: shots into the gum, a needle in the gum in 313 00:18:46,560 --> 00:18:50,240 Speaker 1: the dentist, which is why the dentist will frequently use 314 00:18:50,400 --> 00:18:56,080 Speaker 1: a topical um. A topical anesthesia. It helps a little, right, Uh, 315 00:18:56,680 --> 00:19:00,400 Speaker 1: so that they'll it will numb your gum when they 316 00:19:00,480 --> 00:19:03,000 Speaker 1: put the needle in. Yeah, they'll put like that gel 317 00:19:03,280 --> 00:19:04,600 Speaker 1: and that will them in a little bit. Or if 318 00:19:04,640 --> 00:19:08,120 Speaker 1: you're getting sometimes like an ivy in the arm, they'll 319 00:19:08,160 --> 00:19:11,200 Speaker 1: spray it with the cold stuff and that all helps, 320 00:19:11,280 --> 00:19:14,159 Speaker 1: for sure. It does. You'll still feel the pressure of 321 00:19:14,200 --> 00:19:16,800 Speaker 1: the needle going into your jaws, but you don't feel 322 00:19:16,840 --> 00:19:20,440 Speaker 1: the pain, right and the the reason why these things 323 00:19:20,480 --> 00:19:25,320 Speaker 1: work is, Uh, they a local anesthetic actually goes to 324 00:19:25,560 --> 00:19:29,520 Speaker 1: the area it's delivered to and blocks the nerve receptors. 325 00:19:29,560 --> 00:19:34,040 Speaker 1: It actually keeps your potassium and your sodium ions um 326 00:19:34,080 --> 00:19:38,440 Speaker 1: from firing, right, which means that it's not conducting electricity, 327 00:19:38,640 --> 00:19:41,320 Speaker 1: which means that your nerves aren't capable of passing along 328 00:19:41,359 --> 00:19:43,920 Speaker 1: the sensation of pain to your brain. They're just shut down. 329 00:19:44,680 --> 00:19:47,920 Speaker 1: That's what a local anesthetic does. And if you pay attention, 330 00:19:48,200 --> 00:19:51,600 Speaker 1: the local anesthetics all in an ain and for a 331 00:19:51,600 --> 00:19:54,440 Speaker 1: pretty good reason, like light decane or no vocaine. Even 332 00:19:54,480 --> 00:19:57,600 Speaker 1: they don't use novocaine that much anymore. Um. It's a 333 00:19:57,640 --> 00:20:01,280 Speaker 1: derivative of cocaine, and cocaine has a topical numbing effect, 334 00:20:01,560 --> 00:20:03,959 Speaker 1: and they used to use it to do that, right. 335 00:20:04,520 --> 00:20:07,879 Speaker 1: And then they said, why is everybody showing up to 336 00:20:07,960 --> 00:20:11,240 Speaker 1: the dentist all the time? Uh? And then they said, oh, yes, 337 00:20:11,280 --> 00:20:13,520 Speaker 1: it's because of the cocaine. So let's figure out a 338 00:20:14,160 --> 00:20:16,760 Speaker 1: a synthesized version of it. And they came up with 339 00:20:16,840 --> 00:20:19,640 Speaker 1: no vocane, lydocane all that, UM. And they stopped using 340 00:20:19,640 --> 00:20:22,879 Speaker 1: no vocane apparently because there were a lot the potential 341 00:20:22,960 --> 00:20:27,080 Speaker 1: for adverse reactions was greater UM, but people still do 342 00:20:27,240 --> 00:20:32,960 Speaker 1: have allergies to UM local anesthetics once amount, but it 343 00:20:33,000 --> 00:20:36,320 Speaker 1: turns out it's not the local anesthetic itself. It's not 344 00:20:36,400 --> 00:20:39,200 Speaker 1: the no vocane, it's not the lydocane. What it is 345 00:20:39,200 --> 00:20:42,880 Speaker 1: is UM. When you use a local anesthetic, it has 346 00:20:42,960 --> 00:20:46,400 Speaker 1: the effect of vasodilation, which means that it makes your 347 00:20:46,920 --> 00:20:51,280 Speaker 1: blood vessels relax, which lowers your blood pressure UM, which 348 00:20:51,320 --> 00:20:54,640 Speaker 1: is good, but it also is not so good. So 349 00:20:54,760 --> 00:20:58,720 Speaker 1: they add epinephrine, which is a vasso constrictor, and it 350 00:20:58,760 --> 00:21:02,639 Speaker 1: actually makes the local anesthetic work better. So if you 351 00:21:02,680 --> 00:21:05,720 Speaker 1: get a local anesthetic, you're getting the local anesthetic like 352 00:21:05,760 --> 00:21:09,800 Speaker 1: Clyda cane mixed with epinefrin and a preservative to keep 353 00:21:09,800 --> 00:21:12,520 Speaker 1: the epine and fresh. And it's the preservative that you're 354 00:21:12,560 --> 00:21:16,160 Speaker 1: having the adverse reaction to. Yeah, and again just a 355 00:21:16,200 --> 00:21:21,080 Speaker 1: well balanced cocktail to give you exactly what you need. UM. 356 00:21:21,760 --> 00:21:23,800 Speaker 1: Local is gonna wear off in a few hours, It 357 00:21:23,840 --> 00:21:26,600 Speaker 1: depends on how much you have UM. When you leave 358 00:21:26,600 --> 00:21:28,600 Speaker 1: the dentist, you know you'll still have your mouth numb 359 00:21:28,680 --> 00:21:31,000 Speaker 1: for a while, and they always want you not to 360 00:21:31,040 --> 00:21:34,200 Speaker 1: eat or talk too much because UM. You can accidentally 361 00:21:34,200 --> 00:21:37,600 Speaker 1: bite your tongue in your cheek and not know it, uh, 362 00:21:37,720 --> 00:21:40,359 Speaker 1: which actually happened to me recently, and I did bite 363 00:21:40,359 --> 00:21:43,680 Speaker 1: my cheek man a lot, Yeah, bled a little bit too. Yeah, 364 00:21:44,200 --> 00:21:46,879 Speaker 1: I'm fine. So it's such just um, it's such just 365 00:21:47,040 --> 00:21:51,479 Speaker 1: dental that you're gonna get like a local anesthetic. You 366 00:21:51,520 --> 00:21:54,480 Speaker 1: could also be given a local anesthetic for what's called 367 00:21:54,560 --> 00:21:59,960 Speaker 1: awake brain surgery. But yes, so in some some type 368 00:22:00,040 --> 00:22:02,960 Speaker 1: some brain surgery, you need to be conscious. You can't 369 00:22:02,960 --> 00:22:06,639 Speaker 1: be unconscious. They need to keep track of what the 370 00:22:06,680 --> 00:22:08,399 Speaker 1: brain is doing and they need it to be in 371 00:22:08,400 --> 00:22:11,720 Speaker 1: a conscious state. So they will give you some drugs 372 00:22:11,720 --> 00:22:15,240 Speaker 1: where you're not necessarily like you you might be sedated 373 00:22:15,440 --> 00:22:17,479 Speaker 1: in the like you might be on a little bit 374 00:22:17,520 --> 00:22:19,520 Speaker 1: of valium or something like that, but you're not. You're 375 00:22:19,560 --> 00:22:22,159 Speaker 1: still conscious, you're still able to respond to questions. But 376 00:22:22,240 --> 00:22:24,280 Speaker 1: they give you a local and aesthetic because they take 377 00:22:24,320 --> 00:22:27,080 Speaker 1: the top of your head off and work on your brain. 378 00:22:27,160 --> 00:22:30,200 Speaker 1: I think it's in Hell Raiser there's like awake brain 379 00:22:30,200 --> 00:22:32,760 Speaker 1: surgery is shown. Yeah, I think I've seen that in 380 00:22:32,840 --> 00:22:36,000 Speaker 1: another movie too. Um. Yeah, because they need to be 381 00:22:36,000 --> 00:22:38,959 Speaker 1: able to ask you things like in the nuts, can 382 00:22:38,960 --> 00:22:42,960 Speaker 1: you believe that your brain is exposed that crazy. Oh 383 00:22:43,040 --> 00:22:48,280 Speaker 1: it is weird. Um are we onto regional? I believe? Uh? 384 00:22:48,440 --> 00:22:52,480 Speaker 1: Local regional anesthesia is sort of like local, but it's 385 00:22:52,520 --> 00:22:55,480 Speaker 1: covers a wider area of your body. Um. So like 386 00:22:55,560 --> 00:22:58,639 Speaker 1: if you need your whole leg numbed for an operation, 387 00:22:59,480 --> 00:23:01,600 Speaker 1: um and just like a small portion of your leg, 388 00:23:02,200 --> 00:23:05,639 Speaker 1: that would be regional. Uh. It's also called a nerve 389 00:23:05,720 --> 00:23:08,760 Speaker 1: block basically because they're just taking a single nerve or 390 00:23:09,000 --> 00:23:11,600 Speaker 1: bundle of nerves and blocking that. Right, they're going after 391 00:23:11,720 --> 00:23:13,439 Speaker 1: like one of the big dad he's rather than a 392 00:23:13,520 --> 00:23:17,119 Speaker 1: little one. But again localized. Um. Like if you know 393 00:23:17,160 --> 00:23:21,200 Speaker 1: women who have given birth, sometimes we'll get an epidural uh, 394 00:23:21,280 --> 00:23:25,240 Speaker 1: and that's what that is. It is injected via catheter 395 00:23:25,560 --> 00:23:29,480 Speaker 1: into the epidural space in the lower back. But that 396 00:23:29,800 --> 00:23:34,480 Speaker 1: doesn't necessarily mean uh, directly into the spine, which also 397 00:23:34,560 --> 00:23:38,000 Speaker 1: can happen with a spinal block, right into that cerebro 398 00:23:38,080 --> 00:23:41,240 Speaker 1: spinal fluid, which is about as direct as you can get. 399 00:23:41,640 --> 00:23:43,440 Speaker 1: And if you get a c section or maybe hurning 400 00:23:43,480 --> 00:23:46,520 Speaker 1: a surgery, and that's when they want you awake again, 401 00:23:47,280 --> 00:23:51,440 Speaker 1: um during the surgery, like with epidurals. Chuck I was wondering, 402 00:23:51,520 --> 00:23:54,560 Speaker 1: So an epidural, it's in the space outside of the 403 00:23:54,600 --> 00:23:58,720 Speaker 1: spinal column um, but it's used to numb you're from 404 00:23:58,760 --> 00:24:00,720 Speaker 1: the waist down, like when you're give birth or something 405 00:24:00,800 --> 00:24:03,480 Speaker 1: like that. Right, And it's actually a catheter is introduced 406 00:24:03,480 --> 00:24:07,560 Speaker 1: in a continuous I V. Cocktails given to your into 407 00:24:07,640 --> 00:24:10,760 Speaker 1: your almost your spine, but not into the spine. No, 408 00:24:11,119 --> 00:24:15,320 Speaker 1: that would be a spinal right. I wondered, how do 409 00:24:15,440 --> 00:24:18,440 Speaker 1: they make it so it's it's your waist down that's 410 00:24:18,440 --> 00:24:21,240 Speaker 1: getting numb. Why isn't your waist up? Oh? Like, how 411 00:24:21,280 --> 00:24:24,480 Speaker 1: does how do they know the path is going downward? Yes? 412 00:24:24,760 --> 00:24:26,760 Speaker 1: So I looked it up and it turns out it 413 00:24:26,840 --> 00:24:31,960 Speaker 1: doesn't always. Sometimes it can reverse and numb you from 414 00:24:31,960 --> 00:24:34,520 Speaker 1: the waist up, in which case you're in like, that's 415 00:24:34,520 --> 00:24:38,280 Speaker 1: a problem because your breathing can stop. Um, your heart 416 00:24:38,320 --> 00:24:40,439 Speaker 1: can stop. There's a bunch of stuff that can stop. 417 00:24:40,680 --> 00:24:45,359 Speaker 1: But apparently it's extraordinarily rare, but it can happen. Where 418 00:24:45,480 --> 00:24:49,480 Speaker 1: like the the intended area is reversed when they give 419 00:24:49,480 --> 00:24:51,760 Speaker 1: you an epidural, there can also be complications from the 420 00:24:51,760 --> 00:24:57,639 Speaker 1: epidural um that aren't great. Um, hopefully that doesn't happen 421 00:24:57,920 --> 00:25:00,359 Speaker 1: giving birth right, well, the same same with this final 422 00:25:00,400 --> 00:25:02,960 Speaker 1: as well. Like there there there are complications, like you 423 00:25:03,000 --> 00:25:08,159 Speaker 1: can get a meningel infection or an abscess something like that. 424 00:25:08,200 --> 00:25:09,439 Speaker 1: I happen to be a friend of ours. That's why 425 00:25:09,440 --> 00:25:10,840 Speaker 1: I got dodgy. I didn't want to say it on 426 00:25:10,880 --> 00:25:20,040 Speaker 1: the air. I'll tell you after, just write it down, okay. Um, yeah, 427 00:25:20,080 --> 00:25:22,800 Speaker 1: I talked about the spinal block. Um, there's a little 428 00:25:22,800 --> 00:25:26,080 Speaker 1: bit more risk, like we said, then local obviously like 429 00:25:26,160 --> 00:25:30,960 Speaker 1: seizures and heart attacks. Um. And sometimes it doesn't give 430 00:25:31,600 --> 00:25:34,080 Speaker 1: enough pain relief and you have to move on to general. 431 00:25:34,320 --> 00:25:37,240 Speaker 1: They're like, Doc, this ain't working right. Um, can you 432 00:25:37,280 --> 00:25:40,480 Speaker 1: just knock me out? Because some patients want to be 433 00:25:40,520 --> 00:25:44,000 Speaker 1: awake and some patients don't. And sometimes they will defer 434 00:25:44,000 --> 00:25:47,760 Speaker 1: to you on that. Who will defer to who? The doctor? 435 00:25:47,760 --> 00:25:50,239 Speaker 1: And like you want to be awake for this or not, 436 00:25:50,720 --> 00:25:54,760 Speaker 1: especially during childbirth, to like give me the drugs, give 437 00:25:54,800 --> 00:25:58,399 Speaker 1: me the drugs or the common refrain, yeah, or I 438 00:25:58,440 --> 00:26:01,959 Speaker 1: want to be awake at least, um, but give me 439 00:26:02,040 --> 00:26:06,840 Speaker 1: the epidural. Uh. Like I'll go in thinking natural childbirth 440 00:26:06,920 --> 00:26:09,560 Speaker 1: is the way to go, and then I changed my mind, 441 00:26:10,040 --> 00:26:13,600 Speaker 1: which is, hey, that's you're right, Yeah, sure, given birth, 442 00:26:13,600 --> 00:26:15,800 Speaker 1: you should do it. However you want to totes at 443 00:26:15,840 --> 00:26:20,760 Speaker 1: home in a tub, uh water boat with a goat. 444 00:26:22,680 --> 00:26:26,359 Speaker 1: Very funny. Uh So, Chuck, you had a pretty great 445 00:26:26,359 --> 00:26:31,399 Speaker 1: segue that we just trod all over into general anesthesia again. 446 00:26:31,840 --> 00:26:35,000 Speaker 1: The big Daddy is what I think most people call it. 447 00:26:35,080 --> 00:26:37,399 Speaker 1: That's when you're put under, and that is when you 448 00:26:37,440 --> 00:26:42,560 Speaker 1: are out. You don't remember anything, you're asleep, you're you're unconscious, 449 00:26:42,680 --> 00:26:45,080 Speaker 1: and that's the one where they don't completely understand how 450 00:26:45,119 --> 00:26:47,119 Speaker 1: it works, which is a little scary. It is a 451 00:26:47,119 --> 00:26:49,600 Speaker 1: little scary UM and there have been people who have 452 00:26:49,680 --> 00:26:52,760 Speaker 1: tried to figure out how to quantify it UM using 453 00:26:53,000 --> 00:27:00,159 Speaker 1: magical boxes and trans magnetic transcranial magnetic stimulation stimulation, and 454 00:27:00,240 --> 00:27:04,879 Speaker 1: I flubbed that one the thinking yeah, um, but ultimately 455 00:27:05,040 --> 00:27:07,640 Speaker 1: we just we don't know. So there's there's a there's 456 00:27:07,640 --> 00:27:10,639 Speaker 1: a general idea, basically a working theory, and that is 457 00:27:10,720 --> 00:27:14,280 Speaker 1: that UM anesthesia the drugs that we use, and it's 458 00:27:14,359 --> 00:27:17,640 Speaker 1: a bunch of different ones working in conjunction, but they 459 00:27:17,680 --> 00:27:22,359 Speaker 1: depressed the activity of the spinal cord, so you're paralyzed UM. 460 00:27:22,400 --> 00:27:27,400 Speaker 1: The brain stem rearticular activating system which is basically they 461 00:27:27,400 --> 00:27:32,720 Speaker 1: think responsible for sleepiness and wakefulness that's stimulated or depressed, 462 00:27:32,720 --> 00:27:35,879 Speaker 1: depending on your way of looking at it. And then, um, 463 00:27:35,960 --> 00:27:40,000 Speaker 1: your cerebral cortex is affected as well, so you're not thinking, 464 00:27:40,080 --> 00:27:43,840 Speaker 1: you're not forming memories, you're not um making associations with 465 00:27:43,880 --> 00:27:46,840 Speaker 1: any of this, and all of that in conjunction with 466 00:27:46,880 --> 00:27:52,280 Speaker 1: one another, comes to anesthesia. General anesthesia, which is utter 467 00:27:52,800 --> 00:27:55,560 Speaker 1: and complete unconsciousness. That's right, And it can last a 468 00:27:55,560 --> 00:27:58,840 Speaker 1: few hours or up to six hours. Um, if you're 469 00:27:58,840 --> 00:28:02,359 Speaker 1: having like serious comp gated surgery. But there is a limit. 470 00:28:02,440 --> 00:28:06,120 Speaker 1: They can't just be like this is a twelve hour surgery. Um. Yeah, 471 00:28:06,440 --> 00:28:08,800 Speaker 1: I thought there are worse surgeries like that where they're 472 00:28:08,840 --> 00:28:11,880 Speaker 1: like the surgery lasted seventy two hours, but the guy 473 00:28:12,880 --> 00:28:17,159 Speaker 1: was successfully transplanted. Yeah, that is true. How do they 474 00:28:17,160 --> 00:28:20,760 Speaker 1: do that? Because really dangerous to get someone under general 475 00:28:20,800 --> 00:28:25,080 Speaker 1: anesthesia for that long. Yeah, that's a good point. I 476 00:28:25,080 --> 00:28:27,280 Speaker 1: didn't I meant to look into that. Someone will let 477 00:28:27,359 --> 00:28:30,359 Speaker 1: us know. Sure, we'll follow up on that for sure. Uh, 478 00:28:30,359 --> 00:28:33,760 Speaker 1: if you are going to be put under general anesthes 479 00:28:33,920 --> 00:28:37,720 Speaker 1: you don't just walk in and start huffing the gash. 480 00:28:37,840 --> 00:28:40,360 Speaker 1: There there's a lot of work that goes into that. Um, 481 00:28:40,520 --> 00:28:42,560 Speaker 1: you have to be invited. You have to be invited 482 00:28:42,560 --> 00:28:45,320 Speaker 1: by her. You have to get a a party invite 483 00:28:45,360 --> 00:28:49,880 Speaker 1: from your anesthesiologist. Um, you will meet with them and 484 00:28:50,480 --> 00:28:53,560 Speaker 1: he or she will basically ask you a bunch of 485 00:28:53,600 --> 00:28:56,680 Speaker 1: questions about your lifestyle and your medical history. Are you 486 00:28:56,720 --> 00:28:59,840 Speaker 1: a natural redhead? Yeah? Because we covered that in the 487 00:29:00,000 --> 00:29:02,080 Speaker 1: Redhead episode. You might need a little more. Are you 488 00:29:02,120 --> 00:29:04,800 Speaker 1: a little kid are you? Yeah? I can tell by 489 00:29:04,840 --> 00:29:08,000 Speaker 1: looking Yeah, because little kids livers process these drugs a 490 00:29:08,040 --> 00:29:12,720 Speaker 1: lot faster, so they need uh higher dose. Basically, Um, 491 00:29:12,760 --> 00:29:16,760 Speaker 1: are you a huge alcoholic? Not? Well, depends on what 492 00:29:16,800 --> 00:29:20,959 Speaker 1: you say, sir. Are you heroin addict? Not anymore? So, 493 00:29:21,040 --> 00:29:23,760 Speaker 1: like the depending on the answers to these questions, they're 494 00:29:23,760 --> 00:29:26,440 Speaker 1: gonna need to adjust your dose depending do you have 495 00:29:26,840 --> 00:29:29,320 Speaker 1: low blood pressure? High blood pressure? Yeah? And this is 496 00:29:29,320 --> 00:29:31,520 Speaker 1: where you want to be super honest about your drinking 497 00:29:31,520 --> 00:29:33,600 Speaker 1: and drugs. Yeah. If you're a heroin addict, you need 498 00:29:33,640 --> 00:29:35,680 Speaker 1: to fast up. You can be like, hey man, can 499 00:29:35,720 --> 00:29:37,800 Speaker 1: you be cool and keep a secret? You don't like 500 00:29:37,920 --> 00:29:40,360 Speaker 1: lie like you do to your shrink, Right, you know 501 00:29:40,920 --> 00:29:42,800 Speaker 1: you really want to be honest because you want this 502 00:29:42,880 --> 00:29:46,680 Speaker 1: to work well and be safe. Um. After they have 503 00:29:46,720 --> 00:29:50,880 Speaker 1: all that, they're gonna basically, um, put together your your 504 00:29:50,960 --> 00:29:54,080 Speaker 1: program on what you're gonna need, and then they're going 505 00:29:54,120 --> 00:29:56,320 Speaker 1: to tell you not to eat because if you eat 506 00:29:56,360 --> 00:30:01,560 Speaker 1: before you go under anesthesia, you can aspirate and basically 507 00:30:01,640 --> 00:30:04,840 Speaker 1: breathe in what's in your stomach. So this is not 508 00:30:04,960 --> 00:30:09,200 Speaker 1: everybody believes this any longer, supposedly about eating before surgery. 509 00:30:09,280 --> 00:30:14,760 Speaker 1: There's what I understand is that when there are so 510 00:30:15,000 --> 00:30:20,080 Speaker 1: few cases of aspiration under anesthesia, especially twilight sedation, because 511 00:30:20,880 --> 00:30:23,600 Speaker 1: that well, no, oh, yeah, that's a pretty good that's 512 00:30:23,600 --> 00:30:28,560 Speaker 1: a good point. I hadn't thought of, um, but apparently, well, yeah, 513 00:30:28,600 --> 00:30:32,640 Speaker 1: you just answered that question. You say, Well, from what 514 00:30:32,680 --> 00:30:34,719 Speaker 1: I understood, there was a study that looked at all 515 00:30:34,800 --> 00:30:38,600 Speaker 1: these different um the cases of aspiration and found it's 516 00:30:38,720 --> 00:30:43,320 Speaker 1: very rare. And they concluded that the danger, the potential 517 00:30:43,600 --> 00:30:49,960 Speaker 1: danger of aspirating under sedation is low enough that it's 518 00:30:49,680 --> 00:30:52,880 Speaker 1: it's outweighed by the benefits of eating. Because if you 519 00:30:53,000 --> 00:30:55,560 Speaker 1: don't eat and you undergo sedation on an empty stomach, 520 00:30:55,560 --> 00:30:58,160 Speaker 1: which is what they want you to do, it's a 521 00:30:58,200 --> 00:31:00,520 Speaker 1: lot harder on your system. You're much or likely to 522 00:31:00,560 --> 00:31:04,440 Speaker 1: be nauseated, to vomit afterward, be dizzy, whereas if you 523 00:31:04,560 --> 00:31:07,720 Speaker 1: eat something, you can your body can process these drugs 524 00:31:07,720 --> 00:31:10,000 Speaker 1: a little better. So are they advising people to eat now. 525 00:31:10,120 --> 00:31:12,760 Speaker 1: I think that they're starting to get to that point, 526 00:31:12,800 --> 00:31:17,560 Speaker 1: but I don't believe it's like current widespread practice. Yeah, 527 00:31:17,640 --> 00:31:20,560 Speaker 1: I don't think I would. I don't know, Maybe I'm superstitious. 528 00:31:20,560 --> 00:31:22,120 Speaker 1: I don't know if i'd be chowing on a burrito 529 00:31:22,200 --> 00:31:25,120 Speaker 1: before I go in for my heart surgery. Well, just 530 00:31:25,200 --> 00:31:28,000 Speaker 1: for the surgeon's benefit, I think you might want to 531 00:31:28,040 --> 00:31:32,320 Speaker 1: avoid burritos before going under for being knocked on content. Yeah, 532 00:31:32,400 --> 00:31:35,880 Speaker 1: you're right. Um, you will be wearing a breathing mask 533 00:31:36,120 --> 00:31:39,680 Speaker 1: when you're under general anesthesia or a breathing too, because 534 00:31:40,480 --> 00:31:43,480 Speaker 1: uh you basically your your muscles are so relaxed that 535 00:31:43,520 --> 00:31:46,240 Speaker 1: your air was airways won't stay open. So that's a 536 00:31:46,280 --> 00:31:50,840 Speaker 1: little creepy in itself. Um. And they're going to monitoring 537 00:31:51,080 --> 00:31:54,360 Speaker 1: lots and lots of things while you're under there in 538 00:31:54,400 --> 00:31:56,840 Speaker 1: the room, and probably have an assistant in the room 539 00:31:56,880 --> 00:32:00,760 Speaker 1: with them to monitor all this stuff like blood pressure, 540 00:32:01,240 --> 00:32:05,640 Speaker 1: heart rate, O two levels, um CEO two levels, temperature, 541 00:32:06,560 --> 00:32:09,200 Speaker 1: brain activity, and there's even a little alarm if you're 542 00:32:09,200 --> 00:32:11,800 Speaker 1: O two level drops, which is great. I think they 543 00:32:11,800 --> 00:32:14,080 Speaker 1: should have an alarmed for everything. Yeah, you know, the 544 00:32:14,120 --> 00:32:16,600 Speaker 1: more alarm is better in that case. And I guess 545 00:32:16,600 --> 00:32:19,760 Speaker 1: we should talk about the four stages um of general 546 00:32:19,800 --> 00:32:23,520 Speaker 1: anesthetic YEP. Stage one is the induction stage, or the 547 00:32:23,600 --> 00:32:25,920 Speaker 1: one you were talking about those fifteen seconds where you're 548 00:32:25,960 --> 00:32:30,560 Speaker 1: like pure bliss, right uh, and then stay that quickly 549 00:32:30,560 --> 00:32:34,120 Speaker 1: moves to stage two, which is the twitchy stage where 550 00:32:34,160 --> 00:32:37,600 Speaker 1: you're just kind of like well twitching, it's your body 551 00:32:37,640 --> 00:32:40,000 Speaker 1: going like what the heck is going on? What is this? 552 00:32:40,440 --> 00:32:42,680 Speaker 1: And then you move quickly to stage three, which is 553 00:32:42,720 --> 00:32:46,200 Speaker 1: the stage that they're after, where you're not twitching anymore, 554 00:32:46,240 --> 00:32:50,440 Speaker 1: you're not conscious any longer, and you are under a 555 00:32:50,640 --> 00:32:55,040 Speaker 1: state of general anesthesia. You're anesticized, right uh. And this 556 00:32:55,080 --> 00:32:57,160 Speaker 1: is where you want to be. But there is, like 557 00:32:57,200 --> 00:32:59,520 Speaker 1: you said, a fourth stage. You don't want to go there. No, 558 00:32:59,640 --> 00:33:02,760 Speaker 1: that's the over dose stage. And once you're in this stage, 559 00:33:03,360 --> 00:33:05,560 Speaker 1: it is now a medical emergency and you have to 560 00:33:05,560 --> 00:33:08,960 Speaker 1: be managed brought out of before you suffer brain damage 561 00:33:09,080 --> 00:33:12,360 Speaker 1: or death or all sorts of other problems. Yeah, and 562 00:33:12,520 --> 00:33:14,560 Speaker 1: I remember when I read this the first time, I thought, 563 00:33:14,640 --> 00:33:17,640 Speaker 1: why did they even have this fourth stage? I don't 564 00:33:17,640 --> 00:33:21,239 Speaker 1: think they think it's just there. Yeah, but it's you know, 565 00:33:21,920 --> 00:33:24,480 Speaker 1: anesthesia is a thing. It doesn't mean like if you 566 00:33:25,000 --> 00:33:28,120 Speaker 1: don't have a great anesthesiologist, there can be that fourth stage. 567 00:33:28,720 --> 00:33:32,360 Speaker 1: I think even with a good anesthesiologists having a bad day, 568 00:33:32,560 --> 00:33:35,600 Speaker 1: things can happen. You know, Um, I hit a squirrel 569 00:33:36,320 --> 00:33:39,720 Speaker 1: and now this guy is dead. When you do go under, 570 00:33:40,760 --> 00:33:43,880 Speaker 1: you are um, like I said, gonna get the gas 571 00:33:43,960 --> 00:33:47,920 Speaker 1: or an ivy or both. Um. There are lots of 572 00:33:47,920 --> 00:33:53,560 Speaker 1: different drugs that they will combine again, katamine, valium, sodium pentethal. Well, 573 00:33:53,640 --> 00:33:55,600 Speaker 1: the go to is they're going to knock you out 574 00:33:55,640 --> 00:33:59,120 Speaker 1: first with the I V usually and almost across the 575 00:33:59,120 --> 00:34:03,160 Speaker 1: board it's propafile Michael Jackson's milk, that's right, Uh, And 576 00:34:03,480 --> 00:34:05,400 Speaker 1: that's what they do to initially knock you out. And 577 00:34:05,400 --> 00:34:07,800 Speaker 1: then they're gonna put ad that. He actually needed that 578 00:34:07,960 --> 00:34:10,920 Speaker 1: to sleep and it didn't even work. It's a crazy thing, 579 00:34:10,960 --> 00:34:14,000 Speaker 1: like he was so wound up that even probe fall 580 00:34:14,080 --> 00:34:21,000 Speaker 1: wouldn't work. Unbelievable. Um. You might also get a muscle 581 00:34:21,040 --> 00:34:24,520 Speaker 1: relaxer to make sure that paralysis really takes hold. Yeah, 582 00:34:24,600 --> 00:34:27,719 Speaker 1: and if this is all kind of familiar, go back 583 00:34:27,760 --> 00:34:33,040 Speaker 1: and listen to our lethal injection episode, because that is 584 00:34:33,840 --> 00:34:39,000 Speaker 1: stage four and technically stage five and general anesthesia is 585 00:34:39,080 --> 00:34:42,240 Speaker 1: lethal injection. Yeah, that's again, that's why this is so nuts. 586 00:34:42,320 --> 00:34:45,600 Speaker 1: Is there there almost killing you? Yeah, well maybe that's 587 00:34:45,600 --> 00:34:49,239 Speaker 1: overstating it, but they're they're not bringing you to the 588 00:34:49,280 --> 00:34:52,080 Speaker 1: brink of death, but they went to close enough to 589 00:34:52,160 --> 00:34:57,000 Speaker 1: where you're out. You know. Um, after surgery, Um, you 590 00:34:57,040 --> 00:34:58,919 Speaker 1: don't just get up and dance out of the room. 591 00:34:59,360 --> 00:35:01,640 Speaker 1: You're gonna go to the pack you the post anesthes 592 00:35:02,000 --> 00:35:05,440 Speaker 1: anesthesia care unit, and then you're gonna keep getting monitored. 593 00:35:05,440 --> 00:35:10,239 Speaker 1: You're gonna be dehydrated and cold because you're heading toward death, 594 00:35:10,760 --> 00:35:12,840 Speaker 1: so they're gonna warm you up some warm I v s. 595 00:35:13,120 --> 00:35:16,600 Speaker 1: There are also some drugs that they've started to use. Now, Um, 596 00:35:16,640 --> 00:35:18,880 Speaker 1: I had some oral surgery and you mean picked me up, 597 00:35:18,880 --> 00:35:21,000 Speaker 1: and I can't remember any of the stories or whatever, 598 00:35:21,600 --> 00:35:24,000 Speaker 1: but I remember going from being out to just being 599 00:35:24,120 --> 00:35:27,520 Speaker 1: totally with it. And apparently I've been given a drug 600 00:35:27,760 --> 00:35:32,080 Speaker 1: that's like a revers sedation drug to wake you up. Yeah, 601 00:35:32,080 --> 00:35:36,200 Speaker 1: there's one called flu mazanell, another called nax alone, and 602 00:35:36,239 --> 00:35:38,960 Speaker 1: it's just basically they also used them for overdoses of 603 00:35:39,000 --> 00:35:41,879 Speaker 1: certain kinds in the e R. But they can use 604 00:35:41,920 --> 00:35:46,760 Speaker 1: them post sedation to get you going again pretty quickly. 605 00:35:46,800 --> 00:35:50,080 Speaker 1: They stick it directly into your heart. Yeah, just sit 606 00:35:50,200 --> 00:35:54,759 Speaker 1: up and inhale deeply. It's not like I had that 607 00:35:55,080 --> 00:35:59,799 Speaker 1: when I had mine. Yeah, I'm cutting edge. Yeah. Uh, 608 00:36:00,280 --> 00:36:04,200 Speaker 1: I still couldn't eat ahead of time. Oh really, yeah, 609 00:36:04,520 --> 00:36:07,120 Speaker 1: but you did anyway, You're like, I read that it 610 00:36:07,160 --> 00:36:11,799 Speaker 1: was fine, I could have a breed. Um. You might 611 00:36:11,840 --> 00:36:14,480 Speaker 1: actually get a little morphine too for the pain after 612 00:36:14,520 --> 00:36:18,600 Speaker 1: your room. Yeah. Um, but you might also have those 613 00:36:18,600 --> 00:36:22,600 Speaker 1: side effects like we talked about with the vomiting and nausea. Um, 614 00:36:22,640 --> 00:36:25,200 Speaker 1: and maybe we're pretty out of it, you know, Yeah, 615 00:36:25,239 --> 00:36:26,640 Speaker 1: you might fall over if you get up to use 616 00:36:26,680 --> 00:36:30,160 Speaker 1: the bathroom. There is a help. There's a probably the 617 00:36:30,200 --> 00:36:35,480 Speaker 1: worst potential side effect of anesthesia possible. It's something called 618 00:36:35,520 --> 00:36:39,640 Speaker 1: anesthesia awareness. And we'll would say death, but we'll talk 619 00:36:39,640 --> 00:36:57,399 Speaker 1: about both of those, right, we'll get into both after this, So, Chuck, 620 00:36:57,680 --> 00:37:00,280 Speaker 1: we're gonna talk about anesthesia awareness, but we should probably 621 00:37:00,320 --> 00:37:05,160 Speaker 1: talk about anesthesiologists first, right, Yeah, there's um many levels 622 00:37:05,239 --> 00:37:14,080 Speaker 1: of anesthesiology g jobs. You can be an anesthesiologist full blown, 623 00:37:14,080 --> 00:37:17,400 Speaker 1: which means you've gone to PREMD undergrad, you've gone to 624 00:37:17,440 --> 00:37:21,280 Speaker 1: med school, you have done your to year residency. Sometimes 625 00:37:21,360 --> 00:37:26,200 Speaker 1: three in your income goes to malpractice insurance doesn't really 626 00:37:26,320 --> 00:37:30,840 Speaker 1: I would guess not that much, but a lot um 627 00:37:30,880 --> 00:37:33,400 Speaker 1: and you can. I didn't see where you had to 628 00:37:33,400 --> 00:37:37,040 Speaker 1: be certified, but you were eligible to take the A 629 00:37:37,080 --> 00:37:39,960 Speaker 1: B A exam I think, and that I think if 630 00:37:39,960 --> 00:37:43,600 Speaker 1: you want to be a physician an stysiologist, you actually 631 00:37:43,600 --> 00:37:46,840 Speaker 1: have to be certified. All you have to do is 632 00:37:46,880 --> 00:37:50,759 Speaker 1: be able to say anthologists correct, Actually that's not true. 633 00:37:50,760 --> 00:37:56,400 Speaker 1: It's physician. Anesthesiologists are certified and most of these physicians 634 00:37:56,400 --> 00:37:59,960 Speaker 1: an aestusiologists um do a one year of specialty training 635 00:38:00,040 --> 00:38:04,600 Speaker 1: as well. Um with either there are several different subspecialties 636 00:38:04,640 --> 00:38:09,280 Speaker 1: like hospice and palliative medicine, critical care medicine, and pain medicine. 637 00:38:09,960 --> 00:38:15,640 Speaker 1: So basically just it's almost like postgraduate graduate school. Or 638 00:38:15,719 --> 00:38:18,040 Speaker 1: you can be an assistant, which means you have your 639 00:38:18,080 --> 00:38:21,120 Speaker 1: four year undergrad in pre med and then you've gone 640 00:38:21,160 --> 00:38:24,880 Speaker 1: through an accredited program and then take an exam. Or 641 00:38:25,040 --> 00:38:33,839 Speaker 1: you can be a nurse anesthesia anesthesias anesthetist. Anesthetist, Man, 642 00:38:34,360 --> 00:38:36,640 Speaker 1: that sounds like such a dope. It's this is some 643 00:38:36,800 --> 00:38:39,320 Speaker 1: tough words, man. I know. It's a lot of stuff 644 00:38:39,360 --> 00:38:40,880 Speaker 1: going on in there, a lot of teas and ages. 645 00:38:40,920 --> 00:38:44,360 Speaker 1: And that means you're a registered nurse who has completed 646 00:38:44,560 --> 00:38:48,680 Speaker 1: UM a training program which last two to three years. 647 00:38:49,200 --> 00:38:51,799 Speaker 1: You're gonna have to have your b s. Degree and 648 00:38:51,840 --> 00:38:55,600 Speaker 1: at the end of one year of practice experience UM 649 00:38:55,719 --> 00:38:57,799 Speaker 1: is when you go through that training program and take 650 00:38:57,800 --> 00:39:01,000 Speaker 1: an exam, so again many years. It's like serious, serious stuff. 651 00:39:01,400 --> 00:39:05,400 Speaker 1: It's not like, oh, I want to you know, I 652 00:39:05,440 --> 00:39:06,759 Speaker 1: want to be a doctor, but I don't want to 653 00:39:06,800 --> 00:39:09,280 Speaker 1: go through all the schooling, so I'll just be an anesthesiologist. 654 00:39:09,440 --> 00:39:11,760 Speaker 1: I want to have access to the finest drugs available 655 00:39:11,800 --> 00:39:15,080 Speaker 1: on the planet Earth. Right now, it's still serious, like 656 00:39:15,160 --> 00:39:17,560 Speaker 1: you're a doctor, you know, well, you're not like you're 657 00:39:17,600 --> 00:39:21,600 Speaker 1: any lesser of a You're a nurse. What do you 658 00:39:21,600 --> 00:39:23,880 Speaker 1: mean And an estatistic said, was a nurse? I No, 659 00:39:23,960 --> 00:39:26,600 Speaker 1: I'm just talking about all of those jobs require lots 660 00:39:26,600 --> 00:39:28,919 Speaker 1: and lots of schooling. It's not like the easy way out, 661 00:39:29,120 --> 00:39:32,920 Speaker 1: I certainly hope. No, No, it's very serious. Job. Okay, 662 00:39:33,000 --> 00:39:36,920 Speaker 1: so it is a very serious job. Again, we said 663 00:39:37,040 --> 00:39:40,080 Speaker 1: you are being brought to the brink of death or 664 00:39:40,360 --> 00:39:43,560 Speaker 1: stupor unconsciousness or whatever you want to call it, and 665 00:39:43,600 --> 00:39:47,040 Speaker 1: then brought back without any side effects as few side 666 00:39:47,040 --> 00:39:51,080 Speaker 1: effects as possible. That's right, and certainly no lasting side effects. 667 00:39:51,120 --> 00:39:55,520 Speaker 1: But there is something. There's a pernicious UH syndrome that 668 00:39:56,040 --> 00:39:58,799 Speaker 1: doctors have been aware of, the anesthesiologists have been aware 669 00:39:58,800 --> 00:40:01,320 Speaker 1: of at least since the six these, which is called 670 00:40:01,680 --> 00:40:07,200 Speaker 1: anesthesia awareness. And basically, anesthesia awareness is where you are 671 00:40:07,320 --> 00:40:11,480 Speaker 1: given anesthesia, which includes a paralytic which means you can't 672 00:40:11,480 --> 00:40:16,040 Speaker 1: move your body at all UH, and your eyes have 673 00:40:16,080 --> 00:40:20,280 Speaker 1: been taped shut so you can't see, but you are conscious. 674 00:40:20,400 --> 00:40:25,040 Speaker 1: You are aware during surgery, so you're the pain killers 675 00:40:25,040 --> 00:40:27,799 Speaker 1: would have probably worked too, but something went wrong and 676 00:40:27,880 --> 00:40:32,399 Speaker 1: you're not unconscious, so you're able to form memories. You're 677 00:40:32,400 --> 00:40:34,560 Speaker 1: able to hear the doctors talking about you like you're 678 00:40:34,560 --> 00:40:37,520 Speaker 1: a piece of meat. You're able to hear the cutting, 679 00:40:37,719 --> 00:40:41,000 Speaker 1: the squishing, the tearing of your organs being moved around. 680 00:40:41,280 --> 00:40:45,879 Speaker 1: You can smell the singed hair and claterized flesh. You're 681 00:40:45,920 --> 00:40:49,640 Speaker 1: able to feel genuine fear in some cases if the 682 00:40:49,680 --> 00:40:54,160 Speaker 1: pain reliever hasn't worked, you're able to experience this excruciating 683 00:40:54,200 --> 00:40:58,160 Speaker 1: pain and you're not able as badly as you want 684 00:40:58,200 --> 00:41:01,759 Speaker 1: to to alert and anybody on the surgical teams like 685 00:41:01,760 --> 00:41:04,960 Speaker 1: you're locked in that you're, yes, that your experienced. It's yes, 686 00:41:05,160 --> 00:41:08,520 Speaker 1: you're It's like performing surgery on a locked in person. Yeah, 687 00:41:08,600 --> 00:41:11,239 Speaker 1: without any kind of pain killer or anything like that. Yeah. 688 00:41:11,239 --> 00:41:16,000 Speaker 1: I didn't know your eyes were taped shut during surgery either, because, Um, 689 00:41:16,280 --> 00:41:19,480 Speaker 1: you never see that on TV shows, do you. I've 690 00:41:19,520 --> 00:41:24,000 Speaker 1: never noticed that. Uh, yeah I don't. I've seen it before, 691 00:41:24,040 --> 00:41:26,600 Speaker 1: but I'm probably on like one of those like remember 692 00:41:26,680 --> 00:41:29,960 Speaker 1: they used to have real surgeries on Any Discovery in 693 00:41:30,000 --> 00:41:32,520 Speaker 1: the early days. Yeah, back when they were doing stuff 694 00:41:32,560 --> 00:41:36,319 Speaker 1: like that. I looked into that though, and um, that's 695 00:41:36,400 --> 00:41:38,439 Speaker 1: for a couple of reasons. Obviously, to keep the eyes 696 00:41:38,480 --> 00:41:41,840 Speaker 1: from drying out, because apparently eyelids do not close in 697 00:41:42,480 --> 00:41:46,640 Speaker 1: fifty of patients when under general anesthesia. They'll just say 698 00:41:47,360 --> 00:41:50,120 Speaker 1: it's so as to keep the eyes from drying. And 699 00:41:50,200 --> 00:41:53,320 Speaker 1: I didn't realize this is to prevent corneal abration. Apparently 700 00:41:53,360 --> 00:41:57,240 Speaker 1: that had been or can be a real problem. Um, 701 00:41:57,320 --> 00:41:59,319 Speaker 1: even if your surgery is not on your eyes. There's 702 00:41:59,360 --> 00:42:03,319 Speaker 1: just a lot of activity around your face like a 703 00:42:03,360 --> 00:42:06,640 Speaker 1: stethoscope and scratch your eye or yeah, a lot of 704 00:42:06,640 --> 00:42:09,359 Speaker 1: stuff can happen. So we'll take your eyes shut, so 705 00:42:09,400 --> 00:42:12,160 Speaker 1: they tape it shut so you can't see. But again 706 00:42:12,239 --> 00:42:14,520 Speaker 1: you can still here. You can still feel and even 707 00:42:14,560 --> 00:42:17,640 Speaker 1: if you're not feeling pain, you can still feel the pressure. Remember, 708 00:42:17,840 --> 00:42:20,479 Speaker 1: even with like a local and aesthetic, you can't feel 709 00:42:20,480 --> 00:42:21,880 Speaker 1: the pain, but you can feel the pressure of the 710 00:42:21,880 --> 00:42:24,480 Speaker 1: needle going in your jaw. This is the same thing 711 00:42:24,480 --> 00:42:28,200 Speaker 1: with like stomach surgery or your heart being taken from 712 00:42:28,239 --> 00:42:31,440 Speaker 1: your chest or what have you. Um So a lot 713 00:42:31,480 --> 00:42:35,440 Speaker 1: of people, apparently, studies have found since the sixties that 714 00:42:35,520 --> 00:42:41,240 Speaker 1: about two out of every thousand patients or centuries will 715 00:42:41,440 --> 00:42:44,879 Speaker 1: experience anesthesia awareness. Yeah, they said that's super rare. That's 716 00:42:44,920 --> 00:42:47,359 Speaker 1: not rare enough for now. I was hoping to see 717 00:42:47,400 --> 00:42:51,080 Speaker 1: like one in a hundred thousand or a hundred million. Yeah, yeah, No, 718 00:42:51,280 --> 00:42:54,840 Speaker 1: it's like two out of every thousand, and supposedly seventy 719 00:42:55,800 --> 00:43:00,440 Speaker 1: of people who experience anesthesia awareness suffered from clinical petz TSD, 720 00:43:00,880 --> 00:43:04,240 Speaker 1: which is five times more than soldiers returning from Iraq 721 00:43:04,320 --> 00:43:07,279 Speaker 1: and Afghanistan. And we're getting this stuff from an Atlantic 722 00:43:07,400 --> 00:43:10,920 Speaker 1: article called Awakening by Joshua Lang. Just go read it. 723 00:43:11,000 --> 00:43:14,399 Speaker 1: It's um it's a really great article. Yeah, they gave 724 00:43:14,440 --> 00:43:16,279 Speaker 1: this one case. There's a bunch of cases in there, 725 00:43:16,360 --> 00:43:19,480 Speaker 1: but this one. Um. Sherman Sizemore Jr. Was a Baptist 726 00:43:19,560 --> 00:43:23,160 Speaker 1: minister and coal miner, former coal miner. He's seventy three, 727 00:43:23,160 --> 00:43:29,759 Speaker 1: and he had exploratory uh laparotomy that right in two 728 00:43:29,760 --> 00:43:34,279 Speaker 1: thousand six. And any kind of exploratory surgery is you know, 729 00:43:34,600 --> 00:43:39,239 Speaker 1: it's not fun because they're basically looking around for stuff, well, 730 00:43:39,520 --> 00:43:42,400 Speaker 1: moving things around. Yeah, they cut away like the flesh 731 00:43:42,400 --> 00:43:44,359 Speaker 1: and his belly fat and all that stuff. And we're 732 00:43:44,400 --> 00:43:47,720 Speaker 1: looking um at the the film that holds your guts 733 00:43:47,719 --> 00:43:51,480 Speaker 1: in place. Yeah, they're poking around in there and um. 734 00:43:51,560 --> 00:43:55,480 Speaker 1: He of course had interoperative recall, which is another term 735 00:43:55,520 --> 00:44:01,120 Speaker 1: for anesthesia awareness, that's right, and he um Basically his 736 00:44:01,239 --> 00:44:04,680 Speaker 1: family couldn't understand what was going on with them. You 737 00:44:04,719 --> 00:44:06,920 Speaker 1: know a lot of times you'll have these bad dreams, 738 00:44:07,280 --> 00:44:11,120 Speaker 1: these nightmares about blood and people coming at you and 739 00:44:11,160 --> 00:44:15,560 Speaker 1: trapping you, and it's it's severe PTSD. And he eventually 740 00:44:16,360 --> 00:44:18,799 Speaker 1: uh killed himself even though he had no history of 741 00:44:18,800 --> 00:44:21,839 Speaker 1: psychiatric illness. Within two weeks of his surgery, yeah, shot 742 00:44:21,880 --> 00:44:25,040 Speaker 1: himself dead. And his family had settled with a lawsuit 743 00:44:25,719 --> 00:44:28,799 Speaker 1: because they claim that no one even said that this 744 00:44:28,840 --> 00:44:32,200 Speaker 1: could happen or you should see counseling or anything like that. 745 00:44:32,960 --> 00:44:36,839 Speaker 1: So sad. Oh, yeah, it's very sad. Supposedly, people who 746 00:44:36,880 --> 00:44:41,160 Speaker 1: suffer from PTSD, from anesthesia awareness um almost across the board, 747 00:44:41,200 --> 00:44:43,600 Speaker 1: can't lay down and sleep. They have to sleep in 748 00:44:43,680 --> 00:44:47,400 Speaker 1: chairs because laying down with uh memories of you know, 749 00:44:47,440 --> 00:44:53,520 Speaker 1: being on the O R table. It's uh yeah. And again, anesthesiologists, philosophers, 750 00:44:53,719 --> 00:44:56,000 Speaker 1: any kind of scientists, they don't know how this is 751 00:44:56,040 --> 00:44:59,600 Speaker 1: happening because we don't understand consciousness, so we don't understand 752 00:44:59,600 --> 00:45:02,600 Speaker 1: the mechan aism that produces unconsciousness. And then even further, 753 00:45:02,880 --> 00:45:06,560 Speaker 1: we don't understand when that mechanism that's supposed to produce 754 00:45:06,640 --> 00:45:11,839 Speaker 1: unconsciousness fails to produce unconsciousness and someone remains conscious and 755 00:45:11,920 --> 00:45:15,320 Speaker 1: experiences anesthesia awareness. Yeah, I would think there's got to 756 00:45:15,400 --> 00:45:22,200 Speaker 1: be some fail safe for this. Untake the eyes midway 757 00:45:22,360 --> 00:45:27,160 Speaker 1: and say like blink, if you can feel me, feel this, 758 00:45:27,400 --> 00:45:30,160 Speaker 1: but you're you've been paralyzed. You can't move, you can't 759 00:45:30,160 --> 00:45:34,680 Speaker 1: even blink. It seems like they should. It's got I mean, 760 00:45:34,719 --> 00:45:36,160 Speaker 1: I don't know. It seems like there's gotta be something 761 00:45:36,160 --> 00:45:37,759 Speaker 1: that could do, Like there's a machine that has to 762 00:45:37,800 --> 00:45:40,960 Speaker 1: breathe for you because your lungs can't even move well. 763 00:45:40,960 --> 00:45:42,440 Speaker 1: And that's why they take your eyes shut to begin with. 764 00:45:42,440 --> 00:45:46,160 Speaker 1: I guess because you can't blink. That's creepy that people 765 00:45:46,400 --> 00:45:50,279 Speaker 1: like their eyes remain open. Yeah, I wonder it's like 766 00:45:50,320 --> 00:45:52,879 Speaker 1: the mom from Throw Mama from the Train, Like even 767 00:45:52,920 --> 00:45:55,000 Speaker 1: if you can't blink, I wonder if there's any kind 768 00:45:55,040 --> 00:45:57,880 Speaker 1: of sign like that you could give. Well. So in 769 00:45:57,960 --> 00:46:01,600 Speaker 1: this awakening Um article they talk about there was a 770 00:46:01,680 --> 00:46:04,719 Speaker 1: guy who like came up with this box that was 771 00:46:04,880 --> 00:46:08,360 Speaker 1: meant to it gave like a number between zero and 772 00:46:08,400 --> 00:46:13,319 Speaker 1: a hundred that supposedly reflected a level of consciousness to 773 00:46:13,440 --> 00:46:16,919 Speaker 1: be used in the operating room for anesthesia, so that 774 00:46:16,920 --> 00:46:21,920 Speaker 1: that anesthesiologist could be confident that somebody wasn't experiencing anesthesia awareness. 775 00:46:21,920 --> 00:46:24,319 Speaker 1: And they found that it doesn't really work. So there 776 00:46:24,320 --> 00:46:27,600 Speaker 1: are there are people who have undertaken this quest to 777 00:46:28,320 --> 00:46:33,440 Speaker 1: two basically show somehow there's some outward sign of whether 778 00:46:33,480 --> 00:46:36,879 Speaker 1: someone's conscious or not. But we just haven't licked it yet. Yeah. 779 00:46:37,080 --> 00:46:38,799 Speaker 1: I can't believe there's not some sort of machine that 780 00:46:38,800 --> 00:46:41,200 Speaker 1: could pick up on that. But they've tried, or maybe 781 00:46:41,200 --> 00:46:44,560 Speaker 1: they're just like, uh, it's two in every thousand. Yeah. 782 00:46:44,680 --> 00:46:47,480 Speaker 1: I can live with those numbers and that that's no, 783 00:46:47,719 --> 00:46:51,480 Speaker 1: that's not that's way too common, man. That scares me 784 00:46:51,520 --> 00:46:53,719 Speaker 1: to death. Yeah, well you said that's the worst thing 785 00:46:53,760 --> 00:46:58,040 Speaker 1: that can happen. I vote for death is the worst thing. UM. 786 00:46:58,040 --> 00:47:02,680 Speaker 1: In the nineteen forties, uh, for every one million patients 787 00:47:02,680 --> 00:47:05,960 Speaker 1: who had full anesthesia, six hundred and forty of them died. 788 00:47:06,520 --> 00:47:09,560 Speaker 1: By the eighties, that was down to four for every million, 789 00:47:10,000 --> 00:47:12,920 Speaker 1: which to me, that's good and rare, four out of 790 00:47:12,920 --> 00:47:16,040 Speaker 1: every million. Yeah, but that number is actually scarily on 791 00:47:16,080 --> 00:47:21,000 Speaker 1: the rise since the nineteen eighties. UM a German publication 792 00:47:21,080 --> 00:47:26,760 Speaker 1: called Deutscheses uh arts ablat it's the German Medical Association's 793 00:47:27,000 --> 00:47:31,759 Speaker 1: UM science journal, and they said that worldwide death rate 794 00:47:31,960 --> 00:47:34,480 Speaker 1: is on the rise to about seven now per million, 795 00:47:35,160 --> 00:47:38,040 Speaker 1: and the number of deaths within one year after general 796 00:47:38,080 --> 00:47:41,560 Speaker 1: anesthesia is one in twenty or if you're over sixty 797 00:47:41,800 --> 00:47:46,520 Speaker 1: one and ten what and that's within the year after. Yeah, 798 00:47:46,560 --> 00:47:49,360 Speaker 1: but even still that's not good. No, and that that 799 00:47:49,440 --> 00:47:52,160 Speaker 1: doesn't necessarily mean that's due to the anesthesia, because they 800 00:47:52,200 --> 00:47:55,080 Speaker 1: make the point that it's not like the quality of 801 00:47:55,200 --> 00:47:59,480 Speaker 1: anesthesiological care is different. It's that older people are having 802 00:47:59,560 --> 00:48:04,800 Speaker 1: surgery these that's that's so good point. Yeah, that's probably 803 00:48:04,800 --> 00:48:08,319 Speaker 1: what it's due to. But yeah, I mean they said, 804 00:48:08,320 --> 00:48:10,399 Speaker 1: for a patient to actually die on the operating table 805 00:48:10,520 --> 00:48:15,759 Speaker 1: is super super rare from anesthesiology. Um, it's apparently much 806 00:48:15,800 --> 00:48:21,000 Speaker 1: more common to experience anesthesia awareness two and every thousand. 807 00:48:21,000 --> 00:48:23,960 Speaker 1: Why don't they say one in five? Yeah, really trying 808 00:48:24,000 --> 00:48:32,880 Speaker 1: to you know, when every thousand nah, and that's not 809 00:48:32,960 --> 00:48:36,840 Speaker 1: one in five patients surgeries. There's a lot more surgeries 810 00:48:36,840 --> 00:48:38,879 Speaker 1: than patients. Yeah. And you know when you go, when 811 00:48:38,880 --> 00:48:43,399 Speaker 1: you take your pets in, they undergo general anesthesi too 812 00:48:43,400 --> 00:48:46,440 Speaker 1: for surgery. They always say like your pet could die, 813 00:48:46,680 --> 00:48:50,760 Speaker 1: like it's rare and it happens this often. But um, 814 00:48:50,800 --> 00:48:52,799 Speaker 1: it can happen. And you know, you have to sign 815 00:48:52,800 --> 00:48:55,960 Speaker 1: the waivers and that's always especially if of an older animal. 816 00:48:56,400 --> 00:48:58,839 Speaker 1: It's a little bit of a quandary you're in, you know, 817 00:48:59,560 --> 00:49:01,200 Speaker 1: whether or not to get the surgery. Is it worth 818 00:49:01,200 --> 00:49:05,640 Speaker 1: the risk? All that stuff? That's all I got. I 819 00:49:05,680 --> 00:49:10,080 Speaker 1: got nothing else to Uh, it's anesthesia. If you are 820 00:49:10,080 --> 00:49:12,920 Speaker 1: feeling confident about spelling that word correctly, go ahead and 821 00:49:12,960 --> 00:49:15,120 Speaker 1: type it into the search bar at how stuff works 822 00:49:15,200 --> 00:49:17,879 Speaker 1: dot com. And I said search for everybody, which means 823 00:49:17,920 --> 00:49:22,120 Speaker 1: it's time for a listener mail. Uh, this one, I'm 824 00:49:22,120 --> 00:49:25,319 Speaker 1: gonna call ESP. We heard from a lot of people 825 00:49:25,360 --> 00:49:27,560 Speaker 1: on this one so far. Yeah, but it wasn't as 826 00:49:27,640 --> 00:49:30,799 Speaker 1: bad as I thought. No. Um, hey, guys, just listen 827 00:49:30,800 --> 00:49:33,520 Speaker 1: to ESP. It was great as usual. Your podcast help 828 00:49:33,560 --> 00:49:35,040 Speaker 1: me get through my work day and make me laugh 829 00:49:35,239 --> 00:49:38,160 Speaker 1: because I learned new and random things. With regards to 830 00:49:38,400 --> 00:49:40,239 Speaker 1: ESP or whatever people want to call it. I don't 831 00:49:40,239 --> 00:49:42,400 Speaker 1: know if I believe in it exactly, but I do 832 00:49:42,440 --> 00:49:44,840 Speaker 1: strongly believe that some individuals are much more intuitive or 833 00:49:44,840 --> 00:49:47,920 Speaker 1: connected than others. Uh. And here's an example. When I 834 00:49:47,960 --> 00:49:50,760 Speaker 1: was eleven, my mother died. We were living in Vancouver 835 00:49:50,800 --> 00:49:52,480 Speaker 1: at the time, and she had died at home. We 836 00:49:52,520 --> 00:49:54,640 Speaker 1: had not yet called any of the family to notify 837 00:49:54,680 --> 00:49:57,960 Speaker 1: them until a few hours later. But about fifteen minutes 838 00:49:58,040 --> 00:50:00,680 Speaker 1: after she passed away, my paternal grandmother, who was in 839 00:50:00,840 --> 00:50:04,560 Speaker 1: Hong Kong called and said, is Lana okay. I suddenly 840 00:50:04,560 --> 00:50:06,200 Speaker 1: got a very strong and bad feeling about her, and 841 00:50:06,239 --> 00:50:08,439 Speaker 1: I thought I should call uh. And again we hadn't 842 00:50:08,480 --> 00:50:10,520 Speaker 1: told anyone yet and it had only been fifteen minutes. 843 00:50:11,080 --> 00:50:13,799 Speaker 1: My grandmother has always been very intuitive. It always felt 844 00:50:13,800 --> 00:50:16,120 Speaker 1: like no matter where our family was, she always somehow 845 00:50:16,320 --> 00:50:20,080 Speaker 1: had her eye on us in a comforting way, not creepy. Right. 846 00:50:21,840 --> 00:50:25,120 Speaker 1: She points out she was devout in practicing Buddhist her 847 00:50:25,120 --> 00:50:27,440 Speaker 1: whole life, and it is partly her devotion to Buddhism 848 00:50:27,880 --> 00:50:30,320 Speaker 1: somehow makes me believe that she was a soul deeply 849 00:50:30,360 --> 00:50:34,239 Speaker 1: connected to the rest of the world. Uh yeah, kind 850 00:50:34,239 --> 00:50:37,120 Speaker 1: of cool. YEA explain that I think we pointed out 851 00:50:37,120 --> 00:50:41,400 Speaker 1: in the ESP podcast that probably the likeliest explanations that 852 00:50:41,440 --> 00:50:43,960 Speaker 1: the Buddha hands it out to his most devout followers. 853 00:50:44,160 --> 00:50:47,439 Speaker 1: There you have. It looks like granny Uh. I don't 854 00:50:47,480 --> 00:50:50,120 Speaker 1: have her last name, but that is from Joy and 855 00:50:50,400 --> 00:50:54,319 Speaker 1: can in Hong Kong. Uh. That's right, even though Joy 856 00:50:54,520 --> 00:51:00,560 Speaker 1: is in Australia can Canberra, Canberra, Canberra, Australia and Thesia, 857 00:51:01,239 --> 00:51:05,919 Speaker 1: Hong Kong. Joy. Thanks Joy, Yeah, thanks a lot. Joy. 858 00:51:06,040 --> 00:51:09,440 Speaker 1: That's a good story. Uh, and we got some like that, 859 00:51:09,560 --> 00:51:14,359 Speaker 1: Actually didn't We probably more of those than Peter doesn't work. 860 00:51:15,320 --> 00:51:18,080 Speaker 1: We got very few of those. I was really surprised. Yeah, 861 00:51:18,080 --> 00:51:19,880 Speaker 1: I thought we did a good job of laying it 862 00:51:19,920 --> 00:51:23,279 Speaker 1: out there. Uh. Well, if you want to share a 863 00:51:23,320 --> 00:51:26,759 Speaker 1: good family story like Joy did, you can tweet to 864 00:51:26,880 --> 00:51:29,160 Speaker 1: us at s Y s K podcast. You can join 865 00:51:29,239 --> 00:51:31,440 Speaker 1: us on Facebook dot com, slash stuff you Should Know. 866 00:51:31,640 --> 00:51:34,160 Speaker 1: You can send us an email to Stuff Podcast at 867 00:51:34,160 --> 00:51:36,239 Speaker 1: how stuff Works dot com, and you can visit our 868 00:51:36,320 --> 00:51:43,840 Speaker 1: home on the web, Stuff you Should Know dot com 869 00:51:43,880 --> 00:51:46,279 Speaker 1: for more on this and thousands of other topics. Does 870 00:51:46,320 --> 00:51:54,960 Speaker 1: it how stuff Works dot com