Secrets of your trade.

Thank you Likethefruit as you can see I've had issues with every sedation/GA!

Something I think is lovely about a former job.

When someone donates their organs (after death) they are never left alone til the body is taken to the mortuary of the hospital. The organ donation nurses are so respectful of the donors and wash and clean them once the surgery has taken place and then will sit and wait with their 'patient' til the porters come to take them. (This unfortunately can be an hour or so during the middle if the night or weekends unfortunately.)

When people talk about a Mortgage Company demanding a specific credit score, no. That's not how it works.
Each individual company will build their own system, and allocates "points" based on their own criteria.
For example. If you miss a couple of catalogue payments, but always make them up the following month, you are actually not a "bad" customer, because they will always make extra money from you. Conversely, if you ever miss a mortgage payment, you will always find it difficult to access mainstream lending.
Also, anyone who is declined for credit, has a statutory right to have a human being re-look at their application, if the decision was made based on an algorithm.

That utility companies can't remotely turn off your gas/electricity.

If you want a different gas or electricity capacity your looking at 12 weeks from beginning to end and potentially large expense if your existing supply isn't up to the job. So when your buying that new big gas cooker make sure you check this!

Gas and electricity meters are hardly ever wrong.

Smart meters are not the work of the devil

Sorry I misunderstood you! If you were in recovery seeing people being wheeled back and forth that's normal. The not breathing/paralysis sounds like you've been woken but not all muscle relaxant has worn off or being reversed fully. Alternatively too much opioid painkiller

If you have concerns I'd contact your hospital to arrange a meeting/debrief so you can go through your medical notes with an anaesthetist so you can get firm answers.

Laparoscopy was the procedure (when I saw the lady screaming (so knew I hadn't imagined or dreamt it) and the not breathing/paralysed lungs

Sorry, I detailed the lady screaming because it was proof that I was aware of everything around theatre and recovery, not because of her awareness or otherwise...BTW, she had no clue, but was screaming in pain with bleeding I'm assuming, its just I was aware of everything g going on

So the tonsils I would put down human error/ the slash and grab way tonsils used to be done.

The lady you saw go back for hysterectomy - not sure whether awareness caused the screaming. More likely to be pain from blood in pelvis which caused her to scream? But difficult to say without full details.

Wisdom teeth - some people are woken in theatre so perhaps this happened to you. also it's normal to remember being in recovery - and yes wisdom teeth extractions can be very painful post op.

Scopes generally all done under "conscious sedation" usually not by an anaesthetist. Depending on what drug were used will lead to how much amnesia of procedure you'll have had.

Laparoscopy - what this at end of procedure?

I dont have a memory of the heavy sedated scope, but with the laparoscopy couldn't breathe when told to, just stared at the team around me and my lungs were not working and I couldn't make them, they out a mask on me.

Mine was across many procedures, recall theatre lights and team as a child having tonsillectomy, had laparoscopy, saw the woman being wheeled out screaming from theatre and wheeled straight back in (confirmed when medical staff told her that they removed a cyst but bleeding meant she had to go back in for hysterectomy),
Had wisdoms removed and remembered being wheeled out of theatre and watching the clock go round in recovery, also the immense pain! And complaining about that having jabs for it.
Most recently several scopes, they ended up dosing me really well, but still I fought enough to prevent them getting a biopsy!

I think you're talking about accidental awareness under anaesthesia? It's tricky to comment on without knowing the specifics of cases. There was a nationwide audit called NAP4 which looked at this. Incidence is 1 in 19,000 anaesthetics but risk much less in some groups (those where no muscle relaxant drug is used : less than 1 in 100,000) and more in others (cardiac surgery, GA Caesarean section, emergency surgery in very unstable patient).

Awareness is much less common than in decades gone past as out monitoring has improved. We monitor the level of anaesthetic gases which equates to "how asleep" someone is, also heart rate, BP and now even electrical brain activity (though no firm consensus on this). The most common causes of accidental awareness in non emergencies lie in either human error (not noticing gas level too low for example) or equipment error (monitoring malfunction for example). In emergencies is more related to underdose due to instability of patient or rapidity of needing patient asleep and operated on. Though new drugs are more heart stable so this shouldn't happen.

Also some people who have had a procedure done under sedation report awareness. This can be very distressing for someone if they were expecting no memory of procedure and is generally due to a lack of explanation around what sedation means. Sedation does not mean no memory or awareness (although some people experience this).

Oooo, anaesthetist!

Why do some people remember a lot despite ga?

I have seen others coming and going to theatre and a woman screaming as she came out of theatre and being taken back in again! I remember not breathing for instance.

I'm an anaesthetist.

A large proportion of the general public don't realise that we're doctors. We don't just "put you to sleep" and walk off. We're there throughout, constantly giving drugs, adjusting the anaesthetic dose, giving fluids, looking after your position, eyes, temperature etc etc. We essentially look after all your body's functions while an op takes place (I.e keep you alive!)

The most important thing you can do to reduce your anaesthetic risk is to stop smoking - even a cheeky cig morning of surgery will have a negative effect.

If you have a very high BMI please be patient with us, everything is more difficult - cannula/monitoring/positioning/airway/spinal/epidural. Most of us won't say at time as don't want to embarrass you.

Just to clear up some of the info on epidurals for labour. The vast majority of them work really well. Baby's position can cause intense pressure if back to back but this can be overcome with different drugs in epidural. Also, they do NOT cause a significant increase in complications as PP said. The evidence shows they increase time of second stage and you are more likely to need assisted delivery (kiwi/forceps) but this is not a cause and effect relationship. And they don't cause back pain! Being pregnancy and delivering a baby do.

Must love to my midwife colleague o think you're great.

Stick it all down your bra if you like Pyongyang

As a pub manager and former restaurant manager and waitress I can tell you @Lightson that some might, in the michelin starred type places, but speaking for myself you paid so you can do what you like with it. Stick it all down your bra if you like, no skin off my nose :o

Lightson tell them to wind their neck in if they do!! Your food!

Yes, I can imagine it would take while to get a good look for the stamp

There is already a proof of Prince Charles ready for when we need the new stamp....it took a while to get a version he was happy with!

I want to ask waitress if they judge people who tip their individual curry , shepherds pie or whatever onto their plate?

Aurynne that was so lovely. Any mother who gets to work with you is very, very lucky ❤️

Wow- aurynne for PM!

Well said, we need more like you aurynne

@aurynne

Beautifully put. Made me cry.

Oooof...wow! That should be said to every birthing woman, by every midwife, that is awesome

That's beautiful aurynne.

I am always appalled that some women who choose to work in the caring professiona (nurses, midwives) can be so judgemental towards other women. Why the hell would anyone care what age a mum was? It doesn't affect you in the slightest! You are there to be their midwife, to support them through pregnancy, labour and birth. You are there to be their advocate when others do not treat them right, what hope do they have if you are actually the one mistreating them? Not judging your women is the number one requirement to offer good care. I honestly don't understand why anyone would want to be a midwife when she holds these judgments inside her. Personally, the most vulnerable a woman in my care is, regardless what the reason is (age, disability, social or financial reasons, drugs, domestic violence, tprevious trauma), the most I strive to give her great care and make her feel the most important person in the world while she is with me. I feel extremely protective of the women I care for, precisely because pregnancy and labour are the most vulnerable moments of a woman's life, even if she is the strongest, most confident person in the world. A woman is unable to stand up for herself when she is in labour, she has something far more important to worry about than asserting herself. She should never have to be worried about what her supporters think about her lifestyle, appearance or any other factor of her life.

You know that saying, "when you're in labour you leave your dignity at the door"? I hate it. I abhor it. It sets women up for shame and puts them in a position of dependence. When you're in labour there will be nudity, yes. There will be bodily fluids. And moaning. It is part of the process of giving birth to another life. And precisely because of that, there is no other time in your life where you will been more beautiful, more brave and more dignified. A woman in labour is a force to be reckoned, a thing of beauty. I want everyone to look up to her, admire her, feel the magic of the moment she lets out the whole new person she has made inside her. Her age, ethnicity, and life circumstances fade away and you are just left with this strong, awe-inspiring beautiful human before you that embodies the best we are and we can be. It embodies hope, potential, fresh new life.

Whoever cannot see and appreciate that, should never be in the caring professions.