PAIN FREE SURGERY

Times of Oman - - LIFESTYLE - — life­style@time­so­fo­man.com

“Ihad a ma­jor surgery last month. I re­ceived 15 stitches. The surgery was to­tally pain free! What a fine sur­geon Dr Pinto is.” Who was your anaes­thetist? Anaes­thetist came to see me but I don’t re­mem­ber her name! Usual isn’t it?

Both CNN and Forbes mag­a­zine lists anaes­thetists as the best pay­ing job in USA fol­lowed by surgery. How­ever in many parts of the world it is not un­usual that peo­ple do not re­mem­ber the lesser mor­tals dur­ing surgery. In­fact, many hardly con­sider them doc­tors. Let us see what it takes to be­come one.

Anaes­thetists or anaes­the­si­ol­o­gists known for heal­ing pain of all kinds, are qual­i­fied med­i­cal doc­tors who take up anaes­the­sia as part of their post­grad­u­ate pro­gramme like other spe­cial­i­ties such as surgery, gy­nae­col­ogy, ENT, oph­thal­mol­ogy, and so on. It takes min­i­mum seven years of spe­cial­ist stud­ies af­ter six years at med­i­cal school to be­come a fully trained anaes­thetist.

Anaes­thetists are om­nipresent in the hos­pi­tal. Be it the oper­a­tion the­atre known to many, but also in in­ten­sive care, on the wards, in the emer­gency depart­ment, and in the pain clinic.

Be­fore any surgery, they as­sess peo­ple’s fit­ness for surgery, how likely they are to suf­fer com­pli­ca­tions, and sup­port them through­out the oper­a­tion and into the post­op­er­a­tive pe­riod. Hence they are rightly termed pe­ri­op­er­a­tive physi­cians. If there’s an emer­gency dur­ing an oper­a­tion the team looks to the anaes­thetist for lead­er­ship, as the sur­geon is of­ten too fo­cused on fix­ing the sur­gi­cal is­sue re­ly­ing to­tally on the anaes­thetists to safe­guard the life of the pa­tient. Dr Juhi Chand­wani Anaes­the­si­ol­o­gists are ex­perts in phys­i­ol­ogy, phar­ma­col­ogy, and physics; they have to know about ev­ery­thing from cel­lu­lar res­pi­ra­tion to how the drugs work, to the in­ter­nal work­ings of a de­fib­ril­la­tor, a ma­chine used to bring a shocked heart back to life.

In the in­ten­sive care and emer­gency depart­ments they are re­quired for pro­vid­ing life sav­ing mea­sures in­clud­ing re­sus­ci­ta­tion. The skills ac­quired dur­ing their train­ing are most re­quired for these pur­poses and hence most of the Adult In­ten­sive Care Units are man­aged by anaes­thetists in many hos­pi­tals around the world. Even when other spe­cialty doc­tor’s train to be­come in­ten­sivists (doc­tors work­ing in ICU/Crit­i­cal Care) they have to un­dergo com­pul­sory anaes­the­sia train­ing for at least six months to ac­quire those skills re­quired for sav­ing lives.

You are likely to come across anaes­thetists in other ar­eas too. Some pro­ce­dures such as ra­di­o­log­i­cal imag­ing, scan­ning, en­doscopy and den­tal treat­ment re­quire the help of the anaes­thetist to en­sure that you are pain free and anx­i­ety free and at times you may be given a gen­eral anaes­thetic dur­ing these pro­ce­dures.

Some anaes­thetists choose to spe­cialise in car­ing for spe­cific sorts of pain in­clud­ing pain in child­birth and long-term pain prob­lems termed as chronic pain.

In this era of sub­spe­cial­i­sa­tion and with widen­ing scope and re­quire­ment in var­i­ous sec­tions of the hos­pi­tal, anaes­thetists now spe­cialise in a par­tic­u­lar area of sur­gi­cal prac­tice such as neu­ro­surgery, car­diac surgery, pae­di­atric surgery, pain man­age­ment or crit­i­cal care to give fo­cussed care.

Most of the doc­tors have very lit­tle ex­po­sure and ex­pe­ri­ence of anaes­the­sia dur­ing their train­ing and there­fore never con­sider it as a ca­reer choice.

With in­creas­ing aware­ness and ris­ing global de­mand for anaes­thetists more and more doc­tors are opt­ing to choose anaes­the­sia for post­grad­u­ate train­ing.

In short, anaes­the­sia (and the ex­po­sure to In­ten­sive Care) of­fers a unique op­por­tu­nity to care for the ‘whole’ pa­tient while man­ag­ing them through their surgery, to fa­cil­i­tat­ing the man­age­ment of the sick­est pa­tients in the hos­pi­tal (fre­quently when other med­i­cal col­leagues in other spe­cial­ties are no longer com­fort­able man­ag­ing them). The re­spon­si­bil­ity is great, but so are the in­ter­ac­tions with mem­bers of al­most ev­ery hos­pi­tal spe­cialty, mak­ing it a fan­tas­ti­cally ‘so­cial’ ca­reer.

Dr Juhi Chand­wani is a Con­sul­tant Anaes­thetist and In­ten­sivist at Royal Hos­pi­tal.

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