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what anesthesiologist do

An anesthesiologist will meet with you before your surgery and ask you questions to assess your risk and suitability to give anaesthesia. These include questions such as:

    • Do you have any health problems?
    • Do you have any dental problems, such as loose teeth or false teeth?
    • What medicines do you take, including over-the-counter medicines and supplements?
    • Do you smoke, drink alcohol, or use any illegal drugs?
    • Do you have any allergies to foods or medicines
    • Have you or any of your relatives ever had a problem with anesthesia medicines?

In some cases, you might have a choice between different types of anesthesia.
Your anesthesiologist will also tell you how your anesthesia will be given and answer any questions you have. They will continually check your breathing, blood \ pressure, and heart rate during the procedure. If you have general anesthesia, your anesthesiologist also makes sure you stay unconscious.

Can I wake up during general anesthesia?

It is very rare to wake up during general anesthesia (less than 1 patient in every 15,000
operations). Your anesthesiologist constantly adjusts the medicines to keep you from waking up.

Are there any side effects from anesthesia?

Each type of anesthesia has possible side effects.
If you have a spinal block or epidural, the numbness will last for a few hours after your
procedure before wearing off. Other side effects can include:

  • Headache – There is a small chance of getting a type of headache that can last for several days. This is sometimes called a “spinal headache.” It usually goes away on its own, but pain-relieving medicines and other treatments can help.
  • Trouble urinating – Some patients have trouble emptying their bladders for a few hours after surgery until the anesthetic wears off.

 If you have general anesthesia, you will likely feel a little groggy or confused for a short time after waking up. Other side effects can include:

 
  • Feeling sick to your stomach (nausea) and throwing up (vomiting) – Your anesthesiologist can give you medicines for this problem.
  • A sore throat – This can happen if you had a breathing tube. It usually gets better quickly.

what is anesthesia

“Anesthesia” is a medical term for different types of medicine people get before and during surgery or procedure. These medicines are given to make sure you do not feel pain during the procedure. In some cases, like when you are “put to sleep” for surgery, the anesthesia medicines also prevent you from remembering it afterwards.
Anesthesia medicines are given by a doctor called an “anesthesiologist.” Sometimes a “nurse anesthetist” is involved, too. These are nurses with special training in anesthesia.

  1. Local

    This type of anesthesia uses medicine to numb a small part of your body so you don’t feel pain. It can be given as a cream, gel, or spray on the skin. It can also be given by an injection (shot) into the skin. You might be awake when you get local anesthesia.

  2. Regional

    This type of anesthesia blocks pain in one area of your body, such as an arm, leg, or the
    lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called “sedatives.” Sedatives are given through a thin tube that goes into a vein, called an “IV.

    One type of regional anesthesia is called a “spinal block.” The anesthesiologist puts a small needle in your lower back, and injects medicine to numb the nerves in your spine. It can be used for surgery done on your legs or inside your belly. Another type is an “epidural.” The anesthesiologist uses a needle to put a small tube (called a “catheter”) into your lower back, near the nerves in your spine. Some women get an epidural during childbirth. Other people get one for a surgical procedure or to control pain after surgery.

  3. General

    This type of anesthesia makes you unconscious so you can’t feel, see, or hear anything during surgery. Some of the medicines are given through an IV. Others are gases that you breathe. You might also get a breathing tube to help you breathe. If this happens, the anesthesiologist will carefully place the tube in your throat while you are asleep during general anesthesia, and remove it before you wake up.

Coronary Artery Calcium Scoring

The coronary arteries are the vessels that supply blood to the heart. Plaque or calcium build-up in the coronary arteries causes heart disease or can lead to a heart attack. A test called Coronary artery calcium (CAC) scoring can detect this build up and is a good predictor of coronary events. This test has been demonstrated to be a better predictor than cholesterol levels in medical studies.

This is done using special X Ray equipment called a CT scanner which takes pictures of the blood vessels supplying the heart. The entire procedure is usually completed with in about 10 Minutes.

How is a CAC score calculated?

A calcium score (sometimes called an Agatston score) is calculated based on the amount of plaque observed in the CT scan.

CAC Score

What is the significance of the CAC score?

Based on your score, your doctor will be able to do risk stratification and suggest preventive strategies or further evaluation.

  • Zero: No plaque. Your risk of heart attack is low.
  • 1 – 10: Small amount of plaque. You have less than a 10 percent chance of having heart disease, and your risk of heart attack is low.
  • 11-100: Some plaque. You have mild heart disease and a moderate chance of heart attack. Your doctor may recommend other treatment in addition to lifestyle changes.
  • 101 – 400: Moderate amount of plaque.  Your chance of having a heart attack is moderate to high.
  • Over 400: Large amount of plaque. This signifies that there is extensive deposition of calcium in the arteries. Your chance of heart attack is high and aggressive prevention strategies are to be used.

Diabetes and high blood pressure are the most common causes of CKD. If you have diabetes or high blood pressure, working with your doctor to keep your blood sugar and blood pressure under control is the best way to prevent kidney disease.

Living a healthy lifestyle can help prevent diabetes, high blood pressure and kidney disease, or help keep them under control. Follow these tips to lower your risk for kidney disease and the problems that cause it:

  • Lose weight if you are overweight. An ideal BMI(Body Mass Index) is between 18.5 – 25.
  • Be active. Regular exercise and physical activity helps control blood sugar levels.
    Quit smoking.
  • Drinking plenty of fluids keeps you well hydrated and your kidneys working well. Your doctor will suggest fluid restrictions as appropriate if you have kidney failure.
  • Take medications as directed.
  • Keep your blood pressure below 130/90, or ask your doctor what your ideal blood pressure target is.
  • If you have diabetes, make sure your blood sugars are well controlled.
  • Eat healthy and ensure your cholesterol is in the acceptable range.
  • Eat foods lower in salt.
  • Eat more fruits and vegetables. If you have kidney failure, make sure you follow dietary restrictions as suggested by your doctor.

stages-and-risk-factors of ckd

About Chronic Kidney Disease

With chronic kidney disease or silent disease, the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.

Glomerular Filtration Rate (GFR)

Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, race, gender and their serum creatinine is used to calculate a GFR. A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.

Below shows the five stages of CKD and GFR for each stage:

Risk Factors

Getting tested for chronic kidney disease (CKD)

  • If you are at risk, get regular tests to check for early kidney disease. Ask your doctor for blood or urine tests.
  • Find it early to take preventative measures to stop kidney disease from progressing.
  • If you have diabetes, get tested yearly for presence of kidney disease.

Chronic kidney disease is called a ‘silent disease’ as there are often no warning signs. It is not uncommon for people to lose up to 90 percent of their kidney function before getting any symptoms.

There are, however, some signs that may indicate reduced kidney function and it’s important to take note of them.

These can include:

  • High blood pressure
  • Changes in the amount and number of times urine is passed
  • Changes in the appearance of your urine (for example, frothy or foaming urine)
  • Blood in your urine
  • Puffiness (in your legs, ankles or around your eyes)
  • Pain in your kidney area
  • Tiredness
  • Loss of appetite
  • Difficulty in sleeping
  • Headaches
  • Itching
  • Breathlessness
  • Nausea and vomiting
  • Bad breath and a metallic taste in the mouth
  • Muscle cramps

These symptoms are very general and may be caused by other illnesses. However, if they are related to kidney disease they may gradually worsen as kidney function declines.

best-cardiology-kakinada

EP Study:

This is a study which is done to evaluate the electrical system of the heart. Heart is an organ which has a capacity to contract on its own with every cell of the heart having the capacity to generate electrical impulses.

The electrical impulse of the heart originates in a group of cells called the sinoatrial node (SA Node) and then travels to other areas of the heart through a very specific pathway. With a normal conduction system, the heart maintains a steady resting heart rate between 60 and 100 beats per minute.

Cardiologist-in-kakinada

In some circumstances, abnormal impulses may originate from other areas of the heart. This could happen when the normal conduction system is diseased and results in very slow or very fast heart rates.

All these abnormalities are studied using EP study Based on the abnormality, appropriate treatment like Radio frequency ablation or Pacemaker implantation is done.

RADIO FREQUENCY ABLATION:

This is a technique where the abnormal circuits in the heart are identified by EP study and a burn is given in that area to stop extra and abnormal impulses.

PACEMAKER:

It is an artificial pulse generator which is placed subcutaneously and it helps to maintain the heart rate.

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