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gas-writer · 1 year

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Always happy to see more writing!

Induction

You’re sitting in one of those Barco chairs, already changed into your gown, cap, and booties. The pre-op nurse has been over and collected her data, started your IV, and covered you with the blanket from the warmer. I’ve been over to see you and discuss the anesthesia plan and we’ve agreed to general anesthesia. I left your chairside for a few minutes, telling you that the room isn’t quite ready and that I’ll be back when it’s time to go inside.

About 10 minutes later, a nurse in a green scrub dress and purple cloth scrub cap comes over and talks with you for a few minutes. She verifies your procedure, your ID band, and a few other questions. As she reaches the end of her checklist, I reappear, but with a surgical mask over my nose and mouth.

“Any questions before we go inside?”

You shake your head no.

“Walking or riding?”

“I’ll walk”

The circulating nurse and I help you stand up and wrap the blanket around you. She puts her surgical mask on and we guide you into the surgical suite and into the second room on the right.

As you walk in, you see the table in the middle of the room, a couple of people at a table in the back of the room, one of whom is already in a sterile gown and gloves, and the anesthesia machine. We guide you to the table.

“I just want you to sit on the side of the table.”

You follow the direction perfectly. I then untie the top of your gown and open it. I place the 5 electrodes from the heart monitor onto your back, directly opposite where you would expect them on your chest.

“Let’s get you to twist and lay back.”

We help you bring your legs up and then help you bring them up onto the table. As you start to lay back, you’re just shy of the doughnut.

“Scoot on up the table for us, until you feel my hand on your shoulder.”

You do exactly as I ask and after a short scoot, my right hand in on your shoulder. The circulator covers you with a heavy green sheet as I start to unsnap the sleeves on your gown. She then places the safety strap over your hips.

I position your left arm onto the arm board and place a strap over it. I then attach the LR to the saline well that the pre-op nurse started in your forearm. You feel the cool fluid entering your vein. I take a few syringes from the tray on the anesthesia machine and turn to you with them.

“Just a little something to help with your nerves.”

You sigh, knowing that your heart is racing a bit – about 100 times a minute. You then nod at me. I take the first syringe, which you read the label as “FENTANYL 50mcg/ml”. I screw it onto your IV and slowly start to inject 2 ml. As I finish the injection, about a minute later, you start to feel the medication helping you to calm down a little. You look a bit more relaxed, too. And your heart rate comes down into the 80s.

I then turn my attention to getting the rest of the monitors on you. I take the blood pressure cuff and place it on your right upper arm, then strap your arm to the arm board. The cuff starts to inflate and get tight. I then place the oximeter onto your right ear lobe and as soon as I do, the monitor starts to beep with each beat of your heart.

“Ready to breathe a little oxygen?”

As you nod, you hear me don a pair of gloves then take the black mask and attach it to the breathing circuit. I turn to the machine and dial the oxygen to 10. You feel my gloved left hand under your chin, bringing it back just a little. Then the mask comes into view and gets closer to your face. As it touches the bridge of your nose, I smile under my mask.

“Nice big breaths. That’s it.”

I encircle your nose and mouth with the mask and hold it in place firmly, but gently. As you breathe, the bag on the machine deflates with each rise of your chest and inflates with each fall of your chest. After a minute or so, I bring the tails of the mask harness up and strap the mask to your face.

I then take the second syringe which you read as “REGLAN 5mg/ml” and I screw it onto your IV and start to inject it into your IV fluid. It takes me a couple of minutes to inject it. You start to feel a bit drowsier. As I finish it, the blood pressure cuff inflates again.

I look back at the monitor and you seem to be a bit more relaxed. Your heart rate is in the mid-70s, blood pressure looks great, and you look more relaxed than you did when I gave you the fentanyl.

“Time for a little gas to help you relax a little more. Keep with the nice deep breaths.”

I turn back to the anesthesia machine and lower the oxygen to 5 and turn the nitrous to 5. It takes a breath or two, but you start to smell the sweetness of the nitrous on top of the rubber of the mask. You start to feel a little tingling at the ends of your fingers and toes. With each breath, the tingling becomes more intense and travels up into your hands and feet. And, your nose and face start to tingle too. I’ve turned to the anesthesia machine and turned the nitrous to 7 and the oxygen to 3.

“You’re doing really great, and it’s time to go odd to sleep.” I rub your right shoulder.

I reach back to the vaporizer and turn the sevoflurane to 4. After a breath, you start to smell the lemony-chemical smell on top of the sweet rubber of the mask. I let you take a few breaths, then turn the vaporizer up to 8.

“Off to sleep now. Nice big breaths.”

With your next breath, you seem to feel like you’re sinking into the table. Even the ambient noises, like the instruments clanking together, seems to be further away. You take another breath and that big light fixture above you looks like it’s moving a little. Your eyelids get really, really heavy. And with the next breath, your eyelids close.

“See you in the recovery room.”

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gas-writer · 4 years

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Love this. Reminds me of one of the stories from the very old Yahoo groups, updated to match these pictures!

"Well, Joe, no need to go to hospital for that - a knee arthroscopy is not a big operation. We can do that right here as an outpatient surgery. Of course you'll need to get anaesthesia - but after the procedure you should be able to go home after one or two hours." The pretty young doctor smiled at him. She had big dark eyes and long dark hair that was tied back into a loose ponytail. The white coat accentuated her olive skin tone and her slim figure. "Let me just check the surgery schedule for Wednesday." She turned to look at her computer screen. After his last football match Joe had suffered from a pain in his knee. He'd hoped it would get better, but as he still wasn't able to play again after two weeks his coach had finally convinced him to see a doctor. He had recommended Dr. Elizabeth Fernandez. "Yes, Joe, I can fit you in at eleven o'clock," Dr. Fernandez now said cheerfully. "Diane at reception will give you the necessary consent forms - just send them back to me before five and we'll prepare everything for your surgery tomorrow ...."

Joe didn't sleep well that night and woke early the next morning. He was glad that the arthroscopy could be done at Dr. Fernandez' office because that would spare him a visit to the hospital, but he still dreaded the operation. On the forms it had said that he would have to fast for six hours before the surgery, so he had no breakfast - not that he could have eaten anything - he was much too nervous.

Joe left early and took a taxi to the surgery that was situated in a modern office complex in a posh part of the town. When he entered through the heavy satinated glass doors he was greeted by Diane, the receptionist. "Oh, hello, Joe! Dr. Fernandez is still in the operating room. She will see you in a couple of minutes! She told me to go through those forms with you." - Dr. Fernandez was in the operating room! Joe pictured the pretty doctor in green scrubs, a scalpel in her gloved hands ... He suddenly became very nervous - soon it would be his turn! Distractedly Joe answered all of Diane's questions - had he fasted - yes - did he smoke - no - did he have any heart problems - no- and so on, but his thoughts always turned to the operation. When he had answered the questions, Diane led him to a small room where he had to undress and change into a surgical gown. She seemed to sense his nervousness. "Don't worry - Dr. Fernandez the best doctor in town!" she said. "She has already treated many top players like you - you'll soon be able to kick again."

Joe doubted whether he could be counted among the "top players" but he appreciated Diane's attempt to calm him down.

Ten minutes later Joe was lying on a bed in the preparation room. Diana had changed into scrubs, connected him with cables to several machines and had finally put an IV into his arm . "That's necessary to give you fluids and medication throughout surgery," she had explained. Then there was a knock at the door and Dr. Fernandez entered. She looked exactly like Joe had imagined. She was fully scrubbed and wearing a light green surgical mask. Joe could only see her pretty dark eyes. "Hi, Joe, how do you feel? I see Diane has already prepared everything! Let's take you next door!" Diane and Dr. Fernandez wheeled his bed into the O.R. Joe immediately looked for the trays with the instruments but he couldn't see any. He only saw a big machine with screens, steel cylinders, valves and long white corrugated hoses. "Well, Joe, you're now going to sleep for a little while," Dr. Fernandez said. She turned to the machine and Joe saw her pick up a face mask and connect it to the corrugated hoses. "Before you know it, you'll wake up in the recovery room next door!" Dr. Fernandez came over to his bed. Joe stared at the mask in her hand. "We'll start with oxygen. I need you to take five deep breaths from the mask for me, ok?" Joe couldn't say anything so he only nodded. Dr. Fernandez gently lowered the mask onto his face. He could feel the oxygen rushing into the mask.

"Now it's important that you take in as much oxygen as possible, so I first want you to breathe out and then take a deep breath in! Remember what I said - five deep breaths! Breathe out into the mask for me, Joe!" He did as she told him . "Breathe out more, more - that's it! Now take a long breath in!" Joe breathed the oxygen from the mask. "Deep, long breath - a little more - that's it! Number one! - Now blow it all out again!" Joe exhaled until his lungs felt empty. He was glad that it was so easy to please her. He took another breath from the mask. "That's great! Number two! Now exhale!" She briefly turned and said something to Diane but he couldn't make it out because he was so concentrated on his breathing. "That's it ! Now take another deep breath for me, Joe!" As he inhaled deeply he noticed a strange smell in the mask - but she'd said he would breathe only oxygen! Why did she... ? "Here we go - number three", Dr. Fernanzed said. "Everything's fine! Breathe out again!" He breathed out, trying to empty his lungs as far as he could. He saw her eyes above him. "Joe, you're doing fine already, but now I want you to take a really deep breath for me! Can you do that?" He did not want to show his fear, so he inhaled and as the gas started to fill his his lungs the pungent chemical smell nearly took his breath away. "Number four! Bravo, Joe! You're doing so well! Now blow it all out again!" Her voice now seemed to come from far away. What did she want him to do? He found it difficult to concentrate... "Don't forget to breathe, Joe! One more time! - Take a deep breath for me!" As the gas filled his lungs again, he wasn't sure if he was still breathing on his own. He saw a balloon the doctor's hands - what did she want with it? A balloon - it reminded him of a little girl's birthday party... It was big and round - now the doctor's hands closed around it - Joe felt the gas rushing into the mask - more and more until the balloon was empty. It made him feel so light, so happy ... a birthday party... balloons...happy... breathe out ... the balloon slowly expanded until it was full again - ready to fly away, up into the clouds where no one could follow, fly away, fly...

"He's out - laryngoscope, please, Diane, " Dr. Fernandez said. " 'Five deep breaths from the mask' - I don't know why they all fall for this but it works every time..."

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