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Thursday, October 3, 2013
Why Thoracic Anesthesia Is Fun
Thoracic Anesthesia, or the anesthesia that is given for lung surgery, when everything is going well, it feels like sailing to me.
I adore sailing.
With the open sky and the sea and the wind in my face it is just about one of the best things to do on Gaia. And you are one with the sea and with the vessel. You move automatically with the lines, the sails, the team, as One.
In the O.R. there are many task to do, all in quick succession. There are fine adjustments to make, just as do when setting your course on the water....sail and tack...sail and tack....sail and tack...
There is more invasive monitoring than in the average case, but not so much as a heart. It's doable.
After induction, which is a big deal because you insert a breathing tube that is adapted to allow to ventilate one lung independently of the other, you place your lines.
You need two very big i.v.'s just in case your surgeon gets into trouble, and there is bleeding. The blood flows thick and fast when something happens, and you have got to be prepared ahead. There isn't time to set up after a hemorrhage. Fortunately, this part is very rare.
Another thing you insert is an arterial line to monitor oxygen, ventilation (CO2 output), and blood pressure. The last time I put in a line, the anesthesia tech blurted out, 'wow! Did you see how fast that line just went in? Yesterday in the other room it took an HOUR!' I had gotten it on the first try at the same rate someone would put in an i.v. I laughed and said, 'That's because I used to do hearts!'.
My surgeon took notice.
Speaking about him, there was the following conversation in the O.R.:
me: (as we were preparing to turn the patient lateral and nurse was putting in foley and I was bronching patient to verify tube position) Would you mind getting me three blankets from the warmer? (I pointed to the equipment)
surgeon: (gives me the look, acts like he doesn't notice, then blurts out) Are you talking to me?
me: Yes. When we turn I am going to need to support the head more than this gel pillow. Three flat blankets will do nicely.
surgeon: I can't. I don't know where the equipment is!
second surgeon: Here, let me get that for you. (goes to the warmer, takes out three blankets, and hands them to me)
me: Gosh, I am sorry if I was rude in asking the surgeon for help by getting a blanket in front of you. I've known him for like, ten years, since I worked with him someplace else. Everyone else was busy, and I was trying to save time by thinking one step ahead...
second surgeon: You know you're not allowed to think!
circulator nurse: (we are alone and she is prepping patient while surgeons both scrub)
That was the PERFECT answer to that situation. He literally said, 'are you talking to me?' Perfect tone, perfect reasoning, perfect timing, perfectly said.
me: You know I almost dated him?
circulator nurse: You could have done better!
me: I'm serious! When he came to our hospital and was new, and single, the other heart surgeon tried to set us up. I saw that he was dark and handsome and exotic, and seemed nice...but something made me think work and dating might not be a good idea. So I never did. It's a good thing that I listened to my 'hunch'--it turns out he has a terrible temper, as you can see.
circulator nurse: (gives me an approving look,, and surgeon walks back into the room, and she lifts her finger to her mask as a warning for us not to talk on the subject)
Why do I share with you all of this?
Some people asked me what Thoracic Anesthesia is. And why I love it.
Besides, I always liked to work in the thoracic cavity--my goal at one point was to become a cardiothoracic surgeon! Not a cardiac anesthesiologist. The lifestyle was horrible! That is why I gave that first dream up.
We move on.
I love it when a case asks much of me. It is so fun and really feels like I am One with my equipment and my purpose and my team...is there much time for Reiki? No. But I do what I can <3
Aloha and mahalos,