I had a double CABG 8 years ago at the age of 48,I'm also a brittle diabetic. 6 caths one heart stent pre-CABG and 2 in my left leg post. 3 silent heart attacks and now when I had an abdominal CT with oral and IV contrast it showed I have severe calcified Aortic valve. wasn't as scared last time as I am this time, and not sure why. Thanks for the video, it is reassuring as much as one can be reassured. I remember when I was awake after all the wires/catheters etc, too bad you can't be asleep when they pull the drainage tube out and the one I had in my neck LOL
I had my triple bypass surgery last month. Endo tube was removed about an hour or so post op. I was transferred to the CTICU and stayed there for four days. I did everything the nurse wanted me to do and was going for a slow walk the next day and longer walks over the next 3 days. I'm 75 but was fit for my age was doing the Oxygen Advantage breathing exercise - nasal breathing only, inhale gently and exhale gently through the nose. No open mouth breathing. The surgeon wanted to keep me for one more day but I mentioned I was ready to be discharged and recover at home. My wife is a retired RN and I was a Respiratory Therapist years ago. He gave in and I went home 4 days after the surgery. I moved around slowly and gradually went up and down stairs and outside the house. I knew what to expect so it wasn't as scary for me. Cheers, Bob
Thank you! this is fascinating! the process was similar when i had abdominal aorta to celiac + gastric artery surgery for a life-threatening birth defect. With all the work involved, it made me appreciate having 7 physicians present to use my rare case to learn about cardiothoracic and vascular surgery and the anesthesia methods involved. In a surprise twist, I ended up working as a cardiothoracic surgical stepdown unit about 3 years later and currently am atteneing CE in pain management. The first-person experience was rough going through surgery and post-op recovery with dismal pain control. It was incredibly helpful in explaining to patients and their loved ones about what they would experience.
This video honestly helped calm my anxiety before my David Procedure early February. I like to hear from the experts and be told exactly what to expect. Low and behold, it went extremely well and was a fantastic experience. Nothing was anywhere near as uncomfortable as I thought it would be thanks to healthcare professionals such as yourself!
Hi, I'm scheduled for a David procedure (biscupid AV leaking 4+ and ascending aneurysm) in May. How is it going after one month? I really don't know what to expect
@@albertore3782 I feel really good! So far things have held up great. I’m off painkillers and I’m able to do most things except lift heavy things. It wasn’t as bad as I thought it would be.
Got a triple bypass surgery at 68 yrs old at Institut de Cardiologie de Montreal and the anesthesia team never put me an oxygen mask. I never saw anybody put me catheter and fall asleep in a fraction of a second. Endo tubes were removed an hour after I woke up. I fell almost no pain and tried that Dilaudid machine just to feel the reaction.
Thank you so much! My dad is having a CABG today, and we aren’t sure how many grafts he’s going to need, and we’re understandably scared. This made me feel so much better.
@@RKMD Thank you, Dr. Kumar! He’s in recovery right now. It ended up being a quadruple bypass and I found out that my friend’s girlfriend (A perfusionist student) was learning with the machine during his surgery! It ended up being a quadruple bypass. Just waiting for him to wake up. I was surprised that the surgery only lasted about 3.5 hours. Thank you again for this video.
I went in by ambulance for a heart attack. It was determined I would need an emergency triple bypass. I'm almost glad I didn't have much time to think about anything that was getting ready to happen. But then again, I went in not knowing much about what was about to happen.
Hi Rishi, I love your channel. The videos are so interesting and educational. I’ve sent you a message via FB, but basically I’ve had 4 heart surgeries and about to have my 5th open-Heart in next few weeks to replace entire aortic arch. Which incidentally I’ve been told can easily take up to 14 hours! It’s a Redo surgery. My last Aortic surgery was 8 hours, also a Redo. So I have three questions not to do with my experience, but general. Firstly I’m in the UK and when I watched your video there are three things I noted that are done differently in the UK and wondered why? Don’t worry if you don’t, but thought I’d ask anyhow: 1. In UK patients undergoing heart surgery are admitted the day before their procedure. All the pre-op things such as ECG, Bloods, CXR etc are done the day before surgery. Wondered why hospitals in US admit patient on day of surgery? 2. In the UK the patient is anaesthetised in what we call the Anaesthetic Room which is adjacent to the OR or Theatre. In all videos showing cardiac surgery in US, the patient is put to sleep in the actual OR on the operating table. Why’s that? 3. Something that really surprised me was when you said many patients having cardiac surgery are generally removed from ventilator and extubated a couple of hours after the end of the surgery. That too does not happen in the UK. At least that’s not my experience. Most are kept on the ventilator until the morning the following day after surgery. In some cases the patient may be kept on the ventilator for a few days to allow heart to rest and recover. Can you explain why the differences? Thank you very much.
Hi there! I'll try to briefly answer these questions. 1.) In many cases, the workup is done days/weeks before the actual operation at outpatient testing centers. Patients arrive the day of surgery and are admitted to the ICU post-operatively. I think this makes sense to allow patients to spend as much time out of the hospital as possible. 2.) Hahaha, this is a fantastic question. In many parts of the world, there's a separate induction room as you described. It's just not something that gained traction in this country, and we're doing the induction as well as operation in the same room. 3.) Assuming there are no concerns from the anesthesiologist and surgeon regarding the patient's intraoperative course, we try to "fast track" our patients for extubation within 6 hours post-operatively so we can work on early physical therapy, nutrition, etc.
@@RKMD Hi Rishi, thanks so much for taking the time to reply and answer my questions. The answers make perfect sense actually. I really like your videos very much. They’re so interesting and educational. Thanks again.
I can answer #1 although I’m no doctor. In the U.S. we admit the day of surgery to save money for the insurance company or Medicare. I think I remember years ago that they used to admit the evening before and you even got a sleeping pill so you could get a good night’s rest.
Why are so many hypnotic drugs used in surgery even minor ones. I'd really like to hear from a professional as to why ? And although I have read the scientific research on this what about, age, anesthesia and cognitive decline?
Any critical care book like Vincent's Textbook of Critical Care (affiliate link: amzn.to/34LurDc) or check out my blog post on this topic: rk.md/2018/blood-gas-interpretation-determining-acidosis-and-alkalosis/
Dr. Rishi Kumar MD or is it Dr. Kumar Rishi,? I ask because my PCP, his name is Dr. Jay Kumar Shah, USC grad , Arcadia (Ca) Methodist hospital. Thank you so much Dr., your explanation is comforting and a great tool of understanding. I am starring at Open Heart at KECK USC, two valve replacements, RFA for Afib and LA appendage removal. Your excellent detailing of the preop is appreciated. Thank you once again.
If you have contra indications for TEE...how do you guide your fluids during surgery, check for PE, cardiac strains etc? You use TTE while surgeons are operating?
No, clinical judgment, blood work, and other hemodynamic monitors. Patients will get a TTE post-op (usually a limited study). If there's a concern for something more dire intraoperatively, we can also use epiaortic imaging.
My wife is young(31and is having open heart surgery for a leiomyosarcoma in her (left) atrium what might we expect as far as recovery goes and the procedure itself or won’t they know until they get in the atrium. What is the expected survival rate. She will have surgery after a month of chemo and it will be done in Beijing,China. … she is Chinese.
I had heart surgery 8 years ago. Before I had the surgery, the thought of waking up with the breathing tube in place freaked me out; however, the reality was that I was so out of it from the anaesthesia that when I couldn’t talk I thought, “Oh, I must have the breathing tube in place.” It was nowhere near the ordeal I had thought it would be. Being extubated was a bit uncomfortable though. Don’t worry about it though. Hope that helps.
I was calm but frustrated that I couldn't talk i was banging on my bed but then they gave me anxiety medication it help but don't worry u will most likely be asleep although I was awake when. Mine was pulled out but put back to sleep for tracheostomy tube
Mine was removed before I was awake enough to be aware of the tube. But educational videos helped and talking with other patients helped prepare me. They don't know in advance if you will be functioning enough to remove it. We're all different.
My anesthesiologist had no problem putting me to sleep. His problem was waking me up. It took fourteen days on life support during which I coded dead twice. It’s now been four and a half years. Both my feet are still swollen with gout and extremely painful to the touch. I don’t wear anything on my feet. Graves disease made my eyes cross. Maybe a second course of Tepezza MIGHT help. but I can walk with assistance. It took me two years to speak well enough to be comprehended. I still can only eat mush without someone standing ready to perform the Heimlich. I WAS a tenured law professor and trial lawyer. I am now unable to do sixth grade arithmetic or count money. I removed the Tracheostomy my self and threw it away. My doctor didn’t notice. How was your day today?
I had heart surgery to remove a tumor in my heart in 2020. It went well, but the Anesthesia doctor started making fun of me before I went under. I know I will never do that surgery again-at least not in that hospital.
Thanks for sharing , Dr !,
However, it would be more interesting and helpful if you gphave some more short clips to demo what you are talikng about !
I had a double CABG 8 years ago at the age of 48,I'm also a brittle diabetic. 6 caths one heart stent pre-CABG and 2 in my left leg post. 3 silent heart attacks and now when I had an abdominal CT with oral and IV contrast it showed I have severe calcified Aortic valve. wasn't as scared last time as I am this time, and not sure why. Thanks for the video, it is reassuring as much as one can be reassured. I remember when I was awake after all the wires/catheters etc, too bad you can't be asleep when they pull the drainage tube out and the one I had in my neck LOL
I had my triple bypass surgery last month. Endo tube was removed about an hour or so post op. I was transferred to the CTICU and stayed there for four days. I did everything the nurse wanted me to do and was going for a slow walk the next day and longer walks over the next 3 days. I'm 75 but was fit for my age was doing the Oxygen Advantage breathing exercise - nasal breathing only, inhale gently and exhale gently through the nose. No open mouth breathing. The surgeon wanted to keep me for one more day but I mentioned I was ready to be discharged and recover at home. My wife is a retired RN and I was a Respiratory Therapist years ago. He gave in and I went home 4 days after the surgery. I moved around slowly and gradually went up and down stairs and outside the house. I knew what to expect so it wasn't as scary for me. Cheers, Bob
Thank you! this is fascinating! the process was similar when i had abdominal aorta to celiac + gastric artery surgery for a life-threatening birth defect. With all the work involved, it made me appreciate having 7 physicians present to use my rare case to learn about cardiothoracic and vascular surgery and the anesthesia methods involved. In a surprise twist, I ended up working as a cardiothoracic surgical stepdown unit about 3 years later and currently am atteneing CE in pain management. The first-person experience was rough going through surgery and post-op recovery with dismal pain control. It was incredibly helpful in explaining to patients and their loved ones about what they would experience.
This video honestly helped calm my anxiety before my David Procedure early February. I like to hear from the experts and be told exactly what to expect.
Low and behold, it went extremely well and was a fantastic experience. Nothing was anywhere near as uncomfortable as I thought it would be thanks to healthcare professionals such as yourself!
I'm so happy to hear that! Thank you for the kind comment! 🙏🏽
Hi, I'm scheduled for a David procedure (biscupid AV leaking 4+ and ascending aneurysm) in May. How is it going after one month? I really don't know what to expect
@@albertore3782 I feel really good! So far things have held up great. I’m off painkillers and I’m able to do most things except lift heavy things. It wasn’t as bad as I thought it would be.
@@taylorfox6531 Thanks for your reply!
I’m going in for a David procedure in 3 months. This is incredibly helpful. Thanks!!!
Wow, I'm having my heart surgery in a few days. This was so helpful. I really appreciate this.
Hello, how did it go?
Excellent video! Had an aortic valve replaced 10 years ago.
Got a triple bypass surgery at 68 yrs old at Institut de Cardiologie de Montreal and the anesthesia team never put me an oxygen mask. I never saw anybody put me catheter and fall asleep in a fraction of a second. Endo tubes were removed an hour after I woke up.
I fell almost no pain and tried that Dilaudid machine just to feel the reaction.
Thank you so much! My dad is having a CABG today, and we aren’t sure how many grafts he’s going to need, and we’re understandably scared. This made me feel so much better.
I'm so glad to hear that! He'll be in my thoughts during surgery and his recovery! 🙏🏽
@@RKMD Thank you, Dr. Kumar! He’s in recovery right now. It ended up being a quadruple bypass and I found out that my friend’s girlfriend (A perfusionist student) was learning with the machine during his surgery! It ended up being a quadruple bypass. Just waiting for him to wake up. I was surprised that the surgery only lasted about 3.5 hours. Thank you again for this video.
Had open heart surgery twice.
It is not fun but by jingo 5 to 6 weeks afterwards ( they were valve surgeries ) I felt like a million bucks
I went in by ambulance for a heart attack.
It was determined I would need an emergency triple bypass.
I'm almost glad I didn't have much time to think about anything that was getting ready to happen.
But then again, I went in not knowing
much about what was about to happen.
Hi Rishi, I love your channel. The videos are so interesting and educational. I’ve sent you a message via FB, but basically I’ve had 4 heart surgeries and about to have my 5th open-Heart in next few weeks to replace entire aortic arch.
Which incidentally I’ve been told can easily take up to 14 hours! It’s a Redo surgery. My last Aortic surgery was 8 hours, also a Redo.
So I have three questions not to do with my experience, but general. Firstly I’m in the UK and when I watched your video there are three things I noted that are done differently in the UK and wondered why? Don’t worry if you don’t, but thought I’d ask anyhow:
1. In UK patients undergoing heart surgery are admitted the day before their procedure. All the pre-op things such as ECG, Bloods, CXR etc are done the day before surgery. Wondered why hospitals in US admit patient on day of surgery?
2. In the UK the patient is anaesthetised in what we call the Anaesthetic Room which is adjacent to the OR or Theatre. In all videos showing cardiac surgery in US, the patient is put to sleep in the actual OR on the operating table. Why’s that?
3. Something that really surprised me was when you said many patients having cardiac surgery are generally removed from ventilator and extubated a couple of hours after the end of the surgery. That too does not happen in the UK. At least that’s not my experience. Most are kept on the ventilator until the morning the following day after surgery. In some cases the patient may be kept on the ventilator for a few days to allow heart to rest and recover. Can you explain why the differences?
Thank you very much.
Hi there! I'll try to briefly answer these questions.
1.) In many cases, the workup is done days/weeks before the actual operation at outpatient testing centers. Patients arrive the day of surgery and are admitted to the ICU post-operatively. I think this makes sense to allow patients to spend as much time out of the hospital as possible.
2.) Hahaha, this is a fantastic question. In many parts of the world, there's a separate induction room as you described. It's just not something that gained traction in this country, and we're doing the induction as well as operation in the same room.
3.) Assuming there are no concerns from the anesthesiologist and surgeon regarding the patient's intraoperative course, we try to "fast track" our patients for extubation within 6 hours post-operatively so we can work on early physical therapy, nutrition, etc.
@@RKMD Hi Rishi, thanks so much for taking the time to reply and answer my questions. The answers make perfect sense actually.
I really like your videos very much. They’re so interesting and educational. Thanks again.
I can answer #1 although I’m no doctor. In the U.S. we admit the day of surgery to save money for the insurance company or Medicare. I think I remember years ago that they used to admit the evening before and you even got a sleeping pill so you could get a good night’s rest.
Why are so many hypnotic drugs used in surgery even minor ones. I'd really like to hear from a professional as to why ? And although I have read the scientific research on this what about, age, anesthesia and cognitive decline?
Excellent video, clear speaking and explanations. Thanks.
Can you tell me anything about percardial cyst surgery per thoracic reg and laproscopy to resection .
Waking up with that tube in the throat was the most terrifying thing in my life. I thought someone is trying to choke me. Horror.
What book do you recommend for reading ABGs? I have always had difficulty interpreting them and I would like to be a better nurse for my pt.
Any critical care book like Vincent's Textbook of Critical Care (affiliate link: amzn.to/34LurDc) or check out my blog post on this topic: rk.md/2018/blood-gas-interpretation-determining-acidosis-and-alkalosis/
Thank you!
Very informative
Brilliant way of explaining
You are an awesome doctor. Excellent explanations.
Great video. Thank you 🙏
Very informative!! Thanks!!
Do you fall asleep from-the sedation before
Excellent video. How long post surgery will the patient usually wakes up? I might have mitral valve repair soon. Thanks.
Dr. Rishi Kumar MD or is it Dr. Kumar Rishi,? I ask because my PCP, his name is Dr. Jay Kumar Shah, USC grad , Arcadia (Ca) Methodist hospital. Thank you so much Dr., your explanation is comforting and a great tool of understanding. I am starring at Open Heart at KECK USC, two valve replacements, RFA for Afib and LA appendage removal. Your excellent detailing of the preop is appreciated. Thank you once again.
If you have contra indications for TEE...how do you guide your fluids during surgery, check for PE, cardiac strains etc? You use TTE while surgeons are operating?
No, clinical judgment, blood work, and other hemodynamic monitors. Patients will get a TTE post-op (usually a limited study). If there's a concern for something more dire intraoperatively, we can also use epiaortic imaging.
My wife is young(31and is having open heart surgery for a leiomyosarcoma in her (left) atrium what might we expect as far as recovery goes and the procedure itself or won’t they know until they get in the atrium. What is the expected survival rate. She will have surgery after a month of chemo and it will be done in Beijing,China. … she is Chinese.
Thank you!
Thanks Rishi!
I am getting a valve replacement soon. Worried about waking up with the breathing tube. Do most patients freak out with it in or are they calm?
I had heart surgery 8 years ago. Before I had the surgery, the thought of waking up with the breathing tube in place freaked me out; however, the reality was that I was so out of it from the anaesthesia that when I couldn’t talk I thought, “Oh, I must have the breathing tube in place.” It was nowhere near the ordeal I had thought it would be. Being extubated was a bit uncomfortable though. Don’t worry about it though. Hope that helps.
I was calm but frustrated that I couldn't talk i was banging on my bed but then they gave me anxiety medication it help but don't worry u will most likely be asleep although I was awake when. Mine was pulled out but put back to sleep for tracheostomy tube
Mine was removed before I was awake enough to be aware of the tube. But educational videos helped and talking with other patients helped prepare me. They don't know in advance if you will be functioning enough to remove it. We're all different.
What’s the typical length of time heart surgeries take?
Lots of factors to consider, but roughly 3-6 hours.
My surgeon told me my aortic replacement and valve repair or replace will take about 5.5 hours
Thanks
My anesthesiologist had no problem putting me to sleep. His problem was waking me up. It took fourteen days on life support during which I coded dead twice. It’s now been four and a half years. Both my feet are still swollen with gout and extremely painful to the touch. I don’t wear anything on my feet. Graves disease made my eyes cross. Maybe a second course of Tepezza MIGHT help. but I can walk with assistance. It took me two years to speak well enough to be comprehended. I still can only eat mush without someone standing ready to perform the Heimlich. I WAS a tenured law professor and trial lawyer. I am now unable to do sixth grade arithmetic or count money. I removed the Tracheostomy my self and threw it away. My doctor didn’t notice. How was your day today?
wow what type of operation did you have done ?
I had heart surgery to remove a tumor in my heart in 2020. It went well, but the Anesthesia doctor started making fun of me before I went under. I know I will never do that surgery again-at least not in that hospital.
Well…for goodness sake, as a person expecting heart surgery in a month, tell us the name of the hospital.
HI, I'm going in for CABG, and have a EXTREMA gage reflex, how is that dealt with, anything special to deal with?? thanks
Sir I wanna be a cardiac surgeon 🤗 .
Do you have any funny stories with patients waking up from anesthesia?
Hah, plenty, but nothing I'd share on the Internet!
Lol I thought you meant DURING surgery and I was thinking “how could that ever be funny???” 😵😂
Listening only is kind of boring !!!!!