IMO, right after having appropriate and adequate knowledge, the most important thing a doctor can have is the ability to communicate. You're very good at that - - and please never lose that quality !!!
@@MaxFeinsteinMD I am thankful that all my anaesthesiologists have been wonderful regarding bedside manner and overall demeanour. Since 2001 I have had some 15 ops for various reasons. Each time, and sometimes luckily enough, my surgeons have had a particular one who does anaesthetics for their patients.
Worked at Columbia and Cornell as a cardiac anesthesia tech before nursing school, some of the cardiac fellows ad residents 9 years later are like family with me. Some of the smartest and coolest people Ive ever gotten to work with, love the video
I had a bicuspid aortic valve replaced. My anesthesiologist was the best guy ever. I was petrified to wake up with the tube in. He told me it all depended on me and if was taken out he also stated that my pain control would be better with it in. I told him please take it out. He did. He is my personal hero. You guys rock! Shout out to St. Francis Hospital in Hartford, CT.
The odds this video came across my TH-cam recommendations. I’m laying here recovering from surgery. My Anesthesiologist was great. Talked with her before surgery. She did a great job.
As a french anesthesiology resident, i find your videos terrific! Both to compare our practices which after all are quite similar but also to learn from you and your tips. Keep it up Max!
Just wanted to thank you very much for these videos, as an aspiring anesthesiologist, you are highly motivating me to study harder and feel the life of anesthesiologists. I wish you best of luck with the rest of your work and never stop producing such excellent content!
Enjoy all your video's Dr Max ! I am a retired RRT, and back in the day ( 1970's), Anesthesia used to be our primary service. I actually first learned at an OJT program @ Yale Med Ctr. But the best part was that the Anesthesia Doc's were always willing to teach those of us who were hungry to learn. Thanks for the channel and please keep it up if you can as you continue your career.
These guys and the doctors deserve way more credit than they get. Hospitals get a bad rap but they are the most patient and caring people around. The hospital staff are overstressed and overworked.
@@Fattony6666 well I don’t know what hospital you work in but not all hospital over work you and underpay you grossly I think it depends what hospital system you are in like a big private hospital system I’m pretty sure you would see less of that
Having had heart surgery I had no idea id wake up with still intubated so that is a interesting feeling lol. Just glad to be alive and have a normal heart function again
I shall file this into the keep in mind in case you ever need it information section in my mind. Glad you're doing better. They really should warn you that's a possibility. I'd rather know. The more I know and understand, the calmer I can be about it.
2 weeks ago I had a HoLEP procedure paid for privately. Unlikely to get this on the National Health Service at the moment so having dropped my £7,500.00 in the biscuit tin I made my way to Spire Bushey (North London). Excellent staff good nursing.Mainly Romanian. I had deliberately not reviewed this on TH-cam but I do watch Max Feinstein. I didn't like my anaesthetist . He answered my questions with questions and I thought made it clear he thought I was a smart ass. I am but I was paying good money. He partially redeemed himself when he said take a deep breath. I thought "ah this is where I'm having a few deep breaths of O2 - yes I watched that clip". No he was inducing me with sevoflurane. What a nice way to go - much nicer than propofol and so on. Keep em coming Dr Feinstein - your'e an enjoyable listen.
Truly amazing, the amount of knowledge through school, residency and beyond is mind boggling...Thank you for sharing this to all of us that otherwise wouldn't have this opportunity.👏
It is very clear that you love what you do. Thank you so much for sharing your knowledge, skills, understanding, and compassion. I am a registered nurse who is highly interested in multiple specialty areas with anesthesia being near the top. I appreciate your enthusiasm and kindness in your videos!
Thankyou for showing us all how well you look after us. I'm lucky to have the NHS in the UK but all you professionals are dedicated, caring, diligent and sooooo knowledgeable ! ! What an incredible achievement to help save lives. Kudos.
My jaw literally dropped when I saw you reference UK Anesthesia! That's where all of my pediatric surgeries were, and all of my anesthesiologists were INCREDIBLE!
Hi Dr Max, I still haven't had my hard palate tumor removed. So frightened. I enjoy your videos because it helps me so much. I wish you could do my anesthesia!! I wouldn't be frightened at all!! Great videos and work!!
Max... just a quick message to say how much I like your posts and sense of humour... I just watched your career advice posting.. EVERTHING you said is so true... I was a mature student who ended up in the Med Lab Tech programme (not my first choice btw)... nothing compared to what you are achieving.... let me tell everyone out there... total focus... the realisation that your life will be absorbed by study... and a willingness to sacrifice the 'easy life' are three factors that I found I had to acquire... and that was just in college.. then came the clinical rotations..the constant tests.. exams.. and the dreaded Boards certification..... I don't want to make it sound like a horror story but as a mature student I found it so challenging most of the time... however I never gave up.... enjoyed my free time.. had support ( but had an aversion to study groups ) and graduated cum laude... then came the big shock of actually being in the hospital lab.. working.. every day...... I learned a lot.. and met wonderful committed helpful co workers and some not so committed too..... anyways I forged a career and am now retired to anyone out there.. please listen to Max.. he knows what he's talking about.. at the level of medicine he is at you really need to know that it's really what you want to do in life... After all 12 years is a long time to study.... keep doing what you're doing...I wish you the best in completion of your goals.. you will get there ☺️
These videos, and others made by doctors really solidified my interest in becoming a doctor, Thanks for all the amazing content and interesting medicine videos.
One of my friends is an Anesthesiologist and was always fascinated to hear him talk about his work. My first job was in Anesthesia research as a lab assistant to the research doctor. I love your dog. Reminds me of my last dog (Shih Tzu and we kept her hair cut short). She has passed on now and I do miss her!
I love the new intro!!!! 🥰 Thoroughly enjoy your videos and how sincerely humble you are, yet incredibly intelligent and passionate about what you do. I’d definitely trust you with my life when it comes to surgery. Thanks for sharing your day with us & I loved seeing your sweet dog, he’s so cute 🥺 Hope you’re having a great holiday season! ♥️
@@ilqaa1761 Sure! It was a number of reasons but I think the big one is that I wanted to be in a specialty that was more hands on with a lot of variety. Anesthesia fit that perfectly for me!
As a fellow undergrad student interested in cardiac anesthesia, you’ve got me hooked. Subscribed, and looking forward to watching your channel grow 🙏🏼💪🏼
a short vid like this shows you how little the general public actually understand of what it takes to become a competent doctor. The training that is required to become a good doctor is very difficult which is why you should trust science and their specialists
hi sir im an anesthesia technologist..... after watchning these videos, i bacame a big fan of you sir........ bcz your videos helps me lots to improve my self,...if i get a chance to assist you....that will a the greatest of all time milestone of mine in my lifetime. you are a GOAT
As someone who is a difficult intubation, I’ve had my share of negative outcomes due to anesthesia. In fact, in 1977 I had major surgery at Mt. Sinai followed by a month in the hospital. Now you’re lucky if they keep you overnight for a posterior cervical fusion of C1-2-3 with an iliac crest bone graft. The surgery went well except for the sponge count. For weeks the incision of the bone graft would not heal. Four months later my orthopedic doctor decided to do a pelvic X-ray and sure enough, a sponge was left in me. Back into Mt. Sinai for the orthopedist, under local in the OR, to dig out the 4x4. The pain was horrible. The sponge count was correct on the anesthesia report, but it wasn’t. When I look at all the equipment, IV’s, instruments and drugs, about the only thing you have control of is the sponge count. You count in 60 and you don’t close the patient until you count 60 out. How do I know? I was an OR tech for a few years and that was part of my job along with the circulating nurse and anesthesiologist. I found this unforgivable considering all I had been through considering I had to leave my 9 week old baby daughter and 2 year old son with family. Over the years I woken up from anesthesia and suffered a stroke. I had an aggressive anesthesiologist who felt he needed to do whatever it took to put me to sleep for a fundoplication. That left me with a paralyzed vocal cord and I aspirated while he’s doing a cricothyrotomy. I was assaulted for over two hours before surgery was canceled. My surgeon was complicit in this assault by applying pressure to my throat. I whispered for over a year and still have dysphasia and an altered voice. It changed my life. Unacceptable! So Dr. Max, I know stuff happens and I educate my anesthesiologist before I go under. I don’t want a CNA, I want an experienced MD who will listen to me and assure me you have a plan that doesn’t include my Doctors ego. Listen to your patients!
When I had back surgery in 2016, the, as she introduced herself, head anesthesiologist. I thought she was an ‘absolute, doll. She is beautiful. I’ll never get her out of my head.
Good call on the anesthetic gas for the pediatric pt. I had surgery done when I was ten and the nurses spent a half hour trying to place an IV on me and it sort of traumatized me back then. They finally gave up and placed the IV once I was under the gas. I'm not a doctor just a simple paramedic that loves all medical specialties and sub specialities. Keep up the great videos!
As a Post Doctoral Fellow in Pediatric Cardiac Anesthesiology, I found the anesthesia plan very interesting. It's exactly the same plan that we follow in India too for most of the cases.
Loved the bit about casting a spell on your pager when on home call! I have a similar rituals when I’m on call rotation during the weekends :) Hey sometimes it actually works!
What an excellent time to become a peds anesthesiologist. 100% match rate with no research years required (vs the 2 years research, 2 years fellowship and 50% match rate of gen surg). Sure the market is slightly saturated rn for pure peds position, but it won't be forever. You basically bought stock low and will sell high. Think of the guys who bought high like in rad onc or IR. Super, super competitive and have a real chance of not matching. Rad onc doesn't even have a good job market anymore. Plus, you found the highest paying pediatric subspecialty that isn't surgery (maybe tied with radiology). And it's a 1 year fellowship instead of 2 +2 research years like surgery. It's amazing. Curious to see if you'll do cardiac. Will definitely help get you into an academic center if that's your goal but the main question is lifestyle vs complexity. Interested to see your decision
Mcbaginns, thanks for the insightful comment! I'll be honest, I landed on Peds because it's the only subspecialty I like more than being a general anesthesiologist. I did consider the employability aspect of it, but I think it's hard to predict which way salary will go in the future. In the end, if there's one thing I've learned in the 10 years I've been pursuing medical training, it's that nothing is worth doing unless intrinsic joy or meaning is derived from it. Cardiac is an interesting and educational experience, and there is a part of me that is intrigued by the thought of Peds cards, but I enjoy the mix of general and adult cases more than the cards. I appreciate your interest!
In the UK our operating department assistants do all of the mechanical prep and often will also draw up your emergency drugs, I've been an anaesthetist for three years and have never had to fill up a machine with sevo.
you are my favorite Doctor Feinstein, I love the Anesthesia specialty field, I always wanted to be an anestetysta doctoe but I gas my son at 19 and daughter at 21 so I'm a Fire Rescue Paramedic because their mom left me as a single dad unable to keep going with med school.
Another great video! I agree that early mornings are one of the cons of anesthesiology. I like overnight oats for a quick grab-and-go breakfast in order to push my wake-up back 20 min. Best of luck on that Peds Cardiac Fellowship. Looks to me like you're doing everything right to prepare for it.
My most recent surgery experience: pre-COVID open prostate surgery, in the recovery room July 2, 2018. When I awakened from my surgery, my bed was adjacent to a station where a surgery staff member was dictating notes about my surgery. I distinctly remember this staff member describing a surgical injury or “incident” during my surgery. Another surgeon was called in to repair a tiny tear in my colon. My point is if there is an incident during surgery, don’t park the injured patient adjacent to the dictating station. To this day I remember every word of it.
Hello Dr. Feinstein! I'm starting my first year Anesthesiology residency this coming Jan 1, 2022! I woud like to thank you for being an inspiration! I'm nervous and excited at the same time for what's about to come! Regards from the Philippines!
I'm about to start as an RN on a pediatric CVICU so it was pretty neat that this video happened to be about one of those cases! I'm sure I will get many post op reports that sound similar to the plan of care for this patient
Choice of scrub cap? Ask the RN and scrub techs. That is usually a good way to get their opinions and break down the doctor-nurse barriers. A good tool for your learning is offering to teach others. Try first responders, EMS, firefighters especially in areas that have limited resources and volunteers, further away from the city. A lot of dedicated people have such a large capacity to learn and you are very good at braking things down.
I really like the content of your videos. It is really interesting to see as a medical student. Could you maybe explain in more details which drugs you are using, their mechanisms of action, why you choose those and not others etc please in future videos?
Hi Greg, thanks for the suggestion! I do have one brief video where I cover basics about anesthetic medications, but I don't go into the detail you're describing. Perhaps in a future video. th-cam.com/video/hQiHj22VcFI/w-d-xo.html
I had thought you were going in to the bedroom to ask your wife about which surgical cap to wear. I guessed that you would wear the first one to hit you in the face when she threw them both back at you. I also said to myself, "This is not going to end well." Your approach definitely had a better process as well as ending.
Great video man! I always get great Knowledge from your videos! I enjoyed it! I’m gonna start Donating to the Anesthesiologist Foundation in June since it was hard for me to go to college to be a Anesthesiologist after I graduated high school in 08 because of my cerebral palsy! You rock man! Your puppy is so cute
Yay! We need more pediatric anesthesiologists! Serious question. During pre-op if a patient tells you that a certain anesthetic doesn't work, do you change your plans or proceed? I've been sedated enough times to tell which medications leaving me screaming and the surgeon telling me to keep it down.
Hi Jennifer, it would really depend on the situation. If a patient told me a certain medication didn't work, I'd want to know what the surgery was, why the felt it didn't work, and also consider what the options are for the current case. But in short, yes, I will tailor plans to patient preference assuming that safety is not compromised.
Love your content & great coverage. As a retired nurse I enjoy doing a mini shadowing. But...when I met the pup, I was totally sold! Of course, I have a Corgi! Medicine & pups, what's not to like, eh?
I'm a CICU nurse in Pennsylvania. I want to go to grad school with the hospital I'm currently working at and am deciding between receiving my DNAP or DNP. Right now I'm weighing my options to see what would be the best fit for me. Your video is informative in giving a glimpse into anesthesiology and your dog is adorable! Thanks! (:
Cardiac is supposed to be the most challenging subspecialty of anesthesia, and yet is seems pretty chill, compared to other specialties. I'm crying in surgery😂
awesome content Max, watching that i decided about changing my plans from doing orthopedics to becoming an anesthesiologist, i value my free time because i like to play electric guitar and i like pharmacology , i was curious if you can make some movies about a work on intensive care unit?
Wow dude, that was a good 15 + hour day! Most people have no idea of the amount of time you put in. Your videos are always so informative and I greatly enjoy them. One question for you. When I asked my surgeon after surgery about how anesthesia was maintained while on the heart lung bypass he explained for me. I didn’t think to follow thru, does the anesthesiologist still control the anesthesia during this period?
Great question. The primary person controlling a patient’s physiology while on bypass is the perfusionist, which is a fascinating career unto itself. Anesthesiologists are still involved with physiology management while on bypass, but I would say the perfusionist plays the primary role.
Great video! Why sevofluorane instead of isofluorane? Taste? I've read about some variation in hemodynamic properties but they seemed minimal. I also have a question about Sugammadex and Rocuronium. If you've administered sugammadex at the end of a case to reverse Roc or Vec, and you need to emergently reintubate, do you choose rocuronium again? Would it be prudent to switch to succinylcholine? Does your dose have to increase four fold with Roc to counteract the saturation of sugammadex? Thanks for your time and all the content!!!
Sevo is (apparently) the least stinky volatile, and also it has a faster onset than isoflurane. Great question about re-paralyzing after giving sugammadex. The general recommendation is to use the higher 1.2mg/kg roc dose, but clinical effect time is less predictable with sugammadex on board, and of course that will be a function of how recently reversal was a given. Interesting article here for reference: www.ncbi.nlm.nih.gov/pmc/articles/PMC4121487/
this is so cool to me. I'm currently in a psych nurse practitioner program, so i never really see anything like this. Regardless, this content is extremely motivating and I wish you the best of luck throughout your residency!
At my hospital, we carry some controlled medications with us because we don’t use Pyxis machines in the OR. Everything gets turned into and accounted for by pharmacy at the end of the day.
I had surgery in the nose today, with local anesthetic. It went well again ☺ but I was so nervous this morning that i dropped the jar with pre shave gel on the floor so it splatted balsam everywhere 🤦♂️ luckily the glass didnt break, but the plastic lid did It seems impossible to not get anxiety before surgery stuff
I don’t know why it took me so long to find this channel. I loved your video ❤️❤️❤️One question though, are you the only anesthesiology resident in this hospital?
He mentioned at one point he was relieving another resident so there's at least two of them haha. Plus it's a pretty big network so I imagine theres a few resident from each year
I’m actually one of about 100 anesthesiology residents at Mt. Sinai Hospital! It’s a surprisingly large number, but corresponds with the large volume of surgeries performed here.
I'm finding your videos rather fascinating in spite of the fact that I'm a stay-@-home mom. (BTW I highly recommend Garden of Life Raw Meal mixed with apple juice. Mix at home, refrigerate and take it anywhere. While it does, unfortunately, taste like freshly- mowed grass clippings it's full of protein. Start with one scoop, not two, and drink alot of water. Ok I'm done. Lol.) Love the videos!
I am a High School student with dreams of becoming someday an Anesthesiologist. I have chosen to study to get a B.S. in Biology. Do you have any recommendations/suggestions? Thank you.
IMO, right after having appropriate and adequate knowledge, the most important thing a doctor can have is the ability to communicate. You're very good at that - - and please never lose that quality !!!
Eat,sleep, breath, anesthesiology for 20 years of your life.
Thanks for the nice feedback @CarolLynnWilliams!
A great bed side manner is really important.. If you show poor bedside manner pre-anaesthesia then it just makes the patient stress more.
@@MaxFeinsteinMD I am thankful that all my anaesthesiologists have been wonderful regarding bedside manner and overall demeanour. Since 2001 I have had some 15 ops for various reasons. Each time, and sometimes luckily enough, my surgeons have had a particular one who does anaesthetics for their patients.
@@MaxFeinsteinMD question who gives the cardiplegia
Worked at Columbia and Cornell as a cardiac anesthesia tech before nursing school, some of the cardiac fellows ad residents 9 years later are like family with me. Some of the smartest and coolest people Ive ever gotten to work with, love the video
In all my procedures I’ve had great anesthesiologists, and they made them much easier for me with my anxiety. Y’all are definitely under appreciated!
Hi 😍
@@austinmahone9541 lol
I had a bicuspid aortic valve replaced. My anesthesiologist was the best guy ever. I was petrified to wake up with the tube in. He told me it all depended on me and if was taken out he also stated that my pain control would be better with it in. I told him please take it out. He did. He is my personal hero. You guys rock! Shout out to St. Francis Hospital in Hartford, CT.
He's so wholesome, I love him.
The odds this video came across my TH-cam recommendations. I’m laying here recovering from surgery. My Anesthesiologist was great. Talked with her before surgery. She did a great job.
As a french anesthesiology resident, i find your videos terrific! Both to compare our practices which after all are quite similar but also to learn from you and your tips. Keep it up Max!
Bonjour frenchy
Just wanted to thank you very much for these videos, as an aspiring anesthesiologist, you are highly motivating me to study harder and feel the life of anesthesiologists.
I wish you best of luck with the rest of your work and never stop producing such excellent content!
Thanks for the nice feedback Yana. Keep up the studying, it's hard work but pays off!
Enjoy all your video's Dr Max ! I am a retired RRT, and back in the day ( 1970's), Anesthesia used to be our primary service. I actually first learned at an OJT program @ Yale Med Ctr. But the best part was that the Anesthesia Doc's were always willing to teach those of us who were hungry to learn. Thanks for the channel and please keep it up if you can as you continue your career.
These guys and the doctors deserve way more credit than they get. Hospitals get a bad rap but they are the most patient and caring people around. The hospital staff are overstressed and overworked.
and, except for doctors, grossly underpaid
@@Fattony6666 well I don’t know what hospital you work in but not all hospital over work you and underpay you grossly I think it depends what hospital system you are in like a big private hospital system I’m pretty sure you would see less of that
Having had heart surgery I had no idea id wake up with still intubated so that is a interesting feeling lol. Just glad to be alive and have a normal heart function again
I think it's really important for anesthesiologists to let patients know when this is a possibility. I'm glad you're doing well!
I shall file this into the keep in mind in case you ever need it information section in my mind. Glad you're doing better.
They really should warn you that's a possibility. I'd rather know. The more I know and understand, the calmer I can be about it.
2 weeks ago I had a HoLEP procedure paid for privately. Unlikely to get this on the National Health Service at the moment so having dropped my £7,500.00 in the biscuit tin I made my way to Spire Bushey (North London). Excellent staff good nursing.Mainly Romanian. I had deliberately not reviewed this on TH-cam but I do watch Max Feinstein. I didn't like my anaesthetist . He answered my questions with questions and I thought made it clear he thought I was a smart ass. I am but I was paying good money. He partially redeemed himself when he said take a deep breath. I thought "ah this is where I'm having a few deep breaths of O2 - yes I watched that clip". No he was inducing me with sevoflurane. What a nice way to go - much nicer than propofol and so on. Keep em coming Dr Feinstein - your'e an enjoyable listen.
Truly amazing, the amount of knowledge through school, residency and beyond is mind boggling...Thank you for sharing this to all of us that otherwise wouldn't have this opportunity.👏
I love that you also blur your mouth to protect patient privacy!
woooo new video!! :D thanks max! love watching your stuff!
It is very clear that you love what you do. Thank you so much for sharing your knowledge, skills, understanding, and compassion. I am a registered nurse who is highly interested in multiple specialty areas with anesthesia being near the top. I appreciate your enthusiasm and kindness in your videos!
Thankyou for showing us all how well you look after us.
I'm lucky to have the NHS in the UK but all you professionals are dedicated, caring, diligent and sooooo knowledgeable ! !
What an incredible achievement to help save lives.
Kudos.
You scored on that quiet call shift! A rare all-night sleep. Great video. Brings back memories!
My jaw literally dropped when I saw you reference UK Anesthesia! That's where all of my pediatric surgeries were, and all of my anesthesiologists were INCREDIBLE!
So excited for you, pediatrics is the BEST!! Truly hope you get your pediatric fellowship!! BTW your wife was so cute helping you pick out your hat!!
Wife? 😊
@@smadm2437 it was a joke, about the dog..., never mind, it was a bad one I guess... I am a nerd, so my jokes aren't usually funny to others.
@@bettysmith4527 this is actually funny, because I too sought to make a joke, guess it didn't work either 😂
You are going to go far in life. It's people like you that really matter to society. ❤
Hi Dr Max, I still haven't had my hard palate tumor removed. So frightened. I enjoy your videos because it helps me so much. I wish you could do my anesthesia!! I wouldn't be frightened at all!! Great videos and work!!
Max... just a quick message to say how much I like your posts and sense of humour... I just watched your career advice posting.. EVERTHING you said is so true... I was a mature student who ended up in the Med Lab Tech programme (not my first choice btw)... nothing compared to what you are achieving.... let me tell everyone out there... total focus... the realisation that your life will be absorbed by study... and a willingness to sacrifice the 'easy life' are three factors that I found I had to acquire... and that was just in college.. then came the clinical rotations..the constant tests.. exams.. and the dreaded Boards certification..... I don't want to make it sound like a horror story but as a mature student I found it so challenging most of the time... however I never gave up.... enjoyed my free time.. had support ( but had an aversion to study groups ) and graduated cum laude... then came the big shock of actually being in the hospital lab.. working.. every day...... I learned a lot.. and met wonderful committed helpful co workers and some not so committed too..... anyways I forged a career and am now retired
to anyone out there.. please listen to Max.. he knows what he's talking about.. at the level of medicine he is at you really need to know that it's really what you want to do in life... After all 12 years is a long time to study....
keep doing what you're doing...I wish you the best in completion of your goals.. you will get there ☺️
Hello from Kentucky! Love that you’re studying from the University of Kentucky!! Love your videos! Thanks so much!
Yes UK videos are fantastic!
These videos, and others made by doctors really solidified my interest in becoming a doctor, Thanks for all the amazing content and interesting medicine videos.
One of my friends is an Anesthesiologist and was always fascinated to hear him talk about his work. My first job was in Anesthesia research as a lab assistant to the research doctor. I love your dog. Reminds me of my last dog (Shih Tzu and we kept her hair cut short). She has passed on now and I do miss her!
Just wanted to say thank you for making these. Your videos really helped me feel calmer going into a crainotomy I had scheduled on 12/30/21!
So glad to know that! Hope your recovery is easy.
I hope your procedure went well.
Procedure went well and recovery is going smooth !
I love the new intro!!!! 🥰 Thoroughly enjoy your videos and how sincerely humble you are, yet incredibly intelligent and passionate about what you do. I’d definitely trust you with my life when it comes to surgery. Thanks for sharing your day with us & I loved seeing your sweet dog, he’s so cute 🥺 Hope you’re having a great holiday season! ♥️
Thanks for the really nice feedback, I appreciate it Gabi! Happy holidays to you, too.
Congrats on choosing your fellowship! That’s super exciting! I’m an IM resident actually applying to anesthesia this year and can’t wait!
Heyy. Can i ask you why you want to switch? Applying in the upcoming match and stuck between IM and Gas
@@ilqaa1761 Sure! It was a number of reasons but I think the big one is that I wanted to be in a specialty that was more hands on with a lot of variety. Anesthesia fit that perfectly for me!
@@BN-cr5bh my thought exactly! Goodluck with the match!
Best wishes for the match, you're making a great choice!!
As a fellow undergrad student interested in cardiac anesthesia, you’ve got me hooked. Subscribed, and looking forward to watching your channel grow 🙏🏼💪🏼
Thanks Josh!
a short vid like this shows you how little the general public actually understand of what it takes to become a competent doctor. The training that is required to become a good doctor is very difficult which is why you should trust science and their specialists
I just want to say that I appreciate you guys a lot and the work you do!
Wow, the quality of your videos has improved a lot. Congrats
Thanks so much!
This would be overwhelming to me, an anesthesiologist competency must be off the scales!!!
Thank you for these detailed, knowledgeable videos. You’re an inspiration! I hope I’m where you’re at one day
I have been blessed to have the best surgeons and anesthesiologist .
hi sir im an anesthesia technologist..... after watchning these videos, i bacame a big fan of you sir........ bcz your videos helps me lots to improve my self,...if i get a chance to assist you....that will a the greatest of all time milestone of mine in my lifetime. you are a GOAT
As someone who is a difficult intubation, I’ve had my share of negative outcomes due to anesthesia. In fact, in 1977 I had major surgery at Mt. Sinai followed by a month in the hospital. Now you’re lucky if they keep you overnight for a posterior cervical fusion of C1-2-3 with an iliac crest bone graft. The surgery went well except for the sponge count. For weeks the incision of the bone graft would not heal. Four months later my orthopedic doctor decided to do a pelvic X-ray and sure enough, a sponge was left in me. Back into Mt. Sinai for the orthopedist, under local in the OR, to dig out the 4x4. The pain was horrible. The sponge count was correct on the anesthesia report, but it wasn’t. When I look at all the equipment, IV’s, instruments and drugs, about the only thing you have control of is the sponge count. You count in 60 and you don’t close the patient until you count 60 out. How do I know? I was an OR tech for a few years and that was part of my job along with the circulating nurse and anesthesiologist. I found this unforgivable considering all I had been through considering I had to leave my 9 week old baby daughter and 2 year old son with family. Over the years I woken up from anesthesia and suffered a stroke. I had an aggressive anesthesiologist who felt he needed to do whatever it took to put me to sleep for a fundoplication. That left me with a paralyzed vocal cord and I aspirated while he’s doing a cricothyrotomy. I was assaulted for over two hours before surgery was canceled. My surgeon was complicit in this assault by applying pressure to my throat. I whispered for over a year and still have dysphasia and an altered voice. It changed my life. Unacceptable! So Dr. Max, I know stuff happens and I educate my anesthesiologist before I go under. I don’t want a CNA, I want an experienced MD who will listen to me and assure me you have a plan that doesn’t include my Doctors ego. Listen to your patients!
I’m so glad you had an assistant for you scrub cap! It’s a hard decision but someone’s gotta do it😂😂😂
When I had back surgery in 2016, the, as she introduced herself, head anesthesiologist. I thought she was an ‘absolute, doll. She is beautiful. I’ll never get her out of my head.
Good call on the anesthetic gas for the pediatric pt. I had surgery done when I was ten and the nurses spent a half hour trying to place an IV on me and it sort of traumatized me back then. They finally gave up and placed the IV once I was under the gas. I'm not a doctor just a simple paramedic that loves all medical specialties and sub specialities. Keep up the great videos!
As a Post Doctoral Fellow in Pediatric Cardiac Anesthesiology, I found the anesthesia plan very interesting. It's exactly the same plan that we follow in India too for most of the cases.
Loved the bit about casting a spell on your pager when on home call! I have a similar rituals when I’m on call rotation during the weekends :)
Hey sometimes it actually works!
These are the best videos ever. I really enjoy watching and learning what happens in surgeries. Thank you so much Dr. Max🙏🙏
What an excellent time to become a peds anesthesiologist. 100% match rate with no research years required (vs the 2 years research, 2 years fellowship and 50% match rate of gen surg). Sure the market is slightly saturated rn for pure peds position, but it won't be forever. You basically bought stock low and will sell high. Think of the guys who bought high like in rad onc or IR. Super, super competitive and have a real chance of not matching. Rad onc doesn't even have a good job market anymore.
Plus, you found the highest paying pediatric subspecialty that isn't surgery (maybe tied with radiology). And it's a 1 year fellowship instead of 2 +2 research years like surgery. It's amazing. Curious to see if you'll do cardiac. Will definitely help get you into an academic center if that's your goal but the main question is lifestyle vs complexity.
Interested to see your decision
Mcbaginns, thanks for the insightful comment! I'll be honest, I landed on Peds because it's the only subspecialty I like more than being a general anesthesiologist. I did consider the employability aspect of it, but I think it's hard to predict which way salary will go in the future. In the end, if there's one thing I've learned in the 10 years I've been pursuing medical training, it's that nothing is worth doing unless intrinsic joy or meaning is derived from it.
Cardiac is an interesting and educational experience, and there is a part of me that is intrigued by the thought of Peds cards, but I enjoy the mix of general and adult cases more than the cards. I appreciate your interest!
In the UK our operating department assistants do all of the mechanical prep and often will also draw up your emergency drugs, I've been an anaesthetist for three years and have never had to fill up a machine with sevo.
you are my favorite Doctor Feinstein, I love the Anesthesia specialty field, I always wanted to be an anestetysta doctoe but I gas my son at 19 and daughter at 21 so I'm a Fire Rescue Paramedic because their mom left me as a single dad unable to keep going with med school.
So crazy that I’m researching to see if this is something I want to do and you ended up working at a place I drive by all the time.
Max, you're not only an outstanding medical student, but an outstanding doctor!
Thank you for sharing this. I have a 5 month old with a CHD and my biggest fear is surgery/anesthesia. It feels a little better seeing your process.
Living in NYC and having this schedule.. dude your life is passing by. But thank you for your service.
Merry Christmas Max!
Same to you!
I love your sense of humor on your shows
Another great video! I agree that early mornings are one of the cons of anesthesiology. I like overnight oats for a quick grab-and-go breakfast in order to push my wake-up back 20 min. Best of luck on that Peds Cardiac Fellowship. Looks to me like you're doing everything right to prepare for it.
My most recent surgery experience: pre-COVID open prostate surgery, in the recovery room July 2, 2018. When I awakened from my surgery, my bed was adjacent to a station where a surgery staff member was dictating notes about my surgery. I distinctly remember this staff member describing a surgical injury or “incident” during my surgery. Another surgeon was called in to repair a tiny tear in my colon. My point is if there is an incident during surgery, don’t park the injured patient adjacent to the dictating station. To this day I remember every word of it.
Why wouldn't you want to know?
I'd rather want to hear that instead of potentially wondering why down the road if there was an issue with said colon.
It's your body; ignorance is not bliss. But I do wonder why your (presumably) urologist didn't repair it. Very simple stuff.
Hello Dr. Feinstein! I'm starting my first year Anesthesiology residency this coming Jan 1, 2022! I woud like to thank you for being an inspiration! I'm nervous and excited at the same time for what's about to come! Regards from the Philippines!
Thanks for watching, best wishes and enjoy the experience!
I'm about to start as an RN on a pediatric CVICU so it was pretty neat that this video happened to be about one of those cases! I'm sure I will get many post op reports that sound similar to the plan of care for this patient
Best wishes for your new work in the Peds CVICU!
Niiiice ! Merry Christmas Max !
Shout out to all the nurses who do all the prep work
Agreed! And anesthesia techs, too.
The little pictures on the leads are adorable
Top 3 favorite piece of equipment in the OR for sure
Thanks max for this video
Choice of scrub cap? Ask the RN and scrub techs. That is usually a good way to get their opinions and break down the doctor-nurse barriers. A good tool for your learning is offering to teach others. Try first responders, EMS, firefighters especially in areas that have limited resources and volunteers, further away from the city. A lot of dedicated people have such a large capacity to learn and you are very good at braking things down.
I really like the content of your videos. It is really interesting to see as a medical student. Could you maybe explain in more details which drugs you are using, their mechanisms of action, why you choose those and not others etc please in future videos?
Hi Greg, thanks for the suggestion! I do have one brief video where I cover basics about anesthetic medications, but I don't go into the detail you're describing. Perhaps in a future video. th-cam.com/video/hQiHj22VcFI/w-d-xo.html
I had thought you were going in to the bedroom to ask your wife about which surgical cap to wear. I guessed that you would wear the first one to hit you in the face when she threw them both back at you. I also said to myself, "This is not going to end well." Your approach definitely had a better process as well as ending.
Great video man! I always get great Knowledge from your videos! I enjoyed it! I’m gonna start Donating to the Anesthesiologist Foundation in June since it was hard for me to go to college to be a Anesthesiologist after I graduated high school in 08 because of my cerebral palsy! You rock man! Your puppy is so cute
Thanks Darrion!
@@MaxFeinsteinMD you welcome
Thank you very much for the video with kindness and respect for excellent explaining and kindness sharing the video with kindness and respect
Yay! We need more pediatric anesthesiologists!
Serious question. During pre-op if a patient tells you that a certain anesthetic doesn't work, do you change your plans or proceed? I've been sedated enough times to tell which medications leaving me screaming and the surgeon telling me to keep it down.
Hi Jennifer, it would really depend on the situation. If a patient told me a certain medication didn't work, I'd want to know what the surgery was, why the felt it didn't work, and also consider what the options are for the current case. But in short, yes, I will tailor plans to patient preference assuming that safety is not compromised.
Howdy a major salute to your efforts
That dog is so cuteeeeee. Loved the video.
I'd be in a moral dilemma as an attending if someone asks me which scrub cap to use after they have gone through an entire surgical plan😂
Love your content & great coverage. As a retired nurse I enjoy doing a mini shadowing. But...when I met the pup, I was totally sold!
Of course, I have a Corgi!
Medicine & pups, what's not to like, eh?
Ahhhh im a grad student at the MSMP program at Case! Applying to med school this cycle, case is on the list. No wonder you're a badass!!!
Really your professional skills
Attract more people who have talent
This so much high value
Lol I loved the part when your dog helped you choose the scrub cap😂💗
I'm a CICU nurse in Pennsylvania. I want to go to grad school with the hospital I'm currently working at and am deciding between receiving my DNAP or DNP. Right now I'm weighing my options to see what would be the best fit for me. Your video is informative in giving a glimpse into anesthesiology and your dog is adorable! Thanks! (:
Interesting video. Love from India.🇮🇳
You have lucky patients ! Lucky to have you that is.
I really enjoy this channel!!
Just found you. Such a sweetie. Good luck with your chosen career. Keep posting Hi from New Zealand
We make this Propofol active pharmaceutical ingredient (API) a lot in india and export to USA and to the world in general
Thank you very much!
How long of a nap did you get during this case?
Happy new year max! Thanks for the video as always. :D
Lol no nap
Thanks for watching!
LOL your dog's face at 4:16!
Cardiac is supposed to be the most challenging subspecialty of anesthesia, and yet is seems pretty chill, compared to other specialties. I'm crying in surgery😂
I am getting into CRNA DNAP program soon and your videos have prepared me for whats to come. Highly informative and educational. Thank you !!!
I was wondering if I can get a glimpse of your pediatric setup list for my future reference? Thanks!
awesome content Max, watching that i decided about changing my plans from doing orthopedics to becoming an anesthesiologist, i value my free time because i like to play electric guitar and i like pharmacology , i was curious if you can make some movies about a work on intensive care unit?
Wow dude, that was a good 15 + hour day! Most people have no idea of the amount of time you put in. Your videos are always so informative and I greatly enjoy them. One question for you. When I asked my surgeon after surgery about how anesthesia was maintained while on the heart lung bypass he explained for me. I didn’t think to follow thru, does the anesthesiologist still control the anesthesia during this period?
Great question. The primary person controlling a patient’s physiology while on bypass is the perfusionist, which is a fascinating career unto itself. Anesthesiologists are still involved with physiology management while on bypass, but I would say the perfusionist plays the primary role.
Great video!
Why sevofluorane instead of isofluorane? Taste? I've read about some variation in hemodynamic properties but they seemed minimal.
I also have a question about Sugammadex and Rocuronium. If you've administered sugammadex at the end of a case to reverse Roc or Vec, and you need to emergently reintubate, do you choose rocuronium again? Would it be prudent to switch to succinylcholine? Does your dose have to increase four fold with Roc to counteract the saturation of sugammadex? Thanks for your time and all the content!!!
Sevo is (apparently) the least stinky volatile, and also it has a faster onset than isoflurane. Great question about re-paralyzing after giving sugammadex. The general recommendation is to use the higher 1.2mg/kg roc dose, but clinical effect time is less predictable with sugammadex on board, and of course that will be a function of how recently reversal was a given. Interesting article here for reference: www.ncbi.nlm.nih.gov/pmc/articles/PMC4121487/
@@MaxFeinsteinMDThat article was perfect, thank you. I did try to research this on my own but to no avail. Thanks so much!
Man got lucky, said the Q-word and STILL got a good night's rest!
this is so cool to me. I'm currently in a psych nurse practitioner program, so i never really see anything like this. Regardless, this content is extremely motivating and I wish you the best of luck throughout your residency!
Very Nice...
Thank you for sharing....
Cool video! Just curious as to why you would have a 20 cc syringe of Diprivan in a break room?
At my hospital, we carry some controlled medications with us because we don’t use Pyxis machines in the OR. Everything gets turned into and accounted for by pharmacy at the end of the day.
I had surgery in the nose today, with local anesthetic. It went well again ☺ but I was so nervous this morning that i dropped the jar with pre shave gel on the floor so it splatted balsam everywhere 🤦♂️ luckily the glass didnt break, but the plastic lid did
It seems impossible to not get anxiety before surgery stuff
Based on my own experience, I'd say the vast majority of patients are nervous before surgery.
@@MaxFeinsteinMD Thanks :) Its always cool and useful to learn from your videos 👍 👨🏻⚕️
I don’t know why it took me so long to find this channel. I loved your video ❤️❤️❤️One question though, are you the only anesthesiology resident in this hospital?
He mentioned at one point he was relieving another resident so there's at least two of them haha. Plus it's a pretty big network so I imagine theres a few resident from each year
I’m actually one of about 100 anesthesiology residents at Mt. Sinai Hospital! It’s a surprisingly large number, but corresponds with the large volume of surgeries performed here.
I'm finding your videos rather fascinating in spite of the fact that I'm a stay-@-home mom. (BTW I highly recommend Garden of Life Raw Meal mixed with apple juice. Mix at home, refrigerate and take it anywhere. While it does, unfortunately, taste like freshly- mowed grass clippings it's full of protein. Start with one scoop, not two, and drink alot of water. Ok I'm done. Lol.) Love the videos!
Minor typo at 9:01, at the point with dead space is 2mg/kg, which should be 2mL/kg.
Love your videos! I’m a veterinary nurse, but love learning human stuff too! So interesting!
Did you set the central line before entering the surgical theater? Why didn't you use ketamine and disproven as an I duction?
Hey Max, 👋 very entertaining and always cool see what you do and how.
I am a High School student with dreams of becoming someday an Anesthesiologist. I have chosen to study to get a B.S. in Biology. Do you have any recommendations/suggestions? Thank you.