A Little Slice Of Hell ((( The Energies Of Partuition )))

It takes a storm to bring a child into the world.

Last night at four in the morning, while I was doing the fourth epidural in a row, the new mother was really in a lot of pain. The charge nurse, who is experienced and excellent and compassionate, all at the same time, explained to the mother, 'giving birth is a (gestures with thumb and first finger) little slice of hell--but it is so worth it!'

Did you know that same nurse has been bit by a patient giving birth?

It was back in the day when medi-cal patients were not given epidurals unless they paid for them with cash. Insurance didn't cover it. They threw things, hit, bit, cursed, scratched, and spit at the nurses in the delivery room.

The OB gyn on call last night shared to me, in a low whisper, that on her way in to the hospital after doing an emergency gyn case at another hospital, she hit a dog with her car. She was heartbroken. It just ran out in front of her, and there was nothing she could do. She saw it wobbling but upright when she looked in the rear view mirror. Just then another car hit it. It went down and didn't move. She brought the car back to take it to the vet if it was alive. It wasn't. She had to come in for her patient here, who was not ready to deliver. I invited her to go to the Doctor's Lounge in the Main O.R. to get a cup of coffee, and talk. She accepted.

Did you know OB-GYN is one of the most malignant training programs in all of medicine? She trained on the East Coast, where it is even worse than here on the West Coast, but even still, it was so horrible that four of her class left the program. There were 'five bitches', four chief residents and one attending, who 'picked on everybody, especially the men'. One male, was not 'able to keep up'. He couldn't understand, even when given her notes she took and kept organized, what admission orders were, what a daily note format was supposed to be, how to follow up on routine labs. There it was explained clearly once and then expected to be perfect after that. He was asked to go. The other was a male who genuinely WAS competent, but the Chiefs didn't like him. He left to go into Sports Medicine because of the bullying he experienced. Another woman left to go to a different training program in the South to be with family. And another stayed at the hospital but changed specialties due to the stress.

Being an OB-GYN resident sometimes is like being in the Lindsey Lohan movie, 'Mean Girls'.

Yet obstetricians brave all this, and sacrifice not just their time but their being in such a malignant environment, because they truly love what they do. Our hospital is exceptional in that the different private practice physicians from all of the different groups socialize together. It is very cohesive, which makes for a better program. We are also all Facebook Friends, the nurses, docs, postpartum, and neonatal teams.

I won't begin to describe the anesthesia end of things--think of it as trying to his a moving target--

What I will share with you, as a teaching point, is how to master suddenly changing scenarios, full of drama, and risk to life.

I was asked to see a mom who had just delivered who had questions, at around seven p.m. I had so many clinical responsibilities (patients) needs I couldn't get to her room until ten at night. I politely explained the situation, and that I had not eaten dinner yet. She said, 'Do you want half of my sandwich?' I declined, saying it had meat and I am vegetarian. She said, 'Pick the meat out and eat it anyway.' which I did. Half a croissant, with lettuce and tomato did wonders! We talked through the question and arrived at an answer and it was very pleasant.

The energies were non-stop throughout the day, one 'drama' after another, and one in which the fetus actually was at risk. I fixed it with my knowledge of drugs, and although I had to leave a c-section (while they were closing) for five minutes to manage it, I confessed to her when I got back, 'I just saved the life of the baby by adjusting the blood pressure. No one will know it but me, and now you.'

What was different this time was the lack of emotional undertow into the drama/rapidly changing clinical situations. By 'hanging on to source and being grounded' I quickly prioritized the work and carried it out. One chart I had to complete at eight o'clock the next morning, because there was NOTHING and no time to chart when everything happened all at one time on the unit.

If the energies of the changes on Gaia arrive as I have a hunch they will, it is going to feel for you like the last OB call did for me. Handle it as best as you can without getting 'sucked in' to the swirling storm of emotions. Remain clear-headed, prioritize, and act. You have what it takes to 'get the job done' and help others who are having trouble adapting to the new energies and changes that are about to come with it.

You are about to go where angels 'fear to tread'--you alone are totally equipped for it, whether you know it or not. You signed up for it. http://aquariusparadigm.com/2013/11/14/taryn-crimi-angelic-guides-first-responders/

I know you will be great at it! Just think of all we had to do on OB to bring a baby into the world--all the training, all the experience, and all the love we have for what we do.

You are like us helping Gaia 'give birth' to the New Society, the Golden Age where everything is fair, just, and highly pleasant!

That is why it is called Heaven On Earth!


Aloha and Mahalos,
Namaste,

Reiki Doc

Something To Add: Silent Surgery

this is how I felt when I was asked to do 'silent anesthesia'

P.S. the hair is supposed to go INSIDE the bouffant cap, thank you very much!

Recently I had the opportunity to stretch my open mind and do anesthesia for a member of Scientology.

The forms were intimidating. a three-page letter from an expert on Silent Surgery, and a one-page letter from the patient basically telling me what to do. I did my best to stay quiet and to avoid the specific agents requested. The patient did fantastic! But  just in case you are curious, no, they were not a celebrity in any way. (Even if they were I couldn't tell you ; )  )

So for the Anesthesia Community in General, For the Silent Surgery Education and Advertisement Department of Scientology, and for the Energy Healers out there, let us proceed to 'Something To Add'.

Here is the 'deal': 

engram: a mental image picture which is a recording of time of physical pain and unconsciousness.

Scientologists don't want them.

They want to stay 'conscious' and 'free of pain'.

Reiki Doc Says: 

The concept that everything is 'heard' and 'not remembered' during surgery is correct. The patient 'knows' everything that is going on, but later has no access to those memories. That's why I don't let people talk trash about my patient, as if anyone would in the first place. But I watch for this.

For staying 'conscious' options, I think regional anesthesia is an excellent choice. Lower extremity and some less invasive abdominal procedures are able to be done under spinal, epidural, or regional blocks such as a femoral three-in-one, sciatic, popliteal, or ankle block. Some upper extremity procedures may be done under axillary block, inter scalene, or Bier block. 

The only drawback with regional anesthesia that is not epidural or spinal is that local anesthesia causes seizure when absorbed too rapidly or injected intravascularly. Small doses of benzodiazepine are routinely given to raise the seizure threshold as added safety against seizure in case of inadvertent rapid absorption of local anesthetic.

Scientology also recommends 'bilateral TAP blocks' for abdominal pain post-op. I have never seen one of these done and would have to look one up before I did one. I wouldn't advise that for post-op pain control. Pain pumps (little spring-loaded slow drip drains filled with local anesthesia) are preferred in this and many thoracic cases. 

General Anesthesia

Scientology Says:

NO! Well actually, no:

• Barbiturate
• Etomidate
• Ketamine
• Benzodiazepines (midazolam, alprazolam, chlordiazepoxide, temazepam)

Again, this is to avoid the engrams.

Otherwise unconsciousness with general anesthetics, propofol, and narcotics is 'okay.

Reiki Doc says:

OK! I'm on it!

Barbiturate--we can't even get Sodium Pentothal for lethal injections by the state. It is no longer made, I believe. This is a non-issue. Years ago, we gave methylhexital for ECT (electroconvulsive therapy) because it gives a better seizure than propofol. Now it's usually propofol.

Etomidate--one dose isn't going to suppress the adrenals much. Those studies were done when etomidate was used for ICU sedation. (plus many elderly are adrenocortically suppressed and have no knowledge they are. I give steroid bolus to all over seventy just in case, it's cheap and preventive.) 

Etomidate is used when the patient is very unstable and might die if given propofol to go to sleep. Typically we use Etomidate for emergencies only. Chances are in an elective setting and good health, it would not be used.  You might want to think about the risk to benefit on etomidate in the situation of emergent, life-saving surgery where a patient is in hemodynamic shock.

Ketamine--This is used in veterinary medicine, too. It is a 'dissociative anesthetic', the patient 'knows' what is going on but 'doesn't care', much in the same way a frontal lobotomy is known to do. There can be terrible hallucinations in adults if no benzodiazepine pre-med is given first. A powerful painkiller, ketamine is used in changing dressings and bathing burn patients who have frequent procedures. It is also often mixed with propofol for long facial plastic surgery procedures under 'MAC'. The only time I would use ketamine clinically is the violent patient that might hurt me (i.m. like a tranquilizer dart), and the dying patient who needs blood pressure to go UP instead of stay level like etomidate on induction. You might want to think about situations where life is at risk and give the okay on ketamine in this instance.

Benzodiazepines--are used to decrease anxiety in surgery, especially pre-op. I can take them or leave them, but in cases of cardiac disease, propofol would frankly kill the patient if I only gave that. I use a large dose of versed and fentanyl to keep blood pressure stable. You might want to re-think risk to benefit on this one for alcoholics (withdrawal in hospital can be fatal), anxiety disorder, and cardiac disease.

On The Healing of Surgery:

Scientology says: 

Surgery is a necessary evil that is full of pain and has to be controlled.

Reiki Doc says:

Surgery is a time for deep healing that is personal for each patient involved. For RELIGIOUS ACCOMMODATION we are pleased to provide what care you request. 

However, surgery can be a time of great joy and service in the healers involved. Many have been called to the healing specialties out of great love for humanity and desire to 'give something back'.  Provided that the patient is sufficiently under general anesthesia, there is little risk of 'pain' being experienced while 'unconscious' so the engram, in my opinion, has little chance to form. The pall and sense of restriction in that room for the length of surgery created feelings that were not 'light' for everyone involved in the procedure. I ask you to question, 'where is the healing when the energy is not favorable to the optimum function of the team at work on the patient in the O.R.?' It's just a thought, whatever you decide is okay with me.

Furthermore, when individuals are trained in energy medicine, vast amounts of healing can be harnessed for the benefit of the patient, no matter what the religion, as health is a divine right and all of humanity is deserving of this gift.

From Me to You:

Thank you for taking me outside my comfort zone. After doing anesthesia for so many years, I had no clue there was any medical 'interaction' with your religion. I consider myself informed and will strive to do whatever possible for the comfort and care of your patients.  It is my hope that my expertise in anesthesia that I shared with you today will help put more of your patients at ease in the future.

After all, Love is the Solution For Everything! 

Do you not agree?

Mahalo and Aloha,

Reiki Doc