Dr. Armen Ketchedjian

Hello,

Yes, there is a chance that medications taken by the patient, and when they take that medication, can affect the care. We recommend against taking any diabetic medication on the day of surgery, however, there are exceptions on the severity of the diabetes and we work closely with the primary care doctor for the management of the diabetes surrounding the time of surgery. We allow and prefer the taking of certain blood pressure medication and not others. The anesthesia department of your medical center has guidelines regarding these medications. Please check with your doctor regarding the specific medications you take.

Dr. Ketch

Hi,

Sometimes people do experience numbness on the arm that is not operated on because that arm is used for frequent blood pressure measurements. This is a temporary sensation and goes away fairly soon after surgery
Dr Ketch

Hi,

Nausea is common if you had general anesthesia.

Dr Ketch

Hello,

Fertility/infertility is not my area of expertise. But one can see that if the lining of the uterus is not smooth or even, it can affect the pregnancy. I think it would be prudent to direct your question who specializes in that field.

Dr. Ketch

Hello,

I am sorry to hear you are suffering terribly with back pain. If the spinal/epidural is performed in the standard manner, then you should have nothing more than soreness temporarily. Women sometimes develop back strain during pregnancy or labor that can get aggravated.

Congratulations for your baby.

Dr Ketch

Adderall is a medication classified as an amphetamine. It speeds up metabolism and is a stimulant for the brain. Advise that your friend follows her physicisn’s advice regarding the reason she takes adderall and her medical condition to ensure there is no conflict between her medication and Anesthesia. Ask that my patients skip the dose for the day of their surgery, but every situation is different.

Dr. Ketch

I would assume that the gel you used had some type of local anesthetic in it like lidocaine or cetocaine. These local anesthetics are not known to cause such lumps or bumps. The lumps could have come about either from other ingredients in the gel or any other products that could have been used during the process.

Dr Ketch

It’s not whether you get more than one anesthetic a year but circumstances surrounding the Anesthesia. Pregnant women and women who just had a baby have a higher risk for Anesthesia due to physiological changes. These changes include, but not limited to hormone changes, increased acidity of the stomach and changes of cardiac and lung circulation. These changes do not return to normal until 6 to 12 weeks after giving birth.

Nausea is common after general anesthesia. Some people are more prone to it than others. Some risk factors increase the chance for nausea. These risk factors include female gender, non smoker, use of volatile gas anestgetics, laparoscopic surgical procedures, gynecological, abdominal and ear, nose and throat surgeries. The risks can be reduced by administering more than one class of anti-nausea medication prior and during surgery and avoiding volatile gas anesthesia techniques.

I hope that is helpful.

Dr Ketch

Agents and medications during anesthesia do not typically lead to side effects of tremors. Nothing that persists for longed periods of time. General anesthesia in elderly can cause some pronged side effects of confusion or memory loss. Even these side effects are not persistent. As we age our minds become more vulnerable to the effects and sensitivities of anesthetics. This's particularly true in elderly who may experience different levels of dementia and Alzheimer's disease.

You are correct in the sense that Plavix is a blood thinner and increases the risk of bleeding during and immediately following surgery. Please do not alter or change taking your Plavix on your own. It is not clear from your question whether you had cardiac stents placed after your heart attack. Customarily, we send our patients who had recent heart attacks to their cardiologist for clearance. Your cardiologist will see you before your surgery and provide guidance regarding the dosage and administration of the Plavix surrounding your surgery. Please do not alter your Plavix dose on your own, that will increase your risk of having another heart attack, Please seek the guidance of your cardiologist who is familiar with your medical history.

Thank you and good luck with your surgery.

Dr Ketch

Anesthesia is safe for elderly people undergoing surgery; however, it is important to note that people with dementia are more susceptible to the effects of the anesthesia. Their period of confusion can be prolonged and be profound. I am careful to choose anesthetics that are short acting and have the minimum mind-altering effects. This is something that your anesthesia care provider needs to take into consideration.

Good luck,

Dr Ketch

Yes, it is very likely he will need some type of anesthesia, because 2-year-olds are seldom cooperative on their own during CT scans.

Dr Ketch

Hi, it depends on the surgery and type of General Anesthesia. If it is a general anesthetic that utilizes an endotrachial tube(ETT) to proved ventilation or there is need for muscle relaxation for surgery, then yes. A paralytic agent is used to relax the muscles to allow the passage of an ETT, to make ventilations easier and provide ease of surgical exposure and access. If paralysis is not necessary an alternative device called the Laryngeal Mask Airway(LMA) can be used without paralysis and allows the patient to breathe on their own through the anesthetic.

I hope that is helpful.

Dr Ketch

Hi, there are certain things that increase a person's risk for nausea and there are a few things that we can do to mitigate the risks. Things that increase risks of nausea include being female, non smoker, history of motion sickness, general anesthesia with volatile anesthetic agents and certain types of surgeries which include gynecological procedures, ENT, etc.,.. there is a point assigned to each of these factors and anyone with greater than 3 points is at a high risk. There are things that we can do to decrease nausea with surgery. Some of these are challenging for the anesthesiologist, but can be done with some experience without a problem. Being well hydrated(this reduces risk of nausea for a few reasons.) please. Review the guidelines with the provider. The new guidelines allow water up to 2 hours before surgery. Scopolamine(Dramamine) patch. Zofran and decadron administered during surgery. Non volatile agent containing general anesthesia(TIVA) if general anesthesia is needed. Opiate free anesthesia if appropriate. Very small doses of droperidol or haldol if available. I hope this helps, good luck. Let me know how it goes.

Hi,

Blood thinners do increase the risk of bleeding. Now, you don't need to stop blood thinners with every surgery and it depends on the blood thinner, your medical conditions and type of surgery. You need to work in conjunction with your surgeon, primary care physician and specialists as to when to stop and start your blood thinner. Anesthesia techniques can be custom-tailored around your blood thinner regiment.

Good luck

Dr Ketch

Anesthesia needs to be administered by a properly trained physician, in a properly monitored setting with all the necessary equipment to resuscitate a person in the event of an emergency. If any one of those components are missing, then you need to worry. Do your research and ask questions about qualifications, types of monitoring and emergency response.

Good luck,

Dr Ketch

Laughing gas does not treat anxiety. Benzodiazepines like Valium, xanax and Ativan treat anxiety.

Dr Ketch

Hi,

Giving premedication depends on circumstances, medical conditions, patient's level of anxiety and type of surgery. There are no rigid guidelines and sometimes, it depends on the provider preference.

I hope that helps.

Dr Ketch

Hi,

There are some factors that increase the risk of nausea with surgery. Being female, non-smoker, history of motion sickness, previous history of nausea with anesthesia, certain types of surgeries, general anesthesia with volatile agents. The duration of nausea can vary, depending on the above factors, if opiate medications were used to treat pain, amount of motion or transportation after surgery, and hydration. Always let your anesthesia provider know if you get nauseated with anesthesia so a plan can be formulated to suit your anesthetic needs.

Good luck,

Dr Ketch