Dr. George Carlson MD?

Dr. George Carlson MD

Anesthesiologist | Addiction Medicine

645 Laniolu Pl Kihei HI, 96753 Show map

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About

Dr. George Carlson is an anesthesiologist practicing in Kihei, HI. Dr. Carlson ensures the safety of patients who are about to undergo surgery. Anestesiologists specialize in general anesthesia, which will (put the patient to sleep), sedation, which will calm the patient or make him or her unaware of the situation, and regional anesthesia, which just numbs a specific part of the body. As an anesthesiologist, Dr. Carlson also might help manage pain after an operation.

Education and Training

Univ of Hawaii MD 1977

Univ of Hawaii Fellowship Addiction Medicine 2005

University of Hawaii 1977

Board Certification

American Board of Addiction Medicine

American Board of Anesthesiology

American Board of Pain Medicine

AnesthesiologyAmerican Board of AnesthesiologyABA

Provider Details

MaleEnglish

Dr. George Carlson MD

Dr. George Carlson MD's Expert Contributions

My Answers

How long does it take to feel normal after anesthesia?
The question is: How long does it take to feel normal after anesthesia? This is a good question as many people have worries and concerns about how they will feel following anesthesia. There are several aspects of this question that contribute to how a person feels after anesthesia. What does it mean to “feel normal”? Is the person awake and alert or is the person feeling sedated or drowsy? Is the person having pain? Is the person capable of walking on their own, of driving a car? Is the person capable of taking care of themselves? Does the person have full control of their cognitive functioning? These are all important questions which contribute to the person feeling “normal”. It is important and generally goes without saying that having anesthesia is not something that occurs as an isolated event. The usual scenario is that a person is having surgery and anesthesia is being administered in order for that surgery to take place. Generally speaking surgery is an assault on the body. Each person having surgery and anesthesia has made a decision that there will be some improvement in bodily function or overall health which will allow them to go ahead with the planned surgery in the hope or understanding that it will be worthwhile. Several factors contribute to a person’s ability to “feel normal” following anesthesia and surgery: 1) The type of surgery and area of the body that surgery involves are vital elements to “feeling normal” in the post-operative period. 2) How long does the operation last. Longer operative procedures necessitate more anesthetic agents or anesthetic agents being administered for longer periods of time. Longer time periods of administration allow for the possibility of accumulation of anesthetic agents or their metabolites. This has the potential to prolong sedative and other effects (like nausea and vomiting) that will be noticed in the post-operative period. Longer operations generally involve larger areas of surgical intervention or more intense attention to one area. This will be noticed by the person as they heal from the operative process. Longer operative procedures often promote more tissue damage, more inflammation and more swelling of the operative area. 3) What type of anesthesia was administered to the person? Anesthetic agents contribute to how the person feels in the post-operative period. Anesthetic agents may produce nausea and vomiting. Anesthetic agents produce sedation and may interfere with a person’s normal cognitive processes. Modern anesthetic agents are remarkable in their safety and efficacy. Particularly pointing out propofol and newer anesthetic gases (sevoflurane and desflurane). Not only are these anesthetic agents safe and effective but they are also short acting and generally are gone or inactive in a short period of time after their administration. 4) What medications have been administered during the operative and post-operative period? Administration of narcotics is often vital to controlling pain. Narcotics may produce sedation or nausea and vomiting. Administration of anti-emetic agents to control nausea and vomiting may produce sedation. 5) What other medications have been administered during the peri-operative period? The person may be taking other medications. It may be necessary to administer medications during the peri-operative period. These other medications may or may not contribute to “feeling normal” in the post-operative period. 6) The person will influence the recovery process either consciously or unconsciously. This will contribute to the time period required before the person can feel “normal”. How long does it take to feel normal after surgery and anesthesia? There is no simple answer to this question as many things are involved. Some people may feel normal within a few minutes or hours following surgery and other people may not feel normal for days or even weeks following surgery. I would say that on average a healthy person may feel normal within a few hours following surgery or by the next day. I recall administering anesthesia to an approximately 50 year old healthy man. He was having a complicated orthopedic procedure that had been scheduled for at least 4 hours. We started this procedure around 8:00 AM in the morning and I recall finishing after 2:30 AM the next day. I was focused on administering “newer” anesthetic agents. Approximately 20 minutes after surgery we were still working on transport of the patient to the recovery area and the surgeon began talking to the patient. They had a discussion about the operation and about how the operation went. The patient later on recalled having this discussion. The surgeon told me that he was impressed that the patient was in a satisfactory state of recovery that this was possible. I remember that I was impressed also and I explained to the surgeon that I had been using these “newer” anesthetic agents. It was still a surprise to see this level of recovery after a very long operative procedure. I also recall watching a colleague administering anesthesia to an approximately 8 year old healthy girl. She was having tubes inserted into her eardrums related to having several inner ear infections. This is a standard operation that is performed on a regular basis and generally will take only a few minutes. I recall that this patient remained sedated and was not waking up promptly after surgery. It took over an hour before this patient was awake enough to transport her to the recovery area. I spoke with my colleague later who was surprised about how long it took for this girl to recover following a short operative procedure. Being asked if I had any thoughts I mentioned choice of anesthetic agents and what (if any) medications the girl had received prior to surgery. The patient did well. It took several days before her parents reported that she seemed to be back to her normal self. Returning to feeling normal following surgery and anesthesia is quite variable and unique to each person. Importantly with the advent of newer anesthetic agents the return to normal will not be prolonged because of anesthesia. The important factor in returning to normal is about recovering from the operation. READ MORE
Will I be put to sleep for carotid surgery?
Routinely patients have general anesthesia for the operation you are describing (carotid endarterectomy). I assume that you mean “will I have general anesthesia?” when you ask “will I be put to sleep?” Several things are important to know about you beforehand. Do your other arteries work well? Particularly, are you coronary arteries functioning well? Is your ECG normal? Are you healthy in other aspects of your body’s functioning. The age of 40 is relatively young to require carotid endarterectomy. Most 40-year-old’s are healthy and this is an important part of the evaluation. It is possible to do carotid endarterectomy using local anesthesia to make the area of the operation numb. This is usually done with the patient being sedated. Modern anesthesia and modern anesthetic agents are very safe. General anesthesia is routinely done for carotid endarterectomy. It is likely that you will have general anesthesia for your carotid endarterectomy. Thank you for asking, George Carlson, MD READ MORE
Does anesthesia always make a person unconscious?
This is a very good question. Many people have a fear that anesthesia will not work. The reality is that there is a condition known as awareness under anesthesia. In this condition, the patient will appear to be anesthetized.The anesthesiologist monitoring the patient will judge that the patient is anesthetized. The patient will not really be awake, but the patient will be aware of everything that is going on. The patient will hear the conversations going on in the operating room. The patient will be aware that he/she is having surgery. Pain is generally not being experienced. These patients do not talk about or remember feeling pain. However, this is a terrifying experience for the patient. Many doctors do not know that this can happen. There are reports of the patient going to a psychiatrist because the experience was so frightening. The patient is trying to get some help. The psychiatrist will sometimes tell the patient that what they are saying is impossible. They will be told that they are making up a story. This adds to the frustration, fear, and terror that the patient is experiencing. Treating this condition is a whole other topic, but it starts with an acknowledgement that the patient did have this experience, that it does happen and that it can be terrifying. Fortunately, this condition is very rare. The incidence is said to be 0.13%. This is about 1 or 2 persons per 1,000 cases of general anesthesia. The reality is that the vast majority of persons will be totally unaware and safe during their anesthetic experience. The fact that this can happen creates many interesting questions about what anesthesia is and how can this possibly happen. This is being explored and answers are being looked for. Thank you for your interest. If you are going to have anesthesia it is quite likely that things will go fine and that you will be totally unaware of what is happening. George Carlson, MD READ MORE